public health – Page 71 – The NEN

Ebola: ‘lifeline of care’ delivered to Sierra Leone

Britain’s latest Ebola aid flight – delivering beds, personal protection suits, tents and vehicles – landed in Sierra Leone capital Freetown yesterday, International Development Secretary Justine Greening has confirmed.

Aid flights from the UK to Sierra Leone have delivered personnel and vital supplies for the construction and operation of the 92 bed treatment facility in Kerry Town – the first of at least five that the UK is building in the country from scratch.

A team of British military personnel – including logisticians, planners and engineers – are currently on the ground to oversee the construction of the treatment centre.

International Development Secretary Justine Greening said: “The UK continues to deliver essential supplies to control and defeat the Ebola outbreak in Sierra Leone.

“This aid will go towards getting the UK’s treatment facility up and running as soon as possible. It will also ensure that heroic health workers working on the front line have the very best protection equipment available to tackle this terrible disease.

“Construction of our treatment centre is now well underway and the first phase will be operational soon. This will provide a lifeline of care to Ebola patients in Sierra Leone.”

Aid supplies delivered so far include: 20 vehicles including ambulances; 75 water tanks; 3 incinerators for disposing of clothing and other materials; 12 generators; personal protection equipment; radio equipment; lighting sets; chlorine for sanitation; latrine slabs; temporary warehouse tents; 14 air conditioning units and isolator equipment.

The vehicles will be used to move blood samples and patients from local communities to the treatment centre. Further aid supplies will be deployed from the Department for International Development’s emergency warehouse in Kemble, Gloucestershire.

The UK has pledged £125 million to support the global effort to contain, control and defeat the disease in Sierra Leone. This includes support for 700 Ebola treatment beds which will provide direct medical care up to 8,800 patients over six months and help to shore up the country’s stretched public health services as they battle to contain the disease. This includes vital supplies such as chlorine and protective clothing for thousands of health workers.

Ebola in Scotland: risk ‘relatively low’ but health chief urges vigilance

The Scottish Government Resilience Committee (SGoRR) met last night to discuss preparedness related to the Ebola situation in West Africa. The meeting was chaired by First Minister Alex Salmond.

The First Minister said: “It is crucial our health service is geared up to deal with any potential confirmed cases of Ebola in Scotland.

“That was the basis of the meeting and I am confident our NHS is ready to respond. But we must not only asses our preparedness in Scotland, we must also ensure we are doing all we can to support the efforts to contain the spread of Ebola in West Africa. I have asked for an urgent assessment of what we can do to build on the £500,000 we have already provided to the World Health Organisation and Scotland will do whatever we can to assist.”

Health Secretary Alex Neil was also part of the meeting, along with experts in infectious diseases from Health Protection Scotland and acting Chief Medical Officer (CMO) Aileen Keel.

Mr Neil said: “Our public health experts, including those at Health Protection Scotland, have been monitoring the position very closely since the outbreak began and putting in place the awareness and advice to ensure our health service is as well prepared as possible to respond.

“While the risk remains relatively low, we are ensuring that we have the robust procedures in place to identify cases rapidly. Our health service also has the expertise and facilities to ensure that confirmed Ebola cases would be contained and isolated effectively minimising any potential spread of the disease.

“Indeed, the CMO has written to clinicians across our NHS today to reinforce the need to be vigilant and take the appropriate steps in any suspected or high risk cases.

“Scotland’s NHS has proved it is well able to cope with infectious diseases in the past, such as swine flu, and I am confident we will be able to respond effectively again.

“We will go on monitoring the situation and maintain a high state of vigilance across our health system. SGoRR will meet again in the coming days to continue to closely monitor developments and ensure robust resilience arrangements are in place.”

Earlier yesterday the Prime Minister chaired a COBR meeting on plans to protect the UK against the Ebola virus and combat the disease in West Africa.

A Number 10 spokesperson said:

“The Prime Minister chaired a COBR meeting on Ebola this afternoon. The attendees included the Chancellor, Home Secretary, Defence Secretary, Health Secretary, Transport Secretary, International Development Secretary, Public Health Minister, Chief Medical Officer, Chief Scientist and Dr Paul Cosford from Public Health England. The Foreign Secretary in the US and UK team in Sierra Leone joined via a video link.

“The meeting covered both the UK preparedness for potential cases of Ebola in this country and the UK’s efforts to combat the disease in West Africa.

“There was a detailed discussion about plans for protecting the UK against Ebola. The Chief Medical Officer, Dame Sally Davies, and Dr Paul Cosford set out that the UK had some of the best public health protection systems in the world and the risk to the UK remained low. The Chief Medical Officer detailed the procedures in place for dealing with any Ebola case in the UK, and the training and preparation that had already taken place with key organisations and staff, including ambulance medics, hospitals, NHS 111, GPs and other key public health workers.

“The case of Will Pooley had demonstrated the UK’s ability to deal with an identified case without wider infection, with a world-leading specialist unit at The Royal Free. Contingency planning would continue and will include a national exercise and wider resilience training to ensure the UK is fully prepared. The Chief Medical Officer has now issued further advice to medical professionals across the country and would continue to do so in the coming weeks. Information posters for passengers would be put up in UK airports.

“The Prime Minister was updated on the situation on the ground by the UK team in Sierra Leone, where the number of cases continues to rise. The UK was already taking a leading role in the efforts to support the government to deal with the outbreak. Using British expertise and local building contractors, the UK has committed to build at least 5 new Ebola Treatment Facilities with a total of 700 beds near urban centres including Port Loko, Freetown and Makeni.

“The package will help up to nearly 8,800 patients over a 6 month period. The UK was also supporting infection training for workers and support to ensure burial sites, and the Department for International Development is undertaking a rapid trial of 10 local community care units to isolate Ebola cases more quickly, with clinics providing swift and accurate diagnosis and appropriate care.

“It was agreed that the UK will increase the level of support further. This will include more training capacity, new treatment centres and helicopter support.

“750 Ministry of Defence personnel will be deployed in total to help with the establishment of Ebola Treatment Centres and an Ebola Training Academy. This will include:

the deployment of RFA Argus to take and support 3 Merlin helicopters, aircrew and engineers in the region to provide crucial transport support to medical teams and aid experts. This will involve around 250 personnel.

over 200 military staff will be deployed to run and staff World Health Organisation-led Ebola training facility that will assist in the training of healthcare workers, logisticians and hygiene specialists who are needed to staff treatment units

300 military personnel making up the existing UK taskforce plans focussed on delivering support to the Sierra Leone government.”

Ebola: should we be alarmed?

The Department of Health confirmed yesterday that a British national residing in Sierra Leone has tested positive for Ebola virus infection. Should we be concerned?

The simple answer is no, there is no immediate cause for alarm – but the health authorities remain vigilant.

‘the risk of any traveller to West Africa contracting Ebola is very low without direct contact with the blood or body fluids of an infected person.’

Professor John Watson, Deputy Chief Medical Officer, said: “The overall risk to the public in the UK continues to be very low. Medical experts are currently assessing the situation in Sierra Leone to ensure that appropriate care is provided. We have robust, well-developed and well-tested NHS systems for managing unusual infectious diseases when they arise, supported by a wide range of experts.”

Ebola haemorrhagic fever is a rare but severe disease caused by the Ebola virus. Ebola is highly transmissible by direct contact with organs or bodily fluids of living or dead infected persons and animals.

An Ebola outbreak was first confirmed in Guinea back in February and quickly spread to Liberia and Sierra Leone. The outbreak is the world’s deadliest to date.

Ebola kills up to 90% of those infected but patients have a better chance of survival if they receive early treatment. The latest outbreak has caused more than 700 deaths since February.

The UK government is closely monitoring the Ebola outbreak – the largest outbreak of the virus in recent times – but said in a statement:

‘This is not an issue that affects the UK directly. We have experienced scientists and doctors including at the Royal Free Infectious Disease Unit, the Liverpool School of Tropical Medicine and the London School of Hygiene and Tropical Medicine. We also have a lot of experience of dealing with dangerous diseases. The risk of this disease spreading fast in the UK is much lower because of that.

‘The UK government is taking precautionary measures and looking at capability but is confident that the UK has experienced people who are ready to deal with anything if it were to arrive here.’

Following a meeting of government committee COBR, Foreign Secretary Philip Hammond said: “We’ve looked at how we are co-ordinating with our French and American colleagues under the World Health Organisation, we’ve considered what additional measures the UK could take to help control the outbreak in West Africa and we’ve also looked at what measures we need to put in place on a precautionary basis in case any UK nationals in West Africa should become affected by the disease.

We do not, at the moment, think this is an issue that affects the UK directly.”

Guidance has been issued to front line Border Force staff on how to identify and safely deal with suspected cases of Ebola – it makes clear what steps need to be taken should a passenger arrive at the border unwell.

If a person is identified at the border as being a potential carrier they will be immediately referred by a Border Force officer to a specialist medical care provider and reported to public health authorities.

There was a local scare earlier this month when an athlete from Sierra Leone fell ill during the Commonwealth Games in Glasgow, but he tested negative for Ebola. Dr Colin Ramsay, of Health Protection Scotland, said then: “There’s been no programme of actively screening athletes simply because of the Commonwealth Games.

“The situation is that if someone presents with symptoms suggestive of the possibility of Ebola virus infection and who has come from a country affected by the current outbreak – and that’s Sierra Leone and Guinea and Liberia – they would be investigated accordingly and that would involve managing them with a set of standard precautions. People in this sort of situation would be investigated for a number of conditions, not just Ebola.”

No cases of imported Ebola have ever been reported in the UK.

Defibrillators: dental practices to receive life-saving machines

‘I firmly believe this scheme will save many more lives’ – Matheson

Communities across Scotland will have access to potentially life-saving defibrillators as the machines are installed in independent NHS dental practices across the country.

The £600,000 programme will see defibrillators delivered by the end of the month. The locations of the defibrillators will be logged with the Scottish Ambulance Service control system, which will increase community access to defibrillators, reduce delays in treatment and increase the chances of survival for cardiac arrest victims.

More than 1500 Scots died after suffering a cardiac arrest outwith hospital last year.

To mark yesterday’s roll-out launch, Minister for Public Health Michael Matheson visited the Montgomery Street Dental Practice in Edinburgh, one of the first to receive a defibrillator.

Mr Matheson, who is himself trained in the use of defibrillators, said: “Every second counts when someone suffers a cardiac arrest and having access to a defibrillator can mean the difference between life and death.

“By the end of this roll-out, there will be more defibrillators in public spaces. With these machines mapped to the Scottish Ambulance Service control system, people can be directed to them more quickly if there is an incident, cutting the delay in treatment and increasing the victim’s chance of survival.

“As these machines are becoming easier to use it is only right that the public have more access to its life-saving potential and I firmly believe that this scheme will save many more lives.”

Alex Coakley, Principal Dentist at the Montgomery Street Practice, added: “This is a fantastic initiative by the Scottish Government. Having defibrillators available in convenient locations such as dental practices will mean that they can be taken to the scene of any incident as quickly as possible, and hopefully save lives.”

Pat Kilpatrick, director of the British Dental Association Scotland, said: “BDA Scotland is delighted that the Scottish Government has recognised the important contribution that the dental team can make in saving lives, and for making this possible by providing defibrillators for every dental practice in Scotland.”

Culture is good for your health!

Research shows a clear link for the first time

Participation in culture is significantly linked to good health and high life satisfaction in Scotland, new research shows. A detailed study carried out by Scottish Government analysts and published today, confirms for the first time that cultural engagement is having a positive impact on the nation’s health and life satisfaction.

The study, based on data from the Scottish Household Survey 2011, considered the impact on health of both culture and sport. It found that those who participate in culture or attend cultural places or events are more likely to report good health and life satisfaction that those who do not. This remains true even when other factors such as age, economic status, income, area deprivation, education qualification, disability or long standing illness and smoking are accounted for.

Key findings show:

Those who attended a cultural place or event in the previous 12 months were almost 60 per cent more likely to report good health compared to those who did not.
Those who participated in a creative or cultural activity in the previous 12 months were 38 per cent more likely to report good health compared to those who did not.
Those who visited a library and those who visited a museum were almost 20 per cent more likely to report good health than those who had not.
Those who visited a theatre were almost 25 per cent more likely to report good health than those who did not.
Those who participated in dance were 62 per cent more likely to report good health than those who did not.
Those who read for pleasure were 33 per cent more likely to report good health than those who did not.

The research follows data from the 2010 Scottish Household Survey that shows that people who are encouraged to participate in cultural activity as children are more likely to continue to do so into adulthood.

It also builds on evidence from the major longitudinal study ‘Growing Up in Scotland’ that shows that from the youngest ages, most children in Scotland are exposed to cultural activities, and that this has an impact on their cognitive development.

Culture Secretary Fiona Hyslop said: “This Government is committed to promoting and supporting cultural activities because we recognise and value the potential benefits not only to individuals but also to our communities.

“Cumulatively, this growing evidence base is giving us more insight into the benefits that taking part in cultural and creative activities brings – at every life stage.

“Starting young, and being encouraged to take part in culture as a child, makes it more likely that the benefits of taking part will be experienced as an adult.

“That’s why this Government has funded activities like Bookbug, Scottish Book Trust’s Early Years programme, which encourages parents and children to read together from birth, and the Royal Scottish National Orchestra’s Astar CD which is helping parents in Scotland to introduce their babies to the joy of music.”

Heather Stuart, Chair of VOCAL, said: “Those of us who are involved in the delivery of culture and sport services on a daily basis have never been in any doubt about the positive impact they have on peoples’ health and wellbeing and quality of life. We see it every day.

“I am therefore delighted that this study evidences so well, and so robustly, the relationship between taking part in culture and sport activities, attendance at cultural places, and quality of life.

“Evidence like this needs to inform the longer term debate about the wider impact of these services and how they contribute to the wellbeing of the population and the priorities of central and local government.

“Their contribution in addressing the key challenges for Scotland around the physical and mental health of the population is clear. There is no doubt culture and sport services are effective preventative medicine.”

Mark O’Neill, Director of Policy & Research, Glasgow Life, commented:
“This is a really ground-breaking piece of work for Scotland – and for the UK. It demonstrates, for the first time, a clear association between cultural attendance and improved health and wellbeing. It strengthens the case for cultural participation being included in any assessment of life satisfaction – and in any holistic public health strategy.”

Legionella Update

The latest reports from the Scottish Government Resilience Room (SGoRR) on the Edinburgh Legionnaires’ outbreak show that there are now 21 confirmed cases and 19 suspected cases.

One of the confirmed cases has died, two have been discharged from hospital and 12 are being treated in intensive care.

An emergency information leaflet will be delivered to all homes and businesses in affected areas today (Thursday). GPs have also been provided with information on spotting the signs of infection.

A dedicated NHS helpline has been set up for anyone concerned and can be reached on 0800 0858 531.

Health Secretary Nicola Sturgeon said: “The fact remains that the risk to the general public is low – however, due to the incubation period of the infection we are still expecting to see an increase in cases over the next couple of days.

“There is a now a dedicated advice line for everyone who is affected by the outbreak and households in affected areas will receive a leaflet advising on the symptoms to look out for.

“A tremendous amount of work has been done to identify and deal with the source of infection and ongoing work is focusing on cooling towers in the area. All of the towers have been treated and the first phase of site inspections has now been completed by HSE.”

Dr Duncan McCormick Consultant in Public Health Medicine NHS Lothian said: “Our advice is that there is a very low risk to the public and people should go about their daily business as usual.

“We remain confident – based on the available evidence – that the general source of the infection has been identified and that the treatment to the cooling towers will prove successful.

“We are expecting cases to continue to emerge over the next few days.

“I would like to assure the public that the drinking water is completely safe – the virus is not passed on by drinking water or from person to person transmission.

“If anyone has any concerns we would advise them to consult their GP or the NHS 24 dedicated helpline.”

Ms Sturgeon will be making a statement on the legionella outbreak to Parliament later this morning.

Legionnaires’ Disease latest

NHS L0thian is now investigating 17 confirmed cases and 15 suspected cases of Legionnaires’ disease. One patient, a man in his 50s with under lying health conditions, has died while being treated at the Royal Infirmary of Edinburgh.

Thirteen men and two women aged between 33 and 74 are in a critical condition with the disease and are being treated in intensive care in hospitals in Lothian. One man has recovered and has been discharged.

Although unconfirmed, 15 other cases – ten men and five women – are also being investigated. All of these patients are being treated in hospitals in Lothian. The majority of the confirmed cases are linked geographically to the Dalry, Gorgie and Saughton areas. Investigations into the other cases and possible links with the area are ongoing.

The source of the outbreak continues to be investigated by officials from the City of Edinburgh Council’s Environmental Health Service and Scientific Service and the Health and Safety Executive.

Industrial cooling towers have been identified as a potential source of the infection and the cooling systems at four facilities in the area have been subject to an additional chemical treatment. Further inspections of these facilities will be carried out by the Environmental Health Service and the Health and Safety Executive over the coming days to ensure control measures continue to be effective.

Samples have been taken from these four facilities, but legionella is a difficult bacteria to culture and it may take up to ten days before results of the samples are available. Other possible sources are not being ruled out.

Dr Duncan McCormick, Consultant in Public Health Medicine and Chair of the Incident Management Team, said: “I would like to express my sincere condolences to the family of the patient that died. Investigations into the possible source of this outbreak are on-going. Meanwhile, medical staff have been actively identifying possible cases to allow us to ascertain the full extent of this outbreak.”

He continued: “I would like to reassure the public that household water supplies are safe and that Legionnaire’s disease cannot be contracted by drinking water. Older people, particularly men, heavy smokers and those with other health conditions are at greater risk of contracting the disease. I would urge anyone who develops symptoms of Legionnaires’ disease to contact NHS 24 or their GP.”

The first case was identified on Thursday 28 May. The symptoms of Legionnaires’ disease can begin anytime from between 2-14 days after exposure to the bacteria.

Legionella bacteria sometimes find their way into artificial water supply systems, such as air conditioning systems, hot water services, and cooling towers. Given the right conditions, legionella bacteria can contaminate these water systems.

Legionnaires’ disease is contracted by breathing in small droplets of contaminated water. However, the condition is not contagious and cannot be spread directly from person to person. It cannot be contracted through drinking water.

Symptoms usually begin with an initial phase lasting 1-2 days, in which you experience mild headaches and muscle pain. This is followed by the onset of more severe symptoms including high fever – usually a temperature of 40C (104F) or above – , more severe muscle pain and chills.

Once the bacteria begin to infect your lungs, you may also experience a persistent cough (usually dry at first but as the infection develops you may start coughing up mucus or possibly blood), shortness of breath and chest pains.

About 30% of people with Legionnaires’ disease will also experience gastrointestinal symptoms including nausea, vomiting, diarrhoea, and loss of appetite. About half of those with Legionnaires’ disease will also experience changes to their mental state, such as confusion.

Legionnaires' Disease latest

The source of the outbreak continues to be investigated by officials from the City of Edinburgh Council’s Environmental Health Service and Scientific Service and the Health and Safety Executive.

The first case was identified on Thursday 28 May. The symptoms of Legionnaires’ disease can begin anytime from between 2-14 days after exposure to the bacteria.