Public health news: December 2005

Oseltamivir-resistant H5N1 associated with poor outcome

22 December 2005

A paper in this week's NEJM by de Jong et al reports two patients presenting with H5N1 infection in Vietnam who did not respond to oseltamivir treatment had evidence of a drug-resistant viral infection.  They note that this is not surprising due to the high viral replication rate seen with H5N1, and that drug resistance is a relatively common finding in paediatric seasonal influenza.  However they suggest that other strategies including alternative antivirals should be looked at for the successful treatment of H5N1.  The paper does not discuss how applicable the current findings (in virulent, poorly-adapted H5N1) may be to a future pandemic strain of influenza (which is likely to be less virulent).

de Jong et al, NEJM (2005) 353: 2667-2672  (NEJM, December 2005)
Bird flu virus 'resisting drug'  (BBC News, December 2005)
Influenza pandemic planning  (Internal link)

Third of hospitals failing on C Diff management

21 December 2005

An interim report by the HPA and Healthcare Commission has found that one third of NHS Trusts are not following current guidelines on the management of Clostridium difficile cases to prevent the infection spreading.

Healthcare agencies urge the NHS to step up measures  (Healthcare Commission, December 2005)
NHS 'failing' on lethal infection (BBC News, December 2005)

Further twists in smoking legislation saga

19 December 2005

The House of Commons Health Select Committee has found in favour of an outright ban on smoking in all public places, including bars and pubs.  This clear message contrasts with the 'will-they won't-they' debate on whether bars not serving food should be included in the ban.  Meanwhile an economic study on smokers in the US found that individuals unable to smoke in bars were more likely to smoke at home in front of children.

Health Select Committee strikes decisive blow (Action on Smoking & Health, December 2005)
Smoke plans 'unworkable' say MPs (BBC News, December 2005)
Smoking in Public Places report (Health Select Committee, December 2005)
Smoking ban 'harmful to children' (BBC News, December 2005)
Adda, J: The effect of taxes and bans on passive smoking (pdf, Adelaide School of Economics, December 2005)

Lords report says more should be done before a pandemic

16 December 2005

A report today on pandemic flu preparedness in the UK by the Science & Technology Committee of the House of Lords suggests wider prophylactic use of antivirals should be explored further (currently the UK is reserving most antivirals for treatment courses) and ties between government and food suppliers should be strengthened, amongst many other recommendations.

House of Lords S&TC: Pandemic influenza (House of Lords, December 2005)
Lords attacks UK's bird flu plans (BBC News, December 2005)
Flu pandemic planning (Internal link)

Many English hospitals fail on cleanliness

15 December 2005

A recent inspection by the Healthcare Commission into the cleanliness of 99 NHS and non-NHS hospitals revealed two-thirds were not as clean as may be expected.

A snapshot of hospital cleanliness in England (Healthcare Commission, December 2005)
Watchdog issues challenge (Healthcare Commission, December 2005)
Swoop on hospitals finds many 'unacceptably dirty' (Guardian, December 2005)

Drink problem worsening in Scotland

15 December 2005

A report released today by NHS Quality Improvement Scotland shows an alarming increase in alcohol-related hospital admissions in the last decade.  The report, Clinical Indicators 2005, also reveals an encouraging 50% drop in heart failure mortality over the same period.

Scotland's drink problem getting worse (NHS QIS, December 2005)
Clinical Indicators 2005 (NHS QIS, December 2005)

Online teaching for pandemic flu

12 December 2005

The Health Protection Agency and Doctors.net.uk are offering online teaching in the presentation and management of suspected cases of pandemic flu for UK-based doctors.

Web training to help doctors spot pandemic influenza (HPA, December 2005)
Doctors.net.uk (Requires registration)
Flu pandemic planning (Internal link) 

Budget curbs at DH

12 December 2005

The Department of Health has been defending a leaked email over the weekend which suggests no new central (i.e. DH) Public Health campaigns are to be authorised until further notice.  Local PCT spending on Public Health is said to be unaffected.  This follows confirmation by the Secretary of State that PCTs should postpone elective operations rather than run a budgetary deficit.

Hewitt defends Public Health spending curbs  (Guardian, December 2005)

Dummies may prevent cot-death

9 December 2005

A case-control study published today shows a negative association between the use of a dummy in infants under the age of 1 and sudden infant death syndrome (SIDS), or cot-death.  The researchers found the odds ratio for SIDS was 0.08 for using a dummy vs not.   Larger prospective trials are needed to test the cause-effect relationship for this association.

Li et al, BMJ (2005) Epub  (BMJ, December 2005)
Dummies 'reduce cot death risk'  (BBC News, December 2005)

Tattoo parlours in Scotland will require licence

8 December 2005

From April next year tattoo parlours in Scotland will require a licence to practise, and written parental consent will be sought for under-16s.

Tougher rules for tattoo parlours  (BBC News, December 2005)

Large racial differences in mental health admissions

7 December 2005

A census by the Healthcare Commission and the National Institute for Mental Health has found that individuals of black ethnic origin were up to three times more likely to be admitted to mental healthcare facilities than other ethnic groups on the day of the census.  The report highlights that this could represent a combination of factors, including increased likelihood of poverty and deprivation amongst black communities causing mental illness, rather than racism in admission procedures.

Count me in (Healthcare Commission, December 2005)
Census shows black people more likely to go into Mental Health hospitals (Healthcare Commission press release, December 2005)
Mental health inequality warning (BBC News, December 2005)

US pandemic flu preparation poor

7 December 2005

A report by the Trust for America's Health has criticised the US for not planning sufficiently for the prospect of an influenza pandemic.

US unprepared for disaster, study finds  (Reuters AlertNet, December 2005)
Ready or not? (Trust for America's Health, December 2005)
Influenza pandemic planning  (Internal link)

Tobacco age limit increase proposed

5 December 2005

Some MPs have suggested increasing the legal age for purchasing tobacco from 16 to 18 in the UK. Although the proposal has wide backing it is reportedly 'unlikely to become law in the near future'.

Smoking lobby backs age increase  (BBC News, December 2005)

UK to get National Institute for Health Research

5 December 2005

The Chancellor Gordon Brown announced on Friday that a new National Institute for Health Research would be founded, including 10 major centres of excellence, 250 clinical academic fellowships and 100 clinical lectureships per annum.  This is a much-needed boost for the UK clinical research community.

Speech by Gordon Brown  (Government News Network, December 2005)
Plans to boost medical research  (BBC News, December 2005)

Benefits of moderate drinking questioned

2 December 2005

The benefits of small amounts of alcohol on IHD risk have been called into question in an article in the Lancet.  Jackson and colleagues wonder whether any beneficial effect is actually seen in heavy drinkers (in whom the risks from alcohol clearly outweigh these benefits) rather than light drinkers.  This comes in the same week the annual Drink Driving campaign is launched in the UK in the run up to Christmas.

Jackson et al, Lancet (2005) 366:1911-1912 (Lancet, December 2005)
THINK! Christmas drink driving campaign (THINK!, December 2005)

Larger emphasis on artemisinin required

2 December 2005

As well as calls for more funding of all types of malaria intervention programme, a cost effectiveness study in this week's BMJ suggests money should be used for combination treatment and prevention programmes rather than focusing on one or the other.  Programmes involving artemisinin-based therapy were most cost-effective.

Morel et al, BMJ (2005) 331:1299  (BMJ, December 2005)

New money for HIV research

2 December 2005

Following World Aids Day yesterday the UK government has pledged an extra £27.5m investment in research into HIV.

Prevention 'focus on HIV fight'  (BBC News, December 2005)
Free HIV tests for all in Lesotho  (Internal link - news archive, November 2005)