Viral hepatitis—400 deaths a day in Europe

Over 13 million people in the WHO European Region are living with chronic hepatitis B infection and over 15 million with chronic hepatitis C infection. Between them, these two diseases lead to 400 deaths in the Region every day. Many cases of viral hepatitis remain asymptomatic until decades after infection, slowly destroying the liver and eventually presenting as grave and deadly complications such as liver cirrhosis, liver cancer and liver failure.

In most countries in the Region, the majority (in some countries, more than 75%) of people living with viral hepatitis do not know about their infection. Many became infected through blood transfusion or other medical procedures years ago when no tests were available and more than 20% will develop liver cirrhosis or cancer if the diseases are not diagnosed in time.

Several vulnerable population groups, particularly people who inject drugs, are at greatest risk of becoming infected. However, everyone is potentially at risk, because unsafe injections and other invasive procedures that can expose individuals to hepatitis C and hepatitis B viruses within and outside the health care sector still occur.

Even though blood safety and safe injecting practices in health care settings have improved in recent years, the hepatitis viruses continue to spread. In the past, viral hepatitis received little attention from policy-makers. Most countries have been reluctant to address viral hepatitis, such as ensuring access to treatment and prevention to all who need them and reducing the costs of drugs and diagnostics. Sexual transmission of viral hepatitis B is an ongoing issue, although universal vaccination to prevent this disease has been in place for over 20 years in most countries. Vaccination of newborns is the most effective, safest way to prevent mother-to-child transmission of viral hepatitis B, and the vaccine provides protection from the infection throughout life.

As transmission of hepatitis C and B viruses through blood and unsafe injection practices continues in the Region, there should be scaled-up prevention programmes for vulnerable groups based on evidence-based interventions, such as harm reduction for people who inject drugs and equal access to services and treatment. Recent revolutionary treatments for chronic hepatitis C have made it possible to cure more than 90% of infected people in just 3 months, without the severe adverse effects often seen with previous treatment regimens. Unfortunately new treatments are still unacceptably expensive and political will from both government and civil society organizations is needed to improve access to treatment and to ensure affordable prices.

WHO is working on a global strategy to combat viral hepatitis, which will include a comprehensive package of prevention measures and call for better access to treatment and better global awareness about viral hepatitis, the so-called “silent killer”.

To download a factsheet on Hepatitis B, click here    on www.euro.who.int

To download a factsheet on Hepatitis C, click here on www.euro.who.int

Health MEPs propose blueprint for safer healthcare

Between 8% and 12% of patients admitted to hospitals in the EU suffer adverse events such as healthcare-associated infections (HAIs), which place a heavy burden on limited health service budgets. According to the European Centre for Disease Prevention and Control, 1 in 20 hospital in-patients, on average, suffers from an HAI in the EU, that is to say, 4.1 million patients annually, and every year 37,000 people in the EU die as a result of an HAI, even though 20%-30% of these infections are considered to be preventable by intensive hygiene and control programmes.

MEPs have suggested a number of measures to improve patient safety, such as tackling growing resistance to human and veterinary antibiotics by using existing treatments more responsibly and promoting innovation. Specific measures include strictly prohibiting their use without prescription, implementing marketing practices designed to prevent conflicts of interest between producers and prescribers, and better information, monitoring and infection control.

Noting that resistance to certain commonly used antibiotics is encountered in at least 25% of cases in several member states, MEPs also urge pharmaceutical companies to invest in developing new antimicrobial agents. MEPs also advocate responsible use of antimicrobials in veterinary medicine, including medicated feed, by allowing their use only for treatment after veterinary diagnosis. Two pieces of legislation on the matter are under discussion in the European Parliament. The use of veterinary antibiotics should therefore gradually be restricted to therapeutic purposes, by progressively eliminating their use for prophylactic ones. Metaphylaxis, i.e. the mass medication of animals to cure sick ones on farms whilst preventing the infection of healthy ones, should also be minimised, say MEPs.

To find out more about the European Centre for Disease Prevention and Control, click here on http://ecdc.europa.eu

Europe needs to scale up measles vaccinations

Over 22,000 cases of measles have been reported in Europe since the start of 2014, so although measles cases have fallen by 50% since 2013, large outbreaks still occur. Over the past two decades, the number of measles cases in Europe has fallen by 96% but WHO is warning that the region is jeopardising its efforts at complete elimination.

The 22,000 cases came from seven countries, including Italy and Germany, where there are pockets of susceptible people who are un- or under-immunised, partly because of barriers to accessing vaccinations, and partly because growing numbers of parents are refusing to vaccinate their children.

In order to control the current outbreaks, all countries must:

  • Improve their ability to detect and investigate all suspected cases
  • Identify chains of transmissions
  • Make high-quality, evidence-based information available to the public on the benefits and risks associated with immunisation

To support European countries in these efforts, the WHO Regional Office for Europe has launched a new European Vaccine Action Plan (EVAP) and offers information on measles and rubella on its website, including reports of epidemiological data, a package of accelerated action for measles and rubella elimination and a framework for verifying the elimination process.

To read more about the seven affected countries, click here   on www.euro.who.int

To read more about the European Vaccine Action Plan, click here on www.euro.who.int

Every day 1000 people in Europe develop TB

An estimated 360,000 Europeans developed tuberculosis (TB) in 2013, or around 1000 people a day.

According to new data published by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe, this figure was about 6% lower than in 2012, continuing a sustained decline over the last decade across the Region.

However, rates of multidrug-resistant (MDR) TB remain at very high levels, particularly in the so-called 18 high-priority countries, which see 85% of all new TB cases in the Region.

These countries also accounted for most of the 38,000 TB-related deaths in 2013.

To read more, click here