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

Brown's superbug plans ignore evidence claims Lancet

Labour government plans for tackling superbugs, such as MRSA, have been condemned by a leading medical journal for not being based on scientific fact. The Lancet said there was little evidence to support hospital "deep cleans" or short sleeves for medical staff as recently proposed.

Instead of "pandering to populism" politicians should listen to the evidence, the editorial said.

The government said the plans were part of a wide range of preventive measures.

Prime Minister Gordon Stalinist Brown announced plans to "deep clean" hospitals ward by ward over the next year to return hospitals to the state they were in when they were built.

His comments followed proposals from Health Secretary Alan Johnson for a new dress code for NHS staff which would advise against long-sleeved coats and ties for doctors as they can become contaminated.

But The Lancet said a government working group had found no conclusive evidence that uniforms or other work clothes posed a significant hazard in terms of spreading infection.

Instead the focus should be on disinfection of high touch surfaces rather than deep-cleaning wards to get rid of visible dirt, the journal said.

The editorial said: "Brown also plans to double the number of hospital matrons, to check on ward cleaning, and accost doctors wearing long sleeves.

"They would be better employed making sure doctors, nurses and visitors wash their hands properly, the proven way to stop hospital acquired infections," the editorial stated.

Professor Richard James, director of the Centre for Healthcare Associated Infections at the University of Nottingham agreed the evidence on transmission of infection from clothing such as long sleeves was not clear but short sleeves may encourage staff to wash their hands properly.

He added: "The main route of transmission of MRSA is person-to-person contact and this will be affected little by deep cleaning.

"In contrast, Clostridium difficile is transmitted by contact with faecal contamination so it may be more effective here."

He said in addition to hand washing, other useful strategies would be screening patients for MRSA on admission, regular use of hydrogen peroxide vapour generators to kill bugs in the hospital environment and educating patients and visitors on ways they can reduce risk.

Chief Nursing Officer, Professor Christine Beasley said there was no single solution and the new proposals were part of a wider set of measures to reduce hospital-acquired infections.

She agreed that there was no evidence that uniforms themselves pose a significant risk of transmitting infections but said long sleeves and watches "get in the way of washing and decontaminating the hands, wrists and forearms".

"Clean and tidy hospitals and staff are very important to patients," she said. "We make no apology for asking hospitals to take every reasonable measure to reduce infection and increase patient confidence that this is an issue the NHS is taking seriously."

Dr Mark Enright, an expert in molecular epidemiology at Imperial College, London said deep cleaning would be a waste of resources and an inconvenience to patients and staff.

"MRSA is a major problem in the UK because it is present, mostly unknowingly, in patients and staff.

"Interrupting the chain of transmission from these people to new hosts should be the main focus of infection control, not attempts at the sterilisation of floors and windows."

From:
http://news.bbc.co.uk/1/hi/health/7016425.stm

On Sept 26, 2007 Health Direct posted: Gordon Stalinist Brown pledge on NHS funding and MRSA as hospitals are to use new deep clean techniques in which wards are stripped and subjected to steam cleaning and high strength disinfectant in an attempt to reduce outbreaks of MRSA and C difficle superbugs.

Earlier this year (11 Jan 07) Health Direct also posted that NHS hospitals may never achieve MRSA superbug targets when the NHS was not on track to meet its MRSA target and perhaps never will, a leaked labour government memo said.