Hormone Replacement Therapy (HRT) To Be Sold Over The Counter in United Kingdom

 

There are plans to for Hormone Replacement Therapy (HRT) to be sold over the counter without prescription in the United Kingdom.

HRT which are vaginal oestrogen tablets used as a treatment to relieve symptoms of the menopause and there are currently about 150,000 women on prescription. This plan would make women able to buy there drugs over the counter without any need to see their GP.

The MHRA, UK medicine regulatory body is proposing to reclassify this drug as a pharmacy medicine in order to make it easier to buy from the chemist.

HRT replaces the hormones that women lack during the menopause due to the lack of oestrogen. this causes vaginal dryness, hot flushes, night sweats, mood changes, brain fog, reduced sex drive and sleeping problems. some types of HRT slightly increases the risk of breast cancer and blood clots in some women. however, the risks are small and usually outweighed by the benefits.

Public Health England (PHE) COVID-19 vaccination programme UPDATE 23rd July 2021

Infections prevented by COVID-19 vaccines doubles to 22 million and deaths prevented rises to 60,000. PHE estimates that 60,000 deaths and 22,057,000 infections have been prevented as a result of the COVID-19 vaccination programme, up to 23 July. This is based on modelling analysis from PHE and Cambridge University’s MRC Biostatistics Unit.

The estimated number of deaths prevented has increased significantly since the most recent estimates were published, with the estimated number of infections prevented doubling in just 2 weeks. It was previously estimated that up to 9 July, around 37,000 deaths and 11,000,000 infections were prevented.

The methods used to estimate deaths and infections prevented are based on direct and indirect effects of the vaccination programme.

Health and Social Care Secretary, Sajid Javid, said: These new figures are fantastic to see – 22 million infections have now been prevented across the country and 60,000 lives have been saved. That’s hundreds of thousands of people whose loved ones have been protected thanks to the vaccines’ remarkable protection. Day by day, jab by jab, we are building a wall of defence which is protecting our nation against the threat of this virus. Make sure to get the jab if you haven’t already and play your part in this historic effort.

Dr Jamie Lopez Bernal, Consultant Epidemiologist at PHE, said: These figures show the vaccine programme’s remarkable impact on saving lives and reducing the spread of the virus. As cases have increased, the true scale of protection from the vaccine programme has become clear. Everyone that has come forward for their vaccine has played a part in this vital effort. It remains vital that everyone gets 2 doses of the vaccine, to protect you and those around you from COVID-19. You must book your second jab when invited, to gain maximum protection.

Minister for COVID-19 Vaccine Deployment, Nadhim Zahawi, said: Over 84 million vaccinations have now been administered since our world-class vaccination programme began in December, by thousands of NHS workers and volunteers at thousands of vaccination sites. We can see the fantastic results of their efforts – 22 million infections prevented and 60,000 lives saved, an achievement we can all feel proud of. Play your part in the UK’s COVID-19 response – it couldn’t be easier to go to a pop-up vaccination site this weekend or book through the NHS website, and get the jab.

Public Health England (PHE) COVID-19 vaccination programme UPDATE 8th July 2021

Public Health England (PHE) has said that it estimates 30,300 deaths and 8,151,000 infections have been prevented as a result of the COVID-19 vaccination programme, up to 25 June. This is based on modelling analysis from PHE and Cambridge University’s MRC Biostatistics Unit.

PHE also estimates that 46,300 hospitalisations have been prevented in people aged 65 or older in England up to 27 June (approximately 7,000 admissions in those aged 65 to 74, 18,000 in those aged 75 to 84, and 21,300 in those aged 85 and over).

The methods used to estimate deaths and infections prevented are based on direct and indirect effects of the vaccination programme. The indirect effects of the vaccination programme will not be incorporated into the analysis of hospitalisations prevented, which only takes into account the direct impact of first and second doses. Therefore the figure of 46,300 hospitalisations averted is likely to be an underestimate.

Dr Jamie Lopez Bernal, Consultant Epidemiologist at PHE, said: The vaccines are very safe and very effective, and they are the best way to protect you and those around you from becoming seriously ill with COVID-19. With restrictions easing, it is absolutely vital that everyone gets 2 doses of the vaccine, to protect you and those around you from the COVID-19 variants currently circulating in the UK.

Remember, you must book your second jab when invited, to gain maximum protection.

Yersinia enterocolitica: Diarrhoea causative agent

Yersinia enterocolitica is a Gram negative rod-shaped bacterium in the family of Enterobacteriaceae known as causative agent of gastrointestinal infections and most often causes the disease yersiniosis with a variety of symptoms such as enterocolitis, acute diarrhea, terminal ileitis and pseudoappendicitis but, if it spreads systemically, can also result in fatal sepsis. The genus Yersinia includes 11 species: Y. pestis, Y. pseudotuberculosis, Y. enterocolitica, Y. frederiksenii, Y. intermedia, Y. kristensenii, Y. bercovieri, Y. mollaretii, Y. rohdei, Y. aldovae, and Y. ruckeri. Among them, only Y. pestis, Y. pseudotuberculosis, and certain strains of Y. enterocolitica are of pathogenic importance for humans and certain warm-blooded animals, whereas the other species are of environmental origin and may, at best, act as opportunists. However, Yersinia strains can be isolated from clinical materials, so have to be identified at the species level.

Signs and symptoms

Symptoms of Y. enterocolitica infection typically include Diarrhea which is the most common clinical manifestation of this infection; diarrhea may be bloody in severe cases, low grade fever, abdominal pain, vomiting. The patient may also develop erythema nodosum, which manifests as painful, raised red or purple lesions, mainly on the patient’s legs and trunk. Lesions appear 2-20 days after the onset of fever and abdominal pain and resolve spontaneously in most cases in about a month.

Diagnosis

Y. enterocolitica infection can be diagnosis by a number of methods which includes Stool culture - This is the best way to confirm a diagnosis of Y. enterocolitica. The figure above shows the growth of Y. enterocolitica on CIN (Cefsulodin, Irgasan, Novobiocin) Agar. The characteristic deep red center with a transparent margin, or "bull's-eye" appearance of Yersinia andAeromonas colonies is important for identification, and is due to the presence of mannitol. Y. enterocolitica ferments the mannitol in the medium, producing an acid pH which gives the colonies their red color and the "bull's eye" appearance. Sodium deoxycholate, cefsulodin, irgasan, and novobiocin are added as selective agents. Altorfer found that by reducing the concentration of cefsulodin from 15.0 to 4.0mcg/ml, CIN Agar could also be used to selectively isolate Aeromonas spp., in addition to Yersinia.

Other diagnosis methods include tube agglutination, Enzyme-linked immunosorbent assays

Radioimmunoassays, Imaging studies - Ultrasonography or computed tomography (CT) scanning may be useful in delineating true appendicitis from pseudoappendicitis, Colonoscopy - Findings may vary and are relatively nonspecific, Joint aspiration in cases of Yersinia- associated reactive arthropathy

Management

Care in patients with Y enterocolitica infection is primarily supportive, with good nutrition and hydration being mainstays of treatment

First-line drugs used against the bacterium include the following agents:

Third-generation cephalosporins

Trimethoprim-sulfamethoxazole (TMP-SMZ)

Tetracyclines

Fluoroquinolones - not approved for use in children under 18 years

Aminoglycosides

Global Shortage of Hepatitis B Vaccine - PHE

There is currently a global shortage of hepatitis B vaccine which has been caused by problems in the manufacturing process.

Public Health England, working with NHS England, the Department of Health and the manufacturers, have put in place a series of measures so that the NHS and other providers can use the available vaccine for those at highest immediate risk. Measures are expected to continue until the beginning of 2018 and will be kept under review.

The risk of catching hepatitis B infection in the UK is very low.

In the UK, vaccination is usually offered to individuals who are at specific risk of being exposed to blood from an infected person. This includes babies born to mothers who are infected with hepatitis B, the sexual partners of infected individuals and a range of other groups such as men who have sex with men, healthcare workers, and people who inject drugs. Vaccination is also recommended for people who will be undertaking certain activities overseas.

A course of hepatitis B vaccine usually involves 3 doses of vaccine, completed over a few months. While supplies are limited, vaccine will be prioritised for those at highest immediate risk based on their doctor’s assessment. For other people, a doctor may advise that hepatitis B vaccine can be deferred until later.

Hepatitis B virus is found in the blood and bodily fluids, such as semen and vaginal fluids, of an infected person. It cannot be spread by kissing, holding hands, hugging, coughing, sneezing, or sharing crockery and utensils.

Individuals can reduce their risk of contracting hepatitis B by taking care to:

·         avoid having unprotected sex

·         not inject drugs, or by not sharing needles when injecting

·         avoid having tattoos, piercing or acupuncture when overseas

·         avoid accessing medical or dental care in high prevalence countries

Vaccination will still be available, as now, for those who have already been exposed to hepatitis B. Such people should seek urgent medical attention as the infection can still be prevented if treated promptly after the incident.

The recently announced addition of hepatitis B protection to the routine childhood immunisation programme at 2, 3 and 4 months will go ahead. The combined vaccine, which protects against hepatitis B and 5 other diseases, is not affected by this shortage.

Long term hepatitis B infection can be symptomless and people who think they may have acquired the infection in the past should seek a test from their healthcare professional.

Source: https://www.gov.uk/government/organisations/public-health-england

Killer Superbug: Pan-Resistant New Delhi Metallo-Beta-Lactamase-Producing Klebsiella pneumoniae

On August 25, 2016, the Washoe County Health District in Reno, Nevada, was notified of a patient at an acute care hospital with carbapenem-resistant Enterobacteriaceae (CRE) that was resistant to all available antimicrobial drugs. The specific CRE, Klebsiella pneumoniae, was isolated from a wound specimen collected on August 19, 2016. After CRE was identified, the patient was placed in a single room under contact precautions. The patient had a history of recent hospitalization outside the United States. Therefore, based on CDC guidance, the isolate was sent to CDC for testing to determine the mechanism of antimicrobial resistance, which confirmed the presence of New Delhi metallo-beta-lactamase (NDM).

The patient was a female Washoe County resident in her 70s who arrived in the United States in early August 2016 after an extended visit to India. She was admitted to the acute care hospital on August 18 with a primary diagnosis of systemic inflammatory response syndrome, likely resulting from an infected right hip seroma. The patient developed septic shock and died in early September. During the 2 years preceding this U.S. hospitalization, the patient had multiple hospitalizations in India related to a right femur fracture and subsequent osteomyelitis of the right femur and hip; the most recent hospitalization in India had been in June 2016.

Antimicrobial susceptibility testing in the United States indicated that the isolate was resistant to 26 antibiotics, including all aminoglycosides and polymyxins tested, and intermediately resistant to tigecycline (a tetracycline derivative developed in response to emerging antibiotic resistance). Because of a high minimum inhibitory concentration (MIC) to colistin, the isolate was tested at CDC for the mcr-1 gene, which confers plasma-mediated resistance to colistin; the results were negative. The isolate had a relatively low fosfomycin MIC of 16 μg/mL by ETEST. However, fosfomycin is approved in the United States only as an oral treatment of uncomplicated cystitis; an intravenous formulation is available in other countries.

A point prevalence survey, using rectal swab specimens and conducted among patients currently admitted to the same unit as the patient, did not identify additional CRE. Active surveillance for multidrug-resistant bacilli including CRE has been conducted in Washoe County since 2010 and is ongoing; no additional NDM CRE have been identified.

The BBC Health described that the analysis found the superbug was resistant to all 26 available antibiotics in the US including the "drug of last resort" - colistin.

E.coli O157 Outbreak Linked to Contaminated Mixed Salad Leaves in England

There is an Escherichia coli (E. coli) outbreak affecting more than 100 UK people could be linked to eating contaminated mixed salad leaves according to public health England. To date, 109 people (figure correct as at 4 July 2016) are known to have caught the bug - 102 in England, 6 in Wales and 1 in Scotland with the South West of England particularly affected.

PHE has been working to establish the cause of the outbreak and has now identified that several of the affected individuals ate mixed salad leaves including rocket leaves prior to becoming unwell. Currently, the source of the outbreak is not confirmed and remains under investigation. PHE is now reminding people to maintain good hygiene and food preparation practices in response to the current outbreak.

E. coli O157 infection can cause a range of symptoms, from mild diarrhoea to bloody diarrhoea with severe abdominal pain. On rare occasions, it can also cause more serious medical conditions and can be caught by eating contaminated food or by direct contact with animals with the bacteria. It can also be passed from an infected individual to another person if hand and toilet hygiene is poor.

Dr Isabel Oliver, director of PHE's field epidemiology service, said: "At this stage, we are not ruling out other food items as a potential source."

PHE was first alerted to the outbreak at the end of June. Dr Oliver said people could help protect themselves from possible infection by washing their hands before eating and handling food and by thoroughly washing vegetables and salads that they were preparing to eat.

E. coli O157 is found in the gut and faeces of many animals, particularly cattle, and can contaminate food and water. Outbreaks of E. coli O157 are rare compared with other food-borne diseases.

Avoiding E. coli O157 infection

§  Wash hands thoroughly after using the toilet, before and after handling food, and after handling animals

§  Remove any loose soil before storing vegetables and salads

§  Wash all vegetables and fruits that will be eaten raw

§  Store and prepare raw meat and unwashed vegetables away from ready-to-eat foods

§  Do not prepare raw vegetables with utensils that have also been used for raw meat

§  Cook all minced meat products, such as burgers and meatballs, thoroughly

§  People who have been ill should not prepare food for others for at least 48 hours after they have recovered

Source - PHE & BBC