Visit to Central Public Health Laboratory,
Public Health Laboratory Service (PHLS)
1. The Sub-Committee visited CPHL PHLS on
23 July 2002. Members present were Lord Haskel, Lord McColl of
Dulwich, Lord Oxburgh, Lord Rea, Lord Soulsby of Swaffham Prior,
Lord Turnberg, Baroness Walmsley, Baroness Warwick of Undercliffe.
They were accompanied by Adam Heathfield, Specialist Assistant
and Rebecca Neal, Clerk.
2. The Committee met Dr Bob Adak, Dr Pat
Cane, Professor Brian Duerden, Dr Barry Evans, Dr Robert George,
Dr David Livermore, Dr Elizabeth Miller, Dr Gillian Smith and
Dr John Watson.
3. Issues discussed included syndromic and
outcome-focused surveillance, vaccines and impact of molecular
4. Passive surveillance depended on micro-organisms
being sent to laboratories. Active surveillance required links
to information about patients, such as symptoms, outcomes of treatment,
as well as information about prescribing.
5. TB was on the increase in the UK, mostly
in London. There had been 88 people diagnosed with drug resistant
tuberculosis in London between 1999-2002. Common factors amongst
those people was that they were young people from North London
who engaged in recreational drug use, with time either spent in
squats or prisons.
6. Control of tuberculosis required treating
and curing active cases, screening people at high risk of disease
(such as people who had been in contact with those with active
TB), vaccination by BCG and, importantly, surveillance of incidence
of cases and outcome of treatment.
7. There was very little surveillance of
treatment of TB so it was difficult to ascertain how effectively
TB was controlled in the UK.
8. The PHLS played a role in developing
and evaluating safety of new vaccines. At present it was involved
with a vaccine for pneumococcal infection.
9. The PHLS reference and specialist laboratories
also developed, evaluated and improved diagnostic tests.
NHS DIRECT AND
10. Communicable Disease Surveillance Centre
had recently established a collaborative surveillance project
with NHS Direct, a telephone helpline providing health information
and advice to the public. Surveillance of this service may help
to identify increase in illness before patients report to hospitals,
both in case of deliberate release of biological or chemical agent
or as a result of community outbreaks of more common infections.