Nasal flu vaccine may help reduce cases of group A strep
UK Health Security Agency (UKHSA) analysis suggests that nasal flu vaccine may also help reduce the rate of group A strep infections (Sinnathamby et al, 2022).
The live attenuated influenza vaccine (LAIV) nasal spray is offered each season to most children aged 2 and 3 years old, and to school-aged children, to help protect against flu. It was first rolled out in England from 2013, adding a school year each calendar year. In some pilot areas, the vaccine was given to all primary school years from 2013 onwards.
The UKHSA analysis looked at data from 2013 to 2017, comparing rates of group A strep (GAS) infections in pilot areas and comparing them to other areas where the vaccine was not being offered as widely. The analysis found that incidence of GAS was lower in pilot areas where the nasal flu vaccine was being offered to all primary school children, compared to areas where it was being rolled out by year group.
In 2 to 4 year olds, rates of GAS were 73.5 per 100 000 children in pilot areas, compared to 93 per 100 000 children in non-pilot areas. In 5 to 10 year olds, rates of GAS were 50.3 per 100 000 children in pilot areas, compared to 57.8 per 100 000 in non-pilot areas.
Dr Jamie Lopez Bernal, Consultant Epidemiologist for Immunisation and Countermeasures at UKHSA, said: ‘Our findings suggest that the nasal spray vaccine programme, which offers very good protection against flu, may also help contribute to reductions in the rates of GAS infections among children. Children who catch influenza are at greater risk from subsequent infections, including group A strep, so these findings provide yet more reasons for parents of eligible children to bring them forward for the flu vaccine. This is particularly important at this time when we are seeing unusually high rates of group A strep infection across the population.’
So far this season there have been 7750 notifications of scarlet fever -an illness caused by GAS. This is much higher than usual at this time of year.
There is high demand for penicillin as it is used to treat strep A and scarlet fever, and the increased demand means that some pharmacists are experiencing temporary and localised supply issues, and may not have the specific formulation listed on the prescription. A Serious Shortage Protocol (SSP) has been introduced by the Department of Health and Social Care. This protocol will allow pharmacists to supply a different formulation or alternative antibiotic in the event of nonavailability of the penicillin.
Nursing strikes may continue in 2023
December's nursing strikes could be the beginning of a longer period of action if governments continue to refuse formal pay negotiations, or if pay talks don't result in a satisfactory outcome, the Royal College of Nursing warns.
Up to 100 000 nursing staff took part in strikes in England, Northern Ireland and Wales, in objection to years of real-terms pay cuts and concerns over patient safety.
Speaking on BBC's Question Time, Cullen warned ‘If this Government doesn't speak to us and doesn't get into a room, I'm afraid that this will escalate,’ she said.
Matthew Taylor, chief executive of the NHS Confederation, said: ‘No health leader wanted to be in this situation and the strikes could have been avoided had the government attempted to find more common ground with the RCN on pay. The government cannot just sit back and let future strikes happen when patient care is on the line. The worry is that this is just the start, that strikes possibly being planned for January could be more severe and coordinated across the different unions, and that we could be in a position of stalemate for the foreseeable future. This benefits no one and the government must act.’
Patients to carry out health checks in comfort of own home
A trial aiming to make it easier and more convenient for patients to carry out health checks and reduce pressure on general practice has been launched in Cornwall.
A total of 15 million people are eligible for free NHS Health Checks in England. The NHS Health Checks aim to prevent stroke, kidney disease, heart disease, type 2 diabetes and some types of dementia.
In the trial, patients will complete an online questionnaire, use a kit to take a blood sample at home, and complete a blood pressure check at home if they have the equipment, in their local pharmacy or in their GP's waiting room.
More than 2000 people from 3 GP surgeries across Cornwall are being invited to take part in the trial -only those whose results indicate an underlying health condition will be followed up by their GP. The results of the trial will help inform the design and development of the new national NHS Digital Health Check.
Dr Andy Sant, managing director of NHS Cornwall's North and East Integrated Care Area, said: ‘Much has been achieved in our county around digital inclusion, and the preventative value of health checks is already proven. So we are delighted that patients in Cornwall are being given the first opportunity to access a digital version through this innovative trial. Amid such sustained pressure upon general practice, this is a welcome and logical progression. The associated benefits are wide-reaching, from the convenience and savings for patients, to the positive impact on GP appointments.’
Professor Kamila Hawthorne, Chair of the Royal College of GPs, said: ‘We expect to see a robust evaluation of this initiative, before further decisions to roll it out more widely are made. Specifically, this needs to look at how digital health checks would link up with GP patient records, and how ‘red flag’ symptoms or recommendations for lifestyle change picked up by the health checks are managed. It also needs to address concerns around the potential for causing unnecessary worry for patients who may not know how to interpret their findings, practice staffing implications regarding the running, interpretation and explanation of tests, and additions to GP workload.’