UK Health Security Agency – The NEN

First case of MPOX detected in UK

‘We have detected a single confirmed human case of Clade Ib mpox. This is the first detection of this Clade of mpox in the UK, the wider risk to the UK population remains low’.

The UK Health Security Agency (UKHSA) has detected a single confirmed human case of Clade Ib mpox. The risk to the UK population remains low.

This is the first detection of this Clade of mpox in the UK. It is different from mpox Clade II that has been circulating at low levels in the UK since 2022, primarily among gay, bisexual and other men-who-have-sex-with-men (GBMSM).

UKHSA, the NHS and partner organisations have well tested capabilities to detect, contain and treat novel infectious diseases, and while this is the first confirmed case of mpox Clade Ib in the UK, there has been extensive planning underway to ensure healthcare professionals are equipped and prepared to respond to any confirmed cases.

The case was detected in London and the individual has been transferred to the Royal Free Hospital High Consequence Infectious Diseases unit. They had recently travelled to countries in Africa that are seeing community cases of Clade Ib mpox. The UKHSA and NHS will not be disclosing any further details about the individual.

Close contacts of the case are being followed up by UKHSA and partner organisations. Any contacts will be offered testing and vaccination as needed and advised on any necessary further care if they have symptoms or test positive.

UKHSA is working closely with the NHS and academic partners to determine the characteristics of the pathogen and further assess the risk to human health.

While the existing evidence suggests mpox Clade Ib causes more severe disease than Clade II, we will continue to monitor and learn more about the severity, transmission and control measures. We will initially manage Clade Ib as a high consequence infectious disease (HCID) whilst we are learning more about the virus.

Professor Susan Hopkins, Chief Medical Adviser at UKHSA, said: “It is thanks to our surveillance that we have been able to detect this virus. This is the first time we have detected this Clade of mpox in the UK, though other cases have been confirmed abroad.

“The risk to the UK population remains low, and we are working rapidly to trace close contacts and reduce the risk of any potential spread. In accordance with established protocols, investigations are underway to learn how the individual acquired the infection and to assess whether there are any further associated cases.”

Health and Social Care Secretary Wes Streeting, said: “I am extremely grateful to the healthcare professionals who are carrying out incredible work to support and care for the patient affected.

“The overall risk to the UK population currently remains low and the government is working alongside UKHSA and the NHS to protect the public and prevent transmission.

“This includes securing vaccines and equipping healthcare professionals with the guidance and tools they need to respond to cases safely.

“We are also working with our international partners to support affected countries to prevent further outbreaks.”

Steve Russell, NHS national director for vaccination and screening, said: “The NHS is fully prepared to respond to the first confirmed case of this clade of mpox.

“Since mpox first became present in England, local services have pulled out all the stops to vaccinate those eligible, with tens of thousands in priority groups having already come forward to get protected, and while the risk of catching mpox in the UK remains low, if required the NHS has plans in place to expand the roll out of vaccines quickly in line with supply.”

Clade Ib mpox has been widely circulating in the Democratic Republic of Congo (DRC) in recent months and there have been cases reported in Burundi, Rwanda, Uganda, Kenya, Sweden, India and Germany.

Clade Ib mpox was detected by UKHSA using polymerase chain reaction (PCR) testing.

Common symptoms of mpox include a skin rash or pus-filled lesions which can last 2 to 4 weeks. It can also cause fever, headaches, muscle aches, back pain, low energy and swollen lymph nodes.

The infection can be passed on through close person-to-person contact with someone who has the infection or with infected animals and through contact with contaminated materials. Anyone with symptoms should continue to avoid contact with other people while symptoms persist.

The UK has an existing stock of mpox vaccines and last month announced further vaccines are being procured to support a routine immunisation programme to provide additional resilience in the UK. This is in line with more recent independent JCVI advice.

Working alongside international partners, UKHSA has been monitoring Clade Ib mpox closely since the outbreak in DRC first emerged, publishing regular risk assessment updates.

The wider risk to the UK population remains low.

UKHSA has published its first technical briefing on clade I mpox which provides further information on the current situation and UK preparedness and response.

Ensuring Scotland is prepared as mpox cases increase in Central and Eastern Africa

With the World Health Organization declaring a recent rise in mpox cases in Central and Eastern Africa a Public Health Emergency of International Concern, Dr Kirsty Roy and Dr Kate Smith, Consultants in Public Health at PHS, explain more about the current international situation and what is being done to prepare for any cases seen in Scotland:

The recent rise of mpox cases in Central and Eastern Africa is of global concern due to the potential for the virus to spread beyond the affected countries. It’s therefore important that we’re prepared in the event a case is identified in Scotland.

Mpox is an uncommon viral infection compared to viruses like influenza or COVID-19.

It typically causes a blistering rash which can last 2 to 4 weeks and can be accompanied by fever, headaches, muscle and back aches, tiredness and swollen lymph nodes.

There are two main types of mpox – clade 1 and clade 2 that are then further divided into clade 1a, clade 1b and clade 2b. Each type can differ in who they affect, how they spread, and the severity of the outcomes.

Clade 1 mpox is more serious than clade 2, as it can be passed on more easily, can make people more severely ill, and has a higher fatality rate. This is why clade 1 is classified as a high consequence infectious disease (HCID). HCIDs are rare in the UK, and established protocols and guidance are in place to manage these.

What’s the current global situation?

Historically, clade 1 mpox has been associated with Central Africa and linked with more severe disease and higher death rates. Recently, a new type (clade 1b) has emerged and is circulating, particularly in sexual networks in the Democratic Republic of Congo (DRC) and neighboring countries.

It was the emergence and rapid spread of clade 1b that prompted the World Health Organization to declare the outbreak as a Public Health Emergency of International Concern (PHEIC) in August 2024.

Although most cases are currently confined to Central and Eastern Africa, there is the potential for the virus to spread out with the continent to other countries, as we saw with the global outbreak of mpox clade 2 in 2022.

It’s therefore important to be aware of the above symptoms. Anyone with these should stay at home, avoid close contact with others and get medical help by phone. More information can be found on NHS inform.

How is mpox passed on?

Mpox is not passed on very easily between people. However, you can get it from close contact with an infected person, including during sex or by contact with contaminated materials (for example bedding or towels).

It’s possible that mpox may also be passed on through close and prolonged contact that can include talking, breathing, coughing or sneezing. There is currently limited evidence around this, and information will be updated when new evidence becomes available.

What’s the current situation in Scotland?

Currently, no cases of clade 1 mpox have been confirmed in Scotland. The UK Health Security Agency (UKHSA) confirmed it had detected the first case of mpox clade 1b in England on 30 October, however, the risk to the UK population is still considered low.

PHS is working closely with public health partners across the UK, as well as NHS boards, to monitor the situation and prepare for any cases of clade 1 mpox in Scotland.

As part of this, we have rapidly put testing in place to ensure suspected cases can be quickly tested in Scotland at the Edinburgh Specialist Virology Centre (SVC) and the West of Scotland Specialist Virology Centre (WoSSVC) Glasgow.

What’s the travel advice?

Currently the risk to most travellers is small. A list of countries where cases of Clade 1 mpox have been identified can be found on the UK Government website

Anyone travelling to an affected country is encouraged to take precautions, such as minimising physical or sexual contact – especially with individuals showing signs of a rash – to reduce the risk of infection.

Working in partnership with Scottish airports, we have ensured that information about the clade 1b international situation is visible to travellers in Scottish Airports. These signpost to key information on affected countries and how to access healthcare services in Scotland if an individual develops mpox symptoms.

Is there a vaccine to protect against mpox?

Mpox belongs to a family of viruses that includes smallpox and a vaccine that was developed to protect against smallpox is also considered effective against mpox.

This vaccine was used as part of the response to the 2022 outbreak of clade 2 mpox, which mainly affected gay, bisexual or other men who have sex with men (GBMSM), and Scotland continues to offer mpox vaccination to those at greatest risk.

On behalf of Scotland, and other devolved nations, the UK Government has procured more mpox vaccine doses to strengthen the UK preparedness against clade 1 mpox. More information about vaccine eligibility can be found on NHS inform.

Scotland has a robust public health intelligence system, is now able to rapidly identify and test potential cases and has a supply of effective vaccines. There is also public health information available to ensure people are prepared if they are visiting an area of higher risk. These should all ensure Scotland is prepared should cases emerge within the country.

PUBLIC HEALTH SCOTLAND

E. coli advice issued amid rise in cases

UKHSA is working with partners to investigate a Shiga toxin-producing E. coli (STEC) outbreak

As of 3 July, there have been a further 13 cases associated with the recent outbreak of STEC O145 since the last update on 27 June. This brings the total number of confirmed cases to 288 in the UK.

All currently confirmed cases had symptom onset dates before 10 June.

Although case reporting rates are continuing to decline, we expect to see an additional small number of cases linked to this outbreak as further samples are referred to us from NHS laboratories and whole genome sequencing is conducted.

Confirmed case totals:

191 in England
62 in Scotland
31 in Wales
4 in Northern Ireland (evidence suggests that they acquired their infection in England)

Based on information from 263 cases to date, 49% were admitted to hospital.

Amy Douglas, Incident Director at UKHSA, said: “It’s encouraging that reported cases are continuing to decline, however we still expect to see a few more cases linked to this outbreak as further samples are referred to us for testing.

“Symptoms of infections with STEC include severe and sometimes bloody diarrhoea, stomach cramps, vomiting and fever. While diarrhoea and vomiting can have a range of causes, there are simple steps you can take to reduce your risk and the risk of infecting others.

“Washing your hands with soap and warm water and using disinfectants to clean surfaces will help stop any further spread of infection. If you are unwell, you should not prepare food for others while unwell and avoid visiting people in hospitals or care homes to avoid passing on the infection in these settings.

“Do not return to work, school or nursery until 48 hours after your symptoms have stopped. If you are concerned about your symptoms, follow NHS.UK guidance on when to seek help and the steps you can take to avoid further spread to family and friends.”

Darren Whitby, Head of Incidents at the Food Standards Agency, said: “The food chain investigation into this outbreak will continue to take account of any new information as it becomes available.

“We will continue to work with the relevant businesses, local authorities and agencies involved to ensure the necessary steps are in place to protect consumers.!

As cases linked to this outbreak are now low and continue to decline, this week’s update (5 July) will be the final weekly report on case numbers unless there is a significant change.

E. coli advice issued amid rise in cases

UKHSA is working with partners to investigate a Shiga toxin-producing E. coli (STEC) outbreak

As of 25 June, there have been a further 19 cases associated with the recent outbreak of STEC O145 since the last update a week ago, bringing the total number of confirmed cases to 275 in the UK.

All currently confirmed cases had symptom onset dates before 4 June. Although case reporting rates are declining, we expect to see more cases linked to this outbreak as further samples are referred to us from NHS laboratories and whole genome sequencing is conducted.

Confirmed case totals:

182 in England
58 in Scotland
31 in Wales
4 in Northern Ireland (evidence suggests that they acquired their infection in England)

Based on information from 249 cases to date, 49% were admitted to hospital.

Through surveillance, UKHSA has identified 2 individuals in England who died within 28 days of infection with the STEC outbreak strain.

Based on the information available from health service clinicians one of these deaths is likely linked to their STEC infection. Both individuals had underlying medical conditions. The deaths occurred in May.

Amy Douglas, Incident Director at UKHSA, said: “We’re pleased that fewer cases have been reported, however we still expect to see a few more cases linked to this outbreak as further samples are referred to us for testing.

“If you are concerned about your symptoms, follow NHS.UK guidance on when to seek help and the steps you can take to avoid further spread to family and friends.”

Darren Whitby, Head of Incidents at the FSA said: “Earlier this month, we confirmed that several sandwich manufacturers had taken precautionary action to withdraw and recall various sandwiches, wraps, subs and rolls after food chain and epidemiological links enabled us to narrow down a wide range of foods to a type of lettuce used in sandwich products as the likely cause of the outbreak.

“This remains a complex investigation and we continue to work with the relevant businesses and the local authorities to ensure necessary steps are being taken to protect consumers.

“Although we are confident in the likely source of the outbreak being linked to lettuce, work continues to confirm this and identify the root cause of the outbreak with the growers, suppliers and manufacturers so that actions can be taken to prevent a re-occurrence.”

For more information, see the interim summary report from the multi-agency investigation into outbreak STEC O145 identified in May 2024.

Latest Winter COVID-19 Infection Study Data released

UKHSA and ONS have published the latest data from the Winter Coronavirus (COVID-19) Infection Study, known as the Winter CIS

Winter COVID-19 Infection Study shows a continued decline in COVID-19 in England and Scotland.

The latest data from the Winter COVID-19 Infection Study, an epidemiological study run in partnership by the UK Health Security Agency (UKHSA) and the Office for National Statistics (ONS), shows a clear decline in the prevalence of SARS-CoV-2 in England and Scotland in the 2 weeks up to 10 January.

Analysis by UKHSA suggests that prevalence in the community is 2.3%, or around one in every 43 people. This represents a decrease in prevalence from 3.1% (one in every 32 people) in the previous report.

Positivity data from the ONS indicates that of the approximately 26,000 participants who reported LFD test results in the last reporting period, 1.9% tested positive for COVID-19, compared to 2.7% in the last report.

The most recent data shows a clear decline in prevalence in Scotland and most of the regions in England. This decline was also observed for the age groups between 18 to 74.

Professor Steven Riley, Director General for Data and Surveillance at UKHSA said: “This week’s data confirms the early signs of a decline in COVID-19 across the country that we saw in last week’s report.

“While this is welcome, it is important to recognise that this does not mean that the risk of becoming ill with COVID-19 has gone away.

“In previous years, we have sometimes seen a decline in early January followed by an increase over the next few weeks, so it remains important that we continue to do what we can to reduce transmission.

“Those people who are most at risk of severe illness from COVID-19 can still receive a seasonal vaccination until the end of this month, and we urge anyone eligible who has not already done so to come forward. You can get a vaccine through your GP, by booking with a local NHS vaccination service, or you can find a COVID-19 vaccination walk-in site.

“If you are showing symptoms of COVID-19 or other respiratory illnesses, you should try to limit your contact with other people as much as possible, especially those who are older or more vulnerable.”

Warning after rise in extremely drug-resistant Shigella

The UK Health Security Agency (UKHSA) reports a concerning rise in Shigella cases, a gut infection that causes diarrhoea, stomach cramps and fever

There has been a concerning rise in cases of extensively antibiotic-resistant Shigella sonnei infections, mainly in gay, bisexual, and other men who have sex with men (GBMSM), UKHSA has announced.

Since the beginning of 2023, the number of extensively-antibiotic resistant Shigella cases has increased by 53%. Much of this increase has been driven by a cluster of extensively-antibiotic resistant Shigella sonnei, of which there have been 97 cases in 2023 (up to and including November), compared to just 4 cases last year.

The strain is difficult to treat because it does not respond to the antibiotics typically used to treat Shigella. Cases have been diagnosed in all regions of England, but cases are concentrated in London (45), the North West (21) and South East (12).

In January 2022, there was a similar rise in cases of extensively antibiotic-resistant Shigella sonnei infections caused by another outbreak strain.

Cases of Shigella have been rising since the easing of COVID-19 restrictions in July 2021, with annual cases now higher than the average before the pandemic. The month with the highest number of reported Shigella diagnoses prior to the COVID-19 pandemic was 392 in September 2019, which increased to 485 in September 2023 – representing a 24% increase.

Shigella is a gut infection that causes diarrhoea (sometimes mixed with blood), stomach cramps and fever. It is caused by bacteria found in faeces.

It can be passed on through the faecal-oral route during sex, either directly or via unwashed hands and only a tiny amount of bacteria can spread the infection. Symptoms are typically seen between 1 and 4 days after exposure and are commonly mistaken for food poisoning.

Dr Gauri Godbole, Consultant Medical Microbiologist at UKHSA, said: “This is a concerning rise in cases of this antibiotic resistant strain, meaning treatment can be very difficult.

“One of the best ways to protect yourself and your partners is to practice good hygiene after sex. Avoid oral sex immediately after anal sex, and change condoms between anal or oral sex and wash your hands with soap after sexual contact.

“It’s important that gay, bisexual, and other men who have sex with men (GBMSM) do not dismiss their symptoms and speak to their GP or sexual health clinic, mentioning Shigella, if they are unwell.

“GBMSM with Shigella may have been exposed to other sexually transmitted infections (STIs) including HIV, so a sexual health screen at a clinic or ordering tests online is recommended.”

Shigella is very infectious. Although symptoms can be unpleasant, in most cases they will subside within a week, but some individuals need hospitalisation and require intravenous antibiotic treatment. Effective antibiotic treatments are limited for this extremely resistant strain.

Antibiotic treatment is recommended in cases with severe symptoms, those requiring hospital admission, those with prolonged diarrhoea (beyond 7 days) or in those who have underlying immunodeficiency.

If you have been diagnosed with Shigella, give yourself time to recover. Keep hydrated and get lots of rest. Don’t have sex until 7 days after your last symptom and avoid spas, swimming, jacuzzis, hot tubs and sharing towels as well as preparing food for other people until a week after symptoms stop.

Reducing transmission is key to protecting more vulnerable groups. You can find out more information about Shigella and get advice on other topics at Sexwise or by calling the free National Sexual Health Helpline at 0300 123 7123.

Covid cases continue to rise

LATEST UPDATE PUBLISHED 31st AUGUST

This fortnightly flu and COVID-19 report brings together the latest surveillance data along with the latest public health advice.

COVID-19 surveillance up until end of week 34

COVID-19 case rates continued to increase this week compared to our previous report. A total 9.7% of 4,288 respiratory specimens reported through the Respiratory DataMart System were identified as COVID-19. This is compared to 7.1% of 4,303 from the previous report.

The overall COVID-19 hospital admission rate for week 34 was 3.37 per 100,000 population, an increase from 3.00 per 100,000 in the previous report.

Intensive care units (ICU) admission rates have increased to 0.11 per 100,000 compared to 0.08 per 100,000 in the previous report.

Hospital admission rates have increased in most age groups.

Those aged 85 years and over continue to have the highest hospital admission rates; these have increased to 34.15 per 100,000 from 32.63 per 100,000 in the previous report. Admission rates among those aged 75 to 84 years have increased to 17.66 per 100,000 from 15.71 per 100,000 in the previous report.

Dr Mary Ramsay, Head of Immunisation at the UK Health Security Agency (UKHSA), said: “Over the last 2 weeks, we have seen an increase in some COVID-19 indicators. This includes hospital admissions and ICU admissions, but these have all stabilised over the last week. While case rates have continued to rise, rates remain low overall, and we will continue to monitor them closely.

“If you are experiencing any symptoms of respiratory illness, you should avoid mixing with other people, especially those who are vulnerable. This will help combat the spread of COVID-19.

“This week, the Department of Health and Social Care (DHSC) announced that the winter vaccination programme has been brought forward as a precautionary measure to deliver greater protection against the potential impact of BA.2.86 variant. We urge everyone eligible to take up the vaccine when offered.”

New BA.2.86 variant found in Scotland

Scotland has detected its first case of a new Covid variant that is being closely monitored by the World Health Organization.

The BA.2.86 variant is not yet considered a variant of concern but it has a high number of mutations.

Scotland’s winter vaccination programme starts on 4 September, but in response to the new cases PHS and Scottish government are now working to bring winter vaccinations forward for those at the highest risk of becoming seriously ill from flu and Covid-19.

Covid: New variant discovered in UK

The UK Health Security Agency (UKHSA) has published an initial risk assessment of the SARS-CoV-2 variant BA.2.86.

This variant was detected in the UK yesterday (Friday 18 August), and has also been identified in Israel, Denmark and the US. It has been designated as V-23AUG-01 for the purpose of UKHSA monitoring.

The newly identified variant has a high number of mutations and is genomically distant from both its likely ancestor, BA.2, and from currently circulating XBB-derived variants.

There is currently one confirmed case in the UK in an individual with no recent travel history, which suggests a degree of community transmission within the UK. Identifying the extent of this transmission will require further investigation.

There is currently insufficient data to assess the relative severity or degree of immune escape compared to other currently-circulating variants.

Dr Meera Chand, Deputy Director, UKHSA said: “V-23AUG-01 was designated as a variant on 18 August 2023 on the basis of international transmission and significant mutation of the viral genome. This designation allows us to monitor it through our routine surveillance processes.

“We are aware of one confirmed case in the UK. UKHSA is currently undertaking detailed assessment and will provide further information in due course.”

UKHSA will continue to monitor the situation closely and will publish the results of our analysis when they are available.

COVID-19 testing guidance update

Testing to be based on clinical need in hospitals, care homes and prisons

Routine COVID-19 testing in hospitals, care homes and prisons is to be substantially reduced following clinical and scientific advice.

Due to the success of the vaccination programme and improved treatments, Public Health Scotland and Antimicrobial Resistance & Healthcare Associated Infection Scotland have recommended a return to pre-pandemic testing.

This means testing will be based on person-centred clinical decisions, rather than a routine policy for all individuals. Routine testing will continue for patients moving from hospitals to care homes and will be reviewed based on future advice and outbreaks. Tests will also continue to be available for those eligible for antiviral treatment.

The new guidance will come into effect by 30 August 2023.

Chief Medical Officer Professor Sir Gregor Smith said: “Due to the success of vaccines in protecting people, and the availability of improved treatments, now is the right time to revise the advice on routine COVID-19 testing across health and social care settings and prisons. This will ensure the testing regime remains effective and proportionate.

“Routine testing will remain when patients are discharged from hospital to care homes, to provide additional reassurance for these settings, and testing will still be required when clinically appropriate.

“The clinical advice tells us that focusing on the risk to individuals under general infection control procedures will allow our hospital, social care and prison staff to better protect those in their care and that there is no longer a requirement to apply separate COVID-19 guidance across the board when so many are now protected from its worst harms.”

COVID CASES ON THE RISE

This UK Health Security Agency fortnightly flu and COVID-19 report brings together the latest surveillance data along with the latest public health advice.

The latest report was produced on 3 August:

COVID-19 case rates continued to increase this week compared to our previous report. 5.4% of 4,396 respiratory specimens reported through the Respiratory DataMart System were identified as COVID-19. This is compared to 3.7% of 4,403 from the previous report.

The overall COVID-19 hospital admission rate for week 30 was 1.97 per 100,000 population, an increase from 1.17 per 100,000 in the previous report.

ICU admission rates have decreased to 0.05 compared to 0.07 in the previous report.

Those aged 85 years and over continue to have the highest hospital admission rates; these have increased to 20.49 per 100,000 from 9.8 per 100,000 in the previous report.

Admission rates among those aged 75 to 84 years have increased to 9.45 per 100,000 from 5.54 in the previous report.

Dr Mary Ramsay, Head of Immunisation at the UK Health Security Agency (UKHSA), said: “We continue to see a rise in COVID-19 cases in this week’s report. We have also seen a small rise in hospital admission rates in most age groups, particularly among the elderly.

“Overall levels of admission still remain extremely low and we are not currently seeing a similar increase in ICU admissions. We will continue to monitor these rates closely.Regular and thorough hand washing helps protect you from COVID-19 and other bugs and viruses.

“If you have symptoms of a respiratory illness, we recommend staying away from others where possible.

“The NHS will be in contact in autumn 2023 when the seasonal vaccine is available for those who are eligible due to health conditions or age, and we urge everyone who is offered to take up the vaccine when offered.”

All children aged 1 to 9 in London to be offered a dose of polio vaccine

As further poliovirus has been detected in sewage, JCVI recommends that polio vaccine booster doses should be offered to children across London.

Following the discovery of type 2 vaccine-derived poliovirus in sewage in north and east London, the Joint Committee on Vaccination and Immunisation (JCVI) has advised that a targeted inactivated polio vaccine (IPV) booster dose should be offered to all children between the ages of 1 and 9 in all London boroughs.

This will ensure a high level of protection from paralysis and help reduce further spread of the virus.

Nationally the overall risk of paralytic polio is considered low because most people are protected from this by vaccination.

Many countries globally provide an additional dose of polio-containing vaccine as part of their childhood vaccination schedule. The NHS in London will contact parents when it’s their child’s turn to come forward for a booster or catch-up polio dose – parents should take up the offer as soon as possible.

The programme will start with the areas affected, where the poliovirus has been detected and vaccination rates are low. This will be followed by rapid rollout across all boroughs.

This booster dose will be in addition to the NHS childhood vaccination catch-up campaign across London, where childhood vaccination uptake is lower than the rest of the country. It’s important all children aged 1 to 9 – even if up to date with their vaccinations – accept this vaccine when offered to further strengthen their protection against the poliovirus.

Following the findings earlier this year of type 2 poliovirus (PV2) collected from the Beckton sewage treatment works, further upstream sampling undertaken by the UK Health Security Agency (UKHSA) and the Medicines and Healthcare products Regulatory Agency (MHRA) has now identified at least one positive sample of the poliovirus, currently present in parts of the following boroughs:

Barnet
Brent
Camden
Enfield
Hackney
Haringey
Islington
Waltham Forest

The sampling has also detected the virus in lower concentrations and frequency in areas adjacent to the Beckton catchment area to the South (immediately below the Thames) and to the east of Beckton. However, it is not clear whether the virus has established itself in these areas or if the detections are due to people from the affected area visiting these neighbouring areas.

The level of poliovirus found and the high genetic diversity among the PV2 isolates suggests that there is some level of virus transmission in these boroughs which may extend to the adjacent areas. This suggests that transmission has gone beyond a close network of a few individuals.

A total of 116 PV2 isolates have been identified in 19 sewage samples collected in London between 8 February and 5 July this year, but most are vaccine-like virus and only a few have sufficient mutations to be classified as vaccine derived poliovirus (VDPV2).

VDPV2 is of greater concern as it behaves more like naturally occurring ‘wild’ polio and may, on rare occasions, lead to cases of paralysis in unvaccinated individuals.

UKHSA is working closely with health agencies in New York and Israel alongside the World Health Organisation to investigate the links between the poliovirus detected in London and recent polio incidents in these 2 other countries.

Dr Vanessa Saliba, Consultant Epidemiologist at UKHSA, said: “No cases of polio have been reported and for the majority of the population, who are fully vaccinated, the risk is low.

“But we know the areas in London where the poliovirus is being transmitted have some of the lowest vaccination rates. This is why the virus is spreading in these communities and puts those residents not fully vaccinated at greater risk.

“Polio is a serious infection that can cause paralysis but nationally the overall risk is considered low because most people are protected by vaccination. The last case of polio in the UK was in 1984, but decades ago before we introduced the polio vaccination programme around 8,000 people would develop paralysis every year.

“It is vital parents ensure their children are fully vaccinated for their age. Following JCVI advice all children aged 1 to 9 years in London need to have a dose of polio vaccine now – whether it’s an extra booster dose or just to catch up with their routine vaccinations. It will ensure a high level of protection from paralysis. This may also help stop the virus spreading further.”

Jane Clegg, Chief Nurse for the NHS in London said: “While the majority of Londoners are protected from polio, the NHS will shortly be contacting parents of eligible children aged 1 to 9 years old to offer them a top-up dose to ensure they have maximum protection from the virus.

“We are already reaching out to parents and carers of children who aren’t up to date with their routine vaccinations, who can book a catch-up appointment with their GP surgery now and for anyone not sure of their child’s vaccination status, they can check their Red Book.”

UKHSA, working with MHRA, has already increased sewage surveillance to assess the extent of spread of the virus and are currently sampling 8 sites across London.

A further 15 sites in London will start sewage sampling in mid-August, and 10 to 15 sites will be stood up nationally to determine if poliovirus is spreading outside of London.

Heat-health alert issued by the UK Health Security Agency in England

The UK Health Security Agency’s (UKHSA) heat-health alert service is designed to help healthcare professionals manage through periods of extreme temperature. The service acts as an early warning system for periods of high temperatures that may affect the public’s health.

The alert will be in place from midday Tuesday 9 August to 6pm on Saturday 13 August for all regions of England.

Temperatures are not forecast to reach the record-breaking levels of the most recent heatwave but are expected to rise throughout the week, potentially reaching mid-30 degrees Celsius on Friday and Saturday in the South East, London, the South West, and the East and West Midlands.

Dr Agostinho Sousa, Head of Extreme Events and Health Protection at the UK Health Security Agency (UKHSA), said: “Temperatures will feel very warm again this week, particularly in southern and central parts of the country.

“We want everyone to enjoy the warm weather safely when it arrives but remember that heat can have a fast impact on health. It’s important to ensure that people who are more vulnerable – elderly people who live alone and people with underlying health conditions – are prepared for coping during the hot weather.

“The most important advice is to ensure they stay hydrated, keep cool and take steps to prevent their homes from overheating.”

Met Office Deputy Chief Meteorologist, Tony Wardle, said: “Heatwave criteria look likely to be met for large areas of the UK later this week, with the hottest areas expected in central and southern England and Wales on Friday and Saturday. Temperatures could peak at 35⁰C, or even an isolated 36⁰C on Saturday.

Elsewhere will see temperatures widely into the high 20s and low 30s Celsius later this week as temperatures build day-on-day through the week due to an area of high pressure extending over much of the UK.

Coupled with the high daytime temperatures will be continued warm nights, with the mercury expected to drop to only around low 20s Celsius for some areas in the south.

Read more on the forecast from the Met Office.

The top ways for staying safe during hot weather:

look out for those who may struggle to keep themselves cool and hydrated – older people who may also live alone, and those with underlying conditions are particularly at risk
stay cool indoors by closing curtains on rooms that face the sun – and remember that it may be cooler outdoors than indoors
drink plenty of fluids and avoid excess alcohol
try to keep out of the sun between 11am to 3pm, when the UV rays are strongest
walk in the shade, apply sunscreen and wear a wide-brimmed hat, if you have to go out in the heat
avoid physical exertion in the hottest parts of the day
make sure you take water with you if you are travelling
check that fridges, freezers and fans are working properly
check medicines can be stored according to the instructions on the packaging
never leave anyone in a closed, parked vehicle, especially infants, young children or animals
take care and make sure to follow local safety advice if you are going into the water to cool down

High temperatures also present a risk of wildfires, especially after long dry periods. People with pre-existing heart and lung conditions such as asthma are most susceptible as breathing wildfire smoke may worsen their symptoms. Children and older people may also be susceptible to health impacts.

If wildfire smoke affects your area, avoid or reduce your exposure to smoke by staying indoors with the doors and windows closed.

Where possible avoid smoky areas. If you should travel through a smoky area, ensure that the vehicle windows are closed and the air conditioning is switched to recycle or recirculate if possible.

Listen out for local news reports and information from the emergency services who will provide advice on the precautions you should take.

Further information:

Read the UKHSA blog on staying safe in extreme heat.

UKHSA’s Beat the heat checklist identifies suitable actions people can take to protect themselves during periods of hot weather.

For more information on the common signs and symptoms of heat exhaustion and heatstroke, visit NHS.UK.

UKHSA has also published advice for the public on how to stay healthy during periods of drought.