Suspected or confirmed cases of Norovirus and Yersinia will soon have to be reported to government health officials by laboratories in England.
The move is part of a decision to amend the Health Protection (Notification) Regulations 2010.
Subject to parliamentary approval, the updated legislation will come into force in April 2025.
Beginning on April 6, 2025, registered medical practitioners, such as doctors, in England will have a statutory responsibility to report suspected or confirmed cases of the covered infectious diseases to a relevant contact in the local authority, which is usually the UK Health Security Agency (UKHSA) regional team.
Laboratories that test human samples in England would need to report an additional 10 causative agents, not currently notifiable, to UKHSA. These include Norovirus, Tick-borne encephalitis virus, Echinococcus, Trichinella, Toxoplasma (congenital toxoplasmosis), and Yersinia. This section already includes Campylobacter, Listeria monocytogenes, Salmonella, and E. coli O157.
For medical practitioners, another eight infectious diseases have been included, such as Middle East respiratory syndrome (MERS), influenza of zoonotic origin, and Creutzfeldt-Jakob disease (CJD). This section already includes botulism, food poisoning, and hemolytic uremic syndrome (HUS).
Changes aim to strengthen surveillance of, and public health response to, these diseases. Placing a legal duty on medical staff to report suspected cases of notifiable diseases helps prompt public health action and ensures that timely prevention and control measures can be taken. Making agents legally notifiable strengthens surveillance capabilities for infectious diseases, which is key to detecting outbreaks and understanding outbreak trends.
Rationale for inclusion
The plan to revise the regulations follows a public comment period by the Department of Health and Social Care (DHSC) in 2023. A total of 151 responses were received.
Norovirus is the most common gastrointestinal infection in the UK. Outbreaks have a significant impact on hospitals, social care, and educational settings. Inclusion of the virus would provide a real time indicator of changes in activity at the national level, improving surveillance.
Yersiniosis is an emerging infection with a significant increase in reported cases in the UK in recent years. Inclusion of the disease, combined with routine testing in patients with gastroenteritis and sepsis, will improve detection of foodborne outbreaks. It could also reduce the burden of long-term chronic complications following initial acute illness due to an improved ability to implement public health protection action.
Very few Trichinella infections are reported annually, with positives usually linked to imported cases or pork products. Adding Trichinella would allow the public health risks of any infection to be followed up promptly and ensure that any local source can be investigated, and other potential exposed individuals identified. This would be valuable as severe cases can be fatal. Inclusion would also help establish changing trends in the epidemiology of infections.
A plan to make all diagnostic labs in England that test human samples report negative and void results for causative agents in the regulation was shelved. However, UKHSA will be looking at this as part of wider work to strengthen laboratory pathogen data.
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Joe Whitworth
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