News Archives |
Volume 4 No 1; 8 January 2010
- Anthrax cases in IDUs in Scotland
- Confirmed measles cases in England and Wales: update to end-November 2009
- Pandemic (H1N1) 2009 influenza: UK situation at 8 January 2010
- Invitation for EPIET fellowship applications
Anthrax cases in IDUs in Scotland
The Chief Medical Officer for England has alerted health trusts to be aware of an outbreak of cases of anthrax among heroin injecting drug users (IDUs) in Scotland. Twelve cases have been confirmed to date, of which six have died [1]. The cases were initially confined to the Greater Glasgow and Clyde area but subsequently were also confirmed in the Tayside, Lanarkshire and Forth Valley areas. Investigations are continuing into the cause of these cases and into any heroin supply routes that may be affected [2].
While cases remain confined to Scotland, health trusts in England have been alerted to the possibility of injecting drug users presenting with severe soft tissue infections or sepsis at their GPs or at A&E departments. In such cases, the CMO alert advises that a local microbiologist should be contacted for advice on management and investigation. Other services dealing with drug misusers should refer any IDUs with the above symptoms to an A&E department, or to a GP, for urgent assessment and management.
The HPA has produced an algorithm for the clinical evaluation and management of injecting drug users presenting with infections for which anthrax should be considered as a cause, outlining actions to be taken, and has provided advice for drug users at risk [3].
References
1. Chief Medical Officer for England. Rise in cases of antrax infections in heroin injecting drug users, 7 January 2009, CEM/CMO/2009/35, London: Department of Health, Available at:
https://www.cas.dh.gov.uk/ViewAndAcknowledgment/viewAlert.aspx?AlertID=101329.
2. Health Protection Scotland. "Anthrax cases involving injecting drug use - update", HPS eWeekly Report Newsletter 44(1), 7 January 2010, http://www.hps.scot.nhs.uk/ewr/index.aspx.
3. HPA website. Home >Topics >Infectious Diseases >Infections A-Z >Anthrax >Guidelines, http://www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1191942145757.
Confirmed measles cases in England and Wales: update to end-November 2009
Only two cases of laboratory confirmed measles within onset dates in November were reported bringing the cumulative total for 2009 to the end of November to 1,143. One of the cases was identified in the Yorkshire and Humber region and had a history of recent travel to Pakistan. The second case was from Wales where measles has been detected intermittently since March.
Despite this low level, it is important to continuing monitoring measles activity and prompt notification and testing of cases is essential.
Confirmed cases of measles by region and month of onset, England and Wales: January to November 2009Month |
Lond-on |
East Mids |
East of Engl'd |
North East |
North West |
South East |
South West |
West Mids |
Wales |
York & Humb |
Total |
Jan 09 |
38 |
8 |
6 |
1 |
8 |
21 |
3 |
13 |
- |
7 |
105 |
Feb 09 |
41 |
- |
3 |
- |
3 |
54 |
1 |
22 |
- |
5 |
129 |
Mar 09 |
20 |
3 |
7 |
2 |
28 |
49 |
3 |
13 |
21 |
3 |
149 |
Apr 09 |
22 |
7 |
12 |
50 |
23 |
61 |
12 |
24 |
40 |
1 |
252 |
May 09 |
26 |
13 |
24 |
43 |
11 |
50 |
10 |
18 |
47 |
15 |
257 |
Jun 09 |
30 |
10 |
20 |
16 |
4 |
34 |
10 |
4 |
29 |
4 |
161 |
July 09 |
15 |
6 |
- |
3 |
- |
5 |
- |
- |
13 |
5 |
47 |
Aug 09 |
4 |
- |
2 |
6 |
1 |
- |
1 |
- |
5 |
7 |
26 |
| Sept 09 | 2 |
- |
- |
1 |
1 |
1 |
1 |
- |
1 |
3 |
10 |
| Oct 09 | - |
- |
- |
- |
- |
- |
2 |
1 |
2 |
- |
5 |
Nov 09 |
- |
- |
- |
- |
- |
- |
- |
- |
1 |
1 |
2 |
| Total 2009 | 198 |
47 |
74 |
122 |
79 |
275 |
43 |
95 |
159 |
51 |
1143 |
The two cases with onset dates in November were both unvaccinated infants under two years of age.
A regional breakdown of cases by age is available at: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1223019390211.
Pandemic (H1N1) 2009 influenza: UK situation at 8 January 2009
The Health Protection Agency's Weekly National Influenza Report of 8 January (week 53) [1] described the UK (and international) situation as follows:
- Pandemic influenza activity is decreasing across the UK;
- In week 53 (ending 3 January), the weekly influenza/influenza-like illness (ILI) consultation rate decreased in England and Scotland and increased slightly in Northern Ireland and Wales;
- 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 remained stable over the past two weeks;
- The increase in respiratory syncytial virus detections observed in recent weeks has slowed and may be declining;
- 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. Thirty-three of 4,640 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 355. There was a total of 584 new patients hospitalised in England with suspected pandemic influenza in the week from 31 December to 6 January. The weekly hospitalisation rates have decreased in most 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 5 January, 13,324 deaths due to pandemic influenza had been reported globally. According to the World Health Organisation (30 December), pandemic influenza transmission continues in many parts of the world although it is declining and has passed its peak except in some focal areas.
Reference
1. HPA. Weekly National Influenza Report: week 53 (8 January 2010, PDF 366 KB), HPA website: www.hpa.org.uk/swineflu/surveillance&epidemiology.
Invitation for EPIET fellowship applications
The European Programme for Intervention Epidemiology Training (EPIET), which provides training and practical experience in intervention epidemiology at national communicable disease centres in the European Union (EU), has issued a call for grants for a 16th cohort of fellowships [1]. The deadline for applications is February 7, 2010. More information on the fellowship scheme is available at www.epiet.org.
Reference
1. ECDC website: http://ecdc.europa.eu/en/aboutus/jobs/Pages/Fellowships.aspx.