The World Health Organization (WHO) has reported a further case of Ebola virus disease (EVD) in the city of Mbandaka, Equateur province, in the northwest of the Democratic Republic of the Congo (DRC). 

As of 4 May 2022, there have been three cases of EVD, two of which have been fatal, with the latest occurrence being a close contact of the first. So far, 444 contacts have been identified by public health authorities and a vaccination programme is underway. 

EVD is a type of viral haemorrhagic fever (VHF), which is spread through contact with the blood, body fluids or organs of a person or animal with the infection. 

Advice for travellers 

When Ebola outbreaks occur, generally the risk of travellers becoming infected or developing EVD is extremely low. 

Travellers returning home from an Ebola outbreak area should seek rapid medical attention by contacting NHS 24 (Scotland) or NHS 111 (rest of UK) for advice prior to attending UK medical facilities if they develop a high temperature (fever) and have:

• returned to the UK within 21 days from a region or area with a known outbreak of EVD 
• had contact with individuals infected with a VHF 

Further information and advice on VHFs are available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites. 

Sources: TRAVAX, 5 May 2022 and fitfortravel, 5 May 2022

In partnership with NHS Education for Scotland (NES), Public Health Scotland (PHS) has developed a new yellow fever eLearning resource. The interactive programme aims to support registered healthcare professionals to gain the knowledge they require to safely and effectively deliver yellow fever vaccines, and will be of interest to healthcare professionals who: 

• undertake yellow fever risk assessment and administer yellow fever vaccines 
• are new to travel health service provision 
• are experienced in travel health service provision looking to refresh their knowledge 

The resource is available to healthcare professionals through the NES TURAS Learn digital platform, for which free registration is available for those without an account. 

Please note that in Scotland, yellow fever vaccine can only be administered from yellow fever vaccination centres (YFVC) designated by PHS. Further details of training requirements for designated YFVC can be found in the PHS designation of yellow fever vaccination centres information pack. 

Source: TRAVAX, 4 May 2022

UNAIDS and the World Health Organization (WHO) have published a report emphasising the importance of integrating HIV and mental health services and other interventions, including linkages to social protection services, for people living with HIV and other vulnerable populations. 

The report finds that mental health conditions increase the risk of HIV infection, and people living with HIV have an increased risk of mental health conditions, which are associated with lower retention in HIV care, increased risk behaviours and lower engagement with HIV prevention. 

The publication is primarily intended for national and local policymakers, global, regional, country and local programme implementers, organisations working in, and providers of, health, HIV, mental health and other relevant services, civil society and community-based and community-led organisations and advocates. 

Although focus is on the integration of mental health with HIV services and other interventions, the considerations in the publication may be relevant to other services, including for HIV comorbidities such as tuberculosis, viral hepatitis and sexually transmitted infections. 

Sources: UNAIDS, 28 April 2022 and WHO, 2 May 2022

The World Health Organization (WHO) Global Tuberculosis Programme has published a rapid communication announcing upcoming updates to the guidance on the treatment of drug-resistant tuberculosis (DR-TB). This includes shorter novel six-month all-oral regimens for the treatment of multidrug- and rifampicin-resistant TB (MDR/RR-TB), with or without additional resistance to fluoroquinolones (pre-XDR-TB), as well as an alternative nine-month all-oral regimen for the treatment of MDR/RR-TB. 

All treatment should be delivered under WHO-recommended standards, including patient-centred care and support, informed consent where necessary, principles of good clinical practice, active drug safety monitoring and management, and regular monitoring of patients and of drug resistance to assess regimen effectiveness. 

The rapid communication is released in advance of updated WHO consolidated guidelines expected later in 2022, to inform national TB programmes and other stakeholders of key changes in the treatment of DR-TB and to allow for rapid transition and planning at country level. 

Source: WHO, 2 May 2022

The European Centre for Disease Prevention and Control (ECDC) has published a report presenting the results of the ECDC European Reference Laboratory Network for Pertussis (ERLNPert-Net) external quality assessment (EQA) scheme for Bordetella pertussis serology, conducted from April to September 2020. The EQA was organised by the National Institute for Biological Standards and Control (NIBSC) in the UK. 

The primary aim of this EQA scheme was to assess the ability of national reference laboratories in EU and EEA member states to correctly perform laboratory serodiagnostic tests for pertussis. This was achieved by assessing each participating laboratory’s ability to correctly measure the anti-pertussis toxin (anti-PT) immunoglobulin G (IgG) in sera samples and identifying any laboratories that are producing results significantly different from the values obtained from most participants. Furthermore, the scheme helped to identify methodologies in need of further improvement and areas for training, such as where particular laboratories may improve their methods, procedures and performance. 

Of the 31 laboratories that were invited to participate in the study, 17 agreed to take part. NIBSC sent blinded panels of eight freeze-dried sera samples containing different concentrations of anti-PT IgG to each of the 17 laboratories in 17 EU and EEA member states. The participating laboratories were asked to quantify concentrations of anti-PT IgG using their own routine diagnostic enzyme-linked immunosorbent assays (ELISA) or multiplex immunoassays (MIA), and raw data were also returned to NIBSC for secondary analysis. 

Of the 17 participating laboratories, one did not return results. Fifteen of the 16 laboratories that returned data used only one diagnostic method, either an in-house ELISA, an in-house MIA or a commercial ELISA kit to determine the anti-PT IgG concentrations of the sera panel. One laboratory submitted the results obtained using all three methods. A total of 57 data sets from individual assays were collected for 18 assay methods. 

Source: ECDC, 28 April 2022

The World Health Organization (WHO) has published the first global report on infection prevention and control (IPC), providing a global situation analysis of how IPC programmes are being implemented in countries around the world, including regional and country focuses. While highlighting the harm to patients and healthcare workers caused by healthcare associated infections (HAIs) and antimicrobial resistance (AMR), the report also addresses the impact and cost-effectiveness of IPC programmes and the strategies and resources available to countries to improve them.

The COVID-19 pandemic and other recent large disease outbreaks have highlighted the extent to which health care settings can contribute to the spread of infections, harming patients, health workers and visitors, if insufficient attention is paid to IPC. The report shows that where good hand hygiene and other cost-effective practices are followed, 70% of those infections can be prevented.

Currently, out of every 100 patients in acute-care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one HAI during their hospital stay. On average, one in every ten affected patients will die from their HAI.

The report reveals that high-income countries are more likely to be progressing their IPC work and are eight times more likely to have a more advanced IPC implementation status than low-income countries. Indeed, little improvement was seen between 2018 and 2021 in the implementation of IPC national programmes in low-income countries, despite increased attention being paid generally to IPC due to the COVID-19 pandemic.

Source: WHO, 6 May 2022

On 29 April 2022, the UK Health Security Agency (UKHSA) issued an update on their investigation into an outbreak of Salmonella linked to some Kinder products made in one of Ferrero’s factories, in Arlon, Belgium. 

The UKHSA, working in partnership on this investigation with the Food Standards Agency (FSA), Food Standards Scotland (FSS), Public Health Scotland (PHS), Public Health Wales (PHW) and Public Health Agency Northern Ireland, as well as international public health and food safety authorities, report that 76 cases are now linked to this outbreak in the UK, with most of the cases being in children under five years of age. Further information on case numbers in all affected countries can be found on the European Centre for Disease Prevention and Control (ECDC) website. 

The UKHSA reminds people that a range of Kinder Egg products and Schoko-Bons should not be eaten. 

Source: UKHSA, 29 April 2022

Food Standards Scotland (FSS) have reported that Strauss Israel have recalled several Elite branded confectionary products due to a possible contamination with Salmonella. Symptoms caused by Salmonella usually include fever, diarrhoea and abdominal cramps.

Customers are advised that these products should not be consumed but returned to the place of purchase for a full refund.

Source: FSS, 29 April 2022

On 29 April 2022, the Food Standards Agency (FSA) advised consumers that some food products may now contain other refined or fully refined food grade vegetable oils, despite being labelled as containing sunflower oil. This update advises consumers that fully refined palm oil, fully refined coconut oil and fully refined soybean oil are being used in some products, without changes to the label being made. Advice to consumers around the use of refined rapeseed oil due to the impact of the conflict in Ukraine on product availability has been previously provided. 

This update follows a rapid risk assessment carried out by the FSA, which focused on the use of these fully refined oils on people with food allergies. The assessment found that the immediate food risk from fully refined palm oil and fully refined coconut oil is very low, while from fully refined soybean oil the risk is negligible, which means that allergic reactions to these fully refined vegetable oils are very rare and, if they do occur, are mild. 

The FSA encourage industry to consider using the healthier and more sustainable oils if substituting their ingredients, while consumers should contact the manufacturer or brand for more information if they are unsure of the content of any product or have concerns about substitution. The FSA expects businesses to inform consumers about any related product change, whether that product is purchased in store or online.  

Guidance has been issued to local authorities on the factors they may wish to take into consideration, to assist in making proportionate enforcement decisions on a case-by-case basis and bearing in mind wider consumer interests.  

Source: FSA, 29 April 2022

World Hand Hygiene Day fell on 5 May 2022, promoting the prioritising of good hand hygiene and effective infection prevention and control (IPC) in adding to health facilities climate or culture of safety and quality. This years' campaign slogan was ' Unite for safety: clean your hands'.

The campaign finds that, in order to prioritize clean hands in health facilities, people at all levels need to believe in the importance of hand hygiene and IPC to save lives, by acting as key players in achieving the appropriate behaviours and attitudes towards it. In other words, health workers at all levels and people accessing health care facilities need to unite on ensuring clean hands.

Source: WHO, 5 May 2022

On 5 May 2022, the European Environment Agency (EEA) published an assessment, which analysed new data from the Urban Atlas of the Copernicus Land Monitoring Service. The data focuses on land use changes and socio‑economic trends in 662 functional urban areas, that is, cities and their commuting zones, in the EU and the UK, which represents 23% of the land territory, and host 75% of the population of the EU and UK.

The data show that, between 2012 and 2018, land take in the urban areas of the EU and UK increased by 3,581 km² and soil sealing increased by estimated 1,467 km², mostly at the expense of croplands and pastures. The soil sealing caused a loss of potential carbon sequestration, estimated at 4.2 million tonnes of carbon during the monitoring period.

Almost 80% of land take took place in commuting zones, which are often important for wildlife, carbon sequestration, flood protection, and supply of food and fibres, the EEA report reminds. Commuting zones have much more artificial areas per person than cities, which means that their land use is less efficient. Adding to pressures on nature, habitats in urban areas get fragmented because of land take and, with an average size of 0.25 km², they are about four times smaller than in rural areas.

The EEA report warns that continuing land take destroys biodiversity and makes Europe increasingly vulnerable to natural disasters. Stopping land degradation and restoring wetlands, peatlands, coastal ecosystems, forests, grasslands, and farmland are key to preventing biodiversity decline and adapting to climate change. Similar messages are raised most recently in the second Global Land Outlook report by the United Nations Convention to Combat Desertification.

Currently, there is no legally binding policy target in relation to land take and soil sealing at the EU level. However, the new EU soil strategy for 2030 calls on member states to set land take targets for 2030, with the aim of reaching land take neutrality by 2050.

Source: EEA, 5 May 2022

On 28 April 2022, the Scottish Environment Protection Agency (SEPA) has published its first water scarcity report of the year, with low levels being recorded in parts of Scotland. 

The report finds the southern half of the country has reached early warning stage and businesses which abstract water should consider how they can be more efficient to protect both the environment and their own operations. 

This comes after dry conditions across Scotland in March, with only half of the long-term average monthly rainfall, with groundwater levels at monitoring sites in Fife and Angus particularly low. Normal amounts for this time of year would have benefited river flows, topped up reservoirs and provided moisture in the soils. 

SEPA is responsible for the forecasting, monitoring, and reporting of the situation facing Scotland's water resources and produces weekly water scarcity reports between May and September. 

Businesses can take steps to protect water supplies by planning ahead, reducing volumes and irrigating at night where possible. Operators should also work together to stagger abstractions. 

Source: SEPA, 29 April 2022

East Dunbartonshire Council has committed to continue sending waste to Scottish Water Horizons’ Deerdykes Bioresources Centre near Cumbernauld, where it undergoes anaerobic digestion, a process which uses bacteria to break down organic matter. 

While a less sustainable alternative is to use comingled waste, that is, mixing food and garden rubbish, which goes to composting, this does generate greenhouse gases, including methane, which are harmful to the environment. Sending waste to a food waste recycling facility which uses anaerobic digestion avoids this issue whilst generating sustainable energy. 

In the previous year, East Dunbartonshire sent 3000 tonnes of food waste for processing, which is the equivalent of more than a quarter of a million weekly food shops, reducing 1,850 tonnes of carbon. 

Scottish Water Horizons and East Dunbartonshire Council have joined forces on the back of the contract renewal to help drive positive behaviours in recycling food waste. Whilst food waste should be avoided, if possible, the teams involved are keen to raise awareness of the benefits of properly segregating and recycling waste. 

The Deerdykes Bioresources Centre in North Lanarkshire has generated more than 50 GWh of green electricity, the equivalent of powering 13,500 homes for a year, since it opened in 2010. The facility harnesses gas from food waste using anaerobic digestion to generate green energy using a combined heat and power engine (CHP). 

Source: Scottish Water, 4 May 2022

On 3 May 2022, the WHO European Regional Obesity Report 2022 was published, warning of the serious health risks associated with rising levels of obesity. Almost two thirds of adults and one-in-three in the WHO European Region are overweight or obese, and these levels continue to grow. Obesity is among the top determinants of death and disability in the region, the condition is a cause of 13 different types of cancer, and it needs to be treated and managed by multidisciplinary teams. 

The report predicts that, in the coming decades, obesity will overtake smoking as the main risk factor for preventable cancer, in some countries in the region. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. Obesity prevalence for adults in the European Region is the second highest of all WHO regions, after the Region of the Americas. The latest data shows that overweight and obesity account for more than 1.3 million deaths globally each year, but even these numbers may be underestimated. 

In the European Region, overweight and obesity have reached epidemic proportions, with prevalence levels higher among males (63%) than among females (54%). The rates tend to be higher in countries with higher incomes. The highest levels of both overweight and obesity are found in Mediterranean and eastern European countries. Educational inequalities are widespread, with higher obesity prevalence found in people with lower educational attainment. 

The COVID-19 pandemic has made the obesity problem even more pressing, with obese patients more likely to experience complications and death from the virus, and many of these patients have experienced disruptions in accessing obesity management services. Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods. 

The WHO highlight the importance of prioritising some immediate policies, such as restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management, then produce a feasible plan to introduce other interventions at a later stage. 

Source: WHO/Europe, 3 May 2022

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

• On 27 April 2022, The Scottish Fire and Rescue Service (SFRS) were alerted to a moorland wildfire at Erbusaig, to the north of Kyle of Lochalsh, in the west Highlands. Fire crews battled to control the fire over the course of two days, bringing in a helicopter to waterbomb the fire, which at that time was burning along a front of three miles. The SFRS, which had beforehand warned of a heightened risk of wildfires due to recent dry and windy conditions, reported no injuries.

More information can be found on the SEISS website.