North Wales 2011

The Five Nations Health Protection Conference 2011 took place on 17th and 18th May at The Quay Hotel in Deganwy, North Wales. The conference takes place annually at a different venue in one of the five host nations (England, Scotland, Wales, Northern Ireland and the Republic of Ireland). The aim of the conference is to provide a focus for CPD for consultants in communicable disease control, consultants and specialists in Public Health and their colleagues in epidemiology, and control of infectious, non infectious and environmental hazards.


Thankfully, no pandemics or ash clouds affected attendance at the conference this year and all participants made it without any major disruption. The only cloud on the horizon was a significantly damp one (Wales lived up to it’s reputation!) though even the weather didn’t mar the amazing views of the Conwy estuary and Conwy castle from the conference room.


The conference booklet for 2011 is available here.


This year the main themes were:

  • Surveillance – What Information for What Action?
  • Organisation of Health Protection across the 5 Nations
  • Immunisation
  • Outbreaks: so what? Lessons learnt and changes in practice
  • Hot topics

The conference was kindly welcomed to the area by Dr Meirion Evans, Consultant Epidemiologist in Public Health Wales.
This was followed by a thought-provoking keynote address delivered by Professor Paul Garner on “What is evidence- based medicine and why is it important?” Prof Garner spoke about the methods used to generate systematic reviews and the relevance of this science to health protection; research into the treatment of tuberculosis was highlighted as a good


The first session was about surveillance and what information was needed for what action. The presentations described a wide range of surveillance systems used by the HPA, Public Health Wales and Health Protection Units in the North East and Yorkshire. These ranged from enhanced surveillance for enteric fever; the development of a multi-data source surveillance system for the Ryder Cup and a data management system for monitoring neonatal hepatitis B.


The next session on the organisation of Health Protection across the 5 nations was run as a panel discussion with representatives from England, Scotland, Wales and Northern Ireland explaining how health protection services were delivered and discussing the strengths and weaknesses of the different models. The challenge of delivering effective health protection services amidst organisational and structural change was a common theme!


The third session comprised three presentations about immunisation. The first discussed the methods used to improve childhood immunisation uptake in a deprived area of Manchester. The second concerned the delivery of neonatal BCG in a Yorkshire hospital and the third focused on the effectiveness of the seasonal 2010/11 and pandemic influenza A (H1N1) 2009 vaccines in preventing influenza infection in the United Kingdom.


The second day of the conference focused on Outbreaks: Lessons learnt and changes in practice and on Hot Topics.

There were presentations on many interesting and varied outbreaks across the five nations (too numerous to mention them all!). A particular highlight was the use of Facebook in the investigation of an outbreak of campylobacter amongst guests at
a wedding party. Whilst it was a useful tool for obtaining up-to-date information on the outbreak there were concerns over information bias as the prospect of compensation claims against the hotel were raised.


Another presentation described a TB outbreak in a small Pakistani/Somali community in Birmingham. This highlighted the need for good community links to enable effective case finding and contact tracing.


There was also a presentation about a listeria cluster in a hospital which demonstrated a link with pre-packed sandwiches.
This investigation demonstrated the need for improved guidance on levels of listeria in ready to eat food and the need to prevent such food being served to vulnerable patients in a hospital setting.


As the conference was hosted in Wales it was interesting to hear a description of the investigation of a community outbreak of legionnaire’s disease in South East Wales. Two clusters of cases were identified though no definitive source for the outbreak was found. A new type of geographical analysis was used to determine the likely exposure period. Obtaining samples and interpretation of the result of environmental sampling was highlighted as an issue that needed to be addressed nationally.


The Hot Topic session on day two provided an opportunity to hear about the satisfactory resolution of high levels of trihalomethanes in a public water supply in southern Ireland; the influence of restricting mass gatherings on influenza transmission, and the development of the Migrant Health Guide – a HPA tool to assist primary care practitioners in the
provision of care for patients who come to live in the UK from abroad.


A Hot Topic guest lecture by Lesley Prosser on “The HPA response to the Fukushima Nuclear Emergency in Japan” provided a fascinating insight into the government response and the Cobra meetings set up to deal with any national effects of this nuclear emergency. There were lots of issues to consider concerning the need for monitoring of radiation levels in British nationals returning from Japan. As a result of this incident detailed logistics have been established for airport monitoring with British airports and NHS direct – should this be needed in the future. The political nature of this incident presented a challenge in communicating the appropriate response to this incident in the UK.


As in previous years at the 5 Nations Health Protection Conference, there were many interesting poster presentations.
There were two prizes awarded for the best poster presentations this year, kindly donated by the Public Health Medicine Environmental Group. The poster winning first prize was entitled “Community screening for tuberculosis in a high-risk, hard to reach population in South Wales” by RhE Stiff and G Lowe. The second prize went to K Chapman, D Wilson and R Gorton and was entitled “Should alcohol misuse be included as an indication for pneumococcal immunisation in the UK?

The conference had something of interest for everybody who attended and provided a valuable insight into the day-to-day workings of health protection across the five nations.

However, It wasn’t all work and no play at the 2011 conference! The conference organisers had laid on a quiz, followed by a conference dinner and dancing to a Welsh ceilidh band into the early hours.

Overall, the whole conference went smoothly and the organisation of the conference and the venue was really outstanding.

Maria Roberts
Epidemiology and Surveillance Analyst
North Wales Health Protection Team