The report on quarterly epidemiological data on Clostridioides (formerly Clostridium) difficile infection (CDI), Escherichia coli bacteraemia (ECB), Staphylococcus aureusbacteraemia (SAB) and Surgical Site Infection (SSI) in Scotland, April to June (Q2) 2018, was published today (2 October 2018) under the mandatory programmes for surveillance of CDI, ECB, SAB, and SSI in Scotland. This report provides data for the second quarter of 2018 in 14 NHS boards and one NHS special health board.

A novel genus Clostridioides has been proposed for Clostridium difficile which will now be known as Clostridioides difficile. There are no implications with regards the natural history of infection, infection prevention and control or clinical treatment. Further information on this reclassification is available on the Science Direct website

The report and an appendix detailing all cases and denominator data for each NHS board and overall for Scotland is available on our website

The Scottish Health Survey (SHeS) provides a detailed picture of the health of the Scottish population in private households and is designed to make a major contribution to the monitoring of health in Scotland. The 2017 report presents statistics on general health, long-term conditions and cardiovascular diseases, mental wellbeing, dental health and services, alcohol, smoking, diet, physical activity, obesity and gambling.

Key findings from the report include:

• the proportion of adults smoking in Scotland has fallen to 18%, down from 21% in 2016 and 28% in 2003;
• around two-thirds (65%) of adults in Scotland were overweight, including 29% who were obese;
• 24% of adults drank at hazardous or harmful levels in 2017, down from 34% in 2003.

The report is available on the Scottish Government website

Source: Scottish Government, 25 September 2018

A Stirling landowner, George Adam, was fined £6,000 and served with a confiscation order under the Proceeds of Crime Act for £20,388 at Stirling Sheriff Court on 26 September 2018. Mr Adam pled guilty to illegally managing and keeping asbestos, plastics and other wastes at the former Cowie Road Landfill, Bannockburn, without the necessary authorisations from the Scottish Environment Protection Agency (SEPA).

SEPA officers attended the former landfill site, operated by Mr Adam, on several occasions between July and December 2015 to assess compliance with the site’s registered exemption. At these visits SEPA officers noted that waste, which did not comply with the exemption, was present on site and also outwith the exemption boundary.

Sampling of the waste confirmed that materials including soil, stones, plastic, metals, wood and waste trommel fines, containing asbestos, were present on site. Leachate was also observed at the site which had the potential to seep into the ground and enter the groundwater, and also to eventually result in odours off-site.

Whilst SEPA served an enforcement notice under the Environmental Protection Act on Mr Adam on 7 December 2015, requiring the removal of waste from the site, further site visits by SEPA officers showed that the waste had not been removed.

Source: SEPA, 27 September 2018

Scotland’s Drinking Water Quality Regulator (DWQR) has published a report on the quality of water found in privately-owned water supplies. The report finds that many of these supplies comply with drinking water standards but a significant number need to make further improvements.

Around 3.6 per cent of the Scottish population receive their water from a private water supply rather than from Scottish Water. Some of these supplies serve hotels, tourist accommodation and other businesses. Where water from these supplies does not meet the standards, there may be a risk to the health of those drinking from them.

In 2017, a total of 46,470 tests were taken from regulated private water supplies – those serving more than 50 people or a commercial activity. Of these, 95% met the required standard. Of the samples taken from regulated supplies, E. coli was found in 11% of samples, indicating that they are not receiving the treatment necessary to make the water safe.

The report from the DWQR is available on their website

Source: Scottish Government, 27 September 2018

The Scottish Environment Protection Agency (SEPA) has published official statistics which provide details of household waste collected across all Scottish local authorities during 2017. For the first time, the statistics also include the carbon impact metric, measuring the whole-life carbon impacts of Scotland’s waste, from resource extraction and manufacturing emissions, right through to waste management emissions, regardless of where in the world these impacts occur.

The statistics show that during 2017 the household waste recycling rate was 45.6%, a slight increase from the 45.0% rate achieved in 2016. The total amount of household waste generated in Scotland was 2.46 million tonnes in 2017, a decrease of 38,153 tonnes (1.5%) from 2016, while there was a decrease of 24,848 tonnes (2.2%) in household waste disposed to landfill.

This is the sixth consecutive decrease in household waste landfilled since 2011. For the first time, there was more Scottish waste recycled (1.12 million tonnes) than landfilled (1.11 million tonnes).

The total amount of waste landfilled in Scotland in 2017 was 3.83 million tonnes, an increase of 90,816 tonnes (2.4%) from 2016.  The increase was primarily due to an increase in the landfill of soils – such as waste soils and rocks from construction sites – which increased by 230,748 tonnes (22.4%) from 2016 to a level consistent with the years 2011-2015.

The total quantity of waste incinerated in Scotland in 2017 was 766,574 tonnes.  This was an increase of 83,347 tonnes (12.2%) from 2016, and an increase of 356,515 tonnes (86.9%) from 2011.

The summary data and commentary text are available on the SEPA website

Official statistics have also been published specifically for all waste landfilled and waste incinerated within Scotland during 2017 and are available on the SEPA website

Source: SEPA, 25 September 2018

Volunteer NHS clinical staff are to work alongside local health workers in Ghana, Tanzania, Uganda and Zambia to tackle antimicrobial resistance (AMR). The new Commonwealth Partnerships for Antimicrobial Stewardship (AMS) scheme is funded by the UK Department of Health and Social Care’s Fleming Fund.

The scheme will send up to 12 volunteer NHS pharmacists and specialist nurses to work with local health workers against AMR in these counties. It will see NHS and national teams work together to help to keep antibiotics working better for longer and stop the emergence of superbugs. They will do this by:

• improving the detection and monitoring of resistant infections at hospital level;
• taking measures to reduce infection;
• putting steps in place to use antibiotics effectively.

It will be delivered in collaboration with the Commonwealth Pharmacists Association (CPA) and the Tropical Health Education Trust.

Source: UK Government, 27 September 2018

World leaders meeting at the United Nations (UN) General Assembly on 26 September 2018 have committed to ensuring that 40 million people with tuberculosis (TB) will receive the care they need by the end of 2022. It was also agreed that 30 million people would be given preventive treatment to protect them from developing TB.

Heads of state and government attending the first-ever UN high-level meeting on TB agreed to mobilise $13 billion a year by 2022 to implement TB prevention and care and $2 billion for research. They committed to take action against drug-resistant forms of the disease, build accountability and prioritise human rights issues such as the stigma that still prevails around TB in many parts of the world.

Source: WHO, 26 September 2018

New data published by Public Health England (PHE) reveals that the number of people in England diagnosed with tuberculosis (TB) is at its lowest level since 1990. The incidence rate of TB in England is now 9.2 per 100,000 population, going below the World Health Organisation (WHO) definition of a low incidence country (10 per 100,000 population) for the first time. There was a 38% drop in new diagnoses from the peak in 2011 to 2017 (from 8,280 to 5,102), with a 9% fall in diagnoses between 2016 and 2017 alone.

PHE has worked with NHS England and other partner organisations to implement the ‘Collaborative Tuberculosis Strategy for England 2015 to 2020’. This strategy includes raising awareness and tackling TB in underserved populations, implementing testing for latent TB in those arriving from countries with high rates of TB and strengthening surveillance and monitoring.

Source: UK Government, 25 September 2018

Public Health England (PHE) has confirmed that a third individual has been diagnosed with monkeypox in England. This person was involved in the care of the case in Blackpool Victoria Hospital before monkeypox was diagnosed (see current note 52/3703). This third case has now been isolated to minimise the risk of onward transmission to others.

PHE are following up with close contacts of this new case to provide advice and monitor their health. They are adopting a highly precautionary approach to minimise the risk of additional cases and are tracing anyone who had contact with this individual 24 hours before they noticed a rash.

Further information on monkeypox and related guidance is available on the PHE website

Information and advice for travellers is available from the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: PHE, 26 September 2018