The report on quarterly epidemiological data on Clostridioides difficile infection (CDI), Escherichia coli bacteraemia (ECB), Staphylococcus aureus bacteraemia (SAB), and surgical site infection (SSI) in Scotland, October to December (Q4) 2020, was published on 13 April 2021, under the mandatory programmes for surveillance of CDI, ECB, SAB, and SSI in Scotland. Please note that data for SSI are not included due to the pausing of surveillance to support the COVID-19 response.

This report provides data for the fourth quarter of 2020 in 14 NHS boards and one NHS special health board. In addition, an appendix can also be accessed which details all cases and denominator data for each NHS board and overall for Scotland.

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. The range and type of measures vary across England, Scotland, Wales and Northern Ireland.

The current UK travel restrictions are stringent and in place to avoid new variants being imported into the UK, and to avoid UK travellers exporting the UK variant during international travel.

Prior to travelling to the UK, all travellers must:

• take a coronavirus (COVID-19) test and get a negative result during the three days before travel to the UK
• book an accommodation and/or testing package through the UK Government portal
• complete a Passenger Locator Form (PLF) declaring which countries have been visited in the ten days prior to arriving in the UK

All travellers arriving into the UK must:

• quarantine for ten days
• take a coronavirus (COVID-19) test on day two and day eight of quarantining
• follow the national lockdown rules for the UK four-nations country they arrive in
• for travellers arriving from, or that have been in a ‘red list’ country where travel to the UK is banned in the last ten days, the ten day quarantine must take place in a managed quarantine hotel

Quarantine rules are different in each of the UK four-nation countries, therefore prior to travel, travellers must ensure they are able to comply with the rules appropriate to the UK nation they will be arriving in and residing in, if different. Further information for travellers arriving into the UK can be found here:

• England
• Scotland
• Wales
• Northern Ireland

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.

Since 6 April 2021, the COVID-19 risk to UK travellers has been increased in:

• Bermuda
• Japan
• Martinique

Advice for travellers

All travellers should be made aware of precautions they should take to reduce their risk of exposure to coronavirus (COVID-19) before, during and after travel, as detailed on the fitfortravel COVID-19: health considerations for travel page.

Source: TRAVAX, 1 April 2021

On 31 March 2021, the Global Polio Eradication Initiative reported two cases of polio in Diourbel, Senegal.

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, 6 April 2021

On 8 April 2021, the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) published a report covering data on antimicrobial resistance (AMR) in zoonotic and indicator bacteria in 2018/19, submitted by 28 EU member states. Resistance in bacterial isolates of zoonotic Salmonella and Campylobacter from humans, animals and food, and resistance in indicator Escherichia coli as well as in meticillin-resistant Staphylococcus aureus from animals and food were addressed and analysed jointly by the two agencies.

The report found that in humans, high proportions of resistance to ciprofloxacin, an antibiotic commonly used to treat several types of infections, were reported in a specific Salmonella type known as S. Kentucky (82.1%). In recent years, S. Enteritidis resistant to nalidixic acid and/or ciprofloxacin has been increasingly reported in several countries. The increasing occurrence of fluoroquinolone and/or quinolone resistance in these types of Salmonella probably reflects the spread of particularly resistant strains. In Campylobacter, resistance to ciprofloxacin is now so common in most countries that this antimicrobial has limited use in the treatment of infections in humans.

The report also found that during the period 2015-2019, a decline in resistance to ampicillin and tetracyclines has been observed in Salmonella isolates from humans in eight and eleven EU member states respectively.

Source: ECDC, 8 April 2021

The European Food Safety Authority (EFSA) has published its latest report on pesticide residues in food in the EU, giving a snapshot of the levels found in a range of products widely consumed in the territory.

A total of 96,302 samples were analysed in 2019, 96.1% of which fell within legally permitted levels. For the subset of 12,579 samples analysed as part of the EU-coordinated control programme (EUCP), 98% were within legal limits.

The EUCP analysed samples randomly collected from 12 food products, apples, head cabbages, lettuce, peaches, spinach, strawberries, tomatoes, oat grain, barley grain, red and white wine, cow’s milk, and swine fat. Of those samples analysed:

• 6,674 (53%) were found to be free of quantifiable levels of residues
• 5,664 (45%) contained one or more residues in concentrations below or equal to permitted levels
• 241 (2%) contained residues exceeding the legal maximum of which 1% led to legal actions

Source: EFSA, 7 April 2021