On 1 November 2021, Public Health Scotland (PHS) implemented the next phase of surveillance for community acute respiratory infection in Scotland. A sentinel approach involving community assessment centres and GP practices is being used to test a representative sample of people with symptoms of respiratory infection for influenza, SARS CoV-2, respiratory syncytial virus (RSV), and other clinically important respiratory infections such as rhinovirus and parainfluenza.

The aim of the programme is to understand the epidemiology of these infections in order to: 

• provide early warning to support and facilitate winter preparedness 
• support local intelligence 
• provide local service response and local patient clinical management 
• support analysis of vaccine effectiveness against COVID-19, as well as influenza

When available, data will be reported on the PHS website, while further information on this surveillance project is available from the Chief Medical Officer.

International travel continues to be impacted due to COVID-19, and a number of variant strains have emerged globally, with information on such travel available for people living in Scotland, England, Wales and Northern Ireland.

On 1 November 2021, the final seven countries were removed from the international travel red list, meaning travellers to the UK from Columbia, Dominican Republic, Ecuador, Haiti, Panama, Peru and Venezuela no longer have to stay in hotel quarantine for ten days on arrival. Despite no countries remaining on the red list, the policy is continuing in Scotland and some managed quarantine capacity will stay in place in order to react to any change in assessment that would see a country added to the red list. These changes do not indicate either which destinations allow UK travellers to enter their country, or if the FCDO advises against travel to these countries. Information relating to this can be checked on the relevant FCDO foreign travel advice country pages.

From 31 October 2021, anyone entering Scotland who is over 18 years and fully vaccinated can take a lateral flow test bought from a private provider, instead of a PCR test, on the second day after their arrival, and will also be required to complete a passenger locator form. Travellers who receive a positive lateral flow test result must book for a confirmatory PCR test immediately.

Travellers should be aware that testing and quarantine rules may differ in Scotland, England, Wales and Northern Ireland and must ensure they comply with the rules appropriate to the UK nation they will be arriving in and reside in, if different.

Country specific COVID-19 risk

The fitfortravel (for the general public) and TRAVAX (for health professionals) country pages have been updated have been updated to include a COVID-19 country specific risk-rating, which identifies the risk of exposure to COVID-19 for UK travellers. 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, previously categorised as either high, moderate or low risk, has been changed, with each country now rated as having either a: 

• high risk of exposure to COVID-19 for UK travellers 
• risk of exposure to COVID-19 for UK travellers

For all countries, travellers should be aware that the risk of COVID-19 may change at short notice. Countries categorised as having a high risk of exposure to COVID-19 either have a high risk of exposure for travellers to COVID-19, or a high risk of emerging or known variants of coronavirus. Travellers should be advised to avoid non-essential travel to high risk countries, even if fully vaccinated against COVID-19.

Advice for travellers

Prior to booking any international travel, travellers must first check if the country they are travelling to is currently accepting UK travellers. 

• The FCDO foreign travel advice country pages have up-to-date information on entry rules, in response to coronavirus (COVID-19), under the ‘Entry Requirements’ section. 
• Travellers should be aware that some countries or territories may require proof of COVID-19 vaccination status for entry. Guidance for demonstrating COVID-19 vaccination status is available for those living in Scotland, England, Wales and Northern Ireland.

It is advised that travellers are aware of all travel restrictions, self-isolation rules and precautions they should take, in order 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, 25 October 2021

Diwali is a festival of lights and one of the major religious festivals in Hinduism, Jainism and Sikhism, with observances differing dependent on region and tradition. The festival usually lasts five days and is celebrated during the Hindu lunisolar month Kartika (between mid-October and mid-November). In 2021, the five days of Diwali are between 2 to 6 November 2021. The main festivities for Diwali are held in India, but is also celebrated in many other countries around the world, with many people travelling to visit friends and relatives at this time.

Advice for travellers

Coronavirus (COVID-19) continues to disrupt international travel. For example, the Foreign Commonwealth and Development Office (FCDO) currently advise that all regularly scheduled international flights between the UK and India remain suspended with only a limited number of flights operating.

Travellers should be aware of the risk of COVID-19 in a country they may wish to visit, and that there may be entry restrictions, vaccination and quarantine requirements for UK travellers.

Travellers attending Diwali celebrations abroad should consider: 

• being up-to-date with routine UK schedule vaccinations, including checking if primary vaccination or boosters are required before travel 
• exercising care with respiratory and hand hygiene 
• having a valid comprehensive travel insurance which covers COVID-19 related illness or unexpected delays 
• seeking medical advice abroad if they are experiencing any symptoms of infection or illness

These guidelines are liable to change at short notice.

On their return to the UK, travellers should be aware to seek urgent medical attention if they develop a fever or flu-like illness and to tell a healthcare professional of their recent travel history, particularly if they have travelled to a malaria-endemic country.

Source: TRAVAX, 28 October 2021

The European Centre for Disease Prevention and Control (ECDC) periodically publishes influenza characterisation reports, giving an overview of circulating influenza viruses. These reports provide details on current vaccine strains, summarise the development of viruses since the last report and closely follow the main developments for the ongoing influenza season.

On 22 October 2021, the ECDC published the tenth virus characterisation period report for the 2020 to 2021 influenza season. As of week 39 of 2021, 1,276 influenza detections across the World Health Organization (WHO) European Region had been reported. Of these, 60% were type A viruses, with A(H3N2) prevailing over A(H1N1)pdm09, and 40% were type B viruses, with 16 having been ascribed to a lineage, 15 being B/Victoria and one B/Yamagata.

Source: ECDC, 22 October 2021

The European Centre for Disease Prevention and Control (ECDC) report that, although the overall number of influenza detections in the majority of EU and EEA countries remains low, indications show that influenza circulation is above the seasonal threshold in Croatia, which is unusually early.

The main reported subtype among the cases recorded in the EU and EEA during the past month is A(H3N2), which disproportionally affects older people, and is associated with lower vaccine effectiveness. This may be a sign that the upcoming influenza season could be severe for elderly people, and that influenza patterns may vary between countries in terms of timing.

Source: ECDC, 26 October 2021

The European Centre for Disease Prevention and Control (ECDC) has published a report presenting the results of the eleventh round of the external quality assessment (EQA-11) scheme for typing of Salmonella enterica subsp. enterica, organised for the national public health national reference laboratories (NPHRLs) in ECDC’s Food- and Waterborne Diseases and Zoonoses network (FWD-Net).

Salmonellosis was the second most commonly reported zoonotic disease in the EU for 2019, with a notification rate of 20.0 cases per 100,000 of the population.

Source: ECDC, 25 October 2021

The World Health Organization (WHO) has issued new guidance to support healthcare providers recognise and deliver care to individuals who have been exposed to lead. The new guidance recommends a blood lead concentration of five micrograms per decilitre (μg/dL) as a trigger for a thorough review of the ways in which a person is being exposed to lead, and for action to reduce or end this exposure. The United Nations Children’s Fund (UNICEF) report that one-in-three children are estimated to have blood lead levels in excess of the 5μg/dL threshold.

The aim of the guidelines is to assist healthcare providers in making decisions about the diagnosis and treatment of lead exposure for individual patients and in mass poisoning incidents. The guidelines present evidence-informed recommendations on the:

• interpretation of blood lead concentrations 
• use of gastrointestinal decontamination 
• use of a chelating agent 
• use of nutritional supplements

Source: WHO, 27 October 2021

Food Standards Scotland (FSS) has launched a consultation on the introduction of new food compliance notices (CNs), which are intended to help enforcement officers deal more fairly and quickly with suspected contraventions of rules on food standards, such as incorrect or fraudulent product labelling.

In the event of any suspected food standards regulation breach by a business, intentional or not, local authority food enforcement officers currently have limited powers, other than to submit a report to the Procurator Fiscal (PF), or serve a seizure and detention notice to remove potentially harmful or non-compliant products from the market. FSS are currently seeking the views of local authority enforcement officers who inspect food businesses and enforce food legislation, food businesses across sectors, such as manufacturing, packaging and labelling of food products, catering, and retailers, and consumers. The consultation is open until 16 December 2021.

Source: FSS, 25 October 2021

On 26 October 2021, the European Environment Agency (EEA) published a report estimating that the EU has achieved its three 2020 climate and energy targets of: 

• reducing greenhouse gas emission by 20%, when compared to 1990 levels 
• increasing the share of renewable energy use to 20% 
• improving energy efficiency by 20%

According to preliminary data, EU greenhouse gas emissions decreased by 10% from 2019 to 2020, a drop the EEA relate to the COVID-19 pandemic. Estimates suggest that in 2020, when counting gross emissions only, EU greenhouse gas emissions were 31% lower than in 1990, constituting an overachievement of the 20% reduction targets.

The EEA highlight that based on the preliminary data, only 21 EU member states reached their national target in 2020. This means that Bulgaria, Cyprus, Finland, Germany, Ireland and Malta would need to use flexibilities, such as buying emission quotas from other EU countries, to comply with their legal objectives.

The EEA analysis is based on final climate and energy data for 2019, and preliminary data for 2020. The analysis is complemented by a new website, which will explore climate and energy data and country profiles, as well as a technical annex on data and targets.

Source: EEA, 26 October 2021

On 26 October 2021, the Scottish Government published an analysis of responses to its consultation on proposals for new environmental standards for Scotland’s water environment, as well as updates to some of the assessment methods used for deriving such standards. The proposed updates were: 

• river fish statistical methodology 
• river phytobenthos assessment method 
• loch fish new eDNA assessment method 
• loch morphology: bank protection assessment method 
• introduction of spatial standards for fish barrier assessment 
• new nitrogen standards for lochs 
• invasive non-native species list 
• river flow standards changes: 
  • artificially increased flows in high hydrological status waterbodies 
  • short term abstraction in good hydrological status waterbodies

The majority of responses were in favour of the proposals and the Scottish Government intend to introduce the standards as outlined in the consultation.

The Scottish Environmental Incident Surveillance System (SEISS) has recorded the following incident: 

• On 25 October 2021, all staff and pupils at Lenzie Academy, East Dunbartonshire, had to leave the building after a strong smell of ammonia was noticed by a member of staff. The smell had not activated any alarms, and was described as not being of natural gas. The Scottish Fire and Rescue Service (SFRS) investigated the scene and no causalities were reported. Pupils and staff are now back in the school and the affected area has been isolated and is being investigated. 

More detailed information can be found on the SEISS website.