Bulletin Board

Safer medicine supply chain?

In a move to clamp down on counterfeit medicines, new reforms for the sale of prescription medicines were announced from Brussels in December. This means sales across Europe could be tracked through the supply chain thus improving patient safety. The European Commission wants drugs bar-coded so that those who dispense medicines can trace their origin, and ensure quality and authenticity.

In the proposed legislation the EC wants to allow companies to provide product information directly to patients - previously banned in the European Union. The proposals still lack detail and have to go before the European Parliament and the Council of Ministers before they can become law. Nevertheless the Commission hopes they will improve innovation, safety and access to medicines.

A guide on safe food for travellers

WHO's global message - Prevention of foodborne disease: Five keys to safer food - is at: www.who.int/foodsafety/consumer/5keys/en

Patients to get counterfeit warning with each prescription

New guidance to raise public awareness of fake medicine and its dangers has been launched by the Royal Pharmaceutical Society of Great Britain (RPSGB) and the Medicines and Healthcare products Regulatory Agency (MHRA). Pharmacies will receive the guidance, developed in conjunction with patient groups to ensure it is clear and easy to read, and asked to distribute the new double-sided postcard-size leaflet in prescription bags.

The leaflet offers advice about counterfeit medicines, how to minimise purchasing fakes and what to do if they suspect they have been sold or supplied counterfeits. One side of the postcard explains the safest way to purchase medicines and the other addresses "the dangers of faking it".

HCC bows out with State of Healthcare

The Healthcare Commission's final report to Parliament on the state of health care in England and Wales is available on the Care Quality Commission website.

In April, the new Care Quality Commission (CQC) replaced the HCC, Commission for Social Care Inspection and the Mental Health Act Commission, joining up the regulation of health and adult social care in England. Healthcare Inspectorate Wales continues to lead on the inspection of health care services there. www.cqc.org.uk

Look for Green Book updates online ...

The web version of the Green Book (Immunisation against infectious disease) is regularly updated. Patches can be downloaded, printed, cut and pasted into the printed versions so that you always have a fully up-to-date copy on the Department of Health website.

... or have them delivered straight to your screen

Simply subscribe to the RSS feed and you will be advised of updates to the Green Book. More information on the Green Book landing page (above) or go directly to the eed on the Department of Health website.

e-Vaccine update

To receive a copy of Vaccine update emailed directly to you each month, contact: vaccine.supply@dh.gsi.gov.uk

Rabies

The case of the woman from Northern Ireland who contracted rabies following her work as a volunteer in South Africa is a timely reminder to people going off to travel or work - especially closely with animals - in countries where the rabies virus is present. Rabies in UK travellers is fortunately rare, but pre-exposure vaccination should be considered for all those at potential risk. Read more on the NaTHNaC website.

Increased vector borne disease 'down under'

Australia has experienced extreme weather conditions this year as a result of which there has been increased mosquito activity. The Australian Department of Health issued warnings for residents or travellers visiting the northern part of Western Australia to take insect bite precautions to avoid the risk of mosquito-borne viruses.

The potentially fatal Murray Valley Encephalitis (MVE) was found in several locations and wet season activity of other mosquito-borne viruses was being monitored. In Queensland the number of cases of dengue fever in Cairns was recorded as the city's worst outbreak ever.

Source: ProMED-Mail 2009#126 and ProMED-Mail 2009#102

Dress sense

Clothing impregnated with permethrin and active for up to 70 washings is available for travellers at:
www.insectshield.com 

Time running out on Euro health cards

British holidaymakers were urged to check their European Health Insurance Cards (EHIC) as millions are due to expire - indeed, between September 2008 and the end of March 2009 some 3.3m cards expired. Although nearly three in five people claim to have an EHIC, a poll for the Department of Health showed that 68 per cent of them do not know when it expires.

The EHIC offers free or reduced cost health care yet the survey suggested that people who fall ill overseas don't seek help for fear of the costs. The card provides access to health care on the same terms as the country's own citizens in all 25 European Union countries, plus Iceland, Norway, Switzerland and Liechtenstein.

Cards can be ordered or renewed online at: https://www.ehic.org.uk/Internet/home.do and will be delivered within seven days.

Who should advise health tourists?

The House of Lords European Union sub-committee on social policy and consumer affairs responded to the EC proposals on cross-border health care by saying that patients travelling abroad for health care should be provided with information financed by each member state. Frontline staff should not be burdened with having to provide this information.

Global financial crisis threatens health in developing countries

The WHO Director-General has issued a statement on the health impact of the global financial and economic crisis available from the WHO website. Dr Margaret Chan calls for governments and political leaders in affluent countries to continue (and increase) their financial support for health and social services to low- and middle-income countries.

Dr Chan emphasises that investment in health will protect poor and vulnerable people, promote economic recovery and social stability, and help generate efficient health systems. She cited previous economic downturns in the 1980s in which the lack of investment in sub-Saharan African health systems meant these countries were tragically unprepared for the HIV/AIDS pandemic in the decade that followed.

WHO on WER

Recent reports from the World Health Organization's Weekly Epidemiological Record (WER) include:

Both are at: www.who.int/wer

CDC on STDs

Centers for Disease Control and Prevention's Sexually transmitted disease surveillance 2007, national overview has now been published at: www.cdc.gov/std/stats07/toc.htm

Warning from the jungle

In January it was confirmed that two dead monkeys in Trinidad had died of yellow fever and a vaccination campaign was implemented to ensure population protection. Visitors to Trinidad were advised to have a valid vaccination against yellow fever to ensure they have the same protection as the local population. Read more on the NaTHNaC website.

Emergency treatment of anaphylaxis

The Royal College of Physicians has issued new guidelines highlighting the important use of adrenaline in treating adults having an anaphylactic reaction. They recommend greater follow up and investigation of patients who have suffered anaphylaxis reactions to help learn more about the causes and the reason for rising numbers of incidents.

Emergency treatment of anaphylaxis in adults: concise guidance was published on 2 April 2009 in Clinical Medicine, 9 (2) www.rcplondon.ac.uk/

Stamping out lymphatic filariasis

Since an eradication programme was launched 10 years ago, lymphatic filariasis has been eliminated in 16 countries. A private-public partnership involving national governments, WHO and two multinational drug companies led a campaign to treat 570 million people in 48 countries. BMJ 2008; 337:a2944.

Cold blooded neglect

According to a new study at least 421,000 people each year are bitten and poisoned by snakes and at least 200,000 die. The authors think this is a neglected risk - figures may be an underestimate and true numbers much higher. PLoS Med (2008) 5:e218 doi:10.1371/journal.pmed.0050218 and BMJ 2008; 337 1136.

Reducing measles deaths

The Measles Initiative reports that deaths from measles worldwide fell by 74 per cent between 2000 and 2007. In the same period eastern Mediterranean countries including Afghanistan, Somalia, Sudan and Pakistan have cut measles deaths by 90 per cent, achieving the United Nations goal three years early. www.measlesinitiative.org

But measles cases up in UK

The HPA figures showed 1,370 confirmed cases of measles in England and Wales last year (January-December 2008) compared to 990 in 2007. Almost half (48 per cent) were from the London region. See the HPA website for more information.

New meningitis B hope

Researchers hope that a new vaccine against meningitis B could be available by 2011. Tests are in the final stages at the University of Oxford following work on the sequencing of the entire genome of the deadly bacterium. The genetic structure of meningococcus B was published in 2000, enabling further work to be done on possible targets for a vaccine. Meningitis B causes most cases and most deaths in the UK and was responsible for 80 per cent of confirmed infections in 2008.

Personal air space

Information on which airlines provide oxygen or allow personal compressors on board is available from the British Lung Foundation at: www.lunguk.org

It's good to talk ...

Ryanair became the first airline operating from the UK to allow mobile phones to be used on board. The service is only available on limited flights and serviced by one provider, but others are expected to sign up. However, with calls reported to cost up to £3 per minute passengers are not rushing to use the facility.

... and Twitter

It seems to have appeared from nowhere, but many travellers are catching on to the new way of communicating through Twitter. Online travel agents are using the tool as a way to target customers and direct them to the best bargains and even to resolve complaints quickly. WHO and CDC used it to update people on A(H1N1) influenza (swine flu). It also conjures up a whole new language like "re-tweeting" your message and getting a recommendation through "crowdsourcing". What next?

Hepatitis C: Get tested, get treated

Some 20 years after the virus was first identified a new campaign to raise awareness of hepatitis C has been launched at: www.nhs.uk/hepatitisc . It is estimated that 100,000 people in England have undiagnosed chronic hepatitis C infection and nurses are being asked to determine whether patients could be at risk by alerting them to the transmission routes for the virus. Also see:

Vaccine supply, storage and distribution

Information is now available in the toolkit on the NHS Immunisation website. www.immunisation.nhs.uk/Local_coordinators_toolkit/Vaccine_supply_distribution_and_storage/Vaccine_supply

Japanese encephalitis vaccine

IXIARO is the new vaccine against the Japanese encephalitis virus from Novartis. Detailed information on this medicine is available on the European Medicines Agency (EMEA) website at: www.emea.europa.eu

Ticks DVD

A short film aiming to raise awareness of ticks among walkers explains bite prevention, tick removal, Lyme disease and tick-borne encephalitis in detail. You can preview the film at:
www.thebmc.co.uk/Feature.aspx?id=2961 . The author is happy to distribute it free to any organisation wishing to host it on their site. Contact the Editor for information.

For parents of child travellers

A useful and informative website aimed at parents of child travellers has been compiled by Dr Karl Neuman, a paediatrician, who invites them to visit www.KidsTravelDoc.com to "keep your family safe and healthy for travel and outdoor activities". The site advises how to minimise illness and mishaps, and what to do if they do occur. New subjects are added weekly and existing ones are updated constantly.