Tennis Surfacing Specifications: May 2018

Wednesday, 30 May 2018

Detailed guide: Nipah virus: epidemiology, outbreaks and guidance

Epidemiology

Nipah virus infection is caused by the paramyxovirus Nipah virus (genus Henipavirus). Nipah virus is related to, but distinct from, Hendra virus. The natural animal reservoir of Nipah virus is bats, particularly fruit bats of the Pteropus genus. Nipah virus infections in humans were reported for the first time in 1998, following identification of the virus during an outbreak of acute encephalitis in Nipah, Malaysia, with cases also seen in Singapore.

Outbreaks have occurred subsequently in parts of North East India and almost annually since 2001 in specific districts in Bangladesh. Cases of henipavirus infection have also occurred in the Philippines, believed to have been caused by Nipah virus or a Nipah-like virus.

In May 2018 an outbreak was reported in Southern India for the first time. Investigations into the outbreak in Kozhikode (formerly Calicut), Kerala (see map), are ongoing and the source of the outbreak is not yet known.

Nipah virus has been isolated from the urine of bats in Malaysia, and antibodies against Nipah virus have been detected in 23 species of bat across Asia, and also in bats in Ghana and Madagascar. However, human outbreaks of Nipah virus infection have not been identified outside South and South East Asia, and most outbreaks have occurred in rural or semi-rural locations.

See WHO Map of henipavirus outbreaks and fruit bat distribution

Transmission

The 1998 Malaysian outbreak occurred following a spill-over event, whereby Nipah virus from bats spread to pigs, with subsequent transmission occurring between pigs, followed by transmission to humans exposed to the infected urine and/or respiratory secretions of infected pigs. Other outbreaks have been associated with consumption or collection of foodstuffs, such as raw or partially fermented date palm sap, which were contaminated with bat saliva and/or excreta containing Nipah virus.

Human-to-human transmission also occurs, although the relative contribution of this mode of transmission has varied considerably between outbreaks. Close and direct, unprotected contact with infected patients, especially those with respiratory symptoms, has been implicated as a transmission risk.

Both human-to-human and horse-to-human transmission (slaughtering horses or consuming infected horse meat) were identified in the Philippines outbreak in 2014. There is evidence that Nipah virus can infect other animals, including dogs, cats, goats and sheep.

Clinical features

The most important complication of Nipah virus infection is encephalitis, which is associated with a high mortality rate; however, the full spectrum of clinical illness is not completely understood. The incubation period is thought usually to be 4 to 14 days, although a period as long as 45 days has been reported.

Typically patients present with a sudden onset, non-specific flu-like or febrile illness, sometimes with gastrointestinal symptoms. Pneumonia and other respiratory manifestations have also been described as a feature, but their onset appears to be variable. These are typically in addition to other signs and symptoms and vary in frequency according to the outbreak (29% in Malaysia; 75% in Bangladesh).

In many of the patients in reported series, symptoms and signs of encephalitis and/or meningitis developed after 3-14 days of initial illness. Cerebrospinal fluid abnormalities are similar to those seen in other acute viral CNS infections. Magnetic resonance imaging of the brain may reveal multiple small subcortical and deep white matter lesions, without surrounding oedema, but these abnormalities may be seen in other acute CNS infections.

Rapid progression to critical illness is said to occur in approximately 60% patients. Mortality has also varied between outbreaks but is high overall (40 to 75%). Neurological sequelae may occur in survivors, including relapsing encephalitis with delayed reactivation of latent virus infection.

Patient assessment

Nipah virus is classed as an airborne high consequence infectious disease (HCID) in England and clinical assessment should be performed by specialist hospital staff, with adherence to strict infection prevention and control precautions (see below) to prevent secondary transmission.

There are currently no agreed case criteria for Nipah virus infection. Consider Nipah virus infection in a patient with a relevant travel or exposure history who presents with a compatible illness, with the onset of illness within 14 days following a potential exposure. Nipah virus infection is a rare disease and other travel associated and common infections should also be considered in the differential diagnosis.

Any suspected cases in England should be discussed with local infection specialists and with the Imported Fever Service (IFS) (24 hour telephone service: 0844 778 8990). The IFS can advise on whether laboratory testing is indicated. The IFS is also available to clinicians in Scotland, Wales and Northern Ireland.

Any suspected cases should be notified immediately to the nearest PHE Health Protection Team.

Laboratory diagnosis

In the UK, the Rare and Imported Pathogens Laboratory (RIPL) at PHE Porton Down is the designated diagnostic laboratory. The mainstay of Nipah virus detection at RIPL is RT-PCR. Serology for Nipah antibodies is not available.

Any suspected case should be discussed with local infection specialists and with the IFS, as above. The IFS can advise on whether laboratory testing is indicated, and if so, will provide advice about the samples types required. IFS will also advise on sample collection precautions and transport requirements.

Treatment

There is no proven, specific treatment for Nipah virus infection, and there is no preventative vaccine; treatment is supportive.

Clinical management of confirmed cases in England should be provided by specialist infectious diseases and critical care teams that are capable of safely managing patients with high consequence infectious diseases.

Patients have received ribavirin in previous outbreaks, but it was not possible to determine a beneficial effect of treatment. Ribavirin was ineffective in small animal models, as was chloroquine. Several experimental therapies are in pre-clinical development or phase 1 clinical trials, including monoclonal antibodies, fusion inhibitors, and novel antivirals.

Nipah virus is one of the pathogens in the WHO R&D Blueprint list of epidemic threats requiring urgent research and development action, including animal and human vaccine development. Further information on experimental therapies and vaccine development is available from WHO.

Infection prevention and control

Prevention of transmission of infection by airborne and contact routes is required. Studies have shown contamination of surfaces in hospitals during outbreaks, suggesting that there may be a risk of fomite-mediated transmission. Since Nipah virus infection is an airborne HCID, strict infection prevention and control (IPC) measures are required when caring for both suspected and confirmed patients. Appropriate respiratory isolation is essential for suspected and confirmed cases.

Hospital clinicians are advised to follow the same IPC measures used for suspected and confirmed cases of Middle East respiratory syndrome (MERS); this guidance is available on the PHE website.

Clinical laboratories should be informed in advance of samples submitted from suspected or confirmed diagnosis of Nipah virus infection, so that they can perform local risk assessments, minimise risk to laboratory workers and, where appropriate, safely perform laboratory tests that are essential to clinical care. Nipah virus is an ACDP/SAPO Hazard Group 4 pathogen.

Advice for travellers to endemic areas

Those travelling to endemic areas, particularly areas with active outbreaks, should avoid contact with bats and their environments, and sick animals. Consumption of raw or partially fermented date palm sap should be avoided. Wash fruit with clean water and avoid any fruit that has been partially eaten by animals or that may be contaminated (for example windfall fruit).

For information about current outbreaks and travel advice, see NaTHNaC

UK risk assessment

Nipah virus does not occur in the UK. Globally, Nipah virus infection has never been reported in a traveller.

The risk of a case from an outbreak area being imported into the UK is very low if standard precautions are undertaken. The main risk activities for Nipah virus infection are associated with local practices (for example collection and consumption of raw or fermented date sap) that are generally not undertaken by tourists.

The risk for other travellers, such as those visiting friends and relatives or doing local volunteer work, maybe higher dependent on activities undertaken.

Further information

See WHO Nipah virus collection

from Public Health England - Activity on GOV.UK https://www.gov.uk/guidance/nipah-virus-epidemiology-outbreaks-and-guidance
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Research and analysis: Measles, mumps and rubella: laboratory confirmed cases in England 2018

For previous reports see:

measles, mumps and rubella: laboratory confirmed cases in England 2017
measles, mumps and rubella: laboratory confirmed cases in England 2016
measles, mumps and rubella: laboratory confirmed cases in England 2015
measles, mumps and rubella: laboratory confirmed cases in England 2014
the UK Government Web Archive for Health Protection Reports on MMR (see under ‘Routine data’) and other vaccine preventable infection reports relating to 2013 and earlier years

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/measles-mumps-and-rubella-laboratory-confirmed-cases-in-england-2018
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Friday, 25 May 2018

News story: Hot weather health warnings: 2018

With a Met Office forecast for a spell of warmer weather for the coming days Public Health England (PHE) is urging people to think now how they’ll handle summer heat this year.

The latest forecast from the Met Office suggests that this weekend there could be high temperatures in many places. Although temperatures like this can be pleasant for many, there are some older people, young children and those with heart and lung conditions whose bodies will struggle to cope and could feel the ill-effects.

Dr Thomas Waite, a public health consultant at PHE, said:

Much of the advice on beating the heat is common sense and for many people spells of warmer weather are something they very much enjoy.

This bank holiday weekend is a really good time to think about what you can do to protect you and your family and friends’ health throughout the summer and warmer weather.

It is also currently Ramadan. If you start to feel unwell, disoriented or confused, or collapse or faint, advice is to stop fasting and have a drink of water or other fluid. This is especially important for older adults, those with poorly controlled medical conditions such as low or high blood pressure, diabetes and those who are receiving dialysis treatment. The Muslim Council of Britain has confirmed that breaking fast in such conditions is allowable under Islamic law. Also, make sure to check on others in the community who may be at greater risk to ensure they are having a safe and healthy Ramadan. Guidance is available on NHS Choices.

For some people, such as older people, those with underlying health conditions and those with young children, the summer heat can bring real health risks. That’s why we’re urging everyone to keep an eye on those you know who may be at risk this summer. If you’re able, ask if your friends, family or neighbours need any support.

The top ways for staying safe when the heat arrives are to:

look out for others, especially older people, young children and babies and those with underlying health conditions
close curtains on rooms that face the sun to keep indoor spaces cooler and remember it may be cooler outdoors than indoors
drink plenty of water as sugary, alcoholic and caffeinated drinks can make you more dehydrated
never leave anyone in a closed, parked vehicle, especially infants, young children or animals
try to keep out of the sun between 11am to 3pm
take care and follow local safety advice, if you are going into the water to cool down
walk in the shade, apply sunscreen and wear a hat, if you have to go out in the heat
avoid physical exertion in the hottest parts of the day
wear light, loose fitting cotton clothes
make sure you take water with you, if you are travelling

Frank Saunders, the Met Office’s Chief Meteorologist said:

Although some places will see cloud and heavy thunderstorms over the bank holiday weekend, many areas will be dry with plenty of sunshine. Where it’s sunniest, particularly in the south and south east, it’ll feel very warm with temperatures rising into the mid to high twenties and possibly a very localised 30 Celsius in the strongest sunshine.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/news/hot-weather-health-warnings-2018
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Guidance: Using the PHSKF to conduct a staff skills survey (2017)

This guidance describes how the local authority used the PHSKF as a basis for extracting and analysing information regarding the skills, knowledge and competencies of their workforce. This information was used to ensure training offer to colleagues was targeted and responsive to their needs whilst making best-use of training and development budget.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/using-the-phskf-to-conduct-a-staff-skills-survey-2017
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Correspondence: Vaccine update: issue 279, May 2018

The May issue features:

National Immunisation Network meeting review
save the dates for the NIN meeting 2019
Pertussis vaccination programme for pregnant women update: is your practice’s prenatal pertussis vaccine coverage on ImmForm what you were expecting?
preliminary vaccine coverage estimates for the meningococcal B (MenB) immunisation programme for England, update from January to March 2018
vaccine supply
vaccine supply for the non routine programme
reminder – Purified Protein Derivative PPD 10TU ImmForm ordering to close in the near future
reminder about MMR vaccine ordering restriction

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/vaccine-update-issue-279-may-2018
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Open consultation: UK SMI V 26: Epstein-Barr virus serology

Public Health England, in partnership with professional organisations, is asking for feedback on the ‘Standards for Microbiology Investigations V 26: Epstein-Barr virus serology’.

We have refined the process so that UK SMI users can comment more easily if they see no requirement for amendments to the document out for consultation.

Use this form to provide comments or amendments for V 26

Use this form if you have no amendments for V 26

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/consultations/uk-smi-v-26-epstein-barr-virus-serology
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Thursday, 24 May 2018

Transparency data: PHE spend over £25,000: March 2018

Details of Public Health England transactions over £25,000 in March 2018.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/phe-spend-over-25000-march-2018
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Transparency data: PHE spend over £25,000: February 2018

Details of Public Health England transactions over £25,000 in February 2018.

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Transparency data: PHE spend over £25,000: January 2018

Details of Public Health England transactions over £25,000 in January 2018.

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Transparency data: PHE government procurement card spend over £500: March 2018

These files show all purchases on Public Health England (PHE) held government procurement cards (GPC) over £500 in March 2018.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/phe-government-procurement-card-spend-over-500-march-2018
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Transparency data: PHE government procurement card spend over £500: February 2018

These files show all purchases on Public Health England (PHE) held government procurement cards (GPC) over £500 in February 2018.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/phe-government-procurement-card-spend-over-500-february-2018
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Transparency data: PHE government procurement card spend over £500: January 2018

These files show all purchases on Public Health England held government procurement cards (GPC) over £500 in January 2018.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/phe-government-procurement-card-spend-over-500-january-2018
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Transparency data: PHE government procurement card spend over £500: December 2017

These files show all purchases on Public Health England held government procurement cards (GPC) over £500 in December 2017.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/phe-government-procurement-card-spend-over-500-december-2017
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Transparency data: PHE government procurement card spend over £500: November 2017

These files show all purchases on Public Health England held government procurement cards (GPC) over £500 in November 2017.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/phe-government-procurement-card-spend-over-500-november-2017
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Transparency data: PHE spend over £25,000: November 2017

Details of Public Health England transactions over £25,000 in November 2017.

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Official Statistics: Seasonal flu vaccine uptake in healthcare workers: winter 2017 to 2018

Report presenting data collected for the final cumulative (February) survey for frontline health care workers, covering the period 1 September 2017 to 28 February 2018 inclusive.

Data is at national, NHS England local team, ‘old’ area team (on behalf of primary care and independent sector healthcare providers) and individual trust level.

See the pre-release access list.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/statistics/seasonal-flu-vaccine-uptake-in-healthcare-workers-winter-2017-to-2018
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Official Statistics: Seasonal flu vaccine uptake in children of primary school age: winter 2017 to 2018

Reporting presenting cumulative data on influenza vaccine uptake in children of primary school age, vaccinated from 1 September 2017 to 31 January 2018 inclusive in England.

The tables present seasonal influenza vaccine uptake data in children of school years reception to year 4, by NHS England local team, ‘old’ area team and local authority (LA).

See the pre-release access list.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/statistics/seasonal-flu-vaccine-uptake-in-children-of-primary-school-age-winter-2017-to-2018
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Official Statistics: Seasonal flu vaccine uptake in GP patients: winter 2017 to 2018

Report and tables presenting data collected in February 2018 for the final cumulative (January) survey. Data is by different eligible and clinical at-risk GP patient groups and by age.

These tables replace the previous provisional figures. They present final seasonal flu vaccine uptake data in GP patients, covering 1 September 2017 to 31 January 2018 inclusive by:

NHS England old ‘area team’ and clinical commissioning group (CCG)
NHS England local team
local authority (LA)

See the pre-release access list.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/statistics/seasonal-flu-vaccine-uptake-in-gp-patients-winter-2017-to-2018
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Guidance: Abdominal aortic aneurysm screening: reducing inequalities

This guidance is for abdominal aortic aneurysm (AAA) screening providers, commissioners and other stakeholders to share learning and good practice in reducing barriers to AAA screening.

The screening quality assurance service (SQAS) and 4 Nations AAA Screening Programmes group review all submissions of best practice and share case studies on the PHE Screening blog.

The case studies are examples of work to reduce barriers and reduce inequality for men invited for AAA screening. We also invite case studies that have not resulted in reduced inequalities as these may help other providers decide what actions to take to address a specific inequality issue.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/abdominal-aortic-aneurysm-screening-reducing-inequalities
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Wednesday, 23 May 2018

Statement to Parliament: UK response to the Ebola outbreak in the Democratic Republic of the Congo

Following the declaration of an outbreak of Ebola in Equateur Province, Democratic Republic of the Congo, on 8th May, I am updating the House on what the British Government is doing to support the response.

The Government of the Democratic Republic of the Congo and the World Health Organisation are leading the response. They have issued a joint funding appeal and response plan. The UK has acted quickly in support of the Government and the WHO.

I have announced today that the Department for International Development (DFID) will be providing £5 million in funding to the World Health Organisation’s response plan. This money will be made available immediately and will support the delivery of a range of WHO activities, including: surveillance, case management, laboratories, coordination, logistics, and operational readiness in neighbouring areas.

In addition to direct support to the joint Government of DRC and WHO appeal, the UK has already supported a variety of elements of the response to the outbreak. The UK has been instrumental in ensuring that lessons have been learned from previous Ebola outbreaks. For example from the Ebola outbreak in West Africa, we have learned the important of acting early and making sure sufficient resources are allocated from the outset. We have invested heavily in global preparedness, early response mechanisms, and vaccines.

In 2014, DFID worked with the Wellcome Trust to develop an experimental Ebola vaccine, thousands of doses of this vaccine are currently being issued by WHO, Médecins Sans Frontières and the Government of DRC through support from UK aid and Gavi, the Vaccines Alliance. Health workers and other frontline staff began receiving the vaccine on 21st May.

Three experts from the Department of Health and Social Care’s UK Public Health Rapid Support Team – two epidemiologists and a data scientist – are being deployed to the DRC imminently to assist our partners in tracking the spread of the disease so that it can be tackled quickly and effectively. Laboratory support has also been offered.

The UK is also a major supporter to a wide range of organisations and response mechanisms which are currently tackling the outbreak. The UK is the largest contributor to the United Nations’ Central Fund for Emergencies and the second largest contributor to the World Health Organisation’s Contingency Fund for Emergencies, including £4 million from the Department of Health and Social Care in March this year. Each of these have provided $2 million for the response. DFID has also made available £1 million from its joint research initiative on epidemic preparedness with Wellcome, alongside a further £2 million available from Wellcome to support improved diagnosis and treatment. The UK aid-supported Start Network of 42 international aid agencies has mobilised £250,000 to help tackle the outbreak. The UK also provides funding to the United Nations Humanitarian Air Service, which has mobilised two helicopters and an aeroplane to meet the logistical needs of the Ebola response.

In addition to the emergency Ebola response, DFID’s new £40 million Tackling Deadly Diseases in Africa programme (TDDAP) is enhancing longer-term preparedness, detection, and response in the region. £20.5m will enable WHO to do this. It builds on the UK’s support to WHO’s reform efforts and systems strengthening following the 2014 Ebola outbreak in West Africa. This is already delivering a much-improved and better coordinated response to the current Ebola outbreak in DRC, helping to prevent it from developing into an epidemic that could seriously threaten more lives and prosperity across Africa and the world. In the future, the programme will also support another specialist regional organisation; this component is currently out to tender. TDDAP also contains a contingency mechanism of up to an additional £20m, which allows the UK to swiftly respond to emergencies like in DRC.

The WHO’s International Health Regulations Emergency Committee met on Friday 18th May and concluded that the Ebola outbreak in the DRC did not presently constitute a global health emergency. However, the committee concluded that the risk to the public in the DRC itself was “very high” and the risk to countries in the region was high.

In our increasingly interconnected world, diseases like Ebola do not respect borders. As a result of lessons learned from the 2014 Ebola outbreak in West Africa, the UK is working to strengthen the international response to health threats in order to ensure future outbreaks are identified quickly and tackled effectively This has included supporting the WHO in Africa to reform and improve their response. Helping countries to identify diseases early – and to limit their spread across borders – is beneficial for all of us: preventing potentially devastating damage in developing countries, and reducing risk to the UK population at home.

The WHO continues to assess the international risk of this outbreak as low. Public Health England has assessed the risk to the UK as negligible to very low and will continue to review this. Led by the Government Chief Scientist, the Department of Health and Social Care, and the Chief Medical Officer, with support from the Cabinet Office, colleagues across Government have ensured that the UK is in a state of readiness to respond should that risk change. The Government will continue to monitor the situation closely and will adapt its international and, if necessary, a UK domestic response as the situation evolves.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/speeches/uk-response-to-the-ebola-outbreak-in-the-democratic-republic-of-the-congo
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Corporate report: PHE Board meeting papers: May 2018

The agenda and papers available for the Public Health England (PHE) Board meeting of 23 May 2018.

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Research and analysis: Blood-borne virus opt-out testing in prisons summary report 2017

The blood-borne virus (BBV) opt-out engagement event was led by Public Health England (PHE) working in partnership with NHS England and HMPPS to promote the final implementation stage of BBV opt-out testing for consenting eligible adults in prisons in England. The main aim of the meeting was to share lessons learnt from the early phases of BBV opt-out testing implementation in prisons in England and promote good practice in the final stages of implementation.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/blood-borne-virus-opt-out-testing-in-prisons-summary-report-2017
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Tuesday, 22 May 2018

Press release: First measure of industry progress to cut sugar unveiled

Public Health England (PHE) has today (Tuesday 22 May 2018) published the first assessment of progress on the government’s sugar reduction programme, measuring how far the food industry has gone towards reducing the sugar children consume through everyday foods.

As part of the government’s plan to reduce childhood obesity, the food industry, including retailers, manufacturers, restaurants, cafés and pub chains, has been challenged to cut 20% of sugar from a range of products by 2020, with a 5% reduction in the first year.

Progress towards meeting the 5% ambition is the focus of this report and is assessed against a 2015 baseline. The assessment shows an encouraging initial start from retailers and manufacturers, achieving a 2% reduction in both average sugar content and calories in products likely to be consumed in one go.

Whilst this doesn’t meet the 5% ambition, PHE recognises there are more sugar reduction plans from the food industry in the pipeline – and some changes to products that are not yet captured in the data as they took effect after the first year cut-off point.

For the 8 food categories where progress has been measured, the assessment also shows:

there have been reductions in sugar levels across 5 categories
yoghurts and fromage frais, breakfast cereals, and sweet spreads and sauces have all met or exceeded the initial 5% sugar reduction ambition
sugar levels are generally the same across all sectors, however for the eating out of home sector, portion sizes in products likely to be consumed in one go are substantially larger – on average more than double – those of retailers and manufacturers

Retailers and manufacturers have also reduced calories in products likely to be consumed in one go in 4 categories, for example by reducing the size of the product. Of these, ice cream, lollies and sorbets, and yoghurts and fromage frais have reduced average calories by more than 5%.

Due to limitations with the data, PHE is not yet able to report on the progress made in the cakes and morning goods categories for retailer and manufacturer’s products. It is also not possible to report on progress for the eating out of home sector alone as part of this assessment. Progress in these areas will be reported on next year.

As part of the programme, businesses are encouraged to focus efforts on their top selling products within 10 categories that contribute the most sugar to the diets of children up to 18 years of age. They have 3 options to help them do this – reduce sugar levels (reformulation), provide smaller portions, or encourage consumers to purchase lower or no sugar products.

Progress is also reported on the drinks covered by the government’s Soft Drinks Industry Levy (SDIL). Sugar has been reduced by 11% and average calories per portion by 6% by retailers and manufacturers in response to the SDIL. Data also shows people are buying more drinks that have sugar levels below the SDIL cut-off of 5g per 100g.

With a third of children leaving primary school overweight or obese, PHE continues to call for increased action from all sectors of the food industry to achieve the 20% reduction ambition by 2020.

Steve Brine, Public Health Minister, said:

We lead the world in having the most stringent sugar reformulation targets and it is encouraging to see that some progress has been made in the first year.

However, we do not underestimate the scale of the challenge we face. We are monitoring progress closely and have not ruled out taking further action.

Duncan Selbie, Chief Executive at PHE, said:

We have seen some of the food industry make good progress, and they should be commended for this. We also know that further progress is in the pipeline.

However, tackling the obesity crisis needs the whole food industry to step up, in particular, those businesses that have as yet taken little or no action.

Dr Alison Tedstone, Chief Nutritionist at PHE, said:

This is about tackling the nation’s obesity crisis. Too many children and adults suffer the effects of obesity, as does society, with our NHS under needless pressure. Obesity widens economic inequalities, affecting the poor the hardest.

PHE has also today published new guidelines for the drinks industry to reduce the amount of sugar children consume through juice and milk based drinks.

The drinks categories join the other 10 categories in PHE’s sugar reduction programme. Juice and milk based drinks are currently excluded from the government’s SDIL, but the exemption of milk based drinks will be reviewed by Treasury in 2020.

By mid-2021, the drinks industry is encouraged to:

reduce sugar in juice based drinks (excluding single juice) by 5%
cap all juice based drinks (including blended juices, smoothies and single juices) likely to be consumed in one go to 150 calories
reduce sugar in milk (and milk substitutes) based drinks by 20% and cap products likely to be consumed in one go to 300 calories

Fruit juice alone accounts for around 10% of the sugar consumed each day by 4 to 18 year olds. Current advice is that only one 150ml portion counts as 1 of our 5 a day.

The next progress report on the sugar reduction programme is due in spring 2019.

Background

The first year of the sugar reduction programme is August 2016 to August 2017.
Single juice (also known as mono juice) products include juice from a single fruit with nothing added to it, for example, 100% orange juice.
Blended juice products include juice from multiple juice sources.
Public Health England exists to protect and improve the nation’s health and wellbeing and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.

Public Health England press office

Email phe-pressoffice@phe.gov.uk

Telephone 020 7654 8400

Out of hours telephone 020 8200 4400

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/news/first-measure-of-industry-progress-to-cut-sugar-unveiled
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Guidance: Sugar reduction: juice and milk based drinks

Guidelines that set out the sugar reduction ambitions for the juice and milk-based drinks industry, including:

clarity on products included in the categories
baseline figures for juice and milk based drinks
mechanisms through which the sugar reduction ambitions can be achieved

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/sugar-reduction-juice-and-milk-based-drinks
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Guidance: Sugar reduction: report on first year progress

The report includes a detailed assessment of progress by the food industry towards the 5% reduction in the first year of the sugar reduction programme.

The reports includes:

top line results showing progress to date in reducing sugar and calories in the product categories included in the programme and the drinks covered by the Soft Drinks Industry Levy
detailed assessment of progress for retailers and manufacturers across the majority of categories and some assessment for the out of home sector
analyses to look at progress by individual businesses and in top selling products in each category and case studies supplied by industry businesses
detailed methodology and information on data limitations
an update on progress through the other workstreams in the wider reduction and reformulation programme

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/sugar-reduction-report-on-first-year-progress
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News story: Innovation fund open to help children of dependent drinkers

£4.5m of joint funding for up to 8 local authorities, aimed at improving the support services for children of dependent drinkers and alcohol dependent parents, has been committed by the Department of Health and Social Care and the Department for Work and Pensions (DWP). The fund is being managed by PHE, who announced today (Tuesday 22 May 2018) that local authorities (LAs) can now bid for funding.

The impact of parental alcohol dependency on the lives of children can be significant and long lasting. Alcohol can be a major factor in causing parental conflict, which can lead to a range of poor outcomes for children including damaging their education, employment and health. It’s estimated there are 200,000 children living with adults who are dependent drinkers. Not only are children of parents with alcohol dependency more likely to become dependent themselves, but between 2011 and 2014 parental alcohol misuse was recorded as a factor in 37% of cases where a child was seriously hurt or killed. Similarly, a Department for Education’s census showed that in 2016 to 2017 18% of children ‘in need’ were affected by alcohol.

Alongside this call for bids PHE has published a toolkit to support LAs in planning services. The toolkit includes data and advice on how best to meet the needs of children growing up in these situations and those of their parents and carers. This is the first time PHE has published local prevalence data of this nature. It is hoped that the data will assist LAs in identifying and commissioning appropriate services with sufficient capacity and resources in their area.

Duncan Selbie, Chief Executive at PHE said:

There are about 200,000 children living with an alcohol dependent parent in England, always with consequences for their childhood and sometimes devastating.

This new fund is an opportunity for local services to get help faster and more effectively to the most vulnerable children and parents and we hope to receive a range of creative applications.

Public Health Minister Steve Brine said:

For far too long, children of alcoholics have had to suffer in silence, too embarrassed and afraid to seek help or know who to turn to.

We know being the child of an alcoholic can lead to a lifetime of problems, from mental health issues to increased risk of alcohol abuse.

Local authorities have the local knowledge and power to make a huge difference – that’s why it’s right we offer this lifeline to thousands of silent sufferers.

Kit Malthouse, Minister for Family Support, said:

Alcohol abuse can have a poisonous effect on a home – it can lead to increased conflict and can ultimately tear families apart. We want to prevent this from happening, and this initiative will get help to alcohol dependent parents earlier and make sure that children are also supported.

As a former councillor, I know how effective local authorities can be in delivering targeted support to families in need and I’d encourage them to apply for funding to develop proposals to tackle this hugely important issue too.

PHE welcomes ambitious bids where there are robust joint plans from public health and children and family commissioners that are designed to lead to identifying more children and parents. In particular, we hope to see how LAs will:

identify more children of alcohol dependent parents and how they can increase support (including where they have taken on inappropriate caring responsibilities)
increase the number of alcohol dependent parents receiving and completing treatment, and to provide support that reduces parental conflict
reduce the number of ‘looked after children’ of alcohol dependent parents being taken back into care, and/or reducing the time spent on the child protection register

In total, PHE is expecting to fund up to 8 areas. The application phase for the innovation fund opens on 22 May 2018, running until 17 July. The total available fund is up to £4.5 million over 3 years. Those interested in the fund should submit an application form to InnovationFund@phe.gov.uk.

Background

Successful applicants will be able to draw down a revenue grant to support their work over the period 2018 to 2019, to 2020 to 2021.
Areas that are working with the DWP’s reducing parental conflict programme are out of scope for this funding.
Payments to successful applicants will be awarded to the local authority as a section 31 grant, under the Local Government Act.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/news/innovation-fund-open-to-help-children-of-dependent-drinkers
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News story: New tool calculates NHS and social care costs of air pollution

The health and social care costs of air pollution in England could reach £5.3 billion by 2035 unless action is taken, according to a new report and cost tool published today by Public Health England (PHE). Last year, the costs were £42.88 million. Local authorities will be able to use it to inform their policies to improve air quality.

The report and tool are part of the wider government strategy to reduce air pollution which was announced today, Tuesday 22 May 2018, by the Department for Environment, Food and Rural Affairs.

Working with the UK Health Forum and Imperial College London, PHE’s report and tool highlight the potential costs to the NHS and social care system of exposure to Particulate Matter (PM2.5) and Nitrogen Dioxide (NO2), 2 of the pollutants to be dealt with under the government strategy.

The costs are for diseases where there is a strong association with air pollution: coronary heart disease; stroke; lung cancer; and child asthma.

When diseases with weaker evidence of association are also added, including chronic obstructive pulmonary disease; diabetes; low birth weight; lung cancer (for NO2 only); and dementia, the costs were £157 million in 2017 and could reach £18.6 billion by 2035.

There could be around 2.5 million new cases of all of the above diseases by 2035 if current air pollution levels persist.

A relatively small reduction in the population’s exposure to PM2.5 and NO2 could lead to a significant reduction in costs. Modelling was carried out at the national level and for 2 local authorities, Lambeth and South Lakeland, which represent areas with high and low levels of PM2.5 and NO2 respectively.

If there was a 1µg/m3 reduction in PM2.5 and NO2 over a year, relative to the 2015 baseline, the cumulative number of new cases of all diseases and NHS and social care costs avoided could be:

		1µg/m3 reduction in PM2.5	1µg/m3 reduction in PM2.5	1µg/m3 reduction in NO2	1µg/m3 reduction in NO2
Years	Region	New cases avoided (per 100,000)	Costs avoided (£m/100,000)	New cases avoided (per 100,000)	Costs avoided (£m/100,000)
2015 to 2025	England	146	0.72	32	0.19
	Lambeth	153	0.72	28	0.15
	South Lakeland	119	0.6	33	0.3
2015 to 2035	England	314	2.42	59	0.6
	Lambeth	310	2.35	57	0.54
	South Lakeland	204	2.05	70	0.75

All local authorities can use the tool to estimate the impact on health and the savings to the NHS and social care under different air pollution scenarios.

Professor Paul Cosford, Medical Director and Director of Health Protection at PHE, said:

Air pollution is a growing threat to the public’s health, evidence shows it has a strong causal association with coronary heart disease, stroke, lung cancer and childhood asthma.

PHE has created a new air pollution tool so, for the first time, local authorities can calculate the cost of air pollution, providing impetus to act to improve air quality.

Local authorities are ideally placed to introduce policies to minimise air pollution, especially given the legal air quality powers they have to tackle it locally. The areas where they can act – health, housing, transport, education, local economies, green space and quality of life – are all relevant to local government policy.

Until now, there has been no simple way for local authorities to estimate the potential savings to the public purse from taking local action on PM2.5 and NO2. This tool may help local authorities make a more fully developed economic and financial case for reducing emissions.

The government’s Clean Air Strategy provides further support to local authorities.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/news/new-tool-calculates-nhs-and-social-care-costs-of-air-pollution
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