The latest HIV surveillance report has been published on 1 May 2018, showing the diagnoses data to the end of December 2017. There have been a total of 361 reports received by Health Protection Scotland (HPS), of which 235 are new reports. An estimated 5,099 individuals are currently diagnosed and living with HIV in Scotland with 94% attending specialist care and 98% of these receiving effective antiretroviral treatment.

The World Health Organization (WHO) is calling on health facilities to prevent health care-associated sepsis through hand hygiene and infection prevention and control (IPC) action. Sepsis is estimated to affect more than 30 million patients every year worldwide and on World Hand Hygiene Day the focus for everyone should be on prevention of sepsis in health care.

The calls to action are:

• Health workers: ‘Take 5 Moments to clean your hands to prevent sepsis in health care.’
• IPC leaders: ‘Be a champion in promoting hand hygiene to prevent sepsis in health care.’
• Health facility leaders: ‘Prevent sepsis in health care, make hand hygiene a quality indicator in your hospital.’
• Ministries of health: ‘Implement the 2017 World Health Authority sepsis resolution. Make hand hygiene a national marker of health care quality.’
• Patient advocacy groups: ‘Ask for 5 Moments of clean hands to prevent sepsis in health care.’

Health Protection Scotland (HPS) is supporting WHO Global Hand Hygiene Day and would encourage NHS boards and organisations to support this day locally. HPS will be issuing tweets on the run up to the day and using hashtags #handhygiene and #sepsis.

More information on Global Hand Hygiene Day can be accessed on the WHO website.

Public Health England (PHE) has opened a consultation in joint partnership with professional organisations which asks for feedback in relation to the Standards for Microbiology Investigations V 27: hepatitis A virus acute infection serology. The consultation closes on 11 May 2018.

Public Health England (PHE) has opened a consultation in joint partnership with professional organisations. This consultation asks for feedback in relation to the Standards for Microbiology Investigations V 8: vertical and perinatal transmission of hepatitis C. The consultation closes on 11 May 2018.

A new rapid risk assessment update has been published by the European Centre for Disease Prevention and Control (ECDC) appraising the risk for spread of Candida auris in hospitals in EU and EEA countries. The assessment considers the newly available information from the ECDC survey on the epidemiological situation as well as laboratory capacity and preparedness for C. auris in EU/EEA countries.

Source: ECDC, 23 April 2018

The incidence of tularaemia in Switzerland has increased greatly in the past decade.

Tularaemia is causes by the bacterium Francisella tularensis which can cause a long-lasting systemic illness that initially has flu-like symptoms. It is widespread in the northern hemisphere and can be transmitted by ticks. It is not transmissible between people. There is no vaccine against tularaemia.

Travellers should be aware of tularaemia, particularly if they are in rural parts of endemic countries. Ticks are more common from April to October.

At-risk travellers should be advised to:

• take precautions against tick bites including the use of insect repellents on the skin and insecticide impregnated clothes covering the skin as much as possible (long sleeves and long trousers tucked into socks)
• the skin should be inspected daily for ticks, ticks may brush onto clothing but keep crawling for hours to find suitable skin to feed on, particularly in the groin, axillae and behind the knees
• any ticks seen should be removed as quickly as possible by grasping the tick as near to the skin surface as possible and applying gentle traction (without twisting)
• if a sore or rash develops at the site of a tick bite, medical advice should be sought

Other prevention measures include:

• do not drinking untreated surface water
• do not handle dead wild animals, particularly rabbits, hares and rodents. If this is unavoidable, e.g. for work purposes, use gloves
• thoroughly cook all meat before eating

Further information and advice for clinicians advising travellers can be accessed on TRAVAX.

At least 22 people in Taiwan have been confirmed with measles. More than 980 people in Taipei are being monitored following an outbreak of measles at a major hospital. A further 3500 are under quarantine in Kaohsiung in the south of Taiwan.

The infection was introduced to Taiwan by a flight attendant working for Tigerair Taiwan. This individual also introduced the infection to the island of Okinawa in Japan, where at least 67 individuals have been infected. Cases linked to this outbreak have been identified elsewhere in Japan.

Advice for healthcare professionals

Travel may increase an individual’s risk of exposure to measles virus, and facilitate the spread of disease to unvaccinated and susceptible populations. The travel consultation provides healthcare practitioners with a valuable opportunity to ensure individuals are protected against the measles virus. Consider vaccinating:

• all travellers who have not previously had two doses of a measles containing vaccine or prior measles infection
• children and those who will be living or working closely with the local population at their destination, in countries with high endemnicity or recent outbreaks

To help decide whether your traveller may be at risk of measles based on year of birth and vaccination history, please read the table for measles recommendations.

Charging for measles containing vaccine

In Scotland, GP practices may charge for the administration of MMR vaccine if the traveller does not fall into one of the groups that can receive free vaccine and it is solely being given for the purposes of travel, but have discretion not to charge.

In England, GPs will be reimbursed for administering one or two doses of MMR vaccine as required to all unvaccinated patients aged 16 and over who present to the GP surgery requesting vaccination.

Advice for travellers

It should be confirmed that children have received their recommended doses of MMR at 12-13 months of age and again pre-school around three years four months. Consider vaccinating all unimmunised adults who have not had the disease themselves, particularly if they are going to be at higher risk. Two doses of MMR vaccine, at least one month apart, are required to give adequate protection.

Further information and advice for clinicians advising travellers can be accessed on TRAVAX.

The Local Air Quality Management Policy Guidance for Scotland’s local authorities has been updated. The guidance has been revised to take account of changes to industrial emissions legislation and requirements.

The guidance is intended to help local authorities with their local air quality management duties under Part IV of the Environment Act 1995. It sets out:

• the statutory background and the legislative framework within which local authorities have to work
• the principles behind reviews and assessments of air quality and the recommended steps that local authorities should take
• how local authorities should handle the designation of Air Quality Management Areas (AQMAs) and the drawing up and implementation of action plans
• suggestions for taking forward the development of local air quality strategies
• suggestions on how local authorities should consult and liaise with others
• the role of transport-related measures in improving air quality
• the general principles behind air quality and land use planning
• the effects of biomass on air quality
• the relationships between air quality and noise policy

Source: Scottish Government, 20 April 2018

The Scottish Government has opened a consultation to gather views from stakeholders on the addition of secondary legislation, under the Environmental Protection Act 1990, to introduce a ban on the manufacture and the sale of plastic-stemmed cotton buds. The proposed bans aim to further protect seas from plastic pollution.

The government is seeking the views of any organisation or individual with an interest in these matters to ensure introducing secondary legislation fully addresses the environmental threat of plastic pollution caused by plastic-stemmed cotton buds entering the seas.

Reflecting the importance of the issue of marine plastic pollution, widespread awareness amongst relevant stakeholders and a wish to introduce legislation at the earliest opportunity, the consultation will run for an abbreviated period of eight weeks, from 27 April to 22 June 2018. Following this consultation, legislative proposals will be brought forward for scrutiny by the Scottish Parliament.

Further restrictions on neonicotinoid pesticides have been approved following a vote by EU member states today. The UK voted in favour of the proposals that will see a ban on outdoor use of three neonicotinoids - Clothianidin, Imidacloprid and Thiamethoxam. Currently, their use is banned for oilseed rape, spring cereals and sprays for winter cereals, but they can be used to treat sugar beet, various horticultural crops and as seed treatments for winter cereals. The current restrictions will stay in place until the new measures comes into force following a phasing out period of around eight months, giving farmers and businesses time to adjust. Unless the scientific evidence changes, the government will maintain these increased restrictions post-Brexit.

Source: Department for Environment, Food & Rural Affairs (DEFRA), 27 April 2018

A report from the European Environment Agency (EEA) is the first review of how the 33 EEA member countries (including the 28 EU member states) have assessed the risks from climate change, and how they used this information in developing adaptation policies to address these risks. The report aims to promote a better understanding among experts and policymakers involved in adaptation planning. The findings will contribute to better informed decision making and adaptation in key vulnerable sectors, such as agriculture, fisheries, biodiversity protection, spatial planning and infrastructure development. It is based on information about relevant multi-sectoral assessments reported from EEA member countries.

Dangerous substances continue to pose risks to the safety and health of Europe’s workers. Raising awareness of the need to eliminate exposure to these substances, and manage them where that is not possible, is the focus of the new campaign 'Healthy Workplaces Manage Dangerous Substances'. The campaign was launched in Brussels on 24 April 2018.

A wide range of campaign materials, along with tools, guidance and good practice examples from across Europe, are available to view on the campaign website. 

On 2 May 2018, the Decontamination Services Team within National Services Scotland (NSS) will be hosting a one day event covering all areas of medical device decontamination the Golden Jubilee Conference Hotel, Clydebank. A programme of national and international speakers will present on the latest regulations, guidance and research.

On 3 May 2018, the IRIC (Incident Reporting and Investigation Centre) national conference focuses on issues affecting the safety of equipment and facilities in Scotland’s health and social care services. The event brings together key players from Scottish Government, MHRA, Scottish Lifesciences Association, NHS Improvement, NHS boards, local authorities and others.

More information about these events and booking details are available to view on the Health Facilities Scotland (HFS) website.

The European Food Safety Authority (EFSA) has published a new version of its Comprehensive European Food Consumption Database.

For the first time the database includes data collected under EFSA’s EU Menu project. The updated database consists of the most recent data collected in member states covering population groups and new food categories, such as energy drinks.

The EU Menu project aims to increase the quality, detail and harmonisation of data collected in member states, covering all age groups from three months to 74 years. This makes the data easier to compare. All data in the database are now classified according to FoodEx2, a system which provides a more detailed and precise description of foods and beverages consumed across the EU than the previous version.

Source: EFSA, 26 April 2018

Scotland’s Digital Health and Care Strategy sets out plans to work collaboratively to maximise the potential of technology to reshape and improve services, support person-centred care, and improve outcomes.

Digital technology will be central in addressing the challenges and realising the opportunities faced in health and social care in Scotland, and in improving health and wellbeing, achieving tailored, person-centred care and improving outcomes.

The new strategy sets out the key priorities in achieving that ambition, and the intended collaborative work in delivering those objectives.

Source: Scottish Government, 25 April 2018

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

• The BBC reported firefighters tackled a large blaze in a remote hillside location in Aberdeenshire. Emergency services were called to the hill about two miles from Glen Tanar House in Aboyne, at about 18:05 on 26 April 2018. A Scottish Fire and Rescue Service spokeswoman said crews had difficulty reaching the incident due to its remote location, and added that firefighters ceased operations once darkness fell for safety reasons. There were no reports of any casualties.

For more detailed information on SEISS, please contact either Ian Henton or Colin Ramsay at HPS on 0141 300 1100.