Y&H HPT Latest News and Briefings
Wuhan novel coronavirus (WN-CoV)
Please see here for the latest guidance for healthcare professionals.
This guidance outlines infection prevention and control advice for healthcare providers assessing possible cases of WN-CoV. It should be used in conjunction with local policies.
This guidance will remain under review as further scientific information is published about WN-CoV.
Vaccination / Immunisation Update
The algorithm for the vaccination of individuals with uncertain or incomplete immunisation status has been updated with effect from 1 January 2020.
Please see here for the latest version.
Increase in Scarlet Fever
We are recording a national increase in notifications of scarlet fever to Public Health England, above seasonally expected levels. Scarlet fever is a notifiable disease, and we would like to take this opportunity to remind practitioners of the signs and symptoms and the actions to be taken if you see a case.
Signs and symptoms of scarlet fever
Scarlet fever is a common childhood infection caused by Streptococcus pyogenes, or group A streptococcus (GAS). The symptoms are non-specific in early illness and may include sore throat, headache, fever, nausea and vomiting. After 12 to 48 hours the characteristic red, generalised pinhead rash develops, typically first appearing on the chest and stomach, rapidly spreading to other parts of the body, giving the skin a sandpaper-like texture. On more darkly-pigmented skin, the scarlet rash may be harder to spot, although the 'sandpaper' feel should be present. Patients typically have flushed cheeks and pallor around the mouth. This may be accompanied by a ‘strawberry tongue’. During convalescence desquamation of the skin occurs at the tips of fingers and toes, less often over wide areas of the trunk and limbs.
The differential diagnosis will include measles, glandular fever and slapped cheek infections.
Complications of scarlet fever
Although scarlet fever is usually a mild illness, patients can develop complications such as an ear infection, throat abscess, pneumonia, sinusitis or meningitis in the early stages and acute glomerulonephritis and acute rheumatic fever at a later stage. Patients, or their parents, should keep an eye out for any symptoms which might suggest these complications and if concerned advised to seek medical help immediately.
Suspected scarlet fever can be confirmed by taking a throat swab for culture of Group A streptococcus, although a negative throat swab does not exclude the diagnosis. Consider taking a throat swab to:
- assist with differential diagnosis,
- if you suspect that the patient may be part of an outbreak
- if the patient is allergic to penicillin or
- in regular contact with vulnerable individuals (e.g. healthcare worker)
- Prescribe antibiotics without waiting for the culture result if scarlet fever is clinically suspected.
- Advise exclusion from nursery / school / work for 24 hours after the commencement of appropriate antibiotic treatment
- Notify your Health Protection Team, including information on the school/nursery attended if relevant.
- Clinicians should be mindful of a potential increase in invasive GAS (iGAS) infection which can follow trends in scarlet fever. It is important to maintain a high index of suspicion, especially in relevant patients (such as those with chickenpox, and women in the puerperal period). Early recognition and prompt initiation of specific and supportive therapy for patients with iGAS infection can be lifesaving.
Increase in winter-related illnesses
Over the past two weeks, the Yorkshire and Humber Health Protection Team has seen a substantial increase in calls from schools about winter illnesses such as diarrhoea / vomiting and flu-like illness. There have been increases across the whole region and, although the types of illnesses that are being reported are what we would expect at this time of year, the increase is earlier and greater than we have seen in recent years.
As we are now aware that winter viruses are circulating widely across Yorkshire and Humber, schools do NOT need to routinely contact the Health Protection Team to report increased levels of illness. However, schools are welcome to contact the Health Protection Team for support and advice in complex situations.
We would like schools to contact us where there are reports of :
- severe illness including hospitalisation
- if the school is attended by high numbers of children with underlying medical conditions (or special needs) that might make them more vulnerable to serious infection
- if there are unprecedented levels of parental concerns which have not been addressed through provision of the information leaflet and other routine measures / communications
Advice on managing increased levels of illness
The most important steps in controlling increased levels of winter illnesses are:
- Excluding pupils and staff who are unwell:
- Please ensure that pupils and staff who are affected do not come to school.
- Adults and children who are affected by flu-like illnesses should stay off school until they have recovered.
- Adults and children who are affected by diarrhoea and vomiting should stay off school until at least 48 hours after they last had diarrhoea or vomiting.
Encouraging good hand hygiene:
- Handwashing is an effective way to stop infections spreading.
- Please ensure that all pupils and staff frequently wash their hands with warm water and soap (hand gel is not as effective as soap), particularly after using the toilet, after using a tissue to catch a cough or sneeze, and before eating.
Cleaning the environment:
- In addition to making sure that any vomit or diarrhoea on school premises is promptly cleaned up according to your usual protocols, increasing general cleaning of the school environment can also help to reduce the spread of winter illnesses.
- For example, you may wish to ensure that there is twice-daily cleaning of areas (with
- particular attention to door handles, toilet flushes and taps) and communal areas where surfaces can easily become contaminated (such as handrails).
Closure of schools
We do not routinely advise that schools close when there are increased levels of D&V or flu-like illness. Closing schools does not usually provide any protection against catching these illnesses, as there are likely to be high levels of the same illness circulating in the community. Children and staff will still be at risk of catching the illness whether or not they are at school.
Schools may choose to close for business continuity / staffing reasons or to facilitate cleaning of premises; this will be at the discretion of the school management team. However, there is no need for a school to remain closed for public health reasons.
The flu vaccine is the best form of protection that we have against influenza (flu). There are several strains of flu and even if there has been illness at school, the vaccine may offer further protection against other strains of flu.
Parents should be encouraged to continue to engage in the school-based immunisation programme and to attend mop-up clinics if they miss scheduled sessions due to illness.
Toddlers aged two and three, children and adults who are in risk groups for flu (including those aged 65 years and over, pregnant women, people with long term medical conditions or weakened immune systems) should attend their GP or pharmacy for vaccination as soon as possible if they have not already been vaccinated.
For further information about any of the https://www.nhs.uk/conditions/flu/
Stay Well This Winter Campaign
Cold weather can be seriously bad for your health. That's why it's important to look after yourself, especially during the winter.
As we get older, changes to our bodies mean that cold weather and winter bugs affect us more than they used to. But what’s changed and why does it mean were more likely to get sick over winter.
Colds, flu and pneumonia are all more common in winter. Last year over 60% of cases of flu that needed hospital treatment were in people over 65. So it’s a good idea for us all to use the MECC approach and encourage people who are more at risk to take up the flu jab and undertake simple actions to lower the risk of catching flu.
Flu vaccination is available every year on the NHS to help protect adults and children at risk of flu and its complications. Flu can be unpleasant, but if you're otherwise healthy, it'll usually clear up on its own within a week.
Please click on the link here to our MECC Link, for further information about vaccination and self-care.
What is MECC Link?
MECC Link is a simple but flexible online tool that has been carefully designed to support an approach to positive behaviour change called 'Making Every Contact Count' (MECC). MECC Link helps you to raise awareness, motivate and signpost people to help them to improve their health and wellbeing. MECC Link gives you access a full range of signposting information for health improvement, including self-care and national and local support services...and it does this all in one place by providing:
- Easily accessible information on key healthy lifestyle topics
- Suggested open questions using the Ask, Assist, Act model
- Information on a range of primary Self-care tools and resources
- Signposting to recommended national and local support services.
To access the MECC Link pages, please click here
Public Health England launches new infectious disease strategy
The new strategy addresses current and future threats to health, including antibiotic resistance and health inequalities.
Please use the following link.
Loss of WHO Measles elimination status in the UK
PHE has warned that one in seven 5-year-olds may not be fully up-to-date with some routine immunisations, with the figure rising to around one in four children in London.
A press release was issued covering measures being taken to improve vaccine uptake and the increase in the number of Measles case reported in 2018.
To read an overview on how vaccines work, please follow the link here.
Latest data on laboratory-confirmed cases reported in the second quarter of 2019 are due to be published shortly.