Research and analysis

HPR volume 11 issue 4: news (27 January)

Updated 15 December 2017

1. Group A streptococcal infections: first report on seasonal activity during the 2016 to 2017 season

Public Health England is continuing to monitor notifications of scarlet fever cases in England in the early phase of the 2016/17 season, following the high levels recorded in previous years.

According to the first report on Group A Streptococcus activity for the 2016/17 season, published in this issue of HPR [1], national scarlet fever activity is showing a typical seasonal pattern, gradually increasing from a low level of notifications each week, nevertheless elevated compared with previous years (see figure).

GPs, microbiologists and paediatricians are reminded of the importance of prompt notification of cases and outbreaks to local PHE health protection teams, obtaining throat swabs (prior to commencing antibiotics) when there is uncertainty about the diagnosis, and ensuring exclusion from school/work until 24 hours of antibiotic treatment has been received [2].

Weekly scarlet fever and iGAS notifications in England, 2010/11 onwards

1.1 References

1. Group A streptococcal infections: first report on seasonal activity, 2016/17.
2. PHE (2014). Interim guidelines for the public health management of scarlet fever outbreaks in schools, nurseries and other childcare settings.

2. Infectious agents in spa-pool systems: new HSE guidance

Spa pool systems are a recognised source of disease caused by infectious agents including the organism that causes legionnaires’ disease, primarily Legionella pneumophila. There have been a number of outbreaks linked to spa pools in leisure centres, hotels, holiday homes, on cruise ships and on display.

New guidance has been published by the Health and Safety Executive, primarily intended for those who manage or operate spa-pool systems, explaining how to manage the risks from legionella and other infectious agents [1]. It also aims to help service suppliers, designers, manufacturers, importers, suppliers and installers of spa-pool systems meet their legal responsibilities.

As well as guidance on operation and maintenance of commercial-type systems, the guidance includes specific advice on domestic spa-pools, or hot tubs, used as part of a business activity: for example, in holiday parks, rental units, hotel bedrooms with a dedicated spa, and where systems are on display or used at exhibitions.

The guide includes advice on effective ways of safely managing and controlling spa-pool systems through:

• design, commissioning, operation and maintenance
• testing and monitoring of spa-pool water quality, and
• appropriate and frequent inspections.

2.1 Reference

1. HSE (January 2017). Control of legionella and other infectious agents in spa-pool systems.

3. Shingles vaccine coverage report in this issue of HPR

A report on vaccine coverage achieved during the first quarter of the fourth year of the herpes zoster (shingles) immunisation programme in England is published in the routine reports section of this issue of HPR [1].

The report presents provisional cumulative coverage data, comparing these with the first quarter of the 2015/16, 2014/15 and 2013/14 programmes. Overall coverage of the shingles vaccination programme was 33.2% in November 2016 for the routine 70-year-old cohort (compared to 37.8% in November 2015, 39.8% in November 2014 and 37.9% in November 2013 for the 2015/16, 2014/15 and 2013/14 cohorts, respectively); and 33.6% for the 78-year-old catch-up cohort (compared to 38.2 in November 2015 and 38.6% in November 2014 for the 2015/16 and 2014/15 cohorts, respectively).

3.1 Reference

1. Shingles vaccine coverage report, England, September to November 2016, HPR 11(4), 27 January 2017.