On 23 June 2020, Health Protection Scotland (HPS), part of Public Health Scotland (PHS), published its annual report on HIV diagnoses and uptake of specialist treatment and care.

There has been a decrease in the number of first ever HIV diagnoses recorded for both men who have sex with men (MSM) and those who have acquired HIV through heterosexual sexual intercourse. However, there is evidence that the outbreak in people who inject drugs, first reported in 2015, has continued in 2019.

An estimated 6,100 people are living with HIV in Scotland, of whom 92% (5,617) are diagnosed. Levels of access to treatment and care continue to be high, with 98% (4,970) of those attending specialist HIV services on antiretroviral therapy, and 95% (4,714) of whom have an undetectable viral load. In 2018, Scotland first achieved the UNAIDS 90-90-90 Fast Track Targets set for 2020, a trend which has continued in 2019.

This report also contains the latest data, taken from July through to December 2019, on the uptake of pre-exposure prophylaxis (PrEP), a drug taken to prevent HIV infection. The uptake of HIV PrEP continues at a similar level to the start of 2019, with around 100 individuals seeking a PrEP prescription for the first time each month during the last six months of 2019.

On 23 June 2020, Public Health Scotland (PHS) published its first report on the HIV pre-exposure prophylaxis (PrEP) minimum dataset, which has been developed through collaboration between Scotland, England, Northern Ireland, Wales and the Republic of Ireland. Data are presented for Scotland for the period from 1 July 2017, when Scotland’s NHS-funded HIV PrEP programme was implemented, to 31 December 2019.

The findings indicate that over the first two and a half years of the HIV PrEP programme in Scotland, approximately 53,000 individuals have attended sexual health clinics at least once during each calendar quarter. Of the 2,560 individuals attending between October and December 2019 and who were prescribed PrEP, 97% (2,486) were men who have sex with men (MSM). Eighteen transgender individuals/trans people, fewer than 10 heterosexual men and fewer than five heterosexual women were also prescribed PrEP during the same period. Work is being led by the national PrEP coordination group to improve equity of access and PrEP awareness among women, trans men, trans women, non-binary people, heterosexual men and people who inject drugs with concomitant sexual risk, while considering alternative service models aimed at providing access to PrEP for others who may benefit.

The coronavirus (COVID-19) pandemic continues to affect almost all countries around the world. Most European countries had imposed strict lockdown measures early in 2020 to contain and control the outbreak, however the initial peak of COVID-19 cases has passed and many countries, including the UK, are now either planning to ease their lockdown measures or have already begun to do so.

The pandemic led to unprecedented international border closures, with some travel restrictions being imposed without notice. Over the coming months, these restrictions may be lifted, although they will remain subject to change. Full details of travel restrictions by country can be found on the Foreign and Commonwealth Office (FCO) information pages.

As lockdown restrictions ease in the UK, many will be considering travel over the summer months, or reviewing pre-existing travel bookings. The fitfortravel website has published information on COVID-19 health considerations for travel, highlighting issues travellers should consider when deciding whether or not to travel this summer. The Exceptional Travel Advisory Notice, issued by the FCO advising British nationals against all but essential travel worldwide, remains in place.

On 22 May 2020, the UK Home Office announced self-isolation (quarantine) plans for all arrivals into the UK, including returning British nationals, would commence on 8 June 2020. These measures will be under review and should be checked both prior to travel, and before returning home, on the UK Government website.

Information relating to travel and COVID-19 is available on the TRAVAX (for healthcare practitioners) and fitfortravel (for the general public) websites.

Information on COVID-19 for the general public is available on the NHS Inform (Scotland) and the NHS.UK (rest of the UK) websites.

Information and resources on COVID-19 for health professionals is available on the Health Protection Scotland (HPS) (Scotland) and Public Health England (PHE) (rest of the UK) websites.

Source: TRAVAX, 26 May 2020

The General Directorate of Public Health in Castilla y Leon, Spain has confirmed that a case of Crimean-Congo haemorrhagic fever (CCHF) has been detected in a patient being treated in the Salamanca University Assistance Complex.

The patient was bitten by a tick in a pine forest in the province of Salamanca in late May and later sought medical attention, after suffering a high fever, which did not improve through time. As of 16 June 2020, the patient is in a stable condition in an infectious diseases unit.

CCHF is uncommon in Spain although a small number of cases have been identified in recent years.

Advice for travellers

CCHF is a viral haemorrhagic fever found in over 30 countries in Africa, Asia, Eastern Europe/the Balkans and the Middle East, which generally presents a low risk to the average traveller. CCHF is spread by infected ticks from an animal reservoir such as cattle, sheep and goats, and can also be transmitted by contact with the blood or body fluids of an infected animal or person. Avoidance of tick bites is essential in risk areas.

Further information on CCHF can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 16 June 2020

French regional public health authorities have reported an outbreak of tick borne encephalitis (TBE), primarily in the Rhone-Alpes-Provence region. As of 10 June 2020, 37 cases had been linked to the consumption of raw milk goat cheeses. The cheese producer has been named as GAEC des Chevrettes du Vieux Valey, located at Condamine in Haut-Bugey, Ain.

Advice for travellers

TBE is uncommon in people in France, but is widespread in Alpine areas of Europe and may occur in neighbouring rural areas. All travellers to endemic areas should be:

• aware of TBE, its transmission and clinical outcomes
• aware of activities that could potentially increase exposure to ticks, such as walking, camping and cycling in forested areas during tick season
• given advice on avoiding tick bites and prompt removal of ticks, the use of appropriate clothing and the use of insect repellents
• avoiding unpasteurised milk and milk-based products, including cheese

Vaccination, dependent on individual risk assessment, should be considered by: 

• travellers to endemic countries during the tick season (spring to early autumn) who plan outdoor activities in forested areas (up-to-date guidance on endemic countries can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites)
• those planning to reside long-term or work, where the nature of the work increases the risk of exposure to ticks, in endemic areas

Further information on TBE can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 17 June 2020

The European Centre for Disease Prevention and Control (ECDC) is providing weekly updates during the current transmission season on reported cases of West Nile fever in EU member states and neighbouring countries.

Since the beginning of the 2020 transmission season, as of 17 June 2020, one human case of West Nile fever has been reported in Romania. No outbreaks among equids or birds have been reported so far.

Source: ECDC, 18 June 2020

On 18 June 2020, the Food Standards Agency (FSA) published updated technical guidance for allergen labelling, following changes to pre-packed for direct sale (PPDS) food. This means food which is packaged on-site by a business, before a customer selects or orders it from the same premises, will be required to have a label with an ingredients list and the allergens contained emphasised. This brings the way allergen information is provided in-line with other pre-packed food, and aims to reduce consumer confusion.

The changes, which are now enshrined in legislation in England, Wales and Northern Ireland, will come into effect from 1 October 2021. The updated technical guidance reflects the legislative changes and aims to support businesses and enforcement authorities in understanding the new requirements.

Source: FSA, 18 June 2020

On 17 June 2020, the European Environment Agency (EEA) published a report providing an overview of bio-waste prevention, generation, collection and treatment in Europe. Bio-waste is the largest component (34%) of all municipal waste in Europe, with about 60% of this being food waste. Along the entire value chain, food waste amounts to about 173kg per EU citizen per year, corresponding to about one-fifth of all food that is produced.

The report found that preventing food waste could considerably lessen environmental impacts from food production, processing and transport, which provides greater environmental benefits than simply recycling food waste, although the report states this is still necessary. The report also notes that much more bio-waste could also be turned into high-quality fertiliser and soil improver, as well as biogas, a renewable fuel.

Source: EEA, 17 June 2020

The Scottish Government has announced additional funding of £5.5 million for renewables projects which contribute towards a green recovery following the coronavirus (COVID-19) pandemic.

Communities will be able to bid for a share of £4.5 million through the Community and Renewable Energy Scheme (CARES), which funds local renewable projects. A further £1 million is being made available through the Low Carbon Infrastructure Transition Programme (LCITP), a scheme which provides support for innovative energy projects such as heat networks and integrated energy systems.

Source: Scottish Government, 17 June 2020

The Scottish Environmental Incident Surveillance System (SEISS) recorded the following incident in the past week: 

• On 19 June 2020, the BBC reported that the Scottish Fire and Rescue Service (SFRS) dealt with a fire at a derelict building in the east end of Glasgow. About 30 firefighters worked through the night and six crews remained at the scene the next morning. There were no reports of any injuries and locals have been urged to keep their windows shut.

More detailed information can be found on the SEISS website.