http://bmj.bmjjournals.com/cgi/content/full/327/7407/120-a

BMJ  2003;327:120 (19 July)
 

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Collections under which this article appears: Other Infectious Diseases Other Epidemiology Other Medical Education Other Public Health UK government

News

Lords committee warns of gaps in infection control measures

Lynn Eaton

London

England has a shortage of appropriately trained experts in identifying infectious diseases, says a report published this week by the House of Lords.

It warns that this is a deficiency that could put the country at risk of failing to notice an outbreak of a potential epidemic, such as the severe acute respiratory syndrome (SARS), and that the country may not be able to cope with a major outbreak of infection.

In its report, Fighting Infection, the select committee on science and technology reports that the lack of expertise in identifying or treating difficult or rare infections means that patients might receive suboptimal clinical care.

"In addition," it says, "there is a risk that potentially significant events... could be overlooked until an epidemic has taken hold. We note that the early detection of the anthrax outbreak in the US was due to general clinicians who became suspicious something untoward was occurring."

Although the report makes no direct mention of terrorist threats—one potential source of an outbreak of disease—it says that the country should be able to produce vaccines quickly. The United States already has an institute working on a vaccine for SARS, but the UK government, it says, recently turned down an application for a similar facility, on the grounds of cost.

The committee calls on the government to draw up a strategy for securing vaccine supplies in the event of a major outbreak of an infectious disease and welcomes moves to reconsider a vaccine institute in the United Kingdom.

It calls on the government to improve cross departmental working and set up infection centres to coordinate working, build up expertise, and do research.

About 70 000 people die in the United Kingdom each year from infection, the report says, and hospital acquired infections cost the NHS an estimated £1bn ($1.6bn; €1.4bn) a year. But the number of infectious disease physicians in England seems to be very low, they say, at 1:750 000 population. This compares with 1:53 000 in the United States and 1:250 000 in the Netherlands, where the structure is more like that in England.

It suggests combining training in microbiology—where it is hard to fill posts—with infectious diseases—where there are more physicians in training but only a limited number of posts.

Fighting Infection is available at www.parliament.uk/hlscience

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