Housed near Bristol, UKHSA’s National Collection of Pathogenic Fungi (NCPF) is home to more than 4,500 isolates of potentially deadly fungi, gathered over the last century.
The collection serves as a remarkable illustration of how scientific endeavours from the World War II era continue to hold significance in the present day. Moreover, it offers a glimpse into the future of health protection, highlighting the importance of preserving and studying these specimens.
In this blog post, we’ll cover the history of the NCPF: why it was set up, what it houses and how it continues to play an important role in protecting our health.
Founded in 1920, the National Collection of Type Cultures (NCTC) is the longest-established collection of its type anywhere in the world. It also serves as a United Nations Educational, Scientific and Cultural Organization (UNESCO) Microbial Resource Centre (MIRCEN).
The collection was originally housed at the London School of Hygiene and Tropical Medicine (LSHTM). The fungal strains from NCTC were combined with a collection of fungi gathered by the first NCPF curator, Dr James T. Duncan, who had undertaken a survey of fungal disease in Great Britain in the 1940s.
Today, the collection is based in Bristol and continues to be an integral part of the Mycology Reference Laboratory.
Fungi (moulds and yeasts) might just sound like ingredients for some of our favourite recipes, but they can also be important pathogens of humans and other animals. Infections caused by fungi range from superficial and relatively mild infections of nails and skin, to highly invasive infections that can destroy muscle tissue, bones, organs and in some cases kill.
Since its inception in 1946, the NCPF has been an integral part of the Mycology Reference Laboratory and is now based in Bristol, which means that the expertise is available on-site to help doctors identify the strain their patient might have.
Our NCPF colleagues offer services related to these fungal strains, such as:
At present, the collection holds over 4,500 strains of mould and yeast isolates of clinical significance from Absidia spinosa to Zygowilliopsis californica, and includes specimens from humans, an elephant, a camel, a dolphin, several hedgehogs, two goats and even a koala bear, amongst others.
Our collection includes:
Name: Curvularia lunata (named due to its crescent moon-shaped spores)
Target: Eyes, bones, heart, central nervous system.
In extreme cases of phaeohyphomycosis, this organism can cause deep infections involving the eyes, bones, heart or central nervous system.
Name: Aspergillus fumigatus
Target: Lungs.
Primarily causing an invasive infection in the lung, A. fumigatus represents a major cause of disease and death in immunosuppressed individuals as well as potentially causing a variety of allergic complications in immunocompetent individuals. In recent years there have been concerns over emerging drug resistance in this species.
Name: Cunninghamella bertholletiae
Target: Human body tissue.
Often entering the body through skin wounds or in patients with severe burns, Cunninghamella bertholletiae can infect and destroy a wide variety of tissue structures.
Name: Pseudallescheria boydii
Target: Central nervous system, lungs, joints, bones.
As well as a chronic subcutaneous disease (eumycetoma) following accidental traumatic inoculation , this organism and its close relatives can cause ear infections, fungal balls in the lungs, joint and bone infections, and infection of the central nervous system in immunosuppressed patients and those with fungal pneumonia after near-drowning.
Name: Lichtheimia corymbifera
Target: Lungs and sinuses.
In those with weakened immune systems, breathing in spores of this fungus and related members of the Mucormycota can cause an infection in the lungs or sinuses. Additional risk factors include diabetes and steroid use. These fungi were responsible for >45,000 cases of “black fungus disease” in patients with severe COVID infection in India in 2020-2021.
Dermatophytes and related fungi that cause skin infections, sourced from the UK and other countries. Many of these are original reference strains that can be used for identification. Included are strains of Trichophyton indotineae, a recent cause of treatment-resistant groin infections that has been spreading worldwide in the last decade.
Mould strains that can cause deep tissue and internal organ infections in humans and animals.
Yeasts that are known to cause infections, including many isolates of Candida auris, a relatively novel yeast species that has caused hospital outbreaks worldwide.
Fungi that can transition between a mould and yeast form (Dimorphic fungi), allowing them to cause different types of infections. These are high containment pathogens (containment level 3) and include Histoplasma, Coccidioides, Blastomyces. Famously, the singer Bob Dylan was forced to cancel the British Leg of a European tour in 1997 due to histoplasmosis and the Johnny Cash song “Beans for Breakfast” accurately made the link between bird guano and catching histoplasmosis.
With an estimated 2-4 million species (only approximately 150, 000 of which have been formally described), members of Kingdom Fungi are ubiquitous with a worldwide distribution and have adapted to inhabit extreme environments ranging from deserts to deep sea environments and even the Chernobyl nuclear exclusion zone.
Although most fungi are primarily decomposers of dead organic matter, some 600 species have been associated with human infections, with 200 of those reported as agents of human disease on a regular basis.
Each year, around 1,500 new species are described, with a new or emerging fungal pathogen of humans or animals described every month.
Over recent decades, the emergence of a number of important new pathogens has been noted together with increased antifungal resistance in known pathogen populations, in many cases driven directly by human activity (indiscriminate use of antifungal drugs in patients or the environment, increased foreign travel and tourism, exportation of exotic animals, planetary temperature changes).
These include the novel human pathogens Candida auris and Trichophyton indotineae, Pseudogymnoacus destructans (the agent of white nose syndrome in bats which has destroyed more than 90% of the US populations of some bat species) and Batrachochytrium dendrobatidis (which has decimated amphibian populations worldwide) together with worldwide increases in the prevalence of resistance to azole antifungal drugs in the human pathogen Aspergillus fumigatus. There have also been reports of new species and even a new genus of Hazard Group 3 fungal pathogens which have to be handled in a special containment facility in the laboratory due to their propensity to cause disease in otherwise healthy individuals.
Some of the primary roles of the Mycology Reference Laboratory (which houses and maintains the NCPF) include the identification, surveillance and tracking of novel and emerging fungal pathogens, antifungal drug susceptibility testing of individual fungi isolated from infections to optimise treatment, studies to understand the biology of new pathogens and to improve the diagnosis and treatment of fungal infections in humans (and animals) and conservation of important organisms in the NCPF so that they are available to other researchers.
]]>In England, data produced by the UKHSA shows that year after year new diagnoses of sexually transmitted infections STIs remain high and, between 2021 and 2022, diagnoses of gonorrhoea and infectious syphilis increased by 50% and 15% respectively.
In this blog post we will explore the rising tide of STIs across the eons, how ancient Greeks feared the killer “scorpions and serpents” in semen, and how goat's milk was thought to be a curative for sexual ailments.
The Greek and Roman Period (5th century BCE - 4th century CE):
Over 2,400 years ago the ancient Greeks and Romans were documenting their complex sexual networks and their sexual health.
Love and relationships in the time of The Minotaur and Medusa were not without their dangers. It is recorded that Pasiphae, the wife of King Minos of Crete, used a goat’s bladder as a condom as the King’s semen was said to contain “scorpions and serpents” that killed his mistresses.
And thanks to the ancient Greek physician Hippocrates, referred to as the Father of Medicine, we have some insights into the prevalence of diseases resembling STIs through his descriptions of clinical cases.
Writings from the Hippocratic corpus describe what might be acute gonorrhoea as “strangury”, which is thought to be caused by indulgences in the pleasures of Venus.
The name gonorrhoea is as ancient as its descriptions, being coined by another Greek doctor before 200 CE, Galen refers to gonorrhoea as “an unwanted discharge of semen”.
The Islamic Golden Age (8th - 14th centuries):
The Persian Rhazes (865-925 CE), a doctor and director of hospitals of what would become Baghdad, describes genital ulcers and what is thought to be gonorrhoea in his text ‘Continens’ with the treatment at the time being the slow introduction of goat's or breast milk to the infection.
These early writings included the transmission of diseases through sexual contact, laying the foundation for future understanding from other Persian doctors such as Aly Abbas who would diagnose and record infections from urethral discharge, burning sensations while urinating and thick discoloured discharge.
European Middle Ages (4th – 14th centuries): STIs in the Middle Ages were often linked to moral judgements. The term "venereal diseases" emerged in the Middle English period between 1150 and 1500, named after Venus, the goddess of love, the term venereal disease nods back to Hippocrates and, while misogynistic in origin, emphasises the connection of infections to sexual activity.
The Renaissance (14th - 17th centuries): The Renaissance promoted the rediscovery of classical philosophy, literature and art but is also believed to have coincided with either the introduction or discovery of syphilis in Europe.
The origin of syphilis in Europe is highly debated by academics, some argue that evidence from combined paleopathology and molecular analyses suggests the increased movement of people across the continent, and between this and other continents encouraged the spread.
The Germ Theory: Advances in microscopy allowed for the identification of specific pathogens and in the 19th century was a turning point in which microorganisms such as bacteria, viruses, fungi and parasites were accepted as the cause of disease, illness and infection.
Germ theory saw the beginning of an era with a more scientific approach to understanding and treating infections, including STIs.
Germ theory allowed for a better understanding of transmission routes from person to person and the development of treatments and the discovery of antibiotics, such as penicillin in the mid-20th century, revolutionised the treatment of STIs, including syphilis and gonorrhoea.
In 2022, gonorrhoea diagnoses were the highest they have been since records began in 1918, and syphilis diagnoses were the highest they have been since 1948.
The increase in diagnoses will in part be due to the success of an increase in testing and detection of more infections, but the scale of the increase in diagnoses in recent years strongly suggests that there is more transmission of STIs within the population driven by various factors such as decreasing condom use.
UKHSA, and other public health bodies charged with monitoring and charting rises and falls in STIs have been doing so in the UK since 1918.
Syphilis
Gonorrhoea
Sexually transmitted infections have been around for eons, but that doesn’t mean they’re here to stay. Discoveries and innovations such as Pre-Exposure Prophylaxis (PrEP) have been used to dramatically reduce the risk of getting HIV (human immunodeficiency virus), and effective HIV treatment now means that those who adhere to their medication cannot pass on the virus, known as Undetectable = Untransmittible (U=U).
In the UK, the British Association for Sexual Health and HIV is working with UKHSA on new guidance to inform the prescribing of doxycycline post exposure prophylaxis (Doxy-PEP) for the prevention of bacterial STIs such as syphilis.
And in the UK, the Joint Committee on Vaccination and Immunisation have recently advised the government on the targeted use of the 4CMenB vaccine for the prevention of gonorrhoea.
]]>They look like something out of nightmare, but these so-called ‘spider viruses’ occur naturally, and could be a powerful new weapon in tackling the growing threat of antibiotic resistance. Bacteriophages, or phages for short, have a remarkable and currently untapped potential for viral therapies. Their name comes from the Greek for to eat - ‘phagein’ - suggesting that phages swallow up bacteria. It’s a great image, although the reality is perhaps even more remarkable: phages inject bacteria with genetic material that ultimately destroys them.
At the end of last week, the government signalled that phages are being taken more seriously as an antimicrobial treatment option in response to a report published last year – great news in the fight against superbugs. Here at UKHSA, we partner with many other organisations on research that feeds into the UK’s plan for using phages.
Essentially, they are viruses that hunt down and destroy bacteria. But unlike antibiotics that kill all bacteria (including the beneficial ones in our gut), phages are more precise: some are even capable of targeting specific strains of bacteria.
Phages have been used therapeutically for decades in parts of Eastern Europe and former Soviet countries, but their potential has been overlooked in the West - until now. As antibiotic resistance has reached crisis levels, scientists are taking a fresh look at how phages might provide another line of defence.
A report from the House of Commons Science, Innovation and Technology Committee, published in November 2023, highlighted the exciting possibilities of using phages more widely to treat drug-resistant bacterial infections. And it doesn't stop there - phages could be combined with antibiotics to boost their bacteria-busting power and break through stubborn biofilms that help bacteria evade conventional drugs.
Phages could allow us to create highly personalised therapies tailored to each individual patient's condition and the specific bacterial strain causing their infection.
But before we get too excited, the report outlined some major hurdles to be overcome. Unlike mass-produced pills, phages are living organisms that may need to be grown on an individual basis to strict quality standards. Current regulations simply aren't set up to handle such a personalised medicine. We're still in the phage-pioneering phase in the UK compared to some other parts of the world.
In a response published on 1 March 2024, the government states it is committed to engaging with the scientific community through forums like the Innovate UK Phage Innovation Network. It acknowledges the need to provide greater clarity around phage regulations, manufacturing requirements and clinical trial pathways.
Importantly, the Medicines and Healthcare Products Regulatory Agency (MHRA) will publish draft guidance later this year on the licensing of phage products, with input from researchers and industry. This should finally start clearing the fog around how phages will be regulated in the UK.
On the critical issue of manufacturing, the government says it will consider the case for developing a Good Manufacturing Practice (GMP) facility that could support phage innovators. Though it can't commit funding yet, it's encouraging that ministers recognise the importance of this infrastructure gap. Crucially, it signals an intent to tackle some of the key regulatory and infrastructure barriers currently holding phages back.
The response also suggests the National Institute for Health and Care Research (NIHR) is open to receiving more applications for phage research funding and clinical trials. With guidance coming on trial requirements, the pathway may become clearer for phage development programmes.
The government states that phage therapy will be wrapped into the broader 2024-2029 national action plan on AMR as one of the potential solutions requiring further evidence.
As interest in phage therapy continues growing, having a centralised repository of phages will be crucial for supporting research and enabling wider adoption of these precise viral treatments. The UKHSA's National Collection of Type Cultures (NCTC) is at the forefront of developments in the UK, having recently established a bacteriophage collection.
The NCTC is the world's oldest bacterial strain library, and this new phage repository is intended to be a trustworthy source where scientists can both access and deposit phages. This dynamic collection will help drive accessibility, reproducibility and further exploration of phages' therapeutic potential.
With a century of experience with phages already under our belts, combined with cutting-edge initiatives like the NCTC phage bank, the UK has a strong foundation to build upon. By prioritising phage research, updating regulations, and fostering a collaborative ecosystem, we can cement our position at the forefront of this exciting next chapter of using viruses to conquer superbugs.
It may sound like a big ask, but the potential payoff is huge. Phages could be a key part of the toolkit we desperately need to keep humanity one step ahead of constantly evolving superbugs.
]]>The COVID-19 pandemic highlighted the urgent need for swift and safe vaccine development during public health emergencies. As detailed in the 100 Days Mission report, proactive vaccine research and development during non-crisis periods is important to help ensure we can quickly mobilise vaccines when new pathogens emerge.
Our Vaccine Development and Evaluation Centre (VDEC) at Porton Down is at the forefront of the UK’s effort in collaborating with global partners to develop life-saving vaccines, including vaccines for use outside of pandemics. mRNA technology is an exciting technology that allowed an agile pandemic response, and continued investment and leadership in this area will help ensure preparedness against future health threats.
Building on the success of mRNA vaccines developed in response to the COVID-19 outbreak, the government partnered with Moderna in December 2022 to ensure the UK is at the forefront of this potentially transformational technology. Under the 10-year partnership, which is led by the COVID Vaccine Unit in UKHSA, Moderna will invest in further mRNA research and development and manufacturing in the UK. The partnership could provide part of the UK’s routine vaccine supply as well as enabling us to scale up production in the event of a future health emergency. This will complement both the work of VDEC and wider government investment in mRNA development.
mRNA vaccines largely came to public awareness during the pandemic with the success of both the Pfizer/BioNTech and Moderna vaccines. These are the main vaccines used in the UK’s COVID-19 vaccination campaigns. However, researchers have been studying this method of creating vaccines for decades.
mRNA, or messenger ribonucleic acid, is a component of all life on earth and has been in cells for billions of years. Its job in the human body is to provide a mechanism by which the instructions in our genes (DNA) can be used to make specific proteins in our cells. When used in vaccines, mRNA delivers the instructions for making a harmless piece of protein identical to one found in a particular virus or bacterium, to the ‘protein factories’ of our cells.
Once the instructions have been decoded and the protein assembled, our immune system recognises it as a foreign body and starts to produce antibodies that can attack the protein if it encounters it again in the form of the ‘real’ virus.
After the process is complete, the body’s own natural immune cells take over and the mRNA instructions from the vaccine break down. The immune system has a memory for producing antibodies, but this can taper off over time meaning a booster is necessary.
All vaccines provide protection by helping our bodies to develop immunity against certain diseases. Some of the more traditional ways vaccines do this is by introducing a weakened or inactivated form of a virus or bacterium into the cell. This triggers our immune system to mount a response if it encounters the pathogen again.
One of the main differences between mRNA vaccines and other types of vaccine is the method by which our immune systems are presented with an antigen (the target against which we want our immune systems to mount a response). Some vaccines contain the whole virus or bacterium (providing lots of different antigens), and some contain selected parts of the virus or bacterium (a more specific antigen). mRNA vaccines are different as they provide the instructions for our bodies to produce the parts of the virus within our own cells.
Developing the mRNA platform is a bit like developing a wanted poster. Once the design has been proven, then a different face (or a different set of genetic instructions for the protein in mRNA’s case) can be slotted in easily. The leading advantage of mRNA vaccines is that they can be designed and produced more quickly than traditional vaccines, which can be crucial for tackling rapidly changing viruses and in a pandemic response.
mRNA vaccines have the potential to be more rapidly tailored to different diseases, or different variants of a disease, by changing the mRNA. They can also be more easily personalised to target the unique profile of cancer in each individual patient or for people with rare diseases. These uses of mRNA vaccines are known as therapeutics as they prevent recurrence in people with an existing condition.
Beyond fighting pandemic-level threats, mRNA technology offers some exciting opportunities in treating non-pandemic disease.
There are many threads being researched at the moment, but there are hopes that in the future mRNA vaccines could be used to train our immune systems to target cancer cells. The government has partnered with BioNTech to run clinical trials for personalised mRNA cancer vaccines in the UK and Moderna has several cancer vaccines in development.
]]>Hay fever is already common during the spring and summer months, but our changing climate could see some symptoms starting earlier in the year for allergy sufferers across the UK. Recent studies suggest that some types of pollen and other allergens could be released earlier in the year and for longer durations as temperatures rise. For some types of pollen, this may mean levels high enough to trigger hay fever as early in the year as January or February.
Pollen grains are tiny particles produced by flowering plants for reproductive purposes; some plants transfer pollen to other flowers of the same kind by means of insects, while many rely on wind to carry pollen grains through the air to their destination.
Pollen contains proteins and a significant number of people have an allergic reaction to these proteins (most commonly hay fever, but also allergic asthma and eczema).
In the UK it is estimated that every year millions of people feel the ill-effects of pollen exposure.
The pollen season in the UK has traditionally had 3 distinct but overlapping phases:
Research suggests that with increasing temperatures, oak and grass pollen seasons may start even earlier, meaning that some allergy sufferers could begin to experience hay fever and other reactions as early as January/February.
The Health Effects of Climate Change in the UK report, published at the end of 2023, listed a number of ways that climate change is likely to have an impact on our lives. It’s likely a changing climate will impact pollen patterns in at least 3 ways:
UKHSA, the Met Office and several universities collaborate on researching various aspects of pollen.
Research suggests that careful cutting regimes of grass could make a significant difference to the amount of grass pollen produced, with more work needed in this area to find out the health impact of such a change.
Looking to improve pollen forecasts using molecular genetics (i.e. DNA sequencing) will give more precise information to allergy sufferers, who already know which types of grass pollens affect them and when, so they can take appropriate action.
There is currently no easy way of distinguishing between the pollen grains produced by 150 species of grass, however understanding which species of grass pollens are in the air in high quantities at a particular time will allow people with hay fever and/or asthma to better manage their allergies and medication.
It may help people to discover which particular types of grass pollen they are reacting to.
Maps developed as part of a joint Met Office/UKHSA project, show the locations of key allergenic plants. They are used by health researchers to study impacts of plants with allergenic pollen on hospital admissions for respiratory conditions, provide information to local authorities and healthcare practitioners, and are helpful to patients suffering from allergies.
It's hoped that in the future more detailed source maps can be used, alongside wind direction and precipitation patterns, to provide improved local warnings to sufferers with information on the type(s) and concentrations of pollen within their area.
The Met Office, working with the University of Worcester’s National Pollen and Aerobiological Unit, has a network of pollen monitoring stations, which suck into a sampler containing sticky tape to capture the pollen. The tape is then placed under a microscope and the pollen particles are counted.
If researchers can improve the quality of information about the type and seasonal occurrence of pollen that is provided to health care professionals, then they can better plan treatment and clinical trials for remedies.
Smart-phone apps can help pollen sufferers by giving them individual forecasts and allowing users to feedback to the data providers.
There is also a need for strategies to monitor and, where possible, contain the spread of invasive species (such as ragweed), to minimise future pollen risks to the UK population.
Longer and more intense pollen seasons are something that we are beginning to experience in the UK. So, if you find yourself sniffling and rubbing your eyes in February, your symptoms could very well be caused by hay fever.
Image: Clare Bell
]]>Pathogen genomics is an important tool in our mission to prepare for and respond to infectious disease threats.
Our new 5-year Pathogen Genomics Strategy will establish a unified programme to enhance and expand our excellence in this field. Using pathogen genomics, we will increase our understanding of infectious disease risks, and enable effective evaluation of interventions to mitigate them.
In this blog post, we will explore the role of pathogen genomics in UK biosecurity and how we are developing our genomic systems to better protect public health in the UK.
Pathogen genomics involves examining the genetic material of microorganisms that cause diseases. We can analyse genomes to identify harmful mutations or variations in a pathogen compared to known strains. This will allow us to detect drug resistance or other characteristics, such as those associated with severity, within a pathogen. By using genomic data, we can track the spread of infections and outbreaks. Additionally, pathogen genomics helps in the development and discovery of new vaccines and therapeutics, playing a crucial role in combating diseases and safeguarding our health.
Pathogen genomics isn’t new: the first bacteria were sequenced in 1995, and the pandemic brought genomics to public attention. It demonstrated the science's real-time impact on public health globally, by detecting and monitoring outbreaks; determining the effectiveness of interventions and by allowing us to adapt the global pandemic response.
Since 2014, over 1 million genomes from routine hospital samples, outbreak investigations, environmental and food samples, and dedicated surveillance projects, have been sequenced by UKHSA and its legacy organisations. To date, the UK has uploaded 3,138,941 SARS-CoV-2 genomes to GISAID through collaborative partnerships between UKHSA, public health agencies in the devolved nations, NHS, academic and industry partners. The proactive sharing of genomic sequences in the public domain has made UKHSA an integral player in collaborative outbreak investigations across various agencies and countries. Last year, for example, global sequence data were used to rapidly identify a novel COVID-19 variant with unusual mutations, and once identified allowed us to quickly track and control local outbreaks.
The knowledge gained from the genomic profile of the variant allowed us to establish in our laboratories the continued effectiveness of Lateral Flow Device (LFD) tests and COVID-19 vaccines.
And automated data pipelines allowed us to rapidly generate information through large-scale accessible genomic datasets, linked across local and national systems, which we could then share with scientists globally.
Genomics also plays a key role in food safety by helping to monitor and prevent outbreaks within the food chain. The Gastrointestinal Bacteria Reference Unit (GBRU) at UKHSA pioneered the first service for genome-based surveillance and tracking of bacterial variants causing gastrointestinal infections. This marked an early shift from traditional laboratory methods to genomic analysis.
In April 2022, a distinct type of salmonella in chocolate was identified using genomics. The early detection of this outbreak and routine surveillance with WGS were instrumental in linking the outbreak to specific products, allowing for prompt and effective intervention. This technology has enabled rapid and decisive actions like food recall notices, which may previously have been delayed. Now, outputs from WGS help provide a robust evidence base to swiftly remove and recall hazardous products.
UKHSA supports the NHS and patients by providing WGS to identify the strain of tuberculosis (TB) causing disease in humans and using pathogen genomics to predict accurately the antibiotics that will effectively cure the individual with TB. This has halved the time from TB detection to understanding the effective drugs from 6 to 12 weeks to approximately 2 to 4 weeks in the vast majority of cases. This is particularly important where individuals have drug-resistant infections, to both improve the opportunity to cure the individual and prevent drug-resistant TB infections spreading in the community by effectively targeting rapid public health interventions.
Over the next 5 years, we will build on existing infrastructure, capacity, and scientific capabilities in pathogen genomics, further benefitting public health and bolstering our mission to protect lives and livelihoods.
This strengthened approach to managing infectious diseases will be underpinned by genomic data which is optimised for clinical and public health decision-making, impacting local and global health settings.
And in practice, our enhanced capabilities will mean the early detection of new threats, a better understanding how diseases spread within our population, and the application will ensure the most effective vaccines and treatments.
Genomic data will also drive advances in diagnostics, vaccines, and therapeutics, enabling a more targeted and efficient response to infectious diseases.
Innovation in new methodologies and technologies, such as metagenomics, will put us on the front foot in detecting new and emerging infections. This pursuit of innovation will be balanced with building high-impact services that are economically efficient.
Equally important is the workforce transformation within and beyond UKHSA. Through training and development, we will build a team well-versed in the complexities and potentials of pathogen genomics.
Committing to open sharing of pathogen genomic data and promoting global collaboration ensures that learnings and breakthroughs benefit a broader global community.
Our world is more interconnected than ever, and infections and outbreaks can spread rapidly.
Our genomics strategy represents a commitment to innovation, collaboration, and excellence in tackling some of the most pressing health challenges of our time.
]]>With the emergence at the end of last year of COVID-19 variant JN.1, there are questions about how it compares to the many other variants that have been identified.
JN.1 descends from variant BA.2.86 and has an additional mutation in the spike protein. It has recently become the most widely circulating variant in the US as well as in France. As of January 2024, approximately 60% of English cases are caused by JN.1.
UKHSA is continuing to monitor data relating to variants both in the UK and internationally, including close monitoring of the JN.1 variant, and assessment of severity and vaccine effectiveness. There is no change to the wider public health advice at this time.
There are no reports of people becoming more ill with this COVID-19 variant than with previous ones.
It is important to note that we will need more data to draw any conclusions about the effect of these mutations on transmissibility and severity of the variant. In this blog post we’ll outline what we know so far and what action we are taking.
It’s normal for viruses to mutate and change, and more widely we’re still getting to grips with how the healthcare system responds to the ebb and flow of seasonal cases. As more data becomes available on this variant, we’ll have a better understanding of how it interacts with our immune systems and how to optimise our protection and as well as actions we can take to keep the most vulnerable safe and live our lives as normally as possible.
If you have symptoms of a respiratory infection, such as COVID-19, and you have a high temperature or do not feel well enough to go to work or carry out normal activities, you should avoid contact with vulnerable people and stay at home if possible.
For those of us who absolutely can’t stay at home, our Living with COVID guidance is unchanged, and outlines how to prevent transmission to others.
Vaccines remain our best defence against severe disease and hospitalisation from flu and COVID-19. That’s why we’re asking over-65s, anyone in a clinical risk group, and anyone living in a household with someone who is in a clinical risk group, to come forward for their vaccination. Their protection since their last vaccination will have waned and they remain at increased risk from a respiratory infection this winter. It’s also important to note that COVID-19 isn’t a special case; respiratory infections can be unpredictable, and we’re asking similar groups to get vaccinated against flu.
The last date that the seasonal COVID-19 vaccination will be available is 31 January 2024.
We publish the latest surveillance data for COVID-19 and other respiratory illnesses weekly, to the UKHSA data dashboard. We’re also getting vital data from those who are admitted to hospital with symptoms, and we are utilising genome sequencing to understand which variants people are most vulnerable to.
There are also specific surveillance programmes in place, where small sample groups are tested regularly. These allow us to monitor trends in the wider community.
Hospital is where we will see the more severe cases, and we will be monitoring the numbers of people attending with COVID-19 symptoms very carefully. This will help us understand the growth rate and transmission potential of the new variant.
We continue to collaborate globally with health organisations in other countries, the World Health Organisation and initiatives such as the Global Influenza Surveillance & Response System (GISAID) to ensure that we have the most current data.
When a new variant appears on our radar, at the initial stages it is often quite difficult to know whether the mutations provide any advantages to the virus. Genetic mutations happen all the time, and in some cases have been known to make a virus less transmissible or cause a milder reaction in people.
At these early stages our scientists at the Vaccine Development and Evaluation Centre (VDEC) are busy growing a stock of the JN.1 variant in our high containment facilities, so that we can begin testing.
At the same time, scientists in our COVID-19 Vaccine Unit work hand in glove with vaccine developers to get samples of new, as yet unlicensed, vaccines to assess whether they will give better protection against the virus.
Vaccinations for flu and COVID-19 help to keep vulnerable people out of hospital and carrying on with their day-to-day lives, as well as reduce pressure on our NHS which is always critical in the winter. If you’re eligible for the jabs, please don’t hesitate, book your vaccine and get winter strong.
]]>With winter in full swing, now is a good time for parents to familiarise themselves with some of the common illnesses that could disrupt children's studies or even cause more serious illness during the colder months.
This blog post covers some of the seasonal illnesses that tend to peak during winter, as well as steps you can take now and throughout the coming term to help protect your family, including from cold weather. We’ll explore available vaccinations, how to recognise symptoms of common illnesses, and how to make informed decisions on whether a sick student is well enough to attend school or college.
Good hygiene stops infections from spreading, which means less disrupted learning time.
Teach your child to wash hands properly for 20 seconds, use tissues for coughs and sneezes, and stay away from others when sick. Letting in fresh air can also reduce the spread of airborne viruses. Our e-bug resources for all ages can help you to explain and discuss hygiene habits – and why they are important - to your child or teenager.
The start of a new term is a good time to familiarise yourself with the symptoms of common illnesses:
The NHS has a useful guide to help parents decide whether a child is well enough to go to school, based on their symptoms.
There are other types of illnesses to watch out for at this time of year, including bacterial infections such as scarlet fever. Although we see cases throughout the year, cases usually peak in the late winter and early spring.
The most common symptoms of scarlet fever include sore throat, fever, swollen neck glands, a bumpy rash on the chest and tummy with a sandpaper-like feel, flushed cheeks and “strawberry tongue”. If you suspect your child has scarlet fever, contact your local GP. Stay away from nursery or school for 24 hours after the first dose of antibiotics.
We are currently seeing the number of cases of measles and mumps increasing in all parts of the country. Measles in particular can be a very serious disease for some children and tragically it can even cause fatalities. The initial symptoms of measles are similar to those for a cold (runny nose; a cough; sneezing; a high temperature; and red, sore, watery eyes) this is followed by white spots in the mouth a few days later, and by a rash on the face and body a few days after that. It's very unlikely to be measles if your child has had both doses of the MMR vaccine or they’ve had measles before. Viral infections such as chickenpox can also spread in schools at any time of year and are highly contagious. An itchy, spotty rash is the main symptom of chickenpox. It can be anywhere on the body.
Vaccines provide the best protection against many common but potentially serious illnesses. Over the past decade, fewer children are getting routine vaccines, putting them at risk of serious disease. This leaves schools vulnerable to outbreaks and increases pressure on the NHS.
If your child is up to date with their NHS vaccination schedule, they will already be protected against diseases like whooping cough, measles, mumps and rubella throughout their school career, as most provide lifelong immunity.
Unvaccinated children are at higher risk of contracting these illnesses and having more severe symptoms than vaccinated classmates. They can also spread diseases to others. Check your child’s red book or contact your GP surgery to ensure they are up to date on all vaccines.
School-age children and young people are offered the following vaccinations:
Low indoor temperatures can have a serious impact on children’s health. Children under the age of 5 are particularly vulnerable. However, the effects of cold, especially in combination with other environmental conditions including damp, can affect children of all ages and particularly those with underlying medical conditions.
UKHSA guidance gives advice on a range of actions you can take to protect your child from cold weather, including:
Financial support is also available to help manage the costs of heating your home, especially for those on low incomes. The government has published energy saving tips to help save money on bills.
Through these preventative measures, and by recognising illnesses promptly, you can help your child stay healthy and keep school absences to a minimum this term.
]]>The Coronavirus (COVID-19) dashboard was a ground-breaking tool that demonstrated the strength of public appetite for data and provided local and national decision-makers with crucial information that helped to inform response.
From Thursday 21 December it will be fully replaced by the UKHSA data dashboard, which has been available alongside it since its launch in September 2023. The new dashboard will continue to highlight priority data and trends with an initial focus on respiratory viruses – including COVID-19 – but its metrics will be constantly assessed and updated with the aim to expand to reflect the full breadth of UKHSA’s remit.
Building on the strong foundations of its predecessor, the new public dashboard will continue to meet the needs of multiple users through a curated and accessible public interface, whilst continuing to provide a more granular data download functionality through APIs for professional users, such as academics, media, and industry. Accessibility, data quality assurance, thoughtful metric selection, and extensive user research have been instrumental in developing this new dashboard.
In this blog post, we will address some of the most common questions we've had from the public about the UKHSA data dashboard and how we will continue to develop it.
The dashboard will allow us to share relevant and useful data, trends and information, in a timely, user-centred and transparent way. It will meet the needs of different types of users, through an accessible, user-friendly front-end design, with data download functionality through application programming interfaces (APIs) for professional users, such as academics, media, and industry.
The dashboard has an expanded focus, and will include data on multiple public health threats, initially opening up data on respiratory viruses other than COVID-19.
The dashboard will also continue to ensure COVID-19 data is presented in an accessible format, while contributing and committing to the organisation’s winter preparedness effort.
The UKHSA dashboard builds on learnings from the COVID-19 dashboard but aims to enhance aspects like accessibility, data quality, metrics, and user experience. Through user testing, we’ve worked to present data in a simple, inclusive and useful way.
The COVID-19 dashboard was designed for use in the height of a global pandemic, whereas the new dashboard is designed and built for longevity - reflecting the context of a post-pandemic world with more curated metrics and the capacity to build in new public health topics over time. The type of data which is now reported has changed some of the data is no longer collected, and some of the metrics are less useful than they were during the pandemic and could be misleading.
User testing and research heavily guided the build of the UKHSA data dashboard. User insight is vital when considering how our users will interact with the dashboard and where they might find any metrics particularly confusing or even misleading.
When deciding which metrics should and should not be on the UKHSA data dashboard, analysts in the Data Product Development team (DPD) considered some key questions:
As a team, we reviewed all the metrics and considered the needs of all of our different types of users, including the general public, public health professionals, media, journalists and academics.
Those metrics which still provide benefit in the context of Living with COVID guidance, where all legal domestic restrictions have been lifted, remain.
For the UKHSA data dashboard, we will only be showing data by event date - when something occurred rather than when it was reported.
Data by publication date, the date by which the metric was reported, was useful at the height of the pandemic alongside event date, as it showed we were presenting the latest data as it was reported.
But now we are not in a pandemic state, data by event date is more representative of the health situation: for example, the publication date could be yesterday, but the latest event date within that data could be 2 weeks ago.
We want to make sure the UKHSA data dashboard has longevity and any metric, whether taken forward from the previous dashboard or newly available, is consistently available now and in the future.
During our review of the metrics, we considered if there were any indications the data might not be available in the future. If there were concerns, we would look into the likelihood of this happening and make a decision on whether to include the metric.
When deciding on whether a new topic will be added to the dashboard, whether that is an existing publication or the latest data connected to an incident, we will assess these topics on criteria which evaluate public health significance and interest and the reliability, availability and quality of the data.
We will still be reporting COVID-19 cases on the UKHSA data dashboard, including test positivity - which is the percentage of total number of reported tests that are positive, and is not the percentage of the population of who currently have COVID-19 - which brings reporting of testing for COVID-19 in line with existing reporting for other respiratory illnesses such as flu.
Feedback from users has driven the design and build choices the whole team has made when building the UKHSA data dashboard. By listening and responding to user feedback and focus groups, we’ve been better able to understand user needs, motivations and pain points and make changes to services which reflect practical daily use.
A public survey gathered usage feedback from over 5,000 respondents, alongside user sessions with media journalists, local authority workers, epidemiologists, data scientists, local community volunteers and those who aren’t users of the dashboard. Helping us to generate personas based on use needs were developed covering the spectrum from casual to expert users.
By focusing on accessibility, data quality, purposeful metrics, and user-centric design, the UKHSA dashboard aims to be an invaluable public health data resource.
We will be continuing to develop the UKHSA data dashboard in the coming months, with new features and functionality being added regularly. You can read about upcoming changes to the dashboard here. Over time, we also plan to add information and more health threats, for example other viruses and diseases.
Our aim is to provide a service that helps our users find the information that they need, and we welcome any feedback or suggestions through our feedback form.
]]>Vector-borne diseases – illnesses that can be transmitted to humans by other living organisms such as mosquitoes and ticks – account for more than 17% of all infectious disease and cause more than 700,000 deaths globally each year. They include West Nile virus, malaria, dengue and yellow fever.
As outlined in our Health Effects of Climate Change (HECC) report, the health risks posed by mosquitoes and ticks in the UK, whether from established or invasive species, are directly impacted by climate change and warming temperatures.
At UKHSA, our dedicated teams of medical entomologists monitor and assess the incursion of new species and diseases which could cause harm to human health, playing a vital role in coordinating efforts to minimise emerging vector-borne threats.
In this blog post, we take a look at the current status of vector-borne diseases in the UK, as well as the vital work being carried out by our specialist entomology team to assess, understand and address the health threats that mosquitoes and ticks pose.
Vectors, such as ticks and mosquitoes, are living organisms that can transmit infectious pathogens between humans, or from animals to humans. In the UK the threat from vector-borne diseases is on the rise, due to factors like growing global travel and trade, changes in land use and climate change.
Mosquitoes with the potential to transmit infectious disease can make their way to our shores in a number of ways, such as hitching a ride in cars and lorries, crossing the border into the UK. They may also be transported through trade channels through goods such as tyres, which are shipped internationally.
Similarly, ticks not commonly found in the UK can attach themselves to pets migratory birds and holidaymakers in search of a blood meal and be imported into the UK.
As temperatures warm, tick and mosquito species not currently native to the UK will begin to find the UK’s climate more bearable making it easier for them to survive, reproduce and establish a local population.
Our Medical Entomology and Zoonoses Ecology (MEZE) team assess the emerging risk posed by ticks, mosquitoes and other arthropods that can carry and transmit bacteria, viruses and parasites. An important part of their remit is to advise the government on the risk to public health from vector-borne disease in the UK.
Our entomologists also work with local authorities to monitor and manage risks, and to put in place strategies to minimise the opportunity for invasive species to become established in our towns and countryside.
The following locations are known to have active mosquito populations:
Characterised by their wetlands, bodies of water and marshy habitats, the North Kent Marshes are an ideal breeding ground for mosquitoes and have been for decades, if not centuries.
In these Marshes and at similar sites across the country, our teams have been conducting surveillance over the last decade using a range of mosquito traps and dip for larvae in water sources, to assess the presence or absence of a species locally, their seasonality and collect specimens for viral analysis.
Ensuring our awareness of and preparedness for diseases such as West Nile virus (WNV) risk involves conducting these types of surveillance for mosquitoes at key parts of the year to identify presence of key mosquito species as vectors of future disease risk.
Culex modestus, a species of mosquito and a primary carrier of WNV in countries where the disease is common, is known to occur in the North Kent Marshes and other coastal marshes in Southeast England could in future be one such disease risk. At present WNV is yet to make a foothold in these areas, but in recent years areas of Europe, including France, have experienced several outbreaks in the summer and early autumn months.
Transport hubs, such as motorway service stations and truck stops, are ideal sites at which in-depth data can be gathered on the detection of invasive mosquito species brought into the country in lorries and other vehicles.
If imported goods or vehicles carrying mosquitoes reach the UK, they could establish a local population. Motorway service stations, showing evidence of eggs or larvae, could be the first sign of a potentially established population in the UK.
Monitoring whether vehicles are bringing in invasive mosquitoes at these types of transport hubs is therefore important, as we can detect and eradicate them before they are disseminated more widely.
The most common mosquito species found in the UK, Culex pipiens, is adept at surviving in urban and suburban areas - breeding in various types of water sources, including artificial containers and stagnant water.
Collaborating with local authorities, mosquito traps targeting invasive species are run at high-risk sites across England. Left unchecked the consequences of not controlling these species can lead to the establishment of this invasive vector and therefore potential for new diseases that we have not seen in the UK.
Coordinated by our teams, local authorities and communities are being encouraged to step into action in these instances and clear out sources of standing and stagnant water such as blocked gutters and drains, and ensure rainwater in litter, tarpaulin, open buckets, bins and discarded items are cleared away or arranged in a way that they drain away.
When surveillance systems identify an invasive species aggressive interventions are put in place to eradicate any health threat. These mosquito control efforts may include reducing mosquito breeding sites, using insecticides, and promoting personal protective measures like wearing long-sleeved clothing, using mosquito repellents to the public and alerting local healthcare settings to the signs of illness to look out for.
Ticks live in many different outdoor environments, but they are particularly common in grassy and wooded areas. To better understand the threat they pose to public health, our team is studying tick populations in several locations, including:
The UK has over 20 recorded tick species, and our teams undertake tick sampling at a number of sites across the country in order to study local species diversity, distribution patterns, host preferences, factors determining population abundance and whether any vector-borne pathogens are present in local populations.
Learning more about our local tick populations helps our teams and local authorities to develop strategies to mitigate the risks associated with tick-borne diseases, understand the disease profile of local ticks and potentially manage exposure of humans to tick populations.
The survival of our current species, and of those potentially invasive to the UK is determined by microclimate, habitat and available hosts, all of which can be impacted by climate change. These determinates can also increase cases of diseases like tick-borne encephalitis and babesiosis which are rare in humans in the UK, but common elsewhere in Europe.
Through a process known as flagging, where a cloth sheet is pulled through grass catching ticks questing for blood, our teams collect samples to take back to the lab for analysis.
Through learning more about the distribution and abundance of ticks in these areas we can work with local authorities to better place control measures and tick awareness which will reduce the risk of tick-borne diseases.
Assessing risk of ticks to UK public health through national surveillance schemes is integral to the team’s ability to coordinate research which looks at ecological drivers of pathogens which cause the spread of diseases like Lyme disease or tick-borne encephalitis. Through enhanced surveillance, our Rare and Imported Pathogens Laboratory (RIPL) collect data on recent positive cases of Lyme, looking at where and when a person may have picked up an infection.
During April, May and June the MEZE team receive submissions to the tick surveillance scheme, receiving thousands of samples from the public, vets, GP surgeries and wildlife charities. These submissions provide valuable data on the distribution and activity of ticks across the country.
These submissions peak in June, at the height of tick season when the climate is most favourable and gives the team a real sense on any seasonal changes – improving our ability to detect any invasive species, update risk assessments on outbreaks, and prepare responses such as habitat management or targeted human or animal surveillance.
Back at our Porton lab the team get up-close and personal with the ticks and mosquitoes they’ve collected, or ticks submitted through surveillance schemes, under the microscope.
Here the team will confirm the species, where they are at in terms of the different stages of their life-cycle and look for any species which are not native to the UK.
Combined datasets for ticks have been collected since 2005, and they provide the best assessment of where ticks are causing human and animal biting in the UK. This information has allowed us to map changes over nearly two decades.
Through studying the lifecycle and development of ticks and mosquitoes in relation to our weather and climate, the MEZE team can work with modellers to create projections of scenarios for potential seasonal changes to tick and mosquito populations. These studies will help to understand when shifts in breeding and feeding patterns might occur, potential increases of incidence of diseases such as Lyme disease and estimate changes in geographical distribution.
The HECC report demonstrates substantial and growing evidence of the effects of climate change on health in the UK.
The impact that climate change could have on vector-borne diseases and our society, if we do not take decisive action, could have major impacts on physical and mental health.
Considering and monitoring the impact of climate and other environmental change in relation to vector-borne diseases through our surveillance systems is vital to our countries ability to safeguard future generations from the increasing threat from diseases such as tick-borne encephalitis, or chikungunya from invasive mosquitoes.
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