Britons get most of their food-health information from big food companies

Britons are becoming increasingly health conscious when it comes to food and drink – and it is the big food brands’ job to guide them in the right direction, a new study finds.

Researchers found that 62 per cent of British consumers care more how nutritious the solids and fluids they consume are now than they did five years ago.

And they say it’s the food and drink brand’s responsibility to inform consumers about the health content of their products – and similar produce more generally – to help them decide what to consume.

A KPMG survey of 2,000 people found that 40 per cent get most of their knowledge about what kinds of food are healthy and what kinds are less healthy from advertising, packaging and other communication from the brands behind the produce.

Other sources of information

By contrast, only 22 per cent said they based their consumption decisions on government advice, or their friends and family. A further 13 per cent said they used an app-based nutritionist, and 4 per cent relied on social media.

“Brands clearly have great influence over what consumers determine as healthy, and customers need to be clued up on the health claims around certain ingredients,” said Jason Parker, UK head of health at KPMG.

“Brands clearly have great influence over what consumers determine as healthy,”

Jason Parker

When looking at a product for nutritional insight, half of respondents said they use the list of ingredients, or the traffic light labelling system – detailing sugar, fat and salt content – to inform their choices.

Forty percent said they use the calorie content, however, as many as 37 per cent based their decisions on price, and 28 per cent based it on the general look of the product.

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Battle to ban junk food adverts before 9pm pits the health of our children against profits

The advertising industry is lobbying new Prime Minister Boris Johnson in an attempt to “halt” Government plans to fight childhood obesity by banning all junk food ads before 9pm.

The proposed watershed on advertising food and drink products that are high in fat, sugar and salt (HFSS) was put forward by Mr Johnson’s predecessor, Theresa May, early this year following a high-profile social media campaign, #AdEnough, led by the television chef Jamie Oliver.

But the ad industry and its clients in the food sector clearly scent an opportunity in Mr Johnson’s accession to Downing Street and have complained to him of the “plans for onerous new advertising restrictions”. In a letter to Number 10, Stephen Woodford, chief executive of the Advertising Association, writes: “We ask you to halt these plans.”

The sin tax

Much has happened since the consultation on an HFSS ad ban, for television and online, started on 18 March. Mrs May’s failure to deliver Brexit on 31 March opened the door to a new Prime Minister who, even before he was selected by Conservative members, promised to “look out how effective the so-called ‘sin taxes’ really are”. Mr Johnson is positioning himself as a free trade champion who will release business from the shackles of regulation and fight “the continuing creep of the nanny state”.

Jamie Oliver was overjoyed at the proposed ban, seeing it as a triumph for his #AdEnough campaign, which encouraged supporters to upload pictures of themselves with their hands over their eyes, in protest against HFSS advertising. “This is a once-in-a- generation chance to stop our kids being bombarded by these ads,” said the chef’s website.

Junk food advertising around children’s programmes is already banned. The proposed watershed would extend it to all content from 5.30am to 9pm, including family shows such as Britain’s Got Talent. London’s Mayor Sadiq Khan introduced a junk food ad ban on London transport this year. Oliver described that as a “massive step forward for child health”.

A closed-down Jamie's Italian restaurant in Glasgow (Photo: Andy Buchanan/AFP/Getty Images0
A closed-down Jamie’s Italian restaurant in Glasgow (Photo: Andy Buchanan/AFP/Getty Images0

The TV chef has had a turbulent few months. His restaurant empire collapsed in May with the loss of 1,000 jobs and closure of 22 outlets. But his strength as a campaigner for improved food standards was underpinned by his success as an entrepreneur and employer.

The ad and food industry might sense this formidable critic and influencer is weakened. In his letter to Mr Johnson, Mr Woodford makes the business case for advertising. “Every pound spent on advertising returns £6 to GDP,” he writes, claiming that total advertising spend delivers £142bn to UK GDP and supports one million jobs.

He might add advertising fuels our market economy, funds free news media and is core to the UK’s internationally admired creative industries. But it feels threatened, not least by Mr Johnson’s willingness to Brexit without a deal. “Having arrangements that allow free flow of services across borders is critical for the continued success of our world-beating advertising industry,” Mr Woodford tells the PM. A new Advertising Standards Authority clampdown on gender stereotyping has also led to bans on campaigns from Volkswagen and Philadelphia.

In a separate letter to Culture Secretary Nicky Morgan, Mr Woodford complains a junk food watershed would cost £1bn in lost GDP. He asks her to “reconsider”.

Childhood obesity battle

The ban has a purpose. Last summer the Government pledged to halve childhood obesity by 2030 and reduce the gap between children from the most and least deprived areas.

Barbara Crowther, of the Children’s Food Campaign, points to a YouGov poll in February showing that 72 per cent of people support a 9pm watershed on junk food adverts during family television shows. The last series of Britain’s Got Talent was “peppered with ads for chocolate, sweets, pizzas, snacks and fast food,” she notes. Such advertising, “constantly nudges” children towards “unhealthy food and drinks”.

In a phone call, Mr Woodford argues that such ads are not aimed at children and have negligible impact on children’s calorific intake. “The products are pleasures in people’s lives,” he says. “Consumed in moderation they are a perfectly rational part of a healthy diet.”

Yet last year a Cancer Research UK study called A Prime for Action made a link between junk food marketing and youth obesity.

Advertising can adapt. Great strides have been taken in reflecting Britain’s cultural diversity in ads, and Dove’s Campaign for Real Beauty has promoted a truer picture of women’s body shapes. Car ads celebrate cleaner, hybrid models and drinks brands showcase low-sugar variants.

But junk food adverts may yet be reprieved as a fixture of family television viewing. In which case it will be Mr Johnson, not Mr Oliver, influencing what ends up on the plates of British children.

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Scientists uncover the link between diabetes and increased cancer risk

Scientists believe they have solved the mystery behind diabetics’ increased risk of cancer – finding that high blood sugar levels cause considerable DNA damage.

The discovery raises hopes that existing treatments for other conditions may one day be used to reduce cancer risk in people with type 1 and 2 diabetes, although experts cautioned that years more research would be needed to determine which, if any, drugs were suitable.

US researchers investigated why diabetics are up to two and a half times more likely to develop cancer than the general population.

They found that the elevated sugar levels associated with the condition causes more damage to a person’s DNA than when blood sugar is at a normal, healthy level – and makes it harder for the body to repair any damage sustained.

Tumour-fighting genes

This, in turn, interferes with the genes that fight tumour growth, making it harder to prevent cancer.

“Exposure to high glucose levels leads to both DNA damage and the suppression of their repair, which in combination could cause cancer,” said John Termini, of the City of Hope research and treatment centre for cancer and diabetics in Los Angeles.

However, he has identified two proteins produced naturally in the body that help repair DNA damage and hopes that existing drugs that boost their levels could be used to decrease cancer risk.

“Exposure to high glucose levels leads to both DNA damage and the suppression of their repair,”

John Termini

He will first test the drugs in mice and, if successful, look to conduct a human trial – although any application for humans is likely to be years away, experts said.

What diabetics can do now

In the meantime, a more immediate way for diabetics to reduce their cancer risk could be better control of their blood sugar. “That sounds like such an easy solution, but it’s extremely difficult for most people to maintain glycemic control,” Dr Termini says.

He presented the findings at the American Chemical Society Fall 2019 National Meeting & Exposition in San Diego.

People with type 2 diabetes (the most common form) are 2.5 times more likely to develop liver or pancreatic cancer.

They also run a higher-than-normal risk of developing colon, bladder and breast cancer. Diabetic women with breast cancer have a higher mortality rate than women with breast cancer alone.

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NHS staff in Bradford force trust bosses to climb down over ‘back door privatisation’ plans

Some of the lowest paid staff at an NHS trust in Bradford have forced health bosses into a climb-down after they voted to go on indefinite strike in protest against “back door privatisation” plans.

Workers in the estates, facilities and clinical engineering departments at Bradford Teaching Hospitals NHS Foundation Trust have been embroiled in a bitter industrial dispute for several weeks, claiming that their NHS status was at risk.

Trust bosses had created a “wholly-owned subsidiary company” and were planning to transfer hundreds of NHS staff to the private company, whose directors were senior trust bosses. The majority of people affected by the change would be porters, cleaners and security and catering staff. They started a two-week strike on 1 August before voting to go on indefinite strike two weeks later, fearing the transfer would strip them of the protections they have as NHS employees. Labour leader Jeremy Corbyn had also thrown his support behind striking staff.

The trust, which includes Bradford Royal Infirmary, St Luke’s Hospital and several community hospitals, had always denied it was privatising services. It had sought to reassure staff that their NHS terms and conditions would be “guaranteed for 25 years”, but Unison said it had received legal advice that this was an impossible promise to keep. Following “constructive talks” between the trust and Unison this week, facilitated by ACAS, the union agreed to suspend the indefinite industrial action that was due to begin on Monday.

Next steps

The trust has agreed not to proceed with the initial 1 October transfer date, although it has left the door open to carry on as planned. The trust’s Board of Directors will meet on 12 September to discuss the situation.

“Unison has been offered the opportunity to present its case to allow the Board to further reflect on the position previously taken,” a A joint statement by acting chief executive of the trust, John Holden, and Unison’s regional organiser, Natalie Ratcliffe, said.

“The outcome of this further consideration will be notified to Unison by the end of September 2019. Should the Board continue with its plans to form Bradford Healthcare Facilities Management Ltd it has been agreed that the earliest transfer date will now be 15 February 2020.”

A Unison spokesperson added: “Unison has suspended the strike planned for next week after Bradford Teaching Hospitals Trust agreed not to transfer staff to its private company in the autumn.  After three weeks of action over the last two months the union will be meeting with the trust’s board in September to make the case for keeping the 300 plus dedicated health workers within the NHS.”

Dr Tony O’Sullivan, co-chair of Keep Our NHS Public, told i: “It is very good news to postpone this dreadful decision to outsource NHS staff to the trust’s private company. Well done Unison staff. I hope common sense prevails when the Trust Board listens to Unison in September and this damaging decision is shelved- helping to end this backdoor privatisation policy.”

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Jamie Oliver to turn the remains of his restaurant business into ethical ‘B Corporation’ and make anti-obesity project his ‘legacy’

Jamie Oliver says he wants to turn his company into an obesity fighting organisation that will deliver his “legacy” and change the UK’s eating habits.

His revamped Jamie Oliver Group published a social impact report on Friday detailing plans to halve childhood obesity by 2030, and the restaurateur plans on turning his business empire into an ethical “B corporation”.

The Government’s 2030 Project was launched in 2018 with the aim of slashing obesity rates and improving the nutritional content of food children eat.

The change in focus comes after his business suffered huge blows this year with all but three of his 25 restaurants closing in May and more than 1,000 people losing their jobs. The three left were sold to the owner of Upper Crust.

Mr Oliver said: “I couldn’t be more excited about what’s next.”

‘A man-made problem’

A closed-down Jamie's Italian restaurant in Glasgow (Photo: Andy Buchanan/AFP/Getty Images0
A closed-down Jamie’s Italian restaurant in Glasgow (Photo: Andy Buchanan/AFP/Getty Images0

He added: “The 2030 Project is my North Star and we will continue to shape our business to make sure that everything we do helps us move the dial a little bit further in the right direction.

“If we’re going to reshape the food landscape, we need to create an environment that cultivates and celebrates healthier lifestyles – giving the public better access to convenient, good, honest food.

“The child health epidemic is a man-made problem – it’s also something we can fix. ”

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He added: “I believe the 2030 Project will be my legacy, and I couldn’t be more excited about what’s next.”

The social impact report lays out how the group’s activities from 2019 onwards will all centre on the goal to halve childhood obesity by 2030.

The group plans to reach the 2030 target through mix of campaigning, Mr Oliver’s TV shows and books, products, and partnerships with other companies.

As part of its commitment to becoming a social impact business, the group is looking into becoming certified as a “B corp”, a status given to for-profit companies which meet certain standards of sustainability, accountability and transparency.

In the social impact report, the chef admitted it had been a “difficult” year.

“The challenges we’ve weathered have galvanised us to be more effective, more focused and more impactful,” he said.

‘Examine every partnership’

Jamie Oliver's beleaguered business has finally toppled into administration (Photo: Getty Images)
Jamie Oliver plans to turn the remains of his business empire into a B Corp (Photo: Getty Images)

Some parts of the restaurant empire still exist in the form of 65 international sites in 25 countries, as well as Fifteen Cornwall which is run as a franchise by a local food foundation.

Mr Oliver’s other business activities include his partnerships with firms such as Shell and Tesco.

He has faced criticism for his collaboration with Shell, but the company said the new food range has increased the number of healthy options for Britain’s drivers.

Paul Hunt, chief executive of the Jamie Oliver Group, said the obesity targets will be considered before signing any new deals.

“We now examine every partnership we consider entering into through the prism of our 2030 Project: does it help us move towards our goal to halve UK childhood obesity over the next decade?”

Additional reporting from Press Association.

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Sunflower lanyard: how the hidden disability scheme works, and what it means if someone wears one

If you’ve ever been out and about, either in the supermarket, on public transport or even at the airport and have seen someone wear a sunflower lanyard, then it could mean more than you think.

What are sunflowers lanyards?

It’s not always easy for those with disabilities that aren’t visible to ask for help, with some feeling that they’ll be judged if they ask for help or finding it frustrating trying to explain symptoms that can’t be seen to others.

However, a scheme – which is supported by charities including RNIB, Alzheimer’s Society, The National Autistic Society and Action on Hearing Loss – has now been introduced where sunflower lanyards can let others know if you have hidden disabilities.

These lanyards are bright green in colour and decorated with a sunflower design.

Gatwick airport first introduced the lanyards in 2016, with nine other airports across the UK having also welcomed the scheme since then. Manchester airport has also recently opened a new Sunflower Room, which allows passengers to have some time away from the busy departure lounges if needed.

Where else might I see a sunflower lanyard being used?

After the success of sunflower lanyards in UK airports, other transport providers and supermarkets are also getting involved in the scheme. Sainsbury’s and Tesco are currently trialling the sunflower scheme in a number of their stores.

The Royal National Institute of Blind People (RNIB) said, “If you have a disability that may not be immediately obvious but would appreciate support from staff in airports or supermarkets, then you may be interested to know there is a lanyard you can wear to signal this.

“The lanyard, which is entirely voluntary for people with hidden disabilities and their families, acts as a discreet sign for staff that additional support or help may be required.”

How do I get one?

RNIB explains that “if you’re due to fly from a major UK airport, you should be able to ask for a lanyard from an airport assistance desk, or order it in advance, depending on your chosen airport. Find out more about the best way of getting the lanyard by contacting the airport before you travel.

“And if you happen to shop in any of the Sainsbury’s or Tesco stores running the trial, you can request the lanyard at the customer service desk of larger stores or the checkout at smaller ones.”

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Athletes have higher rates of tooth decay and poorer gum health

They may have perfect bodies and excellent general health but there is one area in which elite athletes are sub-optimal – their mouths. Thanks to the high intake of sugary sports drinks and bars that come with the game, the top performers on track, field and park have higher rates of tooth decay and poorer gum health than among their non-sporting elite counterparts.

A new study of 352 Olympic and professional sports men and women finds that, while they brush and floss more than the average person, they’re also suckers for sweet solids and fluids.

“We found that a majority of the athletes in our survey already have good oral health related habits in as much as they brush their teeth twice a day, visit the dentist regularly, don’t smoke and have a healthy general diet,” said researcher Julie Gallagher, of University College London.

“However, they use sports drinks, energy gels and bars frequently during training and competition. The sugar in these products increases the risk of tooth decay and the acidity of them increases the risk of erosion,” she said. The researchers surveyed athletes across 11 sports, including cycling, swimming, rugby, football, rowing, hockey, sailing and athletics, who provided dental check-ups measuring tooth decay, gum health and acid erosion.

The results

Child tooth decay costs
The cost of child tooth extractions to the NHS since 2012 is more than £205m (Photo: PA)

These revealed that 49.1 per cent had untreated tooth decay, compared to 36 per cent for the average person of the same age. Meanwhile most showed early signs of gum inflammation.

This is despite 94 per cent reporting that they brush their teeth at least twice a day, and 44 per cent saying they regularly floss. This is substantially higher than for the general population, where the figures are 75 per cent and 21 per cent, respectively.

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The researchers found that 87 per cent of athletes regularly consume sports drinks, while 59 per cent regularly eat energy bars and 70 per cent use energy gels, which are known to damage teeth.

The study is published in the British Dental Journal.

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Cannabis oil ‘too expensive’ to give to severely epileptic children on NHS

Children with rare forms of epilepsy will not be allowed a cannabis-based drug on the NHS after the UK’s medical advisory body deemed it too expensive to prescribe. Cannabidiol, in the form of Epidiolex, will not be recommended for use on the NHS after the ruling by the National Institute for Health and Care Excellence (Nice), despite the drug having been shown to reduce seizures.

Campaign group Cannabis Patient Advocacy and Support Services described the decision as “disappointing” as it said the oil had “dramatically” helped some children. The decision mirrors the one that Nice made last November for Sativex, a cannabis-based medicine that is sprayed into the mouth, in multiple sclerosis.

Nice’s draft guidance said that while there was evidence that cannabis oil reduced the number of seizures children had, Epidiolex was not an “effective use of NHS resources” and its long-term effects were unclear.  Officials also had concerns about the “validity of the economic model” of GW Pharma, the company that provides Epidiolex. The drug treats two types of severe epilepsy, Lennox-Gastaut syndrome and Dravet syndrome.

Dravet syndrome usually begins within the first year of life, affecting around 600 people in England. Around one in five people will die because of their condition, the majority before 10 years of age. Lennox-Gastaut syndrome is another severely debilitating form of epilepsy diagnosed in childhood, affecting up to 4,000 people in England. Around five per cent of people with Lennox-Gastaut syndrome will die prematurely because of their condition.People who currently have access to cannabis-derived drugs to treat epilepsy will not be affected by the ruling.

Licences to use medical cannabis

A limited number of parents have licences to use medical cannabis oils, with some resorting to bringing in the medication from abroad in addition to having a valid UK licence. It is believed Epidiolex has been given to around 150 NHS patients as of March, according to a Government Health and Social Care Committee meeting.

Since 1 November 1 last year, specialist NHS doctors can legally prescribe unlicensed cannabis-based products containing THC, the psychoactive constituent of cannabis which is what makes users “high”. However, only two patients – both of whom are children – are believed to have been given a prescription on the NHS. Cannabidiol itself, which does not contain THC, is not licensed for use in the UK but a Nice spokesperson said it expected this to change in the near future.

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Professor David Nutt, a neuropsychopharmacologist at Imperial College London, said the decision came as no surprise.

“Getting pure extracts of plant cannabis products into the NHS now seems a lost cause. I have repeatedly argued that medical cannabis isn’t suitable for traditional pharmaceutical development programmes in part because of their high costs and low likelihood of returns for investors,” he said.

“At the very least all those children who were hoping for Epidiolex to become available to make their lives better should now have their specialists prescribe medical cannabis for them as a matter of urgency.”

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How Somaliland’s first midwife led the fight against FGM after traumatic childhood experience

As a child, Edna Adan Ismail’s doctor father, Adan Ismail, taught her to wash forceps and make bandages out of old bed sheets in the hospital he ran in Somaliland.

In 1950, when he went to work in a relief camp for people suffering from the drought known as the Year of Red Dust, he left notes for Ismail, then 13, telling her to ensure patients received medication and had sutures removed. “I did not know what these medicines were for but I was the boss’s daughter, so I would go to whoever was in charge and say, ‘By the way, dad wanted you to remove these.’”

She noticed the hospital never had enough instruments or supplies. “I can’t remember the exact moment when I decided I would build a hospital, but I do know I had a very clear image of how it would be run.”

Ismail went on to do more than that. Now 87, she is a former first lady of Somaliland, its first woman cabinet minister, foreign minister, and nurse-midwife, an anti-FGM campaigner and, today, the director of the maternity and teaching hospital she founded in the capital, Hargeisa. She is certain she is the only foreign minister in the world to have had to leave a meeting to deliver triplets.

As First Lady of Somaliland, Edna Adan Ismail met US President Lyndon B. Johnson
As First Lady of Somaliland, Edna Adan Ismail met US President Lyndon B. Johnson (Photo: supplied)

Fight against FGM

Ismail’s life has been defined by her fight to improve maternal healthcare in Somaliland and the fight against FGM. Somalia, and the autonomous region of Somaliland, has the highest rate of FGM in the world, with the procedure carried out on up to 98 per cent of women. Ismail’s mother and grandmother arranged for her to be cut when she was eight and her father was away from home. It was a deeply traumatic experience she has spoken about around the world.

The problem is that the practice is “glorified” in some communities, she says. “The ones who haven’t had it say, ‘Why have we not been purified? Why am I being denied this?’ But we need to educate young people, young parents, and not glorify the procedure.”

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Ismail never had children but tried for many years. She says FGM could be have been to blame because it can cause pelvic organ inflammation. As a midwife, Ismail has seen the many complications it can cause during childbirth.

Ismail says she only became a midwife because her father made sure she learned to read and write, which was almost unheard of at the time for girls in the region. When she was 17, Ismail moved to the UK to train as a nurse after winning a scholarship. She was accepted on a course at the West London Hospital in Hammersmith.

Today, Edna is the director of the maternity and teaching hospital she founded in the capital, Hargeisa. Photo: supplied.
Today, Edna Adan Ismail is the director of the maternity and teaching hospital she founded in the capital, Hargeisa (Photo: supplied)


The rotation she enjoyed most was in surgery. “I loved operating theatres,” she says. “They were so clean and efficient. The satisfying sense of accomplishment was like nothing I had experienced before.”

When she returned to Somaliland three years later, she was determined to become a surgical nurse. “I didn’t want to be a midwife,” she says. “But then my father asked, ‘What are you going to do for women? What will you do if there’s a woman in labour who needs you?’ My father gave me so many opportunities and never stopped me from doing anything. It felt like it was his way of asking me to do something.”

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Ismail returned to London and learned to be a midwife at Hammersmith and Lewisham hospitals. When she was delivering four or five babies in a day, she understood why her father had suggested she train as a midwife. “Somaliland has the highest maternal mortality rate in the world. There are still areas where they have never had a trained midwife. I have scars of a forceps birth, my sister died after just such a delivery and someone who wasn’t medically trained dropped and killed my baby brother. I would return to Somaliland with my midwife training where it was desperately needed.”

Edna Adan Ismail with her pet leopard in 1968
Edna Adan Ismail with her pet leopard in 1968 (Photo: supplied)

Facing new challenges

When she returned in 1961 to the new Somali Republic, formed of British Somaliland and Somalia, she met new challenges. She was assigned to work in a hospital, but was given no position, no salary and had to fight to be allowed to drive. “The administrators had never encountered a woman with nursing and midwifery certificates.” People reacted with hostility, saying she would never marry.

In fact, she married three times. Her first marriage was to Mohamed Haji Ibrahim Ega when he was head of government in British Somaliland five days prior to Italian Somalia’s independence. They met in London and he went on to become prime minister of Somalia (1967-69) and president of Somaliland in 1993. They divorced five years later. Ismail married twice more, but says midwifery and the hospital are her most important relationships. In 2002, after stints working for the World Health Organisation (WHO), Unicef and the Ministry of Health, Ismail opened the Edna Adan Maternity Hospital. It was built on a former rubbish dump donated by the government.

Most nurses or midwives had fled or been killed during the Somali Civil War, which destroyed Somaliland’s health infrastructure and 95 per cent of its cities between 1982 and 1991.

As foreign minister of Somaliland, she met US president Bill Clinton
As foreign minister of Somaliland, she met US president Bill Clinton (Photo: supplied)
With seventh Secretary-General of the United Nations, Kofi Annan
With seventh Secretary-General of the United Nations, Kofi Annan (Photo: supplied)

Ismail recruited more than 30 candidates and began training them while the hospital was still under construction.

There are now 200 staff members and 1,500 students, and almost three-quarters are female. “I just did what needed to be done,” she says about her decision in 1998 to sell her home and car, and donate her UN pension, to fund the hospital. Patients come from as far away as Mogadishu, more than 800km south, and neighbouring Ethiopia, to seek treatment in the best-equipped general hospital around. More than 14,000 babies have been delivered and more than 140,000 patients have been treated.

In 2002, Ismail became Somaliland’s first female cabinet minister. She became foreign minister the following year, but continued to work in the hospital. “I am a midwife first and foremost. One day when I was meeting with a European delegation, I knew that there was a woman in the hospital who was going to have triplets. When the hospital called I had to say, ‘I’m sorry, I know we have got important things to discuss but I really have to go. I’ll talk to you tomorrow.’”

A Woman of Firsts by Edna Adan Ismail is out now, published by HQ

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Boris Johnson’s desire to raise childhood vaccination rates is more than just a battle against conspiracy theorists

Boris Johnson took to Twitter this week to deliver a message to the nation about the importance of getting children vaccinated as it emerged the UK has lost its “measles-free” status with the World Health Organisation (WHO) – three years after the virus was eliminated in the country.

“Hi folks, it’s very important to remember that vaccinations save lives,” the Prime Minister told his 903,000 followers. Johnson puts the problem down to “complacency” and increasing numbers of people listening to “superstitious mumbo jumbo”. He has ordered urgent action to improve vaccination uptake. NHS England will write to GPs urging them to promote “catch up” vaccination programmes for measles, mumps and rubella (MMR) for 10-11 year olds, as well as all those 5-25  year olds who have not had two doses of the jab.

The comments posted beneath Johnson’s video are shocking: “anti-vaxxers” spout conspiracy theories about how vaccine ingredients are “neuro toxic”, damaging to children and based on “fraudulent” studies. However, Jamie Lopez Bernal, a senior epidemiologist with Public Health England (PHE) has said anti-vaxx messages may not be behind the lack of jabs and that “timing, availability and location of appointments” were bigger barriers instead.

The closure of 500 Sure Start centres, launched 20 years ago as a flagship of Tony Blair’s Labour Party, has also had a damaging impact. The centres brought “big benefits for children’s health” according to a recent report by The Institute for Fiscal Studies which pointed out they were often a first port of call for parents needing information and support for vaccinations.


The Government also wants to strengthen the role of local immunisation coordinators – healthcare professionals that promote vaccines particularly with hard-to-reach families. This includes supporting areas with low uptake and tailoring specific local interventions to under-vaccinated communities.

Responding to the Government’s plans, Helen Donovan, a public health expert at the Royal College of Nursing, said: “These suggestions will go some way towards improving the uptake of vaccines. A system-wide approach, better access to appointments combined with improved public information and communication with parents on a one-to-one level, is the most effective way to ensure more people receive vaccines they need.

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“Nurses are pivotal to earning public trust in the vaccination programme and are a vital source of information for parents and guardians. This job is made more difficult when vaccination services are fragmented. The widespread nursing shortages further compound the issue.”

The recent rise in anti-vaxxers is also damaging as although they remain a minority, it only takes a minority of parents who refuse to allow their children to be vaccinated for the whole vaccination programme to be put at risk.

Increasing knowledge

Social media companies will also be called to a summit to discuss how they can promote accurate information about vaccination (Photo: Getty)

Oxford University’s excellent Vaccine Knowledge Project, a source of independent information about vaccines and infectious diseases, states that “herd immunity” only works when a high percentage of the population (93 to 95 per cent) is vaccinated, as it is difficult for infectious diseases to spread because there are not many people who can be infected. For example, if someone with measles is surrounded by people who are vaccinated against measles, the disease cannot easily be passed on to anyone, and it will quickly disappear again. It gives protection to vulnerable people such as newborn babies, elderly people and those who are too sick to be vaccinated.

And yet in 2017-18, coverage declined in nine of the 12 routine vaccinations measured at ages 12 months, 24 months or five years in England compared to the previous year, the latest data shows. The message is either not getting through or not being listened to. MenB coverage is reported as a national statistic for the first time this year and achieved 92.5 per cent at 12 months.
Last year 6-in-1 vaccine coverage – known as the 5-in-1 vaccine until 2017 and which protects children against diptheria and tetanus among other diseases – declined for the fifth year in a row, decreasing 1.6 per cent since 2012-13 and is at its lowest since 2008-09. However, coverage at 24 months has remained above the 95 per cent target since 2009-10.

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Parents urged to ‘trust your nurse’ when it comes to vaccinating children

Coverage for the Measles Mumps and Rubella (MMR) vaccine as measured at two years decreased for the fourth year in a row. Coverage for this vaccine is now at 91.2 per cent, the lowest it has been since 2011-12. Little wonder that the Prime Minister has stepped in to try and reverse the decline. Cases of the “really nasty disease”, as Mr Johnson put it, rose to 966 in England last year – nearly four times as many as the total number confirmed in 2017.

Unicef estimated 527,000 children in the UK missed out on their first dose of the measles vaccine between 2010 and 2017: two innoculations are needed for children to be covered. It means the UK has lost its “measles-free” status with the World Health Organisation – three years after the virus was eliminated in the country.

Low understanding

Here is why we need to look deep behind the anti-vaccination movement beyond social media (Photo: YURI DYACHYSHYN/AFP/Getty)

In its report on promoting vaccination uptake, the Royal Society for Public Health found that the vast majority of people who chose not to vaccinate did not cite inconvenience as a key factor, suggesting people are more likely to have been swayed by “anti-vaxx” messages online.

There was a fairly low understanding of herd protection, especially for working-age adults, and the myth of vaccine overload remains persistent, the report found, with just over a quarter (28 per cent) of people believing incorrectly that “you can have too many vaccinations”.

Johnson has now called for health leaders to renew their efforts to meet 95 per cent for both doses of MMR, which would mean herd immunity. Currently just 87 per cent of children are getting their second dose of the jab, which has likely contributed to the spread of measles.

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Instagram clamps down on hashtags spreading fake news about vaccines

The advice online from will also be updated to address parents’ concerns about vaccines and address misleading information about the dangers of vaccines, by giving people NHS-approved, evidence-based and trusted advice on vaccines including through a new website. A summit of social media companies is also being called, to discuss how they can play their part in promoting accurate information about vaccination. Finally, the Department for Health and Social Care – working with PHE and NHS England – will deliver a “comprehensive strategy” to address the issue in the autumn.

Back on the Prime Minister’s twitter feed, the odd voice of reason does interrupt the flow of conspiracy theorists. One responder said: “I can’t understand the mentality of people who don’t get their children vaccinated.

“What is the point in not getting them protected from these deadly diseases? Absolutely crazy.”

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Listeria outbreak: NHS hospital sandwich deaths ‘due to dramatic public health cuts’

The deaths of 18 people, including six linked to an outbreak of listeria, were down to “systematic failures” in public health following “dramatic” budget cuts, according to a former health chief.

Professor John Ashton described 18 deaths linked to separate deadly outbreaks of listeria and streptococcus earlier this year as “serious failures” of the system.

His attack comes after the latest outbreak in which six hospital patients across the UK died after eating pre-packed sandwiches contaminated with listeria supplied to the NHS and 12 Mid Essex NHS patients died from streptococcus infection. Professor Ashton, now an independent public health consultant, warned that years of cuts to local authority budgets had stripped the ability of watchdog environmental health departments to protect people. Public health establishments had been “whittled away” while budgets and salaries had been cut “dramatically”.

Professor Ashton, the former North West regional director of public health from 1993 to 2006, warned that “massive cuts” to local authority budgets had led to environmental health departments that were no longer able to “keep ahead of the threats to human health”. Writing in the Journal of the Royal Society of Medicine, he said: “It is now time to digest these latest failings of a public health system that was only put in place six years ago as part of [former health secretary] Andrew Lansley’s structural changes to the NHS and for public health.

Salmonella comparison

Professor Ashton drew comparisons with two incidents that caused 41 deaths in the 1980s involving outbreaks of salmonella food poisoning and legionella. Both these outbreaks followed “radical changes” to local government which “unravelled” the existing public health system.

A 1988 inquiry concluded that a lack of effective local environmental and communicable disease control was deemed to be central to both events, he said. Professor Ashton warned that the lesson from history was not to embark on another re-organisational “folly”.

He said: “So in 2019, just six years after the pack of cards was thrown up in the air and public health rearranged in an NHS-style top-down reorganisation we have a systemic problem resulting in the deaths of 17 elderly citizens who deserved better.

“The lesson from history is that we should not embark on another re-organisational folly but rather find ways to strengthen what we now have and support its evolution into something fit for purpose.”

Recent casualties

Public Health England (PHE) said earlier this month that a sixth person had died after eating pre-packaged sandwiches and salads linked to a listeria outbreak. The latest death was one of the nine cases previously confirmed and PHE said there have been no new cases linked to the outbreak.

The patient, whose age and gender were not given, acquired listeriosis from Good Food Chain products while at Western Sussex Hospitals NHS Foundation Trust, PHE said. The Food Standards Agency has previously confirmed that the Good Food Chain, which went into liquidation in June, was not the source of the outbreak.

NHS Mid Essex Clinical Commissioning Group said last month that 13 people had died in an outbreak of invasive Group A streptococcus. Health bosses had previously reported 12 deaths due to the spread of the rare bacterial infection, but an additional case has been added to the total after PHE reviewed how cases are defined.

Spain issues global alert over pork listeria outbreak

Spain has issued international health alerts in light of a widening outbreak of listeria from pork that has affected 150 people and killed one of them.

The health minister, María Luisa Carcedo, said alerts had been posted to the EU and the World Health Organisation given the possibility that some tourists may be affected.

The outbreak started on 15 August in the southern Andalusia region and claimed its first victim, a 90-year-old woman, on Monday.

The product blamed for the outbreak is a stringy cooked meat sold under the brand “La Mecha”. Authorities have closed the supplier plant and are testing all its products.

Listeria is a bacterium that usually causes mild illness but can be dangerous to pregnant women or those with weak immune systems. AP

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The Great British Bake Off judge Prue Leith to help improve ‘unpalatable’ NHS hospital food

Bake Off judge Prue Leith has been named the star adviser for a government “root-and-branch review” into NHS hospital meals which the Prime Minister has promised will result in healthier meals for patients. Ms Leith has previously said “most hospital food is a disgrace” and that patients were being served ready meals “that look like an unidentifiable plate of grey mush”. Now the broadcaster and former chair of the School Food Trust has been tasked with putting her menus where her mouth is and help to improve the whole system.

Fears about the state of hospital food have peaked in recent weeks following a listeria outbreak in May which killed six patients. The review aims to improve public confidence in hospital food by “setting out clear ambitions for delivering the high-quality food patients and the public have a right to expect”.

The NHS in England serves more than 140 million meals to patients every year. Around half of the NHS’s hot food is bought in from external suppliers. Around a fifth of all hot meals served at NHS hospitals in England, Scotland and Wales are made at private firm Apetito in Trowbridge, Wilts, and shipped up to 650 miles.

Patients at around 430 hospitals are served 46,000 reheated ready meals from that company. The food is held in freezers for an average of two months while unusual product lines may be stored for up to a year. Campaigners have called for more fresh food to be made on site in hospitals.

Send it back

Around half of NHS hospitals are failing to comply with basic food standards, the Campaign for Better Hospital Food said this month. That followed a Unison survey which found more than half of hospital staff in England say they would not eat the food served to patients because it is unhealthy and of poor quality. Staff had major concerns over the meals served to patients alongside their own access to good quality, nutritious meals.

No free drinking water, poor food-preparation facilities or meals unsuitable for dietary or religious needs were among other top complaints. Health campaigner said the findings highlight the failure of the NHS to ensure hospital vending machines, restaurants and shops provide good quality, nutritious meals.

An audit of NHS health centres in May found that three-quarters of the best-selling snacks in hospital cafes and canteens were rated as unhealthy, along with half of the most popular cold drinks.

Despite hospitals taking steps to promote healthier eating, the audit found that medical staff, patients and visitors tended to shun nutritious snacks in favour of crisps, sweets, cakes and other baked foods including pastries and muffins. The Scottish researchers who carried out the audit called for radical restrictions on junk food in UK hospitals.

The review will consider how NHS trusts could use less frozen food, make greater use of seasonal, fresh produce and source locally where appropriate. New systems to monitor food safety and quality more transparently, including looking at how NHS Boards are held to account, will also be assessed.

Whether too many hospitals rely on outsourced catering and whether the NHS needs to increase the number of hospitals who have their own chefs will also be considered.

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Ms Leith, who accused previous Health Secretary Jeremy Hunt of “ducking the issue”, said: “Millions of pounds are wasted in hospitals with food ending up in the bin, unpalatable food being the main complaint. I’m delighted that at long last Downing Street and the Department of Health have decided to do something about it.

“A hospital meal should be a small highlight, a little pleasure and comfort, and it should help, not hinder, the patient’s recovery.”

Some food offerings at NHS hospitals could be healthier (Photo: Katherine Button)
A lot of food offerings at NHS hospitals could be healthier, critics have said repeatedly (Photo: Katherine Button)

Philip Shelley, former head of the Hospital Caterers Association and catering lead for Taunton and Somerset NHS Foundation Trust, will chair the review which will draw on the expertise of hospital caterers, patient groups, suppliers and kitchen staff across the country.

Mr Johnson said: “Guaranteeing hospitals serve nutritional, tasty and fresh meals will not only aid patient recovery, but also fuel staff and visitors as they care for loved ones and the vulnerable.

“Our NHS has led the way since the day it was formed. This review will ensure it remains the standard-bearer for healthy choices, as it works unstintingly to improve the nation’s well-being.”

Shadow Health Secretary Jonathan Ashworth said: “Years of austerity mean that some hospitals are only spending close to £3 per patient a day on meals for patients – it’s an utter disgrace. Labour will invest in hospital catering, enforce mandatory minimum standards and bring catering back in-house.”

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Four-drug pill ‘may prevent heart diseases and strokes’

A low-cost pill which contains four different drugs is effective in preventing heart disease and strokes, a study has claimed.

Results of a clinical trial into the “polypill” are said to demonstrate for the first time its effectiveness in preventing cardiovascular disease. When compared with just receiving lifestyle advice, those who took the polypill reduced their risk of major cardiovascular disease by 34 per cent. Those without a history of cardiovascular disease saw a risk reduction of around 40 per cent and those with a history of cardiovascular problems saw a reduction of 20 per cent.

The study, led by the Tehran University of Medical Sciences in Iran and published in The Lancet, monitored 6,841 people aged 55 and over who were living in 236 villages in northern Iran. The villages were randomly divided into two groups, with one made up of 3,417 participants who were given general advice on diet, exercise and smoking.

The second group, containing 3,421 people, was given the same advice, but were also required to take a polypill every day. After five years, 202 people in the group that took the polypill – which contained aspirin, a statin and two drugs to lower blood pressure – had suffered a heart attack or a stroke, compared with 301 in villages where only lifestyle advice was given.

Step forward for prevention

Professor Neil Thomas, from the University of Birmingham, which was involved in the research, said: “Previously there had been concerns as to whether a polypill would be effective in those who had not already had cardiovascular disease, but this study shows that, in high-risk populations as in Iran, this approach is effective in preventing first and subsequent cardiovascular disease.”

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Professor Reza Malekzadeh, of Tehran University of Medical Sciences, said: “Our research has shown a polypill prevents heart disease in a developing country and is an important step forward in preventing heart disease.”

The idea of combining several drugs in a single pill – the polypill – was originally proposed in 2001. Since then, several small, short-term studies in a number of countries have shown that a polypill could reduce blood pressure and cholesterol levels.

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‘My severe asthma went undiagnosed for three years – until I ended up in a coma for a month’

When Jennifer O’Hara-Jordan was diagnosed with asthma as a teenager she wasn’t overly worried. At worst, an attack would leave her slightly breathless with a tight feeling in her chest, symptoms that would disappear with a few puffs from her inhaler. The condition didn’t affect her life too badly and seemed to even improve over the next few years.

But her asthma returned and eventually got so bad that an attack would leave her unconscious and dangerously close to death within minutes. No amount of medication alleviated her symptoms, and despite telling doctors the drugs they were giving her weren’t working, Jennifer wasn’t helped properly until it was almost too late.

She ended up in a coma several times fighting for her life, after her heart, lungs and kidneys started to fail.

Jennifer, here with her sister, didn’t suffer too badly with asthma at first (Photo: Jennifer O’Hara-Jordan)

“I had developed a rare and severe form of asthma but it took three years before I was properly diagnosed and given the correct treatment,” she told i. “In that time, I ended up in a coma four times, almost dying each time, because the medication I was given did nothing to help.

“I needed specialist treatment and if I hadn’t eventually got it, I probably wouldn’t even be here now.”

Stress trigger

Jennifer was first diagnosed with asthma in her teens, which she believes was brought on by the stress of doing her exams.

“I’d just get a bit wheezy and tight-chested from time to time so my mum took me to see the GP who gave me an inhaler,” she explained. “After that I was fine.”

Read more: Deaths from asthma attacks are at their highest level for 10 years

When the stressful period in her life passed, her asthma symptoms seemed to improve until she no longer needed medication. But then, at the age of 20 when she moved from southern Ireland to London to study, her symptoms returned.

“They were worse this time and I think it was because of the pollution in the air,” Jennifer recalled. “My attacks came back full force and inhalers or nebulisers didn’t help.

Jennifer ended up in a coma again and again (Photo: Jennifer O’Hara-Jordan)

“I would get dizzy and start struggling to breathe to the point where I’d be turning blue quite quickly and would have to be rushed to hospital.”

Although she was placed under the care of the respiratory team at hospital and given several different inhalers, nebulisers and medications to help control the attacks, they kept getting worse and increasing in frequency. By the time she was 40, she was in and out of hospital almost weekly.

“Nothing seemed to improve my asthma and I had no idea why,” she said. “It was really frightening but whenever I complained to my GP he would just give me some steroids or a different type of inhaler to try.”

When Jennifer met her husband, Simon, 45, online in 2010, he was understanding of her condition.

“I couldn’t go out to bars or other social places because people smoked outside and it was too risky for me,” she said. “So, we met online. Simon was brilliant from day one. He could always tell when I was about to have an attack and would help.”

Asthma slowly took over as Jennifer got older (Photo: Jennifer O’Hara-Jordan)

But in 2015 things took a turn for the worse when Jennifer’s dad passed away. The shock and grief brought on a huge asthma attack which left her in a coma for the first time.

“I didn’t get any warning at all,” she said. “All I remember was that I was at home and suddenly just couldn’t breathe. I was getting really hot too and was struggling to walk because oxygen wasn’t getting into my system.”


Jennifer fell unconscious and luckily, Simon was at home and called the paramedics. When they arrived she had already begun flatlining, meaning her heart had stopped and she was at risk of permanent brain damage.

“I had never had an attack that bad before,” Jennifer said. “They had to put me into an induced coma and on a life support machine because my body couldn’t cope. My heart, kidneys and liver were failing.”

Read more: ‘My brain damaged father is slowly starving to death – I need to get him home’

Luckily, Jennifer recovered after being given medication to open her airways and strengthen her organs but the episode frightened her.

“I tried not to think about it afterwards,” she said. “It was too frightening for my brain to comprehend. It was hard to believe that something like that had happened to me – that my husband had seen me dying.”

Countless drugs: Jennifer tried all sorts of medication and inhalers (Photo: Jennifer OHara-Jordan)

Although she saw a consultant in the respiratory care team every three months, Jennifer was still given the standard medication to manage and control her asthma, which was continually getting worse.

Over the next three years she suffered three more almost fatal attacks – in May and December 2018 and again in February this year.

The episode in May was one of the worst, leaving her in an induced coma for a month as she lay fighting for her life.

“My heart and liver were failing and Simon was about to turn off my life support machine until, miraculously, I turned a corner and lived to fight another day,” she said. “But I knew my time was running out and that I might not be so lucky again.

“Simon was constantly on high alert at home and I had to give up my job as an office manager and rely on friends and neighbours popping in regularly when Simon was at work to keep an eye on me.”

Lung failure

Her most recent extreme asthma attack happened when Jennifer had returned home from a trip to the beauty salon this February.

“All I remember was walking through the door and that’s it,” she said. “Simon later told me I came in looking grey and just collapsed. My heart stopped once again, and I was basically dead for 45 minutes. I ended up in an induced coma in intensive care for two weeks that time.”

Jennifer was initially taken to to Basildon Hospital in Essex, but her lungs had collapsed from the strain of the attack and she suffered kidney failure too. She had to be transferred to St Thomas’ Hospital in London and put on an Extra Corporeal Membrane Oxygenation machine, which oxygenates the body when the lungs can’t.

It was then doctors realised that the treatments she had been given weren’t working and she was finally referred for specialist care and properly diagnosed.

“The consultant said, ‘I can’t believe you’ve been in this state and nobody has upped their game'”

Jennifer O’Hara-Jordan

“A consultant at St Thomas’ said to me that I really should be under the care of Addenbrooke’s Hospital in Cambridge where they had a specialist asthma clinic. He said, ‘I can’t believe you’ve been in this state and nobody has upped their game.’

“He told me I had severe asthma, which is different from milder forms of asthma, and needed to be looked after by an asthma team, not a respiratory one. He said they could provide a medication called Mepolizumab, which was better for people with severe asthma. For the first time I had hope.”

Her rock: Jennifer says she would never have got through the last few years without her husband Simon (Photo: Jennifer O’Hara-Jordan)

Left temporarily paralysed from the neck down because her muscles were so weak from the asthma attack, Jennifer had to have intensive rehabilitation before being allowed to go home. The following month she had a referral letter for Addenbrooke’s.

“When I saw the specialist there he was shocked by what I’d been through,” she remembered. “He diagnosed me with a rare form of asthma called eosinophilic asthma, which meant I had high levels of a white blood cells, making it difficult to control.

“I was full of energy and could live my life again. I could go round to my neighbour’s for a catch up without worrying that I’d have an attack or even go out for a drive and not need to take medication with me”

Jennifer O’Hara Jordan

The consultant recommended Jennifer be put on Mepolizumab as soon as possible and, since then, the drug has completely transformed her life.

“When I first had the injection I could instantly feel my airways opening up afterwards – it was amazing,” Jennifer recalled. “For the first time in years I could breathe properly and I can’t even put into words how wonderful that felt.

“I was full of energy and could live my life again. I could go round to my neighbour’s for a catch up without worrying that I’d have an attack or even go out for a drive and not need to take medication with me.”

The drug had an amazing effect on her asthma (Photo: Jennifer O'Hara-Jordan)
The drug gave Jennifer her life back (Photo: Jennifer O’Hara-Jordan)

Jennifer has to have one injection of the drug every four weeks as it starts to wear off by then, and travels to Cambridge each time. But she says the results are more than worth it.

“I still have asthma attacks but they are nowhere near as bad as before and I haven’t been in hospital once since I started on it,” she said. “Now, if I start to feel breathless, I use my nebuliser and within an hour, I’m back to normal. Before it would be days before an attack could be brought under control. I just can’t believe that, all this time, my asthma wasn’t properly diagnosed and because of that, I wasn’t being given the proper treatment.

“It took me being in a coma four times and almost dying before I was actually given the help I needed and I know there are others in the same boat as me.

“When you have severe asthma mainstream treatment just won’t touch it. You need specialist care under at an asthma clinic and drugs like Mepolizumab. But unfortunately, there aren’t enough of these clinics, GPs aren’t properly educated about the condition, and there isn’t enough funding available to provide this drug for more people like me.”

Read more: Over one million asthmatics at risk of life-threatening attack

According to Asthma UK, four in five people at the highest risk of asthma attacks are not getting the life-saving care that they need. The charity says tens of thousands of sufferers are ‘in limbo’ in primary care instead of being referred to specialists for diagnosis and treatment, which is putting their lives at risk. It also claims the current guidelines from the National Institute of Clinical Excellence (Nice) are not clear about when to refer people with severe asthma, and is now calling for this to change, and for the NHS to increase access to life-changing treatments.

Constant risk

Dr Samantha Walker, Director of Policy and Research at Asthma UK said: “Tens of thousands of people with suspected severe asthma are stuck in a never-ending cycle, in and out of hospital and at constant risk of a life-threatening asthma attack.

“We want healthcare professionals to take asthma seriously and refer suspected severe asthma patients more quickly, as they are have the highest risk of dying from an asthma attack. NICE must also urgently put in place clear, simple and unambiguous guidelines so healthcare professionals can follow the protocol and more people with severe asthma can receive life-saving and life-changing treatment.”

Charity says sufferers like Jennifer are constantly at risk (Photo: Jennifer O’Hara-Jordan)

Dr Andy Whittamore, Clinical Lead at Asthma UK and a practising GP, added: “GPs are hampered by a lack of clear and effective referral guidelines from NICE for severe asthma. If someone’s symptoms cannot be controlled or they have more than two flare-ups requiring oral steroids, healthcare professionals should consider referring their patient to a specialist asthma clinic.”

A spokesperson for Nice said: “When treating uncontrolled asthma in adults, young people and children under five, Nice guidance recommends seeking advice from a healthcare professional with expertise in the field. We are also currently working with partners at the British Thoracic Society (BTS) and Scottish Intercollegiate Guideline Network (SIGN) to produce UK-wide guidance for the diagnosis and management of chronic asthma in adults, young people and children. This will help healthcare professionals to make accurate diagnoses and provide effective treatments.

“Nice produces guidelines that reflect the best, most up to date evidence and we believe people have the right to be involved in discussions about their care in order to make informed decisions about their treatment.”

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Is it safe to travel to Spain? Listeria outbreak sparks health alert – here’s the latest travel advice

An international warning has been issued after a killer listeria outbreak in Spain has infected more than 150 people.

The Spanish Ministry of Health has issued the warning to EU authorities and the World Health Organisation amid fears for tourists’ health after a 90-year-old woman died from listeriosis – the disease caused by the bacteria.

The first casualty of the disease was announced on August 15.

What parts of Spain have been affected?

Some 80 million people visit Spain every year, and it is one of the most popular destinations for British holidaymakers.

On top of the 150 people known to be infected, the ministry has confirmed that it is also investigating another 523 suspected cases.

Most of the cases reported have been in the south of the country in the Andalusia region, the location of a packaged pork plant that has been linked to the outbreak.

But there have also been reports of cases in the Catalonia region in the north east of the country, and 50 people remain hospitalised from the infection in total.

What causes Listeriosis?

Listeriosis is caught when a person eats food contaminated with listeria bacteria.

It has most commonly been found in unpasteurised milk, soft cheeses and chilled, ready-to-eat snacks like pre-packed sandwiches.

It usually causes mild illness, however it is more dangerous to those with weaker immune systems, unborn and newborn babies and pregnant women.

It has been known to cause illnesses such as sepsis, meningitis and encephalitis, and can be fatal in some cases.

Of the 50 people currently hospitalised, 23 of them are pregnant women.

The packaged meat plant, owned by Seville-based firm Magrudis, which is believed to be linked to the outbreak is being inspected by Spanish officials after lab tests showed the presence of listeria.

The Spanish health ministry has said that the source of the outbreak is believed to be a kind of pork meatloaf sold under the brand name La Mechá.

Product recall

All products manufactured at the contaminated plant since May 1 have been recalled by supermarkets.

Seville City Council took the precautionary measure of halting production at the factory on August 14.

The regional government did likewise on Wednesday this week (August 21).

Magrudis has declined to comment on the situation.

However a representative told Spanish news agency EFE that since the discovery of the bacteria they had followed protocol ‘to the letter’and launched an investigation into the source.

Maria Luisa Carcedo, acting health health minister, said: “Obviously there was a failure to follow the established procedures.

“Now we need to carry out the inspections and investigations to figure out exactly where this failure took place.”

The outbreak in Spain comes not long after six people in the UK died from listeriosis after eating contaminated hospital food.

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Older people are being prescribed medicines in ‘excessive numbers and unsafe combinations’

Doctors need to take more care in treating their patients as individual people rather than “symptoms to solve”, The Patients Association has said.

The warning comes after new research claims older people are being prescribed medicines in excessive numbers and unsafe combinations.

Nearly two million people over 65 are on seven or more medications while nearly four million are taking at least five drugs, according to Age UK.

The charity’s More Harm Than Good report warns that such high levels of “polypharmacy” could lead to severe and even life-threatening side effects. It suggests that prescribing more drugs is not always the best option for older people.

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‘Big potential problem’

“We are incredibly fortunate to live at a time when there are so many effective drugs available to treat older people’s health conditions, but it’s a big potential problem if singly or in combination these drugs produce side effects that ultimately do an older person more harm than good,” said Caroline Abrahams, charity director at Age UK.

“That’s why it is really important that a clinician, typically your GP, has a good overview of all your medicines and considers from time to time with you whether they are still the best for your health, not only on their own but when taken together with the other medications you are on.”

Tablets are measured out in a high street pharmacy in the UK (Photo: PA)

The charity called on the NHS to take a “zero tolerance” approach to inappropriate polypharmacy and ensure older people are fully involved in decisions regarding their medicines.

Responding to the findings, John Kell, head of policy at The Patients Association, told i: “This report shows how important it is for doctors to deal with the patient in front of them as a person, not just an individual symptom to solve. Prescribing decisions should be made in discussion with the patient, identifying what they want to achieve for their health and taking full account of their circumstances, including other medicines they are being prescribed.

“For patients where many medicines are prescribed, each of those decisions might have had some justification in isolation, but considered together as a care regime they can fail badly to meet that person’s needs,” he added.

Side effects

Older people tend to be more susceptible to side effects, including nausea, dizziness, loss of appetite, low mood, weight loss, muscle weakness and delirium.

Age UK quoted evidence that showed taking more drugs increased the risk of falling and hospital admission.

The report said between 2008 and 2015 the number of emergency hospital admissions caused by adverse drug reactions increased by 53 per cent and in 1-in-50 cases that reaction proved to be fatal.

The charity also found medicines are sometimes being prescribed without the consent or involvement of the older people concerned and without the support and help older people need to take them.

A customer uses an independent chemist to collect a prescription
The NHS said it knew patients were being prescribed more medicines than needed (Photo: Getty)

‘Strong advice’

“Our strong advice to older people is never to stop taking any of your medications off your own bat, but to talk to your GP if you have concerns and to ask for a review if you haven’t had one for a year or more,” said Ms Abrahams.

“Everyone’s needs change over time and new treatments are always becoming available so it is well worth your doctor looking at whether your medicines are the best they can be and, indeed, whether they are all still necessary. Most older people would agree that the fewer pills they have to pop, the better.

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“This NHS review of overprescribing is happening not before time because the problem is not new and, as our report shows, it can have a really damaging impact on older people’s lives. We will look forward to seeing the outcomes and we are confident that there is much more that can be done to ensure every older person gets the medicines they really need – neither too many nor too few – which given the NHS’s spiralling drugs bill will be good for us all as taxpayers as well,” she added.

The NHS said it knew patients were being prescribed medicines they may not need but is investing £20m in a programme to employ 240 pharmacy professionals to reduce unnecessary medication and ensure people are getting the right treatment.

“The NHS is also already investing in thousands of new clinical pharmacists to work with GPs and care homes to carry out medication reviews with the most vulnerable patients,” said England’s Chief Pharmaceutical Officer Keith Ridge.

A Department of Health and Social Care spokesperson said: “We are committed to making sure patients get the safest and most appropriate treatment, while cutting down unnecessary prescriptions.

“From October, patients leaving hospital will get more time with their pharmacists to discuss any changes to their medication. And as part of the NHS Long Term Plan, 900,000 more people will be referred to social prescribing schemes over the next five years.

“We recently launched a review into overprescribing in the NHS which experts, including Age UK, are contributing to and the findings will be published in due course.”

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Not sitting down for hours is the best way to lower risk of death in middle age

Not sitting down for hours is the best way to lower risk of death in middle age and beyond, scientists say.

Anyone who sits for at least nine-and-a-half hours a day, excluding sleeping, is putting themselves at greater risk of death, a new study has found. Previous research has repeatedly suggested that sedentary behaviour is bad and physical activity is good for health and long life.

Scientists from Norway analysed eight high quality studies involving 36,383 adults, with an average of age of 62, that assessed physical activity and sedentary time with death. Activity levels were categorised into quarters from least, such as cooking, washing dishes or walking, to most active, such as jogging or carrying heavy loads. Over the next six years 2,149 (5.9 per cent) participants died.

“Our findings provide clear scientific evidence that higher levels of total physical activity—regardless of intensity level—and lesser amounts of sedentary time are associated with a substantially lower risk of death,” said lead author Professor Ulf Ekelund, from the Norwegian School of Sport Sciences in Oslo.

Health benefits

For adults up to the age of 64, the NHS recommends at least 150 minutes of moderate aerobic activity such as cycling or brisk walking every week
For adults up to the age of 64, the NHS recommends at least 150 minutes of moderate aerobic activity such as cycling or brisk walking every week (Photo: AFP/Getty)

There were approximately five times more deaths in those being inactive compared with those most active. The researchers say this strengthens the view that any physical activity is beneficial and likely achievable for large segments of the population. In contrast, spending nine and a half hours or more each day sedentary was associated with a statistically significant increased risk of death.

The researchers point out that all studies were conducted in the US and western Europe, and included adults who were at least 40 years old, so findings may not apply to other populations or to younger people. But they say the large sample size and device based measures of sedentary time and physical activity provide more precise results than previous studies.

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For adults up to the age of 64, the NHS recommends at least 150 minutes of moderate aerobic activity such as cycling or brisk walking every week and strength exercises on two or more days a week that work all the major muscles.

Researchers say their results provide important data for informing public health recommendations, and suggest that the public health message might simply be “sit less and move more and more often”. Their study is published in The BMJ.

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Cervical cancer: symptoms, signs, causes, smear tests and screening explained

Almost 1,000 women in the UK die from cervical cancer every year.

The disease, which mostly affects sexually active women between the ages of 30 and 45, affects the cervix, and is usually caused by the common HPV virus.

There are around 3,000 new cases diagnosed in the UK each year.

Cervical cancer often displays no symptoms and signs during the early stages of the disease.

Symptoms and signs of cervical cancer

The most common indication is vaginal bleeding occurring during or after sex, between periods or new bleeding after the menopause.

This bleeding does not necessarily mean you have cervical cancer, but the NHS recommends seeing a GP as soon as possible for assessment.

Other symptoms of the disease can include pain or discomfort during sex, lower back or pelvic pain and unusual vaginal discharge.

If the disease reaches an advanced stage, it can lead to further symptoms, such as back pain, blood in your urine, incontinence and leg swelling.

A girl is vaccinated against HPV, the primary cause of cervical cancer (Photo: Getty Images)

Causes of cervical cancer

The overwhelming cause of cervical cancer is the common HPV virus (human papillomavirus), which accounts for 99.7 per cent of cases, and can be transmitted through any sexual contact between men or women.

Two particular strains of the virus (there are more than 100 types in total, mostly harmless) are responsible for most cases of cancer: HPV 16 and HPV 18.

These are among the variants that can cause abnormalities in the cells of the cervix, which can eventually become cancer.

However, even these are very common and only result in the disease in a small proportion of cases.

The most effective prevention against the virus is the HPV vaccine, which from September 2019 will be offered to all Year 8 pupils boys and girls on the NHS. Those who miss the vaccination can continue to have it until they turn 25.

Using condoms during sex can also help to prevent the chance of the infection spreading, but given that skin-on-skin contact can transmit HPV it is not a foolproof measure.

A file photo shows Professor Ian Frazer at work in a bio medical laboratory at the Princess Alexandra Hospital
The development of an effective HPV vaccine could have a decisive effect on cervical cancer (Photo: Getty Images)

Screening, or ‘smear tests’

Cervical screening, or a “smear test”, represents the most effective way of protecting against cancer.

The process involves a small sample of cells being taken from the cervix to be checked for abnormalities.

If such abnormalities are found, it doesn’t necessarily mean you have cancer – it can instead indicate signs of HPV, or represent precancerous cells which can be treated.

Following an abnormal screening test, you will usually be referred to a colposcopy, when a specialist nurse uses a small microscope and a speculum to inspect the cervix.

The procedure may also include a small biopsy being taken to inspect for cancerous cells, which can cause some vaginal bleeding and period-like pains.

The NHS Cervical Screening Programme open to all women between 25 and 64 years old. Screening is offered to women between 25 and 49 every three years, and to those between 50 and 64 every five years.

How cervical cancer is treated

Cervical cancer can usually be treated with surgery if the disease is diagnosed at an early stage, often the removal of the cervix or uterus.

Radiotherapy is also an option for some women at this stage, and is sometimes used in conjunction with surgery.

Cervical cancer is categorised into four stages, with the chance of survival ranging from 80-99 per cent for women with stage 1, to 20 per cent for those with stage 4.

If the disease is more advanced, then usually chemotherapy is used alongside radiotherapy. Some treatments can cause serious side effects, such as early menopause and infertility.

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Female heart attack myths busted: women experience same symptoms and warning signs

Women who have heart attacks experience the same key symptoms as men, quashing one of the reasons given for women receiving unequal care, according to new British Heart Foundation funded research.

The analysis puts into question a long-held medical myth that women tend to suffer unusual or “atypical” heart attack symptoms, and emphasises the need for both sexes to recognise and act on the warning signs. Incorrectly assuming that women having a heart attack suffer different symptoms to men could lead to misdiagnosis, delayed treatment and less intensive medical interventions being offered, experts said. Previous BHF-funded research has shown the resulting differences in care for women were estimated to have contributed to at least 8,200 avoidable deaths in England and Wales in the last decade.

In the new study, published in the Journal of the American Heart Association, researchers at the University of Edinburgh recorded the symptoms of people attending the Emergency Department (ED) at Edinburgh Royal Infirmary who had a blood test called a troponin test. This test is used when doctors suspect a person is having a heart attack, and measures a protein released by damaged heart cells during a heart attack.

Doctors in the ED ordered the troponin test for 1,941 people between June 2013 and March 2017. Of this group some 274 people – 90 women and 184 men – were diagnosed as having a type of heart attack known as an NSTEMI, the most common type of heart attack which occurs when the coronary artery is partially blocked.

Common symptoms

Some patients suffering from heart attacks and strokes are waiting up to an hour to be picked up by an ambulance (Pexels)
Some patients suffering from heart attacks and strokes are waiting up to an hour to be picked up by an ambulance (Photo: Pexels)

Chest pain was the most common symptom for both men and women, with 93 per cent of both sexes reporting this symptom. A similar percentage of men and women reported pain that radiated to their left arm. More women had pain that radiated to their jaw or back and women were also more likely to experience nausea in addition to chest pain (33 per cent vs 19 per cent).

Less typical symptoms, such as heartburn, back pain, or pain that was burning, stabbing or similar to that of indigestion, were more common in men than women (41 per cent in men vs 23 per cent in women).

Fact or fiction?

1 — It’s a man’s disease. More than 35,000 women are annually admitted to UK hospitals following a heart attack – an average of four every hour.

2 — Men and women receive the same care. Women are more often misdiagnosed initially, reports the Scripps Women’s Health Centre. Female survivors are reportedly less likely than men to receive beta-blockers, statins, and ACE inhibitors.

3 — Heart attacks in post-menopausal women. Heart attacks have been called an “old man’s disease” – recent studies show a rise in heart attacks among women aged 35-54.

Previous research has suggested that women and men report different heart attack symptoms. However, the symptoms were often recorded after a heart attack diagnosis was confirmed, which may introduce bias according to experts. Official UK guidelines state that men and women with suspected acute coronary syndrome should not be assessed differently.

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Amy Ferry, cardiology research nurse at the University of Edinburgh and study first author, said: “Our concern is that by incorrectly labelling women as having atypical symptoms, we may be encouraging doctors and nurses not to investigate or start treatment for coronary heart disease in women.

“Both men and women present with an array of symptoms, but our study shows that so-called typical symptoms in women should always be seen as a red flag for a potential heart attack.”

Professor Jeremy Pearson, associate medical director at the BHF, said: “Heart attacks are often seen as a male health issue, but more women die from coronary heart disease than breast cancer in the UK. We need to change this harmful misconception because it is leading to avoidable suffering and loss of life.”

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Thousands of homeless children forced to live in shipping containers and office blocks

Thousands of children are growing up in office blocks, B&Bs, and even shipping containers, a shocking new report from the Children’s Commissioner for England reveals.

More than 210,000 children in England are estimated to be homeless – 124,000 officially homeless and living in temporary accommodation, plus around 90,000 children living in “sofa-surfing’ families”, according to the report. Officials believe the total could be even higher due to a lack of data on the number of children placed in temporary accommodation by children’s services.

In the “Bleak Houses” report commissioner Anne Longfield warns changes to planning regulations mean thousands of children are being housed in temporary accommodation that is frequently not fit for them to live in, dangerous due to drug dealers and prostitutes living nearby, and often far away from family, friends and their school.

Her report warns that a further 375,000 children in England are in households that have fallen behind on rent or mortgage payments, putting them at financial risk of becoming homeless in the future.

Unfit housing

The label “temporary” is sometimes anything but: the analysis suggests that in 2017 around two in five children in temporary accommodation – an estimated 51,000 children – had been there for at least six months. Furthermore, around 1 in 20 – an estimated 6,000 children – had been there for at least a year. Of the 2,420 families known to be living in B&Bs in December 2018, a third had been there for more than six weeks, despite this being unlawful.

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Ms Longfield said she is particularly concerned about the recent development which has seen the “repurposing” of shipping containers for use as temporary accommodation. Often they are located on “meanwhile sites” – land that is earmarked for future development but currently not in use.

The units are typically one or two-bedroom and small in size, meaning that overcrowding can be an issue. They can become really hot in summer and too cold in the winter. As with some office block conversions, antisocial behaviour has been a problem, leaving some parents worrying about letting their children play outside, forcing them to stay in cramped conditions inside instead.

‘They failed me in so many ways’

Lucy is in her early twenties. Her son Jake is 2. When she became homeless they were placed by her local authority in a converted office block far from home. Although this was considered an emergency placement, they were there for 11 months.

“They put me in a small room in an office block which had been converted into flats. It was in an industrial estate in the middle of nowhere. The cars and lorries would whizz round really fast. It was very noisy and it felt unsafe to walk to the shops,” Lucy said.

“There were a lot of people congregating at the entrance who didn’t live there and I felt unsafe. I was approached to buy drugs during the day on the way to the shops with my son.”

It took six months and a formal complaint before Lucy’s local authority completed its assessment and found that it had a duty to find the family a permanent home – but she was then placed on a waiting list. Lucy then had to submit yet another complaint in order to be moved back to her local area. This took a further three months.

Eventually Lucy was able to move back to her local area, where she was offered a self contained flat – up 3 flights of stairs with no lift. She still does not know when she and her son will be offered a permanent home, what it will be like or where it will be.

“They failed me in so many ways. The fact that they get away with it is so, so bad.”

Ms Longfield said: “Something has gone very wrong with our housing system when children are growing up in B&Bs, shipping containers and old office blocks. Children have told us of the disruptive and at times frightening impact this can have on their lives. It is a scandal that a country as prosperous as ours is leaving tens of thousands of families in temporary accommodation for long periods of time, or to sofa surf.

“It is essential that the Government invests properly in a major house-building programme and that it sets itself a formal target to reduce the number of children in temporary accommodation.”

‘Trapped by rents’

A person sleeping rough in a doorway (Photo: Yoi Mok/PA)

Simone Vibert, senior policy analyst at the Children’s Commissioner’s Office and author of the report, said: “Trapped by increasing rents and an unforgiving welfare system, there is very little many families can do to break the cycle of homelessness once it begins.

“Preventing homelessness from happening in the first place is crucial. Yet government statistics fail to capture the hundreds of thousands of children living in families who are behind on their rent and mortgage repayments.

“Frontline professionals working with children and families need greater training to spot the early signs of homelessness and councils urgently need to know what money will be available for them when current funds run out next year.”

A Government spokesperson said: “No child should ever be without a roof over their head and we are working to ensure all families have a safe place to stay. If anyone believes they have been placed in unsuitable accommodation, we urge them to exercise their right to request a review.

“We have invested £1.2bn to tackle all types of homelessness, including funding a team of specialist advisors which has, in two years, helped local authorities to reduce the number of families in B&B accommodation for more than six weeks by 28 per cent.”

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Children continue to shun cigarettes with number of young smokers dropping to record low

Young people are continuing to shun cigarettes, with the number of school pupils in England aged 11 to 15 who say they have ever smoked falling to its lowest rate on record last year, according to a major survey.

NHS Digital questioned more than 13,000 pupils aged 11 to 15 from nearly 200 schools in England about smoking, drinking and drug use for a biennial poll. In total 16 per cent of 11- to 15-year-olds said that they had smoked a cigarette in their lifetime, down from 19 per cent in 2016 and 49 per cent in 1996.

One quarter of pupils (25 per cent) said they had used e-cigarettes, the same as in 2016. Pupils who had smoked a cigarette were much more likely to also have vaped, than those who had not, the research found.

Rosanna O’Connor, director of drugs, alcohol, tobacco and justice at Public Health England said: “These results show again that e-cigarettes are not leading more young people to smoke. As you would expect, some young people experiment but regular vaping among those who have never smoked is very rare…Youth smoking rates are continuing to decline at an encouraging rate”.

Drug use

While cigarette use has continued to decline among young people, drug use has remained nearly as high as in 2016, with one quarter (23.7%) of 11- to 15-year-olds admitting they had taken drugs in their lifetime. In 2014 this figure stood at 14.6%, jumping to 24.3% two years later.

NHS Direct said this sharp rise could be attributed to respondents not answering questions on whether they had tried individual drugs but that “some level of genuine increase [was] evident”.

Nearly one in 10 (nine per cent) of 11 year olds and close to two fifths (38 per cent) of 15-year-olds said they had ever taken drugs.

Nine per cent of all pupils said that they had taken drugs in the past month.

Nearly half have had a drink

The proportion of young people who said they had ever had an alcoholic drink also remained the same as in 2016 at 44 per cent.

Relatively few 11-year-olds reported having a drink (14 per cent), but among 15-year-olds this number leapt to 70 per cent.

Respondents who said they had obtained alcohol in the last four weeks, were most likely to have been given it by their parents or guardians, the survey found.


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British man dies after contracting legionnaires’ disease on holiday in Bulgaria

The family of a British man who died after contracting legionnaires’ disease on holiday in Bulgaria is taking legal action against tour operator Jet2, claiming it has made no effort to help.

John Cowan, 43, from Hamilton in South Lanarkshire, died in June a week after falling ill at the Hotel Kalofer in the country’s Sunny Beach resort alongside several other holidaymakers.

The causes of death listed on his death certificate were septic shock and pneumonia caused by legionella bacteria, which can be inhaled in small droplets of water in the air.

At least one other Briton who was staying at the same hotel is also known to have died since returning home, with another person seriously ill, but neither have so far been named.

‘Short of breath’

Mr Cowan’s mother Marie Cowan, 63, said her son had been feeling unwell when he returned from his holiday and had stayed in bed for most of the following week.

“It wasn’t until he started getting short of breath that we went to the GP,” she added. “As soon as the doctor saw John he realised he needed urgent attention and phoned an ambulance.”

After running emergency tests, staff at University Hospital Wishaw put Mr Cowan on a ventilator after discovering he had pneumonia in one lung, but it later spread to the other one and his kidneys also stopped working.

Mr Cowan's family are taking legal action in an attempt to get answers from Jet2
Mr Cowan’s family are taking legal action in an attempt to get answers from Jet2

During an operation to help him breathe, Mr Cowan went into cardiac arrest and was unresponsive for half an hour, suffering what his mother described as “catastrophic brain damage”.

She added: “We gave permission to turn off the ventilator and give John a dignified passing.”

Legal action

The family has now decided to launch a civil action against Jet2 after being told that other holidaymakers were struck down with the same virus at the hotel.

Mr Cowan’s brother Barry, 41, said: “We are all devastated. We just want answers – to know why this happened, to know it will never happen to anyone else and to know why the tour operator and the hotel have done nothing to help.”

A Jet2 spokeswoman said the tour operator had instructed independent specialists to test water samples from the hotel, but they had come back negative for legionella bacteria.

“Sadly, we can confirm that two customers recently passed away shortly after returning to the UK from holiday in Bulgaria,” she added.

“We would like to offer our heartfelt condolences to their families at this very difficult time, and we have been in constant contact to offer all the assistance and support that we can.

“The health and safety of our customers is our absolute priority. We will continue to assist the local authorities in their investigations as required.”

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Online brain games allow 80-year olds to multitask like players in their 20s

Completing online brain exercises can help elderly people to multitask as effectively as people 50 years their junior, a study has found.

Researchers from the University of California found the majority of highly practiced players of brain training games in their seventies and eighties were able to match of exceed the performance of younger players with little to no experience of the games.

“The brain is not a muscle, but like our bodies, if we work out and train it, we can improve our mental performance,” said lead author Mark Steyvers, a UCI professor of cognitive sciences.

Mark Steyvers, cognitive scientist photo: Steve Zylius/UCI
“The brain is not a muscle, but like our bodies, if we work out and train it, we can improve our mental performance,” says the study’s lead author, Mark Steyvers, a UCI professor of cognitive sciences (Photo: Steve Zylius, UCI)

“We discovered that people in the upper age ranges who completed specific training tasks were able to beef up their brain’s ability to switch between tasks in the game at a level similar to untrained 20- and 30-year-olds.”

The researchers randomly sampled the performance of 1,000 players of a task-switching game called Ebb and Flow, which challenged players to interpret shapes and movement.

Players were selected from two categories: those aged between 21 and 80-years old who had completed fewer than 60 training sessions and adults aged between 71 and 80-years old who had logged a minimum of 80 sessions.

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Any lead the older players established over their younger counterparts swiftly diminished once the 21-30-year old players completed more than 10 practice sessions.

“Medical advances and improved lifestyles are allowing us to live longer,” Mr Steyvers said in the study, published in Proceedings of the National Academy of Sciences.

“It’s important to factor brain health into that equation. We show that with consistent upkeep, cognitive youth can be retained well into our golden years.”

Completing crossword puzzles and reading newspapers have also been credited with helping brains to stay sharp in older age.

Researchers calculate that people who engage in word puzzles have brain function equivalent to 10 years younger than their age, on tests of grammatical reasoning speed and short-term memory accuracy.

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What is Pneumonia? Symptoms, causes and treatment after Maurizio Sarri is diagnosed with the infection

Maurizio Sarri – a former manager of Chelsea – is being treated for pneumonia.

The 60-year-old, now Juventus coach, missed a weekend friendly because of the illness, which was initially thought to be flu.

Further tests diagnosed pneumonia, and the club later confirmed that Sarri’s treatment had begun.

Juventus are scheduled to play their opening Serie A match on Saturday (24 August), though it is not yet known whether Sarri will be well enough to attend.

But what is pneumonia, and how damaging can it be? Here’s everything you need to know:

What is pneumonia?

Pneumonia is an inflammatory condition – usually caused by an infection -which affects small air sacs in the lungs called alveoli.

Risk factors include underlying lung diseases like as asthma, diabetes, heart failure, a history of smoking, a poor ability to cough, or a weak immune system.

What are the symptoms?

Typical symptoms of pneumonia include a dry cough, chest pain, fever, and trouble breathing.

In elderly people, confusion may be the most prominent sign, and in children under five, the most common symptoms are fever, cough, and fast or difficult breathing.

It you are experiencing any of these symptoms, go and see you doctor.

A pneumonia diagnosis is usually attained through an examination of physical signs (such as listening to your chest through a stethoscope), and if your GP is concerned you may have pneumonia, they might send you for an X-ray for confirmation.

What is the treatment?

Senior Doctor is examining An Asian patient with stethoscope
(Photo: Shutterstock)

The underlying cause of the pneumonia affects the way it is treated.

If it is thought the pneumonia has been caused by an infection – which is the most common cause – then treatment is simply through a course of antibiotics, rest and keeping topped up on fluids, similar to how flu would be managed.

However, if you’re more vulnerable, perhaps elderly or with an underlying condition, more advanced care may be required, and hospitalisation may occur particular if symptoms do not improve.

The need for hospitalisation is still relative small though: 7 – 13 per cent of cases in children result in hospitalisation, while 22 – 42 per cent of adults require hospital treatment.

If your pneumonia is particularly nasty, further complications may arise, such as respiratory failure and circulatory problems.

Oxygen therapy may be required to keep blood-oxygen levels optimal (sometimes through nasal tubes), and an intravenous fluid drip may be used to combat poor blood flow or low blood pressure.

Doctor examining chest x-ray film of patient at hospital
(Photo: Shutterstock)

In most cases of pneumonia, symptoms will begin to get better after about 3 – 6 days of rest and recovery, although it may be a few weeks until your symptoms have cleared completely.

In the elderly or people with other lung problems, recovery may take more than 12 weeks.

Mortality rates are generally low at around one per cent, though in those who require hospital treatment, the rate of mortality increases to about 10 per cent.

How can I avoid pneumonia?

Pneumonia vaccinations are available which will help reduce your risk of developing the condition.

If you are a smoker, the most proactive step you can take to avoid this nasty illness is to quit; research shows that smoking in this biggest risk factor in otherwise-healthy adults.

Otherwise, practising good basic hygiene – like washing your hands and coughing into your sleeve – and reducing indoor air pollution from cookers and other household appliances can help reduce your risk.

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‘I kept getting déjà vu and put it down to the stress of studying – but I had a brain tumour that had been growing for years’

Many of us have experienced déjà vu, an overwhelming sense that what you’re currently doing has already happened. The words translate as “already seen” and, according to one expert, 60 to 70 per cent of healthy people experience this transitory mental state.

Neurologist Professor Patrick Y Chauvel also notes that among students, fatigue or stress may cause the phenomenon.

When 21-year-old undergraduate Emeline Gilhooley began experiencing it daily, that’s exactly what she brushed it off as.

The student with her sister Clarisse (Photo: Emeline Gilhooley)
The student with her sister Clarisse (Photo: Emeline Gilhooley)

I put it all down to the stress of reading and studying a lot

Emeline Gilhooley

“I had been getting déjà vu and headaches for several years,” she told i. “I put it all down to the stress of reading and studying a lot.”

But the sensation can also be a symptom of a neurological disorder. After having a large epileptic fit in her sleep last year, Emeline discovered she had a malignant brain tumour, that may have been growing for the previous five to ten years.

‘I thought it was common’

Emeline, from Sheffield, explained: “I’d been getting déjà vu every day. I was in a restaurant with my mum and I had this intense feeling I’d had the conversation I was having with her already.

“I didn’t worry about it though as I thought it was common, which déjà vu is. But now I know it’s not normal to get it that often.”

Her first MRI scan in March 2018 (Photo: Emeline Gilhooley)
Her first MRI scan in March 2018 (Photo: Emeline Gilhooley)

The déjà vu episodes were me having five or six little seizures a week. I had no idea

Emeline Gilhooley

And while headaches associated with brain tumours tend to be severe, persistent and not managed by pain killers, Emeline’s were milder but regular.

“I didn’t worry about them either because they were never that bad and they went away with Ibuprofen,” she said. “Again I just thought they were due to stress.”

Then in February 2018 the University of Leeds student was sharing a bed with a friend who called an ambulance when she had an epileptic attack, and she was taken to hospital where the mass in her brain was discovered.

“The doctors say the epilepsy is likely caused by the tumour. I only had one big fit. The déjà vu episodes were me having five or six little seizures a week. Because I thought fits were always the stereotypical thrashing around on the floor types I had no idea.”

Surgery while awake

Emeline lost her hair during radiotherapy (Photo: Emeline Gilhooley)
Emeline lost her hair during radiotherapy (Photo: Emeline Gilhooley)

Last July, Emeline had life-saving brain surgery to remove the tumour while she was awake, as there was a danger her right side could be paralysed.

“I was put asleep while they opened up my skull, then woken up so they could work on removing the tumour while I moved my right side to check they weren’t causing any damage.

“I was absolutely convinced I could hear my skull being drilled back into place but the surgeons told me it was just the suction to keep my brain dry while they were operating.”

Emeline’s tumour is called an anaplastic astrocytoma. She was told it had been slow growing, but after a biopsy it was categorised as a faster-growing grade 3.

She was also given a six-week course of radiotherapy which made her lose her hair and is three-quarters of the way through a year long chemotherapy treatment, which has caused her nausea and fatigue.

Young ambassador

Emeline took part in a photography exhibition called Behind The Scars (Photo: Sophie Mayanne)

Read more: ‘My stress headaches turned out to be a brain tumour’: Woman, 33, reveals how the time of day she had migraines were a telltale sign

But now she is planning to return to university in September to finish her Sociology and Social Policy degree.

Emeline has also become a young ambassador for the Brain Tumour Charity, and she has taken part in photographer Sophie Mayanne’s Behind The Scars exhibition, which is aiming to end the stigmas around scars. She sailed with the Ellen MacArthur Trust too – all things she says have helped restore her confidence.

“The Brain Tumour Charity events have been fantastic as it meant I could meet other young people who have gone through the same thing. I met a girl who had the same surgery while being awake and she and she talked me through what to expect. Now I hope to do the same for others. Without that it’s easy to feel so alone.”

When déjà vu signals a problem

According to Professor Patrick Y. Chauvel, a neurologist at Cleveland Clinic, déjà vu occurs most often between 15 and 25 and decreases progressively with age.

Experts aren’t quite sure why, but one theory is that as we age, we’re less likely to spot memory mistakes.

Chauvel says that people who are more susceptible to it it are those who are educated, travel, remember their dreams and hold liberal beliefs.

But déjà vu may suggest a neurological problem when it:

  • Occurs frequently (a few times a month or more often versus a few times a year)
  • Is accompanied by abnormal dream-like memories or visual scenes
  • Is followed by loss of consciousness and/or symptoms such as unconscious chewing, fumbling, racing of the heart, or a feeling of fear

If there is any doubt about the cause of déjà vu, it is important to consult a neurologist.

Source: Cleveland Clinic

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Why were Corn Flakes invented? Not to be an anti-masturbatory aid, despite the viral rumour

Corn Flakes were not invented as an anti-masturbatory aid, despite a popular rumour which has surfaced online.

In recent weeks, several memes have appeared on social media suggesting people ask Google: “Why were Corn Flakes invented?”

Search results claim that the popular breakfast cereal was designed to be deliberately bland in order to stave off sexual urges.

But the theory that Corn Flakes were developed to be an “anti-masturbatory morning meal” has turned out to be false.

Who invented Corn Flakes?

J.H. Kellogg, the founder of the eponymous cereal manufacturer, developed Corn Flakes to provide nourishment to patients at the Kellogg sanitarium in Michigan.

As a devout Seventh Day Adventist, Kellogg believed in strict abstention from almost all forms of sexual activity or contact, even among married, heterosexual couples.

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In an 1887 book, Kellogg described masturbation as “self-pollution” and called it “the most dangerous of all sexual abuses”.

Kellogg cited several vices as the causes of masturbation including the consumption of “exciting and irritating food”.

The doctor-entrepreneur advocated “the most simple, pure and unstimulating diet” as a means to preventing oneself from masturbating.

Cornflakes were first invented by John Harvey Kellogg.
John Harvey Kellogg was a strict Seventh Day Adventist who bellieved in abstention from masturbation. (Wikipedia)

Why were they created?

Despite J.H. Kellogg’s apparently extreme religious beliefs, there is no proof that Corn Flakes were created specifically as an anti-masturbatory tool.

It is more likely that the cereal reflect’s Kellogg’s desire to create a healthy breakfast dish.

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Contrary to some reports, Corn Flakes were never advertised as helping people stop masturbating.

Several sources claimed that the inventor initially created them to serve as a “healthy, ready-to-eat anti-masturbatory morning meal”.

According to fact-check website Snopes, however: “The phrase was never used by Kellogg, nor was it ever used to promote or advertise corn flakes.”

In fact, early advertisments from the 1900s promote the cereals as “nutritious and healthful” while telling consumers of their benefits to the digestive system.

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GP leaders hit out at ‘fantasy’ NHS England claims that ending half-day closures could save 280,000 appointments a year

GP leaders have hit out at “fantasy” claims from NHS England that ending half-day closures could save more than 280,000 GP appointments a year. More than 700 surgeries, or a tenth of England’s total number, are currently thought to shut for part of the week, the NHS has said. And the service said a small number of surgeries are opening for just 15 hours per week.

Half-day closures meant more than an estimated one million hours of GP time could have been lost last year, according to health officials. As part of the NHS Long Term plan, practices will have to seek permission from local health authorities to shutter during working hours or risk losing funding worth more than £40,000 per business.

Dr Nikki Kanani, acting director of NHS primary care, said GPs will also be made to create more appointments before 8am and after 6.30pm. She said: “By curbing half day closures we will be freeing up hundreds of thousands of appointments at a time when we know it can sometimes be tricky to see your GP.

“Whilst occasionally practices need to close for training that ensures the up to date skills of family doctors, our changes aim to further reduce regular half day closures and improve the availability of appointments across core hours in the week, supporting the best possible patient access in primary care.”

Less access

However, BMA GP committee chair Dr Richard Vautrey accused NHS England of coming up with “fantasy figures” – warning that forcing practices to offer more appointments during core hours could simply drive down their ability to offer access at evenings and weekends.

He said: “It is disingenuous for NHS England to be so categorical in claiming they know exactly how many more appointments would be available if practices changed their opening arrangements.

“Every GP practice wants to be able deliver the best for their communities in the 21st century but with significant workforce shortages, and a failure of NHS England to invest in much needed premises and IT infrastructure, it has left GPs under greater pressure than ever before.

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“And so instead of coming up with fantasy figures and threatening GPs with reduced funding, NHS leaders must work to address the ongoing recruitment and retention crisis to bring about lasting improvement to patient care and avoid putting overworked doctors under further strain.”

Professor Helen Stokes-Lampard. Royal College of Gps chair, said: “GPs and our teams are working under intense resource and workforce pressures – and it is disingenuous to insinuate that we are in some way shirking our responsibilities to patients.”

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My dad became a celebrity overnight after his heart transplant 40 years ago

The son of the UK’s first “successful” heart transplant patient 40 years ago has spoken about how his father “became a celebrity overnight” after the pioneering operation.

Keith Castle, then a gravely-ill 52-year-old builder from London, lived for more than five years after his surgery at Papworth Hospital, Cambridgeshire, in August 1979. To mark the 40th anniversary of the historic event, Mr Castle’s son, Keith Jnr, met the surgeon who carried out the procedure, Sir Terence English, for the first time on Monday.

Keith Jnr said: “I was 29 when my father had his transplant and I remember that the family were always optimistic and determined it would be a success. Perhaps that was naïve, but the way we saw it was quite simple, really – without the operation dad would have soon died.

“I remember his first words when he came round the following day [19 August 1979] were along the lines of ‘did Fulham win on Saturday?’ Me and my two boys are still Fulham fans to this day.

Keith, pictured here with his wife Doreen, survived for more than 5 years following his heart transplant. He died aged 58 in 1985
Keith, pictured here with his wife Doreen, survived for more than 5 years following his heart transplant. He died aged 58 in 1985 (Photo: Royal Papworth)

“Dad became a celebrity overnight, really. The press were really interested in him and people would always stop us in the street to talk about what happened. He even got a new car and a trip to France funded by newspapers who were so keen on covering his story.”

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Sir Terence, 86, said this week that despite being a poor candidate due to his heavy smoking, Mr Castle turned out to be “a great survivor”. The operation signalled a new era for transplants and Mr Castle became a regular on TV.

“I actually think he did more in the months that followed to publicise the value of heart transplantation than I ever could,” the retired surgeon said. “It’s very hard to say how long Keith’s survival would have been without the transplant, but we are talking about weeks or even days. He had peripheral vascular disease and was very sick. We’d waited a long time for a donor heart to become available for him.”

Terence English at old Royal Papworth Hospital duck pond
Terence English at old Royal Papworth Hospital duck pond (Photo: Royal Papworth)

1979 was also the year the powerful immunosuppressant drug ciclosporin, which helped prevent the immune system rejecting donor organs, had become available. Despite that, Sir Terence said he also struggled to get government support for the procedure.

“Before [Keith Castle’s] operation I’d been met with tremendous criticism about heart transplantation, including a letter from the Department for Health at the end of 1978 saying there would be no funding and the moratorium on heart transplantation would be continuing,” he said. “I thought ‘damn that’ and managed to get approval from the Cambridge Area Health Authority – and we went ahead.”

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Sir Terence carried out a heart transplant on Charles McHugh in January 1979. Unfortunately, he had suffered brain damage while waiting for the organ and died three days after the operation. Mr Castle was Sir Terence’s second heart transplant patient.

“Keith spent 28 days in isolation following the transplant and his success allowed us to generate more funding to ensure the heart transplant programme in the UK could become what it is today,” said Sir Terence.

Surgeons at Papworth have performed about 1,500 heart transplants, including 45 this year. The hospital, now named the Royal Papworth, completed its move to Cambridge earlier this year.

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UK loses measles-free status from WHO after fall in MMR vaccination rates

The UK has lost it’s three year “measles-free” status from the World Health Orgnanisation following a rise in confirmed cases and a fall in the number of children getting the measles, mumps and rubella (MMR) vaccination.

The virus was eliminated in the UK in 2016, but there have now been 231 confirmed cases of measles recorded in the first quarter of 2019, alongside a decline in the number of children getting the second dose of the MMR jab. 

Only 87.2 per cent of children in the UK are getting the second dose of the vaccination, a fall from the 88.6 per cent rate recorded in 2014-15 and well below the 95 per cent needed to ensure full immunity against the illness.

Prime Minister Boris Johnson has ordered urgent action in response to the rise in measles cases, and is calling for health leaders to ensure that 95 per cent of the population have full coverage.

New plans

Uptake for the second dose has gone down, with only 87.2% of children having it last year (Photo: Getty)

The WHO recommends 95 per cent coverage to ensure herd immunity, the form of indirect protection from infectious disease created when enough of the population is vaccinated.

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NHS England will write to all GPs urging them to promote “catch-up” vaccination programmes, and will seek to strengthen the role of local immunisation co-ordinators in a bid to improve uptake.

The Government will also seek to update the advice on the NHS’s website to address misleading information about the dangers of vaccines.

Social media companies will also be called to a summit to discuss how they can promote accurate information about vaccination.

The Department for Health and Social Care will also deliver a strategy to address the issue in the autumn, in which the NHS is expected to be asked to use technology to identify who may have missed a vaccination and make booking appointments easier.

‘Determined to step up’

Prime Minister Boris Johnson has said he is determined to tackle its spread (Photo: Getty)

Ahead of the visit, Mr Johnson said: “After a period of progress where we were once able to declare Britain measles free, we’ve now seen hundreds of cases of measles in the UK this year.

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“One case of this horrible disease is too many, and I am determined to step up our efforts to tackle its spread.

“This is a global challenge and there’s a number of reasons why people don’t get themselves or their children the vaccines they need, but we need decisive action across our health service and society to make sure communities are properly immunised.

“From reassuring parents about the safety of vaccines, to making sure people are attending follow-up appointments, we can and must do more to halt the spread of infectious, treatable diseases in modern-day Britain.”

Eliminate measles ‘for good’

Social media companies will also be called to a summit to discuss how they can promote accurate information about vaccination (Photo: Getty)

The Health Secretary said the new system is committed to eliminating the disease for good.

Health Secretary Matt Hancock added: “It’s easy to forget how devastating measles can be, precisely because vaccines are so effective at preventing it in the first place.

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“With this strategy, the whole health system will come together to renew focus on vaccinations, especially for our children, and this time we will eliminate measles for good.”

Dr Mary Ramsay, head of immunisation at Public Health England, said: “Losing our measles-free status is a stark reminder of how important it is that every eligible person gets vaccinated.

“Measles is one of the most infectious diseases known to man – only one person travelling back to an area with lower vaccination rates can lead to an outbreak.

“Anyone who has not received two doses of MMR vaccine is always at risk.

“Making it as easy as possible for parents to access vaccines so that they can offer their children the best possible start in life is a priority for us, DHSC and for NHS England.

“Through our Value of Vaccines campaign we’ll be using all opportunities to remind people to get two doses of MMR vaccine – whether that’s new parents, school children or younger adults.”

Additional reporting from Press Association.

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Operation Yellowhammer: social care providers ‘will start to go bust’ in a no deal Brexit

The parlous state of social care will be considerably worsened in the event of a no deal Brexit, according to the leaked documents.

Rising costs will hit the sector with “smaller providers impacted within 2-3 months and larger providers 4-6 months after exit”. Experts said the already “fragile” social care system is expected to be tipped over the edge by a no-deal, with providers starting to go bust by the new year.

The publication of a Green Paper on social care has been delayed several times. Originally due to published in “summer 2017”, the latest position is that it will be published “at the earliest opportunity”. However, the Green Paper has now been “ditched” and instead a White Paper – a more authoritative report – will be published in the autumn.

The original rationale for a Green Paper was to explore the issue of how social care is funded by recipients, and a number of policy ideas have reportedly been under consideration for inclusion in the possible Green Paper including: a more generous means-test; a cap on lifetime social care charges; an insurance and contribution model; a Care ISA; and, tax-free withdrawals from pension pots.

Deep concerns

The leaked Yellowhammer document exposes the government’s deep concerns about the impact of a no deal which may have contributed to the delays.

“An increase in inflation following EU exit would significantly impact adult social care providers due to increasing staff and supply costs, and may lead to provider failure, with smaller providers impacted within two-three months and large providers four-six months after exit,” it says.

Recent reports suggest that the government was so concerned about the impact on the sector that it was considering plans to exempt it from new immigration rules to boost the workforce, which is facing an exodus of staff from the EU. Some 104,000 social care staff are from the European Union – almost double the number of EU staff in the NHS.

Vacancies in adult social care are also rising, currently totally 110,000, with around 1 in 10 social worker and 1 in 11 care worker roles unfilled.

Simon Bottery, senior fellow at The King’s Fund charity, said: “Years of underfunding have left adult social care services in England at crisis point. Any reduction in EU social care workers will make this even worse.”

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