The impact of restricting the use of e-cigarettes in public places: a systematic review.

Background: We explored whether restrictions on using e-cigarettes in public places deter smokers from switching to e-cigarettes for harm reduction purposes. Secondary objectives looked at the ability to use e-cigarettes in public places as a reason for use and attitudes towards this among smokers. Methods: Systematic review of the scientific and grey literature. Results: No studies were found for the primary question. Twelve studies estimated the proportion of smokers citing the ability to use e-cigarettes in public places as a reason for use; estimates varied considerably but were typically higher for smokers than never smokers and lower for former than current smokers. Fourteen studies reported attitudes towards restrictions in public places. Smokers were significantly more likely to support the use of e-cigarettes in public places than never smokers and former smokers significantly less likely to support their use than current smokers. Conclusions: There is a gap in the evidence base on whether restrictions on e-cigarettes in public places would deter smokers from switching for harm reduction purposes. The role that restrictions in public places play in smoker's choosing to vape, and the level of support for their use in public, is likely to vary between populations and by smoking status.

Extreme water-related weather events and waterborne disease.

Global climate change is expected to affect the frequency, intensity and duration of extreme water-related weather events such as excessive precipitation, floods, and drought. We conducted a systematic review to examine waterborne outbreaks following such events and explored their distribution between the different types of extreme water-related weather events. Four medical and meteorological databases (Medline, Embase, GeoRef, PubMed) and a global electronic reporting system (ProMED) were searched, from 1910 to 2010. Eighty-seven waterborne outbreaks involving extreme water-related weather events were identified and included, alongside 235 ProMED reports. Heavy rainfall and flooding were the most common events preceding outbreaks associated with extreme weather and were reported in 55·2% and 52·9% of accounts, respectively. The most common pathogens reported in these outbreaks were Vibrio spp. (21·6%) and Leptospira spp. (12·7%). Outbreaks following extreme water-related weather events were often the result of contamination of the drinking-water supply (53·7%). Differences in reporting of outbreaks were seen between the scientific literature and ProMED. Extreme water-related weather events represent a risk to public health in both developed and developing countries, but impact will be disproportionate and likely to compound existing health disparities.

The public health response to the re-emergence of syphilis in Wales, UK.

During the 1990s, cases of infectious syphilis were uncommon in Wales. In 2002, an outbreak occurred in a sexual network of men who have sex with men (MSM) attending a sauna. A multidisciplinary outbreak control team was convened to raise awareness of the outbreak among MSM and health professionals, assess the extent of outbreak, and initiate surveillance measures. It is likely that early intensive control efforts dampened the epidemic curve. However, since 2006 the number of cases has increased steadily to a peak of four cases per 100,000 population in 2008. The majority of cases continue to occur in MSM (81% in 2009) and in those attending genitourinary (GU) medicine clinics in south east Wales (76%). Traditional sexual networks such as saunas, bars/clubs and cruising grounds remain frequently reported, but Internet-based networks are assuming increasing importance. Public health interventions have been sustained, using traditional partner notification, health promotion initiatives, and more innovative Internet network tracing methods.