HPS Weekly Report - Health Protection Scotland

1 HPS Weekly Report4 April 2017 Volume 51 No. 2017/13 ISSN 1753-4224 (Online)ContentsCurrent notesNeedle Exchange Surveillance Initiative (NESI) 2008-09 to 2015-16 102 SHPN Guidelines - management of tetanus, botulism or anthrax among PWID 102 Human papillomavirus - vaccination campaign impact 103 Quarterly data for CDI, ECB, SAB and SSI 104 NICPM - chapter 3 l aunch 104E. coli O157 outbreak 2016 - unpasteurised cheese 104 New rules for purchase and supply of vapour products 105 Regulation of cosmetic treatments / independent clinics 105 Environmental incidents - SEISS reports (chemical incident - Inveralmond Industrial Estate) 106 Current notesNeedle Exchange Surveillance Initiative (NESI) 2008-09 to 2015-1651/1301 The aim of the Needle Exchange Surveillance Initiative (NESI) is to measure and monitor the prevalence of blood-borne viruses and injecting risk behaviours among people who inject drugs (PWID)

2 In initiative was initially funded by the Scottish Government as part of the Hepatitis C Action Plan, which stated that efforts to prevent hepatitis C virus (HCV) in Scotland must focus on preventing transmission of the virus among PWID. More recently, however, the initiative has been funded under the auspices of the Scottish Government s Sexual Health and Blood Borne Virus Framework. NESI provides information to evaluate and better target interventions aimed at reducing the spread of infection amongst new Report published on 31 March presents the results, at the NHS board level, for the data collection period from February 2015 until March 2016, during which data were collected across the 11 mainland Scottish NHS boards.

3 These were Ayrshire and Arran, Borders, Dumfries and Galloway, Fife, Forth Valley, Grampian, Greater Glasgow and Clyde (GGC), Highland, Lanarkshire, Lothian, and Report (available at ) also presents the findings of the NESI survey, at Scotland -wide level, from 2008-09 until the most recent survey, Guidelines - management of tetanus, botulism or anthrax among PWID51/1302 On 23 March, the Scottish Health Protection Network (SHPN) published new Guidelines for the Public Health Management of Tetanus, Botulism or Anthrax Among People Who Use Drugs .103 HPS Weekly Report Volume 51 April 2017 The guidance is primarily targeted at those involved in the management of incidents involving the contamination of illegal drugs with spore forming bacteria in Scotland , including public Health professionals, frontline staff and police officers, and aims to i) eliminate or minimise the risk of, and consequences from, infection and ii) clarify the roles and responsibilities of the different organisations involved in the public Health response.

4 The guidance does not deal with the clinical management of the specific illnesses other than that required for the prevention of illness, post-exposure prophylaxis where focused on the three infections that are commonly encountered in an outbreak context, the principles of the approach can, also be applied to incidents of severe illness among PWID caused by other pathogenic spore forming bacteria which may have a significant Health impact ( Clostridium histolyticum, Clostridium perfringens, Clostridium sordellii and Clostridium novyi).The guidance including a quick reference guide is available at It has also been added to the Scottish Health Protection Information Resource (SHPIR) at papillomavirus - vaccination campaign impact51/1303 On 5 April, at the Microbiology Society s Annual Conference in Edinburgh, researchers will show that levels of cancer-causing human papillomavirus (HPV) in Scotland have dropped 90% in young women, following a vaccination campaign that began in 2008.

5 The researchers believe that this may itself lead to a 90% reduction in cervical cancer cases in Scottish is a sexually transmitted virus that is responsible for the majority of cervical cancer cases. Two genotypes of the virus - 16 and 18 - are themselves responsible for around 80% of cervical cancers in Scotland and 70% around the Health Protection Scotland team - led by Dr Kevin Pollock, Senior Epidemiologist - performed a longitudinal population study to measure the impact that HPV immunisation has had since its introduction in patients Community Health Index (CHI) numbers, the team could link anonymous results from women born in 1995 attending cervical screening with their vaccination records.

6 They could then assess the levels of HPV and the genotypes present. These results were then compared with women who were born between 1989 and 1990 who were unvaccinated. In total, the study included samples collected from over 20,000 women, making this one of the largest population-based studies to examine the impact of the clinically validated assay showed that only ~ of women from the 1995 group tested positive for HPV 16/18, compared with of women born before 1990. In addition, the study showed evidence that the vaccine also protects against three other high-risk HPV genotypes involved in the development of cervical cancer.

7 31, 33 and details of the conference are at 104 HPS Weekly Report Volume 51 April 2017 Quarterly data for CDI, ECB, SAB and SSI 51/1304 The commentary on quarterly epidemiological data on Clostridium difficile infection (CDI), Escherichia coli bacteraemia (ECB), Staphylococcus aureus bacteraemia (SAB), and Surgical Site Infection (SSI) in Scotland , October to December (Q4) 2016, was published on 4 April 2017 under the mandatory programmes for surveillance of CDI, ECB, SAB, and SSI in Scotland . This Report provides data for the fourth quarter of 2016 in 14 NHS boards and one NHS special Health board.

8 The Report and an appendix detailing all cases and denominator data for each NHS board and overall for Scotland can be accessed from NICPM - chapter 3 launch51/1305 On 3 April, Health Protection Scotland launched chapter 3 of the National Infection Prevention and Control Manual (NICPM - ) - Healthcare Infection, Incidents, Outbreaks and Data Exceedence . The new chapter, published along with revised appendices and resources to aid implementation, was developed by the National Policies, Guidance and Outbreaks Consensus Group and has been aligned to the SHPN Guidelines on the Management of Public Health Incidents guidance.

9 As with chapters 1 and 2, chapter 3 will be mandatory for NHSS cotland employees and applies to all healthcare Chief Nursing Officer and medical, dental and pharmaceutical colleagues have welcomed the new chapter as a significant contribution towards reducing the risk of HAI and aligning practice, monitoring, quality improvement and scrutiny. [Source: HPS News Release, 30 March 2017. ] E. coli O157 outbreak 2016 - unpasteurised cheese51/1306 On 29 March, Health Protection Scotland (HPS) published the Escherichia coli O157 outbreak Report on behalf of the Incident Management Team (IMT) which was established to investigate the national outbreak in summer Report confirms that a total of 26 cases of the same strain of E.

10 Coli O157 were identified in the outbreak between July and mid-September 2016. Seventeen of the cases required admission to hospital and a three year old child Report (available at ) was produced on behalf of the multi-agency Incident Management Team and has been approved by all team members. The Report describes the detailed epidemiological, microbiological, food and environmental investigations and concludes that Dunsyre Blue cheese was the source of this outbreak. It also presents lessons learned and recommendations for improvement. [Source: HPS News Release, 29 March 2017. ]Food Standards Scotland has commented on the Report at Weekly Report Volume 51 April 2017 New rules for purchase and supply of vapour products51/1307 From 1 April, new rules apply to the sale and purchase of tobacco and nicotine vapour products - known as NVPs or legislative changes mean that: it is illegal to sell NVPs to anyone under 18; it is illegal to buy NVPs for someone under 18; all retailers selling tobacco or NVPs will need to be registered; stores will need to have an age verification policy for sales of tobacco and NVPs.