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Volume 3 No 50; 18 December 2009

Reduction of healthcare-associated infections remains priority in the NHS



Reduction of healthcare-associated infections remains one of five national priorities in the recently-published National Health Service operating framework for 2010/11 [1]. The new policy document includes the announcement of two new developments for the control of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia and Clostridium difficile infections (CDI) during the 2010/11 period.

Although the NHS has achieved more than the 50% national reduction in MRSA bacteraemia the Department of Health set in November, 2004, some organisations have been less successful than others in achieving reductions.To sustain continuing progress and help all organisations apply a zero tolerance approach to healthcare-associated infections, the National Quality Board has developed a new objective for MRSA bacteraemia for 2010/11 [2]. This will require organisations with the highest rates to make the biggest reductions while also challenging the best performers to sustain their low rates and strive for further reductions where possible.

The Department of Health will also publish a new minimum standard for CDI in the spring of 2010 with a view to their implementation from April 2011 [1].


References

1. Department of Health. The NHS operating framework for England for 2010/11 (16 December 2009), Chapter 2. Priorities. Available at: www.dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/DH_110107.

2. Department of Health. "MRSA objective for 2010-11" (11 December 2009). Available at: www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/
DH_109951.

Pandemic influenza: UK situation at 17 December 2009



The Health Protection Agency's Weekly National Influenza Report of 17 December (week 51) [1] described the UK (and international) situation as follows:
  • Pandemic influenza activity is decreasing across the UK;
  • In week 50 (ending 13 December), the weekly influenza/influenza-like illness (ILI) consultation rate decreased to below baseline levels in all UK schemes (where set);
  • The National Pandemic Flu Service (NPFS) continued to issue antiviral drugs to people in England with the number of assessments and antiviral collections The number of assessments and antiviral collections have decreased over the past week;
  • Interpretation of data to produce estimates on the number of new cases continued to be subject to a considerable amount of uncertainty. HPA modelling gave an estimate of 9,000 (range 4,500 - 19,000) new cases in England in week 50. The estimated number of new cases decreased in all regions and age groups;
  • An increase in respiratory syncytial virus detections has been observed in recent weeks;
  • The main influenza virus circulating in the UK continued to be the pandemic (H1N1) 2009 strain, with few influenza H1 (non-pandemic), H3 and B viruses detected. Twenty-five of 4405 pandemic viruses tested have been confirmed to carry a mutation which confers resistance to the antiviral drug oseltamivir; three are phenotypically resistant to the drug but retain sensitivity to zanamivir;
  • The majority of pandemic influenza cases continued to be mild. The cumulative number of deaths reported due to pandemic (H1N1) 2009 in the UK was 296. There was a total of 1082 new patients hospitalised in England with suspected pandemic influenza in the week from 10 to 16 December. The weekly hospitalisation rates have decreased in all age groups;
  • The UK pandemic influenza vaccination programme continues for people at high risk of severe disease, health-care workers and healthy children aged between 6 months and 5 years. For further information see the Department of Health website;
  • According to the European Centre for Disease Prevention and Control, by 16 December, 11,188 deaths due to pandemic influenza had been reported globally.  According to the World Health Organisation (11 December), pandemic influenza activity has passed its peak in North America and in parts of western, northern, and eastern Europe, but is increasing in parts of central and south-eastern Europe. Transmission is still occurring in parts of Asia, is declining in tropical regions and pandemic influenza 2009 virus continues to be detected in Africa.

Reference

1. HPA. Weekly National Influenza Report: week 51 (17 December 2009, PDF 598 KB), HPA website: www.hpa.org.uk/swineflu/surveillance&epidemiology.