An on-going outbreak of pneumonia in Wuhan City, Hubei Province, China has been linked to a newly-discovered coronavirus.

The World Health Organisation (WHO) reports that, as of 20 January 2020, there have been 205 cases including three deaths. Coronaviruses are a well-recognised cause of human illnesses that range from mild to severe. This outbreak has been linked to possible exposure to infection at the South China Seafood City market in Wuhan.

As of 20 January 2020, all cases are people who live in, or have travelled to, Wuhan.

While the risk to UK travellers to Wuhan is currently considered low, because of this incident and the ongoing risk of avian flu in China generally, travellers are advised to take simple precautions such as practicing good hand, personal and respiratory hygiene, and to minimise contact with birds and animals in markets in Wuhan or elsewhere in China.

If travellers returning from Wuhan or elsewhere in China become unwell within 14 days of their return to the UK, particularly with respiratory symptoms, they should call their GP or NHS 111 and report their recent travel details.

Further information and travel advice can be found on the UK Government website, while information on travel to China can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 20 January 2020

Public Health England (PHE) has published a new report which shows that HIV transmission in the UK has continued to fall. The drop in HIV transmission has been especially large among men who have sex with men (MSM), from an estimated 2,300 transmissions in 2014, to 800 in 2018, a fall of 73%. The number of MSM living undiagnosed with HIV has almost halved since 2014, dropping from an estimated 7,000 to 3,600 in 2018.

Across the UK, the scale-up of combination prevention, which includes the use of condoms, HIV testing in a wide range of settings, starting antiretroviral therapy (ART) as soon as possible if positive and the availability of pre-exposure prophylaxis (PrEP) for those who are negative, is working.

The goal of eliminating HIV transmission by 2030 depends upon sustaining prevention efforts and further expanding them to reach all at risk, and the report shows that because of increases in HIV testing, fewer people remain unaware of their HIV status. 

The UK is one of the few countries in the world to have reached and exceeded all UNAIDS 90:90:90 targets. Of the 103,800 people living with HIV in the UK in 2018, 93% were diagnosed, 97% of people diagnosed were receiving treatment and 97% of people receiving treatment were virally suppressed.

The most recent reports on PrEP, HIV diagnoses and treatment and care in Scotland are available via the HPS website.

Source: PHE, 16 January 2020

NHS Highland health board has agreed to become involved in the EU NorthTick research project, which aims to strengthen healthcare systems’ abilities to prevent, diagnose, treat and provide information about tick-borne diseases.

NHS Highland is one of ten partners from seven European countries collaborating to develop tools to meet the challenges of tick-borne diseases.

There has been an increase in people affected by tick-borne disease in recent decades, with the reasons for this including climate change, increased urbanisation and other human impacts on the ecosystem.

The mains aims of NorthTick are to increase awareness and stimulate the public sector towards generate innovative ideas and solutions for improving how tick-borne diseases are treated. The project is set to run for three and a half years.

The work will include looking at prevention measures by improving awareness rates and developing new microbial diagnostic tools for common and emerging new tick-borne diseases in the European North Sea region.

Institutions from Sweden, Belgium, Denmark, Germany, the Netherlands, and Norway are also involved in the project.

Source: NHS Highland, 14 January 2020

The Human Animal Infections and Risk Surveillance (HAIRS) group, a multi-agency cross-government horizon scanning and risk assessment group, has published a qualitative assessment of the risk that canine leishmaniasis presents to the UK population.

Leishmaniasis is the term used to cover a diverse group of diseases which can affect humans and other mammals, and is caused by obligate intracellular protozoan parasites of the genus Leishmania. Canine leishmaniasis is primarily caused by L. infantum and has been reported in untravelled dogs in UK.

In summary, the risk assessment concludes that the probability of human infection with canine Leishmania species in the UK population is very low and that the impact of canine leishmaniasis on human health in the UK is very low to moderate. 

The recommendations of the risk assessment are:

• raising awareness among vets and pet owners 
• maintaining an overview of changing epidemiology and/or evidence 
• to consider the need to institute systematic surveillance for sandflies

The risk assessment document was prepared by Public Health England (PHE) on behalf of the joint HAIRS group.

Source: PHE, 16 January 2020

Public Health England (PHE) has updated the yellow fever chapter (chapter 35) of the Green Book to reflect the recommendations made by the Commission on Human Measures (CHM), which urges the strengthening of measures to minimise the potential risk of rare but serious and fatal adverse events associated with yellow fever vaccination, in those with weakened immune systems, aged 60 years or older and/or those who have had their thymus removed.

The importance of the individual risk assessment is emphasised, to ensure that only individuals who require yellow fever protection, or the International Certificate of Vaccination, are vaccinated. Further guidance on issuing exemption certificates is also included.

Further information and advice on yellow fever is available to view on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

The World Health Organization (WHO) has warned that declining private investment and lack of innovation in the development of new antibiotics are undermining efforts to combat drug-resistant infections.

The warning came as the WHO published two new reports that reveal a weak development pipeline for new antibiotic drugs. The 60 products in development, comprising of 50 antibiotics and 10 biologics, were found to bring little benefit over existing treatments and few target the most critical resistant bacteria, gram-negative bacteria.

The reports also show that while pre-clinical drugs (those in the early stages of testing) are more innovative, they will not be available for patients for many years. The reports also highlight the fact that research and development for antibiotics is mainly driven by small or medium-sized enterprises, while large pharmaceutical companies are continuing to exit the field.

The reports are both available from the WHO website: 

• Antibacterial agents in clinical development: an analysis of the antibacterial clinical development pipeline 
• Antibacterial agents in preclinical development

Source: WHO, 17 January 2020

On 16 January 2020, the UK Government launched a new taskforce dedicated to tackling serious and organised waste crime.

The Joint Unit for Waste Crime (JUWC) aims to tackle crimes such as dumping hazardous materials on private land and falsely labelling waste so it can be exported abroad. 

The JUWC brings together law enforcement agencies, environmental regulators, HMRC and the National Crime Agency to work together to tackle waste crime.

By working together, it is hoped that Joint Unit partners will be able to more easily share their intelligence and resources to take action when investigating criminal waste operations and other connected illegal activities.

The new unit will conduct site inspections, make arrests and prosecutions and, upon conviction, push for heavy fines and custodial sentences.

The Scottish Environment Protection Agency (SEPA) has been confirmed as a JUWC partner and will work in partnership with the task force. Organised waste crime is estimated to cost the UK economy £600 million a year.

Source: Environment Agency, 16 January 2020

The Scottish Government has opened a new consultation seeking views on the need for further regulation to ensure the safety of people considering, or undergoing, cosmetic procedures such as dermal fillers or lip enhancement.

In Scotland, independent clinics run by a doctor, nurse, dentist, dental nurse, midwife or dental care professionals who provide these procedures are regulated by Healthcare Improvement Scotland (HIS). 

However, non-surgical cosmetic procedures that pierce or penetrate the skin, such as lip enhancement or dermal fillers, are not currently regulated and can be carried out by anyone. There is a growing potential risk posed by an increase in unregulated premises carrying out these procedures.

In addition, a number of pharmacists have entered the field and are providing injectable procedures in premises that are not currently regulated by HIS.

The consultation opened on 17 January and will remain open for comments until 30 April 2020.

Source: Scottish Government, 17 January 2020