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Health: Panton-Valentine Leukocidin

Volume 701: debated on Thursday 1 May 2008

asked Her Majesty’s Government:

What action they propose to take to deal with the spread of Panton-Valentine leukocidin in playgrounds and parks.

My Lords, Panton-Valentine leukocidin—PVL—infections are not a specific problem for playgrounds or parks. This is an uncommon infection that has been known about for many years. Like other infections, PVL is controlled by good infection control. However, these infections can be very serious. Health Protection Agency guidance on management of PVL, available since 2006, is currently being updated and new guidance from expert groups in diagnosis and treatment was published in March.

My Lords, I thank the Minister for that reply, but the extensive press coverage on this over the past week indicates that the cases have arisen from playgrounds. There has been so much coverage, including on television, that many parents are anxious about the situation. Can the Minister tell us what information the department has, and what it thinks should be done to allay these anxieties and explain what should be done to protect children?

My Lords, I know that noble Lords may have read about PVL infections in the past few days. However, as I repeat, it is not a new condition; in fact, it was first described in the 1930s. The risk to the general public of becoming infected with PVL is small. Our advice to parents is always to maintain the good practice of appropriate hygiene measures, including proper cleansing and disinfection of cuts and minor wounds. Wounds should be covered with a dressing until healed and individuals should avoid contact with other people’s bandages and lesions. However, parents should not stop their children from going out to play. If the infection spreads or recurs, go to your GP or to an accident and emergency department for further investigation or treatment. The chances of contracting all types of these infections are reduced by maintaining good hand hygiene and not sharing personal items.

My Lords, in view of the recent hysterical response of the press in the run-up to the local elections, I am rather surprised that the Government have not announced that in the next few weeks there will be a deep-clean of all school playgrounds. Perhaps they are more sensible. The pharmaceutical companies are reluctant to invest in research in new antibiotics because the return is bad—antibiotic treatments are very short term. What incentives are being given to pharmaceutical companies to develop new antibiotics for these dangerous, resistant strains of bacteria?

My Lords, that is slightly wide of this Question. I have received no information that pharmaceutical companies are reluctant to continue their excellent research and development work. Indeed, the range of antibiotics available for a whole range of infections increases by the day.

My Lords, does not the Minister recognise that we all have a wide range of organisms on our skin? Indeed, 50 per cent of the population—that includes your Lordships’ House—have candida on them. These bugs become a problem only when the immune system is compromised and when there has been antibiotic overuse, because they become more virulent.

Do the Government recognise that we need to be encouraging children to be exposed to social interaction for their development and because it seems to have a protective effect against developing childhood leukaemia and may even have some protective effect against allergies and so on in the long term?

My Lords, the noble Baroness is absolutely correct. In fact, the doctors who were briefing me on this Question said that I could share with your Lordships' House the fact that 30 per cent of you will have the bacteria that creates this condition. It needs to be said that an infection of PVL normally manifests itself as minor skin infections, boils, carbuncles and abscesses, but occasionally this can become a severe infection. The Health Protection Agency is aware of this and is monitoring the situation most carefully.

My Lords, does the Minister accept that the most important message that should go out from this House on this issue has already been alluded to: it is to the media not to create a crisis out of a fairly normal affair that occasionally ends in a tragedy? Some reports in the media lead one to believe that they really want to put children in a totally fumigated room and throw away the key, whereas most of us are prepared to take the risks that inevitably arise in life and let children have a normal life.

My Lords, my noble friend is correct. The message to parents is, “You must continue to encourage your children to go out, play, get exercise and mix with their friends”.

My Lords, is it not the case that there is some doubt about precisely how the problem arises? Some children have contracted it from falling down and grazing or cutting themselves, whereas one 23 year-old lady contracted it with no knowledgeable links, as she had not fallen down. Does that not indicate that we need to have a little more research into this, and is such research going on?

My Lords, the noble Baroness is quite correct. This is not a new condition, but little is known about its origin and the spread of these particular strains. Infections are rare and most can be treated by antibiotics. Indeed, PVL infections occur in patients who have no previous history of direct or indirect healthcare contact. Research is being undertaken, and I will write to the noble Baroness detailing that.

My Lords, is the Minister aware that on 8 February 2007, I asked a Question on this subject? Is she also aware that it affects not only children, but also the military, people in colleges and people living together in close contact? Is it not the case that it may be being misdiagnosed as leukaemia or pneumonia? The white cells just pack up. Is it not time for statutory reporting?

My Lords, in response to this question and that asked by the noble Baroness, Lady Knight, we are funding a project through the HPA to look at the prevalence of community-associated PVL infections, which are the ones that have been in the news recently. The HPA is looking at technical developments in testing. However, I return to my original Answer which is that a lot of this is to do with hygiene, cleanliness, not touching things we should not touch and issues of that sort which feed into people living in close proximity to each other.

My Lords, does the Minister agree that a child’s best protection from these infections is a strong immune system and vigorous good health, and that those come from a healthy diet, plenty of exercise and plenty of sleep?