Scarlet Fever update

Public Health England (PHE) is advising parents to be aware of the signs and symptoms of scarlet fever following a substantial increase in reported cases across England in 2017 to 2018.

scarlett fever

Scarlet fever is a very contagious, seasonal bacterial illness that mainly affects children and is not uncommon for this time of year.

In the latest publication of  PHE’S  Health Protection Report  there were 6,225 reported cases of scarlet fever since mid-September 2017, compared to 3,764 for the same period last season. There were 719 cases reported for the most recent week (22 to 28 January 2018).

The full new story is at Public Health

Guidelines for the management of Scarlet Fever are also available from Public Health here


Measles: Don’t let your child catch it

This poster highlights the current new campaign to encourage parents to get their child vaccinated | PHE

Image source: PHE

This poster has been revised and updated as part of the measles elimination strategy. The number of young people catching measles is rising. To be protected they need to be immunised with the MMR vaccine. It’s never too late to be vaccinated. It’s time to make measles a disease of the past.

An A3 size downloadable poster is available here

Can vitamin D really stop you getting cold and flu?

New study claims that Vitamin D can reduce the risk of colds and influenza. A new study, published in the British Medical Journal found that daily pills of the vitamin reduced infections by 12%


Objectives To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect.

Design Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials.

Results 25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants.  In subgroup analysis, protective effects were seen in those receiving daily or weekly vitamin D without additional bolus doses but not in those receiving one or more bolus doses.  Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event. The body of evidence contributing to these analyses was assessed as being of high quality.

Conclusions Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.

Full reference: Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data  | Published 15 February 2017 | BMJ 2017;356:i6583

See also: BBC News: Vitamin D pills ‘could stop colds or flu’

Promoting better hygiene with children and young people

NICE and Public Health England recommend children and young people are taught the importance of hand washing to tackle antimicrobial resistance.


The guidance recommends children in nurseries and young people at university be taught when and how to wash and dry their hands, for example after going to the toilet and before preparing food, in order to prevent the spread of infections. Public Health England’s (PHE) educational resources, e-Bug and Germ Defence, are listed as two ways to promote better hygiene.

The guidance by NICE and PHE, is aimed at NHS organisations, local authorities and health and social care professionals so they can provide information to people in their care.

Record numbers of NHS frontline staff have had flu jab this winter

Record numbers of NHS staff have had their flu jab this winter, official figures from Public Health England (PHE) show | OnMedica


Some 594,700 (61.8%) frontline NHS staff across England were vaccinated against flu between 1 September and 31 December last year. That figure is expected to increase in January and February.

The highest level achieved by the end of February in previous winters was 541,757 (just under 55%) in 2014-15.

PHE does not have recorded numbers of deaths from flu. But it is estimated that, in 2015-16, there were about 2,300 excess deaths over the winter linked to the time of year. Flu and extreme cold weather are the two most likely causes.

Read the news story here

Respiratory tract infections: infection control

Guidance on transmission routes and precautions in healthcare settings | PHE

B0010277 Rhinovirus
Image source: David S. Goodsell, RCSB Protein Data Bank – Wellcome Images // CC BY-NC-ND 4.0 

Image shows molecular model from X-ray diffraction data of a rhinovirus particle.

Avoiding transmission of acute respiratory infections in healthcare settings can prevent considerable mortality, morbidity and healthcare costs. Patients in healthcare settings, which include acute hospitals, outpatient clinics, A&E departments, specialised units and primary care, are often vulnerable because of age or chronic disease, and may suffer more severe disease or complications from acute respiratory infections.

This document summarises recommendations for the prevention and control of  acute respiratory infections in healthcare settings for clinical and public health colleagues. Preventing infection in healthcare settings requires the consistent application of infection control measures by healthcare workers and the involvement of the local infection control team. It also requires efforts to: maximise coverage of seasonal influenza vaccine among vulnerable groups and healthcare workers, and limit the spread of infection by visitors or infected staff, as well as general education and awareness-raising.

Read the full guidance here

Practice Transformation Program Increases Adult Influenza Vaccination

Infection Control Today | Published online: 3 November 2016


An evidence-based, step-by-step guide, the 4 Pillars™ Practice Transformation Program, was the foundation of an intervention to increase adult immunizations in primary care and was tested in a randomized controlled cluster trial. The purpose of this study by Lin, et al. (2016) was to report changes in influenza immunization rates and on factors related to receipt of influenza vaccine.

Twenty-five primary care practices were recruited in 2013, stratified by city (Houston, Pittsburgh), location (rural, urban, suburban) and type (family medicine, internal medicine), and randomized to the intervention (n = 13) or control (n = 12) in Year 1 (2013-14). A follow-up intervention occurred in Year 2 (2014-15). Demographic and vaccination data were derived from de-identified electronic medical record extractions.

A cohort of 70,549 adults seen in their respective practices (n = 24 with 1 drop out) at least once each year was followed. Baseline mean age was 55.1 years, 35 % were men, 21 % were non-white and 35 % were Hispanic. After one year, both intervention and control arms significantly (P < 0.001) increased influenza vaccination, with average increases of 2.7 to 6.5 percentage points. In regression analyses, likelihood of influenza vaccination was significantly higher in sites with lower percentages of patients with missed opportunities (P < 0.001) and, after adjusting for missed opportunities, the intervention further improved vaccination rates in Houston (lower baseline rates) but not Pittsburgh (higher baseline rates). In the follow-up intervention, the likelihood of vaccination increased for both intervention sites and those that reduced missed opportunities (P < 0.005).

The researchers say that reducing missed opportunities across the practice increases likelihood of influenza vaccination of adults. The 4 Pillars™ Practice Transformation Program provides strategies for reducing missed opportunities to vaccinate adults.

Read the full overview here

Read the original article here