¡Los hospitales no se incendian!

¡Los hospitales no se incendian! Guía hospitalaria para la prevención de incendios y evacuación Esta guía ha sido creada para poner de relieve la vulnerabilidad de los hospitales a los incendios. Es necesario que se adopten todas las medidas posibles para minimizar el riesgo de incendios en hospitales y asegurar la evacuación. El documento se puede aplicar en hospitales que han sido reforzados para mejorar la seguridad en cuanto a incendios, así como en nuevas instalaciones en proyecto. El documento está dividido en cuatro secciones principales a considerarse en caso de incendio en hospitales, a saber, prevención, supresión, evacuación y simulacros de capacitación. REFERENCIA: http://www.paho.org/disasters/index.php?option=com_docman&task=doc_download&gid=2140&Itemid=

Antimicrobial Resistance in the Food Chain: A Review

Overview of horizontal gene transfer in food products
(For complete image click HERE).

Antimicrobial resistant zoonotic pathogens present on food constitute a direct risk to public health. Antimicrobial resistance genes in commensal or pathogenic strains form an indirect risk to public health, as they increase the gene pool from which pathogenic bacteria can pick up resistance traits. Food can be contaminated with antimicrobial resistant bacteria and/or antimicrobial resistance genes in several ways. A first way is the presence of antibiotic resistant bacteria on food selected by the use of antibiotics during agricultural production. A second route is the possible presence of resistance genes in bacteria that are intentionally added during the processing of food (starter cultures, probiotics, bioconserving microorganisms and bacteriophages). A last way is through cross-contamination with antimicrobial resistant bacteria during food processing. Raw food products can be consumed without having undergone prior processing or preservation and therefore hold a substantial risk for transfer of antimicrobial resistance to humans, as the eventually present resistant bacteria are not killed. As a consequence, transfer of antimicrobial resistance genes between bacteria after ingestion by humans may occur. Under minimal processing or preservation treatment conditions, sublethally damaged or stressed cells can be maintained in the food, inducing antimicrobial resistance build-up and enhancing the risk of resistance transfer. Food processes that kill bacteria in food products, decrease the risk of transmission of antimicrobial resistance.
REFERENCIA:
Verraes C. Antimicrobial Resistance in the Food Chain: A Review. Int J Environ Res Public Health. 2013 July; 10(7): 2643–2669.

Influence of temperature and organic load on chemical disinfection

ABSTRACT:
This study evaluated the influence of temperature and organic load on the effectiveness of domestic bleach (DB), Surface Decontamination Foam (SDF), and Virkon in inactivating Geobacillus stearothermophilus spores, which are a surrogate for Bacillus anthracis spores. The spores were suspended in light or heavy organic preparations and the suspension was applied to stainless steel carrier disks. The dried spore inoculum was covered with the disinfectants and the disks were then incubated at various temperatures. At −20°C, the 3 disinfectants caused less than a 2.0 log10 reduction of spores in both organic preparations during a 24-h test period. At 4°C, the DB caused a 4.4 log10 reduction of spores in light organic preparations within 2 h, which was about 3 log10 higher than what was achieved with SDF or Virkon. In heavy organic preparations, after 24 h at 4°C the SDF had reduced the spore count by 4.5 log10, which was about 2 log10 higher than for DB or Virkon. In general, the disinfectants were most effective at 23°C but a 24-h contact time was required for SDF and Virkon to reduce spore counts in both organic preparations by at least 5.5 log10. Comparable disinfecting activity with DB only occurred with the light organic load. In summary, at temperatures as low as 4°C, DB was the most effective disinfectant, inactivating spores within 2 h on surfaces with a light organic load, whereas SDF produced the greatest reduction of spores within 24 h on surfaces with a heavy organic load.
REFERENCE:
Jiewen Guan, Maria Chan, Brian W. Brooks, and Liz Rohonczy. Influence of temperature and organic load on chemical disinfection of Geobacillus steareothermophilus spores, a surrogate for Bacillus anthracis. Can J Vet Res. 2013 April; 77(2): 100–104.

Histoplasmosis: Protecting Workers at Risk

This booklet is a revised edition of the NIOSH document Histoplasmosis: Protecting Workers at Risk, which was originally published in September 1997. The updated information in this booklet will help readers under­ stand what histoplasmosis is and recognize activities that may expose workers to the disease-causing fungus  Histoplasma capsulatum. The booklet also informs readers about methods they can use to protect themselves and others from exposure.
Outbreaks of histoplasmosis have shared similar circumstances: People who did not know the health risks of  breathing in the spores of H. capsulatum became ill and sometimes caused others nearby to become ill when they disturbed contaminated soil or accumulations of bird or bat manure. Because they were unaware of the hazard, they did not take protective measures that could have prevented illness.
This booklet will help prevent such exposures by serving as a guide for safety and health professionals, environmental consultants, supervisors, and others responsible for the safety and health of those working near material contaminated with H. capsulatum. Activities that pose a health risk to workers at these sites include disturbance of soil at an active or inactive bird roost or poultry house, excavation in regions where this  fungus is endemic, and removal of bat or bird manure from buildings.
REFERENCE:
Histoplasmosis: Protecting Workers at Risk. NIOSH/CDC 2003

Technologies to Enable Autonomous Detection for BioWatch

Technologies to Enable Autonomous Detection for BioWatch is the summary of a workshop hosted jointly by the Institute of Medicine and the National Research Council in June 2013 to explore alternative cost-effective systems that would meet the requirements for a BioWatch Generation 3.0 autonomous detection system, or autonomous detector, for aerosolized agents . The workshop discussions and presentations focused on examination of the use of four classes of technologies--nucleic acid signatures, protein signatures, genomic sequencing, and mass spectrometry--that could reach Technology Readiness Level (TRL) 6-plus in which the technology has been validated and is ready to be tested in a relevant environment over three different tiers of temporal timeframes: those technologies that could be TRL 6-plus ready as part of an integrated system by 2016, those that are likely to be ready in the period 2016 to 2020, and those are not likely to be ready until after 2020. Technologies to Enable Autonomous Detection for BioWatch discusses the history of the BioWatch program, the role of public health officials and laboratorians in the interpretation of BioWatch data and the information that is needed from a system for effective decision making, and the current state of the art of four families of technology for the BioWatch program. This report explores how the technologies discussed might be strategically combined or deployed to optimize their contributions to an effective environmental detection capability.

Paperback

300 pages | 6 x 9 

ISBN 978-0-309-29251-1

Oct 15, Día Mundial del Lavado de Manos #IWashMyHands

Un gesto tan simple como lavarse las manos con agua y jabón puede ser clave para la supervivencia de millones de personas, sobre todo de los más pequeños. Los niños y niñas son especialmente vulnerables a los efectos de la diarrea y de las infecciones respiratorias, enfermedades que se pueden prevenir fácilmente y de forma barata con un poco de agua y jabón. Este día quiere servir como recordatorio de la importancia de esta práctica

El Día Mundial del Lavado de Manos es un llamamiento para concientizar a la población de que un poco de agua y jabón pueden salvar muchas vidas. Este día se celebra por primera vez este 15 de octubre en 70 países de los cinco contienentes. Es la primera vez en la historia en la que una campaña mundial pide a millones de personas que laven sus manos con agua y jabón
Referencias:
Global Hand Washing
UNICEF   

Fire Exposures of Fire Fighter Self-Contained Breathing Apparatus Facepiece Lenses

National Institute of Standards and Technology (NIST), conducted experiments which demonstrated a range of realistic thermal exposures and environmental conditions that firefighters could be exposed to. Self-contained breathing apparatus (SCBA) facepieces were exposed to thermal environments from propane-fueled calibration experiments and furnished townhouse fire experiments. The rooms and the facepieces were instrumented to measure temperatures of the environment and the facepieces. The fire experiments lasted 5 minutes to 10 minutes and produced ceiling temperatures of approximately 500 °C (932 °F) to 750 °C (1382 °F) in the room adjacent to the fire. A heat flux gauge was also installed next to the facepieces and measured peak heat fluxes from approximately 2 kW/m2 to 55 kW/m2. Eight facepieces were tested in six different experiments, with three facepiece lenses showing evidence of thermal degradation from the exposure. Maximum exterior lens temperatures were as high as 300 °C (572 °F) in these cases. The environments that caused the failures were identified in an attempt to characterize the thermal performance of SCBA facepieces. Although much was learned about conditions associated with thermal degradation of SCBA facepiece lenses, more experiments are needed to be able to understand the thermal degradation and more definitively predict the conditions that are likely to cause a facepiece lens failure.
REFERENCE
Fire Exposures of Fire Fighter Self-Contained Breathing Apparatus Facepiece Lenses
National Institute of Standards and Technology Technical Note 1724
Natl. Inst. Stand. Technol. Tech. Note 1724, 45 pages (November 2011)
CODEN: NSPUE2

The Handwashing Handbook

This handbook grows out of the experience of the Global Public-Private Partnership for Handwashing with Soap (PPPHW) and its predecessor, the Central American Handwashing for Diarrheal Disease Prevention Program. These efforts demonstrated that mass programs with public and private sector involvement can be successful in promoting handwashing and reducing disease. With core support from the Bank Netherlands Water Partnership, the PPPHW has brought together global public and private agencies to consolidate approaches while initiating large-scale handwashing promotion in Ghana, Peru, Senegal, and Nepal. While much has been learned about handwashing promotion in recent years, especially in the areas of research and program design, countries are still experimenting with, and optimizing approaches to implementation. It is important to lay out what is known so that others can begin designing programs and contributing to a global body of knowledge and experience in the fight against child mortality. This handbook is intended for staff in government and development organizations charged with carrying out handwashing programs. Decision-makers in Ministries and funding agencies will also find assistance in designing policies and programs to improve public health.

TheHandwashingHandbook:A guide for developing a hygiene promotion programto increase handwashing with soap

Volcanoes: Protecting the Public´s Health

This instructional guide is meant for use before, during and after the viewing of the video "Volcanoes: Protecting the Public’s Health." It uses a simple format to present the most important aspects of the video, providing technical information for health personnel who may be involved in prevention, preparedness, or response activities in volcanic emergencies. The information in the video and guide are based on experiences in the Americas, addressing the major health risks associated with volcanic eruptions and basic planning measures that the health sector should undertake to reduce potential losses. The video is divided into two distinct but complementary sections that can be used together or separately.
REFERENCIA:
Volcanoes: Protecting the Public’s Health

Advancing infection control in dental care settings

ABSTRACT
Background and Overview. The authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention’s Guidelines for Infection Control in Dental Health-Care Settings—2003.
Methods. In 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists’ demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling.
Results. Responding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied.
Conclusions. Implementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education requirements and developing multiple modes of instruction may increase implementation of current and future Centers for Disease Control and Prevention guidelines.
REFERENCE:
Jennifer L. Cleveland, et al.  Advancing infection control in dental care settings. JADA 2012;143(10):1127-1138.

StarTalkRadio: Zombie Apocalypse (Part 2)

PART 2: The Zombie Apocalypse rages on as Neil deGrasse Tyson hunts for the truth with World War Z author Max Brooks and Pulitzer Prize winning journalist and virus expert Laurie Garrett.
45 mins.

How to choose a suit for a BSL4 laboratory

Elegir el traje apropiado para un laboratorio BSL4 es de vital importancia para crear un ambiente de trabajo seguir dentro de las instalaciones. El traje debe de proveer protección para quien lo usa y ser compatible con la infraestructura en las instalaciones, además de proporcionar cierto grado de confort. En este artículos los autores desarrollaron un programa de pruebas para comparar los diferentes modelos de traje y garantizar que los trajes elegidos puedan ser utilizados bajo condiciones específicas.
REFERENCIA:
Kümin D, Krebs C & Wick P. How to choose a suit for a BSL4 laboratory- The approach taken at Spiez Laboratory.  Applied Biosafety 2011. Vol. 16, No. 2, p94-102

Intervención de laboratorios y bancos de sangre en situaciones de desastre

ISBN 92 75 32380 1
OPS/HSP/HSE/08-2001

Las situaciones de emergencia o desastre requieren de una respuesta rápida y oportuna por parte de los servicios de salud. Desde hace varios años, la Organización Panamericana de la Salud ha venido promoviendo el desarrollo de acciones para reducir la vulnerabilidad del sector salud y fortalecer los programas de preparativos ante emergencias y desastres.

Desastres recientes ocurridos en Centroamérica como los huracanes Mitch y George en 1998 o el terremoto de El Salvador en 2001, alertaron sobre la necesidad de integrar a los laboratorios de salud pública, laboratorios clínicos y bancos de sangre dentro de los planes de contingencia sectorial de salud, revelando tres áreas prioritarias de intervención:
• La confirmación diagnóstica de las enfermedades transmisibles de alta mortalidad.
• La disponibilidad de exámenes básicos para el manejo de heridos.
• La provisión oportuna de sangre segura.
La presente guía pretende sensibilizar y orientar a las autoridades de salud, directores y técnicos de laboratorios y bancos de sangre en la identificación de responsabilidades y funciones de estos servicios ante situaciones de desastres, basándose en prioridades, necesidades y capacidad de respuesta inmediata local. La incorporación de actividades de mitigación y reducción de vulnerabilidad, rehabilitación y reorganización de los servicios en los planes de contingencia permitirá una mejor respuesta de los servicios de salud posterior a los desastres.
REFERENCIA:
Intervención de laboratorios y bancos de sangre en situaciones de desastre

StarTalkRadio: Zombie Apocalypse (Part 1)

PART 1: There’s no escaping the Zombie Apocalypse when Neil deGrasse Tyson interviews Max Brooks, author of World War Z and the world’s leading “authority” on these nonexistent killers.
45 mins.

Evaluation of the Operator Protection Factors Offered by Positive Pressure Air Suit

Laboratories throughout the world that perform work with Risk Group 4 Pathogens generally adopt one of two approaches within BSL-4 environments: either the use of positive pressure air-fed suits or using Class III microbiological safety cabinets and isolators for animal work. Within the UK at present, all laboratories working with Risk Group 4 agents adopt the use of Class III microbiological safety cabinet lines and isolators. Operator protection factors for the use of microbiological safety cabinets and isolators are available however; there is limited published data on the operator protection factors afforded by the use of positive pressure suits. This study evaluated the operator protection factors provided by positive pressure air suits against a realistic airborne microbiological challenge. The suits were tested, both intact and with their integrity compromised, on an animated mannequin within a stainless steel exposure chamber. The suits gave operator protection in all tests with an intact suit and with a cut in the leg. When compromised by a cut in the glove, a very small ingress of the challenge was seen as far as the wrist. This is likely to be due to the low airflow in the gloves of the suit. In all cases no microbiological penetration of the respiratory tract was observed. These data provide evidence on which to base safety protocols for use of positive pressure suits within high containment laboratorios.
REFERENCE

Jackie A. Steward * and Mark S. Lever. Evaluation of the Operator Protection Factors Offered by Positive Pressure Air Suits against Airborne Microbiological Challenge.

Viruses. 2012 August; 4(8): 1202–1211. PMCID: PMC3446757