On 22 May 2018, Health Protection Scotland (HPS) published the latest hepatitis C surveillance report. This report shows diagnoses up to the end of December 2017. A total of 1,511 people were diagnosed HCV antibody positive in Scotland in 2017, which represents the lowest number of new diagnoses in more than a decade. It is estimated that around 45% of those infected with HCV in Scotland remain undiagnosed.

A short life working group co-chaired by Prof John Dillon (NHS Tayside/University of Dundee) and Dr Esther Aspinall (NHS Ayrshire & Arran/Glasgow Caledonian University/HPS) has been established to bring together partners from NHS Scotland, health and social care partnerships and the third sector, to agree recommendations for best practice on HCV case-finding, re-engagement in care for people with HCV and HCV care pathways.

A national stakeholder event will be held on 24 May 2018 at COSLA in Edinburgh to present draft recommendations from this group. Guest speaker Professor Jeffrey Lazarus (University of Copenhagen/University of Barcelona) will present a global perspective and delegates will discuss recommendations, which will be published later this year.

On 8 May 2018, the Democratic Republic of Congo (DRC) Government declared a new outbreak of Ebola virus disease (EVD), the country’s ninth outbreak (see current note 52/1905). The latest situation report can be found on the World Health Organization (WHO) website.

The public health risk to the UK regarding the current Ebola outbreak is very low.

The UK Public Health Rapid Support Team (UK-PHRST) is being deployed to the DRC to help control the outbreak of Ebola virus disease. The three UK-PHRST team members, two epidemiologists and a data scientist, are to remain in the DRC for around six weeks. UK-PHRST has the capability to rapidly deploy public health experts at 48 hours notice in order to strengthen the in-country response, curtail the spread of disease, and ultimately save lives.

The deployment is in response to a call from the WHO’s Global Outbreak Alert and Response Network (GOARN). The GOARN team, which the members of the UK-PHRST will be part of, is working closely with the government of the DRC to rapidly scale up its operations in response to the current outbreak.

As the UK-PHRST’s deployment progresses, it will continue to provide support and share expertise with partners in DRC to strengthen the health system beyond the immediate response.

A rapid risk assessment on the current Ebola outbreak in the DRC has been published by the European Centre for Disease Prevention and Control (ECDC).

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

Source: Public Health England (PHE), 18 May 2018

Four additional countries in the WHO European Region have successfully added the inactivated poliomyelitis (polio) vaccine (IPV) to their routine immunization schedules this year.

With support from Global Polio Eradication Initiative (GPEI) partners, Turkmenistan, the Republic of Moldova, Uzbekistan and Kyrgyzstan have all introduced IPV this year. Tajikistan plans to introduce IPV in June.

This progress means that IPV will now be routinely offered to children in every member state in the region, as prescribed in the global Polio Eradication and Endgame Strategic Plan 2013–2018 (for further information on the international spread of polio, see current note 52/1907). 

Source: WHO Europe, 14 May 2018

Many people worldwide are unable to get tested for diseases, or are incorrectly diagnosed, because they cannot access diagnostic services. As a result they do not receive treatment, or receive incorrect treatment. Undiagnosed Type 2 diabetes and late diagnosis of infectious diseases such as HIV and tuberculosis cause major health issues and lead to the spread of disease.

To address this gap, the World Health Organization (WHO) has published its first Essential Diagnostics List, a catalogue of the tests needed to diagnose the most common conditions as well as the identification of a number of global priority diseases.

The list concentrates on in vitro tests, that is tests of human specimens like blood and urine. It contains 113 products: 58 tests are listed for detection and diagnosis of a wide range of common conditions, providing an essential package that can form the basis for screening and management of patients. 

The remaining 55 tests are designed for the detection, diagnosis and monitoring of priority diseases such as HIV, tuberculosis, malaria, hepatitis B and C, human papillomavirus (HPV) and syphilis.

Source: WHO, 15 May 2018

The focus of this year’s World No Tobacco Day is ‘tobacco and heart disease.’ The campaign will increase awareness on the:

• links between tobacco and heart and other cardiovascular diseases (CVD), including stroke, which combined are the world’s leading causes of death
• feasible actions and measures that key audiences, including governments and the public, can take to reduce the risks to heart health posed by tobacco

World No Tobacco Day 2018 will focus on the impact tobacco has on the cardiovascular health of people worldwide. Tobacco use is an important risk factor for the development of coronary heart disease, stroke, and peripheral vascular disease.

Despite the known harms of tobacco to heart health, and the availability of solutions to reduce related death and disease, knowledge among large sections of the public that tobacco is one of the leading causes of CVD is low.

The World Health Organization (WHO) provide tobacco factsheets, general information on tobacco and a global atlas on CVD prevention and control.

Source: WHO, May 2018

The 'Independent Review of Building Regulations and Fire Safety' was commissioned by the UK Government following the Grenfell Tower fire to make recommendations on the future regulatory system. The review was led by Dame Judith Hackitt. The purpose of the review was to make recommendations that will ensure a sufficiently robust regulatory system for the future and to provide further assurance to residents that the complete system is working to ensure the buildings they live in are safe and remain so. Further, the review examined building and fire safety regulations and related compliance and enforcement, with a focus on high rise residential buildings.

This final report, published on 17 May 2018, sets out over 50 recommendations for government as to how to deliver a more robust regulatory system for the future.

In a press release, the Institution of Occupational Safety and Health (IOSH) urged the UK government to act swiftly to implement the recommendations made in the review.

The World Health Organization (WHO) wants to eliminate industrially produced trans fats from the global food supply. Artificial trans fats are often contained in hardened vegetable fats, such as margarine and ghee, and are often present in snack food, baked foods and fried goods. The WHO estimates that every year trans fat intake contributes to the death of more than 500,000 persons worldwide from cardiovascular disease.

The WHO has released a step-by-step strategy on how to achieve the elimination of industrially made trans fats called REPLACE. This stands for REviews dietary sources, Promote use of healthier fats, Legislate, Assess changes, Create awareness and Enforcement.

Source: WHO, 14 May 2018

The European Food Safety Authority (EFSA) has updated its risk assessment of opium alkaloids in poppy seeds, confirming many of its previous findings, including the amount of these substances that can be consumed safely. The latest opinion also broadens the evidence that should be considered when calculating the possible risk to consumers.

EFSA’s previous assessment, published in 2011, set a safe level – or acute reference dose (ARfD) – of 10 μg per kilogram (kg) of body weight based on the morphine content of poppy seeds.

The European Commission asked EFSA to update the opinion taking into account new data on the alkaloid content of poppy seeds submitted to EFSA since 2011. The new opinion confirms the safe level of 10 μg/kg of body weight but this time as a ‘group ARfD’ that, in addition to morphine, takes codeine content into account when calculating dietary exposure. This is because the new data show that in some poppy seed samples on the European market, the concentration of codeine can be higher than that of morphine.

Source: EFSA, 16 May 2018

The operators of a chemical plant in Fife have issued an apology after local communities complained of being disturbed by flaring.

Local people reported seeing bright flares and feeling ground vibrations. Seven fire engines were at the site near Cowdenbeath as a precaution for three hours on Saturday night.

ExxonMobil said flaring at Mossmorran was necessary because of a mechanical issue with a pump, but it was unable to predict precisely when it would return to normal operations. The company stated that the flare was essential to the site’s safety systems and there was no danger to local communities or employees.

ExxonMobil added that it was working closely with SEPA to resolve the issue.

Source: SEPA, 20 May 2018

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

• On 20 May 2018, firefighters tackled a large wildfire on Arthur’s seat in Edinburgh. Crews were called at 1.40pm on Sunday when large plumes of smoke could be seen rising above the peak. Grass was alight near the summit and six fire appliances attended. Around 30 officers were at the scene, with firefighters using water backpacks to tackle the flames. One casualty was taken into the care of paramedics with a leg injury. The Scottish Fire and Rescue Service said crews left the scene at 11.30pm on Sunday. Firecrews had to return to the fire on Monday morning after it reignited. 
• On 19 May 2018, more than 30 firefighters tackled a wildfire in the Highlands. Nine appliances were called to Mybster Croft in Spittal, Caithness, at 11.42am to deal with the large heather fire which took six hours to control. The Scottish Fire and Rescue Service is calling on the public to help cut the likelihood of such blazes spreading across the country, which can devastate vast areas of land. With the country experiencing warmer weather, the service said there is an increased risk of wildfire in Scotland in place until Sunday. 

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

The Saudi Ministry of Health have issued their annual requirements and recommendations for entry visas for the Hajj and Umrah in 2018. 

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

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