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Vol 16 no 51 |
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Final Issue: Volume 16 Number 51 |
Published on: 21 December 2006 |
Final Issue in PDF |
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News
Last updated: 21 December Volume 16, No.51 (PDF file, KB) Next update: 5 January 2006
News Archives: | 2006 | 2005 | 2004 | 2003 | 2002 | 2001
CDR Home | News
New guidelines on malaria prevention for travellers from the United Kingdom
New practical guidelines on malaria prevention for travellers from the United Kingdom (UK) have been published by the Health Protection Agency [1]. These update and combine previous 2003 guidance issued in 2003 [2,3] in a new format available on the web, and as a handy reference manual.
Updates include extensively revised advice for travellers to the Indian sub-continent, and increased emphasis on bite prevention. The guidelines also highlight that awareness needs to be raised, among those travelling back to endemic countries to visit friends and relatives. The view that this group is relatively protected is a dangerous myth and their children are particularly vulnerable [4].
The guidelines are for use by healthcare workers who advise travellers, but may also be of use to prospective travellers who wish to read about the options themselves. Together with new ACMP malaria treatment guidelines being published in the Journal of Infection [5] it is hoped that the risk of illness and death from malaria in UK travellers can be reduced.
Each year between 1500 and 2000 people are diagnosed with malaria on their return to the UK . Anyone visiting a malarious area can become infected no matter what age or sex or ethnic background. Malaria can kill very quickly if not diagnosed in time. In 2005 there were 11 deaths from malaria in the UK [6]. These deaths and illness are, however, avoidable, as most people requiring medical attention for malaria in the UK have not taken the correct precautions needed for their visit.
References
1. Chiodini P, Hill D, Lalloo D, Lea G, Walker E, Whitty C, Bannister B. Guidelines for malaria prevention in travellers from the UK. London: Health Protection Agency, January 2007. Available at <http://www.hpa.org.uk/infections/topics_az/malaria/default.htm>.
2. Bradley DJ, Bannister B; Health Protection Agency Advisory Committee on Malaria Prevention for UK Travellers. Guidelines for malaria prevention in travellers from the United Kingdom for 2003. Commun Dis Public Health . 2003; 6: 180-99. Available at <http://www.hpa.org.uk/cdph/issues/CDPHvol6/No3/6(3)p180-99.pdf>
3. Hughes C, Tucker R, Bannister B, Bradley DJ. Malaria prophylaxis for long- term travellers. Commun Dis Public Health 2003; 6 :200-8. Available at <http://www.hpa.org.uk/cdph/issues/CDPHvol6/No3/6(3)p200-208.pdf>.
4. Health Protection Agency. Migrant health: infectious diseases in non-UK born populations in England , Wales and Northern Ireland . A baseline report - 2006. London : Health Protection Agency, 2006.
5. Lalloo DG, Shingadia D, Pasvol G, Chiodini PC, Whitty CJ, Beeching NJ, et al for the HPA Advisory Committee on Malaria Prevention in UK travellers. UK malaria treatment guidelines . Journal of Infection In Press.
6. Health Protection Agency. Malaria imported into the United Kingdom in 2005: implications for those advising travellers. Commun Dis Rep CDR Wkly 2006; 16 (23) News. Available at <http://www.hpa.org.uk/cdr/archives/2006/cdr2306.pdf>.
Trends in Antimicrobial Resistance in England and Wales: 2004 to 2005
The Health Protection Agency has published its third report providing a detailed overview of antimicrobial resistance in a range of pathogens (bacteria, viruses, fungi, and protozoa) of public health importance [1]. The majority of the data presented relate to England and Wales , although some data from other European countries are included reflecting the participation of the HPA in the European Antimicrobial Resistance Surveillance Scheme (EARSS). Although this report focuses on data collected during 2004 and 2005, where possible, trend data over a longer period of time are also presented in order to put the most recent data into context.
References
1. HPA. Trends in Antimicrobial Resistance in England and Wales: 2004 to 2005. London: Health Protection Agency, 2006. Available at <http://www.hpa.org.uk/publications/PublicationDisplay.asp?PublicationID=65>.
Outbreak of pneumonia due to Streptococcus pneumoniae serotype 1 in a primary school in North Tyneside - an update
Since the previous report on the outbreak of pneumococcal pneumonia with three cases occurring between 10 and 13 October in a primary school in North Tyneside [1] two additional cases have been identified within the school. Both cases presented following the half-term break, with dates of onset of 15 and 20 November, with clinical features of acute lobar pneumonia confirmed by chest radiograph. Both were urinary antigen positive for Streptococcus pneumoniae and further typing at HPA Centre for Infections detected S. pneumoniae serotype 1, as in the previously reported cases. Neither required inpatient hospital treatment.
The children, aged four and five years old, are in a different reception class to the three previously reported cases. At the outset, both reception classes were considered as one cohort because of the degree of shared activity, and children in both classes were included as classroom contacts for the first three cases. Both additional cases had completed a course of rifampicin chemoprophylaxis (given in response to the first three cases) 18 and 23 days before the onset of lobar pneumonia.
With this evidence of ongoing transmission of infection amongst this cohort, further public health protection actions were recommended as a precautionary measure.
All 83 eligible (ie over 2 years of age) classroom and household contacts of cases were offered the 23-valent polysaccharide pneumococcal vaccine (PPV - Pneumovax II®), which includes serotype 1. In addition, throat swabs were obtained from all contacts and cases (n=89) to identify S. pneumoniae serotype 1 carriage, with a view to offering a further course of chemoprophylaxis to eradicate carriage. As there is no firm evidence-base, the chemoprophylaxis regimen was selected on the basis of antibiotic susceptibility, likely compliance, and the guidance for Group A streptococcal infections, ie a five-day course of azithromycin (12mg/kg/day - maximum 500mg) to carriers.
Out of 84 throat swabs submitted up to 19 December 2006, S. pneumoniae was identified in three individuals. Serotyping of these three isolates revealed serotype 1, serotype 19F and 23A. The individual with serotype 1 carriage has been given a course of azithromycin.
Of the 83 who were eligible for PPV, 70 have been vaccinated by 19 December. Two individuals did not consent and one had received PPV within the past two years. The others are awaiting vaccination.
Reference
1. HPA. Outbreak of pneumonia due to Streptococcus pneumoniae serotype 1 in a primary school in North Tyneside. Commun Dis Rep CDR Wkly [serial online]; 16 (47); news. Available at <http://www.hpa.org.uk/cdr/archives/2006/cdr4706.pdf>.
Hepatitis C in England - An Update 2006
The Health Protection Agency has recently published a report, Hepatitis C in England - An Update 2006, summarising current knowledge of the infection and the action being taken to tackle it [1]. The report shows that the number of people newly diagnosed with hepatitis C has increased; from 2,116 in 1996, to 7,580 in 2005. New figures also show that testing for hepatitis C has increased overall, for example, in GP surgeries', testing has increased by almost 60 per cent between 2002 and 2005.
Preliminary resultsfrom recent work to estimate the number of adults infected with hepatitis C suggest that, in 2003, around 231,000 were predicted to be anti-HCV positive . Many of these infected people do not realise they have the virus as it can take years or even decades for symptoms to appear. Early treatment, however, is effective at clearing the virus in the majority of people. It is therefore important that individuals at risk are tested by their GP or other health services.
The report also highlights the Department of Health's hepatitis C awareness campaign, FaCe It, which has now reached over 16 million people. The exhibition campaign visits cities across England and features large photographic portraits of people living with Hepatitis C.
References
1. Health Protection Agency. Hepatitis C in England - An Update 2006. London: HPA, 2006. Available at <http://www.hpa.org.uk/publications/PublicationDisplay.asp?PublicationID=66>
The Spongiform Encephalopathy Advisory Committee (SEAC) - vacancies for three expert members
The Spongiform Encephalopathy Advisory Committee (SEAC) has vacancies for three expert members: a clinical neurologist, a quantitative epidemiologist, and a public health expert. Members of SEAC are required to be independent and leading experts within their fields, and are selected for their personal knowledge and experience. These are public appointments, not employment, although meeting allowances, travelling expenses and subsistence allowances will be paid.
The Spongiform Encephalopathy Advisory Committee (SEAC) is appointed by Ministers and sponsored jointly by the Department for Environment, Food and Rural Affairs, the Department of Health and the Food Standards Agency. SEAC is an Advisory Non-Departmental Public Body whose role is to provide independent expert scientific advice to the Government on spongiform encephalopathy such as, Creutzfeldt-Jakob Disease, scrapie, and bovine spongiform encephalopathies. SEAC's remit is wide ranging, covering public health, food safety and animal health issues. SEAC is committed to making as much of its work open to public scrutiny as possible. More information is available at www.seac.gov.uk.
For an application pack, contact Public Appointments at Defra by email at publicappts@defra.gsi.gov.uk or by telephone on 01905 768841. The application forms are also available from <www.defra.gov.uk/corporate/appointments/index.htm>. The closing date for applications is 26 January 2007.
From communicable disease to health protection – the changing face of CDR Weekly
As our regular readers will know, this is the last issue of CDR Weekly . From January 2007, CDR will be superseded by a new publication, the Health Protection Report (HPR) Weekly, to reflect the full range of the Health Protection Agency's work. HPR Weekly will retain all the content currently available in CDR Weekly , with the addition of information on chemicals, radiation, and emergency planning. The layout of the HPR web pages will be similar to that of the current CDR and the Health Protection Agency website, so online readers should feel at home. Those who currently receive a pdf version of CDR in their email will automatically receive HPR.
The Communicable Disease Report first appeared on 6 May 1967, superseding the previous Weekly Summary which had been published since the wartime days of the Emergency Public Health Laboratory Service. The original CDR was a 'restricted' document and was only placed in the public domain in 1991. Over 500 issues were published from 1991 to 2000 before the transition to an online journal in January 2001, although a pdf version had been available since 1995 as part of the Open Government project. Since then, over 300 issues have been published covering the transition from the Public Health Laboratory Service to the Health Protection Agency. All these past issues will, of course, remain available in the present format and location, providing a valuable week-by-week record of communicable disease issues over the past 16 years.
The Health Protection Report will be with you on Friday 5 January at www.hpa.org.uk/hpr.
