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Volume 4 No 49; 10 December 2010

New meningitis vaccine deployed in sub-Saharan Africa

A new conjugated group A meningococcal vaccine was launched on 6 December in Ouagadougo, the capital of Burkina Faso in West Africa, marking the start of a campaign to immunise 20 million people between 1-29 years in Burkina Faso, Mali and Niger, three of the worst effected countries in Africa's notorious meningitis belt. The long-term aim is to immunise 300 million people in 25 African countries by 2015 [1].

For over a century, epidemics of group A Neisseria meningitidis have swept over the sub-Saharan Africa. Last year alone, more than 88,000 cases of group A meningococcal disease were reported along with approximately 5000 fatalities. In one of the worst recorded epidemics in 1996, there were 250,000 cases with 25,000 deaths.

The vaccine has been developed, evaluated and licensed by the Meningitis Vaccine Project (MVP), a partnership between the World Health Organization and the Programme for Appropriate Technology and Health (PATH). MVP has received support from the Bill and Melinda Gates Foundation which contributed approximately £44 million to the project. The vaccine is being produced by the Serum Institute of India for approximately 30 pence (UK sterling) per dose. The Health Protection Agency in England and the Centres for Disease Control and Prevention (CDC) in the United States are key partners and have completed the serological evaluation for vaccine licensure.

Reference

1. http://www.path.org/menafrivac.

Confirmed measles cases in England and Wales in 2010: update to end-October

The number of laboratory confirmed measles cases continued to fall in October for the third consecutive month. Only 23 cases with onset dates were reported in the period bringing the total in England and Wales for the year to the end of October to 349 cases. Sixteen of the October cases were associated with three distinct clusters within London involving one hospital [1] and two educational institutions. The other six cases were reported from the East of England (4) and the South East (2). Five cases had a recent history of travel to Sri Lanka (2), Pakistan , Ethiopia and Morocco .

Cases continue to occur predominantly in unvaccinated children under 18 years of age (70%). A detailed age breakdown of cases for 2010 to the end of September by region is available at http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1223019390211.

Number of confirmed cases of measles by region and month of onset, England and Wales: January to October 2010

Month/
Year

London

East Mids

Eastern

North East

North West

South East

South West

West Mids

Wales

York & Hum

Total

Total 2009

198

47

74

122

79

276

43

95

159

51

1144

Jan-10

–

–

–

–

–

–

–

–

–

–

–

Feb-10

–

–

2

–

–

3

–

–

–

–

5

Mar-10

1

–

2

–

–

3

2

–

–

–

8

Apr-10

6

–

2

–

5

3

1

–

3

–

20

May-10

22

2

13

1

5

10

1

–

2

1

57

Jun-10

2

–

13

1

10

5

1

–

–

3

35

Jul-10

13

4

10

–

11

43

–

9

–

10

100

Aug-10

8

1

6

5

7

27

–

4

3

10

72*

Sep-10

4

–

3

3

5

6

–

–

–

8

29
Oct-10

16

–

4

–

–

2

–

–

–

1

23

Total 2010

72

7

55

10

43

102

5

13

8

33

349*

* Includes one case with region not known.

 

Number of confirmed measles cases by month of onset, England and Wales: January 2006 to October 2010

Reference

1. HPA. Confirmed measles cases in England and Wales in 2010: update to end-September, Health Protection Report HPR [serial online] 2010 [cited 5 November 2010]; 4(44): news.
Available at http://www.hpa.org.uk/hpr/archives/2010/news4410.htm#msls.

National public health service for England to be launched by 2012

A government white paper, Healthy Lives, Healthy People: our strategy for public health in England, published by the Department of Health [1] in November, outlines a major re-organisation of state-funded public health activity in England, scheduled to be complete by April 2012, subject to the necessary primary legislation being passed.

Among the government's key proposals is devolving responsibility for leading many local public health activities to local government, including allocating ring-fenced budgets for public health to upper tier and unitary authorities. Directors of Public Health, currently based in PCTs, will move to local government. This devolution involves "radically shifting power to local communities, enabling them to improve health throughout people's lives, reduce inequalities and focus on the needs of the local population", the white paper says.

A new public health service - to be called Public Health England and be an integral part of the Department of Health [2] - will strengthen the national response, when appropriate, will have a new protected public health budget and will support local action through funding and the provision of evidence, data and professional leadership. The new service will lead health protection and will harness the efforts of the whole of government to improve the nation's health.

Directors of public health would be appointed (jointly with Public Health England) within local authorities with responsibility for achieving public health outcome goals specified in local "strategic needs assessments" drawn up by local authority health and well-being boards.

Public Health England would absorb the current functions of the Health Protection Agency.

The white paper contains considerable discussion of the health improvement "domain" of public health - ie "positively promoting the adoption of healthy lifestyles". It notes, for example, that two of the biggest threats to public health - obesity and diabetes - are amenable to lifestyle changes and states that nationally co-ordinated health improvement strategies on obesity, tobacco control and sexual health are to be the subject of further separate policy documents during the coming year. In addition more detailed proposals on pandemic flu preparedeness, health protection and emergency preparedness will be published, together with documents from other government departments addressing many of the wider determinants of health.

The changes are to be enshrined in a health and social care bill, due to be published later in 2011.

References

1. DH white paper, Healthy Lives, Healthy People: our vision for public health in England, 30 November 2010: http://www.dh.gov.uk/en/Publichealth/Healthyliveshealthypeople/index.htm .

2. Department of Health press release: http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_122249.