Contact tracing during an #ebola outbreak

Persons in close contact with Ebola cases (alive or dead) are at higher risk of infection. All potential contacts of Ebola cases should be identified and closely observed for 21 days from the last day of exposure. Contacts that develop illness should be immediately isolated to prevent further transmission of infection. An effective system for contact tracing should be established at the onset of the outbreak. Early involvement and full cooperation of affected communities is critical for successful contact tracing.
This document provides guidance for establishing and conducting contact tracing during filovirus disease outbreaks. The guidance notes are based on extensive field experience in filovirus disease outbreak response in the WHO African region. The notes are intended for frontline epidemiologists, surveillance officers, health workers and other volunteers involved in contact tracing. National and sub-national emergency management committees and rapid response teams require these guidelines to plan, implement and monitor contact tracing.National emergency management committees are advised to adapt these guidance notes to the local context in their application

REFERENCES:
Contact tracing during an #ebola outbreak
CDC poster: What is contact tracing?
Australasian Contract Tracing Manual
Development of a risk assessment tool for contact tracing people after contact with infectious patients while travelling by bus or other public ground transport: a Delphi consensus approach
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Detailed Hospital Checklist for #Ebola Preparedness

Lohud.com

Every hospital should ensure that it can detect a patient with Ebola, protect healthcare workers so they can safely care for the patient, and respond in a coordinated fashion. Many of the signs and symptoms of Ebola are non-specific and similar to those of many common infectious diseases, as well as other infectious diseases with high mortality rates. Transmission can be prevented with appropriate infection control measures.
In order to enhance our collective preparedness and response efforts, this checklist highlights key areas for hospital staff -- especially hospital emergency management officers, infection control practitioners, and clinical practitioners -- to review in preparation for a person with Ebola arriving at a hospital for medical care. The checklist provides practical and specific suggestions to ensure your hospital is able to detect possible Ebola cases, protect your employees, and respond appropriately.
While we are not aware of any domestic Ebola cases, now is the time to prepare, as it is possible that individuals with Ebola in West Africa may travel to your city, exhibit signs and symptoms of Ebola, and present to facilities.

REFERENCES:

• CDC Detailed Hospital Checklist for Ebola Preparedness
• Ebola infection control. WHO guideline
• AIDE-MEMOIRE. For infection prevention and control in a health care facility 

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Practicability of Hygienic Wrapping of Touchscreen Operated Mobile Devices in a Clinical Setting

Background. To prove effectiveness of wrapping tablet computers in order to reduce microbiological contamination and to evaluate whether a plastic bag-covered tablet leads to impaired user satisfaction or touchscreen functionality.
Materials and Methods. Within a period of 11 days 115 patients were provided with a tablet computer while waiting for their magnetic resonance imaging examination. Every day the contamination of the surface of the tablet was determined before the first and after the final use. Before the device was handed over to a patient, it was enclosed in a customized single-use plastic bag, which was analyzed for bacterial contamination after each use. A questionnaire was applied to determine whether the plastic bag impairs the user satisfaction and the functionality of the touchscreen.
Results. Following the use by patients the outside of the plastic bags was found to be contaminated with various bacteria (657.5 ± 368.5 colony forming units/day); some of them were potentially pathogenic. In contrast, the plastic bag covered surface of the tablet was significantly less contaminated (1.7 ± 1.9 colony forming units/day). Likewise, unused plastic bags did not show any contamination. 11% of the patients reported problems with the functionality of the touchscreen. These patients admitted that they had never used a tablet or a smartphone before.
Conclusions. Tablets get severely contaminated during usage in a clinical setting. Wrapping with a customized single-use plastic bag significantly reduces microbiological contamination of the device, protects patients from the acquisition of potentially pathogenic bacteria and hardly impairs the user satisfaction and the functionality of the touchscreen.

REFERENCE;
Hammon M, et al. (2014) Practicability of Hygienic Wrapping of Touchscreen Operated Mobile Devices in a Clinical Setting. PLoS ONE 9(9): e106445. doi:10.1371/journal.pone.0106445
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Review on #Ebola vaccines

Introduction. Ebolaviruses cause severe viral hemorrhagic fever in humans and non-human primates, with case fatality rates of up to 90%. Currently, neither a specific treatment nor a vaccine licensed for use in humans is available. However, a number of vaccine candidates have been developed in the last decade that are highly protective in non-human primates, the gold standard animal model for Ebola hemorrhagic fever.
Areas covered. This review analyzes a number of scenarios for the use of ebolavirus vaccines, discusses the requirements for ebolavirus vaccines in these scenarios, and describes current ebolavirus vaccines. Among these vaccines are recombinant Adenoviruses, recombinant Vesicular Stomatitis viruses, recombinant Human Parainfluenza viruses and virus-like particles. Interestingly, one of these vaccine platforms, based on recombinant Vesicular Stomatitis viruses, has also demonstrated post-exposure protection in non-human primates.
Expert opinion. The most pressing remaining challenge is now to move these vaccine candidates forward into human trials and towards licensure. In order to achieve this, it will be necessary to establish the mechanisms and correlates of protection for these vaccines, and to continue to demonstrate their safety, particularly in potentially immunocompromised populations. However, already now there is sufficient evidence that, from a scientific perspective, a vaccine protective against ebolaviruses is possible.

REFERENCE;
Hoenen T, Groseth A & Feldmann H. Current Ebola vaccines. Expert Opin Biol Ther 2012; 12(7): 859–872.
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Aviso preventivo de viaje por #ebola a países africanos

La Secretaria de Salud Federal, a través del Unidad de Inteligencia Epidemiológica y Sanitaria emite el siguiente aviso preventivo de viaje ante los brotes de Enfermedad por Virus del Ébola, en GUINEA, LIBERIA, SIERRA LEONA, NIGERIA Y SENEGAL en el continente Africano, actualizado al 03 de Octubre de 2014.
La Secretaría de Salud reitera la recomendación de evitar viajes no esenciales a Guinea, Liberia, Sierra Leona, Nigeria y Senegal debido a la evolución del brote de Enfermedad por el Virus del Ébola.

DESCARGAR AVISO PDF     /      DESCARGAR AVISO WORD

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People, planet and profits: the case for greening operating rooms

Green Healthcare

Over the past 40 years, the health care industry has undergone radical changes in the types of products it uses and its waste disposal practices. In the 1980s, concerns about the spread of blood-borne diseases prompted a shift from reusable to single-use devices, resulting in increases in waste production.
The most recent environmental data on health care in Canada show that in 2008 the sector generated about 1.46% of Canada’s total greenhouse gas emissions and in 2001 was a source of 1% of total solid waste. Canadian hospital activities were the second most energy-intensive activity in the commercial and institutional sector in 2008, consuming the equivalent annual energy of 440 000 Canadian homes. In 2007, US health care facilities contributed 8% of total greenhouse gas emissions, disposed of more than 4 billion pounds (1 lb = 0.45 kg) of waste and were the second-largest contributor to landfills after the food industry.
Few Canadian hospitals have published their ecological footprints (a calculation of the bioproductive land and water required to sustain a population). However, in 2001, Lions Gate Hospital in Vancouver, British Columbia, reported a footprint of 2841 hectares (ha) or 719 times its actual area. In 2006, London Health Sciences Centre in London, Ontario, reported a footprint of 63 074 global hectares or about 384 times its actual area.
It is ironic that our efforts in hospitals to improve the health of patients contribute detrimentally to the health of the ecosystem. In 2009, the World Health Organization emphasized that hospitals have responsibilities in making health care more sustainable.
REFERENCE:
Kagoma Y, et al. People, planet and profits: the case for greening operating rooms. CMAJ. Nov 20, 2012; 184(17): 1905–1911.
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Efficacy of a Educational Tool to Improve Handrubbing Technique in Healthcare Workers

Introduction. Hand hygiene is a key component of infection control in healthcare. WHO recommends that healthcare workers perform six specific poses during each hand hygiene action. SureWash (Glanta Ltd, Dublin, Ireland) is a novel device that uses video-measurement technology and immediate feedback to teach this technique. We assessed the impact of self-directed SureWash use on healthcare worker hand hygiene technique and evaluated the device's diagnostic capacity.
Methods. A controlled before-after study: subjects in Group A were exposed to the SureWash for four weeks followed by Group B for 12 weeks. Each subject's hand hygiene technique was assessed by blinded observers at baseline (T0) and following intervention periods (T1 and T2). Primary outcome was performance of a complete hand hygiene action, requiring all six poses during an action lasting ≥20 seconds. The number of poses per hand hygiene action (maximum 6) was assessed in a post-hoc analysis. SureWash's diagnostic capacity compared to human observers was assessed using ROC curve analysis.
Results. Thirty-four and 29 healthcare workers were recruited to groups A and B, respectively. No participants performed a complete action at baseline. At T1, one Group A participant and no Group B participants performed a complete action. At baseline, the median number of poses performed per action was 2.0 and 1.0 in Groups A and B, respectively (p = 0.12). At T1, the number of poses per action was greater in Group A (post-intervention) than Group B (control): median 3.8 and 2.0, respectively (p<0.001). In Group A, the number of poses performed twelve weeks post-intervention (median 3.0) remained higher than baseline (p<0.001). The area under the ROC curves for the 6 poses ranged from 0.59 to 0.88.
Discussion. While no impact on complete actions was demonstrated, SureWash significantly increased the number of poses per hand hygiene action and demonstrated good diagnostic capacity.

REFERENCE:
Stewardson AJ, et al. Efficacy of a New Educational Tool to Improve Handrubbing Technique amongst Healthcare Workers. PLoS One. 2014; 9(9): e105866.

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Addressing climate change in healthcare settings

Publication details
Number of pages: 28
Publication date: 2009
Languages: English

Global climate change is no longer an ominous future threat but a dawning reality – one that is already creating disturbing shifts in the natural and human environment and eroding the delicate balance of our planet’s ecosystem and the species that depend on it.
This discussion draft is based on the World Health Organization’s (WHO) mandate from member states to develop “programmes for health systems that will contribute to reducing their own greenhouse gas emissions”. It also takes root in Health Care Without Harm’s (HCWH) more than 12 years of experience of working globally to transform the health sector so that it is no longer a source of harm to human health and the environment.

The paper begins to define a framework for analysing and addressing the health sector’s climate footprint – including identifying seven aspects of a climate-friendly hospital. It also draws on a series of examples from around the world that demonstrate that the health sector is indeed already beginning to provide leadership in this most important area of concern to the global community. This paper is the first step in a WHO project in collaboration with Health Care Without Harm (HCWH) aimed at addressing the climate footprint of the health sector.

REFERENCE:
World Health Organization and Health Care Without Harm. Healthy hospitals, healthy planet, healthy people: Addressing climate change in healthcare settings, 2009.

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Future Projections for #ebola outbreak

BACKGROUND. On March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a “public health emergency of international concern.”
METHODS. By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa — Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14.
RESULTS: The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0 ) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total.
CONCLUSIONS: These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.
REFERENCES:
Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections. NEJM 2014
Meltzer mi, et al. Estimating the Future Number of Cases in the Ebola Epidemic — Liberia and Sierra Leone, 2014–2015. MMWR 2015. September 23, 2014 / 63(Early Release);1-14. 

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The durability of examination gloves used on intensive care units

Background: The use of examination gloves is part of the standard precautions to prevent medical staff from transmission of infectious agents between patients. Gloves also protect the staff from infectious agents originating from patients. Adequate protection, however, depends on intact gloves. The risk of perforation of examination gloves is thought to correlate with duration of wearing, yet, only very few prospective studies have been performed on this issue.
Methods: A total number of 1500 consecutively used pairs of examination gloves of two different brands and materials (latex and nitrile) were collected over a period of two months on two ICU’s. Used gloves were examined for micro perforations using the “water-proof-test” according to EN 455–1. Cox-regression for both glove types was used to estimate optimal changing intervals.
Results: Only 26% of gloves were worn longer than 15 min. The total perforation rate was 10.3% with significant differences and deterioration of integrity of gloves between brands (p<0.001). Apart from the brand, “change of wound dressing” (p = 0.049) and “washing patients” (p = 0.001) were also significantly associated with an increased risk of perforation.
Conclusion: Medical gloves show marked differences in their durability that cannot be predicted based on the technical data routinely provided by the manufacturer. Based on the increase of micro perforations over time and the wearing behavior, recommendations for maximum wearing time of gloves should be given. Changing of gloves after 15 min could be a good compromise between feasibility and safety. HCWs should be aware of the benefits and limitations of medical gloves. To improve personal hygiene hand disinfection should be further encouraged.
Keywords: Hand hygiene, Examination gloves, Micro perforation, Glove change, Intensive care unit, Disinfection, Multi-barrier strategy
REFERENCE:
Hübner NO, et al. The durability of examination gloves used on intensive care units. BMC Infect Dis. 2013; 13: 226.
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Reporte de casos de #ébola en trabajadores de la salud en África

En el reporte publicado el día de ayer, la organización mundial de la salud actualiza los datos de la situación epidemiológica del ébola en África. En resumen, existen 5335 casos reportados (probables, confirmados y sospechosos), con 2622 muertes hasta el 14/Sep/2014. Los países afectados son Guinea (942 casos, 601 muertes), Liberia (2710 casos, 1459 muertes), Sierra Leona (1673 casos, 562 muertes), Nigeria (21 casos, 8 muertes), y Senegal (1 caso, 0 muertes).
Dentro del reporte se hace mención de los casos registrados en trabajadores de la salud, que como resultado del trabajo de atención a pacientes con ébola, han resultado infectados con ébola. En el reporte de situación por países, claramente el país mas afectado es Liberia con 85 muertes de 172 casos reportados. En total de todos los países se han reportado 151 muertes de 318 casos de ébola. 
Los casos de los trabajares de la salud, es por lo tanto una de las más alarmantes, dado que son ellos quienes realizan las funciones del control de la epidemia, atención y cuidado de pacientes. Sin trabajadores de la salud, difícilmente podrá controlarse la epidemia, agravado por el hecho de que estos países cuentan con muy bajo número de médicos y enfermeras.

Tabla. Resumen de infecciones por ébola en trabajadores de la salud. 14/Sep/2014. 

PAÍS	MUERTES	CASOS
Guinea	30	61
Liberia	85	172
Nigeria	5	11
Sierra Leona	31	74
TOTAL	151	318

REFERENCIA
WHO: Ebola Response Roadmap Situation Report 18 September 2014
REPORTE DE CASOS ACTUALIZADO WHO: Ebola Response Roadmap Situation Report 24 September 2014

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Fatal meningococcal disease in a laboratory worker - california, 2012

Occupationally acquired meningococcal disease is rare. Adherence to recommendations for safe handling of Neisseria meningitidis in the laboratory greatly reduces the risk for transmission to laboratory workers. A California microbiologist developed fatal serogroup B meningococcal disease after working with N. meningitidis patient isolates in a research laboratory (laboratory A). The California Department of Public Health (CDPH), the local health department, the California Division of Occupational Safety and Health (CalOSHA), and the federal Occupational Safety and Health Administration (OSHA) collaborated on an investigation of laboratory A, which revealed several breaches in recommended laboratory practice for safe handling of N. meningitidis, including manipulating cultures on the bench top. Additionally, laboratory workers had not been offered meningococcal vaccine in accordance with Advisory Committee on Immunization Practices (ACIP) recommendations and CalOSHA Aerosol Transmissible Diseases Standard requirements. In accordance with OSHA and CalOSHA regulations, laboratory staff members must receive laboratory biosafety training and use appropriate personal protective equipment, and those who routinely work with N. meningitidis isolates should receive meningococcal vaccine.

REFERENCE:
Sheets CD, et al. Fatal meningococcal disease in a laboratory worker - california, 2012. MMWR Morb Mortal Wkly Rep. 2014 Sep 5;63(35):770-2.
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UNICEF recruiting healthcare workers & other specialists

Ebola Crisis Response

The current crisis in West Africa is the largest Ebola outbreak ever reported, with 26 million people, including over 4.5 million children living in affected areas.

UNICEF is on the ground, working with community and religious leaders, youth organizations and others to fight widespread misconceptions about the disease and improve hygiene practices. UNICEF is also providing water and sanitation services to the affected communities, particularly through the procurement of water, sanitation and hygiene equipment and supplies -- as well as appropriate training for the health and medical partners.

As part of our drive to tackle the Ebola outbreak in West Africa, UNICEF seeks committed professionals, ready to be deployed immediately to countries in the affected area in the domains of Health and Nutrition, Communication for Development and Water and Sanitation.

Do you have the skills, competency and technical knowledge that we seek? Are you available to be deployed on short notice? UNICEF would like to hear from you.

Apply to our vacancies below and help our response to the Ebola crisis.

This page will be updated regularly to reflect our vacancies below in Ebola affected countries.

For more information, or if you have difficulties in applying, contact us at eRecruitment@unicef.org.

Check the full list of vacancies at: http://www.unicef.org/about/employ/index_75734.html

WHO guidelines on hand hygiene in health care

The WHO guidelines on hand hygiene in health care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs.
The present guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants. Definitions of health-care settings are proposed in Appendix 1.
REFERENCE:
WHO guidelines on hand hygiene in health care
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WHO Antimicrobial resistance: global report on surveillance 2014

     Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. An increasing number of governments around the world are devoting efforts to a problem so serious that it threatens the achievements of modern medicine. A post-antibiotic era – in which common infections and minor injuries can kill – far from being an apocalyptic fantasy, is instead a very real possibility for the 21st Century. This WHO report, produced in collaboration with Member States and other partners, provides for the first time, as accurate a picture as is presently possible of the magnitude of AMR and the current state of surveillance globally.
     The report makes a clear case that resistance to common bacteria has reached alarming levels in many parts of the world and that in some settings, few, if any, of the available treatments options remain effective for common infections. Another important finding of the report is that surveillance of antibacterial resistance is neither coordinated nor harmonized and there are many gaps in information on bacteria of major public health importance. Strengthening global AMR surveillance is critical as it is the basis for informing global strategies, monitoring the effectiveness of public health interventions and detecting new trends and threats. As WHO, along with partners across many sectors moves ahead in developing a global action plan to mitigate AMR, this report will serve as a baseline to measure future progress.
REFERENCE:
WHO Antimicrobial resistance: global report on surveillance 2014

     SLIDE SET   |    INFOGRAPHIC   |   SUMMARY

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Reducing Needle Stick Injuries in Healthcare Occupations

oasisdiscussions.ca

Needlestick injuries frequently occur among healthcare workers, introducing high risk of bloodborne pathogen infection for surgeons, assistants, and nurses. This systematic review aims to explore the impact of both educational training and safeguard interventions to reduce needlestick injuries. Several databases were searched including MEDLINE, PsycINFO, SCOPUS, CINAHL and Sciencedirect. Studies were selected if the intervention contained a study group and a control group and were published between 2000 and 2010. Of the fourteen studies reviewed, nine evaluated a double-gloving method, one evaluated the effectiveness of blunt needle, and one evaluated a bloodborne pathogen educational training program. Ten studies reported an overall reduction in glove perforations for the intervention group. In conclusion, this review suggests that both safeguard interventions and educational training programs are effective in reducing the risk of having needlestick injuries. However, more studies using a combination of both safeguards and educational interventions in surgical and nonsurgical settings are needed.
REFERENCE:
Yang L, Mullan B. Reducing needle stick injuries in healthcare occupations: an integrative review of the literature. ISRN Nurs. 2011;2011:315432.
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Infection Control During Filoviral Hemorrhagic Fever Outbreaks #Ebola

Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg) hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website.

REFERENCES:

1. Raabea VN, Borcherta M. Infection control during filoviral hemorrhagic Fever outbreaks. J Glob Infect Dis. 2012 Jan;4(1):69-74.
2. CDC Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus
3. WHO 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 => DESCARGA OPCIONAL
4. Health Canada. Interim Biosafety Guidelines for Laboratories Handling Specimens from Patients Under Investigation for Ebola Virus Disease

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.@WHO & CDC Interim Guidelines for #Ebola

CDC ebola print resources

• WHO 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  => PDF opcional

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

• CDC Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus
• CDC Interim Guidance for Specimen Collection, Transport, Testing, and Submission for Persons Under Investigation for Ebola Virus Disease in the United States
• CDC Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure
• CDC Ebola Guidance for Airlines
• CDC Guidance for Safe Handling of Human Remains of Ebola Patients in U. S. Hospitals and Mortuaries
• CDC ebola print resources
• CDC Information for Healthcare Workers

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Safe management of wastes from healthcare activities - Second edition

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

Descargar   PDF 1    /    PDF 2

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IFBA Certification of Biorisk Management Professionals

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Certification Program

Ensuring Quality Biorisk Management 

Through  Certification of Professionals

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

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

For further information please visit www.internationalbiosafety.org
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The International #Ebola Emergency

On August 8, 33 weeks into the longest, largest, and most widespread Ebola outbreak on record, the World Health Organization (WHO) declared the epidemic to be a Public Health Emergency of International Concern (PHEIC). This declaration was not made lightly. A PHEIC is an instrument of the International Health Regulations (IHR) — a legally binding agreement made by 196 countries on containment of major international health threats.

The August 8 statement made by WHO Director-General Margaret Chan followed advice from the independent IHR Emergency Committee. Reviewing all the available evidence, the committee concluded that further international spread of Ebola could have serious consequences. Their concern was based on the continuing transmission of Ebola in West African communities and health facilities, the high case fatality rate of Ebola virus disease (EVD), and the weak health services of Guinea, Liberia, Sierra Leone, Nigeria, and other neighboring countries at risk for infection.

REFERENCIA

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

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

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

Crowdfunding para el la atención de pacientes con ébola 

en áreas rurales en Kono, Sierra Leona: 

Regala una caja de guantes!! Por eso, aquí una lista de las organizaciones, que enviando a su gente, intentan controlar esta epidemia, pero que necesitan fondos para ampliar su ayuda:

1. Cruz Roja Británica. Está colectando fondos, que van directamente a gastos para el control de la epidemia. Si después de que la emergencia ha terminado, los fondos restantes serán utilizados en otras emergencias humanitarias. 
2. Médicos Sin Fronteras México y Médecins Sans Frontiers (Internacional). Los fondos son canalizados al fondo global de emergencias, pero que son usados activamente en las emergencias actuales, incluyendo la epidemia de ébola. 
3. UNICEF. Los donativos, cuando son otorgados como "Where most needed", van al fondo de emergencias, que además reciben fondos del Fondo Central de Respuestas de Emergencias de la ONU. Los donativos directos de México están desactivados, pero pueden hacerlo eligiendo "Otros Países". 
4. AFRICARE. Apoya directamente a la adquisición de equipo de protección personal (EPP) para los trabajadores de la salud en Liberia. 
5. DIRECT RELIEF. Apoya directamente con envíos de equipo médico y EPP en Liberia y Sierra Leona. Una de las 20 ONGs más eficientes. Hace entregas en especie. 
6. WELLBODY ALLIANCE. En colaboración con UCSF están realizando un Crowdfunding para el la atención de pacientes con ébola en áreas rurales en Kono, Sierra Leona. https://crowdfund.ucsf.edu/project/53e4f5e60920655b8211663c
7. Otras organizaciones que están realizando actividades de apoyo al control de la epidemia incluyen: a) ActionAid (UK); b) Samaritans Purse (Asociación cristiana); c) Medical Teams International (apoyo médico in Liberia), d) Giving Global (Sierra Leona); e) CARE (imprime material informativo en Sierra Leona); 

Como DIRECT RELIEF hace notar, una donación de tan sólo 6 dólares ayudan a comprar algo tan esencial como 1 caja de guantes de látex!

Recomendación: Antes de hacer una donación, hagan un poco de investigación, sobre quien va manejar su dinero, es importante que el dinero se utilice en lo que queremos apoyar. Pueden revisar la seriedad de las ONG´s en BBB y Charity Navigator. Si conocen otras organización que realice trabajos para el control del ébola, envíenme un mensaje para ampliar la lista.

1,400 Are Dead From #Ebola and We Need Help, Says Doctors Without Borders President http://t.co/rOT35md4he
— Bioseguridad (@Klintsy) agosto 23, 2014

ONU y OMS prometen medios "sin precedentes" contra #ébola en Liberia http://t.co/FUXbkYU9Jf
— Bioseguridad (@Klintsy) agosto 23, 2014

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REFERENCIAS:

• Wall Street Journal. Ebola Virus: For Want of Gloves, Doctors Die
• Ebola Crisis Intensifies as West Africa Struggles to Cope
• Containing Ebola: Gloves and Masks Are Needed, Not Drugs
• Ebola aid workers having to help sick without masks or gloves 

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Evaluation of mycobactericidal activity of selected chemical disinfectants

BACKGROUND: The history of the investigation of standardized mycobactericidal activity of disinfectants and antiseptics is not very long. There is growing interest among the manufacturers of disinfectants in carrying out research on the antimicrobial activities in accordance with European standards (EN). This research could facilitate the introduction of high-quality disinfectants to the market. The aim of this study was to evaluate the mycobactericidal activity of selected chemical disinfectants and antiseptics used in the medical and veterinary fields.
MATERIAL AND METHODS: This study included 19 products submitted to the National Medicines Institute in Poland for evaluation of mycobactericidal activity. These products contain in their composition active substances belonging to different chemical groups, including aldehydes, alcohols, amines, quaternary ammonium compounds, phenols, guanidine, and oxidizing compounds. This study, conducted according to the manufacturers' description of the preparations, was carried out in accordance with European standards, which also met the Polish standards: PN-EN 14204: 2013, PN-EN 14348: 2006, and PN-EN 14563: 2012.
RESULTS: Tested products for disinfection and antiseptics containing active substances from different chemical groups showed high mycobactericidal activity and met the requirements of the appropriate European standards in most cases. In the case of products containing guanidine and amine compounds, the concentration of active ingredients used in the test and the test conditions specified by the manufacturer did not provide the mycobactericidal activity required by the standards.
CONCLUSIONS: Prior to the launch of a new product on the market, it is important to establish the appropriate usage and testing conditions of the preparation, such as its practical concentration, contact time, and environment condition (clean or dirty).
REFERENCIA
Bocian E, Grzybowska W, Tyski S. Evaluation of mycobactericidal activity of selected chemical disinfectants and antiseptics according to European standards. Med Sci Monit. 2014 Apr 22;20:666-73.
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2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings #ebola

• GUIDELINE FOR ISOLATION PRECATIONS:

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

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

• INFECTION PREVENTION AND CONTROL FOR PATIENTS CARE WITH EBOLA:

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