Immunisation and vaccine-preventable diseases quarterly report
October to December 2024 (Q4)

About this release

Our quarterly update

This release by Public Health Scotland (PHS) provides quarterly information on the following immunisations and vaccine-preventable diseases under surveillance in Scotland:

• Diphtheria
• Invasive Haemophilus influenzae (H.influenzae) disease
• Measles
• Meningococcal disease
• Mumps
• Pertussis
• Invasive pneumococcal disease
• Rotavirus
• Rubella
• Shingles

Next release

The next release of this publication will be 3 June 2025.

Main points

Vaccine-preventable disease

There was an increase in pertussis (whooping cough) case numbers from late 2023, continuing into 2024, and peaking in June 2024. Case numbers in 2024 (n=7,050) were higher than annual case numbers associated with the last significant outbreak of pertussis in Scotland that occurred in 2012 and 2013. Twenty-four measles cases were reported in Scotland in 2024, most of which originated outside Scotland and the UK, reflecting increased measles activity in many countries worldwide.

Pertussis

Pertussis case numbers in Scotland began increasing from late 2023. Laboratory-confirmed cases peaked in June 2024 and have declined since.

There were 7,050 laboratory-confirmed cases in 2024: 1,084 cases in the first quarter and 3,765 cases in the second quarter, 1,890 cases in the third quarter and 311 cases in the fourth quarter. In 2023, there were 73 laboratory-confirmed cases of pertussis, the majority of which (n=56) were reported in the final quarter of the year. Prior to 2024, the last significant outbreak in Scotland occurred in 2012 and 2013, with 1,896 and 1,188 laboratory-confirmed cases per year, respectively. There was also increased pertussis activity in 2016, with 1,075 cases laboratory-confirmed cases that year.

Measles, mumps and rubella

There were 24 laboratory-confirmed measles cases reported in 2024: six cases in the first quarter, eight cases in the second quarter, five cases in the third quarter and five cases in the fourth quarter. Of these 24 cases, 15 are thought to have been imported to Scotland (with four related to travel within the rest of the UK, and 11 related to travel outwith the UK), and with five further (secondary) cases resulting from contact with three of these imported cases. The remaining four cases were of unknown origin with no known epidemiological links to other cases or travel outwith Scotland.  The lack of onward transmission associated with the majority of these cases highlights the success of the MMR vaccination programme, the importance of maintaining high vaccine uptake in Scotland, and reflects the robust public health management of these cases.  

There were twelve cases of laboratory-confirmed mumps reported in 2024: four cases in the first quarter, five cases in the second quarter, one case in the third quarter and two cases in the fourth quarter. There were 16 cases of laboratory-confirmed mumps reported in 2023, seven cases in 2022 and one in 2021. This is a considerable reduction from the 864 cases reported in 2020 and 784 cases reported in 2019.

There have been no reported cases of rubella in Scotland since 2017.

Invasive bacterial diseases

Case numbers for meningococcal disease in 2024 were higher than the number of cases reported for the previous four years, but lower than case numbers for 2019 which is the last pre-COVID-19 pandemic year for which data are presented. Several cases of serogroup W and Y disease were reported in 2024, but most cases continue to be serogroup B disease (n=40). There were 56 cases of meningococcal disease reported in 2024. This compares with 52 cases in 2023, 29 in 2022, 17 in 2021, 33 in 2020, and 59 in 2019. 

Case numbers for invasive pneumococcal disease in 2024 were higher than those reported for the previous four years, but lower than the number of cases reported for the same period in 2019, which is the last full pre-COVID-19 pandemic year for which data are presented. There were 506 cases of invasive pneumococcal disease reported in 2024. This compares with 463 cases in 2023, 373 in 2022, 286 in 2021, 274 in 2020, and 610 in 2019.

Case numbers for invasive Haemophilus influenzae disease in 2024 were lower than the number of cases reported in 2023, but higher than the number of cases reported for 2022, 2021, 2020 and 2019. There were 87 invasive H. influenzae cases reported in 2024. This compares with 102 cases in 2023, 74 cases in 2022, 51 cases in 2021, 51 cases in 2020, and 83 cases in 2019.

Results and commentary

Diphtheria

Background information

Diphtheria is an acute bacterial infection affecting the upper respiratory tract or the skin, caused by toxins from Corynebacterium diphtheriae (C. diphtheriae), Corynebacterium ulcerans (C. ulcerans), and less commonly Corynebacterium pseudotuberculosis (C. pseudotuberculosis).

The most common symptoms of diphtheria affecting the upper respiratory tract are membranous pharyngitis with fever, lymphadenopathy and upper respiratory tract soft tissue swelling 'bull neck' potentially leading to life-threatening airway obstruction. Cutaneous diphtheria may cause pus-filled blisters on legs, hands and feet, and ulceration of the skin.

In unvaccinated or partially vaccinated individuals, systemic absorption of the toxin can lead to late complications such as cardiac and neurological conditions, and sometimes death.

Surveillance update for October to December 2024 (week 52)

Diphtheria is rare in the UK because babies and children have been vaccinated against it since the 1940s. Prior to the introduction of a vaccine, up to 70,000 cases a year were confirmed, causing around 5,000 deaths.

There was one case of toxigenic diphtheria (C.ulcerans) reported in 2024, which occurred in the first quarter of the year. In 2023, there were two unrelated cases of toxigenic diphtheria (both C.ulcerans). Prior to these, the last case of toxigenic diphtheria in Scotland was reported in 2020.

The UK Health Security Agency (UKHSA) reported an increase in cases of toxigenic C. diphtheriae among asylum seekers arriving by small boat to England in 2022 and 2023, with similar increases reported elsewhere in Europe. Several health protection measures were undertaken to prepare for potential cases in Scotland, but none were identified. Further details can be found at Diphtheria: cases among asylum seekers in England, 2022 to January 2024 - GOV.UK (www.gov.uk).

Vaccination Information

More information on vaccines against diphtheria can be found on the following pages:

• 6-in-one vaccine
• 4-in-one vaccine
• 3-in-one vaccine

Vaccine uptake statistics

Vaccine uptake statistics for children are published in Teenage Td/IPV and MenACWY Immunisation Statistics Scotland - school year 2023/2024 and childhood immunisation statistics quarterly report.

Invasive Haemophilus influenzae

Background information

Haemophilus influenzae (H. influenzae) are bacteria commonly carried in the respiratory tract, which can cause acute invasive disease. They are divided into encapsulated and unencapsulated (non-typeable) strains. Encapsulated strains can be classified into six serotypes, from a to f, of which type b (Hib) was most prevalent prior to vaccine introduction. Infection with H. influenzae can cause the following conditions:

• meningitis
• septicaemia
• acute respiratory infections

Less frequent conditions which may be caused by H. influenzae infection include:

• epiglottitis
• osteomyelitis
• septic arthritis

For more information on H. influenzae type b, visit NHS inform.

In 1992, following introduction of the Hib vaccine for young children, the number of invasive H. influenzae type b cases fell dramatically, not only in the vaccinated group, but also in older age groups. The addition of the Hib booster vaccine to the childhood immunisation schedule in 2006, reduced case numbers further.

Due to reduced carriage of the organism within the respiratory tract of vaccinated children, transmission to the wider community was effectively suppressed.

In Scotland, typing is conducted on cases with positive laboratory reports for invasive H. influenzae to monitor national trends in disease subtypes.

Further enhanced surveillance is carried out for all invasive H. influenzae cases identified in children under the age of five, and for invasive H. influenzae cases caused by type b strains across all age groups.

Surveillance update for July to September 2024 (week 39)

There were 26 invasive H. influenzae cases reported in the final quarter of 2024, bringing the total for number of cases in 2024 to 87. This is lower than the number of cases reported in 2023 (n=102), but higher than case numbers reported in 2022, 2021, 2020 and 2019 (n=74, n=51, n=51 and n=83 respectively).

Figure 1 is a series of line graphs showing the cumulative number of Haemophilus influenzae cases reported to Public Health Scotland per week, by year. Each line represents a different year from 2019 to the end of 2024. The number of cases reported in 2024 is lower than the number of cases reported for 2023, but higher than for 2022, 2021, 2020 and 2019.

Close

Figure 1: Cumulative number of laboratory-confirmed Haemophilus influenzae cases in Scotland, 2019 to 2024 (week 52)

Of the 87 cases reported in 2024:

• 32 were people aged over 65 years
• 35 were people aged between 35 and 64 years
• six were people aged between 10 and 34 years
• 10 were children aged between one and four years
• four were infants aged under one year

Figure 2 demonstrates the epidemiological impact of the Hib vaccine, for those aged under five (routinely vaccinated group) and for all ages (including under-fives).

There was a marked decrease in cases from 1992 in all age groups, followed by a rise in case numbers in the early 2000s. Case numbers decreased again following the introduction of the Hib booster vaccine, and figures have remained relatively stable since 2011. See the vaccine-preventable disease summary for the number and incidence of H. influenzae disease in Scotland over the last six years.

Figure 2 is a line graph showing the number of invasive Haemophilus influenzae type b disease cases reported in Scotland from 1988 to the end of 2024. There are two lines on the graph, one representing the under 5 age group and the other, total number of cases (including under 5 years). Following introduction of the Hib vaccine in 1992, cases rapidly decreased to single figures. However, in 2001 a sharp increase was observed, and total number of cases peaked at 31 in 2002, prompting introduction of the Hib booster campaign in June 2003. Cases across all ages subsequently decreased and following introduction of a routine Hib booster in 2006, reached low numbers by 2009. There was one Hib case reported in 2024. The last Hib case before this was reported in 2020. The last Hib case in the under 5 age group was reported in 2015.

Close

Figure 2: Number of laboratory-confirmed Haemophilus influenzae type b disease in Scotland, 1988 to 2024 (week 52)

Figure 3 presents laboratory reports by serotype, since the introduction of the Hib booster campaign in 2003.

Of the 87 isolates reported in 2024:

• one was type b
• two were type a
• two were type e
• three were type f
• 48 were non-typable (i.e. non-encapsulated type)
• typing was not carried out/available for the remaining 31 isolates

The invasive H. influenzae type b case was the first type b to be reported in Scotland since 2020. This was an adult case. The last case of type b in the under 5 age group was in 2015.

Figure 3 is a bar chart showing the laboratory reports of Haemophilus influenzae by type from 2003 to the end of 2024. The chart shows a steady decline in type b infection since introduction of the Hib vaccine in 2003, with a corresponding increase in non-typeable strains. Non-typeable strains are now the most commonly reported type followed by type f, with very few reports of types a, b, d, and e.

Close

Figure 3: Number of laboratory-confirmed invasive Haemophilus influenzae cases in Scotland, by serogroup, 2003 to 2024 (week 52)

Vaccination information

More information on vaccines against invasive Haemophilus influenzae type b can be found on the following pages:

• 6-in-one vaccine
• Hib/MenC vaccine

Vaccine uptake statistics

Vaccine uptake statistics are published in our childhood immunisation statistics quarterly report.

Measles

Background information

Measles is a rash illness resulting from infection with the measles virus. It can affect people of all ages but infants less than one year of age, pregnant women, and those who are immunocompromised are at increased risk of complications and death. Measles is spread through airborne transmission and respiratory droplets and is highly infectious. It is the most infectious of all diseases transmitted through the respiratory route. It is estimated that on average, there will be around 15 to 20 individuals infected from a single case in a totally susceptible population.

Before vaccination, measles was a very common childhood disease in Scotland and deaths attributable to measles were substantial.

Following the introduction of measles vaccine in 1968 and the subsequent introduction of the MMR vaccine in 1988, the incidence of the disease has decreased dramatically.

However, as Figure 4 shows, outbreaks have occurred in recent years. These outbreaks have largely occurred in under-immunised populations.

Figure 4 is a line chart showing the number of laboratory-confirmed cases of measles reported in Scotland by year from 1988 to December 2024 (week 52). The figure shows a sharp increase in the number of measles cases in 1994, when 536 cases were reported. The number of cases decreased to 23 in 1995 and has generally remained low since, with the exception of 2008 (when 54 cases were reported) and 2013 (when 51 cases were reported). There were no cases reported in 2015, 26 cases reported in 2016, 5 cases reported in 2017, and 2 cases reported in 2018. Eighteen cases were reported in 2019, no cases were reported in 2020 or 2021. One case was reported in 2022, and one in 2023. Twenty four cases were reported in 2024. The graph is also annotated with important measles vaccination time points, with the MMR vaccine introduced in 1988, the measles/rubella campaign initiated in 1994, and the second dose of MMR added to the vaccine schedule in 1996.

Close

Figure 4: Number of laboratory-confirmed cases of measles in Scotland by year, 1988 to December 2024 (week 52)

Surveillance update for October to December 2024 (week 52)

There was a total of 24 laboratory-confirmed measles cases reported in Scotland in 2024: six in the first quarter, eight cases in the second quarter, five case in the third quarter and five cases in the fourth quarter.  

In 2024, there were one or more laboratory-confirmed measles cases in the following Board areas: NHS Lothian (n=8), NHS Fife (n=6), NHS Greater Glasgow and Clyde (n=6), NHS Tayside (n=2), NHS Ayrshire and Arran (n=1), and NHS Highland (n=1).

Of these 24 cases, 15 are thought to have been imported to Scotland (with four related to travel within the rest of the UK, and 11 related to travel outwith the UK), and with five further (secondary) cases resulting from contact with three of these imported cases. Of the remaining four cases, three were of unknown origin with no known epidemiological links to other cases or travel outwith Scotland; one further case was related to one of these cases.

There were three known chains of transmission of measles in 2024 in Scotland which resulted in six epidemiologically-linked cases.

The lack of onward transmission associated with most of these cases highlights the success of the MMR vaccination programme, the importance of maintaining high vaccine uptake in Scotland, and reflects the robust public health management of these cases. 

Eleven individuals with laboratory-confirmed measles were completely unvaccinated, seven had unknown vaccination status, and two individuals were partially vaccinated. Four were fully vaccinated (classified as presumptive breakthrough cases) with mild infections and that didn’t lead to any further cases. In highly vaccinated populations such as Scotland, it is rare but possible for individuals who have received two doses of MMR vaccine to develop symptoms following exposure to a measles case. However, symptoms are usually attenuated, and individuals are unlikely to be as infectious.

Of the 24 confirmed measles cases in Scotland in 2024, nine cases were admitted to hospital. There were no deaths associated with measles cases in Scotland in 2024.

Genotyping results were available for 22 out of 24 laboratory-confirmed cases: 10 were B3 genotype, and 12 were D8 genotype. The number of different genotypes of measles virus that are detected globally has been decreasing in recent years. The WHO recognises 24 genotypes of measles virus, but only six genotypes are considered active, and in 2021, only two genotypes were reported globally: B3 and D8.

As shown in Figure 5, the number of cases each year has been variable. See Vaccine-preventable disease summary for the number and incidence of measles in Scotland over the last six years. There was one case of laboratory-confirmed measles reported in 2023, and one in 2022, prior to which there had been no cases since 2019.Weekly updates on measles case numbers in Scotland are currently available on the PHS website.

Figure 5 is a bar chart showing the number of laboratory-confirmed cases of measles reported in Scotland by month and year between 2015 to December 2024 (week 52). The graph shows that the number of measles cases fluctuates each year. In 2016, measles cases were reported throughout the year, with a peak in October. In 2017 and 2018, cases were reported during the spring and summer months. In 2019, cases were reported in February, in May through to August and October. No cases were reported in 2020 or in 2021. One case was reported in 2022, and one in 2023. In 2024, six cases were reported in the first quarter, eight cases in the second quarter, five cases in the third quarter and five cases in the fourth quarter.

Close

Figure 5: Number of laboratory-confirmed cases of measles in Scotland by month and year, 2015 to December 2024 (week 52)

The age distribution of measles cases has varied over recent years, but most cases are observed in children and young adults.

Of the 24 cases reported in 2024:

• one case was in the under 1 year age group
• one case was in the one-to-four-year age group
• five cases were in the five-to-nine-year age group
• two cases were in the 10-to-14-year age group
• one case was in the 15-to-19-year age group
• eight cases were in the 20-to-29-year age group
• six cases were aged 30 years or older

Measles in Europe and the UK

Cases in England rapidly increased from late 2023, most notably in London, followed by a large outbreak in the West Midlands resulting in over 2,900 cases in 2024. Cases have followed a downward trajectory since mid-July 2024. Updates on the epidemiology of measles in England are published by UKHSA with provisional numbers of laboratory-confirmed cases in England updated monthly on the UKHSA measles dashboard.

Many countries in the WHO European Region reported a rise in laboratory-confirmed cases from late 2022 and throughout 2023, with cases remaining high into 2024. In February 2024, WHO Europe issued a press release highlighting the urgency of a swift and concerted response to measles outbreaks in the WHO European Region. In the same month, ECDC released a threat assessment brief on the rise in measles cases in EU/EEA, and considerations for public health response. Both highlight the critical importance of achieving and sustaining high MMR vaccine coverage.

In the most recent 12 months to December 2024 there were a total of 16,510 cases of measles reported to the European Centre for Disease Prevention and Control with a rate of 36.3 reported cases per million population for EU/EEA region (without UK).  The EU/EEA countries with highest reported rates of cases for this period were Romania, Austria, Belgium, Ireland and Cyprus with rates of 631.9, 59.5, 45.2, 39.7 and 29.3 cases per million population, respectively.

Ongoing measles activity in Europe and globally poses a threat to international travellers and Scotland will continue to face an elevated risk of imported cases from other countries and other regions of the UK.

Vaccination information

More information on vaccines against measles can be found on the following page:

• MMR vaccine

Vaccine uptake statistics

Vaccine uptake statistics are published in our childhood immunisation statistics quarterly report.

Meningococcal Disease

Background information

Meningococcal disease is an invasive infection of Neisseria meningitidis (N. meningitidis) bacteria in:

• blood
• cerebrospinal fluid (CSF)
• other normally sterile sites

Meningococcal disease most commonly presents as meningitis (inflammation of the meninges) or septicaemia (blood poisoning). It can also present as a combination of both or as a rarer clinical presentation, such as joint infection. Meningococcal disease is a significant cause of morbidity and mortality.

Although approximately 10% of the population are estimated to carry N. meningitidis in the nasopharynx, the vast majority do not have symptoms or develop invasive disease. Carriage is typically acquired through inhalation of, or direct contact with, respiratory droplets from either an infected person or an asymptomatic carrier. It is not fully understood why invasive disease develops in some individuals but not in others.  

N. meningitidis is classified according to its outer membrane characteristics via a process known as serogrouping. There are several different serogroups, the most common of which in the UK is B, followed by W. Cases of serogroup Y, Z and C disease have also been reported.

In 1999, the Meningococcal Invasive Disease Augmented Surveillance (MIDAS) system was introduced.

The surveillance scheme is managed jointly by Public Health Scotland and the Scottish Haemophilus Legionella Meningococcus and Pneumococcus Reference Laboratory (SHLMPRL).

Surveillance data from MIDAS informs the epidemiology of meningococcal disease in Scotland, as analyses can be conducted according to:

• age
• serogroup
• molecular typing
• clinical presentation
• outcome

Surveillance update for October to December 2024 (week 52)

There were ten cases of meningococcal disease reported in the final quarter of 2024, bringing the total for the year to 56. This is higher than the number of cases reported in the same period of the previous four years (range n=17 to n=52), but lower than for 2019 (n=59), which is the last full pre-COVID-19 pandemic year for which data are presented, as shown in Figure 6.

Figure 6 is a series of line graphs showing the cumulative number of meningococcal cases reported in Scotland per week, by year. Each line represents a different year from 2019 to the end of 2024. The number of cases reported in 2024 is higher than the number of cases reported in the same period of the previous four years, but lower than those reported in 2019.

Close

Figure 6: Cumulative number of meningococcal disease cases in Scotland, 2019 to 2024 (week 52)

Figure 7 shows the number of meningococcal disease cases, according to age group and by quarter from 2001 to the end of 2024 (week 52).

In 2024, there were:

• six cases aged under five years, of whom three were aged under one year
• 25 cases in the five to 24 years age group
• 25 cases in those aged 25 years or over

Figure 7 is a series of line graphs showing the number of meningococcal cases reported in Scotland per quarter, by year. The data covers 2001 to the end of 2024. Each line on the graph represents number of cases for a specific age group, and there is a line for the total number of cases.

Close

Figure 7: Meningococcal disease cases in Scotland by age group and quarter, 2001 to 2024 (week 52)

Of the 56 cases of meningococcal disease reported in 2024:

• 40 were serogroup B
• six were serogroup W
• four were serogroup Y
• one case was non-groupable (un-encapsulated)
• serogrouping was not available for one case
• four cases were based on clinical diagnosis, as shown in Figure 8

Figure 8 is a bar chart showing the number of meningococcal cases reported to MIDAS by serogroup, from 2005 to the end of 2024. Since 2012, serogroup B infections comprise the majority of laboratory confirmed cases. In 2016, laboratory reports of serogroup C infection increased, alongside serogroup W infections.

Close

Figure 8: Meningococcal disease cases reported in Scotland by serogroup, 2005 to 2024 (week 52)

Since 2015 the MenACWY vaccine has been offered to teenagers, and first-time university entrants aged under 25 years old to provide protection against meningococcal disease caused by serogroups A, C, W and Y. This vaccination programme was introduced in response to an increase in severe invasive disease with high rates of intensive care admissions and fatalities among older children and young adults caused by serogroup W infections observed from 2009 in the UK. Figure 9 demonstrates a positive impact of the MenACWY vaccine for the eligible population. Six serogroup W cases were reported in 2024.

Figure 9 is a series of line graphs showing the number of serogroup W cases reported in Scotland from 2009 to the end of 2024, by age group. From 2014 to 2016 there was an increase in serogroup W amongst all age groups with exception of those aged 5 to 14 years.

Close

Figure 9: Meningococcal serogroup W by age group reported in Scotland 2009 to 2024 (week 52)

The number of deaths between 2004 and the end of 2024, reported by serogroup, is shown in Figure 10. There were three deaths from meningococcal disease in 2024, all attributed to serogroup B disease.  

See Vaccine-preventable disease summary for the number and incidence of invasive meningococcal disease in Scotland over the last six years.

Figure 10 is a bar chart showing the number of deaths from meningococcal disease reported in Scotland by serogroup, from 2005 to the end of 2024.

Close

Figure 10: Meningococcal deaths by serotype reported in Scotland 2005 to 2024 (week 52)

Vaccination information

More information on vaccines against meningococcal disease can be found on the following pages:

• MenB vaccine
• Hib/MenC vaccine
• MenACWY vaccine

Vaccine uptake statistics

Vaccine uptake statistics are published in our childhood immunisation statistics quarterly report.

Vaccine uptake statistics for the teenage MenACWY vaccine for school year 2023/2024 can be found at: Teenage Td/IPV and MenACWY Immunisation Statistics Scotland.

Mumps

Background information

Mumps is a disease resulting from infection by the mumps virus.

It was a common childhood disease prior to the introduction of the MMR vaccine in 1988, with more than 85% of adults having evidence of previous infection at that time.

The rate of disease has decreased substantially following the introduction of the vaccine. However, there have been periodic increases in the number of laboratory-confirmed cases in the UK.

Cases of mumps are commonly identified by laboratory testing based on positive PCR or IgM serology. However, many cases of mumps may be diagnosed clinically, with no laboratory confirmation testing, or go undiagnosed since individuals may not present to healthcare. Therefore, the reliance on laboratory reports may represent an underestimate of the true burden of disease in the community.

For more information on mumps, visit NHS Inform.

Surveillance update for October to December (week 52)

There were two cases of laboratory-confirmed mumps reported in the fourth quarter of 2024, bringing the total for 2024 to 12 cases.

Since April 2020, there has been a substantial reduction in number of cases of mumps reported. As shown in Figure 11, outbreaks occurred in:

• 2004/2005
• 2009
• 2012
• 2014 to 2015
• 2019 to early 2020

An increase in laboratory-confirmed mumps was observed in late 2019 and early 2020, primarily in adolescents and young adults. There was a sharp decrease in reported cases from April 2020, a result of measures and restrictions implemented in response to the COVID-19 pandemic, which also interrupted the transmission of mumps.

Figure 11 is a line chart showing the number of laboratory-confirmed cases of mumps by year from 2000 to the end of December 2024 (week 52). The figure shows an outbreak which started in 2004 and peaked in 2005 with 1,892 and 2,586 cases, respectively. While the number of cases decreased since 2005, smaller outbreaks have occurred since in 2009, 2012, 2014 to 2015, and 2019 to early 2020. The graph shows a total of 784 laboratory-confirmed cases of mumps reported in 2019, 864 from January to December 2020, and only one laboratory-confirmed case in 2021. There were 12 cases of laboratory-confirmed cases reported in 2024.

Close

Figure 11: Number of laboratory-confirmed cases of mumps in Scotland by year, 2000 to December 2024 (week 52)

See vaccine preventable disease summary for the number and incidence of mumps in Scotland over the last five years.

Figure 12 is a bar chart showing the number of laboratory-confirmed cases of mumps by month and year from 2015 to December 2024 (week 52). The graph shows recurring peaks in the number of mumps cases reported by month, with the highest peaks occurring in June 2015 (142 cases), November 2017 (122 cases), April 2019 (119 cases) and December 2019 (109). The chart shows a sharp rise in cases at the beginning of 2020; showing 316 cases in January, 343 in February and 194 in March. However, following this the number of cases fell to zero from June to November 2020, with a single case in December 2020. Only one case was reported in 2021, seven cases in 2022 and 16 cases in 2023. There have been twelve cases reported in 2024.

Close

Figure 12: Number of laboratory-confirmed cases of mumps in Scotland by month and year, 2015 to December 2024 (week 52)

Age distribution of cases

Figure 13 shows that most mumps cases in recent years have been in those aged 17 to 34 years. However, in 2024, nine of the 12 cases in the 35 years and over age group.

Although the vaccination status of cases is not routinely collected, this is consistent with the age groups that are likely to be under-immunised with a mumps-containing vaccine.

Figure 13 is a bar chart showing the number of laboratory-confirmed cases of mumps by age group and year from 2015 to December 2024 (week 52). In 2024, most cases have been in the 35 years and over age group. In most previous years, whilst the overall number of cases varies by year, the majority of mumps cases have occurred in individuals aged 17 to 34 years.

Close

Figure 13: Number of laboratory-confirmed cases of mumps in Scotland by age group and year, 2015 to December 2024 (week 52)

The incidence of mumps in 2020, by age group, shown in Figure 14, reflects a higher incidence among individuals aged 17 to 20 years compared to other age groups (130.0 cases per 100,000 population). This was followed by those aged 21 to 24 years (92.2 cases per 100,000 population).

Figure 14 is a bar chart and shows the incidence per 100,000 population of laboratory-confirmed cases of mumps by age group between 01 January and 30 December 2020. The incidence of mumps was highest among individuals aged 17 to 20 years, at 130.0 cases per 100,000 population. This was followed by those aged 21 to 24 years, at 92.2 cases per 100,000 population. Data from 2021 to 2024 are not presented due to the low number/absence of cases.

Close

Figure 14: Incidence of laboratory-confirmed cases of mumps in Scotland, by age group, 2020*

*There is insufficient data from 2021 to 2024 to represent the ages of cases, therefore 2020 data have been presented to reflect the age distribution of cases, which are similar to that seen in previous years.

Vaccination information

More information on vaccines against mumps can be found on the following page:

• MMR vaccine

Vaccine uptake statistics

Vaccine uptake statistics are published in our childhood immunisation statistics quarterly report.

Pertussis

Background information

Pertussis (or whooping cough) is an acute bacterial disease of the respiratory tract, resulting from infection with Bordetella pertussis.

It can affect people of all ages. Unimmunised infants are more likely to develop complications from pertussis infection which can require hospital treatment and, in severe cases, can be fatal. It is often less severe in adolescents and adults, however they may suffer a prolonged cough.

In response to the increase in cases and to protect young infants in the first few weeks of life until starting the routine childhood immunisation programme at eight weeks, a programme was introduced in October 2012 to offer pertussis vaccination to all pregnant women.

Pregnant women are typically vaccinated between gestational weeks 16 and 32 to protect newborn babies from disease before they are old enough to receive their first immunisation at eight weeks. Antibodies that protect against disease, produced by the vaccinated mother, can cross the placenta to protect the baby. Women may still be immunised after week 32 of pregnancy but this may not offer as high a level of passive immunological protection to the baby. Vaccination late in pregnancy may, however, directly protect the mother against disease and thereby reduce the risk of exposure to her infant. As pertussis continues to circulate in Scotland, immunisation of pregnant women and young children is vital.

The immunity that young infants receive from their mother, although very important in the first few weeks of life, offers only short-term protection. Therefore, it is important that infants are vaccinated as part of the routine childhood schedule on time to provide longer-term protection.

For more information on pertussis, visit NHS inform.

Surveillance update for October to December 2024 (week 52)

Scotland experienced a very high number of pertussis cases in 2024. Case numbers increased from late 2023, peaked in June 2024, and subsequently declined (see Figure 15). There were 1,084 laboratory-confirmed cases in the first quarter of 2024, 3,765 cases in the second quarter, 1,890 cases in the third quarter and 311 cases in the fourth quarter. The total number of laboratory-confirmed pertussis cases in 2024 was 7,050. There was one reported death, occurring in quarter two of 2024, in an infant under one year of age who developed pertussis.

In 2023, there were 73 laboratory-confirmed cases, the majority of which (n=56) were reported in the final quarter of the year. Prior to this, the last significant outbreak in Scotland occurred in 2012 and 2013, with 1,896 and 1,188 laboratory-confirmed cases per year, respectively. There was also increased pertussis activity in 2016, with 1,075 cases laboratory-confirmed cases that year.

There was a reduction in laboratory-confirmed pertussis cases over the COVID-19 pandemic period with 198 in 2020, the majority of which occurred in the first quarter of the year, and four and three cases in 2021 and 2022, respectively. Monthly epidemiological reports on pertussis case numbers were published from July to November 2024.

Figure 15 is a bar chart showing the number of laboratory-confirmed Bordetella pertussis cases by month from 2012 through to December 2024 (week 52). The figure shows the outbreak that occurred in 2012 into 2013 with 1,896 and 1,188 reports, respectively, as well as an increase in activity that occurred in 2016 (1,075 reports). From the first quarter of 2020, cases drop to very low numbers with only four cases reported in 2021 and three cases reported in 2022. Pertussis activity has been increasing since late 2023. There were 73 cases reported in 2023, most of which were in the last quarter of the year. In 2024, there were 1,084 laboratory-confirmed cases in the first quarter, 3,765 cases in the second quarter, 1,890 cases in the third quarter and 311 cases in the fourth quarter.

Close

Figure 15: Number of laboratory-confirmed Bordetella pertussis cases in Scotland, by month, 2012 to December 2024 (week 52)

Age breakdown of cases

Figure 16 shows the number of laboratory-confirmed cases of pertussis by age group, from January to December 2024 (week 52). The 10 to 14 years age group accounted for the highest number of cases in 2024 (n=1,215), and 62.7% (4,418) of cases were aged 15 years and over. The highest incidence of infection in 2024 was observed in the under one year age group, as in previous years (2017 to 2023), with 441.6 cases per 100,000 population, as shown in Figure 17. The second highest incidence rate in 2024 was observed in the 10 to 14 years age group with 398.3 cases per 100,000 population.

Figure 18 shows the percentage of cases of pertussis by age group and year from 2012 to 2024 (week 52). Case numbers in 2021 and 2022 were low, and age distribution for those years should be interpreted in that context. Data for 2024 show that the relative proportions of cases in children aged five to nine years and 10 to 14 years are higher than that in recent pre-COVID-19 pandemic years.

Figure 16 is a bar chart showing the number of laboratory-confirmed cases of Bordetella pertussis by age group in 2024. The graph shows that the ten to 14 years age group accounted for the highest number of cases.

Close

Figure 16: Number of laboratory-confirmed Bordetella pertussis cases in Scotland by age group, January to December 2024 (week 52)

Figure 17 is a bar chart showing the incidence of laboratory-confirmed Bordetella pertussis cases per 100,000 population by age groups from under 1 years to over 70 years between 2017 and December 2024 (week 52). Data for 2024 show the highest incidence in the under 1 year age group, with the second highest incidence rate in the ten to 14 years age group.

Close

Figure 17: Incidence of laboratory-confirmed Bordetella pertussis cases per 100,000 population in Scotland by age group, 2017 to December 2024 (week 52)*

*Incidence rates for 2024 use the mid-year population estimates for 2023.

Figure 18 is a stacked bar chart that shows the percentage of laboratory reports of pertussis by age group and year from 2012 through to December 2024 (week 52). The chart shows that in the 2024, children aged ten to 14 years accounted for the largest proportion of cases.

Close

Figure 18: Percentage of laboratory-confirmed cases Bordetella pertussis in Scotland by age group and year, 2012 to December 2024 (week 52)

Laboratory-confirmed cases by NHS Health Board

NHS Greater Glasgow and Clyde, NHS Lothian and NHS Grampian had the greatest number of laboratory-confirmed pertussis cases in 2024, as shown in Figure 19. Data presented in Figure 20 shows that NHS Greater Glasgow and Clyde, NHS Borders, NHS Highland and NHS Grampian were the Health Boards with the highest incidence in 2024, with 174.5, 167.2, 162.6 and 161.6 cases per 100,000 population, respectively.

Figure 19 is a bar chart that shows the number of laboratory reports of Bordetella pertussis in Scotland, by NHS Health Board for 2024. The chart shows that NHS Greater Glasgow and Clyde, NHS Lothian and NHS Grampian had the highest number of cases.

Close

Figure 19: Number of laboratory reports of Bordetella pertussis in Scotland by NHS Health Board, January to December 2024 (week 52)

Figure 20 is a bar chart showing the incidence of laboratory-confirmed pertussis in Scotland by NHS Health Board for 2024. The chart shows that NHS Greater Glasgow and Clyde, NHS Borders, NHS Highland and NHS Grampian had the highest incidence rates in that period.

Close

Figure 20: Incidence of laboratory-confirmed Bordetella pertussis cases in Scotland, by NHS Health Board, January to December 2024 (week 52

There was a difference in incidence by age group, between territorial NHS Boards. Incidence was highest in the under one year age group, compared to other age groups, in seven NHS Boards, and highest in the ten to 14 age group, compared to other age groups, in four NHS Health Boards. Case numbers were too low in the three island Boards to present incidence by age group.

Figure 21 is a bar chart showing the incidence of laboratory-confirmed pertussis in Scotland by NHS Health Board and age group for 2024. Incidence per 100,000 was highest in the under one year age groups, compared to other age groups, in NHS Greater Glasgow and Clyde (649.1), NHS Forth Valley (524.0), NHS Dumfries and Galloway (467.7), NHS Ayrshire and Arran (428.1), NHS Lanarkshire (338.0), NHS Tayside (299.9), and NHS Fife (237.4). Incidence per 100,000 was highest in the ten to 14 age group in NHS Highland (651.3), NHS Borders (615.3), NHS Grampian (600.0), NHS Lothian (565.9). Case numbers were too low in the three island Boards to present incidence by age group.

Close

Figure 21: Incidence of laboratory-confirmed Bordetella pertussis in Scotland by NHS Health Board and age group, January to December 2024 (week 52)

Pertussis in Europe and UK

England also experienced a very high number of laboratory-confirmed cases of pertussis in 2024: provisionally there were 14,905 laboratory-confirmed cases of pertussis reported to the UKHSA between January and December 2024. The number of reported laboratory-confirmed cases peaked in England in May 2024 (3,038).

The European Centre for Disease Prevention and Control (ECDC) published a risk assessment in May 2024 regarding an increase of pertussis cases in the EU/EEA. In 2023, more than 25,000 cases of pertussis were reported, and more than 32,000 cases were reported between January and March 2024. 

Vaccination information

More information on vaccines against pertussis can be found on the following pages:

• Pertussis (maternal)
• 6-in-one vaccine
• 4-in-one vaccine

Vaccine uptake statistics

Childhood vaccine uptake statistics are published in our childhood immunisation statistics quarterly report.   

.

Invasive pneumococcal disease

Background information

Invasive pneumococcal disease (IPD) is caused by infection of normally sterile sites, for example, blood, causing septicaemia, and cerebrospinal fluid (CSF) causing meningitis. Streptococcus pneumoniae (S. pneumoniae) is the bacterium responsible for causing invasive pneumococcal infection and is characterised by its outer coat, known as capsular polysaccharide. Different capsular types can be distinguished by serotyping. Over 90 different types of pneumococci have been identified, about a quarter of which are known to cause serious illness.

IPD is a major cause of morbidity and mortality, especially amongst:

• the very young
• the elderly
• those with impaired immunity.

As with most infectious respiratory diseases, the numbers of cases of pneumococcal infection peak during winter. Up to 50% of people can carry pneumococci in their nose and throat without developing serious infection.

For further information on pneumococcal disease, visit NHS inform.

IPD surveillance is based on local and reference laboratory reports confirming isolation of Streptococcus pneumoniae from sterile body sites, mainly blood and cerebrospinal fluid (CSF).

In 1999, the Scottish Pneumococcal Invasive Disease Enhanced Reporting (SPIDER) scheme was introduced. The enhanced surveillance scheme is jointly managed by Public Health Scotland and the Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory (SHLMPRL).

Data from SPIDER informs understanding of the epidemiology of IPD in Scotland.

Surveillance update October to December 2024 (week 52)

There were 134 cases of IPD reported in the last quarter of 2024, 84 in the third quarter, 121 in the second quarter and 167 in the first quarter, bringing the total for the year to 506. This is higher than the number of cases reported for the previous four years (range n=274 to n=463), but lower than the number of cases reported for 2019 (n=610), as shown in Figure 22, which was the last full pre-COVID-19 pandemic year for which data are presented.

Figure 22 is a series of line graphs showing the cumulative number of invasive pneumococcal disease cases reported to SPIDER per week by year. Each line represents a different year from 2019 to the end of 2024. Across all years there is a steady increase in the cumulative number of cases per week. The graphs show that case numbers for 2024 are higher than those reported for 2020, 2021, 2022 and 2023, but lower than for 2019.

Close

Figure 22: Cumulative number of invasive pneumococcal disease cases reported in Scotland, 2019 to 2024 (week 52)

Figure 23 presents data on cases by age group and indicates that the burden of IPD is in adults over 35 years. In 2024:

• 239 cases were aged 65 years or older (47.2%)
• 198 cases were aged 35 to 64 years (39.1%)
• 23 cases were aged 15 to 34 years (4.5%)
• 14 cases were aged five to 14 years (2.8%)
• 32 cases were aged under five years (6.3%)

Figure 23 is a series of line graphs showing the number of invasive pneumococcal disease cases reported to SPIDER per quarter by year from 2004 to the end of 2024. Each line represents number of cases for each age group. The graphs show that the majority of cases were observed in those aged 35 years and over.

Close

Figure 23: Cases of IPD reported in Scotland by quarter and by age group, 2004 to 2024 (week 52)

IPD in children under five years old

Of the 506 IPD cases reported in 2024, 32 were children under five years of age. This is lower than the number of cases in children aged under five years in 2023 (n=53), 2022 (n=44), 2021 (n=35) and 2019 (n=41), but higher than in 2020 (n=17). Pneumonia was the most common clinical presentation in children aged under five years old. Eight of the 32 children aged under five years who had IPD in 2024 were known to have an underlying condition.

Serotypes detected among children aged under five years in 2024 are shown in Table 1.

*Typing results not available

Circulating serotypes of Streptococcus pneumoniae

Serotyping results were available for 378 of the 506 cases reported in 2024. This accounts for 74.7% of cases reported.  

The four most common serotypes reported were:

• Serotype 8 (50 cases)
• Serotype 3 (38 cases)
• Serotype 22F (34 cases)
• Serotype 9N (33 cases)

​A total of 96 cases, or 25.4% of those with available typing results, were caused by serotypes covered by the PCV13 vaccine.​

For the most recent information on antimicrobial resistance in Streptococcus pneumoniae, see Scottish One Health Antimicrobial Use and Antimicrobial Resistance in 2023.

Vaccination information

More information on vaccines against pneumococcal disease can be found on the following pages:

• PPV23 pneumococcal vaccine
• PCV13 pneumococcal vaccine

Vaccine uptake statistics

Vaccine uptake statistics for PCV13 are published in our childhood immunisation statistics quarterly report. Vaccine uptake statistics for PPV23 are published in the PHS Vaccination Surveillance Dashboard.

Poliomyelitis

Background information

Poliomyelitis (polio) is an acute viral illness caused by one of the three serotypes of poliovirus. Most infections are mild or cause no symptoms but in a small number of people polio can result in a potentially life-threatening infection that can cause temporary or permanent paralysis. Acute flaccid paralysis (AFP) / acute flaccid myelitis (AFM), a rare but serious set of symptoms that affects the nervous system and can be caused by both poliovirus and other non-polio viruses such as enteroviruses. People may become infected with the poliovirus through contact with infected faecal matter or respiratory secretions. For more information on polio see NHS inform.

Poliovirus is targeted by the World Health Organization (WHO) for eradication and due to the efforts of countries worldwide, two of the three wild poliovirus types (type 2 and type 3) have been eradicated. In August 2024, the WHO Emergency Committee on the international spread of poliovirus stated that evidence indicated global transmission of wild poliovirus type 1 was geographically limited to Pakistan and Afghanistan, noting that there had been geographical spread within the two countries in 2023 and 2024. The committee also noted the ongoing risk of vaccine-derived poliovirus (VDPV) transmission. A full list of countries currently reporting circulating VDPD is available from the Polio Global Eradication Initiative.

Towards the end of 2024, vaccine-derived poliovirus type 2 (VDPV-2) was detected in wastewater samples in Finland, Germany, Poland, Spain, and England, see Eurosurveillance | Detection of circulating vaccine-derived poliovirus type 2 (cVDPV2) in wastewater samples: a wake-up call, Finland, Germany, Poland, Spain, the United Kingdom, 2024 and HPR volume 18 issue 11: news (10 December) - GOV.UK. This is separate to the detections of genetically-linked VDPV-2 detected in samples from London sewage works in 2022 (Poliovirus detected in sewage from North and East London - GOV.UK (www.gov.uk)).

There have been no associated cases of paralysis or human infections of poliovirus reported in the UK.

Surveillance

Following the introduction of the first vaccine in the UK in 1956, the number of cases fell rapidly:

• the last UK case of poliomyelitis caused by wild polio virus was in 1984.
• the last imported case of polio in the UK was 1993.

Acute flaccid paralysis (AFP) surveillance

Public Health Scotland conducts enhanced surveillance of AFP.

View further information on AFP and AFP surveillance forms.

Vaccination Information

More information on vaccines against polio can be found on the following pages:

• 6-in-one vaccine
• 4-in-one vaccine
• 3-in-one vaccine

Vaccine uptake statistics

Vaccine uptake statistics for children are published in Teenage Td/IPV and MenACWY Immunisation Statistics Scotland and childhood immunisation statistics quarterly report.

Rotavirus

Background information

Rotavirus infections in children and adults can last approximately three to eight days and symptoms include:

• severe diarrhoea
• vomiting
• stomach cramps
• mild fever

The combination of symptoms can lead to dehydration, requiring admission to hospital, especially in young infants.

Rotavirus is highly infectious and a leading cause of gastroenteritis in children worldwide. In Scotland, most children will have had at least one rotavirus infection by age five years.

Prior to the implementation of the rotavirus vaccination programme in 2013, rotavirus reports peaked annually between February and April.

For further information on gastroenteritis, visit NHS inform.

Surveillance update October to December 2024 (week 52)

Figure 24 shows the number of laboratory-confirmed rotavirus cases in Scotland from 2011 to the end of 2024 (week 52). There were 393 laboratory-confirmed cases in 2024.

Following the introduction of the immunisation programme, there was a marked reduction in the number of laboratory reports, which clearly demonstrates the impact of the vaccine.

See vaccine-preventable disease summary for the number and incidence of rotavirus laboratory reports in Scotland over the last six years.

Figure 24 is a line graph which presents the number of rotavirus laboratory reports in Scotland by month and year from 2011 to December 2024 (week 52). There has been a marked reduction in the number of laboratory reports following introduction of the rotavirus vaccine.

Close

Figure 24: Laboratory reports of rotavirus in Scotland from 2011 to December 2024 (week 52)

More detailed information on the epidemiology of rotavirus in Scotland can be found in the Gastrointestinal and Zoonoses Biennial Report 2022-2023.

Vaccination information

More information on the rotavirus vaccine can be found on the following page:

• rotavirus vaccine

Vaccine uptake statistics

Vaccine uptake statistics are published in our childhood immunisation statistics quarterly report.

Rubella

Background information

Rubella is a rash illness caused by the rubella virus. It's generally a mild illness, but if acquired by women in the first 16 weeks of pregnancy, it can have devastating effects on the unborn child, leading to Congenital Rubella Syndrome (CRS). The virus can affect all foetal organs and lead to serious birth defects such as learning difficulties, cataracts, deafness, cardiac abnormalities, restriction of intrauterine growth and inflammatory lesions of the brain, liver, lungs and bone marrow.

Before the introduction of rubella vaccination, more than 80% of adults had evidence of previous exposure to rubella.

A vaccination programme targeting girls and non-immune women of childbearing age was introduced in the UK in 1970 and reduced the number of congenital rubella syndrome (CRS)-related births and terminations.

 In 1988, the Measles, Mumps and Rubella (MMR) vaccine was introduced for both boys and girls and further decreased cases of rubella to near elimination levels (Figure 25).

In 2016, the decision was made to end the national policy of screening for rubella susceptibility in pregnancy. This followed a review of evidence by the UK National Screening Committee and considered the high levels of uptake of the MMR vaccine.

The WHO confirmed that the UK achieved elimination status for rubella in 2016. Elimination status is assessed on an annual basis.

For more information on rubella see NHS inform.

Surveillance update October to December 2024 (week 52)

No laboratory-confirmed cases of rubella were reported in 2024. The last reported case of laboratory-confirmed rubella in Scotland was reported in 2017.

Figure 25 is a line chart showing the number of laboratory-confirmed cases of rubella reported in Scotland by year from 1988 through to December 2024 (week 52). The figure shows that the number of cases of rubella fluctuated each year between 1988 and 1995. The number of cases peaked in 1996 at 766 but decreased dramatically in 1997 before increasing slightly to 47 cases in 1999. Since 1999, the number of cases has been low and stable. No laboratory-confirmed cases of rubella have been reported in Scotland since 2017, when one case was reported. The graph is also annotated with relevant time points in rubella vaccination, with the MMR vaccine introduced in 1988, the measles/rubella campaign initiated in 1994, and the second dose of MMR added to the vaccine schedule in 1996.

Close

Figure 25: Number of laboratory-confirmed cases of rubella in Scotland by year, 1988 to December 2024 (week 52)

Congenital rubella surveillance

Information about congenital rubella surveillance can be viewed on the Royal College of Paediatrics and Child Health (RCPCH) website.

Vaccination Information

More information on vaccines against rubella can be found on the following page:

• MMR vaccine

Vaccine uptake statistics

Vaccine uptake statistics are published in our childhood immunisation statistics quarterly report.

Shingles

Background information

Shingles, also known as herpes zoster, is caused by reactivation of latent varicella zoster virus. Varicella zoster is the same virus that causes chickenpox.

Shingles is characterised by a painful skin rash. The main complication from shingles is post-herpetic neuralgia (PHN), a long-lasting neuropathic pain after the rash has disappeared.

PHN can persist for months or years and the risk and severity increases with age. Its effect can be very debilitating.

The shingles vaccine can reduce the risk of getting shingles and the risk of complications. Further information about eligibility and getting the shingles vaccine is available on NHS inform and from the Chief Medical Officer for Scotland letter on shingles vaccination. 

Shingles surveillance data

Shingles is not a notifiable disease, so the number of hospital admissions for shingles and related complications are used to estimate the burden of shingles.

Figure 26 shows the rate of admissions per 100,000 population for shingles and related complications by age group between 2010 and 2022.

This graph shows that the rate of admissions is higher among the older age groups, which is why older age groups are offered shingles vaccine.

Figure 26 is a line graph which shows the rate of hospital admissions per 100,000 population for shingles and related complications by age group between 2010 and 2022. This graph shows that the rate of admissions increases with increasing age.

Close

Figure 26 Rate of hospital admissions per 100,000 population for shingles and related complications in Scotland, by age group and year, 2010 to 2022

Vaccination information

More information on shingles vaccination can be found on the following page:

• shingles immunisation

Vaccine uptake statistics

Shingles vaccine uptake statistics are published in the PHS Vaccination Surveillance Dashboard.

Vaccine-preventable disease summary

Contact

General enquiries

If you have an enquiry relating to this publication, please contact Laura MacDonald at phs.immunisation@phs.scot.

Further information

Statistical designation

This is an Official Statistics publication

Public Health Scotland has authority to produce official statistics on any matter in accordance with The Official Statistics (Scotland) Order 2008, The Official Statistics (Scotland) Amendment Order 2019 and the Statistics and Registration Service Act 2007.

All official statistics should comply with the UK Statistics Authority’s Code of Practice which promotes the production and dissemination of official statistics that inform decision making. They can be formally assessed by the UK Statistics Authority’s regulatory arm for Accredited official statistics status.

Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to. You are welcome to contact us directly with any comments about how we meet these standards.

Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or through the OSR website.

Visit the UK Statistics Authority website for more information about the Code of Practice and Official Statistics.

Visit our website for further information about our statistics and PHS as an Official Statistics producer.

Pre-release access

Under terms of the "Pre-Release Access to Official Statistics (Scotland) Order 2008", PHS is obliged to publish information on those receiving Pre-Release Access ("Pre-Release Access" refers to statistics in their final form prior to publication). The standard maximum Pre-Release Access is five working days.

Shown below are details of those receiving standard Pre-Release Access.

Standard pre-release access:

• Scottish Government Health Department
• NHS Board Chief Executives
• NHS Board Communication leads

About Public Health Scotland (PHS)

PHS is a knowledge-based and intelligence driven organisation with a critical reliance on data and information to enable it to be an independent voice for the public’s health, leading collaboratively and effectively across the Scottish public health system, accountable at local and national levels, and providing leadership and focus for achieving better health and wellbeing outcomes for the population. Our statistics comply with the Code of Practice for Statistics in terms of trustworthiness, high quality and public value. This also means that we keep data secure at all stages, through collection, processing, analysis and output production, and adhere to the Office for National Statistics ‘Five Safes’ of data privacy.​

Metadata

The metadata for this document has been split into sections as there are some differences between the diseases.