Resistant bacteria spreading in hospitals across Europe

Antibiotic resistance is widespread across the whole of Europe. High resistance, often seen in the southern and eastern countries of the European Union, is also found in the eastern part of the European Region. In particular, resistant bacteria are spreading in hospitals and health care settings, putting patients at risk of contracting incurable diseases. This is the concerning picture painted by the second Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR) report, published by WHO.

The aim of the report is to provide guidance and inspiration to countries that are building or strengthening their national AMR surveillance and to stimulate the sharing of data internationally. 19 non-EU countries are engaged in CAESAR (Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Kazakhstan, Kyrgyzstan, Montenegro, the Republic of Moldova, the Russian Federation, Serbia, Switzerland, Tajikistan, the former Yugoslav Republic of Macedonia, Turkey, Turkmenistan, Ukraine, Uzbekistan.)

More information about Anti-Microbial Resistance in Europe on the euro.who.int website

Toxoplasmosis: greater awareness needed

Toxoplasmosis, caused by the parasite Toxoplasma gondii, is estimated to affect more than 2 million people every year in the European Region. Although most people do not have symptoms, if a woman becomes infected just before or early in her pregnancy, it can have very serious health consequences for her child.

Toxoplasma can be acquired trans-placentally (mother to baby), through contact with infected soil or water, ingestion of contaminated food, or in very rare cases through blood/organ donation. It is assumed that half the cases come from eating contaminated food, such as inadequately cooked animal meat, or raw fruits and vegetables. Infection can also occur through contact with cat faeces in the environment, but cats only shed oocysts for a few weeks of their life, usually when kittens. Cats play an important role in the life cycle of the parasite, but they are not the main vehicle of infection.

To prevent food-borne toxoplasmosis, hand-washing and the use of clean water in food production and preparation is critical. Pregnant women should avoid undercooked meat. Fruits and vegetables should be thoroughly washed with clean water.

For more information about Toxoplasmosis on the euro.who.int website

Water, sanitation and health

14 people die every day in the pan-European region, due to inadequate water, sanitation and hygiene.

In response a Protocol on Water and Health has been developed which urges an holistic approach to water, sanitation and health, enabling countries to use the Protocol as a tool to implement Strategic Development Goals SDG) at national levels. Through improving their water, health and environmental situations, countries also support and reinforce the benefits to many other areas of development. This creates positive, interlinked and mutually supportive outcomes that reduce poverty, address inequality and promote sustainability – all of which are overarching themes of the SDGs.

More information about the Protocol on Water and Health on the euro.who.int website

European Knowledge Hub on Health and Migration

Although the number of refugee and migrant arrivals has seen an overall reduction in recent months, migration to Europe continues at a steady rate. In 2016 more than 330,000 refugees and migrants reached Italy and Greece with over 4,200 being found dead or reported missing at sea, compared to 3,771 in 2015.

The health systems in countries receiving refugees and migrants should be able to deal with the immediate health needs of new arrivals, as well as diagnose and treat common infectious diseases and noncommunicable illnesses. They should have effective disease surveillance and reporting systems in place to investigate and respond to outbreaks.

WHO has launched the first ever European Knowledge Hub on Health and Migration to support the work of those who deal directly with the health aspects of migration, serving as a repository for scientific evidence on the subject. It will act as a learning platform for all stakeholders working in the field of migration and health, including policy-makers, health professionals, social workers, managers of migration centres and first-line responders.

More information about Migrants and Health on the euro.who.int website

Tracing donated tissue and cells

The EU has recently launched a Coding Platform to support healthcare professionals and national authorities in tracing donated tissues and cells from donor to recipient in the entire EU. The EU Directive on standards for quality and safety of human tissues and cells sets standards for tissues and cells such as bone marrow, reproductive cells, corneas, skin, etc., that are used within the EU and which will be identified by a Single European Code (SEC).

This SEC is an important tool for better patient safety as it enables the tracing of tissues and cells along the supply chain – from the donor to the patient receiving it. In case of a quality or safety issue, it allows appropriate action, including – where necessary, withdrawing or recalling all tissues and cells from the same donor, to be taken quickly. The EU Coding Platform contains information on all 2800 tissue establishments authorised in the EU as well as categories of tissue and cell product codes. It provides users with a free, simple and efficient tool, to build their SEC for a tissues and cells product, and takes into account the needs of small-sized and not-for-profit tissue establishments.

For more information about the Single European Code on the webgate.ec.europa.eu website

Climate change and health

All populations will be affected by climate change, but some are more vulnerable than others. In Europe it will be people living on small islands, in coastal regions and on rivers who will be particularly vulnerable.

WHO have produced a fact sheet on climate change and health which provides key facts, outlines patterns of infection, measures health effects and details the WHO’s response.

The key facts include:

  • Climate change affects the social and environmental determinants of health – clean air, safe drinking water, sufficient food and secure shelter.
  • Between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress.
  • The direct damage costs to health (i.e. excluding costs in health-determining sectors such as agriculture and water and sanitation), is estimated to be between US$ 2-4 billion/year by 2030.
  • Areas with weak health infrastructure – mostly in developing countries – will be the least able to cope without assistance to prepare and respond.
  • Reducing emissions of greenhouse gases through better transport, food and energy-use choices can result in improved health, particularly through reduced air pollution.

In 2015, the WHO Executive Board endorsed a new work plan on climate change and health. This includes:

  • Partnerships: to coordinate with partner agencies within the UN system, and ensure that health is properly represented in the climate change agenda.
  • Awareness raising: to provide and disseminate information on the threats that climate change presents to human health, and opportunities to promote health while cutting carbon emissions.
  • Science and evidence: to coordinate reviews of the scientific evidence on the links between climate change and health, and develop a global research agenda.
  • Support for implementation of the public health response to climate change: to assist countries to build capacity to reduce health vulnerability to climate change, and promote health while reducing carbon emissions.

For more information on climate change and health on the who.int website

Human blood, tissues and cells

The European Commission has published two reports on the implementation of EU legislation which sets standards of quality and safety for both human blood and human tissues and cells.

According to the legislation, donations of human blood, tissues and cells should be voluntary and unpaid and all EU countries have taken measures to encourage this, although what is considered compensation and incentive vary between Member States.

The reports also point to some gaps and difficulties in applying and enforcing the rules. For both sectors, these difficulties relate to such things as the protection of donors, the inspections framework and testing and deferral criteria for new epidemiological and technological developments (eg testing for Malaria).

For more information, including links to both reports, on the ec.europa.eu website.

Public Health threats to air safety

The AIRSAN Project looked at coordinated action in the aviation sector to control public health threats and has developed a range of tools to ensure a well- organised and coherent response. The Project targeted public health and civil aviation authorities, local public health authorities at airports, airport and airline management and medical services across EU member states.

AIRSAN Partners have developed:

  • an AIRSAN Network,
  • AIRSAN Communication Platform,
  • an AIRSAN Bibliography,
  • AIRSAN Guidance Documents, and
  • an AIRSAN Training Tool.

To access these and find out more about the AIRSAN project on the airsan.eu website

Zika virus in Europe

The WHO has declared the Zika virus outbreak a “Public Health Emergency of International Concern”.

The European Commission has created a central web page with information on the Zika outbreak and how it is being managed in the EU. It will be regularly updated in line with the latest developments.

To see more about the Zika virus in Europe on the ec.europa.eu website.

Serious cross-border threats to health

At the end of 2015, the EU implemented a decision to improve preparedness across the EU and strengthen the capacity for coordinated responses to health emergencies. This will improve health security in the EU and will help member states prepare for cross-border threates caused by communicable diseases, chemical, biological or environmental events.

The Decision has four major benefits:

  • to strengthen preparedness planning
  • to improve risk assessment and management of cross-border health threats
  • to establish the necessary arrangements for the development and implementation of a joint procurement of medical countermeasures
  • to enhance the coordination of response at EU level by providing a solid legal mandate to the Health Security Committee

To read more about this decision on the ec.europa.eu website