License to Serve - U.S. Trainees and the #Ebola Epidemic

Before medical school, Sara L., now a fourth-year resident, worked for 6 years as a microbiologist at the Centers for Disease Control and Prevention. While there, she focused on hemorrhagic fevers, and she went to West Africa several times to assist in outbreaks. Indeed, until recently, Sara was one of only a few hundred people in the United States who was trained to work in a biosafety level 4 “spacesuit” laboratory, which requires the same personal protective equipment (PPE) needed for working with Ebola. As the current Ebola epidemic exploded, and after careful deliberation, Sara sought and secured a position with an international aid organization, got approval from her residency program's leadership, found coverage for her time away, and 6 weeks later, was set to deploy. Then she got a call from her institution's risk-management department with disappointing news: the institution would not support her deployment.

Rosenbaum L. License to Serve — U.S. Trainees and the Ebola Epidemic. N Engl J Med. 2014 Dec 17. 

 
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The hidden face of academic researches on classified highly pathogenic microorganisms

Highly pathogenic microorganisms and toxins are manipulated in academic laboratories for fundamental research purposes, diagnostics, drugs and vaccines development. Obviously, these infectious pathogens represent a potential risk for human and/or animal health and their accidental or intentional release (biosafety and biosecurity, respectively) is a major concern of governments. In the past decade, several incidents have occurred in laboratories and reported by media causing fear and raising a sense of suspicion against biologists. Some scientists have been ordered by US government to leave their laboratory for long periods of time following the occurrence of an incident involving infectious pathogens; in other cases laboratories have been shut down and universities have been forced to pay fines and incur a long-term ban on funding after gross negligence of biosafety/biosecurity procedures. Measures of criminal sanctions have also been taken to minimize the risk that such incidents can reoccur.
REFERENCE:
Devaux CA. The hidden face of academic researches on classified highly pathogenic microorganisms. Infect Genet Evol. 2015 Jan;29:26-34. doi: 10.1016/j.meegid.2014.10.028. Epub 2014 Nov 7.
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Preventing Worker Fatigue Among #Ebola Healthcare Workers #CDC

The National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) recognize that healthcare workers and responders involved with cases related to Ebola in the United States may be required to work longer or unusual shifts. This can involve extended shifts (more than 8 hours long), rotating or irregular shifts, or consecutive shifts resulting in more than the typical 40-hour work week. Long work hours may increase the risk of injuries and accidents and can contribute to poor health and worker fatigue.
Additionally, the personal protective equipment (PPE) required for working with Ebola patients can increase workers’ core body temperature, contributing significantly to fatigue. Although these guidelines are geared toward workers responding in the United States, the same concepts apply to those working in other countries.

DOWNLOAD / DESCARGA
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A los patrocinadores de #AMexBio

Las personas interesadas en promover sus productos en el próximo VII Simposio de Bioseguridad y Biocustodia de la Asociación Mexicana de Bioseguridad A.C. Existen amplias oportunidades para posicionar sus marcas ante este público especializado.​
Mayor información con:

Cristina Wilhelm 
cristina.wilhelm[at´]amexbio.org

Guillermo Wilhelm Ferriz
Nextel Id: 52*167789*3
Tel Fijo: (473) 732-4681
Tel Celular: (55) 4410-6383
guillermo_wilhelmf[at´]hotmail.com
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Plant-made #vaccine antigens against #malaria

This paper is an overview of vaccine antigens against malaria produced in plants. Plant-based expression systems represent an interesting production platform due to their reduced manufacturing costs and high scalability. At present, different Plasmodium antigens and expression strategies have been optimized in plants. Furthermore, malaria antigens are one of the few examples of eukaryotic proteins with vaccine value expressed in plants, making plant-derived malaria antigens an interesting model to analyze. Up to now, malaria antigen expression in plants has allowed the complete synthesis of these vaccine antigens, which have been able to induce an active immune response in mice. Therefore, plant production platforms offer wonderful prospects for improving the access to malaria vaccines.

REFERENCE:
Clemente M, Corigliano MG. Overview of plant-made vaccine antigens against malaria. J Biomed Biotechnol. 2012;2012:206918.
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Conferencia: "#Ebola, panorama epidemiológico"

Impartida por el Dr. Mario Martínez González.
Asesor de la Organización Panamericana de Salud.

Lunes 8 de diciembre del 2014
De 12:00 a 14:00 hrs.
En la sala 2 del Auditorio de la Unidad de Posgrado,
Universidad Nacional Autónoma de México
Ver MAPA
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Alberto Díaz Quiñonez, recibe el "IFBA Biosafety Heroes Award 2014" #AMexBio

El Dr. José Alberto Díaz Quiñonez, Miembro Fundador y Presidente del Consejo Directivo 2011-2012 de la Asociación Mexicana de Bioseguridad obtuvo el reconocimiento "IFBA Biosafety Heroes Award 2014" otorgado por la International Federation of Biosafety Associations.

Este galardón fue creado por la IFBA en 2011, con el objetivo de reconocer a los profesionales que realizan contribuciones importantes en temas de gestión del riesgo biológico en el mundo. 

De acuerdo con IFBA el "Dr. Díaz Quiñonez ha demostrado ser un incansable promotor de la cultura de gestión del riesgo biológico en México".

Felicidades Alberto!

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Chimpanzee Adenovirus Vector #Ebola Vaccine - Preliminary Report.

Background 

The unprecedented 2014 epidemic of Ebola virus disease (EVD) has prompted an international response to accelerate the availability of a preventive vaccine. A replication-defective recombinant chimpanzee adenovirus type 3-vectored ebolavirus vaccine (cAd3-EBO), encoding the glycoprotein from Zaire and Sudan species that offers protection in the nonhuman primate model, was rapidly advanced into phase 1 clinical evaluation. 

Methods 

We conducted a phase 1, dose-escalation, open-label trial of cAd3-EBO. Twenty healthy adults, in sequentially enrolled groups of 10 each, received vaccination intramuscularly in doses of 2×1010 particle units or 2×1011 particle units. Primary and secondary end points related to safety and immunogenicity were assessed throughout the first 4 weeks after vaccination. 

Results 

In this small study, no safety concerns were identified; however, transient fever developed within 1 day after vaccination in two participants who had received the 2×1011 particle-unit dose. Glycoprotein-specific antibodies were induced in all 20 participants; the titers were of greater magnitude in the group that received the 2×1011 particle-unit dose than in the group that received the 2×1010 particle-unit dose (geometric mean titer against the Zaire antigen, 2037 vs. 331; P=0.001). Glycoprotein-specific T-cell responses were more frequent among those who received the 2x1011 particle-unit dose than among those who received the 2×1010 particle-unit dose, with a CD4 response in 10 of 10 participants versus 3 of 10 participants (P=0.004) and a CD8 response in 7 of 10 participants versus 2 of 10 participants (P=0.07). 

Conclusions 

Reactogenicity and immune responses to cAd3-EBO vaccine were dose-dependent. At the 2×1011 particle-unit dose, glycoprotein Zaire-specific antibody responses were in the range reported to be associated with vaccine-induced protective immunity in challenge studies involving nonhuman primates. Clinical trials assessing cAd3-EBO are ongoing. (Funded by the Intramural Research Program of the National Institutes of Health; VRC 207 ClinicalTrials.gov number, NCT02231866 .).

REFERENCE:

Ledgerwood JE, et al; the VRC 207 Study Team. Chimpanzee Adenovirus Vector Ebola Vaccine - Preliminary Report. N Engl J Med. 2014 Nov 26. [Epub ahead of print] PubMed PMID: 25426834.

Algae-based oral recombinant vaccines

Recombinant subunit vaccines are some of the safest and most effective vaccines available, but their high cost and the requirement of advanced medical infrastructure for administration make them impractical for many developing world diseases. Plant-based vaccines have shifted that paradigm by paving the way for recombinant vaccine production at agricultural scale using an edible host. However, enthusiasm for “molecular pharming” in food crops has waned in the last decade due to difficulty in developing transgenic crop plants and concerns of contaminating the food supply. Microalgae could be poised to become the next candidate in recombinant subunit vaccine production, as they present several advantages over terrestrial crop plant-based platforms including scalable and contained growth, rapid transformation, easily obtained stable cell lines, and consistent transgene expression levels. Algae have been shown to accumulate and properly fold several vaccine antigens, and efforts are underway to create recombinant algal fusion proteins that can enhance antigenicity for effective orally delivered vaccines. These approaches have the potential to revolutionize the way subunit vaccines are made and delivered – from costly parenteral administration of purified protein, to an inexpensive oral algae tablet with effective mucosal and systemic immune reactivity.

REFERENCE:
Specht EA and Mayfield SP. Algae-based oral recombinant vaccines. Front Microbiol. 2014; 5: 60.
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Preventing Health Care–Associated Infections

The occurrence and undesirable complications from health care–associated infections (HAIs) have been well recognized in the literature for the last several decades. The occurrence of HAIs continues to escalate at an alarming rate. HAIs originally referred to those infections associated with admission in an acute-care hospital (formerly called a nosocomial infection), but the term now applies to infections acquired in the continuum of settings where persons receive health care (e.g., long-term care, home care, ambulatory care). These unanticipated infections develop during the course of health care treatment and result in significant patient illnesses and deaths (morbidity and mortality); prolong the duration of hospital stays; and necessitate additional diagnostic and therapeutic interventions, which generate added costs to those already incurred by the patient’s underlying disease. HAIs are considered an undesirable outcome, and as some are preventable, they are considered an indicator of the quality of patient care, an adverse event, and a patient safety issue.

REFERENCIA:
Amy S. Collins. Chapter 41. Preventing Health Care-Associated Infections. From Patient Safety and Quality: An Evidence-Based Handbook for Nurses: Vol. 2.

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El virus de #Chikungunya

La fiebre chikungunya es una enfermedad vírica transmitida al ser humano por mosquitos infectados. Además de fiebre y fuertes dolores articulares, produce otros síntomas, tales como dolores musculares, dolores de cabeza, náuseas, cansancio y erupciones cutáneas.
Algunos signos clínicos de esta enfermedad son iguales a los del dengue, con el que se puede confundir en zonas donde este es frecuente. Como no tiene tratamiento curativo, el tratamiento se centra en el alivio de los síntomas. Un factor de riesgo importante es la proximidad de las viviendas a lugares de cría de los mosquitos. La enfermedad se da en África, Asia y el subcontinente indio. En los últimos decenios los vectores de la enfermedad se han propagado a Europa y las Américas. En 2007 se notificó por vez primera la transmisión de la enfermedad en Europa, en un brote localizado en el nordeste de Italia.

REFERENCIAS:

1. WHO Chikungunya factsheet ESP
2. Chikungunya: un nuevo virus en la región de las Américas
3. Cuidados para prevenir y tratar el chikungunya
4. CHIKUNGUNYA VIRUS. PATHOGEN SAFETY DATA SHEET - INFECTIOUS SUBSTANCES
5. CDC: Chikungunya
6. CDC: Chikungunya. Información para el público

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How to conduct safe and dignified burial of a #ebola patient

Overview

This protocol provides information on the safe management of dead bodies and burial of patients who died from suspected or confirmed Ebola virus disease. These measures should be applied not only by medical personnel but by anyone involved in the management of dead bodies and burial of suspected or confirmed Ebola patients.  Twelve steps have been identified describing the different phases Burial Teams have to follow to ensure safe burials, starting from the moment the teams arrive in the village up to their return to the hospital or team headquarters after burial and disinfection procedures.

DOWNLOAD => How to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola virus disease

Publication details 

Number of pages: 17
Publication date: October 2014
Languages: English
WHO reference number: WHO/EVD/Guidance/Burials/14.2

NEWS:

W.H.O. Issues New Guidelines on Safely Burying Ebola Victims

New WHO safe and dignified burial protocol - key to reducing Ebola transmission

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COURSE: Guidance for use of Personal Protective Equipment (PPE) During Management of Patients with #Ebola Virus

GO TO THE COURSE

The following informational materials demonstrate the procedures described in CDC guidance for donning and doffing (i.e., putting on and removing) personal protective equipment (PPE) for all healthcare providers entering the room of a patient hospitalized with known or suspected Ebola virus disease (Ebola). These informational materials are intended to promote patient safety and increase the safety of the healthcare provider.
Prior to working with Ebola patients, all healthcare providers involved in the care of Ebola patients must receive training and demonstrate competency in performing all Ebola-related infection control practices and procedures, specifically in donning and doffing proper PPE.

REFERENCE:
Guidance for Donning and Doffing Personal Protective Equipment (PPE) During Management of Patients with Ebola Virus 
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Plant-derived virus-like particles as vaccines

Virus-like particles (VLPs) are self-assembled structures derived from viral antigens that mimic the native architecture of viruses but lack the viral genome. VLPs have emerged as a premier vaccine platform due to their advantages in safety, immunogenicity, and manufacturing. The particulate nature and high-density presentation of viral structure proteins on their surface also render VLPs as attractive carriers for displaying foreign epitopes. Consequently, several VLP-based vaccines have been licensed for human use and achieved significant clinical and economical success. The major challenge, however, is to develop novel production platforms that can deliver VLP-based vaccines while significantly reducing production times and costs. Therefore, this review focuses on the essential role of plants as a novel, speedy and economical production platform for VLP-based vaccines. The advantages of plant expression systems are discussed in light of their distinctive posttranslational modifications, cost-effectiveness, production speed, and scalability. Recent achievements in the expression and assembly of VLPs and their chimeric derivatives in plant systems as well as their immunogenicity in animal models are presented. Results of human clinical trials demonstrating the safety and efficacy of plant-derived VLPs are also detailed. Moreover, the promising implications of the recent creation of "humanized" glycosylation plant lines as well as the very recent approval of the first plant-made biologics by the U. S. Food and Drug Administration (FDA) for plant production and commercialization of VLP-based vaccines are discussed. It is speculated that the combined potential of plant expression systems and VLP technology will lead to the emergence of successful vaccines and novel applications of VLPs in the near future.

REFERENCE:
Chen Q1, Lai H. Hum Plant-derived virus-like particles as vaccines. Vaccin Immunother. 2013 Jan;9(1):26-49.
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Happy "Día de Muertos" (Day of the Deaths)

       For our english-speaking visitors. Happy Halloween!. Here in  México is "Día de Muertos" (Day of the Deaths), on November 1st, and 2nd. This year we will be walking around deaths. momies, vampires, and Catrinas...
       Literary Calaveras (skulls)  are written as epitaphs for the living. It´s a fun  way to remember the deaths. In local newspapers publish Calaveras from living politicians, also a way to make fun of them.  Many calaveras were written about the individuals in a given profession. Butchers, teachers, priests, housekeepers, artists, mail carriers, and shopkeepers were all satirized by writers of calaveras. I´m giving you one...  People goes to the pantheons, to sing, eat, and remember their love ones. Also they dress up, cook special food and big parties. It´s a nice time to visit México.

Control of #ebola virus disease - firestone district, Liberia, 2014

WSJ

On March 30, 2014, the Ministry of Health and Social Welfare (MOHSW) of Liberia alerted health officials at Firestone Liberia, Inc. (Firestone) of the first known case of Ebola virus disease (Ebola) inside the Firestone rubber tree plantation of Liberia. The patient, who was the wife of a Firestone employee, had cared for a family member with confirmed Ebola in Lofa County, the epicenter of the Ebola outbreak in Liberia during March-April 2014. To prevent a large outbreak among Firestone's 8,500 employees, their dependents, and the surrounding population, the company responded by 1) establishing an incident management system, 2) instituting procedures for the early recognition and isolation of Ebola patients, 3) enforcing adherence to standard Ebola infection control guidelines, and 4) providing differing levels of management for contacts depending on their exposure, including options for voluntary quarantine in the home or in dedicated facilities. In addition, Firestone created multidisciplinary teams to oversee the outbreak response, address case detection, manage cases in a dedicated unit, and reintegrate convalescent patients into the community. The company also created a robust risk communication, prevention, and social mobilization campaign to boost community awareness of Ebola and how to prevent transmission. During August 1-September 23, a period of intense Ebola transmission in the surrounding areas, 71 cases of Ebola were diagnosed among the approximately 80,000 Liberians for whom Firestone provides health care (cumulative incidence = 0.09%). Fifty-seven (80%) of the cases were laboratory confirmed; 39 (68%) of these cases were fatal. Aspects of Firestone's response appear to have minimized the spread of Ebola in the local population and might be successfully implemented elsewhere to limit the spread of Ebola and prevent transmission to health care workers (HCWs).

REFERENCE:
Reaves EJ, et al. Control of ebola virus disease - firestone district, Liberia, 2014. MMWR Morb Mortal Wkly Rep. 2014 Oct 24;63(42):959-65.
NEWS:
How Firestone Liberia’s unique approaches helped stem the spread of the ebola virus
Liberian Rubber Farm Becomes Sanctuary Against Ebola
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Preguntas sobre #ébola

Las preguntas se recibirán hasta el Viernes 31 de Octubre, 2014.

El formato para las preguntas ha sido desactivado. Gracias por participar!

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Cluster of #ebola cases among liberian and u.s. Health care workers in an ebola treatment unit and adjacent hospital - Liberia, 2014

aljazeera

The ongoing Ebola virus disease (Ebola) epidemic in West Africa, like previous Ebola outbreaks, has been characterized by amplification in health care settings and increased risk for health care workers (HCWs), who often do not have access to appropriate personal protective equipment. In many locations, Ebola treatment units (ETUs) have been established to optimize care of patients with Ebola while maintaining infection control procedures to prevent transmission of Ebola virus. These ETUs are considered essential to containment of the epidemic. In July 2014, CDC assisted the Ministry of Health and Social Welfare of Liberia in investigating a cluster of five Ebola cases among HCWs who became ill while working in an ETU, an adjacent general hospital, or both. No common source of exposure or chain of transmission was identified. However, multiple opportunities existed for transmission of Ebola virus to HCWs, including exposure to patients with undetected Ebola in the hospital, inadequate use of personal protective equipment during cleaning and disinfection of environmental surfaces in the hospital, and potential transmission from an ill HCW to another HCW. No evidence was found of a previously unrecognized mode of transmission. Prevention recommendations included reinforcement of existing infection control guidance for both ETUs and general medical care settings, including measures to prevent cross-transmission in co-located facilities

REFERENCE:
Forrester JD et al. Cluster of Ebola Cases Among Liberian and U.S. Health Care Workers in an Ebola Treatment Unit and Adjacent Hospital — Liberia, 2014. MMWR Morb Mortal Wkly Rep. 2014 Oct 17;63(41):925-9.
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Biologically hazardous agents at work and efforts to protect workers' health: a review of recent reports

Because information on biological agents in the workplace is lacking, biological hazard analyses at the workplace to securely recognize the harmful factors with biological basis are desperately needed. This review concentrates on literatures published after 2010 that attempted to detect biological hazards to humans, especially workers, and the efforts to protect them against these factors. It is important to improve the current understanding of the health hazards caused by biological factors at the workplace. In addition, this review briefly describes these factors and provides some examples of their adverse health effects. It also reviews risk assessments, protection with personal protective equipment, prevention with training of workers, regulations, as well as vaccinations.

REFERENCE:
Rim KT, Lim CH. Biologically hazardous agents at work and efforts to protect workers' health: a review of recent reports. Saf Health Work. Jun 2014; 5(2): 43–52.

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Consolidated #Ebola Virus Disease Preparedness Checklist

The Consolidated Checklist for Ebola Virus Disease Preparedness is based on efforts by various national and international institutions, including WHO, CDC and UN OCHA.
It identifies 10 key components and tasks for both countries and the international community that should be completed within 30, 60 and 90 days respectively from the date of issuing this list. Minimal required resources in terms of equipment and material as well as human resources are defined. Key reference documents such as guidelines, training manuals and guidance notes will help the technical experts to implement required action in the key components.

DESCARGA 1   /   DESCARGA OPCIONAL
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OSHA: Cleaning and Decontamination of #Ebola on Surfaces

Guidance for Workers and Employers in Non-Healthcare/Non-Laboratory Settings
Workers tasked with cleaning surfaces that may be contaminated with Ebola virus, the virus that causes Ebola hemorrhagic fever (EHF), must be protected from exposure. Employers are responsible for ensuring that workers are protected from exposure to Ebola and that workers are not exposed to harmful levels of chemicals used for cleaning and disinfection.
DESCARGA A   /   DESCARGA B

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Mobile phones carry the personal microbiome of their owners

Most people on the planet own mobile phones, and these devices are increasingly being utilized to gather data relevant to our personal health, behavior, and environment. During an educational workshop, we investigated the utility of mobile phones to gather data about the personal microbiome — the collection of microorganisms associated with the personal effects of an individual. We characterized microbial communities on smartphone touchscreens to determine whether there was significant overlap with the skin microbiome sampled directly from their owners. We found that about 22% of the bacterial taxa on participants’ fingers were also present on their own phones, as compared to 17% they shared on average with other people’s phones. When considered as a group, bacterial communities on men’s phones were significantly different from those on their fingers, while women’s were not. Yet when considered on an individual level, men and women both shared significantly more of their bacterial communities with their own phones than with anyone else’s. In fact, 82% of the OTUs were shared between a person’s index and phone when considering the dominant taxa (OTUs with more than 0.1% of the sequences in an individual’s dataset). Our results suggest that mobile phones hold untapped potential as personal microbiome sensors.

REFERENCE
Meadow JF, et al. Mobile phones carry the personal microbiome of their owners. PeerJ. 2014; 2: e447.
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Back to basics: hand hygiene and isolation

Purpose of review. Hand hygiene and isolation are basic, but very effective, means of preventing the spread of pathogens in healthcare. Although the principle may be straightforward, this review highlights some of the controversies regarding the implementation and efficacy of these interventions.
Recent findings. Hand hygiene compliance is an accepted measure of quality and safety in many countries. The evidence for the efficacy of hand hygiene in directly reducing rates of hospital-acquired infections has strengthened in recent years, particularly in terms of reduced rates of staphylococcal sepsis. Defining the key components of effective implementation strategies and the ideal method(s) of assessing hand hygiene compliance are dependent on a range of factors associated with the healthcare system. Although patient isolation continues to be an important strategy, particularly in outbreaks, it also has some limitations and can be associated with negative effects. Recent detailed molecular epidemiology studies of key healthcare-acquired pathogens have questioned the true efficacy of isolation, alone as an effective method for the routine prevention of disease transmission.
Summary. Hand hygiene and isolation are key components of basic infection control. Recent insights into the benefits, limitations and even adverse effects of these interventions are important for their optimal implementation.
Keywords: alcohol-based hand rub, hand hygiene, hospital acquired infections, isolation, WHO
REFERENCE:
G. Khai Lin Huang, et al.  Back to basics: hand hygiene and isolation. Curr Opin Infect Dis. Aug 2014; 27(4): 379–389.
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Día Mundial del Lavado de Manos, Octubre 15

Este 15 de Octubre, la Organización Mundial de la Salud, en conjunto con la UNICEF celebran el Día Mundial del Lavado de Manos. Esta es una oportunidad para recordar a todos la importancia del Lavado de Manos. Infórmate y distribuye la información acerca de la importancia del lavado de manos en: http://globalhandwashing.org
Descarga los posters y manuales de la campaña de la UNICEF AQUI.

OTROS MATERIALES Y RECURSOS (INGLÉS)

• Hand Hygiene Interactive Training Course

This course and promotional materials review key concepts of hand hygiene and other standard precautions to prevent healthcare-associated infections.

• Educational resources

Promotional materials (Posters).

• Hand hygiene in healthcare facilities

A variety of resources including guidelines for providers, patient empowerment materials, the latest technological advances in hand hygiene adherence measurement, frequently asked questions, and links to promotional and educational tools.

• WHO Tools for training and education

All health-care workers require clear and comprehensive training and education on the importance of hand hygiene, the "My 5 Moments for Hand Hygiene" approach and the correct procedures for handrubbing and handwashing.

• Water related hygiene

Hygiene refers to behaviors that can improve cleanliness and lead to good health, such as frequent hand washing, face washing, and bathing with soap and water. In many areas of the world, practicing personal hygiene etiquette is difficult due to lack of clean water and soap. Many diseases can be spread if the hands, face, or body are not washed appropriately at key times.

• WHO video on hand hygiene (DOWNLOAD)

• NEJM VIDEO ON HAND HYGIENE (SEVERAL LANGUAGES)

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#VIDEOS: Lávate las manos, Octubre 15, #IWashMyHands #ebola

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