On 10 February 2021, Public Health Scotland (PHS) published its weekly national seasonal respiratory report, containing epidemiological information on seasonal influenza activity in Scotland. As of Week 5, ending 7 February 2021, provisional data showed the incidence rate of influenza was at baseline activity level, or 0.0 per 100,000 of the population.

The data includes the estimated influenza vaccine uptake to the end of Week 3, ending 24 January 2021. The report finds that influenza vaccine uptake in Scotland, in most eligible cohorts, was higher than in previous seasons, although the data are not directly comparable. As of Week 3, provisional data on influenza vaccine were estimated as: 

• 79.6% for those aged 65 years and over 
• 54.8% for those under 65 years old in an at-risk group 
• 45.5% in pregnant women (including those with and without risk factors) 
• 60.7% in preschool children (aged two to under five years, not yet in school) 
• 75.5% in primary school children 
• 41.1% in health and social care staff 
• 55.4% in unpaid and young carers

Travel restrictions and self-isolation (quarantine) rules have been implemented across the UK since the start of the coronavirus pandemic in March 2020, in order to reduce the spread of COVID-19 and protect the health of the public.

As of 15 February 2021, all arrivals to Scotland from outside the Common Travel Area must book and pay for managed isolation in quarantine hotels. All travellers must quarantine for at least ten days and will be tested twice for the virus, on days two and eight after arrival. These measures have been announced to reduce both the risk of COVID-19 transmission and decrease the risk of importing new variants. Guidance concerning quarantine for travellers arriving in England, Wales and Northern Ireland is also available.

The Foreign, Commonwealth & Development Office (FCDO) provides guidance on travelling abroad, including the latest information on COVID-19 and other non-COVID-19 risks such as safety and security, entry requirements, and travel warnings. This guidance is being kept under constant review and may change at short notice.

Country specific COVID-19 risk

The fitfortravel (for the general public) and TRAVAX (for health professionals) country pages have been updated to include a COVID-19 country specific risk-rating, with every country being identified as high, moderate or low risk and each rating accompanied by appropriate travel advice. This information will be listed in the ‘Alerts’ section on each country page of fitfortravel and the 'Emerging Health Risks' section of every TRAVAX country page. This risk-rating is based on a robust public health assessment of the COVID-19 risks for travellers to each country and is regularly reviewed.

Advice for travellers

Before planning or booking international travel, travellers should consider if their journey is essential and legally permitted. The following sources should be consulted both prior to travel and during the trip, as guidance may change at short notice: 

• the FCDO website, for country specific Travel Advisory Notices regarding travel and entry restrictions, and review the local medical care available at your destination 
• the COVID-19 risk-rating at your destination, which will be listed in the ‘Alerts’ section of all fitfortravel country pages and the ‘Emerging Health Risks’ section of all TRAVAX country pages 
• the TRAVAX travel insurance page, as such insurance should be considered essential 
• the fitfortravel COVID-19 health considerations for travel page 
• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• requirements for COVID-19 testing at their destination prior to return to the UK

Information relating to travel and COVID-19 is available on the TRAVAX (for healthcare practitioners) and fitfortravel (for the 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, 5 February 2021

The Scottish Government has reminded bird keepers in Scotland to maximise biosecurity measures and keep their flocks housed, after avian influenza (H5N1) was confirmed in a flock of approximately 14,000 kept birds on a gamebird rearing premises in Leven, Glenrothes. Laboratory results of samples taken from the flock have identified the strain as highly pathogenic in poultry.

In order to limit the further spread of disease, restrictions have been imposed on the premises, including a protection zone of three kilometres and a surveillance zone of ten kilometres. Within these zones, a range of controls are in place, including restrictions on the movement of poultry, carcasses, eggs, used poultry litter, and manure.

The Scottish Government has advised that the risk to human health from the virus is very low, and food standards bodies inform that avian influenza poses a very low food safety risk for UK consumers, as it does not affect the consumption of poultry products, including eggs.

Source: Scottish Government, 13 February 2021

On 10 February 2021, the Global Polio Eradication Initiative reported one new case of polio in Khatlon province, Tajikistan, the first in the country. The case is linked to an outbreak originating in Pakistan.

Advice for travellers 

• Poliomyelitis is spread mainly through person-to-person contact via the faecal-oral route. 
• Travellers should be offered a booster dose of poliomyelitis vaccine if it has been more than ten years since their last dose.

Further information is available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 12 February 2021

The World Health Organization (WHO) has reported that the government of the Democratic Republic of the Congo (DRC) declared a new outbreak of Ebola virus disease (EVD), following confirmation of a new case in North Kivu Province.

On 7 February 2021, laboratory testing confirmed the positive case of EVD in an adult living in Biena Health Zone. To date, the source of infection is still under investigation.

Advice to travellers

When EVD outbreaks occur, generally the risk of travellers becoming infected or developing the disease is extremely low.

Travellers returning from an Ebola outbreak area should seek rapid medical attention if they develop flu-like symptoms, such as fever, headache, diarrhoea or general malaise, within 21 days after return. They should call NHS24 (Scotland), NHS111 (England and Wales) or contact their GP by telephone. While EVD is unlikely, the returning traveller should mention any potential exposure to the virus, including dates and itinerary of travel.

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

Source: TRAVAX, 12 February 2021

The European Centre for Disease Prevention and Control (ECDC) has published three annual epidemiological reports on communicable diseases in Europe for 2019. 

• The Ebola and Marburg virus diseases annual report for 2019 reported no cases of Ebola or Marburg viral diseases in the EU/EEA. 
• The tularaemia annual report for 2019 reported 1,463 confirmed cases of tularaemia in EU/EEA countries, with a notification rate of 0.3 cases per 100,000 of the population. 
• The yellow fever annual report for 2019 reported no cases of yellow fever in the EU/EEA.

Sources: ECDC, 9 February 2021, ECDC, 10 February 2021 and ECDC, 9 February 2021

On 11 February 2021, new legislation was presented before the Scottish Parliament, which will require food businesses in Scotland to include the product name and full ingredients, including allergen information, on pre-packed for direct sale (PPDS) foods. Examples of PPDS foods include sandwiches placed into packaging by the food business and sold from the same premises, wrapped delicatessen counter goods such as cheese and meats, and boxed salads placed on a refrigerated shelf prior to sale.

The new labelling requirements will come into force on 1 October 2021, and are in-line with similar changes being made in England, Wales and Northern Ireland.

Source: Food Standards Scotland (FSS), 11 February 2021

In response to the impact climate change is having on human health and health systems, countries may decide to develop and implement a health national adaptation plan (HNAP) as part of their national adaptation plan (NAP). The NAP process aims to help countries conduct comprehensive medium and long-term climate adaptation planning, and is a flexible process that builds on each country’s existing activities, supporting the integration of climate change into national decision making.

The World Health Organization (WHO) has recently published ‘Quality Criteria for Health National Adaptation Plans’, providing policy makers with good practice examples to assist in developing a comprehensive, feasible and implementable HNAP. The quality criteria cover six topic areas for health adaptation planning: 

• leadership and enabling environment 
• cross-sectoral co-ordination and policy coherence 
• comprehensive coverage of climate-sensitive health risks 
• comprehensive coverage of adaptation options and actions 
• resourcing 
• monitoring, evaluation and reporting

The criteria should be used in conjunction with the WHO guidance on protecting health from climate change through health adaptation planning.

Source: WHO, 10 February 2021

The European Agency for Safety and Health at Work (EU-OSHA) has launched a database containing information on the prevalence, causes, and consequences of work-related musculoskeletal disorders (MSDs). The database includes a variety of practical tools and guidance materials, developed at both EU and individual country levels.

The resources include case studies and visual materials that cover a range of sectors, hazard types, and prevention measures, with some specifically aimed at certain groups of stakeholders, for example employers, workers or managers, and others designed to help in managing MSDs among specific groups of workers. The resources can be filtered by these groups and other categories, such as by country, when searching the database.

Source: EU-OSHA, 9 February 2021

The Scottish Government has launched a consultation seeking views on proposed plans to ensure buildings in Scotland are warmer and more energy efficient. The heat in buildings strategy sets out proposals to transform more than one million homes, and an estimated 50,000 non-domestic buildings, to the use of low and zero emissions heating systems by 2030. The draft strategy outlines the steps that will be taken to reduce greenhouse gas emissions from Scotland’s homes, workplaces and community buildings, and aims to ensure that poor energy performance as a driver of fuel poverty is removed.

Over the next five years, the Scottish Government has committed £1.6 billion in investment to improve heat and energy efficiency in Scotland’s buildings. It is hoped that this funding will support the acceleration of energy efficiency measures and zero emissions heating systems, in order to decarbonise an area currently responsible for creating one-fifth of Scotland’s greenhouse gas emissions each year.

The consultation is open until 30 April 2021 and can be viewed on the Scottish Government website.

Source: Scottish Government, 5 February 2021