The Health Protection Agency (HPA) was a non-departmental public body in the United Kingdom. It was an organisation that was set up by the UK government in 2003 to protect the public in England from threats to their health from infectious diseases and environmental hazards. It did this by providing advice and information to the general public, to health professionals such as doctors and nurses, and to national and local government. There were four HPA centres – at Porton Down in Salisbury, Chilton in Didcot, South Mimms in Hertfordshire, and Colindale in NW London. In addition, the HPA had regional laboratories across England and administrative headquarters in Central London.On April 1, 2013, the HPA minus the South Mimms site became part of Public Health England, a new executive agency of the Department of Health (DoH). The National Institute for Biological Standards and Control (NIBSC) located in South Mimms was merged with the Medicines and Healthcare products Regulatory Agency (MHRA).The HPA's role was to provide an integrated approach to protecting public health in the UK by providing emergency services, support and advice to the National Health Service (NHS) and local authorities, other Arms Length Bodies, the Department of Health and the Devolved Administrations. The HPA also had a lead role in helping preparations for new and emerging health threats, such as a bioterrorism or in the event of an emerging virulent disease strain.
Current treatment for pulmonary fibrosis is limited to nintedanib and pirfenidone, which slow but do not halt or reverse the progression of the disease. These treatments are widely used globally. Emerging agents, such as nerandomilast, showed positive results in phase 3 trials and was approved in the US in 2025 for idiopathic pulmonary fibrosis and progressive pulmonary fibrosis, but is not yet licensed for clinical use in the UK. As our understanding of the pathogenesis of pulmonary fibrosis advances, so does the potential to develop treatments that more effectively target underlying mechanisms while being safe and well tolerated. Insights into key pathogenic pathways, including epithelial injury, fibroblast activation, extracellular matrix deposition, B and T cell involvement, and dysregulated cytokine signalling pathways, have enabled various therapeutic targets to be explored. Despite the extensive efforts behind each study, many questions remain unanswered. Negative trials are equally important, in providing insights into how future clinical trials can be better designed and targeted. Meanwhile, positive studies show encouraging results and identify potential treatments, all contributing to the overarching goal of not just slowing, but ultimately reversing, fibrosis.
Background To improve TB surveillance systems in South-East Asia Region countries’ TB control programs, it is vital to understand the existing scenario, assess the gaps and needs through a systematic situation analysis. Here we report an analysis of the existing TB surveillance systems, the challenges faced and the way forward in these countries. Methods A narrative questionnaire collected information regarding the different information systems currently in operation. A focused group discussion to understand each country's system and short communications to clarify aspects or seek missing information was conducted subsequently. Results We studied 21 separate information systems used in National TB programs of seven countries of the South-East Asia Region (Bangladesh, Bhutan, India, Indonesia, Maldives, Nepal, and Sri Lanka). Each country had more than one information system in place. Indonesia and India have more advanced systems, have implemented a life cycle approach and were able to link all major service-related information to one citizen together. It is also inclusive of all forms of TB and across all sectors. Common implementation challenges observed included, increased workload, operational delays, reduced data quality, the need for continuous training and bold decision and policy reform. Conclusion The information systems in SEAR countries are evolving from traditional data entry and reporting systems, towards information systems that enable service delivery, with data capture as a by-product. There is a wealth of experience and a significant scope of collaboration among SEAR countries to define new standards and generate common information.
We aimed to evaluate 12-y (2012-2024) burden, clinical and microbiological characteristics of Invasive Pneumococcal Disease (IPD) at one large research hospital - IRCCS Fondazione Policlinico San Matteo - in northern Italy, with focus on serotypes' distribution, resistance trends, and vaccination impact on outcomes and costs. The study included 234 IPD cases. Data were obtained from medical records, microbiological reports, and vaccination registries. Statistical analyses included descriptive measures, multivariate regression models for risk factors (adjusted for sex, age group, comorbidities), and comparison of length of stay and costs between vaccinated and unvaccinated patients. Most cases occurred in males aged ≥65. Bacteremia with pneumonia was the most frequent presentation (55.6%). Obesity and splenectomy were associated with higher risk of severe outcome. The most common serotypes overall were 3 and 8. Among vaccinated patients serotypes 15A, 14, 19A, and 15C were more frequent. Macrolide resistance was detected in 26.9% of isolates and beta-lactam resistance in 14.9%. Collectively, 34.5% of cases were caused by serotypes preventable with Pneumococcal Conjugate Vaccine 13 (PCV13), an additional 5.1% by PCV15, 21% by PCV20 and 14.4% by V116 preventable serotypes. Vaccine-preventable serotypes accounted for 64% of cases, mostly (56%) in patients aged ≥65. Vaccinated patients reported shorter hospital stay (median 8 vs 16 d) and lower associated costs (€3313 vs €5101). IPD surveillance is critical to inform prevention strategies. Our findings quantify how much vaccination reduces disease severity and healthcare costs but highlight gaps in vaccine coverage against emerging serotypes due to replacement mechanisms.
In a single-center Italian study (2016-2023), we analyzed all children and young people (n = 53) with tuberculosis. All were born to foreign-born parents. Those born in Italy were younger and mainly had pulmonary tuberculosis, whereas those born abroad were more frequently malnourished and vaccinated with Bacillus Calmette-Guerin. These findings highlight the need for targeted screening, nutrition support, and vaccination strategies.
Traumatic brain injury is a common cause of admission in Emergency Department (ED) for pediatric patients. The aim of this study was to evaluate the application of the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) algorithm in ED for head CT decision-making in pediatric patients. The secondary objective was to evaluate the impact of adherence to this protocol on ED crowding, length of stay, and boarding time. We conducted a retrospective study including children aged ≤ 15 years who were admitted in a level 2 trauma center ED for mild TBI from 1 January 2016 to 31 December 2019. Collected data included amnesia, symptoms, demographics, outcomes, length of ED stay, the patient’s outcomes, including intracranial injuries (ICI) and injuries requiring neurosurgery. A total of 1372 children with mild TBI were included. More than half of the patients were male (59.8
