Winter NHS deaths rise a national scandal

The highest winter NHS deaths figures in almost 10 years should act as a "deafening wake-up call" for the labour Government, charities said today.

There were an extra 36,700 deaths in England and Wales from December 2008 to March 2009, compared with the average for non-winter periods, figures from the Office for National Statistics (ONS) showed.

This was the highest number since the winter of 1999/2000 and a rise of 49% compared with 2007/08.

Andrew Harrop, head of policy at Age Concern and Help the Aged, said: "It is a national scandal that the UK has more older people dying in winter, compared to the rest of the year, than countries with more severe weather, such as Sweden and Finland.

"Excess winter deaths of older people have remained stubbornly high in recent years, but last winter's huge spike sounds a deafening wake-up call about the older population's well-being if we have another cold snap.

"To end this national scandal, the Government must do much more to tackle fuel poverty, which currently affects one in three older households."

Fuel poverty charity National Energy Action (NEA) warned that a combination of high energy prices, low incomes and poor insulation will continue to pose a serious threat to the health of millions of people, especially pensioners, during the coming months.

Jenny Saunders, NEA chief executive, said: "The Government needs to step up action that will end these shameful statistics and comprehensibly tackle fuel poverty in the UK."

The winter of 2008/9 had the coldest average winter temperature since 2005/6, one of the factors which affects the number of so-called excess winter deaths, an ONS spokesman said.

He added that the Health Protection Agency (HPA) said influenza activity started early and reached moderate levels during the winter of 2008/9.

Temperature and levels of disease in the population are two of the key factors which contribute to the number of deaths.

The greatest number of excess winter deaths occurred in people aged over 85, the ONS figures showed.

Women accounted for the highest number of excess winter deaths, a fact mostly explained by the higher number of women than men aged over 85, the ONS said.

There were 21,400 excess winter deaths in women and 15,300 in men in the winter of 2008/9, the ONS said.

But the largest increase - 59% - was in men aged 75 to 84, with the overall rate for men 44% higher than the previous year.

Among women, the overall rate increased by 52% compared with 2007/8.

A Department of Health (DH) spokesman said: "The causes of excess winter deaths are very complex. Last year was a colder than average winter, which explains some of the extra deaths seen.

The NEA called for an extension of the winter fuel payments "to include other vulnerable households and not just those who are over 60".

It also urged the Government to increase the budget for the Warm Front Scheme - which provides a package of insulation and heating improvements up to the value of £3,500 - to £530 million next year.

Ms Saunders said: "As it stands, the budget for 2010 is set to be cut back by around 50% on this year's budget.

"I urge the Chancellor in his Pre-Budget Report on December 9 to increase support for the life-saving heating and insulation measures available to low income households under this flagship programme.

"People need to be aware of the help that is available to them through the various grants and schemes from DECC, energy companies and our own Warm Zones where we have established these with local authorities.

"Pensioners in particular are often anxious to avoid debt and turn their heating down or even off, often unaware that they are putting their health in danger."

She said there were more than five million households who cannot afford to heat their homes, putting them at risk of serious health problems like heart disease, strokes, respiratory illnesses - such as asthma and bronchitis - and exacerbating common ailments like colds and flu.

She added that the increase in excess winter deaths was "sadly expected but remains extremely worrying".

From:

http://www.independent.co.uk/winter-deaths-rise-a-national-scandal

Swine flu- rise in UK deaths but overall numbers decline

The number of deaths in England linked to swine flu jumped by nine to 36 over the past week, according to the Health Protection Agency.

The Health Protection Agency (HPA), at a briefing in London, said 530 patients had been admitted to hospital in England - down on the previous week's total of 793.

The HPA estimated there were 30,000 new cases of swine flu in England, but said the majority of cases continued to be "mild".

"There is no sign that the virus is changing," said the HPA. "It is not becoming more severe or developing resistance to anti-virals."

The number of weekly GP consultations dropped over the past week, coinciding with the launch of the National Pandemic Flu Service.

Chief Medical Officer Sir Liam Donaldson said the rise in the death toll did not indicate that the virus was becoming more potent.

"I don't think it suggests any increase in severity in the disease because we would have expected a higher proportion to be in intensive care or in hospital if the severity was increasing," he said.

"I think we are probably seeing the level of increase in the disease that would be expected, really, from the proportion of people in hospitals with serious disease."

Sir Liam predicted a second wave of the virus could strike after children returned to school but was unable to state exactly when this was likely to hit.

"It's just guesswork," he said. "We would anticipate when the schools were back, at some point after that, it will start to rise again."

He added there were no plans to close schools or delay their opening on a national scale.

"I think we are pretty certain we will see a second wave," said Sir Liam.

The HPA said 56 of the 530 people admitted to hospital after contracting swine flu were in "critical care".

Globally, the total of confirmed cases has reached 193,000 and the number of deaths is 1,362.

Sir Liam said the National Pandemic Flu Service would remain in place although the briefing was told it could be "scaled up or down" depending on the number of new cases reported.

http://www.telegraph.co.uk/health/swine-flu/5983531/Swine-flu-rise-in-deaths-but-overall-numbers-decline.html

Tamiflu side effects linked to children reports find

More than half of children taking Tamiflu to combat swine flu suffer side effects such as nausea, insomnia and nightmares, new research claims.

The antiviral drug, which is being handed out to hundreds of thousands of Britons, can also produce stomach pains, vomiting and diarrhoea, research suggests.

A study found that almost one in five youngsters experience neuropsychiatric side effects, such as poor concentration, confusion, and sleeping problems.

Thousands of schoolchildren were given the drug as a preventive measure during the early stages of the swine flu pandemic in Britain.

The findings are likely to lead to concern among parents that their children's performance at school has been jeopardised by taking the drug.

Only people with suspected or confirmed swine flu are now being prescribed Tamiflu, and around 150,000 packs have been distributed by the newly launched National Pandemic Flu Service in the past week alone.

Two studies from experts at the Health Protection Agency (HPA) showed a "high proportion" of British schoolchildren reporting problems after taking Tamiflu.

Data was gathered from children at three schools in London and one in south west England who were given Tamiflu earlier this year after classmates became infected.

One study, of 248 children aged 11 and 12 at a school in south west England, which was closed after a pupil contracted the virus, found that more than half suffered side effects from taking Tamiflu.

The report said: "Fifty-one per cent experienced symptoms, such as feeling sick (31.2 per cent), headaches (24.3 per cent) and stomach ache (21.1 per cent).

"Although some children were ill with flu-like symptoms, those tested did not have A (H1N1) v (swine flu) infection."

The researchers said "likely side effects were common" and the "burden of side effects needs to be considered" when deciding on giving Tamiflu to children prophylactically.

Another study of 103 schoolchildren found 45 suffered side-effects such as nausea, stomach pain, problems sleeping, vomiting and diarrhoea.

Almost one in five (18 per cent) reported a neuropsychiatric side effect, such as poor concentration, inability to think clearly, problems sleeping, feeling dazed or confused and nightmares.

The report concluded: "This may be of particular concern to exam year students (and their parents)."

The studies were carried out in the early stages of the pandemic, when everyone sharing a classroom with a child who developed swine flu was given the drug, even if they showed no symptoms.

The findings were disclosed as it emerged that Japanese authorities are advising doctors not to prescribe Tamiflu to youngsters aged 10 to 19 over fears of neuropsychiatric side effects.

A statement from Roche, which manufactures Tamiflu, said the contribution of Tamiflu to neuropsychiatric effects "has not been established".

Tamiflu-linked-to-side-effects-among-children-reports-find

Timebomb of Britons unaware they have HIV

Senior doctors accuse the Department of Health of failing to take HIV virus seriously and neglecting to test high risk groups.

More than 20,000 people with HIV are unaware they are carrying the virus and are infecting thousands of others, setting a devastating health “timebomb”, medical experts have warned.

Senior doctors have accused the Department of Health of failing to take the spread of HIV seriously and neglecting to test enough people in high-risk groups, including gay men and heterosexual black Africans.

HIV specialists say they are seeing people in clinics with full-blown Aids who have no idea they have been carrying the virus. They now want all sexually active people to be routinely offered an HIV test.

The Lancet medical journal has published an editorial accusing ministers of an “appalling failure to tackle HIV” and of having “no credible strategy to diagnose and care for those living with, but unaware of, HIV in Britain”.

The Health Protection Agency (HPA), the labour government’s health watchdog, warned that about 77,000 people in the UK have HIV but 21,000 of these do not know they are infected. In 2007, the number of infections through heterosexual contact increased to 960, up from 540 in 2003.

Doctors warn that a third of people with HIV are being diagnosed when their virus is advanced. One London hospital recently treated two teenage sisters, one of whom was pregnant, infected with HIV from the same man. Hospitals are also concerned about men who are diagnosed with HIV but abscond before they can be treated.

They called on the government to take testing more seriously, warning that an A&E target to treat patients within four hours meant people with early symptoms of HIV were not being tested in emergency rooms because of time pressure.

Dr Phillip Hay, reader in HIV medicine at St George’s hospital in Tooting, south London, said testing for the virus should be routine to stop its spread through unprotected sex.

He said: “We have identified some people who have infected multiple individuals”, including couples “where there is a big difference in age between an older adult and a teenager. All men and women accessing medical care should be routinely offered a test”.

The HPA said high-risk groups should be targeted for testing.

“It is a matter of concern that so many individuals in the UK are unaware that they are HIV-infected,” it said.

All the Department of Health could say was that HIV prevention was still a priority.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article6447107.ece

Swine flu- nanny state launches mass advertising campaign as ministers step up fight

Labour ministers will blow more taxpayers' money as a mass advertising campaign will be mounted to try to contain the growing swine flu outbreak in the UK.

Every household in the country will have a leaflet through the door from next Tuesday onwards

As five cases of swine flu were confirmed in the UK – including a 12-year-old girl – and 78 further people are being tested, labour ministers mounted a major offensive to contain the problem.

Adverts will run in newspapers, on radio and on TV from today giving information about swine flu and advising people that basic hygiene measures such as covering your nose and mouth with a tissue and washing your hands are the best ways to protect against the disease.

Every household in the country will have a leaflet through the door from next Tuesday onwards also giving information on the disease and what to do in the event of someone showing symptoms.


Health Secretary Mr Johnson said: "We are following the philosophy to hope for the best but absolutely prepare for the worst. It is inevitable there will be more cases. What is reassuring is that if you take Tamiflu early you make a full recovery. It is just like a dose of flu. It could get much worse but we are prepared."

Sir Liam Donaldson, chief medical officer, said the last bad seasonal flu year was in the winter of 1999/2000 when 22,000 people died – ten times the norm – and he warned that a pandemic could be similar to that situation but 'multiplied several times over'.

Mr Johnson announced a raft of new measures including boosting the stock of antiviral drugs, Tamiflu and Relenza, which reduce symptoms and severity of flu from 33m courses to 50m courses and extra antibiotics are being purchased to treat people who may develop secondary complications such as pneumonia.

Extra face masks with inbuilt filters are being bought for NHS staff and all front line health workers will receive their own course of anti-virals to take if they treat someone found to be infected with swine flu.

Health Protection Agency staff will be at all airports where flights come in from infected areas and all passengers on flights from affected areas to be given a leaflet with advice about seeking medical attention if display symptoms within seven days.

Airlines are being asked to keep passenger manifests for seven days instead of usual 24 hours to aid in contact tracing if necessary.

The public are being advised not to buy face masks as there is no evidence they prevent the spread.

Sir Liam, said: "So far all the cases in the UK have been imported cases from the main affected areas and we have not seen any ongoing transmission."

He said the positive side of this situation is that the virus is so far not spreading easily between people and no onward transmission has been yet seen outside Mexico and the US with the only confirmed cases having caught the disease in Mexico.

He said: "The virus is giving us a bit of time. It may become fast and furious at a later stage."

He warned that in past epidemics and pandemics children have been the 'supercarriers' so the school holidays, going back to school have been key factors in the spread.

This may be why health experts acted quickly to advise that the Paignton Community College be closed for a week after a 12-year-old girl there was confirmed as having contracted swine flu.

Ed Balls, the Schools Secretary egotist said: "We will put the health of children first."

From:
http://www.telegraph.co.uk/health/swine-flu/5244796/Swine-flu-Mass-advertising-campaign-as-ministers-step-up-fight.html

Swine flu confirmed in Britain

Swine flu has reached Britain it was disclosed last night, as officials confirmed that two people were being treated in a hospital isolation unit after contracting the disease on holiday in Mexico.

Cases have also been confirmed in Spain, Canada, and several states in the USA.

They were named in the Scottish press as honeymooners Iain and Dawn Askham, of Polmont, near Falkirk.

The World Health Organisation upgraded its pandemic alert level to 4 - two stages below the most serious threat - while the Foreign Office advised against all but essential travel to Mexico.

"British nationals resident in or visiting Mexico may wish to consider whether they should remain in Mexico at this time," a statement on the Foreign Office website added.

It comes as WHO Assistant Director General Keiji Fukuda said it was "too late" to contain swine flu and countries should now focus on mitigating the effects of the virus.

Describing the significance of the level four threat, Mr Fukuda said: "What this can really be interpreted as is a significant step towards pandemic influenza. But also, it is a phase that says we are not there yet."

It is believed twenty two other people who have been in close contact with the Scottish couple since their return who are receiving anti-viral drugs as a precaution. Seven of them are showing mild symptoms of influenza.

The seven with symptoms have been told to stay at home and will be tested to see if they have swine flu.

Fears were growing that the virus could cause a flu pandemic as a series of countries confirmed cases.

Officials in Mexico – the centre of the outbreak – said there were 1,455 probable cases and 149 confirmed deaths.

Cases have also been confirmed in Spain, Canada, and several states in the USA. More are suspected in New Zealand, Israel and Colombia. Four people in the Irish Republic were being tested for the virus.

The two British patients, from the Falkirk area of Scotland, returned from holiday last Tuesday and on Saturday developed symptoms and contacted doctors.

They are being kept in isolation at a hospital in Airdrie. They are being treated with anti-viral drugs and are said to be ‘‘recovering well’’.

Senior civil servants met in an emergency session in Whitehall to discuss the threat posed by the disease.

Nicola Sturgeon, the Scottish Health Minister, said every precaution was being taken to prevent further spread of the virus.

She said: “The seven displaying, and I stress, very mild symptoms will now be given anti-virals as treatment. The 22 that are not symptomatic will be given very extensive advice about minimising the spread.

“The focus is on the immediate contacts. Effectively, what we are trying to do is put a ring around this. We are trying to contain this as effectively as we can.”

Sir Liam Donaldson, the Government’s Chief Medical Officer, had earlier said that it was “inevitable” that the infection would reach Britain. “Hopefully, if we identify those early and treat people and their contacts, we might be able to reduce the spread,” he said.

Alan Johnson, the Health Secretary, told MPs there had been 25 suspected cases so far in Britain. Eight of them had subsequently tested negative for the disease.

A Canadian woman was taken to hospital in Manchester showing symptoms of flu, but officials said it was highly unlikely she had swine flu.

Mr Johnson added that Britain was – with France – one of the two best-prepared countries in the world to deal with a potential flu pandemic.

The Government had imposed “enhanced” port health checks in an attempt to identify passengers arriving in Britain with symptoms of the illness, he said, and measures were in place to allow the swift nationwide distribution of the drug Tamiflu, which can reduce the severity and length of flu illnesses.

In the Government’s pandemic plan the worst case scenario suggests that if half the population contracted pandemic flu there could be around 709,000 deaths.

Schools, sports events and concerts could be shut down to limit the spread of the illness. Doctors who come into contact with suspected cases should wear face masks, gloves and aprons, under protocols issued by the Health Protection Agency.

The World Health Organisation (WHO) has said the disease has ‘‘pandemic potential’’ and work has already begun on a vaccine against the potentially lethal virus – a variation of H1N1 swine flu – although this is likely to take months before it is ready for use.

Mr Johnson said: “Everywhere outside Mexico the symptoms have been mild and all the victims have made a full recovery.”

People who suspect they may have been infected should stay at home and seek medical advice over the telephone, he added.

The WHO increased the pandemic alert level from level three, where experts have identified little or no human to human transmission to level four indicating that it was spreading much more easily between people across large areas. A pandemic is declared at level six.

Since the alerts were introduced in 2005 it has never been higher than level three.

The Department of Health pandemic plan says that a likely scenario during a pandemic is that businesses should expect repeated waves of one in four employees being off work.

Stephen Alambritis, of the Federation of Small Businesses, said that this could be disastrous during a recession.

From:
http://www.telegraph.co.uk/health/swine-flu/5232846/Swine-flu-confirmed-in-Britain.html

Drug resistant superflu in Britain

A potentially deadly, drug resistant strain of "superflu" is circulating in Britain, scientists have warned.

The potent virus, which is more likely to trigger serious complications in patients, is a strain of the previously known H1N1 influenza virus, but cannot be treated with the most common flu drug, Tamiflu.

Scientists have found that the strain is three times more likely to cause pneumonia in patients than the normal strain, making it more deadly.

Some patients in Britain have already become infected with the drug-resistant H1N1 virus, but the Health Protection Agency (HPA) said that it was seeing only a very small number of cases.

The recent study, completed by researchers from the Norwegian Institute of Public Health and the HPA, found that, in addition to the heightened possibility of pneumonia, twice as many flu patients with the drug-resistant strain developed inflamed sinuses.

"Resistance in a more virulent influenza virus can have serious public health implications," Siri Hauge, who led the study, said.

Fewer treatment options and a more severe form of the virus can result in "more severe illness and death in those who become infected', she warned.

"These findings should be taken into consideration when shaping future strategies for treating and preventing seasonal and pandemic influenza.''

Flu kills thousands of people in Britain every year, particularly the elderly who struggle to fight off secondary infections like pneumonia. Most flu cases in Britain, around 90 per cent, are caused by the H3 strain of the the virus.

Tamiflu is an anti-viral treatment that has been stockpiled by the Government in case of a flu pandemic. The new strain can, however, be treated by other, less common flu drugs.

A spokesman for the HPA said: "We are seeing very, very small numbers of cases of this [drug-resistant H1N1] strain of flu.

"We are also monitoring cases and from our surveillance have no evidence at the moment that it is any more virulant than was previously thought."

The resistant strain of H1N1 was first seen in significant numbers during last year's flu season. A variant of the same virus caused the Spanish flu outbreak that killed an estimated 50 million people worldwide in 1918.

The research, published in the journal Emerging Infectious Diseases, studied 300 people in Norway who suffered from the virus last year.

Earlier this week health officials warned that another deadly type of influenza, H3N2 Brisbane 10, was affecting Britain.

That strain caused the death of six children and was responsible for a three fold rise in the usual number of cases of flu in Australia last year.

From:
http://www.telegraph.co.uk/health/4060912/Drug-resistant-superflu-in-Britain.html

Over a quarter of people in UK with HIV unaware of it, says HPA

Twenty eight per cent of people living with HIV in the UK are unaware they are infected, the Health Protection Agency has said.

An estimated 77,400 people in the UK are thought to have HIV, up from an estimated 73,000 in 2006.

The agency said there were 7,734 new diagnoses of HIV in 2007 but almost a third of people are being diagnosed late, after the stage at which they should have begun drug therapy for the condition. It said testing needed to be more widely available to reduce transmission rates in the heterosexual and homosexual populations.

"It is very worrying that so many people remain unaware of their HIV status. Wider HIV testing in high prevalence areas of the UK is urgently needed," said HPA Centre for Infections head of HIV surveillance Valerie Delpech.

Prevalence is greatest in London, parts of the south coast, Manchester and Blackpool.

Of new diagnoses in 2007, 41 per cent were among gay men, the majority of whom had become infected in the UK, and 55 per cent were acquired through heterosexual contact. The majority of the latter were probably acquired abroad.

A total of 180 new infections were acquired through injection drug use and 110 through mother to child transmission.

over_a_quarter_of_people_in_uk_with_hiv_unaware_of_it_says_hpa.html

Harmful mistakes of sex education in school

Judged by its results – sex education has been an utter failure. The increase in sex education here in recent years has coincided with an explosion of unwanted pregnancies and sexually transmitted disease (STD) far worse than anywhere else in Europe.

Since the labour government’s teenage pregnancy strategy was introduced in 1999, the number of girls having abortions has soared. You might well be tempted to argue that sex education causes sexual delinquency.

Only two months ago the Health Protection Agency reported that a culture of promiscuity among the young had driven the rate of STDs to a record. Almost 400,000 people – half of them under 25 – were newly diagnosed, 6% more than in 2006.

When something fails, the usual procedure is to drop it and try something else. With sex education, the worse it gets, the more people cry out for more of it and earlier.

Labour ministers are considering whether to make schools offer more sex education, offer it earlier and deny parents the right to withdraw their children from it.

Last week the Family Planning Association – now calling itself the fpa, having joined other charities in a mad rush to reduce themselves to a couple of lower-case letters – published a comic-style sex education booklet for six-year-olds to be marketed in primary schools for use in sex and relationships lessons.

It has printed 50,000 copies of Let’s Grow with Nisha and Joe, and tried it out in more than 50 primary schools; it hopes to encourage schools that have shied away from sex lessons to take them on with Nisha and Joe. Oh dear.

It seems to me highly unrealistic (given that 25% of children leave primary school struggling to read and write) to assume that many six-year-olds could begin to read the labels “testicles” or “vagina”.

And it is infuriating, given that medical-style euphemism has triumphed over plain English, that the authors have chosen one that’s wrong. “Vagina” does not mean the external genital organs, commonly referred to as “front bottom”. It comes from the Latin for sheath or scabbard and means what that suggests. The correct word would be “vulva”, but the ill-educated educationists blithely impose inaccuracy on our tiny children. However, that is not what I most object to.

What I object to about the book is what I object to about sex education as a whole (quite apart from its failures). Sex education – particularly compulsory and standardised sex education – is based on mistaken assumptions.

The first is the pervasive assumption of equality – that is, that all six-year-olds or all 11-year-olds or 15-year-olds can discuss the complexities of sex in the same form in the same way. That’s nonsense. Children vary in intelligence and progress. Some young children can easily decipher words such as “urethra”; others may never be able to read them.

More importantly, children and teenagers mature at different ages and come from different backgrounds with different family expectations. You cannot talk the same way to a shy 13-year-old who hasn’t had her first period to another who is well acquainted with the darker recesses of the school bike shed. Some boys are men at 11 and 12, physically; others are children until much later.

Some children’s parents find it acceptable that their sons and daughters are having sex at 13, while others would be shocked: you cannot talk to all these children together. It would puzzle and offend them and might do them serious damage.

And it undermines the authority of those parents who do not share the values of the teacher, or of the majority of the other pupils. It is wrong to assume that people want equality in such matters. They want differences.

Children and families and moral values are not equal, neither within schools nor outside them. They simply aren’t the same.A sensitive teacher will try to make allowances, but there is a shortage in this country of good and sensitive teachers – hence the crisis in education.

Another mistaken assumption is that sex education ought, necessarily, to be entrusted to teachers, given how wildly they vary in ability and in moral attitudes. The thought that the government is considering making sex and relationship education compulsory in schools is terrifying.

From:

http://www.timesonline.co.uk/tol/comment/columnists/minette_marrin/article4795056.ece

Measles endemic in Britain official warning

Measles has become endemic in Britain, 14 years after its spread was halted in the resident population, the country's public health watchdog says.

The Health Protection Agency (HPA) warned that the number of unvaccinated children was now large enough to sustain the "continuous spread" of the potentially lethal virus in the community. It blamed a failure by parents over the past 10 years to give their children the measles, mumps and rubella (MMR) vaccine.

This has resulted in vaccine rates falling below the level necessary to prevent the disease becoming established in the general population.

Figures published show cases of measles in London reached a new peak last month, exceeding last year's monthly record set in August 2007, and are continuing to rise.

There were 95 cases confirmed in the capital and 35 in the rest of England and Wales bringing the total for the year to 461. A 17-year-old victim from West Yorkshire died from the disease in the first fatality since 2006.

In another case a doctor working in a hospital cancer ward contracted measles prompting the Department of Health to write to all hospitals telling them to ensure that all staff working with vulnerable patients have documented immunity to the disease.

Measles causes fever, and can have serious complications including pneumonia and encephalitis (swelling of the brain). Fifty years ago the illness killed 500 children a year in the UK but vaccination almost eliminated the disease. Last month's death was only the second in more than a decade.

The HPA, which published the latest figures in its weekly report, said the rise in measles cases in London was linked to an outbreak at a secondary school which had spread to neighbouring schools and nurseries in the capital. It was also the source of clusters in Cornwall and South Yorkshire.

The report said: "Due to almost 10 years of sub-optimal MMR vaccination coverage across the UK, the number of children susceptible to measles is now sufficient to support the continuous spread of measles.

"Health services should exploit all possible opportunities to offer MMR vaccine to children of any age who have not received two doses. Greater awareness of the increasing measles incidence by health professionals and the public is essential to control the spread of infection."

Elizabeth Miller, head of immunisation at the HPA, said: "In 1994 we interrupted the spread of measles in the UK so that it ceased to be endemic. Since that time the only cases we have had have been as a result of importation and spread from those imported cases. Now we have reached a point where there are a sufficient number of susceptible [unvaccinated] children in the population to sustain spread of the disease. We are concerned there may be a return to pre-1994 levels where there was sustained spread. It is quite disturbing."

Vaccination rates against MMR vary widely across the country and are especially low in London. In the last quarter of 2007, the rate stood at 71 per cent for children at age two (first dose) and 50 per cent at age five (second dose) compared with the 95 per cent coverage needed to maintain herd immunity and prevent endemic spread.

Nationally, vaccination rates against MMR fell from 92 per cent a decade ago to 79 per cent in 2004, at the height of the scare over the vaccine's supposed link with autism. They have since recovered to 84 per cent at age two (75 per cent at age five) but are still well below the target level of 95 per cent.

Professor Miller said: "Vaccination rates are on the increase but we have the problem of the legacy of the unvaccinated children over the past six or seven years. People do need to realise that measles is a highly infectious disease and if your child is not vaccinated and exposed to the virus there is a high probability that it will find susceptible children."

Measles was the single most lethal infectious agent in the world until a vaccine was developed in 1963. In the early 1960s, the disease claimed six million lives yearly in the developing world with about 135 million cases. Today the global death toll has been cut to below 350,000 and the World Health Organisation believes it may be possible to eliminate the disease.

In the UK, cases fluctuated between 160,000 and 800,000 during the 1950s and 1960s, with an epidemic every two years, until the measles vaccine was launched in 1970. In 1987, the year before it was superseded by the triple MMR jab, there were 86,000 cases of measles. Vaccination rates against MMR rose to 92 per cent in the early 1990s and the annual number of measles cases fell. But confidence in the vaccine was dashed by publication of a paper in The Lancet in 1998 by Andrew Wakefield and colleagues from the Royal Free Hospital, linking the jab with autism.

Controversy over the link continued for eight years but is now widely accepted to be without substance. Dr Wakefield and two of his former colleagues have been charged with serious professional misconduct over their research in a case before the General Medical Council which is expected to conclude later this year.

Measles, which is accompanied by a rash, is one of the most infectious diseases known and is spread through direct contact or through droplets in the air when an infected person coughs or sneezes. It is most infectious before the rash appears.

About 90 per cent of people who have not been vaccinated, or have not had measles, catch the disease if they live in the same house as someone with it.

From:
official-warning-measles-endemic-in-britain-851584.html

MRSA superbug rises show deep clean did not work

MRSA superbug infections caught in hospital are still at unacceptable levels and Labour is failing to tackle the problems of fatal bugs in the correct way, the Conservatives said.

New figures released showed C.Difficile infection cases had gone down but there were still nearly 10,000 cases in those aged over 65.

And while MRSA cases have dropped over the past year they rose slightly in the last quarter of 2007.

Figures released by the Office for National Statistics (ONS) in February showed a huge rise in the number of death certificates mentioning C diff.

In England and Wales, there was a 72% rise, from 3,757 mentions in 2005 to 6,480 in 2006.

Death rates involving C diff increased by 77% among males and 66% among females between 2005 and 2006.

Rates went up from 37 to 65.5 per million males, and from 38.6 to 64.2 per million females.

Andrew Lansley, the Shadow Health Secretary, said: “From start to finish, Labour's attitude to hospital infections has been woefully misguided. For years even their own advisers have been telling them that the way to tackle the problem is to identify infected patients as early as possible and then isolate them to make sure others don't catch it.

"But Labour have ignored the experts and Gordon Brown has stubbornly chosen to put time, money and effort into a 'deep clean' which made a good headline but wasn't backed up by any evidence.

"These figures are for the period when the 'deep clean' started. If it had been effective we would be expecting to start to see a decrease in the number of infections, not another rise.”

The new data shows there were 1,087 cases of MRSA during October to December 2007.

This represents a 0.6% increase on the previous quarter, when 1,080 cases were reported to the Health Protection Agency.

In the same quarter in 2006 there were 1,543 cases.

Meanwhile, figures for the bug Clostridium difficile (C diff) showed an 8% drop, to 9,872 cases in patients aged 65 and over between October and December 2007 compared with the previous quarter.

However, the HPA warned that changes to how NHS trusts report their C diff figures could have influenced the result, as some data may be incomplete.

The HPA stressed it could not be confident that the apparent reduction was an accurate reflection of the current situation.

Dr Duckworth, who is head of the HPA's healthcare-associated infection and antimicrobial resistance department, said: “Over the last year cases of MRSA bloodstream infection have been steadily falling.

"We would obviously like to have seen the trend continued in this quarter and hope that ongoing surveillance will show that this plateau is not indicative of a levelling trend, but we need to see next quarter's figures.

"The NHS has faced a great challenge in turning around the seemingly unstoppable rise in MRSA bloodstream infections that we saw throughout the 1990s.

"The substantial decreases seen in recent quarters clearly demonstrate the huge efforts made by our NHS colleagues to combat these infections.

"Although the current figures indicate a plateau, variations in the rate of decrease over time are not unexpected and are not necessarily a cause for alarm.”

Professor Peter Borriello, director of the HPA's centre for infections, said: “The reduction of healthcare-associated infections is a big challenge throughout the world.

"The Agency continues to support the hard work of our NHS colleagues in combating these infections and the never-ending battle to fight all types of infection.”

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/04/24/nmrsa124.xml

Health Direct notes that once again labour's dithering is literally killing people with preventable early deaths at the same time as wasting yet more taxpayers' money.

Superbug related deaths up by 72 per cent to 6,480- nearly twice UK road deaths

The number of death certificates mentioning clostridium difficle has risen by almost three quarters in one year, official figures reveal.

The large increase comes after the Government ordered doctors to note healthcare acquired infections on death certificates whether it is the underlying cause of death or not.

This figures from the Office of National Statistics show the 6,480 death certificates in 2006 mentioned the bug, which takes hold in vulnerable patients often after a course of antibiotics. The previous year just 3,757 certificates mentioned it.

Data from the Health Protection Agency, which collects the total number of reported cases of infection from hospitals, shows there were 51,892 cases in patients over the age of 65 in 2005, rising to 55,636 in 2006.

Meanwhile, the number of death certificates mentioning MRSA levelled off at 1,652 in 2006. In one in three of these cases the infection was the main cause of death.

Figures from the HPA show the total number of cases of MRSA blood stream infection is dropping from 7,233 in 2004/5 to 7,096 in 2005/6 and down to 6,383 in 2006/7.

In 2005, the Government’s Chief Medical Officer Sir Liam Donaldson issued guidelines saying where a patient dies with an infection it should be put on the death certificate.

The proportion of patients where the death certificate shows C.diff was the cause of death has remained stabled at around 55 per cent of all certificates mentioning the bug.

Murray Devine, head of safety at Healthcare Comission said: “The sharp increase in reported deaths from C difficile is disturbing - but not surprising because it shows that previous deaths rates were probably seriously under-reported.”

She added: “Recent steps taken to combat the spread of C. difficile and MRSA won’t yet be fully reflected in these figures.”

The rise in the number of death certificates mentioning C.diff is due to better reporting and overall infection rates are dropping, Prof Brian Duerden, the Government’s Chief Microbiologist said.

He said: “The Chief Medical Officer wrote to the NHS in July 2005 to make clear that we wanted infections such as MRSA and C. difficile to be reported more accurately on death certificates. These statistics from 2006 show that this move has worked and our figures are now in line with other developed countries.

“Since 2006 we have taken significant steps to tackle infections. These include stringent hand-washing guidance for the NHS, a bare below the elbows dress code, putting matrons back in charge of cleanliness on their wards and an ongoing deep clean of every ward.

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/02/28/nsuperbug228.xml

C Difficile and hospital bugs remain a problem

The number of cases of the potentially dangerous Clostridium difficile (C Difficile) is thriving, figures show. A review by the Health Protection Agency showed hospital MRSA cases had fallen by 10% in the first three months of 2007 compared with a year ago. But rates for C. difficile, which mainly strikes the elderly, rose by 22% this quarter.

Some NHS trusts complained that targets - both clinical and financial - were hindering the fight against infection.

In a separate survey carried out by the Healthcare Commission - an NHS watchdog - some 45% of the 155 trusts said time targets for treating patients in A&E were getting in the way of infection control measures.

These figures represent a very small proportion of the 10 million inpatients that the NHS treats in hospitals every year.

Pressure to move patients to any available bed rather than the most appropriate bed or an isolation ward was one reason cited for the difficulties.

A further 36% of trusts said they were having problems combining investment in cleaning with financial targets, while 88% said their limited IT infrastructure "was restricting their ability to draw important lessons from incidents of infection".

The survey was carried out in May 2006, and the watchdog noted that a number of practices - particularly regarding individual staff objectives for bringing down infection - had changed.

But Healthcare Commission chief executive Anna Walker added: "We cannot afford to lose momentum. Trusts should be asking themselves what more they can do to protect patients and the public from healthcare associated infection."

The National Audit Office has estimated that these infections cost the NHS as much as £1bn each year.

Between April 2006 and March 2007, there were 6,378 cases of MRSA infections reported, compared with 7,096 for the previous year, the Health Protection Agency (HPA) said.

Meanwhile, there were 15,592 reported cases of C. difficile in patients aged 65 and over in England in the first quarter of 2007. This represents a 2% rise when compared with the same period last year, but is 22% higher than the previous quarter.

The HPA says this rise can be explained by the fact that higher numbers of vulnerable people are admitted to hospital at this time of year.

Liberal Democrat health spokesman Norman Lamb said the government had "spectacularly failed" to halt C. difficile.

Shadow health secretary Andrew Lansley called the figures "the tip of the iceberg, because they do not include the number of infections in people aged under 65".

From:
http://news.bbc.co.uk/1/hi/health/6913873.stm

On 2 May 07 Health Direct posted that Deadly NHS superbugs continue rising with C difficile again up when more hospital patients in England are getting the deadly Clostridium difficile bug, figures show.

Health Protection Agency (HPA) data showed 55,681 cases were reported among over 65s in 2006 - up 8% in a year. MRSA cases continued their downward trend, but they are not falling quickly enough to meet Labour's target next year.

Patients Association spokeswoman Katherine Murphy said: "Too many people are dying from these infections. We must learn from other countries such as Holland which have got infection rates close to zero.