The UK risks the spread of antibiotic-resistant and other infectious diseases if it leaves the European Union’s (EU) early warning system after Brexit without an effective replacement, the Brexit Health Alliance has warned.
This briefing from the Brexit Health Alliance (BHA) and the Faculty of Public Health, a sets out how people across Europe currently benefit from the close collaboration between the UK and EU on public health, and proposes solutions to maintain and improve a high level of public health protection after the UK leaves the European Union.
The Alliance is calling for:
Both the EU Commission and UK government to prioritise the public’s health in negotiations on the future relationship between the UK and the EU.
A security partnership based on strong coordination between the UK and EU in dealing with serious cross-border health threats, such as pandemics, infectious diseases, safety of medicines (pharmacovigilance) and contamination of the food chain. Ideally, this would be by continuing access to the European Centre for Disease Prevention and Control and other relevant EU agencies, systems and databases.
Alignment with current and future EU regulatory and health and safety standards relating to (for example) food, medicines, transplant organs and the environment, to avoid the need for replication of inspections and non-tariff barriers at the UK/EU border.
The UK government to commit to a high level of human health protection when negotiating future free trade and investment agreements.
Laboratory confirmed cases of measles, mumps and rubella, England: January to March 2018 | Health Protection Report Volume 12 Number 19 | Public Health England
This latest Quarterly report, provides commentary on cases confirmed by Public Health England’s Virus Reference Department.
In England, 265 new measles infections were confirmed in the first quarter of 2018
compared to 149 in the period between October and December 2017
In this quarter there has been a relative increase in confirmed cases amongst adults with 42% confirmed cases in adults aged 20 years and above compared with 19% in the previous quarter. 11% confirmed cases occurred in infants under the age of 1; this is higher than the 7% reported in the previous quarter. The hospitalisation rate remains high at 36%, although lower than the previous quarter (45%).
Laboratory confirmed cases of measles by month of onset of rash/symptoms reported, London and England: January 2014 to March 2018
An increase in mumps activity in England was observed this quarter with 275 laboratory confirmed mumps infections compared to the 160 the previous quarter, in line with usual seasonal trends and similar to levels observed in quarter 1 of 2017
Mumps cases were reported in all regions of England predominantly in young
adults aged 15 to 24 years
Department of Health and Social Care, Innovate UK & Steven Brine | March 2018 | UK-China collaboration to tackle antimicrobial resistance
The Department of Health and Social Care (DHSC) will invest up to £10 million in UK businesses and academics who work in conjunction with Chinese scientists to advance work on antimicrobial resistance (AMR). The fund is to support the development and, where appropriate, clinical evaluation of new products or services, which must be of value in addressing the threat from AMR.
Innovate UK will deliver the funding to UK researchers (£750,000) and The Chinese Ministry of Science and Technology will invest up to 60 million Renminbi (RMB) to fund the project. Projects can last up to 3 years.
UK applicants must demonstrate that projects are primarily and directly relevant to the needs of people in low and middle income countries (LMICs), including China, as defined by the Organisation for Economic Co-operation and Development (OECD). There must be a clear economic and societal benefit to LMICs from their proposed project. The competition will open on 3 April 2018 (Innovation Funding Service)
Projects must address the specified criteria at DHSC here
Full details including eligibility criteria are available from DHSC
Laird K et al | 2018 | Domestic laundering of nurses’ uniforms: what are the risks? | Nursing Times | ePub | Vol. 114 | 2 | P. 18-21
Researchers at De Montfort University, Leicester reviewed the literature on domestic laundering of hospital uniforms. An earlier study (2015) also at De Montfort, which included 265 healthcare staff from across disciplines and in a range of roles (nurses, healthcare assistants, ward clerks, housekeepers, and physiotherapists) completed a questionnaire. It showed 43.7% laundered their uniforms below the 60°C recommended by the Department of Health; a third (33%) washed them at 40°C and 5% at 30°C. Around a quarter of the staff sampled also revealed that they wore their uniform for two or more shifts before washing it, longer than the recommended wash after every shift (via Nursing Times).
In a laboratory experiment, the scientists repeated the staff’s most common laundering practices (derived from the 2015 study), and assessed the survival of Staphylococcus aureus and Escherichia colion cotton and polyester fibres (Riley et al, 2017). The data showed that both bacteria were able to survive on polyester for up to seven days and on cotton for up to 21 days.
For the authors this raises the question of the storage of dirty uniforms at home, especially with regard to potential cross-contamination with surfaces in the home environment. They also experimented to find if cross-contamination occurred in the wash, including sterile samples with the uniforms. Washing at 40˚C did remove most micro-organisms, but the cells that were left were in excess of 1,000, and similar numbers had been transferred to the sterile items. This highlights the risk that other items of clothing in the home could become contaminated, or that domestically laundered uniforms could re-contaminate the home and/or healthcare environment.
NHS Improvement | Clostridium difficile infection objectives for NHS organisations in 2018/19, guidance on sanction implementation and notification of changes to case attribution definitions from 2019| March 2018
NHS Improvement have updated the objectives on Clostridium difficile infection (CDI). This document outlines the objectives for acute trusts and clinical commissioning groups to make continuous improvement in Clostridium difficile infection (CDI) care.
They objectives are updated every April. The updated objectives are available from NHS Improvement
Clostridium difficile infection assessment tool and action plan guidance can be accessed from NHS England
Background information to the CDI objectives can be read here
Antibiotic Research UK | Staff shortages could unleash superbug epidemic | March 2018
Antibiotic Research UK (ANTRUK) believe that the over-occupancy affecting hospitals across the country makes transmitting deadly bacteria easier. They also air concerns that a scarcity of nurses means staff will simply be too busy to notice the poor levels of cleanliness that encourage bugs thrive. ANTRUK is reminding patients and visitors to be vigilant and report incidents of improper cleaning to complaint bodies like Patient Advice and Liaison Service (PALS) (via ANTRUK).
Professor Colin Garner, Chief Executive of ANTRUK remarked that “we need the Government, medical research organisations, the pharmaceutical
industry and the public to work together to develop new but effective medications,
fast. And while we wait for that to happen, we must do everything in our power to
prevent the spread of bacterial infections – especially in our hospitals.”
The International Journal of Infectious Diseases has published a new article on environmental cleaning and disinfection of patient areas. The authors undertook a narrative review of the literature comprises hospital surfaces, other potential reservoirs of infection and the monitoring of cleaning. Their review also considers antimicrobial ‘self-cleaning’ surfaces, cleaning robots ‘touchless’ technologies and also discuss other interventions to improve manual cleaning. They also summarise the strategies for environmental cleaning and disinfection of patient areas in a table. For the researchers, human factors will ultimately determine the quality of environmental cleaning in the hospital and will remain the patient’s best defense against invisible threats from the hospital environment.
The healthcare setting is predisposed to harbor potential pathogens, which in turn can pose a great risk to patients. Routine cleaning of the patient environment is critical to reduce the risk of hospital-acquired infections. While many approaches to environmental cleaning exist, manual cleaning supplemented with ongoing assessment and feedback may be the most feasible for healthcare facilities with limited resources.
Full reference: Doll, M., Stevens, M., & Bearman, G. |Environmental cleaning and disinfection of patient areas | International Journal of Infectious Diseases |57| 2018 | P.52-57| Doi https://doi.org/10.1016/j.ijid.2017.10.014
The full article is available for NHS Athens users, it can be accessed here