Public Health Scotland – Page 5 – The NEN

Monkeypox: First case in Scotland

Monkeypox has been confirmed in an individual in Scotland. The individual is receiving care and treatment appropriate to their condition and contact tracing is underway.

Monkeypox is a viral infection usually found in West and Central Africa. The West African strain that has been recently detected in the UK is generally a mild self-limiting illness, spread by very close contact with someone already infected and with symptoms of monkeypox. Most people recover within a few weeks.

Public Health Scotland (PHS) is working with the UK Health Security Agency (UKHSA), Public Health Wales and Northern Ireland HSC Health Protection Agency to monitor and respond to potential and confirmed cases of monkeypox in the UK.

As of Friday 20 May, the UKHSA has identified 20 cases in England but more are expected.

Dr Nick Phin, Director of Public Health Science and Medical Director, PHS explains: “Public Health Scotland is aware of an individual in Scotland who is confirmed to have monkeypox. The affected individual is being managed and treated in line with nationally agreed protocols and guidance.

“We have well established and robust infection control procedures for dealing with such cases of infectious disease and these will be strictly followed.

“We are working with NHS Boards and wider partners in Scotland and the UK to investigate the source of this infection. Close contacts of the case are being identified and provided with health information and advice. This may include the offer of vaccination.

“The overall risk to the general public is low.

“Anyone with an unusual blister-like rash or small number of blister-like sores on any part of their body, including their genital area, should avoid close contact with others and seek medical advice if they have any concerns.”

Symptoms

Initial symptoms of monkey pox include fever or high temperature, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.

A blister-like rash or small number of blister-like sores can develop, often beginning on the face, then spreading to other parts of the body, including the genital area.

The rash changes and goes through different stages, before finally forming a scab, which typically falls off over the course of a couple of weeks. Individuals are infectious from the point symptoms start until all the scabs fall off. During this time close contact with others must be avoided.

UKHSA identifies thirty-six more cases of monkeypox in England

The UK Health Security Agency (UKHSA) has detected 36 additional cases of monkeypox in England.

The latest cases bring the total number of monkeypox cases confirmed in England since 7 May to 56.

The virus does not usually spread easily between people, but it can be passed on through close person-to-person contact or contact with items used by a person who has monkeypox, such as clothes, bedding or utensils. Monkeypox is usually a self-limiting illness and most people recover within a few weeks.

While the current outbreak is significant and concerning, the risk to the UK population remains low.

Anyone with unusual rashes or lesions on any part of their body, especially their genitalia, should immediately contact NHS 111 or their local sexual health service.

A notable proportion of cases detected have been in gay and bisexual men, so UKHSA continues to urge this community to be alert to monkeypox symptoms.

People should notify clinics ahead of their visit and can be assured their call or discussion will be treated sensitively and confidentially.

Dr Susan Hopkins, Chief Medical Adviser, UKHSA, said: Alongside reports of further cases being identified in other countries globally, we continue to identify additional cases in the UK. Thank you to everyone who has come forward for testing already and supported our contact tracing efforts – you are helping us limit the spread of this infection in the UK.

“Because the virus spreads through close contact, we are urging everyone to be aware of any unusual rashes or lesions and to contact a sexual health service if they have any symptoms.

“A notable proportion of recent cases in the UK and Europe have been found in gay and bisexual men so we are particularly encouraging these men to be alert to the symptoms.”

UKHSA health protection teams are contacting people considered to be high-risk contacts of confirmed cases and are advising those who have been risk assessed and remain well to isolate at home for up to 21 days.

In addition, UKHSA has purchased supplies of a safe smallpox vaccine (called Imvanex) and this is being offered to identified close contacts of someone diagnosed with monkeypox to reduce the risk of symptomatic infection and severe illness.

We continue to engage with partners across the sector to ensure people are aware of the signs and symptoms and what action to take.

The vaccination of high-risk contacts of cases is underway. As of 10am on 23 May 2022, over 1,000 doses of Imvanex have been issued, or are in the process of being issued, to NHS Trusts. There remain over 3,500 doses of Imvanex in the UK.

HPV: Get Protected!

NHS Lothian’s Community Vaccination Team has administered an incredible 5,200 HPV vaccinations in schools across Edinburgh and the Lothians this past month, even with a break over the Easter holidays.

Cervical cancer is the most common cancer in women under 35 and HPV is the main cause. A 2018 Scottish study showed that the vaccine has reduced pre-cancerous cervical disease in 20-year-old women by up to 71%.

The prevalence of certain HPV types in 16- to 18-year-old women in England, who were offered vaccination at 12 to 13, was found to have reduced from 15% before the vaccination programme to less than 2% in 2018.

The vaccination also provides vital protection against genital warts and anogenital cancers in both boys and girls. Consent forms were provided to schools earlier this year. Consent is provided for the vaccination course and, once given, covers your child for both doses.

The team began vaccinating at the beginning of April and this year’s programme runs until the end of June. If your child’s form was misplaced or lost, you can contact the school’s office to get another.

If your child has any questions or concerns, they are encouraged to speak to our vaccinators.

More info can also be found here http://ow.ly/t3VW50Iy0bu

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World Immunisation Week

Immunisation helps protect your child from serious diseases.

It’s very important to go to their appointments as planned. Do not delay in getting your baby immunised.

To find out more visit

http://ow.ly/WnI950IPEnj

#WorldImmunisationWeek

Vaccines offered in the Scottish Immunisation Programme are free of charge.

When everyone takes up their offer of vaccination, everyone in the community has a better chance of living long, healthy lives.

Find out about the immunisations offered in Scotland at NHS Inform

http://ow.ly/ZAun50IPEO5

#WorldImmunisationWeek

Cases of non A to E Hepatitis

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.”

Cross-border purchasing unlikely to affect alcohol consumption

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.

Alcohol sales and harm in Scotland during the COVID pandemic

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

Read the report: Alcohol sales and harm in Scotland during the COVID-19 pandemic

NHS Lothian launches vaccination clinics for 5-11-year-old children

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:

https://www.nhsinform.scot/covid-19-vaccine/the-vaccines/vaccinating-children-aged-5-to-11-years/

Information on clinic locations and opening times for over 12s is also available on NHS Lothian’s website:

https://www.nhslothian.scot/Coronavirus/Vaccine/Pages/Drop-in-Clinics.aspx

Public Health Scotland publishes First Annual Report

Public Health Scotland (PHS) has published its first Annual Report and Accounts.

Since opening on the 1^st 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.”

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Omicron: Boosting Protection

COVID-19 Vaccine Boosters are being prioritised over the flu vaccine to help protect as many people from coronavirus as quickly as possible.

If you are eligible for the flu vaccine, you may not receive it until the new year.

More information http://www.gov.scot/…/steps-to-accelerate-booster…