Select Committee on Health Appendices to the Minutes of Evidence


Letter from the Assistant Chief Services Officer (Health), Kerrier District Council to the Clerk of the Committee (PH 95)


  I have been passed a copy of your letter to Ms Jane Naish of the RCN, dated 19 December 2000 by David Purchon (President of Chartered Institute of Environmental Health).

  If I may comment (unsolicited!) both on behalf of the CIEH (as an elected Trustee sitting on the "Food & General Health" Sub-Committee) and as an individual who has undertaken formal research into E.coli O157 sources?

  1.  The management of infectious diseases such as E.coli O157 is indeed complex and may involve many people and agencies such as local authorities, GPs, Consultants in Communicable Disease Control (CCDCs), Directors of Public Health, MAFF, DWO, Water Companies, FSA, the Public Health Laboratory Service (PHLS) and the Communicable Disease Surveillance Centre (CDSC).

  I know from experience whilst undertaking my 3-year research study how difficult it is initially to make the necessary contacts—but generally everyone is keen to co-operate and make the `system' work. However, I am also aware that unless the local EHO (or other investigating Officer) has such commitment and `staying power', many opportunities to properly ascertain a cause for the infection are lost.

  Countless people have tried to produce a comprehensive but simple solution, but to my knowledge we have all failed! Perhaps such investigations truly are "multi-agency" in nature and in reasonably serious/extensive clusters of infection or outbreaks the `Outbreak Control Team' (ICT), which will invariably be formed, will have the task of pulling everyone together. The problem, as I have already alluded to, is when one is investigating a `sporadic' case of infection which doesn't warrant an ICT and yet, in potentially serious infections such as E-coli O157 we then lose the opportunity to advance our knowledge on the organism and its numerous sources.

  The CIEH has worked closely with CDSC and the PHLS in work around infectious disease investigations and would be keen to be involved in any further discussions/debate in this area. David Purchon or I would be pleased to liaise with your Committee as you see fit.

  2.  I feel that NHS Direct has an important role to play in the area of public health. Again, I have first-hand experience of where this has been the case with E.coli O157.

  I am a co-Patron of an organisation called the "Heather Preen Trust" (together with Professor Hugh Pennington) which was set up by Mrs Julie Preen after the tragic death of her daughter, Heather, in August 1999 following a cluster of case of E.coli O157 associated with Dawlish Warren beach in Devon.

  Julie and the Trust convened a high-level meeting of relevant `experts' and professional bodies, including NHS Direct, to discuss how best to deliver key messages concerning the infection to both relevant health professionals and the public. As a result, NHS Direct agreed to adapt its protocol for dealing with queries which may potentially relate to E.coli O157 infection in an attempt to avoid inappropriate advice and/or medication.

  I hope you don't mind me making these unsolicited comments, but I felt it was too good an opportunity to miss! I would be very pleased to discuss any of these issues with you if necessary.

26 January 2001

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