A cluster randomised trial of cloth masks compared with medical masks

Cloth mask, Aliexpress.com
Objective
The aim of this study was to compare the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs). The null hypothesis is that there is no difference between medical masks and cloth masks.
Setting
14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam.
Participants
1607 hospital HCWs aged ≥18 years working full-time in selected high-risk wards.
Intervention
Hospital wards were randomised to: medical masks, cloth masks or a control group (usual practice, which included mask wearing). Participants used the mask on every shift for 4 consecutive weeks.
Main outcome measure
Clinical respiratory illness (CRI), influenza-like illness (ILI) and laboratory-confirmed respiratory virus infection.
Results
The rates of all infection outcomes were highest in the cloth mask arm, with the rate of ILI statistically significantly higher in the cloth mask arm (relative risk (RR)=13.00, 95% CI 1.69 to 100.07) compared with the medical mask arm. Cloth masks also had significantly higher rates of ILI compared with the control arm. An analysis by mask use showed ILI (RR=6.64, 95% CI 1.45 to 28.65) and laboratory-confirmed virus (RR=1.72, 95% CI 1.01 to 2.94) were significantly higher in the cloth masks group compared with the medical masks group. Penetration of cloth masks by particles was almost 97% and medical masks 44%.
Conclusions
This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.
Trial registration number
Australian New Zealand Clinical Trials Registry: ACTRN12610000887077.
Keywords: Influenza, Cloth mask

REFERENCE:
MacIntyre, C Raina et al. “A Cluster Randomised Trial of Cloth Masks Compared with Medical Masks in Healthcare Workers.” BMJ Open 5.4 (2015): e006577. PMC. Web. 22 Oct. 2015.

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Laboratory-Acquired #Dengue Virus Infection—A Case Report #LAIs

The WHO estimates there may be 50 million dengue virus (DENV) infections worldwide every year, with the disease being endemic in more than 100 countries [1]. There has been a dramatic rise in the incidence of dengue in recent decades, making this an arbovirus of major international public health concern. Dengue viruses belong to the family Flaviviridae and are transmitted between humans via infected female Aedes mosquitoes, particularly Aedes aegypti. In the state of Queensland, Australia, infected travellers from overseas have facilitated numerous DENV outbreaks [2], [3]. However, these outbreaks are limited to the far north of the state, the only area of Australia where Ae. aegypti occurs [4]. There have been case reports of non-vector, healthcare-associated transmission of DENVs—four cases of percutaneous transmission via needlestick injuries, mucocutaneous transmission through a blood splash to the face, vertical transmission, and transmission via bone marrow transplant (summarised in [5]). We report the first case to our knowledge of DENV infection acquired by a laboratory scientist conducting mosquito infection and transmission experiments.

REFERENCE:
Britton, Sumudu et al. “Laboratory-Acquired Dengue Virus Infection—A Case Report.” Ed. Maria G. Guzman. PLoS Neglected Tropical Diseases 5.11 (2011): e1324. PMC. Web. 3 Sept. 2015.

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MERS-CoV Outbreak in the Republic of Korea, 2015

philstar.com
Objectives: The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea started from the index case who developed fever after returning from the Middle East. He infected 26 cases in Hospital C, and consecutive nosocomial transmission proceeded throughout the nation. We provide an epidemiologic description of the outbreak, as of July 2015.
Methods: Epidemiological research was performed by direct interview of the confirmed patients and reviewing medical records. We also analyzed the incubation period, serial interval, the characteristics of superspreaders, and factors associated with mortality. Full genome sequence was obtained from sputum specimens of the index patient.
Results: A total of 186 confirmed patients with MERS-CoV infection across 16 hospitals were identified in the Republic of Korea. Some 44.1% of the cases were patients exposed in hospitals, 32.8% were caregivers, and 13.4% were healthcare personnel. The most common presenting symptom was fever and chills. The estimated incu bation period was 6.83 days and the serial interval was 12.5 days. A total of 83.2% of the transmission events were epidemiologically linked to five superspreaders, all of whom had pneumonia at presentation and contacted hundreds of people. Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90e12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64 e14.65) were significantly associated with mortality. Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus
from Riyadh, Saudi Arabia.
Conclusion: A single imported MERS-CoV infection case imposed a huge threat to public health and safety. This highlights the importance of robust preparedness and optimal infection prevention control. The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.

REFERENCE:
Korea Centers for Disease Control and Prevention. “Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015.” Osong Public Health and Research Perspectives 6.4 (2015): 269–278. PMC. Web. 22 Oct. 2015.

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Accidental Infection of Laboratory Worker with Vaccinia #LAIs

We report the accidental needlestick inoculation of a laboratory worker with vaccinia virus. Although the patient had previously been vaccinated against smallpox, severe lesions appeared on the fingers. Western blot and polymerase chain reaction–restriction fragment length polymorphism were used to analyze the virus recovered from the lesions. The vaccinia virus–specific immunoglobulin G levels were measured by enzyme-linked immunosorbent assay. Our study supports the need for vaccination for laboratory workers that routinely handle orthopoxvirus.

REFERENCE:
Moussatché, Nissin et al. “Accidental Infection of Laboratory Worker with Vaccinia.” Emerging Infectious Diseases 9.6 (2003): 724–726. PMC. Web. 11 Sept. 2015.
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NSF/ANSI Standard 49 Certification Testing of Biosafety Cabinets

NSF International maintains NSF/ANSI Standard 49 Class II (laminar flow) biosafety cabinetry and also certifies that biosafety cabinets conform to the requirements of the standard. More than 20 tests are required during initial qualification testing; of these, the biological challenge tests are the most critical to ensuring that the model tested will provide personnel, product, and cross contamination protection.

REFERENCE:
Maren H. Roush and Stephen C. Williams. NSF/ANSI Standard 49 Certification Testing of Biosafety Cabinets. JALA 2009;14:171–3

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Freedom and Responsibility in Synthetic Genomics: The Synthetic Yeast Project

First introduced in 2011, the Synthetic Yeast Genome (Sc2.0) Project is a large international synthetic genomics project that will culminate in the first eukaryotic cell (Saccharomyces cerevisiae) with a fully synthetic genome. With collaborators from across the globe and from a range of institutions spanning from do-it-yourself biology (DIYbio) to commercial enterprises, it is important that all scientists working on this project are cognizant of the ethical and policy issues associated with this field of research and operate under a common set of principles. In this commentary, we survey the current ethics and regulatory landscape of synthetic biology and present the Sc2.0 Statement of Ethics and Governance to which all members of the project adhere. This statement focuses on four aspects of the Sc2.0 Project: societal benefit, intellectual property, safety, and self-governance. We propose that such project-level agreements are an important, valuable, and flexible model of self-regulation for similar global, large-scale synthetic biology projects in order to maximize the benefits and minimize potential harms.

REFERENCE:
Sliva, Anna et al. “Freedom and Responsibility in Synthetic Genomics: The Synthetic Yeast Project.” Genetics 200.4 (2015): 1021–1028. PMC. Web. 24 Sept. 2015.

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The Hidden Geometry of Complex, Network-Driven Contagion Phenomena

The global spread of epidemics, rumors, opinions, and innovations are complex, network-driven dynamic processes. The combined multiscale nature and intrinsic heterogeneity of the underlying networks make it difficult to develop an intuitive understanding of these processes, to distinguish relevant from peripheral factors, to predict their time course, and to locate their origin. However, we show that complex spatiotemporal patterns can be reduced to surprisingly simple, homogeneous wave propagation patterns, if conventional geographic distance is replaced by a probabilistically motivated effective distance. In the context of global, air-traffic–mediated epidemics, we show that effective distance reliably predicts disease arrival times. Even if epidemiological parameters are unknown, the method can still deliver relative arrival times. The approach can also identify the spatial origin of spreading processes and successfully be applied to data of the worldwide 2009 H1N1 influenza pandemic and 2003 SARS epidemic.

REFERENCE:
Brockmann D, Helbing D. The hidden geometry of complex, network-driven contagion phenomena. Science. 2013 Dec 13;342(6164):1337-42.
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NOM-018-STPS-2015, Sistema armonizado para la identificación y comunicación de peligros y riesgos por sustancias químicas peligrosas en los centros de trabajo.

1. Objetivo
Establecer los requisitos para disponer en los centros de trabajo del sistema armonizado de identificación y comunicación de peligros y riesgos por sustancias químicas peligrosas, a fin de prevenir daños a los trabajadores y al personal que actúa en caso de emergencia.
2. Campo de aplicación
La presente Norma Oficial Mexicana rige en todo el territorio nacional y aplica a todos los centros de trabajo donde se manejen sustancias químicas peligrosas. No aplica a productos terminados tales como: farmacéuticos, aditivos alimenticios, artículos cosméticos, residuos de plaguicidas en los alimentos y residuos peligrosos.

REFERENCIA:
Diario Oficial de la Federación, Octubre 09, 2015. Tercera Sección. NOM-018-STPS-2015, Sistema armonizado para la identificación y comunicación de peligros y riesgos por sustancias químicas peligrosas en los centros de trabajo.
DESCARGAR

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PODCAST: #Nobel Prize in Physiology or Medicine 2015


The Nobel Assembly at Karolinska Institutet has today decided to award the 2015 Nobel Prize in Physiology or Medicine with one half jointly to William C. Campbell and Satoshi Ōmura
for their discoveries concerning a novel therapy against infections caused by roundworm parasites and the other half to Youyou Tu for her discoveries concerning a novel therapy against Malaria
Diseases caused by parasites have plagued humankind for millennia and constitute a major global health problem. In particular, parasitic diseases affect the world''s poorest populations and represent a huge barrier to improving human health and wellbeing. This year''s Nobel Laureates have developed therapies that have revolutionized the treatment of some of the most devastating parasitic diseases.
William C. Campbell and Satoshi Ōmura discovered a new drug, Avermectin, the derivatives of which have radically lowered the incidence of River Blindness and Lymphatic Filariasis, as well as showing efficacy against an expanding number of other parasitic diseases. Youyou Tu discovered Artemisinin, a drug that has significantly reduced the mortality rates for patients suffering from Malaria.
These two discoveries have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually. The consequences in terms of improved human health and reduced suffering are immeasurable.
Please visite http://www.nobelprize.org/ for more information, and view the complete press release on the following link







REFERENCE:
"The Nobel Prize in Physiology or Medicine 2015". Nobelprize.org. Nobel Media AB 2014. Web. 5 Oct 2015. <http://www.nobelprize.org/nobel_prizes/medicine/laureates/2015/>

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Quaternary Ammonium Biocides: Efficacy in Application

Quaternary ammonium compounds (QACs) are among the most commonly used disinfectants. There has been concern that their widespread use will lead to the development of resistant organisms, and it has been suggested that limits should be place on their use. While increases in tolerance to QACs have been observed, there is no clear evidence to support the development of resistance to QACs. Since efflux pumps are believe to account for at least some of the increased tolerance found in bacteria, there has been concern that this will enhance the resistance of bacteria to certain antibiotics. QACs are membrane-active agents interacting with the cytoplasmic membrane of bacteria and lipids of viruses. The wide variety of chemical structures possible has seen an evolution in their effectiveness and expansion of applications over the last century, including non-lipid-containing viruses (i.e., noroviruses). Selection of formulations and methods of application have been shown to affect the efficacy of QACs. While numerous laboratory studies on the efficacy of QACs are available, relatively few studies have been conducted to assess their efficacy in practice. Better standardized tests for assessing and defining the differences between increases in tolerance versus resistance are needed. The ecological dynamics of microbial communities where QACs are a main line of defense against exposure to pathogens need to be better understood in terms of sublethal doses and antibiotic resistance.

REFERENCE:
Gerba, Charles P. “Quaternary Ammonium Biocides: Efficacy in Application.” Ed. V. Müller. Applied and Environmental Microbiology 81.2 (2015): 464–469. PMC. Web. 9 July 2015.

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Biological Risks and Laboratory-Acquired Infections: A Reality That Cannot be Ignored in Health Biotechnology #LAIs

Advances and research in biotechnology have applications over a wide range of areas, such as microbiology, medicine, the food industry, agriculture, genetically modified organisms, and nanotechnology, among others. However, research with pathogenic agents, such as virus, parasites, fungi, rickettsia, bacterial microorganisms, or genetic modified organisms, has generated concern because of their potential biological risk – not only for people, but also for the environment due to their unpredictable behavior. In addition, concern for biosafety is associated with the emergence of new diseases or re-emergence of diseases that were already under control. Biotechnology laboratories require biosafety measures designed to protect their staff, the population, and the environment, which may be exposed to hazardous organisms and materials. Laboratory staff training and education is essential, not only to acquire a good understanding about the direct handling of hazardous biological agents but also knowledge of the epidemiology, pathogenicity, and human susceptibility to the biological materials used in research. Biological risk can be reduced and controlled by the correct application of internationally recognized procedures such as proper microbiological techniques, proper containment apparatus, adequate facilities, protective barriers, and special training and education of laboratory workers. To avoid occupational infections, knowledge about standardized microbiological procedures and techniques and the use of containment devices, facilities, and protective barriers is necessary. Training and education about the epidemiology, pathogenicity, and biohazards of the microorganisms involved may prevent or decrease the risk. In this way, the scientific community may benefit from the lessons learned in the past to anticipate future problems. Keywords: biological risks, biosafety, biotechnology, laboratory-acquired infections, health.

REFERENCE:
Coelho, Ana Cláudia, and Juan García Díez. “Biological Risks and Laboratory-Acquired Infections: A Reality That Cannot Be Ignored in Health Biotechnology.” Frontiers in Bioengineering and Biotechnology 3 (2015): 56. PMC. Web. 21 Aug. 2015.
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