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jueves, 28 de agosto de 2014

.@WHO & CDC Interim Guidelines for #Ebola

CDC ebola print resources
This document provides a summary of infection prevention and control (IPC) measures for those providing direct and non-direct care to patients with suspected or confirmed cases of Filovirus haemorrhagic fever (HF), including Ebola or Marburg haemorrhagic fevers, in health-care facilities (HCFs). It also includes some instructions and directions for those managing the implementation of IPC activities. These IPC measures should be applied not only by health-care professionals but by anyone in direct contact with patients (e.g., visitors, family members, volunteers), as well as by those not in contact with patients but potentially exposed the virus through contact with the environment (e.g., c leaners, laundry, house-keepers, security).
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martes, 26 de agosto de 2014

Safe management of wastes from healthcare activities - Second edition

The waste produced in the course of health-care activities, from contaminated needles to radioactive isotopes, carries a greater potential for causing infection and injury than any other type of waste, and inadequate or inappropriate management is likely to have serious public health consequences and deleterious effects on the environment. This handbook – the result of extensive international consultation and collaboration – provides comprehensive guidance on safe, efficient, and environmentally sound methods for the handling and disposal of health-care wastes in normal situations and emergencies. Future issues such as climate change and the changing patterns of diseases and their impacts on health-care waste management are also discussed.
For health-care settings in which resources are severely limited, the handbook pays particular attention to basic processes and technologies that are not only safe, but also affordable, sustainable, and culturally appropriate. The guide is aimed at public health managers and policy-makers, hospital managers, environmental health professionals, and all administrators with an interest in and responsibility for waste management. Its scope is such that it will find application in developing and developed countries alike.
REFERENCIA:
Safe management of wastes from healthcare activities - Second edition
DESCARGA OPCIONAL
Edited by Yves Chartier, Jorge Emmanuel, Ute Pieper,Annette Prüss,
Philip Rushbrook, Ruth Stringer, William Townend,
Susan Wilburn and Raki Zghondi.
© 2014, WHO
ISBN 978 92 4 154856 4
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lunes, 25 de agosto de 2014

viernes, 22 de agosto de 2014

IFBA Certification of Biorisk Management Professionals

DESCARGAR 
Certification Program
Ensuring Quality Biorisk Management 
Through  Certification of Professionals
The International Federation of Biosafety Associations (IFBA) is launching a new certification program for biorisk management and biosafety professionals worldwide. This distinctive program strives to fulfill our mission of “safe, secure and responsible work with biological materials” by advancing the body of knowledge and increasing the competency of our profession. IFBA’s certificants bring increased value to their employers by demonstrating competence to carry out their responsibilities and by achieving high standards of excellence, professionalism, and continuous learning. By earning certifications from the IFBA, individuals reap the benefits of safer workplaces, career advancement, and international recognition among colleagues.
Professional certifications are offered in the following technical disciplines:

  • Biorisk Management (Pre-requisite certification for all others)
  • Biological Waste Management
  • Biocontainment Laboratory Design & Maintenance (coming soon)
  • Laboratory Biosecurity (coming soon)
  • Biological Safety Cabinets (coming soon)

For further information please visit www.internationalbiosafety.org
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jueves, 21 de agosto de 2014

The International #Ebola Emergency

On August 8, 33 weeks into the longest, largest, and most widespread Ebola outbreak on record, the World Health Organization (WHO) declared the epidemic to be a Public Health Emergency of International Concern (PHEIC). This declaration was not made lightly. A PHEIC is an instrument of the International Health Regulations (IHR) — a legally binding agreement made by 196 countries on containment of major international health threats.
The August 8 statement made by WHO Director-General Margaret Chan followed advice from the independent IHR Emergency Committee. Reviewing all the available evidence, the committee concluded that further international spread of Ebola could have serious consequences. Their concern was based on the continuing transmission of Ebola in West African communities and health facilities, the high case fatality rate of Ebola virus disease (EVD), and the weak health services of Guinea, Liberia, Sierra Leone, Nigeria, and other neighboring countries at risk for infection.
REFERENCIA

Briand S. et al. The International Ebola Emergency. NEJM 2014.

lunes, 18 de agosto de 2014

¿Cómo ayudar al control de la epidemia de #ébola?

 Por Klintsy Torres
DESCARGAR POSTER
El virus del ébola es muy contagioso, y el 54% de las personas infectadas en la actual epidemia del ébola han muerto. Los países africanos más afectados son Guinea, Liberia y Sierra Leona. Y a pesar de los esfuerzo, la epidemia no disminuye.
El principal problema es la falta de equipo de protección personal, tan básico como guantes y batas. Muchos trabajadores de la salud ha muerto por falta de equipo de protección, o han cerrado los centros de atención por miedo al virus. Pero también hace mucha falta personal médico entrenado que atienda a los pacientes enfermos, pero también que se dedique a buscar contactos de las personas.
Desafortunadamente, no podremos enviar guantes o mascarillas por correo a la gente que esta haciendo la batalla, pero si podemos ayudar a las organizaciones que día a día trabajan para el control de la epidemia. Apelo a las buenas intenciones de las personas que leen este blog, y que saben que nuestro trabajo es, ha sido y seguirá siendo sin ánimos de lucro.

Crowdfunding para el la atención de pacientes con ébola 
en áreas rurales en Kono, Sierra Leona: 
    Regala una caja de guantes!! Por eso, aquí una lista de las organizaciones, que enviando a su gente, intentan controlar esta epidemia, pero que necesitan fondos para ampliar su ayuda:
  1. Cruz Roja Británica. Está colectando fondos, que van directamente a gastos para el control de la epidemia. Si después de que la emergencia ha terminado, los fondos restantes serán utilizados en otras emergencias humanitarias. 
  2. Médicos Sin Fronteras México y Médecins Sans Frontiers (Internacional). Los fondos son canalizados al fondo global de emergencias, pero que son usados activamente en las emergencias actuales, incluyendo la epidemia de ébola. 
  3. UNICEF. Los donativos, cuando son otorgados como "Where most needed", van al fondo de emergencias, que además reciben fondos del Fondo Central de Respuestas de Emergencias de la ONU. Los donativos directos de México están desactivados, pero pueden hacerlo eligiendo "Otros Países". 
  4. AFRICARE. Apoya directamente a la adquisición de equipo de protección personal (EPP) para los trabajadores de la salud en Liberia. 
  5. DIRECT RELIEF. Apoya directamente con envíos de equipo médico y EPP en Liberia y Sierra Leona. Una de las 20 ONGs más eficientes. Hace entregas en especie. 
  6. WELLBODY ALLIANCE. En colaboración con UCSF están realizando un Crowdfunding para el la atención de pacientes con ébola en áreas rurales en Kono, Sierra Leona. https://crowdfund.ucsf.edu/project/53e4f5e60920655b8211663c
  7. Otras organizaciones que están realizando actividades de apoyo al control de la epidemia incluyen: a) ActionAid (UK); b) Samaritans Purse (Asociación cristiana); c) Medical Teams International (apoyo médico in Liberia), d) Giving Global (Sierra Leona); e) CARE (imprime material informativo en Sierra Leona); 
Como DIRECT RELIEF hace notar, una donación de tan sólo 6 dólares ayudan a comprar algo tan esencial como 1 caja de guantes de látex!
Recomendación: Antes de hacer una donación, hagan un poco de investigación, sobre quien va manejar su dinero, es importante que el dinero se utilice en lo que queremos apoyar. Pueden revisar la seriedad de las ONG´s en BBB y Charity Navigator. Si conocen otras organización que realice trabajos para el control del ébola, envíenme un mensaje para ampliar la lista.


REFERENCIAS:

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Evaluation of mycobactericidal activity of selected chemical disinfectants

BACKGROUND: The history of the investigation of standardized mycobactericidal activity of disinfectants and antiseptics is not very long. There is growing interest among the manufacturers of disinfectants in carrying out research on the antimicrobial activities in accordance with European standards (EN). This research could facilitate the introduction of high-quality disinfectants to the market. The aim of this study was to evaluate the mycobactericidal activity of selected chemical disinfectants and antiseptics used in the medical and veterinary fields.
MATERIAL AND METHODS: This study included 19 products submitted to the National Medicines Institute in Poland for evaluation of mycobactericidal activity. These products contain in their composition active substances belonging to different chemical groups, including aldehydes, alcohols, amines, quaternary ammonium compounds, phenols, guanidine, and oxidizing compounds. This study, conducted according to the manufacturers' description of the preparations, was carried out in accordance with European standards, which also met the Polish standards: PN-EN 14204: 2013, PN-EN 14348: 2006, and PN-EN 14563: 2012.
RESULTS: Tested products for disinfection and antiseptics containing active substances from different chemical groups showed high mycobactericidal activity and met the requirements of the appropriate European standards in most cases. In the case of products containing guanidine and amine compounds, the concentration of active ingredients used in the test and the test conditions specified by the manufacturer did not provide the mycobactericidal activity required by the standards.
CONCLUSIONS: Prior to the launch of a new product on the market, it is important to establish the appropriate usage and testing conditions of the preparation, such as its practical concentration, contact time, and environment condition (clean or dirty).
REFERENCIA
Bocian E, Grzybowska W, Tyski S. Evaluation of mycobactericidal activity of selected chemical disinfectants and antiseptics according to European standards. Med Sci Monit. 2014 Apr 22;20:666-73.
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jueves, 14 de agosto de 2014

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings #ebola


  • GUIDELINE FOR ISOLATION PRECATIONS:

This document is intended for use by infection control staff, healthcare epidemiologists, healthcare administrators, nurses, other healthcare providers, and persons responsible for developing, implementing, and evaluating infection control programs for healthcare settings across the continuum of care. The reader is referred to other guidelines and websites for more detailed information and for recommendations concerning specialized infection control problems.

  • INFECTION PREVENTION AND CONTROL FOR PATIENTS CARE WITH EBOLA:

This document provides a summary of infection control recommendations when providing direct and non-direct care to patients with suspected or confirmed Filovirus haemorrhagic fever (HF), including Ebola or Marburg haemorrhagic fevers. These recommendations are interim and will be updated when additional information becomes available
DOWNLOAD: Interim Infection prevention and control guidance for care of patients with Suspected or Confirmed Filovirus Haemorrhagic fever in health-care settings, with focus on Ebola
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miércoles, 13 de agosto de 2014

Barriers to rapid containment of the #Ebola outbreak

By August 11, 2014, a total of 170 healthcare workers has been infected, 81 have died. 

The outbreak of Ebola virus disease in west Africa continues to evolve in alarming ways, with no immediate end in sight. Many barriers stand in the way of rapid containment.
The Ebola virus is highly contagious, but is not airborne. Transmission requires close contact with the bodily fluids of an infected person, as can occur during health-care procedures, home care, or traditional burial practices, which involve the close contact of family members and friends with bodies. 

ESPAÑOL:

El virus del Ebola es uno de los patógenos más virulentos. El equipo de protección personal es esencial, pero escasea. Además es caliente e incómodo, y limita mucho el número de horas que el personal médico y de enfermería puede trabajar en una planta de aislamiento. Según las estimaciones actuales, un centro en el que se estén tratando 70 pacientes necesitará como mínimo 250 profesionales sanitarios.

Ahora que el brote ha cumplido 6 meses, se comprueba que el miedo es el obstáculo más difícil de vencer. El miedo hace que los contactos de los casos escapen al sistema de vigilancia, que las familias escondan a los parientes con síntomas o los lleven a curanderos tradicionales, y que los pacientes huyan de los centros terapéuticos. El miedo y la hostilidad que este puede alimentar han puesto en peligro la seguridad de los equipos de respuesta nacionales e internacionales.

El personal sanitario teme por sus vidas. Hasta la fecha se han infectado más de 170 profesionales sanitarios y al menos 81 han fallecido.

REFERENCE:
En españolhttp://www.who.int/csr/disease/ebola/overview-august-2014/es/
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lunes, 11 de agosto de 2014

CDC´s #Ebola Virus Disease Information for Clinicians

The Centers for Disease Control and Prevention is working closely with the World Health Organization and other partners to better understand and manage the public health risks posed by Ebola virus disease (EVD). As of August 10, 2014, no EVD cases have occurred in the United States. The purpose of this document is to provide updated information about EVD to clinicians working in U.S. hospitals and health clinics. Includes:
  • Clinical Presentation and Clinical Course
  • Pathogenesis
  • Laboratory Findings
  • Initial evaluation of patients known or suspected to have EVD
  • Treatment
REFERENCE:
Ebola Virus Disease Information for Clinicians in U.S. Healthcare Settings

VEA TAMBIEN:
La OPS/OMS llama a países de las Américas a estar vigilantes y prepararse ante la potencial introducción del virus del Ébola
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Decontamination Efficacy Sporicidal Disinfectants Contaminated with Spores of #anthrax

In the event of a wide area release and contamination of a biological agent in an outdoor environment and to building exteriors, decontamination is likely to consume the Nation's remediation capacity, requiring years to cleanup, and leading to incalculable economic losses. This is in part due to scant body of efficacy data on surface areas larger than those studied in a typical laboratory (5×10-cm), resulting in low confidence for operational considerations in sampling and quantitative measurements of prospective technologies recruited in effective cleanup and restoration response. In addition to well-documented fumigation-based cleanup efforts, agencies responsible for mitigation of contaminated sites are exploring alternative methods for decontamination including combinations of disposal of contaminated items, source reduction by vacuuming, mechanical scrubbing, and low-technology alternatives such as pH-adjusted bleach pressure wash. If proven effective, a pressure wash-based removal of Bacillus anthracis spores from building surfaces with readily available equipment will significantly increase the readiness of Federal agencies to meet the daunting challenge of restoration and cleanup effort following a wide-area biological release. In this inter-agency study, the efficacy of commercial-of-the-shelf sporicidal disinfectants applied using backpack sprayers was evaluated in decontamination of spores on the surfaces of medium-sized (∼1.2 m2) panels of steel, pressure-treated (PT) lumber, and brick veneer. Of the three disinfectants, pH-amended bleach, Peridox, and CASCAD evaluated; CASCAD was found to be the most effective in decontamination of spores from all three panel surface types.
REFERENCE:
Edmonds JM, Sabol JP, Rastogi VK. Decontamination efficacy of three commercial-off-the-shelf (COTS) sporicidal disinfectants on medium-sized panels contaminated with surrogate spores of Bacillus anthracis. PLoS One. 2014 Jun 18;9(6):e99827.

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viernes, 8 de agosto de 2014

Guías y hojas para el manejo del #ébola

A number of guidelines and training tools are available from the WHO and have been posted on the emerging issues resources section of the International Federation of Biosafety Associations (IFBA) website as follows:
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En la página de la Organización Panamericana de la Salud pueden encontrar adicionalmente los siguientes materiales:

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#LIBRO: Science Needs for Microbial Forensics

Microbial forensics is a scientific discipline dedicated to analyzing evidence from a bioterrorism act, biocrime, or inadvertent microorganism or toxin release for attribution purposes. This emerging discipline seeks to offer investigators the tools and techniques to support efforts to identify the source of a biological threat agent and attribute a biothreat act to a particular person or group. Microbial forensics is still in the early stages of development and faces substantial scientific challenges to continue to build capacity.
The unlawful use of biological agents poses substantial dangers to individuals, public health, the environment, the economies of nations, and global peace. It also is likely that scientific, political, and media-based controversy will surround any investigation of the alleged use of a biological agent, and can be expected to affect significantly the role that scientific information or evidence can play. For these reasons, building awareness of and capacity in microbial forensics can assist in our understanding of what may have occurred during a biothreat event, and international collaborations that engage the broader scientific and policy-making communities are likely to strengthen our microbial forensics capabilities. One goal would be to create a shared technical understanding of the possibilities - and limitations - of the scientific bases for microbial forensics analysis.
REFERENCE:
National Research Council. Science Needs for Microbial Forensics: Initial International Research Priorities. Washington, DC: The National Academies Press, 2014.
Free download when register.
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jueves, 7 de agosto de 2014

Evaluation of transmission risks associated with in vivo replication of several high containment pathogens in a biosafety level 4 laboratory #EBOLA

Containment level 4 (CL4) laboratories studying biosafety level 4 viruses are under strict regulations to conduct nonhuman primate (NHP) studies in compliance of both animal welfare and biosafety requirements. NHPs housed in open-barred cages raise concerns about cross-contamination between animals, and accidental exposure of personnel to infectious materials. To address these concerns, two NHP experiments were performed. One examined the simultaneous infection of 6 groups of NHPs with 6 different viruses (Machupo, Junin, Rift Valley Fever, Crimean-Congo Hemorrhagic Fever, Nipah and Hendra viruses). Washing personnel between handling each NHP group, floor to ceiling biobubble with HEPA filter, and plexiglass between cages were employed for partial primary containment. The second experiment employed no primary containment around open barred cages with Ebola virus infected NHPs 0.3 meters from naïve NHPs. Viral antigen-specific ELISAs, qRT-PCR and TCID50 infectious assays were utilized to determine antibody levels and viral loads. No transmission of virus to neighbouring NHPs was observed suggesting limited containment protocols are sufficient for multi-viral CL4 experiments within one room. The results support the concept that Ebola virus infection is self-contained in NHPs infected intramuscularly, at least in the present experimental conditions, and is not transmitted to naïve NHPs via an airborne route.

REFERENCE:
Alimonti J, et al. Evaluation of transmission risks associated with in vivo replication of several high containment pathogens in a biosafety level 4 laboratory. Scientific Reports 4, Article number: 5824.
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miércoles, 6 de agosto de 2014

Transmission of #Ebola virus from pigs to non-human primates

Ebola viruses (EBOV) cause often fatal hemorrhagic fever in several species of simian primates including human. While fruit bats are considered natural reservoir, involvement of other species in EBOV transmission is unclear. In 2009, Reston-EBOV was the first EBOV detected in swine with indicated transmission to humans. In-contact transmission of Zaire-EBOV (ZEBOV) between pigs was demonstrated experimentally. Here we show ZEBOV transmission from pigs to cynomolgus macaques without direct contact. Interestingly, transmission between macaques in similar housing conditions was never observed. Piglets inoculated oro-nasally with ZEBOV were transferred to the room housing macaques in an open inaccessible cage system. All macaques became infected. Infectious virus was detected in oro-nasal swabs of piglets, and in blood, swabs, and tissues of macaques. This is the first report of experimental interspecies virus transmission, with the macaques also used as a human surrogate. Our finding may influence prevention and control measures during EBOV outbreaks.
REFERENCE:
Weingartl HM et al. Transmission of Ebola virus from pigs to non-human primates. Scientific Reports 2 (2012), Article number: 811 doi:10.1038/srep00811
COMMENT ON:
Are we *sure* Ebola isn’t airborne?
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martes, 5 de agosto de 2014

Enfermedad por el virus del #Ebola

Nota descriptiva n.°103. OMS
  • El virus del Ebola causa en el ser humano la enfermedad homónima (antes conocida como fiebre hemorrágica del Ebola).
  • Los brotes de enfermedad por el virus del Ebola (EVE) tienen una tasa de letalidad que puede llegar al 90%.
  • Los brotes de EVE se producen principalmente en aldeas remotas de África central y occidental, cerca de la selva tropical.
  • El virus es transmitido al ser humano por animales salvajes y se propaga en las poblaciones humanas por transmisión de persona a persona.
  • Se considera que los huéspedes naturales del virus son los murciélagos frugívoros de la familia Pteropodidae.
  • No hay tratamiento específico ni vacuna para las personas ni los animales.
Para ver el artículo completo siga el siguiente link
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lunes, 4 de agosto de 2014

International Society for the Advancement of Cytometry Cell Sorter #Biosafety Standards

Flow cytometric cell sorting of biological specimens has become prevalent in basic and clinical research laboratories. These specimens may contain known or unknown infectious agents, necessitating precautions to protect instrument operators and the environment from biohazards arising from the use of sorters. To this end the International Society of Analytical Cytology (ISAC) was proactive in establishing biosafety guidelines in 1997 (Schmid et al., Cytometry 1997;28:99–117) and subsequently published revised biosafety standards for cell sorting of unfixed samples in 2007 (Schmid et al., Cytometry Part A J Int Soc Anal Cytol 2007;71A:414–437). Since their publication, these documents have become recognized worldwide as the standard of practice and safety precautions for laboratories performing cell sorting experiments. However, the field of cytometry has progressed since 2007, and the document requires an update. The new Standards provides guidance: (1) for laboratory design for cell sorter laboratories; (2) for the creation of laboratory or instrument specific Standard Operating Procedures (SOP); and (3) on procedures for the safe operation of cell sorters, including personal protective equipment (PPE) and validation of aerosol containment.
REFERENCE:
Kevin L. Holmes, et al. International Society for the Advancement of Cytometry Cell Sorter Biosafety StandardsCytometry A. 2014 May; 85(5): 434–453. 
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