Surveillance of laboratory exposures to human pathogens and toxins: Canada 2018.

BACKGROUND: The Laboratory Incident Notification Canada (LINC) surveillance system monitors laboratory incidents reported under the Human Pathogens and Toxins Act. The year 2018 marks the third complete year of data.

OBJECTIVE: To describe the laboratory exposure and laboratory-acquired infection incidents that occurred in Canada in 2018 compared to previous years, and then by sector, human pathogens and toxins involved, number of affected persons, incident type and root causes.
METHODS: Laboratory incidents that occurred in 2018 were reported through the LINC system. The number of laboratory incidents, people exposed and laboratory-acquired infections were compared to previous years, then the incidents were analyzed by sector, human pathogen or toxin involved, the type of incident, people exposed, route of exposure and root causes. Microsoft Excel 2016 was used for descriptive analysis.
RESULTS: In 2018, there were 89 exposure incidents to human pathogens and 235 people were exposed. There were five suspected and one confirmed laboratory-acquired infections. This was approximately twice the number of exposure incidents that were reported in 2017 (n=44) and 2016 (n=46). The highest number of exposure incidents occurred in the academic and hospital sectors, and the ratio of incidence to licences was the lowest in the private sector. The majority of incidents (n=50; 56%) involved Risk Group 2 human pathogens that were manipulated in a Containment Level 2 laboratory. Most exposures were related to sharps or procedures and the most common people exposed were laboratory technicians. Human interaction and standard operating procedures were the leading root causes.
CONCLUSION: Although overall the annual incidence of laboratory exposures in Canada remains relatively low, the incidence was higher in 2018 than in previous years. Whether this is a true increase in incidence or an increase in reporting is not known at this time as baseline estimates are still being established.
REFERENCE:
Choucrallah, D et al. Surveillance of laboratory exposures to human pathogens and toxins: Canada 2018. Canada communicable disease report = Releve des maladies transmissibles au Canada vol. 45,9 244-251. 5 Sep. 2019, doi:10.14745/ccdr.v45i09a04

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#BOOK: The Use and Effectiveness of Powered Air Purifying Respirators in Health Care

80 pages | 6 x 9

ISBNs:

Paperback: 978-0-309-31595-1

Ebook: 978-0-309-31598-2

DOI: https://doi.org/10.17226/18990

Protecting 18 million United States health care workers from infectious agents - known and unknown - involves a range of occupational safety and health measures that include identifying and using appropriate protective equipment. The 2009 H1N1 influenza pandemic and the 2014 Ebola virus outbreak in West Africa have called raised questions about how best to ensure appropriate and effective use of different kinds of personal protective equipment such as respirators, not only to promote occupational safety but also to reduce disease transmission.
The Use and Effectiveness of Powered Air Purifying Respirators in Health Care is the summary of a workshop convened by the Institute of Medicine Standing Committee on Personal Protective Equipment for Workplace Safety and Health to explore the current state of practices and research related to powered air purifying respirator (PAPRs) and potential updates to performance requirements. Presentations and discussions highlighted current health care practices using PAPRs and outlined the research to date on the use and effectiveness of PAPRs in health care settings with a focus on the performance requirements. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care focuses on efficacy, current training, maintenance, supplies, and possible enhancements and barriers to use in inpatient, clinic, nursing home, and community (home) settings. This report also explores the strengths and weaknesses of using various approaches to health care PAPR standards.
REFERENCE:
Institute of Medicine. 2015. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care: Workshop Summary. Washington, DC: The National Academies Press. https://doi.org/10.17226/18990.

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Managing epidemics

.

This manual provides concise and up-to-date knowledge on 15 infectious diseases that have the potential to become international threats, and tips on how to respond to each of them.

The 21st century has already been marked by major epidemics. Old diseases - cholera, plague and yellow fever - have returned, and new ones have emerged - SARS, pandemic influenza, MERS, Ebola and Zika. These epidemics and their impact on global public health have convinced the world's governments of the need for a collective and coordinated defense against emerging public health threats and accelerated the revision of the International Health Regulations (2005), entered into force in 2007. Another Ebola epidemic, another plague epidemic or a new influenza pandemic are not mere probabilities, the threat is real. Whether transmitted by mosquitoes, other insects, via contact with animals or person-to-person, the only major uncertainty is when and where they, or a new, but equally lethal epidemic, will emerge. These diseases all have the potential to spread internationally highlighting the importance of immediate and coordinated response. The diseases covered are: Ebola virus disease, lassa fever, Crimean-Congo haemorrhagic fever, yellow fever, Zika, chikungunya, avian and other zoonotic influenza, seasonal influenza, pandemic influenza, Middle-East respiratory syndrome (MERS), cholera, monkeypox, plague, leptospirosis and meningococcal meningitis. Although originally developed as guidance for WHO officials, this publication is available to a wide readership including all frontline responders - communities, government officials, non-State actors and public health professionals - who need to respond rapidly and effectively when an outbreak is detected.

REFERENCE:

Managing epidemics: Key facts about major deadly diseases. Authors: World Health Organization

Number of pages: 255 Publication date: May 2018 Languages: English

ISBN: 978-92-4-156553-0

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A cryogel-based bioreactor for water treatment applications

The aim of this study was to develop and test a non-diffusion limited, high cell density bioreactor for biodegradation of various phenol derivatives. The bioreactor was obtained using a straightforward one-step preparation method using cryostructuration and direct cross-linking of bacteria into a 3D structured (sponge-like) macroporous cryogel composite material consisting of 11.6% (by mass) cells and 1.2-1.7% polymer, with approximately 87% water (in the material pores). The macroporous cryogel composite material, composed of live bacteria, has pore sizes in the range of 20-150 μm (confirmed by SEM and Laser Scanning Confocal Microscopy). The enzymatic activity of bacteria within the cryogel structure and the effect of freezing on the viability of the cross-linked cells was estimated by MTT assay. Cryogels based on Pseudomonas mendocina, Rhodococcus koreensis and Acinetobacter radioresistens were exploited for the effective bioremediation of phenol and m-cresol, and to a lesser extent 2-chlorophenol and 4-chlorophenol, utilising these phenolic contaminants in water as their only source of carbon. For evaluation of treatment scalability the bioreactors were prepared in plastic "Kaldnes" carriers to improve their mechanical properties and allow application in batch or fluidised bed water treatment modes.
REFERENCE:
Berillo DA, et al. A cryogel-based bioreactor for water treatment applications. Water Res. 2019 Apr 15;153:324-334. doi: 10.1016/j.watres.2019.01.028. Epub 2019 Jan 31. PubMed PMID: 30739074.

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#BOOK: Global Guidelines for the Prevention of Surgical Site Infection

The first ever Global guidelines for the prevention of surgical site infection (SSI) were published on 3 November 2016, then updated in some parts and published in a new edition in December 2018. They include a list of 29 concrete recommendations on 23 topics for the prevention of SSI in the pre-, intra and postoperative periods, which are based on 28 systematic reviews of the evidence.

For the 2018 update, the membership of the guidelines development group (GDG) was broadened to include an additional eight anaesthesiology experts. The 2018 edition of the guidelines includes the revision of the recommendation regarding the use of 80% fraction of inspired oxygen (high FiO2) in surgical patients under general anaesthesia with tracheal intubation and the update of the section on implementation. Between 2017 and 2018, WHO re-assessed the evidence on the use of high FiO2 by updating the systematic review related to the effectiveness of this intervention to reduce SSI and commissioning an independent systematic review on adverse events potentially associated with it. Based on the updated evidence, the GDG decided to revise the strength of the recommendation from strong to conditional.

REFERENCIA:
Global Guidelines for the Prevention of Surgical Site Infection. Geneva: World Health Organization; 2018. ISBN 978-92-4-155047-5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536404/ 

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Días de Muertos, Noviembre 1 y 2

En México, la tradición del Día de Muertos surge como parte del sincretismo religioso, en la época colonial. Durante la etapa prehispánica, el culto a la muerte estuvo presente en distintas culturas a lo largo y ancho de México. El día 1° de noviembre, se celebra el Día de Todos los Santos de acuerdo a la tradición católica. En esta fecha se recuerdan a todos aquellos que murieron sin ser beatos y santos, además de quienes fallecieron a temprana edad como los niños. De acuerdo a la religión católica, el Día de los Fieles Difuntos que tiene lugar el 2 de noviembre, se realiza una oración por aquellos que no han accedido al paraíso. En México, las tradiciones de esta celebración incluyen visitar a los seres queridos que ya partieron en los cementerios y preparar altares con alimentos, veladoras, incienso, fotografías y flores para recordarlos. Es solo durante estos días que las almas de los seres queridos pueden volver del más allá para estar cerca de los suyos.
FUENTE

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#BOOK: Reusable Elastomeric Respirators in Health Care

226 pages | 6 x 9

ISBNs:

Paperback: 978-0-309-48515-9

Ebook: 978-0-309-48518-0

DOI: https://doi.org/10.17226/25275

Protecting the health and safety of health care workers is vital to the health of each of us. Preparing for and responding to a future influenza pandemic or to a sustained outbreak of an airborne transmissible disease requires a high-level commitment to respiratory protection for health care workers across the wide range of settings in which they work and the jobs that they perform. Keeping health care workers healthy is an ethical commitment both in terms of addressing the occupational risks faced by health care workers and of providing for the continuity of patient care and services needed to maintain the health of individuals and communities.
During a public health emergency, challenges will arise concerning the availability of respiratory protective devices (i.e., respirators). Reusable respirators (specifically, reusable half-facepiece elastomeric respirators) are the standard respiratory protection device used in many industries, and they provide an option for use in health care that has to date not been fully explored. The durability and reusability of elastomeric respirators make them desirable for stockpiling for emergencies, where the need for large volumes of respirators can be anticipated. However, they are used infrequently in health care.
Reusable Elastomeric Respirators in Health Care explores the potential for the use of elastomeric respirators in the U.S. health care system with a focus on the economic, policy, and implementation challenges and opportunities. This report examines the practicability of elastomeric use in health care on a routine basis and during an influenza pandemic or other large aerosol-transmissible outbreak, when demand for respiratory protective devices by U.S. health care personnel may be larger than domestic supplies. The report also addresses the issues regarding emergency stockpile management of elastomeric respiratory protective devices.
REFERENCE:
National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. https://doi.org/10.17226/25275.

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Intervención educativa en trabajadores de limpieza en áreas de investigación

Objetivo. Evaluar los resultados de una intervención educativa sobre salud y seguridad laboral bajo principios de bioseguridad en trabajadores y trabajadoras de limpieza de una institución de salud. Material y métodos. Evaluación con métodos mixtos concurrentes sobre conocimientos, actitudes y prácticas en bioseguridad y percepción de riesgos, con medición basal y dos seguimientos, en 31 trabajadores y trabajadoras. Se realizaron modelos fraccionales separados para estimar interacciones de las mediciones. Se hizo análisis cualitativo temático y triangulación metodológica. Resultados. Los conocimientos (+33.3 puntos, escala 0 - 100), actitudes (+10.6) y prácticas (+23.5) incrementaron significativamente en el primer seguimiento; los conocimientos disminuyeron en el segundo seguimiento (p<0.001). Los hallazgos cualitativos revelaron mejora en actitudes y prácticas de prevención frente al riesgo, enmarcados por experiencias de vulnerabilidad, estigma y discriminación. Conclusiones. El estudio aporta elementos clave para la investigación en bioseguridad relacionada con grupos vulnerables y es efectivo para la promoción de la salud de un sector desfavorecido e invisibilizado.
REFERENCIA:
Parra-Tapia E, Perales-Ortiz G, Quezada AD, Torres-Pereda P. Salud y seguridad laboral: intervención educativa en trabajadores de limpieza en áreas de investigación. Salud Publica Mex. 2019;61:657-669. https://doi.org/10.21149/10026

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Reduced Effectiveness of Current Hand Hygiene against mucus with #Influenza Virus

IMPORTANCE: Antiseptic hand rubbing (AHR) and antiseptic hand washing (AHW) are important to prevent the spread of influenza A virus (IAV). This study elucidated the situations/mechanisms underlying the reduced efficacy of AHR against infectious mucus derived from IAV-infected individuals and indicated the weaknesses of the current hand hygiene regimens. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the efficacy of AHR using ethanol-based disinfectant against mucus is greatly reduced until infectious mucus adhering to the hands/fingers has completely dried. If there is insufficient time before treating the next patient (i.e., if the infectious mucus is not completely dry), medical staff should be aware that effectiveness of AHR is reduced. Since AHW is effective against both dry and nondry infectious mucus, AHW should be adopted to compensate for these weaknesses of AHR.
REFERENCE:
Hirose R, et al. Situations Leading to Reduced Effectiveness of Current Hand Hygiene against Infectious Mucus from Influenza Virus-Infected Patients. mSphere. 2019 Sep 18;4(5). pii: e00474-19. doi: 10.1128/mSphere.00474-19. PubMed PMID: 31533996; PubMed Central PMCID: PMC6751490.

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Tratamiento de una infección por el virus de la Vaccinia de un pinchazo profesional

¿Qué se sabe sobre este tema?
La exposición accidental al virus Vaccinia, un ortopoxvirus utilizado en la investigación biomédica, puede causar lesiones considerables y pérdida de tiempo en el trabajo. Se recomienda la vacunación para los laboratorios que utilizan el virus vaccinia competente en replicación; sin embargo, los laboratorios establecen sus propias políticas.
¿Qué agrega este informe?
El tecovirimat, un nuevo antiviral aprobado para el tratamiento de la viruela, y la inmunoglobulina vaccinia se usaron para tratar de manera segura una exposición ocupacional en un laboratorio no vacunado que fue excluido del trabajo durante 4 meses.
¿Cuáles son las implicaciones para la práctica de la salud pública?
Los laboratorios deben asegurarse de que los trabajadores estén informados sobre los riesgos asociados con la manipulación del virus vaccinia y deben aconsejar a los trabajadores sobre los beneficios potenciales de la vacunación recibida de acuerdo con las pautas actuales.

REFERENCIA:
Whitehouse ER, Rao AK, Yu YC, et al. Novel Treatment of a Vaccinia Virus Infection from an Occupational Needlestick — San Diego, California, 2019. MMWR Morb Mortal Wkly Rep 2019;68:943–946. DOI: http://dx.doi.org/10.15585/mmwr.mm6842a2

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Survival of Microorganisms on N95 masks

Bioaerosol is a threat at workplaces, therefore the selection and safe use of filtering facepiece respirators (FFRs) is important in preventive activities. The aim of the study was to assess the survival of microorganisms on materials used for FFRs construction. The parameters for microorganism growth under model conditions were described using the Gompertz equation, model verification was also carried out using FFRs at the farmers’ workplaces. We found that the factors determining a high survival of microorganisms were as follows: moisture corresponding to the conditions of use and storage of FFRs at workplaces, the presence of sweat and organic dust; inorganic dust and addition of biocide in nonwovens limited the growth of microorganisms, resulting in a shortening of the stationary growth phase and decreased cell numbers (5–6 log). Dust concentration at workplaces was higher than EU occupational exposure limit values and WHO recommendations for airborne particulate matter. Microbial contaminations of the air (103–104 CFU/m3), settled dust (104–106 CFU/g) and FFRs (105 CFU/4cm2) during the grain harvest were high, the main contamination being bacteria (actinomycetes, Pseudomonas fluorescens) and xerophilic fungi. A high correlation was found between the number of microorganisms and the weight of dust on FFRs (R2 = 0.93–0.96).
REFERENCE:
Jachowicz A, et al. Survival of Microorganisms on Filtering Respiratory Protective Devices Used at Agricultural Facilities. Int J Environ Res Public Health. 2019;16(16):2819. Published 2019 Aug 7. doi:10.3390/ijerph16162819

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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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