Research and analysis

HPR volume 11 issue 10: news (10 March)

Updated 15 December 2017

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1. International travellers reminded to check latest recommendations on yellow fever vaccination in light of Brazil outbreak

NaTHNaC has reiterated its advice to international travellers to Brazil – and to any country with a recognised risk of yellow fever– that they should always check on latest vaccination recommendations in the light of the ongoing Brazil outbreak, as recommendations are likely to be subject to further change [1].

WHO this week made a further incremental change to its official vaccination recommendations for Brazil – the State of Espírito Santo, in its entirety, now being considered at risk for yellow fever transmission [2].

Consequently, NaTHNaC has re-emphasised that vaccination is recommended for personal protection in all countries in the region where a risk of yellow fever is indicated [3]. Detailed information for specific areas of Brazil is available on NaTHNaC’s Brazil Country Information page.

When undertaking yellow fever risk assessments for other countries, health professionals should refer to the NaTHNaC Country Information Pages for information on risk areas, recommendations for yellow fever vaccination and IHR (2005) certificate requirements.

General information about yellow fever is available on the PHE website.

1.1 References

  1. NaTHNaC (7 March). Yellow Fever outbreak in Brazil: update.
  2. WHO (6 March). Updates on yellow fever vaccination recommendations for international travellers related to current situation in Brazil.
  3. WHO (2013). Yellow fever vaccination recommendations in the Americas.

2. Updated EFSA/ECDC assessment of multi-country outbreak of S. Enteritidis

On 7 March 2017, the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) published an update to the joint rapid outbreak assessment relating to a multi-country outbreak of Salmonella Enteritidis [1].

From 1 May 2016 to 24 February 2017, 14 EU/EEA countries had reported 218 confirmed cases and 252 probable cases of Salmonella Enteritidis related to this outbreak.

Whole genome sequencing (WGS) and phylogenetic analysis, performed by PHE, confirmed that cases reported in Belgium, Croatia, Denmark, Finland, France, Greece, Hungary, Italy, Luxembourg, the Netherlands, Norway, Slovenia, Sweden, and the United Kingdom were genetically related and formed part of this EU-wide outbreak.

Through collaborative working between ECDC, EFSA and EU member states, extensive environmental and food investigations, whole genome sequencing and a trace-back investigation of eggs, links between the outbreak and multiple farms and egg packing centres in Poland were established.

Control measures were applied by the Polish Authorities to ensure no eggs from infected flocks were placed on the market without first undergoing heat treatment to eliminate salmonella.

The use of WGS at an international level allowed this outbreak to be detected and effectively investigated across the EU. The involvement of organisations such as ECDC, EFSA and the European Commission helped to ensure appropriate, robust public health protection measures were taken at the source of the infection in line with EU legislation.

2.1 References

  1. EFSA/ECDC (7 March 2017). Rapid outbreak assessment: multi-country outbreak of Salmonella Enteritidis phage type 8, MLVA profile 2-9-7-3-2 and 2-9-6-3-2 infections.

3. NCSP facilitated workshops programme

PHE launched its first Quality Awards in March to celebrate innovative quality improvement activity across the organisation. The awards celebrate the contributions made by staff across the agency in providing a high quality service, aiming to ensure PHE remains a world class public health organisation. The NIS National Chlamydia Screening Programme team’s work on the Chlamydia Care Pathway Tool was shortlisted for the Most Improved Innovation Award.

The Chlamydia Care Pathway describes the individual steps which, taken together, represent comprehensive case management for an episode of chlamydia testing, diagnosis and treatment – as recommended by the NCSP [1].

The tool allows relevant data for each step of the Chlamydia Care Pathway – test uptake, detection of infections, treatment and partner management – to be analyzed. It has been used as the basis for discussions with PHE Centre teams, commissioners and service providers in a country-wide programme of workshops, each facilitated by an NCSP team member. The workshops helped users identify areas of programme delivery where implementing change could lead to improved outcomes, local chlamydia activities have been reviewed and data-driven action plans to improve service provision and outcomes instigated.

Between April 2016 and March 2017, 75% of local authorities in England (114) were represented at a workshop. Delegates’ feedback was extremely positive, in particular because the pathway approach allowed commissioners and providers to understand how best to use the limited resources available to them for infection control.

3.1 Reference

  1. PHE website. NCSP: chlamydia care pathway.

4. Infection reports in this issue of HPR

The following infection reports are published in this issue of HPR. The links below are to the relevant webpage collections or publications:

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