Public Heath Scotland (PHS) is investigating the cause of a small number of cases of hepatitis (liver inflammation) in young children across the central belt of Scotland.
We are aware of 11 cases of hepatitis requiring admission to hospital that have been identified in children aged between 1 and 5 years old in four NHS Health Board areas in Scotland (Lanarkshire, Tayside, GGC and Fife). Most cases have presented from March. The hepatitis viruses commonly associated with this condition have been excluded.
Each year around 7 or 8 cases of non A to E hepatitis (without other underlying diagnoses) are detected in children in Scotland. The number of cases in such a short period of time, combined with the geographical spread and severity of illness, in some cases, is unusual and requires further investigation.
As yet, there is no clear connection between the cases.
At present, there is no clear cause. All potential causes are being explored but infection is considered to be a more probable source this time.
Investigations are still in the early stages and work is ongoing with partners and other agencies across the UK to investigate these cases.
Dr Nicholas Phin, Director of Public Health for Public Health Scotland said: “If you have a child who is showing signs of jaundice, where the skin has a yellow tinge and is most easily seen in the whites of the eyes, then parents should contact their GP or other Health Care professional.
“We are continuing to investigate these cases and will provide further updates as and when they are available.”
A study published yesterday by Public Health Scotland (PHS) examined the extent to which people might be travelling outside Scotland to purchase alcohol at a lower price, since the introduction of Minimum Unit Pricing in Scotland.
The findings indicate that minimal cross-border purchasing occurs, and this is unlikely to be happening on a scale that would significantly affect alcohol consumption at a population level or impact the intended outcomes and aims of MUP.
Interviews with retailers indicated that households in close proximity to the border made most use of cross-border purchasing, reflecting established shopping habits. None of the retailers had knowledge of people from Scotland appearing to travel to England to buy large quantities of alcohol. Analysis shows that substantial bulk purchasing would be needed for individuals to make significant savings whether purchasing in-person or online, once travel and delivery costs are taken into account.
The research also shows that licensing near the border did not display a shift from Scotland to England following the introduction of MUP legislation. Analysis of off-trade alcohol sales data in the combined areas of North East and North West England in the 12 months following implementation of MUP showed a small increase (1.14%).
When a panel of over 1,000 Scottish adults was asked whether they have travelled to another part of the UK for the sole purpose of buying alcohol only 3% responded that they had done so.
Helen Chung Patterson, Public Health Intelligence Adviser at Public Health Scotland said: “The research published today shows that while cross-border purchasing does happen, the extent is small relative to the purchasing behaviours of Scotland’s population as a whole.
“A key strength of this report is that it enables us to build up a picture of cross-border alcohol-purchasing behaviours from several perspectives. We have examined data on retail sales and alcohol licencing near the border, drawn on qualitative interviews with retailers, gathered customer survey data and explored the factors affecting in-person and online cross-border purchases. When several different methods produce broadly similar results, as is the case with the report published today, this increases confidence in the findings.”
Further evidence may arise on cross-border purchasing at a later date (both from within and out-with Public Health Scotland’s portfolio on MUP evaluation), for example as part of the study on Drinking at Harmful Levels, which is due to be published by PHS later this year.
Public Health Scotland (PHS) has published an analysis of the latest available data on alcohol sales and harms in Scotland during the COVID-19 pandemic. This provides a picture of how the pandemic and its related restrictions may have impacted on alcohol sales, alcohol-related hospital stays and alcohol-specific deaths.
Presenting data on alcohol sales up to 8 May 2021, and previously published data on hospital stays up to 31 March 2021 and deaths up to 31 December 2020, the report shows that while rates of hospital stay related to alcohol fell, rates of alcohol-specific death increased. This was driven by an increase in deaths in men and those aged 45 to 64 years, groups that experienced the highest rates of deaths caused by alcohol prior to the pandemic.
This is despite total alcohol sales (litres of pure alcohol per adult) being 9% lower in 2020 than the 2017-19 annual average, and 16% lower in 2021 (January–May) than the average for January–May 2017-19. While sales of alcohol through supermarkets and shops (off-trade) increased during the pandemic, sales through pubs, clubs and restaurants (on-trade) decreased substantially due to the restrictions imposed because of the pandemic.
This, combined with other evidence of how alcohol consumption may have changed during the pandemic, suggests that drinking at hazardous and harmful levels may have increased for some groups who potentially experienced higher rates of mortality as a consequence.
Lucie Giles, Public Health Intelligence Principal at Public Health Scotland said:“The data show that the number of people accessing hospital with an alcohol-related diagnosis fell during the pandemic, particularly at times when restrictions were at their most stringent.
“We saw the greatest reductions amongst men and those aged 45 years and over and it was in these same groups that we saw increases in deaths caused by alcohol. This was despite average alcohol consumption for the population falling, a change driven by a reduction in sales of alcohol through pubs and clubs.
“Despite the reduction in sales overall the data indicate that population level consumption of alcohol was still above recommended levels. Between March 2020 and May 2021, 17 units (171 ml) of pure alcohol have been sold per adult each week on average, 16 (162 ml) of which have been from off-trade premises. This represents enough alcohol to put every adult in Scotland over the Chief Medical Officer’s low-risk weekly drinking guideline of 14 units.
“Taken together, the evidence points to increased drinking amongst some groups, coupled with a reduction in the number of people accessing hospital treatment and greater rates of death caused by alcohol. Tackling alcohol consumption and harms, particularly among high-risk groups, should be a critical objective of any COVID-19 recovery plans.”
Matt Lambert, CEO of the Portman Group– the alcohol social responsibility body and marketing regulator – said: “Public Health Scotland’s latest data reaffirms a body of research that shows overall alcohol consumption fell during 2020.
“Yet in contrast alcohol-related deaths tragically increased which may in part be due to the heaviest drinkers finding it harder to access support. There is a duty of care to now focus on targeted measures for the minority, those who were already drinking at the heaviest and most harmful rates, who then increased their drinking as the impact of the pandemic compounded existing problems.
“Finally, we would be interested to understand why this report focuses on alcohol sales while downplaying the Scottish Government’s own studies on actual alcohol consumption that shows a persistent fall in drinking rates for over a decade.
“With the majority of people in Scotland drinking an average of 12.1 units a week, below the CMO low risk guidelines of 14 units per week, it is important to view drinking rates accurately and address this within policy making.”
Alcohol sales and harm in Scotland during the COVID-19 pandemic
Children in Lothian at risk from COVID-19, along with children living with an immunosuppressed person, are now eligible to get a COVID-19 vaccination.
Launched yesterday, dedicated clinics especially designed for to cater for children will operate across the region. They will be open between 8.30am – 4.30pm, seven days a week, for pre-booked appointments only.
Jane McNulty, Director of Nursing for Primary and Community Care, NHS Lothian, said: “We are delighted to offer these clinics to the youngest people in our community.
“These clinics will be operated by specially trained paediatric vaccinators in a clinical environment, which will allow children, parents and guardians to discuss the vaccination process in a calm environment.”
The vaccination will first be offered to children with a higher COVID-19 risk factor and children living in the household of an immunosuppressed person, it will then be offered to the wider child population in due course.
Those eligible for the vaccination will receive a letter from NHS Lothian in the coming days with details about how to book an appointment through the National Vaccination Helpline. Parents and guardian do not need to actively contact NHS Lothian to arrange an appointment.
The clinics are opening their doors following the publication and government acceptance of the advice of the UK’s four Chief Medical Officers (CMOs) to offer two doses of the Pfizer childhood COVID-19 vaccine.
All children will receive two doses eight weeks apart. A third primary dose is also being offered to children aged 5-11 years with a severely weakened immune system. The third primary dose will be offered from 8 weeks after the second dose.
Ms McNulty added: “We recognise that parents and guardians may have questions regarding the COVID-19 vaccination and we encourage them to visit the pages on NHS Inform where there is a range of information available.
“Alongside this, our paediatric vaccinators are one hand to answer any questions people may have when they attend their child’s vaccination appointment.
“Vaccination remains critically important in the continued fight against COVID-19 and we welcome the further expansion of the vaccination programme across Lothian.”
Established vaccination clinics for over 12s will continue to operate separately from these clinics, with NHS Lothian still encouraging all over 12s to get any outstanding vaccinations.
Over 18s can receive their 1st, 2nd and booster vaccinations at all drop-in clinics. Those aged 12-17 can also attend for their second dose if it has been at least 12 weeks since their first dose and they have not tested positive for COVID-19 in the past 12 weeks.
More information on the 5-11 vaccination programme is available on NHS Inform:
Responding to Public Health Scotland’s latest stroke statistics, John Watson, Associate Director Scotland of the Stroke Association, said: “The latest stroke figures reinforce what the Stroke Association has repeatedly said – that stroke has a huge impact on the health and social care landscape in Scotland, and those who live in the poorest parts of our country are the most adveresly affected.
“The health and social burden of stroke falls most heavily on certain groups. The death rate for cerebrovascular disease in the most deprived areas in 2020 was 43% higher than in our least deprived areas.
“Stroke remains Scotland’s fourth biggest killer. More than 128 000 Scots are living with the effects of their stroke. The need for improvements in stroke prevention, treatment and care is urgent and recognised by the Scottish Government.
“We await the imminent publication of the Scottish Government’s vision report outlining a new progressive stroke service for Scotland.
“We then expect a Stroke Action Plan to follow that quickly – outlining how the vision is to be delivered in Health Boards and communities across Scotland.”
Since opening on the 1st April 2020, PHS has played a significant part in the country’s response to the COVID-19 pandemic, working in collaboration with NHS Boards, the Scottish Government, Local Authorities and many others to tackle the virus, improve and protect health, and reduce health inequalities.
Public Health Scotland, Chief Executive, Angela Leitch, said:“The publication of this, our first, Annual Report, records what has been a year of great challenge and significant achievement.
“I would like to thank all PHS staff for their professionalism and commitment during this extraordinary year. In addition to our contribution to managing the response to the pandemic we have continued to produce a wealth of data, intelligence and evidence that is supporting decision making to address the public health priorities we have in Scotland.
“Our work relies on strong partnerships with many organisations across Scotland, the UK and beyond and I look forward to building on the strong foundation that has been established in our first year.
“I’m very conscious of the impact of the pandemic on the lives of so many of our communities and we remain committed to doing our part in keeping Scotland as safe as possible.
“I commend this report to you and as we move forward into the future we remain committed to our key aims of helping to create a fairer and more equitable Scotland for all of our citizens.”
Given the number of COVID-19 outbreaks that are being linked to Christmas parties, particularly those caused by Omicron, Public Health Scotland (PHS) is URGING PEOPLE TO DEFER SUCH PARTIES AT THIS TIME.
Dr Nick Phin, Director of Public Health Science and Medical Director, PHS explains: “There is much that we still need to learn about Omicron, but early evidence suggests that this new Covid variant is much more transmissible.
“The impact of this transmissibility has been seen in recent weeks, with a number of Omicron outbreaks linked to parties.
“We still need to learn more about the severity of disease caused by Omicron and the effectiveness of vaccines, but there are important things that we can do to help protect ourselves and our families now. To help minimise the further spread of Covid-19, and Omicron in particular, I would strongly urge people to defer their Christmas parties to another time.
“I appreciate that everyone is keen to celebrate this festive season, particularly after the pressures of the last twenty months, but by postponing some plans we can all do our bit to protect ourselves and our loved ones.”
A reminder of the other measures we can all take to continue to keep safe over the festive period:
Please get your vaccine and your booster when your turn comes.
Please test at least twice weekly using LFDs and take a test each time you are socialising with people out with your household.
Reduce the number of people you catch up with. Try to meet outdoors; if indoors, ensure ventilation is good.
Keep up the other public health measures: wash your hands, clean surfaces, maintain distances and of course wear a face covering in public spaces.
It’s understood First Minister Nicola Sturgeon will give a Coronavirus update tomorrow (Friday).
Flu is very infectious and can be serious. Flu can lead to complications that may result in hospitalisation or even death.
The flu vaccine will reduce the risk of your child getting or spreading flu to friends and family who are at greater risk from flu and coronavirus, such as grandparents or people with health conditions.
The flu vaccine provides both individual protection for the child and reduces transmission across all age groups.
Getting the flu vaccine will help prevent the flu virus putting extra strain on our NHS services this winter.
Every year in Scotland, children are hospitalised for the treatment of flu or its complications.
In some cases flu can lead to complications. These can include:
bronchitis
pneumonia
painful middle-ear infection
vomiting
diarrhoea
For children with health conditions getting flu can be even more serious. Health conditions that make children more vulnerable include:
asthma
bronchitis
heart disease
kidney disease
liver disease
neurological disease
diabetes
immunosuppression
asplenia or dysfunction of the spleen
Childhood vaccinations are very important. Please bring your child to their vaccination appointment to protect them and others against flu.
If you think you or your child are showing symptoms of coronavirus call the number on your invitation to rearrange your appointment.
From September 2021 all primary and secondary school pupils in Scotland will be offered the flu vaccine.
How will my child get the vaccine?
The child flu vaccine is normally given at school between September and December.
If your child misses their vaccination in school, please contact your local NHS Board to find out about local arrangements for getting their vaccine at another time.
Home-schooled children are also eligible for the flu vaccine. Your local health board will contact you directly to offer vaccination.
Children aged 6 months to less than 2 years of age with an eligible health condition will also be offered the flu vaccine. Your local health board or GP practice will invite you by letter to get your child’s flu vaccine.
Primary and secondary school-aged children (including those with eligible health conditions) will be offered the vaccine at school.
If a young person has left secondary school, they are not eligible to get a flu vaccine at school. 16 and 17 year olds with an eligible health condition who have left school can phone 0800 030 8013 to receive an appointment for the flu vaccine.
If you don’t know the phone number for your local health board, you can phone 0800 030 8013.
What vaccine is used?
Children aged 2 years and older are given the flu vaccine as a nasal (nose) spray into each nostril. It is quick and painless and is the best available protection against flu.
Your child does not have to sniff or inhale the vaccine and will just feel a tickle in their nose.
The flu vaccine is the safest, most effective protection against flu.
All medicines, including vaccines, are tested for safety and efficacy before they’re allowed to be used.
Once they’re in use, the safety of vaccines continues to be monitored by the Medicines and Healthcare products Regulatory Agency (MHRA).
The nasal spray flu vaccine has been used safely since 2014 and millions of doses of the vaccine have been given to children in the UK
The virus in the vaccine has been weakened so it doesn’t cause flu. It helps your child build up immunity to flu.
Children who don’t get the vaccine are not at risk of catching flu from children who have had the vaccine. The only exception to this would be children who are extremely immunocompromised (have a weakened immune system).
How effective is the vaccine?
The annual vaccine offers protection against the most common types of flu virus that are around each winter. The flu vaccine should start to protect most children about 10 to 14 days after they receive their vaccination.
Over the last few years the flu vaccine has worked very well, providing protection against flu. It has also reduced the chance of spreading flu into the wider community.
There is still a chance that your child could get flu after having the vaccine. If they do get flu after vaccination, it is likely to be milder and not last as long.
Children who can’t have the nasal spray vaccine
An alternative injectable form of the vaccine is available for children who cannot have the nasal spray vaccine.
This includes children who:
have their immune system suppressed because they’re getting treatment for serious conditions, such as cancer, or if they’ve had a transplant
have a serious condition which affects the immune system, such as severe primary immunodeficiency
live with or are in close regular contact with very severely immunocompromised people who require isolation
are taking regular high doses of oral steroids
have had a severe reaction to a previous dose of the vaccine
are undergoing salicylate treatment (for example, taking aspirin)
Children with egg allergies
Children with an egg allergy can safely have the nasal spray vaccine, unless they’ve had a life-threatening reaction to eggs that required intensive care.
An egg-free injectable vaccine which can be used in those from 2 years of age is available. If you’re affected, please speak to your immunisation nurse for advice.
Children with severe asthma
The nasal spray vaccine may not be suitable for some children with severe asthma who regularly need oral steroids for asthma control. If you’re affected, please speak to your health professional for advice.
Children on medications
If your child is at school, please make sure you list all of your child’s medications on the consent form. All consent forms will be checked by a health or immunisation team member before the immunisation session to make sure your child can have the nasal spray.
Pork gelatine
The nasal spray vaccine contains a highly processed form of gelatine (pork gelatine) which is used in many essential medicines.
The gelatine helps keep the vaccine viruses stable so the vaccine provides the best protection against flu.
Many faith groups, including Muslim and Jewish communities, have approved the use of vaccines containing gelatine.
However, it’s your choice whether or not you want your child to get the nasal spray vaccine.
The nasal spray vaccine is a much more effective vaccine than the injected flu vaccine and is the preferred option.
If you do not want your child to get the nasal spray vaccine for religious reasons, you may request the injectable alternative by ticking the box on the consent form (your child won’t automatically be offered the injectable alternative, you’ll need to tick the box every year).