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News Article
Hepatitis: UK investigates sudden cases in children
Patient Safety Learning posted a news article in News
The UK’s Health Security Agency (UKHSA) says it is investigating after finding more than 100 cases of sudden hepatitis in children. Doctors said they had seen "increasing" evidence the problem is linked to adenoviruses - a group of viruses that can cause illnesses such as the common cold and flu. The HSA said it cannot rule out other possible causes such as Covid, which it is also investigating, but that an adenovirus has been identified in 40 out of the 53 cases so far tested. In Britain, cases have reached 81 in England, 14 in Scotland, 11 in Wales and five in Northern Ireland, with the majority of patients under five years old. No children in the UK have died, it was confirmed, after the World Health Organization said there had been 169 cases globally with at least one child who had died from the illness. Read full story Source: The Independent, 26 April 2022 -
News Article
Hepatitis cases detected in children in Europe and the US
Patient Safety Learning posted a news article in News
Health officials say they are now investigating unexplained cases of hepatitis in children in four European countries and the US. Cases of hepatitis, or liver inflammation, have been reported in Denmark, Ireland, the Netherlands, Spain and the US, health officials say. Last week UK health authorities said they had detected higher than usual cases of the infection among children. The cause of the infections is not yet known. The European Centre for Disease Control (ECDC) did not specify how many cases have been found in the four European countries in total. But the World Health Organization (WHO) said less than five had been found in Ireland, and three had been found in Spain. It added that the detection of more cases in the coming days was likely. Investigations into the cause of the infections are ongoing in all of the European countries where cases have been reported, said the ECDC. In the US, Alabama's public health department said nine cases have been found in children aged one to six years old, with two needing liver transplants. Investigations into similar cases in other states are taking place, it added. Read full story Source: BBC News, 20 April 2022 -
News ArticlePregnant women should be tested for Group B Strep to save the lives of dozens of babies every year, campaigners have warned. Group B Strep is the most recurrent cause of life-threatening illness in newborn babies, with an average of two babies a day identified with the infection. Each week, one of these babies goes on to die while another develops an ongoing long-term disability. More than one in five women carry Group B Strep, a common bacteria that normally causes no harm and no symptoms. However, its presence in the vagina or rectum means babies can be exposed to it during labour and birth. Pregnant women in Britain are not routinely tested for its presence, but a trial led by the University of Nottingham is examining whether such a move would be effective. Campaigners have called for more hospitals to join the pilot to ensure it is successful. Jane Plumb, chief executive of campaign group Group B Strep Support, said: “It’s taken over 20 years of campaigning to get this trial commissioned. It’s devastating that only 30 of the 80 hospitals needed have signed up. We can’t let this trial fail. “We need to fight for the 800 babies per year that are infected with this too-often-deadly infection. We need more hospitals to take part. We need to rally together and get this trial over the finish line.” Ms Plumb said the majority of Group B Strep infections in babies are preventable. “If we don’t know, then they can’t be offered the protective antibiotics in labour,” she said. “Families so often tell us that the first time they hear of Group B Strep is after their baby falls ill. For a mostly preventable infection, this is unforgivable – and must change. “We want to encourage every hospital to take part. We need people to ask for their MP’s support. This is an opportunity to save so many babies’ lives, but we only have six months to get hospitals on board. It really is now or never.” Read full story Source: The Independent, 19 April 2022
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News Article
Increase in hepatitis (liver inflammation) cases in children under investigation
Patient Safety Learning posted a news article in News
The UK Health Security Agency (UKHSA) has recently detected higher than usual rates of liver inflammation (hepatitis) in children. Similar cases are being assessed in Scotland. Hepatitis is a condition that affects the liver and may occur for a number of reasons, including several viral infections common in children. However, in the cases under investigation the common viruses that cause hepatitis have not been detected. UKHSA is working swiftly with the NHS and public health colleagues across the UK to investigate the potential cause. In England, there are approximately 60 cases under investigation in children under 10. Dr Meera Chand, Director of Clinical and Emerging Infections, said: "Investigations for a wide range of potential causes are underway, including any possible links to infectious diseases. We are working with partners to raise awareness among healthcare professionals, so that any further children who may be affected can be identified early and the appropriate tests carried out. This will also help us to build a better picture of what may be causing the cases." "We are also reminding parents to be aware of the symptoms of jaundice – including skin with a yellow tinge which is most easily seen in the whites of the eyes – and to contact a healthcare professional if they have concerns." Read full story Source: UK Health Security Agency, 6 April 2022 -
News ArticleHundreds of people identified as contacts following a tuberculosis (TB) outbreak in a Carmarthenshire village are yet to attend a screening, health officials have said. Public Health Wales (PHW) said 31 cases of active TB had been identified since the 2010 outbreak in Llwynhendy. PHW urged the 485 people who have been identified as contacts, but not attended a screening, to act. More than 2,600 people have attended screenings since June 2019. TB is a bacterial infection, spread through inhaling tiny droplets from the coughs or sneezes of an infected person. It is a serious condition, but can be cured with proper treatment. PHW said since 2010, 303 people - or more than one in 10 of those who had been screened - had been diagnosed with latent TB, which is not infectious and does not affect a person's quality of life, but may develop into active TB at a later date. Dr Brendan Mason, from Public Health Wales, said: "We understand that during the coronavirus pandemic people may have been reluctant to go to a hospital to have their screening done, but I can assure them that there are safety measures in place in order to prevent the spread of Covid-19. "Now is the time to get tested. "It is really important that we screen all the contacts identified and make sure that anyone diagnosed with latent or active TB gets the monitoring or treatment that they need to prevent any further spread." Read full story Source: 24 February 2022
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Content ArticleOn 1 February the UK Health Security Agency warned that coverage of the measles, mumps, and rubella (MMR) vaccine’s first dose had dropped below 90% in 2 year olds. By age 5, uptake of two doses had dropped to 85.5%—well below the World Health Organization’s 95% target needed for elimination of measles. The latest quarterly vaccination figures show very small drops in uptake in England from July to September 2020, and uptake continued to decline over the next year. And it’s not just MMR: small decreases have been seen in coverage of other childhood vaccines including the combined diphtheria, hepatitis B, Hib, polio, tetanus, and whooping cough vaccine, as well as those for rotavirus and meningitis B. But MMR is the one that public health officials worry about most because of historically lower uptake and the risks of outbreaks. With uptake of the MMR vaccine falling in the UK, Emma Wilkinson examines whether anti-vaccination sentiment around Covid-19 has played a part.
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News Article
Lassa fever: Patient who died in UK ‘was newborn baby’
Patient Safety Learning posted a news article in News
A patient who died from Lassa fever last week was a newborn baby, according to reports. The UK Health Security Agency (UKHSA) confirmed on Friday that an individual with the Ebola-like disease had died in Bedfordshire, and that two other people were infected. All three cases were linked to recent travel in West Africa. The BBC said the fatality had been an infant at Luton and Dunstable Hospital, quoting an email sent to staff by Cambridge University Hospitals NHS Trust. Hundreds of frontline workers at the hospital, as well as at Addenbrooke’s Hospital in Cambridge, were reportedly told to isolate after being identified as potential contacts. Lassa fever is an acute viral infection endemic in parts of Africa, and the UKHSA has assured the public that the risk of further infections in the UK remains “very low”. Read full story Source: The Independent, 15 February 2022 -
Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) is to help improve patient safety in relation to recognition of the acutely ill infant and child, recognising the difficulty in distinguishing between simple viral illnesses and life-threatening bacterial infections in very young patients. This Healthcare Safety Investigation Branch investigation reviewed the case of Mohammad, a baby who had become unwell and was taken to an emergency department by ambulance following a call to NHS 111. He arrived at 8.04pm and was considered to have a mild viral illness, subsequently being transferred to a paediatric observational ward, and discharged at 11.45pm with a diagnosis of likely bronchiolitis. At approximately 3.40am his mother contacted the ward as his condition worsened, which resulted in a 999 call. The ambulance crew did not consider that Mohammad was seriously ill so did not conduct a ‘blue light’ emergency transfer to hospital. Mohammad was admitted to the emergency department at approximately 4.40am and suffered a respiratory and then cardiac arrest at 5:28am, with attempts to resuscitate unsuccessful and stopped at 6:10am. Mohammad died of septicaemia caused by meningococcus (serogroup B) bacteria.
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News Article
Change to sepsis advice after mums' herpes deaths
Patient Safety Learning posted a news article in News
Advice on how new mothers with sepsis should be treated is to change after two women died of a herpes infection. The Royal College of Obstetricians and Gynaecologists says viral sources of infections should be considered and appropriate treatment offered. This comes after the BBC revealed one surgeon might have infected the mothers while performing Caesareans on them. The East Kent Hospitals Trust said it had not been possible to identify the source of either infection. Kimberley Sampson, 29, and Samantha Mulcahy, 32, died of an infection caused by the herpes virus 44 days apart in 2018, shortly after giving birth by Caesarean section. Their families were told there was no link between the deaths but BBC News revealed on Monday that both operations had been carried out by the same surgeon. Documents we uncovered showed that the trust had been told two weeks after the second death that "it does look like surgical contamination". Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, which set standards in maternity care, said routine investigation and management of maternal sepsis "should always consider viral sources of infection, and appropriate changes should be instituted to support earlier diagnosis and treatment". Medics treating Ms Sampson and Mrs Mulcahy assumed they were suffering from a bacterial infection and didn't prescribe the anti-viral medication that may had saved their lives. The Royal College said the two deaths should be "fully investigated" as "surgical infection appears to be a significant possibility". But BBC News has learned that the East Kent Hospitals Trust, which treated both women, never told the coroner's office that the same surgeon had carried out both operations or that an investigation they had ordered had suggested the virus strains the two women had died from appeared to be "epidemiologically linked". Read full story Source: BBC News, 23 November 2021 -
Content Article
At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That’s why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples. To mark World Antimicrobial Awareness Week, which takes place every year in November, we’ve selected ten resources related to antimicrobial resistance. Shared with us by hub members and patient safety advocates, they provide valuable insights and practical guidance about AMR. -
Content ArticleThis e-book provides an extensive overview of the day-to-day challenges posed by antimicrobial resistance, tools for setting up stewardship programmes and guidance of how to make the most of existing programmes. Its resources apply the principles of antimicrobial stewardship to a wide range of professions, populations and clinical/care settings. It was published by the British Society for Antimicrobial Chemotherapy in collaboration with the European Society of Clinical Microbiology and Infectious Diseases.
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News Article
Long-acting HIV jabs to replace daily pills in ‘great step forward’
Patient Safety Learning posted a news article in News
The NHS has been given the green light to offer people living with HIV the first "long-acting injectable" to keep the virus at bay. Charities have hailed the "incredible news" which offers an alternative to adults living with HIV who have to take daily antiretroviral drugs. Many people living with HIV can keep the virus at very low levels by taking antiretroviral tablets each day. These drugs keep the number of virus particles in the blood - also known as the viral load - so low that it cannot be detected or transmitted between people. But now an estimated 13,000 people will be eligible for the injectable treatment in England which means they no longer need daily treatment but will have two injections every two months. This means they can reduce the days they receive treatment from 365 to 6 per year. Meindert Boysen, deputy chief executive NICE, said: "Despite scientific advances HIV is still incurable, but the virus can be controlled by modern treatment. However, for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle." "We're pleased therefore to be able to recommend cabotegravir with rilpivirine as a valuable treatment option for people who already have good levels of adherence to daily tablets, but who might prefer an injectable regimen with less frequent dosing." Read full story Source: 18 November 2021 -
Content Article
WHO: World Antimicrobial Awareness Week 2021
Patient-Safety-Learning posted an article in Medication
World Antimicrobial Awareness Week takes place from the 18-24 November every year. On this page the WHO explains what antimicrobial resistance is and provides several short explanatory videos about how this can be prevented. -
News Article
NHS trust investigates cluster of ‘unusual infections’ in children’s hospital
Patient Safety Learning posted a news article in News
A number of “unusual infections” have been discovered among patients at the Royal Aberdeen Children’s Hospital (RACH), prompting investigation by an NHS trust. NHS Grampian said they were taking a “very precautionary approach” and looking for any potential links that these infections could have to the hospital environment. These precautions include relocating some procedures, with the trust also warning that there may be delays in treatment for a small number of patients. They were keen to point out that the hospital will continue to admit and treat patients as normal whilst the investigation is ongoing. An NHS Grampian spokesman explained: “While we investigate the causes of this – and whether or not there is a link to the hospital environment – we are taking a very precautionary approach. Read full story Source: The Independent, 16 May 2021 -
News Article
UK hospitals failing to follow guidelines on group B Strep
Patient Safety Learning posted a news article in News
Failures to follow national guidelines to prevent group B Strep infections in newborn babies is leading to a postcode lottery of care and opportunities to stop deadly infections being missed, a new report has found. Nearly 90% of hospitals in the UK are not using the recommended test for GBS carriage – which costs around £11- despite clear guidance issued by the Royal College of Obstetricians and Gynaecologists (RCOG) and Public Health England (PHE) that the test can significantly decrease false-negative results. Group B Strep is the UK’s most common cause of severe infection in newborn babies, causing sepsis, pneumonia, and meningitis. Approximately 800 babies a year in the UK develop group B Strep infection in their first 3 months of life, 50 babies will die, with another 70 survivors left with life-changing disabilities. Most of these infections could be prevented. Only a tiny number of NHS Trusts are following the key new recommendations around giving pregnant women information on group B Strep, offering testing to some pregnant women, and following Public Health England guidelines on testing for group B Strep. As a result, pregnant women face a postcode lottery, potentially receiving significantly different care from recommended practice. Read full story Source: Group B Strep Support, 1 February 2021 -
Content ArticleThe Royal College of Obstetrics and Gynaecology (RCOG) has guidance on group B Strep infection in newborn babies, which was last updated in September 2017. A national learning published earlier in 2020 by the Healthcare Safety Investigation Branch (HSIB) highlighted that the RCOG guidance was not being followed. This report from the Group B Strep Support reinforces these findings. Only a tiny number of NHS Trusts are following the key new recommendations around giving pregnant women information on group B Strep, offering testing to some pregnant women, and following Public Health England guidelines on testing for group B Strep. As a result, pregnant women face a postcode lottery, potentially receiving significantly different care from recommended practice. Group B Strep Support recommends that the NHS prioritises the prevention of group B Strep infection in newborn babies. A key step towards this would be to ensure published national guidance from recognised expert bodies is adopted and implemented in a timely manner.
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News ArticleA new state of the art institute for antimicrobial research is to open at Oxford University thanks to a £100 million donation from Ineos. Ineos, one of the world’s largest manufacturing companies, and the University of Oxford are launching a new world-leading institute to combat the growing global issue of antimicrobial resistance (AMR), which currently causes an estimated 1.5 million excess deaths each year- and could cause over 10m deaths per year by 2050. Predicted to also create a global economic toll of $100 trillion by mid-century, it is arguably the greatest economic and healthcare challenge facing the world post-Covid. It is bacterial resistance, caused by overuse and misuse of antibiotics, which arguably poses the broadest threat to global populations. The world is fast running out of effective antibiotics as bacteria evolve to develop resistance to our taken-for-granted treatments. Without urgent collaborative action to prevent common microbes becoming multi-drug resistant (commonly known as ‘superbugs’), we could return to a world where taken-for-granted treatments such as chemotherapy and hip replacements could become too risky, childbirth becomes extremely dangerous, and even a basic scratch could kill. The rapid progression of antibacterial resistance is a natural process, exacerbated by significant overuse and misuse of antibiotics not only in human populations but especially in agriculture. Meanwhile, the field of new drug discovery has attracted insufficient scientific interest and funding in recent decades meaning no new antibiotics have been successfully developed since the 1980s. Alongside its drug discovery work, the IOI intends to partner with other global leaders in the field of Antimicrobial Resistance (AMR) to raise awareness and promote responsible use of antimicrobial drugs. The academic team will contribute to research on the type and extent of drug resistant microbes across the world, and critically, will seek to attract and train the brightest minds in science to tackle this ‘silent pandemic’. Read full story Source: University of Oxford, 19 January 2021
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Content ArticleAntimicrobial resistance (AMR) is a global problem that impacts all countries and all people, regardless of their wealth or status. The scale of the AMR threat, and the need to contain and control it, is widely acknowledged by country governments, international agencies, researchers and private companies alike. This document sets out the UK’s 2019–2024 national action plan to tackle AMR within and beyond our own borders. Developed in consultation with a broad range of stakeholders across different sectors, it builds on the achievements of our last strategy (2013–2018), and is aligned with global plans and frameworks for action. The plan has ultimately been designed to ensure progress towards our 20-year vision on AMR, in which resistance is effectively contained and controlled. It focuses on three key ways of tackling AMR: reducing need for, and unintentional exposure to, antimicrobials; optimising use of antimicrobials investing in innovation, supply and access.
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Content ArticleNeonatal herpes simplex virus (HSV) disease is a rare, and potentially fatal, disease which usually occurs in the first four weeks of a baby's life. Early recognition and treatment of the virus has been shown to significantly improve babies' chances of making a full recovery. Kit Tarka Foundation works to prevent newborn baby deaths; primarily through raising awareness of neonatal herpes, funding research and providing advice for healthcare professionals and the general public.
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News ArticleThe social restrictions imposed upon our lives because of coronavirus have taken a toll on our emotions, finances, and our waistlines, but there may yet be a silver-lining: a reduction in cases of other infectious diseases. From the common cold to chickenpox, there has been a substantial drop in the number of infections being reported to GPs, despite children returning to school – and that looks set to continue as winter approaches and lockdown restrictions tighten across the country. According to the latest GP surveillance data for England there were 1.5 cases of common cold for every 100,000 people during the week ending 6 October – compared to 92.5 cases reported during the same week last year. The rate of other non-Covid respiratory illnesses was also lower, at 131 for every 100,000 people, compared to 303 last year. Influenza-like illness is also down, at 131 cases for every 100,000 people, versus 303 cases in 2019. Although there has been in increase since the start of the school term, for all of these illnesses, infection rates remain below expected seasonal levels for this time of year, the report by the Royal College of General Practitioners’ research and surveillance centre said. Equivalent data was not immediately accessible for Wales and Scotland. GP consultations for other infectious diseases like strep throat, tonsillitis and impetigo, as well as infectious intestinal diseases like norovirus are also well below the five-year average – and have been since late March – the report suggests. Read full story Source: The Guardian, 9 October 2020
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Content Article
The BMJ interview: Anthony Fauci on COVID-19
PatientSafetyLearning Team posted an article in Coronavirus (COVID-19)
There are few better known authorities on the covid-19 pandemic than Anthony Fauci. One of the world’s most respected infectious disease experts, he spoke with The BMJ’s editor, Fiona Godlee, about the pressures of advising the US president, the challenging nature of the new coronavirus, and how the pandemic might end. -
Content ArticleThis Take, Treat and Test webinar took place on 10 September 2020, presented by Dr Ron Daniels, Founder, and Executive Director – Clinical – Sepsis Trust UK and Consultant in Critical Care and Anaesthesia, University Hospitals Birmingham NHS Foundation Trust.
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News ArticleThe emergence of antimicrobial resistance (AMR), including drug-resistant bacteria, or “superbugs”, pose far greater risks to human health than Covid-19, threatening to put modern medicine “back into the dark ages”, an Australian scientist has warned, ahead of a three-year study into drug-resistant bacteria in Fiji. “If you thought Covid was bad, you don’t want anti-microbial resistance,” Dr Paul De Barro, biosecurity research director at Australia’s national science agency, the CSIRO, told The Guardian. “I don’t think I’m exaggerating to say it’s the biggest human health threat, bar none. Covid is not anywhere near the potential impact of AMR. We would go back into the dark ages of health.” WHO warns overuse of antibiotics for COVID-19 will cause more deaths While AMR is an emerging public health threat across the globe, in the Pacific, where the risk of the problem is acute, drug-resistant bacteria could stretch the region’s fragile health systems beyond breaking point. An article in the BMJ Global Health journal reported there was little official health data – and low levels of public knowledge - around antimicrobial resistance in the Pacific, and that high rates of infectious disease and antibiotic prescription were driving up risks. “A challenge for Pacific island countries and territories is trying to curtail antimicrobial excess, without jeopardising antimicrobial access for those who need them,” the paper argued. Read full story Source: The Guardian, 10 September 2020
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Content ArticleThis article from Delaveris et al. outlines one health system's experience implementing a bundle to reduce sepsis-related mortality and the observed connection between adherence to the bundle and improved sepsis care.
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News ArticleBabies are at risk of dying from common treatable infections because NHS staff on maternity wards are not following national guidance and are short-staffed and overworked, an investigation has revealed. The Healthcare Safety Investigation Branch (HSIB), a national safety watchdog, has warned that NHS staff on maternity wards face sometimes conflicting advice on treating women who are positive for a group B streptococcus (GBS) infection. They are also making errors in women’s care because of the pressure of work and a lack of staff, with antibiotics not being administered when they should be. HSIB’s specialist investigators examined 39 safety incidents in which GSB had been identified, and found that the infection had contributed to six baby deaths, six stillbirths and three cases of babies being left with severe brain damage. In its report, the watchdog warned that the problems on maternity wards meant that even in cases where mothers were known to be positive for GBS infection, this wasn’t shared with the mother or noted in the record, resulting in the standard care and antibiotics not being provided. It added: “The identification and escalation of care for babies who show signs of GBS infection after birth was missed. This has resulted in severe brain injury and death for some of the affected babies.” Read full story Source: The Independent, 19 July 2020
