Shooting Up: infections among people who inject drugs in the UK

 This Public Health England report describes the extent of infections among people who inject drugs (PWID) in the United Kingdom.

Click here for government report

PTSD Nearly Doubles the Risk of Infection

A new study finds that people with post-traumatic stress disorder (PTSD) are 1.8 times as likely to have any infection as those without PTSD, ranging from being 1.3 times as likely to have meningitis, to 1.7 times as likely to have influenza, to 2.7 times as likely to have viral hepatitis. Read PsychCentral Article here

New NIHR Signal Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk

New NIHR Signal Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk
Published on 5 June 2018


Urinary tract infection symptoms resolved by three days for 80% of women given antibiotics compared with 54% given anti-inflammatories. Anti-inflammatories reduced antibiotic use, but 5% of women developed more severe infection of the kidneys.
From the NIHR Dissemination centre
https://discover.dc.nihr.ac.uk/content/signal-000598/anti-inflammatories-for-urine-infection-reduces-antibiotic-use-but-increases-complication-risk

New NIHR Signal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics

New NIHR Signal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics
Published on 1 May 2018

Giving probiotics to people taking antibiotics reduces the chance of them developing diarrhoea caused by Clostridium difficile (C. difficile) bacteria by 60%. One case of Clostridium-associated diarrhoea was prevented for every 42 people receiving probiotics. They appear to work best for patients at more than 5% risk of Clostridium infection.

From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00589/probiotics-to-prevent-diarrhoea-caused-by-c-difficile

HPV vaccination programme for men who have sex with men

The government has confirmed that it will introduce a nationwide HPV vaccination programme for men aged 45 or younger who have sex with other men.

NHS England and Public Health England (PHE) will work to start the programme from April 2018, for those attending sexual health (GUM) clinics and HIV clinics in England.

Sore throat (acute): antimicrobial prescribing [NG 84]

New:  NICE guideline


acute sore throat (including pharyngitis and tonsillitis) is self‑limiting and often triggered by a viral infection of the upper respiratory tract

symptoms can last for around 1 week, but most people will get better within this time without antibiotics, regardless of cause (bacteria or virus).

Assess and manage children under 5 who present with fever as outlined in the NICE guideline on fever in under 5s.

Use FeverPAIN or Centor criteria to identify people who are more likely to benefit from an antibiotic and manage in line with recommendations 1.1.4 to 1.1.13.

Pneumococcal: the green book, chapter 25

Chapter 25 of the Green Book on pneumococcal has been updated.

NIHR Signal Biological therapies for psoriasis do not increase serious infection risk

People with psoriasis who take an immune-modulating treatment are no more likely to get serious infections than people taking standard therapies.inf




There are fears that these biological therapies raise the risk of serious infections and this has discouraged their use. They are recommended by NICE for moderate to severe psoriasis. Previous studies have reached conflicting conclusions, making it hard to advise on the true risk.




This study used a large database of people with psoriasis from the UK and Ireland. It compared serious infection risk of the biological therapies (etanercept, adalimumab or ustekinumab) with non-biological therapies, after accounting for factors such as other illnesses. It found none of the biological therapies studied had a higher risk of infection compared to non-biological therapies or compared to each other.




From the NIHR Dissemination Centre

NIHR Signal Blood test reduces mortality and shortens antibiotic use among adults with chest infection

It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier.


This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.


From the NIHR Dissemination Centre

Latest Avian influenza (bird flu) updates Winter 2017 to 2018

Avian influenza (bird flu), a disease of birds, has been identified in wild birds in England in 2018. All poultry keepers should review their biosecurity, sign up for disease alerts, and register their birds with APHA. Keepers must report any unexplained deaths or sickness to their vet.

Public Health England advises the risk to public health from H5N8 and H5N6 avian influenza is very low and the Food Standards Agency has said the disease poses no food safety risk for UK consumers.

Read the latest updates in full at https://www.gov.uk/government/news/avian-influenza-bird-flu-in-winter-2017-to-2018

Bird flu prevention zone extended to cover whole of England

A bird flu prevention zone has been declared across the whole of England, Chief Veterinary Officer Nigel Gibbens has confirmed today.
This means it is a legal requirement for all bird keepers to follow strict biosecurity measures. It comes as 13 dead wild birds were confirmed to have the virus in Warwickshire.
https://www.gov.uk/government/news/bird-flu-prevention-zone-extended-to-cover-whole-of-england

NIHR Signal Blood test reduces mortality and shortens antibiotic use among adults with chest infection

It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier.


This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.


From the NIHR Dissemination Centre

NIHR Signal Starting antiretroviral therapy immediately after HIV diagnosis reduces transmission of the virus

Giving antiretroviral therapy to people newly diagnosed with HIV may be an effective and cost-effective way of reducing new infections. Increased HIV testing in at-risk populations may identify more people for treatment and also reduce infection rates.


Using data from a number of sources including NIHR funded projects, researchers developed a computer simulation model. The model looked at the relationship between HIV infections, sexual risk behaviours and antiretroviral therapy over a 30 year period. Introduction of antiretroviral therapies and increased condom use were associated with lower rates of new cases. Most new HIV infections arose due to people not yet being aware of their HIV status. Modelling projections suggested that increasing the rate of HIV testing, and initiating antiretroviral therapy from diagnosis could both reduce the rates of new infections.


From the NIHR Dissemination Centre

UK flu levels continue to increase according to PHE statistics

Seasonal flu levels have continued to increase in the last week across the UK, with flu hospitalisations up 50% according to Public Health England figures.  

The statistics show over the last week there has been a 78% increase in the GP consultation rate with flu like illness, a 50% increase in the flu hospitalisation rate, and a 65% increase in the flu intensive care admission rate. The main strains circulating continue to be flu A(H3N2), A(H1N1) and Flu B.

Update on the use of adjuvanted trivalent flu vaccine for 2018-19 flu season

A new flu vaccine has been licenced and made available for use for 2018/19. A letter summarising the joint committee on vaccination and immunisation’s (JCVI) advice on adjuvanted trivalent flu vaccine (aTIV) was sent to NHS England local teams on 22 December.

The letter is intended to help support decisions on influenza vaccines for 2018/19. In particular the JCVI has advised the use of aTIV is a priority for those aged 75 and over, given that the non-adjuvanted inactivated vaccine has showed no significant effectiveness in this group over recent seasons. Funding is available for the use of the adjuvanted trivalent flu vaccine in those aged 75 and over in 2018/19.

NIHR Signal A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use

Delaying antibiotic prescribing made little difference to most symptoms of respiratory infection. It reduced antibiotic use and did not affect patient satisfaction compared with immediate prescribing of antibiotics.

Increasing antibiotic resistance is a global health concern. Many people don’t realise that viruses cause most respiratory infections and that antibiotics won’t help. The strategy allows some time for symptoms to improve naturally.

From the NIHR Dissemination Centre

NHS England announces new specialised treatments for patients

NHS England has announced the results of the first of two prioritisation rounds to decide which new specialised commissioning treatments and services will be made available for patients for the 2018/19 financial year.

An initial three new treatments and services were approved for funding including a treatment for HIV, a new specialised service for adults with primary ciliary dyskinesia, a genetic disorder affecting the respiratory system, and a new specialised service for Stevens-Johnson syndrome, a serious disorder of the skin.

Funding for the new treatments and services will begin from April.

Group B Streptococcus (GBS) in pregnancy and newborn babies

This RCOG patient information leaflet provides advice for women who are pregnant or planning to become pregnant about Group B Streptococcus (GBS) infection in newborn babies.

Culture and sensitivity reporting in odontogenic infections: do microbiology swabs change antibiotic prescribing practice?

British Journal of Oral and Maxillofacial Surgery , Volume 55 , Issue 10 , e94 - e95 

Odontogenic infections are commonly polymicrobial. Effective treatment depends on definitive drainage of abscesses and empirical antimicrobial therapy based on likely organisms.

UHCW Research: Jasdeep Singh Saggu, Jean Medard Croos, Ross Elledge and Gary Walton

NHS uses sickness data as early warning to cope with winter surges

A sickness surveillance system will help the NHS plan for surges in demand this winter by tracking outbreaks of norovirus, which causes vomiting and diarrhoea, and other illness around the country.

Data gathered by Public Health England will be used by NHS England operational monitoring teams to study winter trends and to help give early warning about rising outbreaks of flu, respiratory syncytial virus (RSV) and norovirus as well as other acute seasonal illnesses.

The findings will allow the NHS to anticipate rises in hospital admissions and produce a planned response by, for example, rescheduling planned surgery in advance to avoid inconveniencing patients as well as free up beds and converting ‘swing’ wards from elective to emergency care for patients with conditions such as respiratory problems.