1. Guidance for HPTs on investigation of LD cases, clusters and outbreaks
Public Health England has issued detailed operational guidance on public health investigations of cases, clusters or outbreaks of Legionnaires Disease .
The new guidance codifies current best practice on investigations, providing a framework for action that can be adapted to different scenarios. This is primarily designed for use by PHE local health protection teams.
Actions to be taken during investigations are described and risk assessment/management algorithms for single LD cases, and for clusters and outbreaks, respectively, are included.
Further information and documentation is available via the Legionnaires’ disease: guidance, data and analysis webpages on the PHE website.
- PHE (December 2016). Guidance on investigating cases, clusters and outbreaks of Legionnaires’ disease.
2. HPV vaccination and cervical cancer: addressing the myths
PHE has published a factsheet for health professionals addressing common myths about the human papillomavirus (HPV) vaccination and cervical cancer . The two-page document – that can be supplied as a hard copy leaflet  – is intended for health professionals who deliver the HPV vaccine programme for girls, complementing other information currently provided for school nurses, GPs and screening and immunisation practioners.
- PHE (December 2016). HPV vaccination and cervical cancer: addressing the myths
- Department of Health health and social care orderline.
3. Possibility of transmission of blood-borne viruses during needle microdermabrasion
A series of needlestick injuries associated with needle microdermabrasion are being investigated by PHE. Needle microdermabrasion is a cosmetic procedure that, in recent years, has become widely available in beauty salons and cosmetic surgery premises throughout the UK.
Needle microdermabrasion is undertaken using proprietary devices that typically comprise a handset with a detachable needle-studded cylindrical roller, and integrated tubing that delivers cosmetic solutions onto the needle cylinder. By holding the handset, beauticians apply mechanical pressure to roll the needle cylinder onto the skin of the face and body of clients, creating multiple small abrasions. Currently, there are no regulations governing the use of needle microdermabrasion systems.
Use of needle microdermabrasion systems can result in bleeding and generation of serous fluid at the site where the device is applied. As such, there is a risk of transmission of blood borne viruses (hepatitis B virus, hepatitis C virus, and HIV) to staff members should needlestick injuries occur, or to clients through cross contamination.
Between March and May 2016, three staff members working in beauty salons in the North West of England experienced needlestick injuries while providing needle microdermabrasion. All exposed individuals were using the same needle microdermabrasion device. Needlestick injuries occurred during the process of disassembling the device after use on clients. All three exposed individuals subsequently tested negative for blood borne viruses.
As part of the investigation, PHE is working with Environmental Health Officers, and the device manufacturer, to recommend design modifications to reduce the risk of needlestick injury and cross-contamination, and to support development of improved training and infection control guidance for providers offering needle microdermabrasion.
4. Infection reports in this issue
The following routine report is published in this issue of HPR: