#HISTORY: The Spanish royal philanthropic expedition to bring #smallpox vaccination to the New World, XIX Century

The New World was ravaged by smallpox for several centuries after the Spanish conquest. Jenner's discovery of the smallpox vaccine made possible the prevention and control of smallpox epidemics. In response to a large outbreak of smallpox in the Spanish colonies, King Charles IV appointed Francisco Xavier de Balmis to lead an expedition that would introduce Jenner's vaccine to these colonies. During the journey, the vaccine was kept viable by passing it from arm to arm in orphaned children, who were brought along expressly for that purpose and remained under the care of the orphanage's director. This expedition was the first large scale mass vaccination of its kind. The historic legacy of this pioneering event in international health should be revisited in the current era of persistent inequalities in global health.

>> VER PELÍCULA (antes del 27DIC2016) <<

REFERENCIA:
Franco-Paredes C, Lammoglia L, Santos-Preciado JI. The Spanish royal philanthropic expedition to bring smallpox vaccination to the New World and Asia  in the 19th century. Clin Infect Dis. 2005 Nov 1;41(9):1285-9.
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Use of transgenic Aedes aegypti in Brazil: risk perception and assessment.

Este artículo se encuentra en ESPAÑOL / This article is translated in multi languages
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The OX513A strain of Aedes aegypti, which was developed by the British company Oxitec, expresses a self-limiting transgene that prevents larvae from developing to adulthood. In April 2014, the Brazilian National Technical Commission on Biosafety completed a risk assessment of OX513A and concluded that the strain did not present new biological risks to humans or the environment and could be released in Brazil. At that point, Brazil became the first country to approve the unconstrained release of a genetically modified mosquito. During the assessment, the commission produced a comprehensive list of - and systematically analysed - the perceived hazards. Such hazards included the potential survival to adulthood of immature stages carrying the transgene - should the transgene fail to be expressed or be turned off by exposure to sufficient environmental tetracycline. Other perceived hazards included the potential allergenicity and/or toxicity of the proteins expressed by the gene, the potential for gene flow or increased transmission of human pathogens and the occupation of vacant breeding sites by other vector species. The Zika epidemic both elevated the perceived importance of Ae. aegypti as a vector - among policy-makers and regulators as well as the general public - and increased concerns over the release of males of the OX513A strain. We have therefore reassessed the potential hazards. We found that release of the transgenic mosquitoes would still be both safe and of great potential value in the control of diseases spread by Ae. aegypti, such as chikungunya, dengue and Zika.
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Uso de Aedes aegypti transgénicos en Brasil: percepción y evaluación de riesgos
La cepa OX513A de Aedes aegypti, que desarrolló la empresa británica Oxitec, expresa un transgén autolimitado que impide que las larvas se desarrollen hasta la edad adulta. En abril de 2014, la Comisión Nacional Técnica de Bioseguridad de Brasil realizó una evaluación de riesgos de OX513A y concluyó que la cepa no presentaba nuevos riesgos biológicos para los humanos o el medioambiente y que podría liberarse en Brasil. En ese momento, Brasil se convirtió en el primer país en aprobar la liberación ilimitada de un mosquito modificado genéticamente. A lo largo de la evaluación, la comisión redactó una lista completa, y analizada sistemáticamente, de las posibles contingencias. Entre dichos peligros se encontraba la posible supervivencia hasta la edad adulta de etapas inmaduras que portan el transgén, en caso de que éste no consiga expresarse o se inutilice debido a la exposición a la suficiente tetraciclina medioambiental. Otras posibles contingencias eran la alergia y/o toxicidad de las proteínas expresadas por el gen, la posibilidad de un flujo genético o el aumento de la transmisión de patógenos humanos y la ocupación de lugares de cría desocupados por parte de otras especies vectores. La epidemia por el virus de Zika aumentó la importancia de Ae. aegypti como vector, entre los responsables y reguladores políticos, así como entre el público general, y aumentó las preocupaciones acerca de la liberación de machos de la cepa OX513A. Por lo tanto, se han vuelto a evaluar los posibles riesgos. Se ha descubierto que la liberación de mosquitos transgénicos sería segura y tendría un gran valor potencial en el control de la propagación de enfermedades por Ae. aegypti, como la fiebre chikungunya, el dengue y la enfermedad por el virus de Zika.
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REFERENCE:
Paes de Andrade P, et al. Use of transgenic Aedes aegypti in Brazil: risk perception and assessment. Bull World Health Organ. 2016 Oct 1;94(10):766-771.
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Película completa "22 angeles" online, por RTVE. Hasta Dic 27, 2016. #viruela

Ya pueden verla en línea. Disponible hasta el 27 de diciembre de 2016.
Gran historia basada en hechos reales: la expedición encabezada por el doctor Francisco Javier Balmis que llevó la vacuna de la viruela a las Américas a comienzos del siglo XIX.
En el barco en el que emprenden la travesía viajan 22 niños, los portadores de la vacuna de la viruela “brazo a brazo”. Junto a ellos, la directora de un orfanato de A Coruña, Isabel Cendal, la encargada de encontrar a los “22 ángeles” y la persona que se ocupará de ellos a lo largo de toda la travesía. Una mujer en un barco lleno de rudos marineros, pero donde también viaja el ayudante del doctor Balmis, el doctor Salvany.

>> VER COMPLETO "22 ÀNGELES" <<
http://www.rtve.es/alacarta/videos/22-angeles/22-angeles-cap-1-hd/3827192/

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Revista Mexicana de Bioseguridad 2016

La Asociación Mexicana de Bioseguridad presentó la nueva Revista MExicana de Bioseguridad 2016, que contiene como artículo principal los Lineamientos para la Gestión de Riesgo Biológico, un gran esfuerzo de profesionales de Bioseguridad en México, con base en el CWA15793: Laboratory Biorisk Management 2018. La revista contiene además, el archivo fotográfico y resúmenes de trabajos libres del 8º Simposio de Bioseguridad y Biocustodia desarrollado en 2016. Pueden descargar la revista y sus ediciones anteriores desde la página: http://amexbio.wildapricot.org/Revista

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Establishing protocols for tick containment at Biosafety Level 4.

Tick-borne diseases continue to emerge and have a great impact on public health and agriculture. In addition, many of the agents of tick-borne diseases, which are classified as Biosafety Level 4 (BSL-4) viruses, have the potential to be used as biothreat agents. In spite of the known importance of these pathogens, there is an acute shortage of facilities and trained personnel to study the pathogenesis of tick-borne diseases and to assess vaccine as well as other therapeutic interventions against tick-borne diseases as they are transmitted in nature. We, at the Galveston National Laboratory, have developed facilities and protocols to safely work with BSL4 virus-infected ticks. This capability adds tremendous value to the Nation's training and research endeavors. In this report we describe the procedures and protocols to establish tick work in a BSL4 laboratory.

REFERENCE:
Thangamani S, Bente D. Establishing protocols for tick containment at Biosafety Level 4. Pathog Dis. 2014 Jul;71(2):282-5.
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Preparation of viral samples within biocontainment for ultrastructural analysis

Transmission electron microscopy can be used to observe the ultrastructure of viruses and other microbial pathogens with nanometer resolution. In a transmission electron microscope (TEM), the image is created by passing an electron beam through a specimen with contrast generated by electron scattering from dense elements in the specimen. Viruses do not normally contain dense elements, so a negative stain that places dense heavy metal salts around the sample is added to create a dark border. To prepare a virus sample for a negative stain transmission electron microscopy, a virus suspension is applied to a TEM grid specimen support, which is a 3mm diameter fragile specimen screen coated with a few nanometers of plastic film. Then, deionized (dI) water rinses and a negative stain solution are applied to the grid. All infectious viruses must be handled in a biosafety cabinet (BSC) and many require a biocontainment laboratory environment. Staining viruses in biosafety levels (BSL) 3 and 4 is especially challenging because the support grids are small, fragile, and easily moved by air currents. In this study we evaluated a new device for negative staining viruses called mPrep/g capsule. It is a capsule that holds up to two TEM grids during all processing steps and for storage after staining is complete. This study reports that the mPrep/g capsule method is valid and effective to negative stain virus specimens, especially in high containment laboratory environments.

REFERENCE:
Monninger MK, et al. Preparation of viral samples within biocontainment for ultrastructural analysis: Utilization of an innovative processing capsule for negative staining. J Virol Methods. 2016 Dec;238:70-76. doi: 10.1016/j.jviromet.2016.10.005. PubMed PMID: 27751950.
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#VIDEO: Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory

Biosafety level 4 (BSL-4) suit laboratories are specifically designed to study high-consequence pathogens for which neither infection prophylaxes nor treatment options exist. The hallmarks of these laboratories are: custom-designed airtight doors, dedicated supply and exhaust airflow systems, a negative-pressure environment, and mandatory use of positive-pressure (“space”) suits. The risk for laboratory specialists working with highly pathogenic agents is minimized through rigorous training and adherence to stringent safety protocols and standard operating procedures. Researchers perform the majority of their work in BSL-2 laboratories and switch to BSL-4 suit laboratories when work with a high-consequence pathogen is required. Collaborators and scientists considering BSL-4 projects should be aware of the challenges associated with BSL-4 research both in terms of experimental technical limitations in BSL-4 laboratory space and the increased duration of such experiments. Tasks such as entering and exiting the BSL-4 suit laboratories are considerably more complex and time-consuming compared to BSL-2 and BSL-3 laboratories. The focus of this particular article is to address basic biosafety concerns and describe the entrance and exit procedures for the BSL-4 laboratory at the NIH/NIAID Integrated Research Facility at Fort Detrick. Such procedures include checking external systems that support the BSL-4 laboratory, and inspecting and donning positive-pressure suits, entering the laboratory, moving through air pressure-resistant doors, and connecting to air-supply hoses. We will also discuss moving within and exiting the BSL-4 suit laboratories, including using the chemical shower and removing and storing positive-pressure suits.

REFERENCE:
Janosko, Krisztina et al. “Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 1. Biosafety Level 4 Suit Laboratory Suite Entry and Exit Procedures.” Journal of Visualized Experiments : JoVE 116 (2016): 52317. PMC. Web. 17 Nov. 2016.
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Containment of Arthropod Disease Vectors

Arthropods
Effective containment of arthropod vectors of infectious diseases is necessary to prevent transmission of pathogens by released, infected vectors and to prevent vectors that escape from establishing populations that subsequently contribute to increased disease. Although rare, past releases illustrate what can go wrong and justify the need for guidelines that minimize risks. An overview of recommendations for insectary facilities, practices, and equipment is provided, and features of four recently published and increasingly rigorous arthropod containment levels (ACLs 1-4) are summarized. ACL-1 is appropriate for research that constitutes the lowest risk level, including uninfected arthropods or vectors that are infected with micro-organisms that do not cause disease in humans, domestic animals, or wildlife. ACL-2 is appropriate for indigenous and exotic arthropods that represent a moderate risk, including vectors infected or suspected of being infected with biosafety level (BSL)-2 infectious agents and arthropods that have been genetically modified in ways that do not significantly affect their fecundity, survival, host preference, or vector competence. ACL-3 is recommended for arthropods that are or may be infected with BSL-3 infectious agents. ACL-3 places greater emphasis on pathogen containment and more restricted access to the insectary than ACL-2. ACL-4 is intended for arthropods that are infected with the most dangerous BSL-4 infectious agents, which can cause life-threatening illness by aerosol or arthropod bite. Adherence to these guidelines will result in laboratory-based arthropod vector research that minimizes risks and results in important new contributions to applied and basic science.

REFERENCE:
Scott TW. Containment of arthropod disease vectors. ILAR J. 2005;46(1):53-61. Review.

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Communicable Diseases and Outbreak Control

Infectious disease during an emergency condition can raise the death rate 60 times in comparison to other causes including trauma. An epidemic, or outbreak, can occur when several aspects of the agent (pathogen), population (hosts), and the environment create an ideal situation for spread. Overcrowding, poor regional design and hygiene due to poverty, dirty drinking water, rapid climate changes, and natural disasters, can lead to conditions that allow easier transmission of disease. Once it has been established that an emergency condition exists, there must be a prompt and thorough response for communicable disease control. A camp should be created, and the disease managed rapidly. The overall goals are rapid assessment, prevention, surveillance, outbreak control, and disease management.
REFERENCE:
AMELI, Jonathan. “Communicable Diseases and Outbreak Control.” Turkish Journal of Emergency Medicine 15.Suppl 1 (2015): 20–26. PMC.

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Informe Mundial sobre el Paludismo 2015

El Informe Mundial sobre el Paludismo 2015 resume la información recibida de los países en los que esta enfermedad es endémica, así como de otras fuentes. En él se evalúan las tendencias mundiales y regionales del paludismo, se destacan los progresos realizados hacia la consecución de las metas mundiales, y se describen las oportunidades y los desafíos en el control y eliminación de la enfermedad.
El informe muestra una disminución dramática en la carga global del paludismo desde el 2000. Cincuenta y siete países redujeron sus casos de paludismo en un 75%, en línea con las metas de la Asamblea Mundial de la Salud para el 2015.
A pesar de este enorme progreso, todavía queda mucho por hacer para reducir aún más la carga del paludismo. La Estrategia Técnica Mundial contra la Malaria 2016-2030, aprobada por la Asamblea Mundial de la Salud en mayo de 2015, establece objetivos ambiciosos pero alcanzables para el año 2030, incluyendo una reducción de por lo menos el 90% en la incidencia y mortalidad por paludismo a nivel mundial.

REFERENCE:
Informe Mundial sobre el Paludismo 2015
Número de páginas: 32
Fecha de publicación: 2016
Idiomas: Español, francés e inglés
Número de referencia OMS: WHO/HTM/GMP.2016.2 (resumen)
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Recent Advances in Antimicrobial Polymers: A Mini-Review

Human safety and well-being is threatened by microbes causing numerous infectious diseases resulting in a large number of deaths every year. Despite substantial progress in antimicrobial drugs, many infectious diseases remain difficult to treat. Antimicrobial polymers offer a promising antimicrobial strategy for fighting pathogens and have received considerable attention in both academic and industrial research. This mini-review presents the advances made in antimicrobial polymers since 2013. Antimicrobial mechanisms exhibiting either passive or active action and polymer material types containing bound or leaching antimicrobials are introduced. This article also addresses the applications of these antimicrobial polymers in the medical, food, and textile industries.

REFERENCE:
Huang, Keng-Shiang et al. “Recent Advances in Antimicrobial Polymers: A Mini-Review.” Ed. Antonella Piozzi and Iolanda Francolini. International Journal of Molecular Sciences 17.9 (2016): 1578.
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VIDEO: Safety procedures for handling sharps

This VIDEO discusses proper safety procedures for handling sharps in the lab:


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The Weekly Epidemiological Record (WER)

The Weekly Epidemiological Record (WER) serves as an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the International Health Regulations and on other communicable diseases of public health importance, including emerging or re-emerging infections.

REFERENCE:
Weekly Epidemiological Record (WER)

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Niveles de bioseguridad

A partir de la publicación del nuevo manual de bioseguridad en el laboratorio de la OMS en Dic/2020, desaparecen los niveles de bioseguridad, y se establecen las medidas de bioseguridad basadas en riesgos. 



REFERENCIA:
Página 15. Manual de bioseguridad en el laboratorio. Tercera edición, Organización Mundial de la Salud. 2005. ISBN 9243546503
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#WEBINAR: The Necrobiome - Microbial Life After Death

What happens to us after we die? A decomposing corpse becomes its own mini-ecosystem, hosting insects, scavengers and multitudes of microbes. Microbes from the environment, the corpse, as well as the insects and scavengers are blended together and work to recycle tissues back to their constituents. Dr. Jennifer DeBruyn will discuss the fascinating process of human decomposition, and how scientists are using that information to inform forensic science, livestock mortality management and fossilization. The talk will start promptly at 6:30 p.m. ET (CDMX: 5:30 p.m.), an you can watch onlineat the ASM Youtube Channel:  https://youtu.be/iqVpL0y5ofM

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HIGH-CONTAINMENT LABS: Improved Oversight of Dangerous Pathogens Needed to Mitigate Risk

The total number of incidents involving incomplete inactivation—a process to destroy the hazardous effects of pathogens while retaining characteristics for future use—that occurred from 2003 through 2015 is unknown for several reasons. One key reason is that the Select Agent Program—operated by the Departments of Health and Human Services (HHS) and Agriculture (USDA) to oversee certain dangerous pathogens, known as select agents—does not require laboratories to identify such incidents on reporting forms. According to the program, 10 incidents occurred from 2003 through 2015. However, GAO identified an additional 11 incidents that the program did not initially identify. Because the program cannot easily identify incidents involving incomplete inactivation, it does not know the frequency or reason they occur, making it difficult to develop guidance to help mitigate future incidents. The 21 identified incidents involved a variety of pathogens and laboratories, as shown below.

REFERENCE:
HIGH-CONTAINMENT LABORATORIES: Improved Oversight of Dangerous Pathogens Needed to Mitigate Risk. GAO-16-642: Published: Aug 30, 2016. Publicly Released: Sep 21, 2016.
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Measuring Pathogen Decay in Bioaerosols

This work aimed to develop an in vivo approach for measuring the duration of human bioaerosol infectivity. To achieve this, techniques designed to target short-term and long-term bioaerosol aging, were combined in a tandem system and optimized for the collection of human respiratory bioaerosols, without contamination. To demonstrate the technique, cough aerosols were sampled from two persons with cystic fibrosis and chronic Pseudomonas aeruginosa infection. Measurements and cultures from aerosol ages of 10, 20, 40, 900 and 2700 seconds were used to determine the optimum droplet nucleus size for pathogen transport and the airborne bacterial biological decay. The droplet nuclei containing the greatest number of colony forming bacteria per unit volume of airborne sputum were between 1.5 and 2.6 μm. Larger nuclei of 3.9 μm, were more likely to produce a colony when impacted onto growth media, because the greater volume of sputum comprising the larger droplet nuclei, compensated for lower concentrations of bacteria within the sputum of larger nuclei. Although more likely to produce a colony, the larger droplet nuclei were small in number, and the greatest numbers of colonies were instead produced by nuclei from 1.5 to 5.7 μm. Very few colonies were produced by smaller droplet nuclei, despite their very large numbers. The concentration of viable bacteria within the dried sputum comprising the droplet nuclei exhibited an orderly dual decay over time with two distinct half-lives. Nuclei exhibiting a rapid biological decay process with a 10 second half-life were quickly exhausted, leaving only a subset characterized by a half-life of greater than 10 minutes. This finding implied that a subset of bacteria present in the aerosol was resistant to rapid biological decay and remained viable in room air long enough to represent an airborne infection risk.

REFERENCE:
Johnson, Graham R. et al. “A Novel Method and Its Application to Measuring Pathogen Decay in Bioaerosols from Patients with Respiratory Disease.” Ed. Nicole M. Bouvier. PLoS ONE 11.7 (2016): e0158763.
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Concentrations and Sources of Airborne Particles in a Neonatal Intensive Care Unit

Premature infants in neonatal intensive care units (NICUs) have underdeveloped immune systems, making them susceptible to adverse health consequences from air pollutant exposure. Little is known about the sources of indoor airborne particles that contribute to the exposure of premature infants in the NICU environment. In this study, we monitored the spatial and temporal variations of airborne particulate matter concentrations along with other indoor environmental parameters and human occupancy. The experiments were conducted over one year in a private-style NICU. The NICU was served by a central heating, ventilation and air-conditioning (HVAC) system equipped with an economizer and a high-efficiency particle filtration system. The following parameters were measured continuously during weekdays with 1-min resolution: particles larger than 0.3 μm resolved into 6 size groups, CO2 level, dry-bulb temperature and relative humidity, and presence or absence of occupants. Altogether, over sixteen periods of a few weeks each, measurements were conducted in rooms occupied with premature infants. In parallel, a second monitoring station was operated in a nearby hallway or at the local nurses’ station. The monitoring data suggest a strong link between indoor particle concentrations and human occupancy. Detected particle peaks from occupancy were clearly discernible among larger particles and imperceptible for submicron (0.3–1 μm) particles. The mean indoor particle mass concentrations averaged across the size range 0.3–10 μm during occupied periods was 1.9 μg/m3, approximately 2.5 times the concentration during unoccupied periods (0.8 μg/m3). Contributions of within-room emissions to total PM10 mass in the baby rooms averaged 37–81%. Near-room indoor emissions and outdoor sources contributed 18–59% and 1–5%, respectively. Airborne particle levels in the size range 1–10 μm showed strong dependence on human activities, indicating the importance of indoor-generated particles for infant’s exposure to airborne particulate matter in the NICU.

REFERENCE:
Licina, Dusan et al. “Concentrations and Sources of Airborne Particles in a Neonatal Intensive Care Unit.” Ed. Jeffrey Shaman. PLoS ONE 11.5 (2016): e0154991.

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Recent advances in synthetic biosafety

Synthetically engineered organisms hold promise for a broad range of medical, environmental, and industrial applications. Organisms can potentially be designed, for example, for the inexpensive and environmentally benign synthesis of pharmaceuticals and industrial chemicals, for the cleanup of environmental pollutants, and potentially even for biomedical applications such as the targeting of specific diseases or tissues. However, the use of synthetically engineered organisms comes with several reasonable safety concerns, one of which is that the organisms or their genes could escape their intended habitats and cause environmental disruption. Here we review key recent developments in this emerging field of synthetic biocontainment and discuss further developments that might be necessary for the widespread use of synthetic organisms. Specifically, we discuss the history and modern development of three strategies for the containment of synthetic microbes: addiction to an exogenously supplied ligand; self-killing outside of a designated environment; and self-destroying encoded DNA circuitry outside of a designated environment.

REFERENCE:
Simon, Anna J., and Andrew D. Ellington. “Recent Advances in Synthetic Biosafety.” F1000 Research 5 (2016): F1000 Faculty Rev–2118. PMC. Web. 19 Sept. 2016.
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Microneedles: A New Frontier in Nanomedicine Delivery

This review aims to concisely chart the development of two individual research fields, namely nanomedicines, with specific emphasis on nanoparticles (NP) and microparticles (MP), and microneedle (MN) technologies, which have, in the recent past, been exploited in combinatorial approaches for the efficient delivery of a variety of medicinal agents across the skin. This is an emerging and exciting area of pharmaceutical sciences research within the remit of transdermal drug delivery and as such will undoubtedly continue to grow with the emergence of new formulation and fabrication methodologies for particles and MN. Firstly, the fundamental aspects of skin architecture and structure are outlined, with particular reference to their influence on NP and MP penetration. Following on from this, a variety of different particles are described, as are the diverse range of MN modalities currently under development. The review concludes by highlighting some of the novel delivery systems which have been described in the literature exploiting these two approaches and directs the reader towards emerging uses for nanomedicines in combination with MN.

REFERENCE:
Larrañeta, Eneko et al. “Microneedles: A New Frontier in Nanomedicine Delivery.” Pharmaceutical Research 33 (2016): 1055–1073. PMC.
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Use of Ultraviolet (UV) Lights in Biological Safety Cabinets

The purpose of this paper is to review information available on the use, risks and benefits of using Ultraviolet (UV) lights in Biological Safety Cabinets (BSC) and set forth a position based on the risk and benefits.

REFERENCE:
BurgenerJ.  Position Paper on the Use of Ultraviolet Lights in Biological Safety Cabinets. Applied Biosafety (2006), 11(4) pp. 228-230
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Respiratory Health in Waste Collection and Disposal Workers

Waste management, namely, collection, transport, sorting and processing, and disposal, is an issue of social concern owing to its environmental impact and effects on public health. In fact, waste management activities are carried out according to procedures that can have various negative effects on the environment and, potentially, on human health. The aim of our study was to assess the potential effects on respiratory health of this exposure in workers in the waste management and disposal field, as compared with a group of workers with no occupational exposure to outdoor pollutants. The sample consisted of a total of 124 subjects, 63 waste collectors, and 61 office clerks. Informed consent was obtained from all subjects before inclusion in the study. The entire study population underwent pulmonary function assessments with spirometry and completed two validated questionnaires for the diagnosis of rhinitis and chronic bronchitis. Statistical analyses were performed using STATA 13. Spirometry showed a statistically significant reduction in the mean Tiffenau Index values in the exposed workers, as compared with the controls, after adjusting for the confounding factors of age, BMI, and smoking habit. Similarly, the mean FEV1 values were lower in the exposed workers than in the controls, this difference being again statistically significant. The FVC differences measured in the two groups were not found to be statistically significant. We ran a cross-sectional study to investigate the respiratory health of a group of workers in the solid waste collection and disposal field as compared with a group of office workers. In agreement with most of the data in the literature, our findings support the existence of a prevalence of respiratory deficits in waste disposal workers. Our data suggest the importance of adopting preventive measures, such as wearing specific individual protection devices, to protect this particular category of workers from adverse effects on respiratory health.

REFERENCE:
Vimercati, Luigi et al. “Respiratory Health in Waste Collection and Disposal Workers.” Ed. Paul B. Tchounwou. International Journal of Environmental Research and Public Health 13.7 (2016): 631. PMC. Web. 18 Aug. 2016.

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Pregnancy, Labor, Delivery & Ebola: Implications for Infection Control in Obstetrics

UNICEF pregnant woman
Many of the survivors of the 2014–2015 epidemic of Ebola virus disease (EVD) in West Africa were women of childbearing age. Limited clinical and laboratory data exist that describe these women’s pregnancies and outcomes. We report the case of an EVD survivor who became pregnant and delivered her child in the United States, and we discuss implications of this case for infection control practices in obstetric services. Hospitals in the United States must be prepared to care for EVD survivors.

REFERENCE:
Kamali, Amanda et al. “Pregnancy, Labor, and Delivery after Ebola Virus Disease and Implications for Infection Control in Obstetric Services, United States.” Emerging Infectious Diseases 22.7 (2016): 1156–1161. PMC. Web. 18 Aug. 2016.

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#Ebola response in Sierra Leone: The impact on children

The West African Ebola virus disease (EVD) outbreak is the largest ever seen, with over 28,000 cases and 11,300 deaths since early 2014. The magnitude of the outbreak has tested fragile governmental health systems and non-governmental organizations (NGOs) to their limit. Here we discuss the outbreak in the Western Area of Sierra Leone, the shape of the local response and the impact the response had on caring for children suspected of having contracted EVD. Challenges encountered in providing clinical care to children whilst working in the “Red Zone” where risk of EVD is considered to be highest, wearing full personal protective equipment are detailed. Suggestions and recommendations both for further research and for operational improvement in the future are made, with particular reference as to how a response could be more child-focused.

REFERENCE:
Fitzgerald, Felicity et al. “Ebola Response in Sierra Leone: The Impact on Children.” The Journal of Infection 72.Suppl (2016): S6–S12. PMC. Web. 18 Aug. 2016.

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Quantitative Microbial Risk Assessment in Occupational Settings Applied to the Airborne Human Adenovirus Infection

Quantitative Microbial Risk Assessment (QMRA) methodology, which has already been applied to drinking water and food safety, may also be applied to risk assessment and management at the workplace. The present study developed a preliminary QMRA model to assess microbial risk that is associated with inhaling bioaerosols that are contaminated with human adenovirus (HAdV). This model has been applied to air contamination data from different occupational settings, including wastewater systems, solid waste landfills, and toilets in healthcare settings and offices, with different exposure times. Virological monitoring showed the presence of HAdVs in all the evaluated settings, thus confirming that HAdV is widespread, but with different average concentrations of the virus. The QMRA results, based on these concentrations, showed that toilets had the highest probability of viral infection, followed by wastewater treatment plants and municipal solid waste landfills. Our QMRA approach in occupational settings is novel, and certain caveats should be considered. Nonetheless, we believe it is worthy of further discussions and investigations.

REFERENCE:
Carducci, Annalaura et al. “Quantitative Microbial Risk Assessment in Occupational Settings Applied to the Airborne Human Adenovirus Infection.” Ed. Andrew Watterson. International Journal of Environmental Research and Public Health 13.7 (2016): 733. PMC. Web. 18 Aug. 2016.

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Occupational health related concerns among surgeons

The surgeon’s daily workload renders him/her susceptible to a variety of the common work-related illness. They are exposed to a number of occupational hazards in their professional work. These hazards include sharp injuries, blood borne pathogens, latex allergy, laser plumes, hazardous chemicals, anesthetic gases, equipment hazards, static postures, and job related stressors. However, many pay little attention to their health, and neither do they seek the appropriate help when necessary. It is observed that occupational hazards pose a huge risk to the personal well-being of surgeons. As such, the importance of early awareness and education alongside prompt intervention is duly emphasized. Therefore, increased attention to the health, economic, personal, and social implications of these injuries is essential for appropriate management and future prevention. These risks are as great as any other occupational hazards affecting surgeons today. The time has come to recognize and address them.

REFERENCE:
Memon, Anjuman Gul et al. “Occupational Health Related Concerns among Surgeons.” International Journal of Health Sciences 10.2 (2016): 279–291. Print.

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Prevalence of Respiratory Protective Devices in U.S. Health Care Facilities

An online questionnaire was developed to explore respiratory protective device (RPD) prevalence in U.S. health care facilities. The survey was distributed to professional nursing society members in 2014 and again in 2015 receiving 322 and 232 participant responses, respectively. The purpose of this study was to explore if the emergency preparedness climate associated with Ebola virus disease changed the landscape of RPD use and awareness. Comparing response percentages from the two sampling time frames using bivariate analysis, no significant changes were found in types of RPDs used in health care settings. N95 filtering facepiece respirators continue to be the most prevalent RPD used in health care facilities, but powered air-purifying respirators are also popular, with regional use highest in the West and Midwest. Understanding RPD use prevalence could ensure that health care workers receive appropriate device trainings as well as improve supply matching for emergency RPD stockpiling.

REFERENCE:
Wizner, Kerri et al. “Prevalence of Respiratory Protective Devices in U.S. Health Care Facilities: Implications for Emergency Preparedness.” Workplace health & safety 64.8 (2016): 359–368. PMC. Web. 18 Aug. 2016.

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Indications and the requirements for single-use medical gloves

Aim: While the requirements for single-use gloves for staff protection are clearly defined, the conventional medical differentiation between “sterile surgical gloves” used during surgical procedures and “single-use medical gloves” used in non-sterile medical areas does not adequately define the different requirements in these two areas of use. Sterilization of single-use medical gloves is not performed if sterility is not required; thus, another terminology must be found to identify the safety quality of non-sterile single-use medical gloves. Therefore, the labeling of such gloves should reflect this situation, by introducing the term “pathogen-free” single-use glove. The hygienic safety of such a glove would be attainable by ensuring aseptic manufacturing conditions during manufacturing and control of pathogen load of batch controls after fabrication. Proposed recommendation: Because single-use gloves employed in non-sterile areas come into contact not only with intact skin but also with mucous membranes, no potential pathogens should be detectable in 100 mL of rinse sample. In order to declare such gloves as pathogen-free we suggest absence of the indicator species S. aureus and E. coli. In addition, the total CFU count should be evaluated, since a high load indicates lack of optimal hygiene during the manufacturing process. Based on the requirements for potable water and findings obtained from investigations of the bacterial load of such gloves after manufacturing, the here suggested limit for the total bacterial count of <102 CFU/mL of rinse sample per glove seems realistic. Keywords: singl
e-use medical gloves, indications, requirements, definitions, “germ-poor” single-use gloves, pathogen-free single-use gloves

REFERENCE:
Kramer, A., & Assadian, O. (2016). Indications and the requirements for single-use medical gloves. GMS Hygiene and Infection Control, 11, Doc01. http://doi.org/10.3205/dgkh000261
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Engineered nanomaterials: toward effective safety management in research laboratories

Background: It is still unknown which types of nanomaterials and associated doses represent an actual danger to humans and environment. Meanwhile, there is consensus on applying the precautionary principle to these novel materials until more information is available. To deal with the rapid evolution of research, including the fast turnover of collaborators, a user-friendly and easy-to-apply risk assessment tool offering adequate preventive and protective measures has to be provided.
Results: Based on new information concerning the hazards of engineered nanomaterials, we improved a previously developed risk assessment tool by following a simple scheme to gain in efficiency. In the first step, using a logical decision tree, one of the three hazard levels, from H1 to H3, is assigned to the nanomaterial. Using a combination of decision trees and matrices, the second step links the hazard with the emission and exposure potential to assign one of the three nanorisk levels (Nano 3 highest risk; Nano 1 lowest risk) to the activity. These operations are repeated at each process step, leading to the laboratory classification. The third step provides detailed preventive and protective measures for the determined level of nanorisk.
Conclusions: We developed an adapted simple and intuitive method for nanomaterial risk management in research laboratories. It allows classifying the nanoactivities into three levels, additionally proposing concrete preventive and protective measures and associated actions. This method is a valuable tool for all the participants in nanomaterial safety. The users experience an essential learning opportunity and increase their safety awareness. Laboratory managers have a reliable tool to obtain an overview of the operations involving nanomaterials in their laboratories; this is essential, as they are responsible for the employee safety, but are sometimes unaware of the works performed. Bringing this risk to a three-band scale (like other types of risks such as biological, radiation, chemical, etc.) facilitates the management for occupational health and safety specialists. Institutes and school managers can obtain the necessary information to implement an adequate safety management system. Having an easy-to-use tool enables a dialog between all these partners, whose semantic and priorities in terms of safety are often different.

REFERENCE:
Groso, Amela et al. “Engineered Nanomaterials: Toward Effective Safety Management in Research Laboratories.” Journal of Nanobiotechnology 14 (2016): 21. PMC. Web. 18 Aug. 2016.

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#UANL: 2º Taller "Control de Riesgos Biológicos en Laboratorios de Investigación"

2º Taller "Control de Riesgos Biológicos en Laboratorios de Investigación"
12 de Septiembre de 2016
Facultad de Ciencias Biológicas, UANL.
Ciudad Universitaria, San Nicolás de los Garza, Nuevo León.



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Use of Protective Gloves in Nail Salons in Manhattan, New York City

Objectives: Nail salon owners in New York City (NYC) are required to provide their workers with gloves and it is their responsibility to maintain healthy, safe working spaces for their employees. The purpose of this study was to determine the frequency with which nail salon workers wear protective gloves.
Methods: A Freedom of Information Law request was submitted to New York Department of State’s Division of Licensing Services for a full list of nail salons in Manhattan, NYC. A sample population of 800 nail salons was identified and a simple random sample (without replacement) of 30% (n=240) was selected using a random number generator. Researchers visited each nail salon from October to December of 2015, posing as a potential customer to determine if nail salon workers were wearing gloves.
Results: Among the 169 salons in which one or more workers was observed providing services, a total of 562 workers were observed. For 149 salons, in which one or more worker was observed providing services, none of the workers were wearing gloves. In contrast, in six of the salons observed, in which one or more workers was providing services, all of the workers (1 in 2 sites, 2 in 1 site, 3 in 2 sites, and 4 in 1 site) were wearing gloves. Almost three-quarters of the total number of workers observed (n=415, 73.8%) were not wearing gloves.
Conclusions: The findings of this study indicate that, despite recent media attention and legislation, the majority of nail salon workers we observed were not wearing protective gloves when providing services.

REFERENCE:
Basch, Corey et al. “Use of Protective Gloves in Nail Salons in Manhattan, New York City.” Journal of Preventive Medicine and Public Health 49.4 (2016): 249–251. PMC. Web. 18 Aug. 2016.

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Performance analysis of exam gloves used for aseptic rodent surgery

Aseptic technique includes the use of sterile surgical gloves for survival surgeries in rodents to minimize the incidence of infections. Exam gloves are much less expensive than are surgical gloves and may represent a cost-effective, readily available option for use in rodent surgery. This study examined the effectiveness of surface disinfection of exam gloves with 70% isopropyl alcohol or a solution of hydrogen peroxide and peracetic acid (HP-PA) in reducing bacterial contamination. Performance levels for asepsis were met when gloves were negative for bacterial contamination after surface disinfection and sham 'exertion' activity. According to these criteria, 94% of HP-PA-disinfected gloves passed, compared with 47% of alcohol-disinfected gloves. In addition, the effect of autoclaving on the integrity of exam gloves was examined, given that autoclaving is another readily available option for aseptic preparation. Performance criteria for glove integrity after autoclaving consisted of: the ability to don the gloves followed by successful simulation of wound closure and completion of stretch tests without tearing or observable defects. Using this criteria, 98% of autoclaved nitrile exam gloves and 76% of autoclaved latex exam gloves met performance expectations compared with the performance of standard surgical gloves (88% nitrile, 100% latex). The results of this study support the use of HP-PA-disinfected latex and nitrile exam gloves or autoclaved nitrile exam gloves as viable cost-effective alternatives to sterile surgical gloves for rodent surgeries.

REFERENCE:
LeMoine DM, et al. Performance analysis of exam gloves used for aseptic rodent surgery. J Am Assoc Lab Anim Sci. 2015 May;54(3):311-6.
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Gain-of-Function Research: Ethical Analysis

Gain-of-function (GOF) research involves experimentation that aims or is expected to (and/or, perhaps, actually does) increase the transmissibility and/or virulence of pathogens. Such research, when conducted by responsible scientists, usually aims to improve understanding of disease causing agents, their interaction with human hosts, and/or their potential to cause pandemics. The ultimate objective of such research is to better inform public health and preparedness efforts and/or development of medical countermeasures. Despite these important potential benefits, GOF research (GOFR) can pose risks regarding biosecurity and biosafety. In 2014 the administration of US President Barack Obama called for a "pause" on funding (and relevant research with existing US Government funding) of GOF experiments involving influenza, SARS, and MERS viruses in particular. With announcement of this pause, the US Government launched a "deliberative process" regarding risks and benefits of GOFR to inform future funding decisions-and the US National Science Advisory Board for Biosecurity (NSABB) was tasked with making recommendations to the US Government on this matter. As part of this deliberative process the National Institutes of Health commissioned this Ethical Analysis White Paper, requesting that it provide (1) review and summary of ethical literature on GOFR, (2) identification and analysis of existing ethical and decision-making frameworks relevant to (i) the evaluation of risks and benefits of GOFR, (ii) decision-making about the conduct of GOF studies, and (iii) the development of US policy regarding GOFR (especially with respect to funding of GOFR), and (3) development of an ethical and decision-making framework that may be considered by NSABB when analyzing information provided by GOFR risk-benefit assessment, and when crafting its final recommendations (especially regarding policy decisions about funding of GOFR in particular). The ethical and decision-making framework ultimately developed is based on the idea that there are numerous ethically relevant dimensions upon which any given case of GOFR can fare better or worse (as opposed to there being necessary conditions that are either satisfied or not satisfied, where all must be satisfied in order for a given case of GOFR to be considered ethically acceptable): research imperative, proportionality, minimization of risks, manageability of risks, justice, good governance (i.e., democracy), evidence, and international outlook and engagement. Rather than drawing a sharp bright line between GOFR studies that are ethically acceptable and those that are ethically unacceptable, this framework is designed to indicate where any given study would fall on an ethical spectrum-where imaginable cases of GOFR might range from those that are most ethically acceptable (perhaps even ethically praiseworthy or ethically obligatory), at one end of the spectrum, to those that are most ethically problematic or unacceptable (and thus should not be funded, or conducted), at the other. The aim should be that any GOFR pursued (and/or funded) should be as far as possible towards the former end of the spectrum.

REFERENCE:
Selgelid MJ. Gain-of-Function Research: Ethical Analysis. Sci Eng Ethics. 2016 Aug 8. doi:10.1007/s11948-016-9810-1

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Soliciting Stakeholder Input for a Revision of Biosafety in Microbiological and Biomedical Laboratories (BMBL): Proceedings of a Workshop.

Since its publication by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) in 1984, Biosafety in Microbiological and Biomedical Laboratories (BMBL) has become the cornerstone of the practice of biosafety in the United States and in many countries around the world. The BMBL has been revised periodically over the past three decades to refine the guidance it provides based on new knowledge and experiences—allowing it to remain a relevant, valuable, and authoritative reference for the microbiological and biomedical community. Seven years after the release of the BMBL 5th Edition, NIH and CDC are considering a revision based on the comments of a broader set of stakeholders. At the request of NIH, the National Academies of Sciences, Engineering and Medicine conducted a virtual town hall meeting from 4 April to 20 May 2016 to allow BMBL users to share their thoughts on the BMBL in general and its individual sections and appendices. Specifically, users were asked to indicate what information they think should be added, revised, or deleted. Major themes from the virtual town hall meeting were further discussed in a workshop held on 12 May 2016 in Washington, DC. This document encapsulates the discussion of the major comments on the BMBL that were posted on the virtual town hall prior to 12 May 2016 and the various BMBL comments and issues related to biosafety that were raised during the workshop by participants who attended the meeting in Washington DC and those who listened to the live webcast.

REFERENCE:
Board on Agriculture and Natural Resources; Division on Earth and Life Studies; National Academies of Sciences, Engineering, and Medicine. Soliciting Stakeholder Input for a Revision of Biosafety in Microbiological and Biomedical Laboratories (BMBL): Proceedings of a Workshop. WASHINGTON (DC): National Academies Press (US); 2016 Jul.
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Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible #Zika Virus Exposure

CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. To increase the proportion of pregnant women with Zika virus infection who receive a definitive diagnosis, CDC recommends expanding real-time reverse transcription–polymerase chain reaction (rRT-PCR) testing. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.† Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease§ (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). Symptomatic pregnant women who are evaluated <2 weeks after symptom onset should receive serum and urine Zika virus rRT-PCR testing. Symptomatic pregnant women who are evaluated 2–12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. For asymptomatic pregnant women who live in areas without active Zika virus transmission and who are evaluated <2 weeks after last possible exposure, rRT-PCR testing should be performed. If the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2–12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2–12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. Asymptomatic pregnant women with ongoing risk for exposure to Zika virus should receive Zika virus IgM antibody testing as part of routine obstetric care during the first and second trimesters; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.

REFERENCE:
Oduyebo T, et al. Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States, July 2016. MMWR Morb Mortal Wkly Rep 2016;65:739–744. DOI: http://dx.doi.org/10.15585/mmwr.mm6529e1

Other:
Brooks JT, et al. Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, July 2016. MMWR Morb Mortal Wkly Rep 2016;65:745–747. DOI: http://dx.doi.org/10.15585/mmwr.mm6529e2
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HISTORY 1951: Yellow fever and Max Theiler: the only Nobel Prize for a virus vaccine

Max Theiler receives the Nobel Prize in Physiology or
Medicine from the hands of  His Majesty the King Gustaf
Adolf VI on December 10, 1951. Photo provided by the
Karolinska Institutet.

In 1951, Max Theiler of the Rockefeller Foundation received the Nobel Prize in Physiology or Medicine for his discovery of an effective vaccine against yellow fever—a discovery first reported in the JEM 70 years ago. This was the first, and so far the only, Nobel Prize given for the development of a virus vaccine. Recently released Nobel archives now reveal how the advances in the yellow fever vaccine field were evaluated more than 50 years ago, and how this led to a prize for Max Theiler.

REFERENCE:
Norrby, Erling. “Yellow Fever and Max Theiler: The Only Nobel Prize for a Virus Vaccine.” The Journal of Experimental Medicine 204.12 (2007): 2779–2784. PMC. Web. 27 July 2016.
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Hipoclorito de sodio como agente desinfectante


Este artículo es sobre soluciones desinfectantes, siga el link para ver desinfección de agua potable.

Publicado originalmente el 19 de Julio de 2008. Actualizado 27Ago2020

El hipoclorito de sodio (NaOCl) es un compuesto oxidante de rápida acción utilizado a gran escala para la desinfección de superficies, desinfección de ropa hospitalaria y desechos, descontaminar salpicaduras de sangre, desinfección de equipos y mesas de trabajo resistentes a la oxidación, eliminación de olores y desinfección del agua. Los equipos o muebles metálicos tratados con cloro, tienden a oxidarse rápidamente en presencia de hipoclorito de sodio.
El hipoclorito de sodio es vendido en una solución clara de ligero color verde-amarillento y un olor característico. Como agente blanqueante de uso domestico normalmente contiene 5-6.5% de hipoclorito de sodio (con un pH de alrededor de 11, es irritante y corrosivo a los metales). Cuando el hipoclorito se conserva en su contenedor a temperatura ambiente y sin abrirlo, puede conservarse durante 1 mes, pero cuando se ha utilizado para preparar soluciones, se recomienda  su cambio diario. Entre sus muchas propiedades incluyen su amplia y rápida actividad antimicrobiana, relativa estabilidad, fácil uso y bajo costo.
El hipoclorito es letal para varios microorganismos, virus y bacterias vegetativas, pero es menos efectivo contra esporas bacterianas, hongos y protozoarios. La actividad del hipoclorito se ve reducida en presencia de iones metálicos, biocapas, materiales orgánicos, bajo pH o luz UV. Las soluciones de trabajo deben ser preparadas diariamente. El cloro comercial que contiene 5-6%, que será utilizado para la desinfección de superficies, debe ser diluído 1:10 para obtener una concentración final de aproximadamente 0.5% de hipoclorito. Cuando se quiere desinfectar líquidos que pueden contener material orgánico, debe tenerse una concentración final de 1% de hipoclorito.
Gracias a su alta disponibilidad continua siendo de alto uso en hospitales. Pueden encontrar otras características y hojas de seguridad del hipoclorito de sodio. 



#VIDEOBLOG:


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CONCENTRACIONES RECOMENDADAS

  • Venta al público: (Blanqueador casero, presentación comercial): 5-6 % (50-60 g/l, 50,000 ppm) de cloro libre
  • Para desinfección con material orgánico o derrames:  1 % (10 g/l, 10,000 ppm)
  • Para desinfección general de áreas sin materia orgánica:  0.5% (5g/L;  5,000 ppm)
  • Para desinfección de superficies (CORONAVIRUS):  0.2%
  • Para limpieza general, desinfección de manos, desinfección de ropa: 0.05% (500 mg/L; 500 ppm) *

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RECOMENDACIONES PARA LA PREPARACIÓN Y USO:

  1. Antes de elegir un agente desinfectante, por favor revisa su efectividad para el microorganismo que te interesa.
  2. USAR agua destilada o desinizada. El agua de la llave contiene muchos metales y sales que interfieren con su efectividad.
  3. Revisar la etiqueta antes de preparar el hipoclorito de sodio buscando la caducidad y la concentración de venta. 
  4. Existen dos tipos de hipoclorito de sodio. El regular, que tiene una caducidad de 2 a 3 meses, y el "estabilizado", que tiene una caducidad de 1 a 2 años. Pero ambos se degradan rápidamente una vez preparados, por lo que no deben utilizarse después de 5 días de su preparación. 
  5. Almacenar en un lugar fresco, seco y obscuro, ya que la luz y el calor aceleran su degradación.
  6. Existen varios procedimientos para la desinfección, pro ejemplo LAVADO => DESINFECCIÓN => ENJUAGUE, es decir, realizar un lavado antes de la desinfección para retirar materia orgánica, luego aplicar el desinfectante, y realizar enjuagado para eliminar el exceso de desinfectate. 
  7. Para la desinfección de líquidos que puedan contener microorganismos, debe prepararse una solución al 2% de hipoclorito de sodio. Posteriormente, mezclar en proporción 1:1 (1 volumen de desinfectante, 1 volumen de líquido). De esta forma, al final tendrá una concentración de 1%. Dejar reposar durante 30 minutos. Por ejemplo: 200 ml de orina + 200 ml de solución de hipoclorito de sodio al 2%.
  8. Para desinfectar superficies o materiales de laboratorio (que no sean metálicos), que no contengan material orgánico, deberá usarse una solución de hipoclorito de sodio al 0.5%. Por ejemplo, para desinfectar gradillas de laboratorio de plástico, sumérjalas en la solución al 0.5% por al menos 30 minutos.
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FÓRMULA PARA PREPARAR SOLUCIONES DESINFECTANTES


Cualquier concentración puede ser utilizada para obtener una solución de hipoclorito diluída utilizando la siguiente fórmula:  =>

Por ejemplo para preparar una solución 0.5% a partir de una 4.5% de hipoclorito de sodio se utilizarán 8 partes de agua con 1 parte de hipoclorito de sodio. 
Donde "parte" puede ser utilizado para cualquier unidad de medida (litro, mililitro, galones, etc), o utilizando cualquier medidor (taza, frasco, garrafón, etc). En países de habla francesa, la cantidad de hipoclorito se expresa como "grados de cloro". Un grado de cloro = 0.3% de cloro activo. (Ref. 8)

Otra fórmula para calcular el volumen necesario para preparar el hipoclorito de sodio 0.5% a partir de una solución concentrada:


REVISAR LA ETIQUETA PARA VER LA CONCENTRACIÓN DE CLORO 





DESCARGAR AQUI TABLA PARA PREPARAR HIPOCLORITO DE SODIO CON FINES DE DESINFECCIÓN PDF

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PREPARACIÓN RÁPIDA DE HIPOCLORITO DE SODIO

En el caso de coronavirus COVID-19 las concentraciones consideradas efectivas es a partir del 0.2%. El tiempo de contacto recomendado es de 2 a 5 minutos. 


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DESINFECCIÓN DE SÁBANAS Y ROPA DE CAMA 

Toda la ropa de cama que ha estado en contacto con pacientes puede estar contaminado con líquidos o fluidos corporales (orina, sangre, vómito). Cuando se manejan este tipo de ropa, debe utilizarse equipo de protección adecuado, pero debe incluirse, guantes, mascarillas, lentes de protección, batas y botas. Los excesos de excremento deberán retirarse y colocarse en bolsas para desechos. Antes de desinfectar, deberá realizarse un lavado en lavadora con agua y jabón. Enjuagar para eliminar el exceso de jabón. Finalmente, colocar las sábanas en una solución de hipoclorito de sodio al 0.05%, durante por lo menos 30 minutos ó una hora. Puede realizarse un segundo enjuague para eliminar el exceso de hipoclorito, y continuar con los procesos normales de secado. 
El lavado a mano debe evitarse en la medida de lo posible. Cuando por las condiciones, no puede utilizarse lavadoras automáticas, las sábanas deberán colocarse en un gran contenedor con agua caliente y jabón, y agitar en círculos con un palo o varilla. Eliminar el agua, y colocar una solución al 0.1% de hipoclorito de sodio por 15 minutos, sumergiendo completamente las sábanas. Enjuagar nuevamente y dejar secar, evitando sacudir en la medida de lo posible (Ver Ref. 8).

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SOBRE LA INESTABILIDAD DEL CLORO:

Una vez preparadas, las soluciones comunes de hipoclorito de sodio guardadas a 25ºC, en recipientes cerrados, contenedores opacos, pierden 50% de su contenido de cloro libre en un periodo de 30 días. Una solución al 1%, tendrá solo 0.5% de cloro 30 días después de preparado. Las soluciones al 5% se degradan más lentamente si se almacenan en contenedores obscuros. A mayor temperatura y con mayor cantidad de luz que reciban, el proceso de degradación se acelera (Ref. 6). 

Existen soluciones "estabilizadas" de hipoclorito de sodio, que tienen una caducidad mínima de 1 año. Estas soluciones deben mantenerse a menos de 25ºC, lejos de la luz del sol y son comercializadas con ese nombre de "estabilizadas". Estas soluciones se mantienen estables mientras se encuentran bien cerradas en su envase original, ya que una vez que se preparan soluciones a partir de ellas, comienza su proceso de rápida degradación, debido a que los "estabilizadores" se diluyen. El hipoclorito de sodio normal se degrada rápidamente (Ref. 11). 

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SOBRE LA TOXICIDAD DEL CLORO:

El hipoclorito de sodio ocasiona:
  • Irritación ocular, orofaríngea, esofagial y quemaduras gástricas.
  • Corrosión a los metales 
  • Reacciona de forma tóxica con el amoniaco y ácidos (presente en los productos desinfectantes comunes), por lo que no deben hacerse mezclas de desinfectantes.
  • Producción de carcinógeno bis (clorometil) eter cuando se mezcla con formaldehído.
  • Producción de carcinógeno trihalometano cuando el agua es hiperclorinada (exceso de cloro).
Por favor visite esta página para ver las características y tratamiento de la intoxicación por cloro: https://medlineplus.gov/spanish/ency/article/002772.htm
 

Revista del consumidor Mayo 2020.

WEBINAR: Toxicidad del Dióxido de Cloro



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REFERENCIAS:

  1. Rutala WA and Weber DJ. Uses of Inorganic Hypochlorite (Bleach) in Health-Care Facilities. Clinical Microbiological Reviews 1997; 10(4):597-610. PDF. 
  2. Enviromental Health and Safety. University of Kentucky. PDF.
  3. Uso de desinfectantes. Guías para la prevención, control y vigilancia epidemiológica de infecciones intrahospitalarias. Secretaría Distrital de Salud de Bogotá. PDF.
  4. Githui WA, Matu SW, Tunge N, Juma E. Biocidal effect of bleach on Mycobacterium tuberculosis: a safety measure. Int J Tuberc Lung Dis 2007. 11(7):798–802. PDF.
  5. Hojas de seguridad de microorganismos, con las recomendaciones de agentes desinfectantes.
  6. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. CDC.
  7. Intoxicación con hipoclorito de sodio
  8. How to make chlorine solutions for environmental disinfection (Annex 6 from 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 2014)
  9. OSHA: Cleaning and Decontamination of #Ebola on Surfaces. Guidance for Workers and Employers in Non-Healthcare/Non-Laboratory Settings
  10. For General Healthcare Settings in West Africa: How to Prepare and Use Chlorine Solutions
  11. D. Lantagne, et al. Hypochlorite Solution Expiration and Stability in Household Water Treatment in Developing Countries. Journal of Environmental Engineering, Vol. 137, No. 2, February 1, 2011.
  12. Wolfe, Marlene K et al. “Handwashing and Ebola virus disease outbreaks: A randomized comparison of soap, hand sanitizer, and 0.05% chlorine solutions on the inactivation and removal of model organisms Phi6 and E. coli from hands and persistence in rinse water” PloS one vol. 12,2 e0172734. 23 Feb. 2017, doi:10.1371/journal.pone.0172734
  13. Potential role of inanimate surfaces for the spread ofcoronaviruses and their inactivation with disinfectantagents
  14. Kampf, G et al. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. The Journal of hospital infection vol. 104,3 (2020): 246-251. doi:10.1016/j.jhin.2020.01.022
  15. Lai, Mary Y Y et al. Survival of severe acute respiratory syndrome coronavirus. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 41,7 (2005): e67-71. doi:10.1086/433186
  16. Lai, Mary Y Y et al. Survival of severe acute respiratory syndrome coronavirus. Clinical infectious diseases.vol. 41,7 (2005): e67-71. doi:10.1086/433186.
  17. Hulkower, Rachel L et al. “Inactivation of surrogate coronaviruses on hard surfaces by health care germicides.” American journal of infection control vol. 39,5 (2011): 401-407. doi:10.1016/j.ajic.2010.08.011