Final Issue: Volume 16 Number 51	Published on: 21 December 2006	Final Issue in PDF PDF format (283 Kb)

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• Cases of hepatitis B associated with lancing devices
• Plasmodium falciparum malaria in Jamaica
  
  

Cases of hepatitis B associated with lancing devices

Since 2004, seven cases of hepatitis B have been reported to the Health Protection Agency from care and residential homes following the incorrect use of lancing devices. On further investigation by local Health Protections Units eleven more cases have been identified in diabetics who have probably been infected by these means. In four patients, hepatitis B infection had contributed to their death. A further single case in a diabetic in another home is still under investigation. There have been reports that some care and residential homes have used the single patient device on more than one patient. As a small amount of blood can remain on the cap of the device, this can lead to infection being passed between patients.

The Medicines and Healthcare products Regulatory Agency (MHRA) has issued a renewed safety warning to healthcare workers over the use of these devices in nursing and care homes after the Agency received continued reports of infection being passed via these devices [1].

The MHRA has advised that care workers or healthcare professionals taking blood glucose samples in any multi-patient environment, including nursing homes and care homes must only use:

• disposable single-use lancing devices for each resident or patient (these are used once and then the entire lancing device is discarded), or;
• a non-disposable lancing device, but this must be one which is intended to be used to take blood samples from multiple patients, used with disposable single-use lancets.

References
1. Lancing devices used in nursing homes and care homes. MDA/2006/066. London: Medicines and Healthcare Products Regulations Agency, 6 December 2006. Available at < http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&ssDocName=CON2025400&
ssSourceNodeId=389&ssTargetNodeId=365>

Plasmodium falciparum malaria in Jamaica

As of 7 December 2006, a cluster of 21 malaria cases, caused by Plasmodium falciparum, has been reported from the city of Kingston in Jamaica [1]. The outbreak is believed to have started in late October 2006. Of the 21 reported infections, 16 cases are females and five are males, ranging from five to 72 years. Four children are among the confirmed cases. For those with known date of onset, the range is from 27 September to 30 November. One case is in a United States resident who travelled to the island from 29 October to 6 November 2006.

Like most Caribbean countries (except for the Dominican Republic and Haiti), Jamaica is not considered endemic for malaria. The mosquitoes capable of transmitting malaria are, however, present on the island, and small localised clusters may occur from time to time as a result of the tropical climate, and its proximity to countries where malaria does occur [2].

Around 160,000 United Kingdom (UK) residents travel to Jamaica every year [3], and malaria has not been documented in any UK travellers to date. The HPA Advisory Committee for Malaria Prevention in UK Travellers (ACMP) does not recommend preventive malaria medication for UK travellers to Jamaica. Travellers to Jamaica, in particular to the Kingston area, should be aware of the risk and protect themselves against evening and night-time biting mosquitoes (see NaTHNaC insect bite avoidance information sheet [4]). Any traveller who develops a febrile illness during travel, or for up to a year following their return to the UK, should be promptly evaluated and have a blood test for malaria without delay [5]. In the unlikely event that any travellers do contract malaria after visiting Jamaica, the appropriate treatment is chloroquine.

For further information about the prevention of malaria in UK travellers, go to the malaria page <http://www.hpa.org.uk/infections/topics_az/malaria/default.htm> on the HPA website or see the information sheet on malaria <http://www.nathnac.org/pro/factsheets/malaria.htm> on the NaTHNaC website.

References
1.  Jamaican Ministry of Health. Malaria outbreak not an epidemic - Dalley . Jamaican Ministry of Health website [online] 6 December 2006 [cited 6 December 2006]. Available at <http://www.moh.gov.jm/malariaOutbreak.htm>.

2.  Public Health Agency of Canada . Malaria in Kingston , Jamaica . Travel Health Notices and International Reports 4 December 2006 [online] [cited 6 December 2006]. Available at < http://www.phac-aspc.gc.ca/tmp-pmv/2006/mal_jam061204_e.html >.

3. World Tourism Organization (WTO). Yearbook of tourism statistics, 2005 [CD ROM]. Madrid : WTO, 2006.

4.  Insect bite avoidance . [online] [accessed 6 December 2006]. London : NaTHNaC, 2006. Available at < http://www.nathnac.org/pro/factsheets/iba.htm >.

5. The National Travel Health Network and Centre. Clinical update: Plasmodium falciparum malaria in Jamaica , 6 December 2006 [online] [cited 6 December 2006]. London : NaTHNaC, 2006. Available at < http://www.nathnac.org/pro/clinical_updates/malaria_061206.htm >.