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Volume 4 No 28; 16 July 2010

Forecast impact of UK cervical cancer vaccination programme updated

A Health Protection Agency/University of Manchester/Manchester Royal Infirmary study has concluded that the cervical cancer vaccination programme launched in the UK in 2008 could prevent more cases of the disease than previously thought [1,2].

The study found that 73%-77% of cervical cancer cases in England were caused by either human papillomavirus (HPV) type 16 or type 18 (both of which are prevented by the current vaccine used in the UK) rather than 70%, as had been previously thought. This means that the immunisation programme could reduce the annual number of cases in England to less than 700 (rather than the previously estimated 1000) from the current number of cases, which is 3000.

The UK national programme, begun in September 2008, has delivered vaccination against HPV 16 and 18 to girls aged 12-13, largely through secondary schools [3]; there is also a catch-up campaign that offers the vaccine to 13-18 year old girls [4].

The new study, which was funded by the NHS Cervical Screening Programme, looked at what types of HPV were present in more than 6000 samples from women of different ages, and with different stages of cervical disease.

References.

1. Howell-Jones R, Bailey A, Beddows S, Sargent A, de Silva N, Wilson G, et al (2010), "Multi-site study of HPV type-specific prevalence in women with cervical cancer, intraepithelial neoplasia and normal cytology, in England", The British Journal of Cancer, vol 104, July 14; http://www.nature.com/bjc/journal/v103/n2/full/6605747a.html (subscription required).

2. "Study confirms vaccine could prevent more cases of cervical cancers than previously expected", HPA press release, 14 July 2010; http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1278944075093.

3. Roll-out of cervical cancer vaccination programmes in the United Kingdom. HPR 2(36): news. Available at:http://www.hpa.org.uk/hpr/archives/2008/news3608.htm#hpv.

4. Acceleration of HPV vaccination catch-up campaign; HPR 3(9): news. Available at: http://www.hpa.org.uk/hpr/archives/2009/news0609.htm#hpv.

MRSA bacteraemia and Clostridium difficile mandatory reports 2009/10

Meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia and Clostridium difficile infection data have been published (16 July, 2009) as part of the Department of Health's mandatory surveillance programme for healthcare-associated infection.

Newly published data include:
  • Annual (April 2009 to March 2010) counts and rates of MRSA bacteraemia by acute trust and by primary care organisation (PCO).
  • Annual (April 2009 to March 2010) counts and rates of Clostridium difficile infection (CDI) by acute trust and by PCO.

Summary points on MRSA bacteraemia (patients of all ages) [1]

Counts and rates of MRSA bacteraemia continue to fall across the NHS. Following on from epidemiological findings that highlighted the importance of distinguishing trust-apportioned cases from all other cases (eg present on admission, community-onset, etc) the HPA is publishing data on trust-apportioned cases which continues a series of analyses first published in December, 2009 in support of the MRSA Bacteraemia Objective [2].

Total reports

A total of 1,898 cases of MRSA bacteraemia were reported across the NHS between April 2009 and March 2010 (ie financial year 2009/10). This represents a 35% reduction on the 2,935 MRSA bacteraemia reports received in FY 2008/09.

Trust apportioned reports

There have also been sizable decreases in the number of trust-apportioned cases. Of the 1,898 cases reported in FY 2009/10, 1,003 (53%) are trust-apportioned. This represents a 38% reduction on the 1,606 trust-apportioned MRSA bacteraemia reports received in FY 2008/09. Over this time period the trust-apportioned rate has decreased from 4.3 to 2.7 cases per 100,000 bed days.

Summary points on Clostridium difficile infection (patients aged two years and over) [3]

Counts and rates of Clostridium difficile Infection (CDI) continue to fall across the NHS.

Total reports

A total of 25,604 cases of CDI occurring in patients aged two years and over were reported between April 2009 and March 2010 (FY 2009/10). This represents a reduction of 29% on the total number of cases of CDI reported in FY 2008/09 when 36,095 cases were reported and a 54% reduction on the 55,498 cases reported the year before (FY 2007/08).

Trust apportioned reports

There have also been sizable decreases in the number of trust-apportioned cases. Of the 25,604 cases reported in patients aged two years and over in FY 2009/10, 13,195 (52%) are trust-apportioned. This represents a 34% reduction on the 19,927 trust-apportioned CDI reports received in FY 2008/09 and a reduction of 61% on the 33,442 trust-apportioned cases reported in FY 2007/09. Between FY 2007/08 and FY 2009/10 the national trust-apportioned rate has decreased from 9.3 to 3.6 cases per 10,000 bed days.


Note

This publication forms part of the range Official Statistics outputs routinely produced by the HPA. Further detailed epidemiological analyses of both the MRSA bacteraemia and CDI data can be found in the quarterly epidemiological commentaries [4].

References

1. Financial year results from the mandatory surveillance of MRSA bacteraemia: July 2010. HPA website: Staphylococcus aureus > Mandatory Staphylococcus aureus bacteraemia surveillance scheme.

2 . MRSA Bacteraemia Objective. HPA website: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1259152379684.

3. Financial year results from the mandatory surveillance of Clostridium difficile Infection: July 2010. HPA website: Clostridium difficile > Epidemiological Data > Clostridium difficile Mandatory Surveillance > Results of the mandatory Clostridium difficile reporting scheme.

4. Trends in MRSA bacteraemia and Clostridium difficile infection data for England up to
January–March 2010: third quarterly commentary. HPR 4(24): news. Available at:http://www.hpa.org.uk/hpr/archives/2010/hpr2410.pdf.