Health Protection Update. Dr Girija Dabke

Transcription

1 Health Protection Update Dr Girija Dabke

2 2 Health Protection Update Scarlet fever

3 3 Health Protection Update Wessex

4 4 Health Protection Update Wessex- scarlet fever by age

5 Weekly count of sterile site igas isolates referred to national reference laboratory 5 Health Protection Update

6 Scarlet fever Streptococcus pyogenes or Group A streptococcus Widespread pink-red rash feels like sandpaper High temperature, flushed face, strawberry tongue Toxins cause the typical rash and swollen tongue Sore throat 90% cases<10 years Notifiable 6 Health Protection Update

7 Transmission and control Highly contagious- sneezing/ coughing/ direct contact with saliva or mucus. 10-day antibiotic course Without antibiotic- infectious up to 3 weeks Risk of invasive disease Chicken pox Guidelines for school/ nursery outbreaks 7 Health Protection Update

8 B. cereus in neonatal intensive care 22 neonates, 11 hospitals in England TPN produced by one manufacturer B. cereus isolated from confirmed cases and unused unopened TPN 8 Health Protection Update

9 Legionella and heated birthing pools Severely ill neonate with Legionnaire s disease. Home birth in a birthing pool Legionella isolated in pool samples. Patient safety alert by NHSE Risk Hired heated pools with circulation pumps, filled more than 24 hours before labour (anything up to 2 weeks) Reassure Hospital birthing pools, those hired/bought pools filled at time of onset of labour (without heaters/ pumps) 9 Health Protection Update

10 10 Health Protection Update Pertussis

11 11 Health Protection Update Pertussis

12 Pertussis Coverage -60%, Wessex 61% Key messages Infant cases of pertussis have been dramatically reduced by the introduction of the temporary maternal immunisation programme. However, the disease continues to circulate in older age groups. It is important for all health professionals to encourage vaccination in pregnant women from 28 weeks, at the earliest opportunity 12 Health Protection Update

13 MERS-CoV Middle-East Respiratory Syndrome Coronavirus. Case fatality rate 45% for primary cases, 9% secondary cases Camels reservoir? Increase in Jeddah- large hospital clusters. 2 cases of passengers travelling via Heathrow with MERS-CoV. 13 Health Protection Update

14 Immunisation HPV vaccination to be reduced from 3 to 2 doses from 1 September 14 Health Protection Update

15 Meningitis C 1 st June 2013: Schedule changed from (3,4,12 months) (3, 12) Previously, 3 Vaccines could be used for 3,4 months- Meningitec, Menjugate, NeisVac-C. Meningitec less immunogenic 15 Health Protection Update

16 TB TB cases and rates, UK, Health Protection Update

17 Non UK-born TB cases by time since entry to the UK to TB diagnosis, UK, Health Protection Update

18 TB Comparison of TB rates per 100,000 population of Western European cities and countries (2009) 18 Health Protection Update

19 19 Health Protection Update Number of TB cases in England vs USA,

20 Tuberculosis case reports and rates by PHE Centre, England, TB in the UK: 2013 report

21 TB Formal TB control boards- areas of high incidence or every community? Model service specification Monitoring indicators 73% cases non-uk born Non-UK born: 50% cases diagnosed within 5 years of entering Pilot in 15 countries. Long-term visas 101 countries with incidence >40/100, Health Protection Update

22 Cluster of TB in cats Cluster of 9 cats with TB infection (M. bovis), 2 households in Wessex involved. Evidence of cat-to-human transmission in this instnace: active TB developed in 1 contact who initially tested positive for latent TB infection. Second clinical case in another contact who had not accepted screening in the first instance. However: Only human cases of M. bovis are diagnosed each year in the UK, and follow up of cases has found the majority acquired their infection overseas or had other risk factors (PHE). Therefore, there is currently no evidence to suggest that transmission of M. bovis from cat to human is anything other than a rare event. 22 Health Protection Update

23 Research Small research projects fund: Once a year, winter Pipeline fund: To develop innovative public health solutions with the potential for commercialisation and delivery of significant return on investment. 23 Health Protection Update

24 24 Health Protection Update

25 Research Study of VTEC shedding duration in children using routinely collected data Key messages: Median duration shedding: 31 days (children< 6 years) exclusion: 39.5 days Secondary cases in 7% of facilities attended by infectious cases. Consider supervised return for prolonged asymptomatic shedders G. Dabke, A. Le Menach, A. Black, J. Gamblin, M. Palmer, N. BOXALL and L. Booth (2014). Duration of shedding of Verocytotoxin-producing Escherichia coli in children and risk of transmission in childcare facilities in England. Epidemiology and Infection, 142, pp Health Protection Update