Review: Space microbiology

The responses of microorganisms (viruses, bacterial cells, bacterial and fungal spores, and lichens) to selected factors of space (microgravity, galactic cosmic radiation, solar UV radiation, and space vacuum) were determined in space and laboratory simulation experiments. In general, microorganisms tend to thrive in the space flight environment in terms of enhanced growth parameters and a demonstrated ability to proliferate in the presence of normally inhibitory levels of antibiotics. The mechanisms responsible for the observed biological responses, however, are not yet fully understood. A hypothesized interaction of microgravity with radiation-induced DNA repair processes was experimentally refuted. The survival of microorganisms in outer space was investigated to tackle questions on the upper boundary of the biosphere and on the likelihood of interplanetary transport of microorganisms. It was found that extraterrestrial solar UV radiation was the most deleterious factor of space. Among all organisms tested, only lichens (Rhizocarpon geographicum and Xanthoria elegans) maintained full viability after 2 weeks in outer space, whereas all other test systems were inactivated by orders of magnitude. Using optical filters and spores of Bacillus subtilis as a biological UV dosimeter, it was found that the current ozone layer reduces the biological effectiveness of solar UV by 3 orders of magnitude. If shielded against solar UV, spores of B. subtilis were capable of surviving in space for up to 6 years, especially if embedded in clay or meteorite powder (artificial meteorites). The data support the likelihood of interplanetary transfer of microorganisms within meteorites, the so-called lithopanspermia hypothesis.

REFERENCE:
Horneck G, et al. Space microbiology. Microbiol Mol Biol Rev. 2010 Mar;74(1):121-56. doi: 10.1128/MMBR.00016-09. Review.

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Exhaled Air Dispersion during Coughing w/wo Wearing a Surgical or N95 Mask

      Room ventilation design and experimental set-up.

Objectives: We compared the expelled air dispersion distances during coughing from a human patient simulator (HPS) lying at 45° with and without wearing a surgical mask or N95 mask in a negative pressure isolation room.
Methods: Airflow was marked with intrapulmonary smoke. Coughing bouts were generated by short bursts of oxygen flow at 650, 320, and 220L/min to simulate normal, mild and poor coughing efforts, respectively. The coughing jet was revealed by laser light-sheet and images were captured by high definition video. Smoke concentration in the plume was estimated from the light scattered by smoke particles. Significant exposure was arbitrarily defined where there was ≥ 20% of normalized smoke concentration.
Results: During normal cough, expelled air dispersion distances were 68, 30 and 15 cm along the median sagittal plane when the HPS wore no mask, a surgical mask and a N95 mask, respectively. In moderate lung injury, the corresponding air dispersion distances for mild coughing efforts were reduced to 55, 27 and 14 cm, respectively, p < 0.001. The distances were reduced to 30, 24 and 12 cm, respectively during poor coughing effort as in severe lung injury. Lateral dispersion distances during normal cough were 0, 28 and 15 cm when the HPS wore no mask, a surgical mask and a N95 mask, respectively.
Conclusions: Normal cough produced a turbulent jet about 0.7 m towards the end of the bed from the recumbent subject. N95 mask was more effective than surgical mask in preventing expelled air leakage during coughing but there was still significant sideway leakage.

REFERENCE:
Hui, David S. et al. “Exhaled Air Dispersion during Coughing with and without Wearing a Surgical or N95 Mask.” Ed. Ravi Jhaveri. PLoS ONE 7.12 (2012): e50845. PMC. Web. 16 Apr. 2016.

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Bactericidal Effects and Mechanism of Action of Olanexidine Gluconate, a New Antiseptic.

Chemical structures of olanexidine (A)
and chlorhexidine (B).

Olanexidine gluconate [1-(3,4-dichlorobenzyl)-5-octylbiguanide gluconate] (development code OPB-2045G) is a new monobiguanide compound with bactericidal activity. In this study, we assessed its spectrum of bactericidal activity and mechanism of action. The minimal bactericidal concentrations of the compound for 30-, 60-, and 180-s exposures were determined with the microdilution method using a neutralizer against 320 bacterial strains from culture collections and clinical isolates. Based on the results, the estimated bactericidal olanexidine concentrations with 180-s exposures were 869 μg/ml for Gram-positive cocci (155 strains), 109 μg/ml for Gram-positive bacilli (29 strains), and 434 μg/ml for Gram-negative bacteria (136 strains). Olanexidine was active against a wide range of bacteria, especially Gram-positive cocci, including methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, and had a spectrum of bactericidal activity comparable to that of commercial antiseptics, such as chlorhexidine and povidone-iodine. In vitro experiments exploring its mechanism of action indicated that olanexidine (i) interacts with the bacterial surface molecules, such as lipopolysaccharide and lipoteichoic acid, (ii) disrupts the cell membranes of liposomes, which are artificial bacterial membrane models, (iii) enhances the membrane permeability of Escherichia coli, (iv) disrupts the membrane integrity of S. aureus, and (v) denatures proteins at relatively high concentrations (≥160 μg/ml). These results indicate that olanexidine probably binds to the cell membrane, disrupts membrane integrity, and its bacteriostatic and bactericidal effects are caused by irreversible leakage of intracellular components. At relatively high concentrations, olanexidine aggregates cells by denaturing proteins. This mechanism differs slightly from that of a similar biguanide compound, chlorhexidine.

Hagi A, et al. Bactericidal Effects and Mechanism of Action of Olanexidine Gluconate, a New Antiseptic. Antimicrob Agents Chemother. 2015 Aug;59(8):4551-9. doi: 10.1128/AAC.05048-14. Epub 2015 May 18.

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HISTORY 1968: Containment of Microbial Aerosols in a Microbiological Safety Cabinet

A microbiological safety cabinet was evaluated to determine conditions under which microorganisms might escape. Tests were conducted under three cabinet-closure conditions, various airflow velocities, and different laboratory operations, with 105, 1.1 × 105, and 106 microorganisms per cubic foot of cabinet space released per min for 5 min. The data revealed that (i) escape of a human infectious dose is possible when the cabinet is used with the glove panel off; (ii) the number of organisms that escaped from the cabinet increased with a decrease in air velocity; and (iii) an increase in the number of laboratory operations resulted in an increase in the number of organisms that escaped. Thus, when the glove panel was off, the cabinet was only safe for operations that released a small number of microorganisms into the cabinet, whereas the cabinet was safe for operations of significantly greater hazard when used with the glove panel on but with the gloves unattached.

REFERENCE:
Barbeito, Manuel S., and Larry A. Taylor. “Containment of Microbial Aerosols in a Microbiological Safety Cabinet.” Applied Microbiology 16.8 (1968): 1225–1229. Print.

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Respiratory consequences of N95-type Mask usage in pregnant healthcare workers-a controlled clinical study.

Tight fitting Hans Rudolph respirator masks
used in Phase II. (a) Control cycles with outlet
open to air, and (b) N95 cycles with outlet
covered by N95 mask materials

BACKGROUND: Outbreaks of emerging infectious diseases have led to guidelines recommending the routine use of N95 respirators for healthcare workers, many of whom are women of childbearing age. The respiratory effects of prolonged respirator use on pregnant women are unclear although there has been no definite evidence of harm from past use.
METHODS: We conducted a two-phase controlled clinical study on healthy pregnant women between 27 to 32 weeks gestation. In phase I, energy expenditure corresponding to the workload of routine nursing tasks was determined. In phase II, pulmonary function of 20 subjects was measured whilst at rest and exercising to the predetermined workload while breathing ambient air first, then breathing through N95-mask materials.
RESULTS: Exercising at 3 MET while breathing through N95-mask materials reduced mean tidal volume (TV) by 23.0 % (95 % CI -33.5 % to -10.5 %, p < 0.001) and lowered minute ventilation (VE) by 25.8 % (95 % CI -34.2 % to -15.8 %, p < 0.001), with no significant change in breathing frequency compared to breathing ambient air. Volumes of oxygen consumption (VO2) and carbon dioxide expired (VCO2) were also significantly reduced; VO2 by 13.8 % (95 % CI -24.2 % to -3 %, p = 0.013) and VCO2 by 17.7 %, (95 % CI -28.1 % to -8.6 %, p = 0.001). Although no changes in the inspired oxygen and carbon dioxide concentrations were demonstrated, breathing through N95-mask materials during low intensity work (3 MET) reduced expired oxygen concentration by 3.2 % (95 % CI: -4.1 % to -2.2 %, p < 0.001), and increased expired carbon dioxide by 8.9 % (95 % CI: 6.9 % to 13.1 %; p <0.001) suggesting an increase in metabolism. There were however no changes in the maternal and fetal heart rates, finger-tip capillary lactate levels and oxygen saturation and rating of perceived exertion at the work intensity investigated.
CONCLUSIONS: Breathing through N95 mask materials have been shown to impede gaseous exchange and impose an additional workload on the metabolic system of pregnant healthcare workers, and this needs to be taken into consideration in guidelines for respirator use. The benefits of using N95 mask to prevent serious emerging infectious diseases should be weighed against potential respiratory consequences associated with extended N95 respirator usage.

REFERENCE:
Tong PS, et al. Respiratory consequences of N95-type Mask usage in pregnant healthcare workers-a controlled clinical study. Antimicrob Resist Infect Control. 2015 Nov 16;4:48. doi: 10.1186/s13756-015-0086-z. eCollection 2015.

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Semana de Vacunación en las Américas, Abril 23 - 30, 2016 #vacúnate

¡Te invitamos a celebrar la SVA 2016 este año para alcanzar el oro a través de la vacunación! El 14º aniversario de la Semana de Vacunación en las Américas se celebrará del 23 al 30 de abril del 2016, con el eslogan regional: “¡Vamos por el oro! ¡Vacúnate!” Las vacunas son patógenos debilitados o muertos que ayudan a tu sistema inmune a combatir enfermedades.Las vacunas no hacen que te enfermes, pero preparan tu cuerpo para luchar contra la enfermedad si te expones a los patógenos en el futuro. Las vacunas refuerzan tu sistema inmune y te ayudan a combatir más de 20 enfermedades prevenibles diferentes.

http://www.paho.org/vwa/

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SEMINARIO INTERNACIONAL

SEMINARIO INTERNACIONAL

Regulación de la protección
De los trabajadores de la salud

Viernes 20 de mayo de 2016, 9:00 hrs. Dirigido a todo público interesado. 
Cupo limitado a la capacidad de la sede. 
Acceso gratuito.

Instituto de Investigaciones Jurídicas, UNAM, Ciudad de México.

http://www.juridicas.unam.mx/inst/evacad/Eventos/2016/0520/

Para ver UBICACIÓN DEL INSTITUTO y formas de acceder a él, pulse el siguiente vínculo: http://www.juridicas.unam.mx/inst/ubicacion/
Circuito Maestro Mario de la Cueva s/n, Ciudad de la Investigación en Humanidades, 
Ciudad Universitaria, Delegación Coyoacán, C.P. 04510, México, D. F.

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Randomised Trial of Cloth Masks Compared with Medical Masks in Healthcare Workers

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

Strengths and limitations of this study:

1. The use of cloth masks is widespread around the world, particularly in countries at high-risk for emerging infections, but there have been no efficacy studies to underpin their use.
2. This study is large, a prospective randomised clinical trial (RCT) and the first RCT ever conducted of cloth masks.
3. The use of cloth masks are not addressed in most guidelines for health care workers—this study provides data to update guidelines.
4. The control arm was ‘standard practice’, which comprised mask use in a high proportion of participants. As such (without a no-mask control), the finding of a much higher rate of infection in the cloth mask arm could be interpreted as harm caused by cloth masks, efficacy of medical masks, or most likely a combination of both.

REFERENCE:
MacIntyre, CR et al. “A Cluster Randomised Trial of Cloth Masks Compared with Medical Masks in Healthcare Workers.” BMJ Open 5.4 (2015): e006577. PMC. Web. 16 Apr. 2016.

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Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals

Contact agar plate cultures showing bacterial colonies
recovered from a patient’s overbed table before (left)
and after (right) the surface was cleaned by a housekeeper
using contaminated quaternary ammonium disinfectant.
Colonies on right are Serratia marcescens andAchromobacter xylosoxidans

Experts agree that careful cleaning and disinfection of environmental surfaces are essential elements of effective infection prevention programs. However, traditional manual cleaning and disinfection practices in hospitals are often suboptimal. This is often due in part to a variety of personnel issues that many Environmental Services departments encounter. Failure to follow manufacturer's recommendations for disinfectant use and lack of antimicrobial activity of some disinfectants against healthcare-associated pathogens may also affect the efficacy of disinfection practices. Improved hydrogen peroxide-based liquid surface disinfectants and a combination product containing peracetic acid and hydrogen peroxide are effective alternatives to disinfectants currently in widespread use, and electrolyzed water (hypochlorous acid) and cold atmospheric pressure plasma show potential for use in hospitals. Creating "self-disinfecting" surfaces by coating medical equipment with metals such as copper or silver, or applying liquid compounds that have persistent antimicrobial activity surfaces are additional strategies that require further investigation. Newer "no-touch" (automated) decontamination technologies include aerosol and vaporized hydrogen peroxide, mobile devices that emit continuous ultraviolet (UV-C) light, a pulsed-xenon UV light system, and use of high-intensity narrow-spectrum (405 nm) light. These "no-touch" technologies have been shown to reduce bacterial contamination of surfaces. A micro-condensation hydrogen peroxide system has been associated in multiple studies with reductions in healthcare-associated colonization or infection, while there is more limited evidence of infection reduction by the pulsed-xenon system. A recently completed prospective, randomized controlled trial of continuous UV-C light should help determine the extent to which this technology can reduce healthcare-associated colonization and infections. In conclusion, continued efforts to improve traditional manual disinfection of surfaces are needed. In addition, Environmental Services departments should consider the use of newer disinfectants and no-touch decontamination technologies to improve disinfection of surfaces in healthcare.

REFERENCE:

Boyce JM. Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals. Antimicrob Resist Infect Control. 2016 Apr 11;5:10. doi: 10.1186/s13756-016-0111-x. eCollection 2016. Review.

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Microbial aerosol liberation from soiled textiles isolated during routine residuals handling in a modern health care setting

BACKGROUND: A wide variety of specialty textiles are used in health care settings for bedding, clothing, and privacy. The ability of textiles to host or otherwise sequester microbes has been well documented; however, their reciprocal potential for liberating airborne bacteria remains poorly characterized. In response, a multi-season survey of bacterial bioaerosols was conducted in the origin and terminus of residual paths which are specifically designed to isolate soiled hospital textiles as they are moved to laundering. This survey used conventional optical particle counting which incorporated multi-channel fluorescence in conjunction with molecular phylogenetic analyses to characterize the bioaerosols liberated during soiled textile storage--immediately before and after the occupation of a modern hospital. Although outfitted with a HEPA filtration system, the number of airborne particles presenting fluorescing optical signatures consistent with airborne bacteria and fungi significantly increased in textile holding rooms soon after the hospital's commissioning, even though these isolated residual areas rarely host personnel. The bioaerosol liberated during textile storage was characterized using Illumina MiSeq sequencing of bacterial 16S ribosomal ribonucleic acid (rRNA) genes. Gene copies recovered by quantitative PCR from aerosol collected in co-located impingers were consistent with fluorescence gated optical particle counting.
RESULTS: The relative abundance patterns of proximal bacterial bioaerosol were such that the air in the origin and terminus of textile storage rooms could not be differentiated once the hospital began processing soiled linens. Genes from microbes typically associating with human skin, feces, and hair--Staphylococcus, Propionibacteria, Corynebacteria, Lactobacillus, and Streptococcus spp.--dominated the aerosol abundance profiles in textile holding rooms, which were generally far less diverse than communities recovered from surfaces in patient rooms.
CONCLUSIONS: These results suggest that aerosol partitioning from the routine handling of soiled textiles can contribute to airborne exposures in the health care environment.
REFERENCE:
Handorean A, et al. Microbial aerosol liberation from soiled textiles isolated during routine residuals handling in a modern health care setting. Microbiome. 2015 Dec 9;3:72. doi: 10.1186/s40168-015-0132-3.

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Effects of Disinfectants on Larval Development of #Ascaris suum Eggs

Ascaris suum eggs in various conditions. 

The objective of this study was to evaluate the effects of several different commercial disinfectants on the embryogenic development of Ascaris suum eggs. A 1-ml aliquot of each disinfectant was mixed with approximately 40,000 decorticated or intact A. suum eggs in sterile tubes. After each treatment time (at 0.5, 1, 5, 10, 30, and 60 min), disinfectants were washed away, and egg suspensions were incubated at 25˚C in distilled water for development of larvae inside. At 3 weeks of incubation after exposure, ethanol, methanol, and chlorohexidin treatments did not affect the larval development of A. suum eggs, regardless of their concentration and treatment time. Among disinfectants tested in this study, 3% cresol, 0.2% sodium hypochlorite and 0.02% sodium hypochlorite delayed but not inactivated the embryonation of decorticated eggs at 3 weeks of incubation, because at 6 weeks of incubation, undeveloped eggs completed embryonation regardless of exposure time, except for 10% povidone iodine. When the albumin layer of A. suum eggs remained intact, however, even the 10% povidone iodine solution took at least 5 min to reasonably inactivate most eggs, but never completely kill them with even 60 min of exposure. This study demonstrated that the treatment of A. suum eggs with many commercially available disinfectants does not affect the embryonation. Although some disinfectants may delay or stop the embryonation of A. suum eggs, they can hardly kill them completely.
REFERENCE:
Oh KS, et al. Effects of Disinfectants on Larval Development of Ascaris suum Eggs. Korean J Parasitol. 2016 Feb;54(1):103-7. doi: 10.3347/kjp.2016.54.1.103. Epub 2016 Feb 26.

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Microbial Contamination on Used Surgical Masks

Objective: To assess the relationship of bacterial and fungal contamination on used surgical masks worn by the hospital personnel and microbial air quality in their working wards.
Methods: This is a cross-sectional study of 230 used surgical masks collected from 214 hospital personnel, and 215 indoor air samples collected from their working wards to culture for bacterial and fungal counts. This study was carried out at the hospital in Bangkok. Group or genus of isolated bacteria and fungi were preliminarily identified by Gram’s stain and lacto-phenol cotton blue. Data were analyzed using paired t-test and Pearson’s correlation coefficient at the significant level of p<0.050.
Results: Means and standard deviation of bacterial and fungal contamination on inside area of the used masks were 47 ± 56 and 15 ± 9 cfu/ml/piece, and on outside area were 166 ± 199 and 34 ± 18 cfu/ml/piece, respectively, p<0.001. The bacterial and fungal contamination on used masks from hospital personnel working in the male and female medical wards and out-patient department, as well as the bacterial and fungal counts of the indoor air sample collected from the same area were relatively higher than the other wards. The predominant isolated bacteria and fungi contaminated on inside and outside areas of the used masks and air samples were similar (Staphylococcus spp. and Aspergillus spp.; respectively). For its relationship, results found that bacterial and fungal counts in air samples showed significantly positive correlation with the bacterial contamination load on outside area of the used masks, r=0.16, p=0.018 and r=0.21, p=0.003, respectively.
Conclusion: High bacterial contamination on outside area of the used masks was demonstrated, and it showed a significant correlation with microbial air quality of working wards.

REFERENCE:
Luksamijarulkul, P et al. “Microbial Contamination on Used Surgical Masks among Hospital Personnel and Microbial Air Quality in Their Working Wards: A Hospital in Bangkok.” Oman Medical Journal 29.5 (2014): 346–350. PMC. Web. 18 Mar. 2016.
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Cursos para el 8º Simposio de Bioseguridad #SIBB16

Inscripciones:http://amexbio.wildapricot.org/Inscripciones
Posted by Asociación Mexicana de Bioseguridad A.C. (AMEXBIO) on miércoles, 16 de marzo de 2016

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Guía técnica de limpieza, desinfección y esterilización

La limpieza, desinfección y esterilización de superficies, aparatos e instrumental, son procesos que están orientados a la minimización de la transmisión de infecciones en el entorno de los centros asistenciales, por lo que se incluyen dentro de las Estrategias de Seguridad para la protección, tanto de los usuarios como de los profesionales. La adecuada realización de estos procesos permitirá elevar el nivel de calidad de la asistencia que presta el Servicio de Salud.
Los trabajadores del sistema sanitario deben poseer conocimientos acerca de la correcta utilización del material sanitario y de los productos empleados en su descontaminación según el marco legal que establece la directiva 93/42/CEE de productos sanitarios, de obligado cumplimiento en nuestro país. Esta directiva europea queda transcrita en España en el Real Decreto 1591/2009 del 16 de octubre en el que se regulan los productos sanitarios.
Según la legislación vigente, cada vez que se limpian, se desinfectan, o esterilizan productos sanitarios se forma parte de una cadena, por ello se adquiere una responsabilidad legal que obliga a que se garantice la correcta ejecución de estos procesos.
El presente documento además de servir de guía de consulta, tiene la finalidad de normalizar las actuaciones que en limpieza, desinfección y esterilización se realicen en todo el ámbito de la Atención Primaria de Asturias.

DESCARGAR:  Guía técnica de limpieza, desinfección y esterilización

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Using a mHealth Tutorial Application for training Healthcare workers in Nigeria

BACKGROUND: The Ebola epidemic exposed the weak state of health systems in West Africa and their devastating effect on frontline health workers and the health of populations. Fortunately, recent reviews of mobile technology demonstrate that mHealth innovations can help alleviate some health system constraints such as balancing multiple priorities, lack of appropriate tools to provide services and collect data, and limited access to training in health fields such as mother and child health, HIV/AIDS and sexual and reproductive health. However, there is little empirical evidence of mHealth improving health system functions during the Ebola epidemic in West Africa.
METHODS: We conducted quantitative cross-sectional surveys in 14 health facilities in Ondo State, Nigeria, to assess the effect of using a tablet computer tutorial application for changing the knowledge and attitude of health workers regarding Ebola virus disease.
RESULTS: Of 203 participants who completed pre- and post-intervention surveys, 185 people (or 91%) were female, 94 participants (or 46.3%) were community health officers, 26 people (13 %) were nurses/midwives, 8 people (or 4%) were laboratory scientists and 75 people (37%) belonged to a group called others. Regarding knowledge of Ebola: 178 participants (or 87.7%) had foreknowledge of Ebola before the study. Further analysis showed an 11% improvement in average knowledge levels between pre- and post-intervention scores with statistically significant differences (P < 0.05) recorded for questions concerning the transmission of the Ebola virus among humans, common symptoms of Ebola fever and whether Ebola fever was preventable. Additionally, there was reinforcement of positive attitudes of avoiding the following: contact with Ebola patients, eating bush meat and risky burial practices as indicated by increases between pre- and post-intervention scores from 83 to 92%, 57 to 64% and 67 to 79%, respectively. Moreover, more participants (from 95 to 97%) reported a willingness to practice frequent hand washing and disinfecting surfaces and equipment following the intervention, and more health workers were willing (from 94 to 97%) to use personal protective equipment to prevent the transmission of Ebola.
CONCLUSIONS: The modest improvements in knowledge and reported attitudinal change toward Ebola virus disease suggests mHealth tutorial applications could hold promise for training health workers and building resilient health systems to respond to epidemics in West Africa.

REFERENCE:
Otu, Akaninyene et al. “Using a mHealth Tutorial Application to Change Knowledge and Attitude of Frontline Health Workers to Ebola Virus Disease in Nigeria: A before-and-after Study.” Human Resources for Health 14 (2016): 5. PMC. Web. 16 Feb. 2016.

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SEMINARIO: Uso adecuado del cloro como desinfectante.

CUPO LLENO PARA EL 11 DE MARZO. 

Invitamos a participar en nuestro Seminario "Uso adecuado del cloro como desinfectante". El hipoclorito de sodio y el etanol son dos de las sustancias químicas más comunes de la vida diaria y en áreas hospitalarias utilizadas como agentes desinfectantes. Sin embargo, muchas de las personas involucradas en el uso o preparación de estas sustancias, desconocen los conceptos básicos para su uso. Al término del seminario de 1 hora las personas conocerán las correctas concentraciones de uso, las limitaciones de uso, los mecanismos de acción y la correcta preparación de estas sustancias para su uso. 

Usted puede elegir entre cualquiera de las fechas para participar:

Título:	Uso adecuado del cloro y etanol como desinfectantes
Profesor titular:	Dra. Klintsy J. Torres Hernández
Objetivo:	Al final de la sesión, el alumno podrá: • Describir el método de desinfección con hipoclorito de sodio (cloro). • Describir los  mecanismos del cloro • Conocer las limitaciones del uso del cloro. • Preparar soluciones de cloro para la desinfección.
Fechas:	Inscríbete en cualquiera de las siguientes fechas:
	- Viernes 11 de marzo de 2016
	- Viernes 12 de Agosto de 2016
	- Viernes 11 de Noviembre de 2016.
Horario:	11 hrs.
Duración:	1 hora
Dirigido a:	Estudiantes, médicos, técnicos de laboratorio, profesionistas y personas que manejan materiales biológicos. Abierto al público en general.
Organizan:	Asociación Mexicana de Bioseguridad A.C. y el Instituto Nacional de Enfermedades Respiratorias
Cupo máximo:	80 Personas
Costo:	Sin costo
Inscripciones:	Registro a partir de Febrero de 2016.
Dirección:	Instituto Nacional de Enfermedades Respiratorias Calzada de Tlalpan 4502
	Col. Sección XVI
	Tlalpan DF 14080
	México

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Quantification of Influenza Virus RNA in Aerosols in Patient Rooms

Background: The potential for human influenza viruses to spread through fine particle aerosols remains controversial. The objective of our study was to determine whether influenza viruses could be detected in fine particles in hospital rooms.
Methods and Findings: We sampled the air in 2-bed patient isolation rooms for four hours, placing cyclone samplers at heights of 1.5m and 1.0m. We collected ten air samples each in the presence of at least one patient with confirmed influenza A virus infection, and tested the samples by reverse transcription polymerase chain reaction. We recovered influenza A virus RNA from 5/10 collections (50%); 4/5 were from particles>4 μm, 1/5 from 1–4 μm, and none in particles<1 μm.
Conclusions: Detection of influenza virus RNA in aerosols at low concentrations in patient rooms suggests that healthcare workers and visitors might have frequent exposure to airborne influenza virus in proximity to infected patients. A limitation of our study was the small sample size. Further studies should be done to quantify the concentration of viable influenza virus in healthcare settings, and factors affecting the detection of influenza viruses in fine particles in the air.

REFERENCE:
Leung, Nancy H. L. et al. “Quantification of Influenza Virus RNA in Aerosols in Patient Rooms.” Ed. Andrew Pekosz. PLoS ONE 11.2 (2016): e0148669. PMC. Web. 16 Feb. 2016.

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Respirator masks protect health but impact performance

Respiratory protective masks are used whenever it is too costly or impractical to remove airborne contamination from the atmosphere. Respirators are used in a wide range of occupations, form the military to medicine. Respirators have been found to interfere with many physiological and psychological aspects of task performance at levels from resting to maximum exertion. Many of these limitations have been investigated in order to determine quantitatively how much performance decrement can be expected from different levels of respirator properties. The entire system, including respirator and wearer interactions, must be considered when evaluating wearer performances. This information can help respirator designers to determine trade-offs or managers to plan to compensate for reduced productivity of wearers.

REFERENCE:
Johnson AT. Respirator masks protect health but impact performance: a review.  J Biol Eng. 2016 Feb 9;10:4. doi: 10.1186/s13036-016-0025-4. eCollection 2016. Review.

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Hospital Preparations for Viral Hemorrhagic Fever Patients #Ebola

The Major Incident Hospital of the University Medical Centre of Utrecht has a longstanding history of preparing for the management of highly pathogenic and infectious organisms. An assessment of the hospital’s preparations for an outbreak of viral hemorrhagic fever and its experience during admission of a patient with Ebola virus disease showed that the use of the buddy system, frequent training, and information sessions for staff and their relatives greatly increased the sense of safety and motivation among staff. Differing procedures among ambulance services limited the number of services used for transporting patients. Waste management was the greatest concern, and destruction of waste had to be outsourced. The admission of an Ebola patient proceeded without incident but led to considerable demands on staff. The maximum time allowed for wearing personal protective equipment was 45 minutes to ensure safety, and an additional 20 minutes was needed for recovery.

REFERENCE:
Haverkort JJ, et al.  Hospital Preparations for Viral Hemorrhagic Fever Patients and Experience Gained from Admission of an Ebola Patient. Emerg Infect Dis. 2016 Feb;22(2):184-91.
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Outbreak of Exanthematous Illness Associated with Zika, Chikungunya, and Dengue Viruses, Salvador, Brazil

Zika virus (ZIKV) has been recognized as an emerging mosquito-borne flavivirus since outbreaks were reported from Yap Island in 2007, French Polynesia in 2013, and Cook Island and New Caledonia in 2014. It has joined dengue virus (DENV) and chikungunya virus (CHIKV) as global public health threats. ZIKV infection typically causes a self-limited dengue-like illness characterized by exanthema, low-grade fever, conjunctivitis, and arthralgia, and an increase in rates of Guillain-Barré syndrome have been observed during ZIKV outbreaks. In Brazil, clusters of cases of acute exanthematous illness have been reported from various regions since late 2014, and in April 2015, ZIKV was identified as the etiologic agent. In May 2015, the Brazilian Ministry of Health recognized circulation of ZIKV in Brazil. We report epidemiologic findings for an ongoing outbreak of acute exanthematous illness in the population of Salvador, the third largest city in Brazil.

REFERENCE:
Cardoso, Cristiane W. et al. “Outbreak of Exanthematous Illness Associated with Zika, Chikungunya, and Dengue Viruses, Salvador, Brazil.” Emerging Infectious Diseases 21.12 (2015): 2274–2276. PMC. Web. 10 Feb. 2016.
Musso, Didier. “Zika Virus Transmission from French Polynesia to Brazil.” Emerging Infectious Diseases 21.10 (2015): 1887. PMC. Web. 10 Feb. 2016.

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#Zika Virus Associated with Microcephaly

A widespread epidemic of Zika virus (ZIKV) infection was reported in 2015 in South and Central America and the Caribbean. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with ZIKV. In this report, we describe the case of an expectant mother who had a febrile illness with rash at the end of the first trimester of pregnancy while she was living in Brazil. Ultrasonography performed at 29 weeks of gestation revealed microcephaly with calcifications in the fetal brain and placenta. After the mother requested termination of the pregnancy, a fetal autopsy was performed. Micrencephaly (an abnormally small brain) was observed, with almost complete agyria, hydrocephalus, and multifocal dystrophic calcifications in the cortex and subcortical white matter, with associated cortical displacement and mild focal inflammation. ZIKV was found in the fetal brain tissue on reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay, with consistent findings on electron microscopy. The complete genome of ZIKV was recovered from the fetal brain.

REFERENCE:

• Mlakar J, et al. Zika Virus Associated with Microcephaly. N Engl J Med. 2016, Feb 10. 

• Rubin EJ, et al. Zika Virus and Microcephaly. N Engl J Med. 2016, Feb 10.

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Evidence of #Zika Virus Infection in Brain and Placental Tissues — Brazil, 2015

NPR AUDIO: Zika in Brasil

Zika virus is a mosquito-borne flavivirus that is related to dengue virus and transmitted primarily by Aedes aegypti mosquitoes, with humans acting as the principal amplifying host during outbreaks. Zika virus was first reported in Brazil in May 2015. By February 9, 2016, local transmission of infection had been reported in 26 countries or territories in the Americas. Infection is usually asymptomatic, and, when symptoms are present, typically results in mild and self-limited illness with symptoms including fever, rash, arthralgia, and conjunctivitis. However, a surge in the number of children born with microcephaly was noted in regions of Brazil with a high prevalence of suspected Zika virus disease cases. More than 4,700 suspected cases of microcephaly were reported from mid-2015 through January 2016, although additional investigations might eventually result in a revised lower number. In response, the Brazil Ministry of Health established a task force to further investigate possible connections between the virus and brain anomalies in infants.

REFERENCE:
Martines RB, Bhatnagar J, Keating MK, et al. Notes from the Field: Evidence of Zika Virus Infection in Brain and Placental Tissues from Two Congenitally Infected Newborns and Two Fetal Losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016;65(Early Release):1–2.
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Biosafety Test for Plant Growth-Promoting Bacteria

Plant growth-promoting bacteria (PGPB) colonize plants and enhance their growth by different mechanisms. Some of these microorganisms may represent a potential threat to human, animal or plant health; however, their use might be approved in parts of Europe if they have been recommended as plant growth enhancers. The current regulatory framework has resulted in a fragmented, contradictory system, and there is an urgent need to establish harmonized protocols for the predictability, efficiency, consistency and especially the safety of PGPB for human and animal health and for the environment. In response to current efforts to update biosafety policies and provide alternative methods to replace the use of vertebrate animals, we propose a panel of tests and an evaluation system to reliably determine the biosafety of bacterial strains used as PGPB. Based on the results of different tests, we propose a scoring system to evaluate the safety of candidates for PGPB within the limitations of the assays used.

REFERENCE:
Vílchez JI, et al. Biosafety Test for Plant Growth-Promoting Bacteria: Proposed Environmental and Human Safety Index (EHSI) Protocol. Front Microbiol. 2016 Jan 7;6:1514.

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Safe transportation of biomedical waste in a health care institution

INTRODUCTION: The chances of health care waste (Biomedical waste) coming in contact with the health care workers, patients, visitors, sanitary workers, waste handlers, public, rag pickers and animals during transportation are high.
MATERIALS AND METHODS: The study was conducted over a period of seven months (April 2013-October 2013) in a 500-bedded hospital where the average quantum of biomedical waste is 0.8 kg/bed/day. The issues related to transportation of health care waste from 39 generation sites to the health care waste storage site inside the hospital (intramural transfer) were addressed and analysed in a predesigned proforma.
RESULTS: The biomedical waste management team inspected the generation sites in the hospital on a daily basis and conformance to the procedures was checked. It was found that waste was collected at scheduled timings in 99.6% occasions; however, compliance to wearing personal protective equipment (PPE) was poor and ranged from 1.22-1.84%.
CONCLUSION: Transportation of health care waste is a crucial step in its management. Regular training program for all the sections of health care workers with special emphasis on waste handlers is needed.

REFERENCE:
Kumar A, Duggal S, Gur R, Rongpharpi SR, Sagar S, Rani M, Dhayal D, Khanijo CM. Safe transportation of biomedical waste in a health care institution. Indian J Med Microbiol. 2015 Jul-Sep;33(3):383-6.
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8º Simposio de #Bioseguridad y Biocustodia 2016 http://amexbio.wildapricot.org/SIBB

8º Simposio de #Bioseguridad y Biocustodia 2016 

INFORMES: http://amexbio.wildapricot.org/SIBB

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