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NHS Grampian Health Protection Team

News Highlights 

 

Seasonal influenza vaccination

The deputy Scottish chief medical officer (CMO) has urged those with heart conditions and other underlying health conditions to get their flu vaccination as early as possible to protect themselves from the winter virus. Statistics reveals that a third of hospitalised people with flu last winter had a heart condition, with the figure rising to half of those aged 45 or above, which has prompted the deputy CMO's call.

 The deputy CMO has urged those eligible to make the vaccination a priority as health professionals have warned that there is potential for this season's flu to be serious. Evidence suggests that heart attack occurs more often during or shortly after having an acute, inflammatory illness, such as flu, therefore, putting those with heart conditions at a greater risk of becoming more seriously ill.

This year, the flu vaccine will be offered to over 1.8 million people in Scotland, which includes those with heart disease. Also, people with other health conditions such as diabetes, asthma and bronchitis are being encouraged to book their appointment with their GP practice. The vaccine is also offered to the aged 65 and overs, pregnant women and healthcare workers.

 

E.coli 0157 outbreak update  

The multi-agency incident management team chaired by the health protection Scotland has been investigating an outbreak of the same strain of E. coli 0157. 20 confirmed cases of this strain have been identified. 11 of the cases have been confirmed to have received hospital care at some point during their illness and unfortunately, a child has died.

All confirmed cases became unwell prior to the end of July and as there are no new confirmed cases, the incident management team will now stand down and work towards producing its final report, which may take up to six month. 

Food standard Scotland and Lanarkshire council will now continue to work with food business operators.

People can become infected or unwell with E.coli 0157 infection after eating food or drinking water contaminated with the faeces of infected animals or from contact with the animals or their environment.  

Symptoms associated with E. coli 0157 can include stomach cramps, diarrhoea (often bloody), vomiting and occasionally fever. Anyone developing symptoms including bloody diarrhoea should contact their GP for advise.  

 Vulnerable groups including pregnant women, children and elderly should not take unpasteurized milk or diary products such as cheese made from unpasteurized milk because of the increased risk of food poisoning.

Advise on food safety and hygiene can be found on the food standard Scotland website .

Chair of the multi-agency incident management team said:

''our epidemiological investigations have identified Dunsyre blue cheese as the most likely cause of the outbreak. To date, IMT has established that 19 of the 22 confirmed cases had eaten blue cheese prior to becoming ill. Of these 15 are known to have eaten Dunsyre blue cheese while others cannot be certain about the brand of blue cheese they have consumed. Investigation are ongoing on the other cases.

The IMT has taken into consideration all information available to them and are optimistic that Dunsyre blue remains the most likely cause of the outbreak.  

The South Lanarkshire and the food standards Scotland carried out an investigation on behalf of the IMT, which has led to a number of cheese being taken for investigation. This has led to the identification of a number of different cheeses produced by Errington Cheese LTD containing organisms with the likelihood of causing serious illness including E.coli 0157 and toxin producing non-E.coli 0175.  

This has led the food standards Scotland to issue a food safety alert for the withdrawal of cheese produced by the company. People who have purchased cheese produced by Errington are strongly advised not to consume them and return them to where purchased. 

 

Zika virus infection 

Background 

Discovered opportunistically in Monkeys in Uganda. Zika virus (ZIKV) is a flavivirus, which relatively cause a mild disease. The virus is transmitted by mosquitoes of genus aedes, responsible for causing yellow fever and dengue fever. The first time zika virus was transmitted outside of Africa and Asia was in 2007 outbreak at the Yap Island, in the federated state of Micronesia. In 2013, a further outbreak was reported in the French Polynesia, which continued into 2014 and in which the first cases of possible perinatal transmission and Gullain-Barre syndrome (GBS) were reported. Further outbreak in the Pacific Island were reported in 2014 and 2015.

 In 2015, the first outbreaks were reported in the South and Central America. In May 2015, zika virus was then suspected and confirmed in the North East of Brazil. Other parts of Brazil soon report news of outbreaks and so did other countries within the region. Further cases were also reported from the Caribbean Islands.  

Countries/territories/areas are assigned into category of risk of zika virus transmission as determined by the data provided by ECDC. Since early 2015, ZIKV has been reported in twenty Brazilian states with estimates of cases ranging from 440,000 to 1.3million by late 2015. The cases with greater concern are reports of developmental defects including microcephaly among babies in Brazil. These cases were reported in the North East of Brazil where zika is prevalence and there is now strong evidence of causation between zika and neurodevelopmental defects, causing WHO to declare these defects as a public health emergency. 

Advice for the travelling public can be found the fit for travel website for countries/areas/territories with all categories of risk. 

Prevention 

There is no medicine or vaccine available that prevents ZIKV infection.  

The most effective way to avoid infection is to prevent mosquito bites by using insect repellents and wearing the appropriate clothing. 

Abstaining or using condoms to reduce the transmission of ZIKV infection during conception or pregnancy. 

 

HCV testing awareness campaign  

Individuals who may have been exposed to HCV via blood or blood products before September 1991, who are yet to be tested are offered the HCV (hepatitis c) testing.

The Scottish government commissioned a short-life working group to ascertain the number of living undiagnosed people with the recommendation of actions aimed at identifying them. A targeted awareness campaign was recommended by the group aimed at individuals who have had a blood transfusion before September 1991, encouraging them to come forward for testing. Anyone who had received a blood transfusion after September 1991 is not at risk as HCV testing was introduced after the time. 

Patients might be unaware they had received blood transfusion in cases of major surgery, severe accident or child birth complications. Highly effective HCV therapies are now available so anyone who might have been at risk of exposure is diagnosed quickly. In some people, HCV may only cause minor or no symptoms until later stages of the infection. Taking the blood test will put minds at rest and if positive, will enable treatment to start immediately.

Around 32 people, who are still alive have been estimated by the short-life working group, who had received blood transfusions in Scotland before September 1991 were infected and yet to be diagnosed. Even though the risk seems small, patients are encouraged to seek further advise should they have doubts. 

For further information, see hepatitis Scotland website at

www.hepatitisscotland.org.uk/penrose-inquiry-awareness-campaign