Relación entre la exposición ocupacional a desinfectantes y la incidencia de la enfermedad #EPOC

EPOC, conjunto de enfermedades pulmonares que
obstruyen la circulación de aire y dificultan la respiración.

Pregunta:  ¿La exposición a desinfectantes y productos de limpieza está relacionada con la incidencia de la enfermedad pulmonar obstructiva crónica (EPOC) entre los trabajadores de la salud?
Conclusiones:  En un estudio de cohortes de 73 262 enfermeras estadounidenses que participaron en el Estudio de salud de enfermeras II, a las que se les dio seguimiento desde 2009 hasta 2015, la exposición ocupacional a productos de limpieza y desinfectantes se relacionó significativamente con un aumento del 25 % al 38 % del riesgo de desarrollar la enfermedad pulmonar obstructiva crónica independiente del asma y del tabaquismo.
Significado:  Las conclusiones de este estudio sugieren que el uso regular de desinfectantes químicos entre las enfermeras puede ser un factor de riesgo para desarrollar la enfermedad pulmonar obstructiva crónica.
REFERENCIA:
Dumas O, et al. Association of Occupational Exposure to Disinfectants With Incidence of Chronic Obstructive Pulmonary Disease Among US Female Nurses. JAMA Netw Open. Published online October 18, 20192(10):e1913563. doi:10.1001/jamanetworkopen.2019.13563

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Factores en la selección de desinfectantes de superficie en instalaciones animales

Debido a que los desinfectantes de superficie son un medio importante para el control de patógenos dentro de las instalaciones de animales de laboratorio, estos productos deben tener un espectro apropiado de actividad antimicrobiana. Sin embargo, también se deben considerar muchos otros factores, incluidos los efectos sobre la salud humana, la seguridad ambiental y el comportamiento animal. Las soluciones acuosas de hipoclorito de sodio a menudo se consideran el "estándar de oro" para la desinfección de la superficie, pero estos productos pueden ser corrosivos, cáusticos y de olor aversivo. Este estudio fue diseñado para identificar desinfectantes que son tan efectivos como las soluciones de hipoclorito pero más aceptables para su uso en un entorno de animales de laboratorio. Se desarrolló un ensayo de eficacia desinfectante antiviral mediante el uso de vectores virales que expresaban la proteína verde fluorescente como sustitutos de virus de tipo salvaje de interés en animales de laboratorio. Las pruebas de eficacia revelaron que la mayoría de los productos eran altamente efectivos cuando se usaban contra vectores virales en suspensión. Sin embargo, cuando los desinfectantes fueron desafiados por el virus amortiguador en proteínas o por el virus de secado en superficies no porosas, los productos de hipoclorito y peroximonosulfato tuvieron el mejor rendimiento. La revisión de las hojas de datos de seguridad para los agentes indicó que un producto a base de peróxido era considerablemente más seguro que los otros productos probados y que el pH de la mayoría de los productos no era propicio para la eliminación por un desagüe. Las pruebas de comportamiento de ratones Swiss Webster, C57Bl / 6 y BALB / c mostraron que los productos a base de hipoclorito y peróxido eran claramente aversivos, dado que los ratones evitaban estos productos de manera sistemática. Todos estos factores deben tenerse en cuenta al elegir el desinfectante apropiado.
REFERENCE:
Campagna MV, et al. Factors in the Selection of Surface Disinfectants for Use in a Laboratory Animal Setting. J Am Assoc Lab Anim Sci. 2016;55(2):175–188.

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A Tool for Assessment of Animal Health Laboratory Safety and Biosecurity

The Laboratory Management Tool (LMT) is a standardized spreadsheet-based assessment tool developed to help support national, regional, and global efforts to maintain an effective network of animal health and veterinary public health laboratories. The safety and biosecurity module of the LMT (LMT-S) includes 98 measures covering administrative, operational, engineering, and personal protective equipment practices used to provide laboratory safety and biosecurity. Performance aspects of laboratory infrastructure and technical compliance considered fundamental for ensuring that a laboratory is able to appropriately function in a safe and biosecure manner are systematically queried and scored for compliance on a four-point scale providing for a semi-quantitative assessment. Data collected is used to generate graphs and tables mapping levels of compliance with international standards and good practices, as well as for documenting progress over time. The LMT-S was employed by trained auditors in 34 laboratories located in 19 countries between 2015 and 2017. The tool is intended to help standardize animal health laboratory assessments, document compliance with recognized laboratory safety and biosecurity measures, serve as a self-help and training tool, and assist global laboratory development efforts by providing an accurate measurement of laboratory safety and biosecurity at local, national, and regional levels.
REFERENCE:
Mouillé, Beatrice et al. A Tool for Assessment of Animal Health Laboratory Safety and Biosecurity: The Safety Module of the Food and Agriculture Organization's Laboratory Mapping Tool. Tropical medicine and infectious disease vol. 3,1 33. 14 Mar. 2018, doi:10.3390/tropicalmed3010033

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Harmonization of Biosafety and Biosecurity Standards for High-Containment Facilities

Following the global-level Ebola virus disease (EVD) outbreak during 2014–2016, international collaboration with multiorganizational participation has rapidly increased. Given the greater priorities for research and development (R&D) outcomes despite the quantitative and qualitative lack of high-containment laboratory facilities in low- and middle-income countries (LMICs), where biological targets for investigation are located near their natural habitats, occupational readiness for health workers' safety has not been well-addressed, where limited global expert human resources are being deployed to high-containment laboratories including biosafety level 4 (BSL-4) facilities for case management and medical investigations. Pursuing scientific and managerial success to make laboratories efficient and productive, most laboratory safety policies have focused on the functionality of technical skills or performance, procedural methodologies, and supervision over the employees to collaborate in LMICs. The experts dispatched from advanced countries bring a long list of scientific tasks with high-tech devices, supplies, and training programs to introduce their collaboration with local partners in LMICs. However, the dispatched experts would subsequently realize their list becomes endless to establish their basic functions required in high-containment laboratories to ensure qualified scientific outcomes in LMICs. Under such circumstances where dual or multiple policies and standards accommodated pose dilemmas for operational procedures to ensure biosafety and biosecurity, all the frontline experts from both LMICs and advanced countries may be exposed to significant risks of life-threating infection of highly pathogenic agents like EVD, without any pragmatic measures or road maps to establish valued international collaboration, pursuing its sustainability. Given the fact mentioned above, we conducted a quick review of the key biosafety and biosecurity management documents, relevant policy analyses, and research to understand the current status and, if any, measures to dissolve critical dilemmas mentioned above. As a result, we found that occupational safety and health (OSH) aspects had not been sufficiently addressed, particularly in the context of international BSL-4 collaboration in LMICs. Moreover, consideration of OSH can be one of the key drivers to make such collaborative interventions more pragmatic, safer to reorient, harness disease-based vertical approaches, and harmonize policies of biosafety and biosecurity, particularly for collaborations organized in resource-limited settings.
REFERENCE:
Maehira, Yuki, and Robert C Spencer. Harmonization of Biosafety and Biosecurity Standards for High-Containment Facilities in Low- and Middle-Income Countries: An Approach From the Perspective of Occupational Safety and Health. Frontiers in public health vol. 7 249. 12 Sep. 2019, doi:10.3389/fpubh.2019.00249

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Improving natural ventilation in hospital waiting and consulting rooms

Background: TB transmission in healthcare facilities is an important public health problem, especially in the often-overcrowded settings of HIV treatment scale-up. The problem is compounded by the emergence of drug resistant TB. Natural ventilation is a low-cost environmental control measure for TB infection control where climate permits that is suited to many different areas in healthcare facilities. There are no published data on the effect of simple structural modifications to existing hospital infrastructure to improve natural ventilation and reduce the risk of nosocomial TB transmission.
The purpose of this study was to measure the effect of simple architectural modifications to existing hospital waiting and consulting rooms in a low resource setting on (a) improving natural ventilation and (b) reducing modelled TB transmission risk.
Methods: Room ventilation was measured pre- and post-modification using a carbon dioxide tracer-gas technique in four waiting rooms and two consulting rooms in two hospitals in Lima, Peru. Modifications included additional windows for cross-ventilation (n = 2 rooms); removing glass from unopenable windows (n = 2); creation of an open skylight (n = 1); re-building a waiting-room in the open air (n = 1). Changes in TB transmission risk for waiting patients, or healthcare workers in consulting rooms, were estimated using mathematical modelling.
Results: As a result of the infrastructure modifications, room ventilation in the four waiting rooms increased from mean 5.5 to 15; 11 to 16; 10 to 17; and 9 to 66 air-changes/hour respectively; and in the two consulting rooms from mean 3.6 to 17; and 2.7 to 12 air-changes/hour respectively. There was a median 72% reduction (inter-quartile range 51–82%) in calculated TB transmission risk for healthcare workers or waiting patients. The modifications cost <US$75 in four rooms, and US$1000 and US$7000 in the remaining two rooms.
Conclusions: Simple modifications to existing hospital infrastructure considerably increased natural ventilation, and greatly reduced modelled TB transmission risk at little cost.
REFERENCE:
Escombe AR, et al. Improving natural ventilation in hospital waiting and consulting rooms to reduce nosocomial tuberculosis transmission risk in a low resource setting. BMC Infect Dis. 2019;19(1):88. Published 2019 Jan 25. doi:10.1186/s12879-019-3717-9

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Enfermedad de Chagas en México

La enfermedad de Chagas, causada por el Trypanosoma cruzi, está considerada como la parasitosis más grave en América. Se transmite principalmente por triatominos (chinches). El doctor Mazzoti reportó los dos primeros casos humanos en México. La forma de transmisión es por la entrada al organismo de los parásitos en heces del insecto, por transfusión sanguínea, de madre a hijo, por trasplante de órganos y por accidentes de laboratorio. En México se estima que 1.1 millones de personas están infectadas; la incidencia en 2012 fue de 0.70 por 100 000 habitantes. En 2017, las mayores tasas de incidencia se registraron en Yucatán, Oaxaca e Hidalgo. La infección ocasiona miocardiopatías y megaórganos del tracto digestivo. El diagnóstico en fase aguda es por abordaje parasitológico y en fase crónica, por estudios de tamizaje por laboratorio. En los bancos de sangre de México, el estudio de la enfermedad de Chagas es de observancia obligatoria; de 2007 a 2016, la seroprevalencia ha disminuido de 0.40 a 0.32 debido a la mejora de los procesos de selección al donante y al cuestionario ad hoc. Los blancos del parásito son las células neuronales y las de los músculos liso y miocárdico. La asociación de la destrucción neuronal y del músculo liso define la presentación de los síndromes megachagásicos. Las manifestaciones iniciales de la enfermedad pueden pasar desapercibidas; 5 % de los pacientes presenta signos y síntomas aparentes y 30 % evolucionará a la fase crónica asintomática. Los tratamientos actuales tienen efecto en la fase aguda. Para el control de la enfermedad de Chagas se dispone del Programa de Acción Específico para la Vigilancia Prevención y Control de la Enfermedad de Chagas (PAE Chagas 2013-2018), encaminado a eliminar la transmisión transfusional y congénita y a controlar la transmisión vectorial. De la detección oportuna, el tratamiento etiológico temprano y la ampliación de cobertura depende el éxito de la atención médica. Por su parte, la vigilancia y tamizaje de las mujeres embarazadas que viven en zonas de riesgo y el tamizaje universal de donadores de sangre y órganos harán posible la eliminación de la transmisión connatal y transfusional.
REFERENCIA:
Rojo-Medina J, Ruiz-Matus C, Salazar-Schettino PM y González-Roldán JF. Enfermedad de Chagas en México. Gaceta Médica de México. 2018;(154), p. 605-612.

SALAZAR-SCHETTINO, PM et al. Enfermedad de Chagas en México. Rev. Fac. Med. (Méx.) [online]. 2016, vol.59, n.3 [citado  2019-10-18], pp.6-16. ISSN 2448-4865.

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A future in which microbes spread health

Antimicrobial resistance continues to outpace the development of new chemotherapeutics. Novel pathogens continue to evolve and emerge. Public health innovation has the potential to open a new front in the war of “our wits against their genes” (Joshua Lederberg). Dense sampling coupled to next generation sequencing can increase the spatial and temporal resolution of microbial characterization while sensor technologies precisely map physical parameters relevant to microbial survival and spread. Microbial, physical, and epidemiological big data could be combined to improve prospective risk identification. However, applied in the wrong way, these approaches may not realize their maximum potential benefits and could even do harm. Minimizing microbial-human interactions would be a mistake. There is evidence that microbes previously thought of at best “benign” may actually enhance human health. Benign and health-promoting microbiomes may, or may not, spread via mechanisms similar to pathogens. Infectious vaccines are approaching readiness to make enhanced contributions to herd immunity. The rigorously defined nature of infectious vaccines contrasts with indigenous “benign or health-promoting microbiomes” but they may converge. A “microbial Neolithic revolution” is a possible future in which human microbial-associations are understood and managed analogously to the macro-agriculture of plants and animals. Tradeoffs need to be framed in order to understand health-promoting potentials of benign, and/or health-promoting microbiomes and infectious vaccines while also discouraging pathogens. Super-spreaders are currently defined as individuals who play an outsized role in the contagion of infectious disease. A key unanswered question is whether the super-spreader concept may apply similarly to health-promoting microbes. The complex interactions of individual rights, community health, pathogen contagion, the spread of benign, and of health-promoting microbiomes including infectious vaccines require study. Advancing the detailed understanding of heterogeneity in microbial spread is very likely to yield important insights relevant to public health.
REFERENCE:

• Tadler et al. Precision public health to inhibit the contagion of disease and move toward a future in which microbes spread health. BMC Infectious Diseases volume 19, Article number: 120 (2019).
• Tang, Julian W, and Yuguo Li. Editorial: the airborne microbiome - implications for aerosol transmission and infection control - special issue. BMC infectious diseases vol. 19,1 755. 29 Aug. 2019, doi:10.1186/s12879-019-4399-z

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Certificaciones IFBA en Manejo de Riesgo Biológico

Los exámenes de la IFBA son una medida estandarizada del conocimiento y las habilidades que se esperan de los profesionales en disciplinas técnicas específicas relacionadas con la gestión de riesgos biológicos. La IFBA publica el resumen del contenido de cada examen que describe los dominios, las tareas y las declaraciones de conocimiento específicas de cada disciplina técnica. Se recomienda encarecidamente a los candidatos que se familiaricen a fondo con este contenido como parte de su preparación. También se han proporcionado ejemplos de preguntas y referencias para ayudar a los candidatos a prepararse para el examen.
La certificación básica es en "Biorisk Management", y es necesaria obtenerla antes de aplicar a las otras certificaciones. La aplicación del examen tiene un costo aproximado de $200 USD, y puede realizarse en cualquier época del año, pero debe programarse con anticipación.
Para más información, visite: https://internationalbiosafety.org/

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Health Security (Journal, Vol. 17) Biosafety

Health Security

Editor-in-Chief: Thomas V. Inglesby, MD

ISSN: 2326-5094 

Online ISSN: 2326-5108 

Published Bimonthly

Current Volume: 17

Free access through October 30, 2019   /   Acceso libre hasta el 30 de Octubre de 2019. 

Building Biosafety Capacity in Our Nation's LaboratoriesChristina L. Chung, Kimberly Spencer Bellis, Amy Pullman, Angelica O'Connor, Alvin Shultz  Read Now

The 2014 Ebola outbreak revealed biosafety vulnerabilities across the United States. We distributed $24.1 million to health departments to support public health laboratories (PHLs) and sentinel clinical laboratory partners to improve biosafety practices. We used 9 indicators to evaluate PHLs and associated clinical laboratories from March 2015 through April 2018 using descriptive statistics. On average, over 6 reporting periods, 59 awardee PHLs and 4,040 clinical laboratories responded. 

Influencing Factors in the Development of State-Level Movement Restriction and Monitoring Policies in Response to Ebola, United States, 2014-15Tara Kirk Sell, Matthew P. Shearer, Diane Meyer, Mary Leinhos, Eric G. Carbone, Erin Thomas  Read Now

During the 2014-15 domestic Ebola response, US states developed monitoring and movement restriction policies for potentially exposed individuals. We describe decision-making processes and factors in the development of these policies. Results may help health officials anticipate potential concerns and policy influencers in future infectious disease responses. Thirty individuals with knowledge of state-level Ebola policy development participated in semi-structured interviews conducted from January to May 2017. Interviewees represented 18 jurisdictions from diverse census regions, state political affiliations, and public health governance structures as well as the US Centers for Disease Control and Prevention (CDC).

Mapping the Synthetic Biology Industry: Implications for Biosecurity

Sarah Carter, Diane DiEuliis  Read Now

Industrial biotechnology has harnessed the tools of genetic engineering for many years to produce valued chemicals and products. As newer synthetic biology tools and capabilities make biology increasingly easier to engineer, a broader, more diverse synthetic biology industry is emerging in support of many industrial sectors. While this industry is still nascent, it is growing each year with accelerating investment.1,2 Some of its novel products and services include advanced protein engineering, organism design and construction, genome editing constructs and vectors, lab sensors and robotics, and scale-up services.

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#INFLUENZA: Inicia tercera semana nacional de vacunación #México

REFERENCIAS:
VIDEO: La secretaría de salud aplicará 34 millones de dosis de vacuna de Influenza en México.
https://www.pscp.tv/w/1RDxlNkENZgGL

Programa de vacunación universal y semanas nacionales de salud. Lineamientos generales 2019. Subsecretaría de Prevención y Promoción de la Salud. Secretaría de Salud.
https://www.gob.mx/cms/uploads/attachment/file/416064/Lineamientos_Generales_PVU_y_SNS_2019.pdf

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The respiratory microbiota: new insights into pulmonary tuberculosis

Background: Previous studies demonstrated that the diversity and composition of respiratory microbiota in TB patients were different from healthy individuals. Therefore, the aim of the present analysis was to estimate the relative proportion of respiratory microbiota at phylum and genus levels among TB cases and healthy controls.
Methods: The PubMed and Google Scholar online databases were searched to retrieve relevant studies for the analysis. The statistical analysis was done using STATA version 11, pooled estimates are presented using graphs. The summary of findings in included studies is also presented in Table 1.
Results: The phylum level analysis shows that the pooled proportions of Firmicutes, Proteobacteria, Bacteroidetes, Actinobacteria, and Crenarchaeota were determined among tuberculosis patients and healthy controls. In brief, Firmicutes, and Proteobacteria were the most abundant bacterial phyla in both TB cases and healthy controls, composing 39.9 and 22.7% in TB cases and 39.4 and 19.5% in healthy controls, respectively. The genus level analysis noted that Streptococcus (35.01%), Neisseria (27.1%), Prevotella (9.02%) and Veillonella (7.8%) were abundant in TB patients. The Prevotella (36.9%), Gammaproteobacteria (22%), Streptococcus (19.2%) and Haemophilus (15.4%) were largely seen in healthy controls. Interestingly, Veillonella, Rothia, Leuconostoc were unique to TB cases, whereas Lactobacillus, and Gammaproteobacteria, Haemophilus, and Actinobacillus were identified only in healthy controls.
Conclusion: The composition of the respiratory microbiota in TB patients and healthy controls were quite different. More deep sequencing studies are needed to explore the microbial variation in the respiratory system in connection with TB.
REFERENCE:
Eshetie S, van Soolingen D. The respiratory microbiota: new insights into pulmonary tuberculosis. BMC Infect Dis. 2019;19(1):92. Published 2019 Jan 25. doi:10.1186/s12879-019-3712-1

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#KeepHandsClean Life is Better with Clean Hands Campaign, Promotion Posters

DOWNLOAD TOOL KIT

cdc.gov/handwashing/

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15 de octubre Día Global del lavado de manos

MANOS LIMPIAS PARA TODOS

15 de octubre Día Global del lavado de manos, un día de promoción global dedicada a aumentar el conocimiento y la comprensión de la importancia del lavado de manos con jabón como una forma eficaz y asequible para prevenir enfermedades y salvar vidas.

DÍA MUNDIAL DEL LAVADO DE MANOS ES UNA OPORTUNIDAD PARA DISEÑAR, PROBAR Y REPLICAR FORMAS CREATIVAS PARA ANIMAR A LA GENTE A LAVARSE LAS MANOS CON JABÓN EN LOS MOMENTOS CRÍTICOS.

Este año, el tema de las “manos limpias para todos” sigue la presión para no dejar a nadie atrás en el programa de desarrollo sostenible. Las desigualdades en las instalaciones de lavado de manos y los programas de promoción del lavado de manos eficaz puede poner individuos con mayor riesgo para las enfermedades que afectan a su salud, educación, y los resultados económicos.

El tema nos recuerda que debemos ser incluido cuando frente a las disparidades de lavado de manos. Independientemente de su función, puede celebrar el Día Mundial del Lavado!

https://globalhandwashing.org/global-handwashing-day/

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Animal Health Laboratory, New Zealand

The AHL is a high-containment facility with specialised equipment and procedures that enable us to work safely with exotic or zoonotic organisms and exotic disease investigation samples. Our staff are highly qualified and experienced in the science disciplines of pathology, virology, bacteriology, immunology, molecular biology and bioinformatics, with specialist knowledge of exotic and emerging pathogens. The AHL maintains international best practice operations, with accreditation and certification to ISO/IEC 17025, AS.NZS 2243.3 and MPI Registered Laboratory Programme and Transitional and Containment Facility regulations.
REFERENCE:
McDonald W. Animal Health Laboratory. Surveillance, Volume 46, Issue 3 Annual Report, pp 12-17, Sep 2019
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Impacts of Glutaraldehyde on Microbial Community Structure

The environmental impacts of hydraulic fracturing, particularly those of surface spills in aquatic ecosystems, are not fully understood. The goals of this study were to (1) understand the effect of previous exposure to hydraulic fracturing fluids on aquatic microbial community structure and (2) examine the impacts exposure has on biodegradation potential of the biocide glutaraldehyde. Microcosms were constructed from hydraulic fracturing-impacted and nonhydraulic fracturing-impacted streamwater within the Marcellus shale region in Pennsylvania. Microcosms were amended with glutaraldehyde and incubated aerobically for 56 days. Microbial community adaptation to glutaraldehyde was monitored using 16S rRNA gene amplicon sequencing and quantification by qPCR. Abiotic and biotic glutaraldehyde degradation was measured using ultra-performance liquid chromatography - high resolution mass spectrometry and total organic carbon. It was found that nonhydraulic fracturing-impacted microcosms biodegraded glutaraldehyde faster than the hydraulic fracturing-impacted microcosms, showing a decrease in degradation potential after exposure to hydraulic fracturing activity. Hydraulic fracturing-impacted microcosms showed higher richness after glutaraldehyde exposure compared to unimpacted streams, indicating an increased tolerance to glutaraldehyde in hydraulic fracturing impacted streams. Beta diversity and differential abundance analysis of sequence count data showed different bacterial enrichment for hydraulic fracturing-impacted and nonhydraulic fracturing-impacted microcosms after glutaraldehyde addition. These findings demonstrated a lasting effect on microbial community structure and glutaraldehyde degradation potential in streams impacted by hydraulic fracturing operations. © 2018 American Chemical Society.
REFERENCE:
Campa MF, et al. Impacts of Glutaraldehyde on Microbial Community Structure and Degradation Potential in Streams Impacted by Hydraulic Fracturing. Environ Sci Technol. 2018 May 15;52(10):5989-5999. doi: 10.1021/acs.est.8b00239. Epub 2018 Apr 30. PubMed PMID: 29683652.


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Cyberbiosecurity Implications for the Laboratory of the Future

Technological innovation has become an integral and inescapable aspect of our daily existence as almost everything of significance in our world now has a cyber (i.e., relating to, or involving computers, computer networks, information technology, and virtual reality) component associated with it. Every facet of our lives is now touched by technology. As such, we're experiencing a digital transformation. Unfortunately, both as individuals and as a society, we're inadequately prepared to embrace the myriad of vulnerabilities presented by cybertechnologies. Unintended cyber vulnerabilities present significant risks to individuals, organizations, governments and economies. Here, we identify current cybersecurity vulnerabilities found in the life science enterprise and discuss the many ways in which these vulnerabilities present risk to laboratory workers in these facilities, the surrounding community and the environment. We also consider the cyberbiosecurity benefits associated with numerous innovations likely to be present in the laboratory of the future. The challenges associated with cyberbiosecurity vulnerabilities are not insurmountable; they simply require thoughtful consideration by equipment designers, software and control systems developers, and by end users. Organizations and the individuals that comprise them must respect, value, and protect their data. End users must train themselves to look at every piece of laboratory equipment and every process from a cyberbiosecurity perspective. With this approach, cyberbiosecurity vulnerabilities can be minimized or eliminated to the benefit of workers, life science organizations, and national security.
REFERENCE:
Reed JC, Dunaway N. Cyberbiosecurity Implications for the Laboratory of the Future. Front Bioeng Biotechnol. 2019 Aug 21;7:182. doi: 10.3389/fbioe.2019.00182. eCollection 2019. Review. PubMed PMID: 31497596; PubMed Central PMCID: PMC6712584.

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Recognition of aerosol transmission of infectious agents

Although short-range large-droplet transmission is possible for most respiratory infectious agents, deciding on whether the same agent is also airborne has a potentially huge impact on the types (and costs) of infection control interventions that are required. The concept and definition of aerosols is also discussed, as is the concept of large droplet transmission, and airborne transmission which is meant by most authors to be synonymous with aerosol transmission, although some use the term to mean either large droplet or aerosol transmission. However, these terms are often used confusingly when discussing specific infection control interventions for individual pathogens that are accepted to be mostly transmitted by the airborne (aerosol) route (e.g. tuberculosis, measles and chickenpox). It is therefore important to clarify such terminology, where a particular intervention, like the type of personal protective equipment (PPE) to be used, is deemed adequate to intervene for this potential mode of transmission, i.e. at an N95 rather than surgical mask level requirement. With this in mind, this review considers the commonly used term of ‘aerosol transmission’ in the context of some infectious agents that are well-recognized to be transmissible via the airborne route. It also discusses other agents, like influenza virus, where the potential for airborne transmission is much more dependent on various host, viral and environmental factors, and where its potential for aerosol transmission may be underestimated.
REFERENCE:
Tellier, Raymond et al. Recognition of aerosol transmission of infectious agents: a commentary. BMC infectious diseases vol. 19,1 101. 31 Jan. 2019, doi:10.1186/s12879-019-3707-y

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Effects of Wipe and Spray-based Decontamination of Gloves and Gowns

We conducted a laboratory simulation to evaluate the contamination of environmental surfaces when using wipe vs spray methods of personal protective equipment (PPE) decontamination. We did not observe any environmental contamination with the bacteriophage MS-2 when bleach solution spray or wipes were used for PPE disinfection.
REFERENCE:
Robinson GL, et al. Preventing Viral Contamination: Effects of Wipe and Spray-based Decontamination of Gloves and Gowns. Clin Infect Dis. 2019;69(Supplement_3):S228–S230. doi:10.1093/cid/ciz622
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CID Supplement: Personal Protective Equipment for Preventing Contact Transmission of Pathogens

Volume 69, Issue Supplement_3

1 October 2019

ISSN 1058-4838

EISSN 1537-6591

https://academic.oup.com/cid/issue/69/Supplement_3
CONTENT:

1. Improving the Use of Personal Protective Equipment: Applying Lessons Learned 
2. Optimizing Contact Precautions to Curb the Spread of Antibiotic-resistant Bacteria in Hospitals 
3. Environmental Contact and Self-contact Patterns of Healthcare Workers: Implications for Infection Prevention and Control 
4. Understanding Workflow and Personal Protective Equipment Challenges Across Different Healthcare Personnel Roles 
5. Healthcare Workers’ Strategies for Doffing Personal Protective Equipment 
6. Evaluation of a Redesigned Personal Protective Equipment Gown
7. Model-based Assessment of the Effect of Contact Precautions Applied to Surveillance-detected Carriers of Carbapenemase-producing Enterobacteriaceae in Long-term Acute Care Hospitals
8. Common Behaviors and Faults When Doffing Personal Protective Equipment for Patients With Serious Communicable Diseases 
9. Variability in the Duration and Thoroughness of Hand Hygiene
10. Effect of Glove Decontamination on Bacterial Contamination of Healthcare Personnel Hands 
11. Preventing Viral Contamination: Effects of Wipe and Spray-based Decontamination of Gloves and Gowns
12. Potential Skin and Inhalational Exposure to Pathogens During Personal Protective Equipment Doffing
13. Design Strategies for Biocontainment Units to Reduce Risk During Doffing of High-level Personal Protective Equipment
14. Effect of an Intervention Package and Teamwork Training to Prevent Healthcare Personnel Self-contamination During Personal Protective Equipment Doffing

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Inactivation of chronic wasting disease prions using sodium hypochlorite

Chronic wasting disease (CWD) is a fatal prion disease that can infect deer, elk and moose. CWD has now been detected in 26 states of the USA, 3 Canadian provinces, South Korea, Norway, Sweden and Finland. CWD continues to spread from endemic areas, and new foci of infections are frequently detected. As increasing numbers of cervids become infected, the likelihood for human exposure increases. To date, no cases of CWD infection in humans have been confirmed, but experience with the BSE zoonosis in the United Kingdom suggests exposure to CWD should be minimized. Specifically, hunters, meat processors and others in contact with tissues from potentially CWD-infected cervids need a practical method to decontaminate knives, saws and other equipment. Prions are notoriously difficult to inactivate, and most effective methods require chemicals or sterilization processes that are either dangerous, caustic, expensive or not readily available. Although corrosive, sodium hypochlorite (bleach) is widely available and affordable and has been shown to inactivate prion agents including those that cause scrapie, bovine spongiform encephalopathy and Creutzfeldt-Jakob disease. In the current study, we confirm that bleach is an effective disinfectant for CWD prions and establish minimum times and bleach concentrations to eliminate prion seeding activity from stainless steel and infected brain homogenate solutions. We found that a five-minute treatment with a 40% dilution (20,000 ppm) of household bleach was effective at inactivating CWD seeding activity from stainless-steel wires and CWD-infected brain homogenates. However, bleach was not able to inactivate CWD seeding activity from solid tissues in our studies.
REFERENCE:
Williams K, et al (2019). Inactivation of chronic wasting disease prions using sodium hypochlorite. PLoS ONE 14(10): e0223659. https://doi.org/10.1371/journal.pone.0223659

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Factores que motivan el uso de protección respiratoria contra cenizas volcánicas

Las comunidades que viven cerca de volcanes activos pueden estar expuestas a riesgos respiratorios por cenizas volcánicas. Comprender su percepción de los riesgos y las acciones que toman para mitigar esos riesgos es importante para desarrollar estrategias de comunicación efectivas. Para investigar este problema, el primer estudio comparativo de las percepciones de riesgo y el uso de protección respiratoria se realizó en 2003 residentes afectados por volcanes activos de tres países: Japón (volcán Sakurajima), Indonesia (volcanes Merapi y Kelud) y México (volcán Popocatépetl). El estudio fue diseñado para evaluar el valor explicativo de un marco teórico que planteaba la hipótesis de que el uso de la protección respiratoria (es decir, la máscara facial) estaría motivado por dos construcciones cognitivas de la teoría de la motivación de protección: la evaluación de amenazas (es decir, las percepciones de daño / preocupación por la inhalación de cenizas). ) y evaluación de afrontamiento (es decir, creencias sobre la eficacia de la máscara). Utilizando el modelo de ecuaciones estructurales (SEM), se encontraron diferencias importantes en la capacidad predictiva de los constructos entre países. Por ejemplo, las percepciones de daño / preocupación fueron predictores más fuertes del uso de mascarillas en Japón e Indonesia que en México, donde las creencias sobre la eficacia de las mascarillas eran más importantes. El SEM también identificó diferencias en las variantes demográficas del uso de máscaras en cada país y cómo fueron mediadas por las construcciones cognitivas. Hallazgos como estos resaltan la importancia de contextualizar nuestra comprensión de la motivación de protección y, por lo tanto, el valor de desarrollar enfoques específicos para promover el comportamiento precautorio.
REFERENCIA:
Covey J,  et al. Factors motivating the use of respiratory protection against volcanic ashfall: A comparative analysis of communities in Japan, Indonesia and Mexico. Int J Disaster Risk Reduct. 2019;35:101066. doi:10.1016/j.ijdrr.2019.101066

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Risk Assessment Technical Guidance

El propósito de este documento es dar orientación técnica a todo el personal que trabaja en un laboratorio biológico y que maneja o maneja activamente agentes biológicos y toxinas, así como otros materiales de laboratorio valiosos. Este documento también está destinado a gerentes de instalaciones, apoyo administrativo, fuerzas de seguridad, partes interesadas de la comunidad, organismos de supervisión y formuladores de políticas, que desean obtener más información sobre la evaluación de riesgos y los riesgos de seguridad que están presentes en sus laboratorios.
El documento describe un proceso generalizado de evaluación de riesgos, un proceso que debe usarse en todos los entornos de laboratorio biológico, independientemente de la capacidad económica u organizativa. Debido a que el riesgo es una función de la probabilidad y las consecuencias y una evaluación de riesgos es específica de los peligros, amenazas y prácticas de trabajo de un laboratorio, los resultados de una evaluación indudablemente variarán dramáticamente entre los entornos de laboratorio. Además, el proceso de evaluación de riesgos no proporciona recomendaciones específicas sobre cómo reducir los riesgos identificados, sino que puede usarse para ayudar o guiar a las personas en el laboratorio, la instalación y la comunidad para tomar decisiones informadas sobre cómo mitigar el riesgo.
El propósito de este documento es triple:

1. describir el proceso de evaluación de riesgos de bioseguridad y bioseguridad del laboratorio y su marco conceptual;
2. proporcionar orientación detallada y metodologías sugeridas sobre cómo realizar una evaluación de riesgos; y
3. presentar algunas estrategias prácticas de proceso de evaluación de riesgos utilizando escenarios de laboratorio realistas.

REFERENCE:
Laboratory Biosafety and Biosecurity Risk Assessment Technical Guidance Document


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Bat Coronaviruses in China

During the past two decades, three zoonotic coronaviruses have been identified as the cause of large-scale disease outbreaks–Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Swine Acute Diarrhea Syndrome (SADS). SARS and MERS emerged in 2003 and 2012, respectively, and caused a worldwide pandemic that claimed thousands of human lives, while SADS struck the swine industry in 2017. They have common characteristics, such as they are all highly pathogenic to humans or livestock, their agents originated from bats, and two of them originated in China. Thus, it is highly likely that future SARS- or MERS-like coronavirus outbreaks will originate from bats, and there is an increased probability that this will occur in China. Therefore, the investigation of bat coronaviruses becomes an urgent issue for the detection of early warning signs, which in turn minimizes the impact of such future outbreaks in China. The purpose of the review is to summarize the current knowledge on viral diversity, reservoir hosts, and the geographical distributions of bat coronaviruses in China, and eventually we aim to predict virus hotspots and their cross-species transmission potential.
REFERENCE:
Fan, Yi et al. Bat Coronaviruses in China. Viruses vol. 11,3 210. 2 Mar. 2019, doi:10.3390/v11030210

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Octubre, mes de la bioseguridad #biosafety_biosecuritymonth

Este tema para este año es:

Más allá del laboratorio: Incrementando de la visibilidad de la bioseguridad y la biocustodia

#VIDEO: 2019 Biosafety and Biosecurity Month: Beyond the Lab: 

Increasing the Visibility of Biosafety and Biosecurity

Los objetivos del tema de este año incluyen los siguientes:

• Promover la visibilidad de los profesionales de bioseguridad y bioseguridad en nuestro lugar de trabajo y comunidad.
• Destacar la naturaleza multidimensional de la profesión de bioseguridad y bioseguridad;
• Defina cómo los profesionales de bioseguridad y bioseguridad son más que personas de cumplimiento.
• Abogar por la educación, capacitación y apoyo de los campos de Ciencia, Tecnología, Ingeniería y Matemáticas (STEM);
• Reconocer la bioseguridad como disciplina científica;
• Apoye la conciencia e interés de los estudiantes de STEM en la profesión a través del alcance y las interacciones en todos los niveles educativos.
• Fomentar el diálogo, la transparencia y la educación en el trabajo con materiales biológicos con todos los interesados.

Visite la página web regularmente para descargar materiales promocionales para usar en su institución y obtener más información sobre lo que puede hacer para aumentar su visibilidad. Las actualizaciones y materiales adicionales para el evento se publicarán periódicamente en esta página a medida que estén disponibles. Además, considere usar el hashtag "#biosafety_biosecuritymonth" en los esfuerzos de las redes sociales.

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Sodium hydroxide treatment effectively inhibits #prion replication in farm soil

Tribble-like amyloid plaques of variant Creutzfeldt-Jakob Disease
acquired from eating prion-infected beef.
Credit: Sherif Zaki; MD; PhD and Wun-Ju Shieh; MD; PhD; MPH CDC

Chronic wasting disease (CWD) agents are shed into biological samples, facilitating their horizontal transmission between cervid species. Once prions enter the environment, binding of PrPCWD by soil particles may maintain them near the soil surface, posing a challenge for decontamination. A 2 N sodium hydroxide (NaOH) or 2% sodium hypochlorite (NaClO) solution is traditionally recommended for prion decontamination of equipment and surfaces. Using protein misfolding cyclic amplification with beads and a bioassay with TgElk mice, we compared the effects of these disinfectants in CWD-contaminated soil for 1 or 16 h to those of controls of known infectious titres. Our results suggest that 2 N NaOH in a 1/5 farm soil volume provides a large decrease (>102-fold) in prion infectivity.
REFERENCES:

• Sohn, Hyun-Joo et al. Sodium hydroxide treatment effectively inhibits PrPCWD replication in farm soil. Prion vol. 13,1 (2019): 137-140. doi:10.1080/19336896.2019.1617623
• Prions Are Forever: The lethal proteins are in the Hard-to-Kill Hall of Fame--and may be more common than we realize

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