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Bronglais Hospital has welcomed a new Consultant Colorectal Surgeon

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Mr Simone Sebastiani

A NEW consultant colorectal surgeon has been welcomed into a new post at Bronglais Hospital, Aberystwyth, meaning that patients will no longer have to travel long distances to receive operations.

After seeing a job advert for his posting early on in 2020, Mr Sebastiani came to visit the hospital and later joined Hywel Dda University Health Board in January 2021 as part of the clinical team at the Ceredigion hospital.

Mr Sebastiani said: “I was really impressed with the quality of all of the professionals working in Bronglais Hospital. Also, after hearing that the patients had to travel for over an hour in order to have their cancer operations, I felt that I could help them to receive colorectal service locally.”

Maria Battle, Chair at Hywel Dda Health Board said: “It is our pleasure to welcome Mr Sebastiani to the Team at Bronglais. We are delighted he has joined us. This is a big step forward for services in Mid Wales. We are fortunate to have such a strong team and Mr Sebastiani will contribute to providing a more comprehensive and united service.”

Originally from Rome, Italy, Mr Sebastiani studied medicine at the University of La Sapienza in the city where he graduated with full marks in 2008. He then started his surgical training in Rome, rotating between a university and rural hospital.

Through the Italian training programme, which allowed a trainee to spend 18 months abroad, Mr Sebastiani spent six months in Belgium working in one of the biggest centres in Europe for laparoscopic liver resection and liver transplant. In moving to the UK for his final year in training and qualifying in 2015, he became a middle grade in colorectal surgery in Luton and more recently in 2019 he moved to Plymouth for a fellowship in laparoscopic colorectal surgery where he worked as a locum consultant.

“I liked the idea of helping to reinstate the service and I believe there is incredible potential for development here at Bronglais, and I wanted to be part of it.”

Mr Sebastiani moved to Ceredigion county in December 2020 with his wife, also from Rome, who is a nurse also working at Bronglais Hospital.

“We like it here. It is small and quiet, but in a nice way. There is the sea and the mountains, so plenty of things to do and places to go.”

Philip Kloer, Medical Director and Deputy CEO at Hywel Dda Health Board said: “We are delighted to welcome Mr Sebastiani here at Bronglais. We have first class facilities at Bronglais Hospital which are improving all the time and Mr Sebastiani’s knowledge and experience will help us to continue strengthening our acute surgical service for our patients at the hospital.”

For regular updates and roles which may interest you or someone you know, follow the University Health Board: on Facebook and Twitter @HywelDdaJobs and on LinkedIn at: www.linkedin.com/company/hywel-dda-university-health-board, or by visiting: https://hduhb.nhs.wales/jobs/working-for-us/

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Health

Childhood hepatitis outbreak – four more cases in Wales under investigation

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PUBLIC HEALTH WALES is investigating four more cases of acute hepatitis among children.

Health officials have identified 17 cases in Wales, an increase of four cases since the last update on 6 May.

UK Health Security Agency launched an investigation in April after hospitals reported a rise in cases of acute childhood hepatitis with no known cause.

Typically, UK hospitals see about 20 cases a year that are not caused by common hepatitis viruses, but cases this year are nearly 10 times higher.

A number of hypotheses are being investigated and the information gathered so far increasingly suggests that the rise in these cases may be linked to adenovirus infection, with other factors likely to be playing a role.

Dr Ardiana Gjini, Consultant in Communicable Disease Control for Public Health Wales, said:

“Hepatitis can cause jaundice and inflammation of the liver, so parents and carers should be aware of the symptoms of jaundice – including skin with a yellow tinge which is most easily seen in the whites of the eyes.

“We are reminding the public to familiarise themselves with this and other symptoms of hepatitis in light of these UK cases.

“In addition, the importance of maintaining normal hygiene routines, especially ensuring that children wash their hands properly, help to reduce the spread of many common infections.

“Parents and carers are reminded that they should keep their children away from school and seek advice from a GP or an appropriate specialist if their child experiences any symptoms linked with hepatitis.”

Hepatitis symptoms include:

  • dark urine
  • pale, grey-coloured poo
  • itchy skin
  • yellowing of the eyes and skin (jaundice)
  • muscle and joint pain
  • a high temperature
  • feeling and being sick
  • feeling unusually tired all the time
  • loss of appetite
  • tummy pain

Regular updates on the ongoing investigation into the cases in the UK can be found on the UKHSA website.

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Monkeypox Q&A: how do you catch it and what are the risks? An expert explains

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THE LATEST outbreak of monkeypox has, at the time of writing, reached 17 countries with 110 confirmed cases and a further 205 suspected cases. It’s a fast-moving story, so if you need to catch up on the latest, here are answers to some of the most pressing questions.

How is monkeypox spreading?

The first patient in the current outbreak had returned to the UK from travels to Nigeria where monkeypox is endemic. However, cases are now spreading among people who have not travelled to west or central Africa, suggesting local transmission is occurring.

Monkeypox usually spreads by close contact and respiratory droplets. However, sexual transmission (via semen and/or vaginal fluid) has been posited as an additional possible route. The World Health Organization (WHO) says: “Studies are needed to better understand this risk.”

Most cases in the current outbreak have been in youngish men, but the virus can spread to anyone.

There are no confirmed cases in Pembrokeshire at the present time.

What are the symptoms?

Early symptoms are flu-like, such as a fever, headaches, aching muscles and swollen lymph nodes.

Once the fever breaks, a rash can develop, often beginning on the face and then spreading to other parts of the body – most commonly the palms of the hands and soles of the feet.

Monkeypox lesions.
Evolution of monkeypox lesions. UK government/Wikimedia

How deadly is monkeypox?

Monkeypox is mostly a mild, self-limiting disease lasting two-to-three weeks. However, in some cases, it can cause death. According to the WHO, the fatality rate “in recent times” has been around 3% to 6%. The west African monkeypox virus is considered to be milder than the central African one.

Monkeypox tends to cause more serious disease in people who are immunocompromised – such as those undergoing chemotherapy – and children. There have been no deaths from monkeypox in the current worldwide outbreak, but, according to the Daily Telegraph, one child in the UK is in intensive care with the disease.

Why is it called monkeypox?

Monkeypox was first identified in laboratory monkeys (macaques) in Denmark in 1958, hence the name. However, monkeys don’t seem to be the natural hosts of the virus. It is more commonly found in rats, mice and squirrels. The first case in humans was seen in the 1970s in the Democratic Republic of the Congo.

Is monkeypox related to smallpox and chickenpox?

Monkeypox is related to smallpox – they are both orthopoxviruses – but it is not related to chickenpox. Despite the name, chickenpox is a herpes virus, not a poxvirus. (How “chicken” got in the name is not entirely clear. In his dictionary of 1755, Samuel Johnson surmised that it is so named because it is “of no very great danger”.) Nevertheless, the vesicles (little pus-filled blisters) caused by monkeypox are similar in appearance to those of chickenpox.

Are cases likely to continue rising?

Cases are likely to continue to rise significantly over the next two-to-three weeks, but this is not another pandemic in the making. Monkeypox doesn’t spread anywhere near as easily as the airborne virus SARS-CoV-2 that causes COVID-19.

Has monkeypox evolved to be more virulent?

RNA viruses, such as SARS-CoV-2, don’t have the ability to check their genetic code for mistakes each time they replicate, so they tend to evolve faster. Monkeypox is a DNA virus, which does have the ability to check itself for genetic mistakes each time it replicates, so it tends to mutate a lot slower.

The first genome sequence of the current outbreak (from a patient in Portugal) suggests that the virus is very similar to the monkeypox strain that was circulating in 2018 and 2019 in the UK, Singapore and Israel. So it is unlikely that the current outbreak is the result of a mutated virus that is better at spreading.

How is monkeypox diagnosed?

In the UK, swab samples taken from the patient are sent to a specialist laboratory that handles rare pathogens, where a PCR test is run to confirm monkeypox. The UK Health Security Agency has only one rare and imported pathogens laboratory.

Is there a vaccine for it?

Vaccines for smallpox, which contain the lab-made vaccinia virus, can protect against monkeypox. However, the vaccine that was used to eradicate smallpox can have severe side-effects, killing around one in a million people vaccinated.

The only vaccine specifically approved for monkeypox, Imvanex, is made by a company called Bavarian Nordic. It uses a nonreplicating form of vaccinia, which causes fewer side-effects. It was approved by the US Food and Drug Administration and the European Medicines Agency in 2019 – but only for use in people 18 years of age or older.

UK health secretary Sajid Javid said that the UK government will be stocking up on vaccines that are effective against monkeypox. The UK currently has about 5,000 doses of smallpox vaccine, which has an efficacy of around 85% against monkeypox.

Are there drugs to treat it?

There are no specific drugs to treat monkeypox. However, antivirals such as cidofovir and brincidofovir have been proven to be effective against poxviruses in animals and may also be effective against monkeypox infections in humans.

By Ed Feil, Professor of Microbial Evolution at The Milner Centre for Evolution, University of Bath

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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No monkeypox cases identified in Wales say public health officials

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THE UK Health Security Agency (UKHSA) has detected 11 additional cases of monkeypox in England.

The latest cases bring the total number of monkeypox cases confirmed since May 6 to 20.

The new cases come on top of the nine already identified in the country.

There are currently no cases of monkeypox identified in Wales, public health in Wales have said.

Public Health Wales said it is working with the UK Health Security Agency (UKHSA), Public Health Scotland, and Northern Ireland HSC Health Protection Agency to respond to UK cases of monkeypox.

Richard Firth, Consultant in Health Protection for Public Health Wales, said: “We are working closely with our UK partners to monitor and respond to cases of monkeypox in the UK. Monkeypox is a rare disease that has been reported mainly in central and West African countries. No cases have so far been identified in Wales.”

“Monkeypox does not spread easily between people and the overall risk to the general public is very low. It is usually a mild self-limiting illness, and most people recover within a few weeks. However, severe illness can occur in some individuals.”

The first case in the current outbreak was confirmed on May 6.

It is not the first time monkeypox has been reported in the UK.

Three cases were also reported in 2021, two of them in Wales.

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