FORCE TO COMBAT DRUGS FALL-OUT
A task force has been established to deal with the spiralling number of
hepatitis B victims in the North-east of Scotland, thought to be linked to
intravenous drug use.

The numbers have soared from single figures three years ago to 35 last
year, and 47 in the first six months of this year.

At a meeting of Grampian Health Board yesterday, members were told that in
the last month alone there had been 15 cases notified.

Three-quarters of the victims are male, most of them in the 15 to 34 age
group, and 70% of the notifications are from Aberdeen.

"Injecting drug use appears to be the main risk factor identified from our
active follow-up of cases," said Dr Stephen Conaly, consultant in public
health medicine for Grampian Health Board.

"Hepatitis B is highly infectious. Sharing of not just needles but any
injecting equipment may lead to transmission. Unprotected sexual contact
can also lead to infection."

He said they did not know what was causing the sudden rise, which appeared
to be unique to the North-east at the moment, although there had been
sudden rises in other places in the past, including Port Glasgow.

"If we can reach these 'at risk' groups we may be able to prevent cases
through immunisation. We can also offer protection to the partners and
children of cases through immunisation. Looking at the way we provide
needle exchange services may also be important."

He said they were looking at all possibilities: "Maybe there are injectors
who don't have good access to needles because of where they live, or
something to do with the way the service is structured."

Mr Frank Hartnett, general manager of Grampian Health Board, said: "We wish
to stress that this is not a major outbreak but is of sufficient concern to
set up arrangements designed to curtail the further spread of this disease.

"These arrangements may include enhanced and targeted immunisation, health
promotion and education, and different arrangements for needle exchanges.

"This enhancement of our existing strategy will be devised and implemented
over the next eight weeks.

"This is no cause for alarm among the general public and our response will
be carefully targeted at those who are most vulnerable."

Hepatitis B is an infection of the liver which causes nausea, stomach pain
and sometimes jaundice. A proportion of those infected, especially those in
childhood and 5% of adults, develop chronic disease.

It is transmitted by exposure to the blood or body fluids of an infectious
person. Typical circumstances are sharing needles while injecting drugs,
unprotected sex, acupuncture or tattooing where needles are not sterilised,
transmission from mother to baby and close household contact.

The board also heard a report on the recent MacDuff E-coli 0157 outbreak,
which affected 29 children and seven adults.

It was traced to unpasteurised goat's cheese which the grandmother of one
of the primary school pupils made for a school project, unaware it was
going to be eaten.

Several of the youngsters required hospitalisation and one seven-year-old
girl suffered renal complications as a result of the outbreak.

The goat was tested and found to be positive for E-coli 0157, as were the
sheep and poultry owned by the grandmother.