Economic implications between antibiotic use and hospital-acquired infections

OBJECTIVES: The emergence and spread of antimicrobial resistance is still an unresolved problem worldwide. Recent evidence shows correlations between the volume of broad-spectrum antibiotics used in the hospital setting and the incidence of multidrug-resistant bacteria. According to this dynamic relationship, loss of antibiotic activity can be modeled as a negative externality of antibiotic consumption.
METHODS: The present study proposes to present an economic model describing the probability of antibiotic treatment failure as a function of antimicrobial use and alcohol-based hand-rub use. Furthermore, the results of recently conducted time-series analyses and cost-of-illness studies are applied to the model to determine the externalities of antibiotic consumption and alcohol-based hand-rub use with respect to the costs of hospital-acquired infections.
RESULTS: According to our calculations, the consumption of third-generation cephalosporins and fluoroquinolones is associated with the highest negative externalities (€143 and €101, respectively) because their use has been shown to be associated with most types of hospital-acquired infections. In contrast, the use of alcohol-based hand-rub solution for hand disinfection is associated with a positive externality of 41 cents per single disinfection of the hands.
CONCLUSIONS: The externalities presented in this work represent a possible application of cost-of-illness data to quantify the impact of antibiotic use on antimicrobial resistance. In addition, the results indicate that most economic research on the topic is biased in assuming the overall use of antibiotics to be responsible for the spread of antimicrobial resistance.
REFERENCE:
Kaier K. Economic implications of the dynamic relationship between antibiotic  use and hospital-acquired infections. Value Health. 2012 Jan;15(1):87-93. doi: 10.1016/j.jval.2011.09.005. Epub 2011 Nov 6. PubMed PMID: 22264976.

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N95 Day 2018 Webinar: Trending Topics in Respiratory Protection

Registration: https://niosh-connect.adobeconnect.com/n95day2018/event/event_info.html

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Alcohol Sanitizer

Fragmento
According to the Center for Disease Control (CDC) hand hygiene encompasses the cleansing of your hands by using hand washing with soap and water, antiseptic hand washes, antiseptic hand rubs such as alcohol-based hand sanitizers (ABHS), foams or gels, or surgical hand antisepsis. For many reasons, alcohol hand sanitizers are increasingly being used as disinfectants over hand washing with soap and water.  Their ease of availability, no need for water or plumbing, and their proven effectiveness in reducing microbial load are just a few. In one study, a hospital-wide, hand hygiene campaign with special emphasis on bedside, alcohol-based hand disinfection resulted sustained improvement in hand-hygiene compliance, coinciding with a reduction of nosocomial infections and MRSA transmission. The promotion of bedside, antiseptic, hand rubs largely contributed to the increase in compliance. Many other studies have demonstrated that having bedside alcohol-based solutions availabale increased compliance with hand hygiene among HCWs.
REFERENCE:
Gold NA, Avva U. Alcohol Sanitizer. [Updated 2018 Jun 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513254/

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Guidance for Prevention of Sexual Transmission of Zika Virus for Men

Zika virus infection can occur as a result of mosquitoborne or sexual transmission of the virus. Infection during pregnancy is a cause of fetal brain abnormalities and other serious birth defects (1,2). CDC has updated the interim guidance for men with possible Zika virus exposure who 1) are planning to conceive with their partner, or 2) want to prevent sexual transmission of Zika virus at any time (3). CDC now recommends that men with possible Zika virus exposure who are planning to conceive with their partner wait for at least 3 months after symptom onset (if symptomatic) or their last possible Zika virus exposure (if asymptomatic) before engaging in unprotected sex. CDC now also recommends that for couples who are not trying to conceive, men can consider using condoms or abstaining from sex for at least 3 months after symptom onset (if symptomatic) or their last possible Zika virus exposure (if asymptomatic) to minimize their risk for sexual transmission of Zika virus.

REFERENCE:
Polen KD, et al. Update: Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Men with Possible Zika Virus Exposure — United States, August 2018. MMWR Morb Mortal Wkly Rep 2018;67:868-871. DOI: http://dx.doi.org/10.15585/mmwr.mm6731e2

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CDC lab training on-demand #Biosafety #CDC #laboratory

Estos cursos on-demand de aproximadamente 1 hr., son para personal de laboratorio que proporcionan certificados avalados por el CDC, que pueden usar en su currículum, con créditos P.A.C.E. y son gratuitos. Para obtener el certificado, deben completar el curso, y aprobar el examen con más de 80%. Los de bioseguridad son los siguientes:

1. Fundamentals Of Centrifuge Safety  
2. Fundamentals of Working Safely in a Biological Safety Cabinet
3. Packing and Shipping Division 6.2 Materials: What the Laboratory Professional Should Know 2016  

La lista completa en: https://www.cdc.gov/labtraining/

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Laboratory-acquired scrub typhus and murine typhus infections #LAIs

This study examined the literature on laboratory-acquired infections (LAIs) associated with scrub typhus (Orientia tsutsugamushi) and murine typhus (Rickettsia typhi) research to provide an evidence base for biosafety and biocontainment. Scrub typhus LAIs were documented in 25 individuals, from 1931-2000 with 8 (32%) deaths during the pre-antibiotic era. There were 35 murine typhus LAI reports and no deaths. Results indicated that highest risk activities were working with infectious laboratory animals involving significant aerosol exposures, accidental self-inoculation or bite related infections. A risk-based biosafety approach for in vitro and in vivo culture of O. tsutsugamushi and R. typhi would require only high-risk activities (animal work or large culture volumes) be performed in high containment BSL3 laboratories. We argue that relatively low risk activities including inoculation of cell cultures or the early stages of in vitro growth using low volumes/low concentrations of infectious materials can be performed safely in BSL2 laboratories within a biological safety cabinet.
REFERENCE:
Blacksell SD, et al; Laboratory-acquired scrub typhus and murine typhus infections: The argument for risk-based approach to biosafety requirements for Orientia tsutsugamushi and Rickettsia typhi laboratory activities, Clinical Infectious Diseases ciy675, https://doi.org/10.1093/cid/ciy675

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Semanas nacionales de vacunación en México

Las Semanas Nacionales de Salud tienen como objetivo aplicar las vacunas que necesitan los menores de 5 años para completar su esquema básico, así como las que se administran de forma complementaria a los adolescentes y adultos.
En el país desde 1980 se iniciaron las Semanas Nacionales de Vacunación que en un principio se llamaron fases intensivas de vacunación, su objetivo principal es proteger la salud de la niñez.
Primera Semana Nacional de Salud
Se lleva a cabo a finales de febrero y principios de marzo y tiene como objetivo principal la aplicación de la vacuna Sabin a todos los menores de 5 años, con lo que se previene la polio. También se refuerza la aplicación de las vacunas anti rotavirus, anti neumococo, pentavalente, BCG y hepatitis B a menores de 1 año de edad, entre otras actividades.
Segunda Semana Nacional de Salud
Se lleva a cabo a finales de mayo y principios de junio y tiene como objetivo principal la aplicación del refuerzo de la vacuna Sabin a todos los menores de 5 años, con lo que se previene la polio.
Tercera Semana Nacional de Salud
Se lleva a cabo a principios del mes de octubre y tiene como objetivo principal la aplicación de la vacuna Triple viral a todos los menores de 6 y 7 años, con lo que se previenen los casos de sarampión, rubéola y paperas. También se refuerza la aplicación de las vacunas BCG, pentavalente A, Hepatitis B, rotavirus y en este año en especial se aplica la que previene el virus del papiloma humano.

Esquema de vacunación:

Vacuna	Enfermerdad que previene	A quién se aplica
Sabin	Poliomielitis	Niños y niñas menores de 5 años
Antihepatitis B	Hepatitis B	Niños y niñas menores de 5 años y adolescentes
Pentavalente acelular	Difteria, Tosferina, Tétanos, Poliomelitis y H. Influenzae	Niños y niñas menores 5 años
DPT	Difteria, Tosferina y Tétanos	Niños y niñas de 4 años
Rotavirus	Gastroenteritis causada por rotavirus	Niños y niñas menores de 1 año
Neumococica conjugada	Infecciones por neumococo	Niños y niñas de 2, 4 y 12 meses
Triple Viral SRP	Sarampión, Rubéola y Parotiditis	Niños y niñas de 1 y 6 años
TD	Tétanos y Difteria	Embarazadas, hombres y mujeres mayores de 12 años
SR	Sarampión, rubéola	Hombres y mujeres de 1 a 4 años

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Pathogen Risk Assessment guideline

The Pathogen Risk Assessment guideline was developed by the Public Health Agency of Canada (PHAC) and the Canadian Food Inspection Agency (CFIA) as part of a series of electronic publications that expand upon the biosafety and biosecurity concepts discussed in the current edition of the Canadian Biosafety Handbook (CBH), the companion document to the Canadian Biosafety Standard (CBS). It describes how to conduct a pathogen risk assessment to evaluate the risks associated with human or animal pathogens, toxins, or other regulated infectious material. This guideline is intended to assist organizations in meeting the requirements specified in the CBS, but should not be interpreted as requirements. Organizations may choose alternate approaches to meet the requirements specified in the CBS.

Conducting a biosecurity risk assessment
This guideline describes best practices for conducting a biosecurity risk assessment in an organization where human or animal pathogens, toxins, or other regulated infectious material are handled or stored. The biosecurity risks associated with the handling and storing of pathogens and toxins can be minimized through the application of appropriate mitigation measures identified through the risk assessment process.

REFERENCIAS

1. Pathogen Risk Assessment
2. Conducting a biosecurity risk assessment.

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8º Curso de animales de laboratorio.

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Biosecurity practices on Australian commercial layer and meat chicken farms: Performance and perceptions of farmers

This paper describes the level of adoption of biosecurity practices performed on Australian commercial chicken meat and layer farms and farmer-perceived importance of these practices. On-farm interviews were conducted on 25 free range layer farms, nine cage layer farms, nine barn layer farms, six free range meat chicken farms and 15 barn meat chicken farms in the Sydney basin bioregion and South East Queensland. There was a high level of treatment of drinking water across all farm types; town water was the most common source. In general, meat chicken farms had a higher level of adoption of biosecurity practices than layer farms. Cage layer farms had the shortest median distance between sheds (7.75m) and between sheds and waterbodies (30m). Equipment sharing between sheds was performed on 43% of free range meat chicken farms compared to 92% of free range layer farms. There was little disinfection of this shared equipment across all farm types. Footbaths and visitor recording books were used by the majority of farms for all farm types except cage layer farms (25%). Wild birds in sheds were most commonly reported in free range meat chicken farms (73%). Dogs and cats were kept across all farm types, from 56% of barn layer farms to 89% of cage layer farms, and they had access to the sheds in the majority (67%) of cage layer farms and on the range in some free range layer farms (44%). Most biosecurity practices were rated on average as 'very important' by farmers. A logistic regression analysis revealed that for most biosecurity practices, performing a practice was significantly associated with higher perceived farmer importance of that biosecurity practice. These findings help identify farm types and certain biosecurity practices with low adoption levels. This information can aid decision-making on efforts used to improve adoption levels.
REFERENCE:
Scott AB, et al. Biosecurity practices on Australian commercial layer and meat chicken farms: Performance and perceptions of farmers. PLoS One. 2018 Apr 18;13(4):e0195582. doi: 10.1371/journal.pone.0195582. eCollection 2018. PubMed PMID: 29668707.

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Desinfectantes para manos a base de alcohol / Alcohol-based hand sanitizers (ABHS)

Según el Centro para el Control de Enfermedades (CDC), la higiene de manos incluye la limpieza de las manos mediante el lavado de manos con agua y jabón, lavados antisépticos para manos, desinfectantes antisépticos para manos como desinfectantes para manos a base de alcohol (ABHS), espumas o geles, o antisepsia quirúrgica de la mano. Por muchas razones, los desinfectantes para manos con alcohol se usan cada vez más como desinfectantes en vez de lavarse las manos con agua y jabón. Su facilidad de disponibilidad, sin necesidad de agua o fontanería, y su probada eficacia para reducir la carga microbiana son solo algunas. En un estudio, una campaña de higiene de manos en todo el hospital, con especial énfasis en la desinfección de manos a base de alcohol, produjo una mejora sostenida en el cumplimiento de la higiene de manos, coincidiendo con una reducción de las infecciones nosocomiales y la transmisión de MRSA. La promoción de la cabecera de la cama, antisépticos, frotamientos de manos contribuyó en gran medida al aumento del cumplimiento. Muchos otros estudios han demostrado que disponer de soluciones basadas en el alcohol a pie de cama aumenta el cumplimiento de la higiene de manos entre los trabajadores de la salud. Sin embargo, es importante tener en cuenta que la eficacia del desinfectante para manos con alcohol depende de qué y cuánto producto se use, la técnica adecuada y la consistencia del uso. También hay situaciones donde estos productos no son ideales, por ejemplo, para prevenir la propagación de ciertas infecciones o cuando las manos están muy sucias y la carga bacteriana es demasiado alta.
REFERENCIA:
Gold NA, Avva U. Alcohol Sanitizer. 2018 Jun 23. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-.

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Fast-Growing Engineered Microbes: New Concerns for Gain-of-Function Research?

Research on fast-growing microbes holds promise for many industrial applications, including shortening test and trial times in research and development stages and reducing the operation costs for production. Such microbes can be obtained either by selecting naturally occurring variants or via metabolic engineering approaches, either eliminating 'unnecessary' or adding necessary pathways affecting growth speed in the cell. Here, we review recent research and development of engineered fast-growing strains in industrial biotechology, with a special focus on vaccine production using (synthetic biology) engineered pathogenic strains. We will discuss whether this represents a security concern and whether the industrial biotech sector needs to pay more attention to issues of Gain-of-Function (GoF) while developing and harnessing these fast-growing microbes. We will also shed a light on the use of in-built biosafety circuits as a way to control the propagation of fast-growing strains, including their capacity to survive in the environment. Other possible GoF concerns raised by the publication of research results in this field will be also addressed. In conclusion, judging from the current development from the field, assessing the potential GoF risks on engineered fast-growing microbes does not lead to a clear generalized outcome. We argue that fast growing strains need to be evaluated in combination with their wild type and engineered characteristics, and require always a case-by-case assessment. Monitoring the progress of the field and proactively raising awareness on the GoF issues among the scientists are important for the further development of the field.
REFERENCE:
Pei L, Schmidt M. Fast-Growing Engineered Microbes: New Concerns for Gain-of-Function Research? Front Genet. 2018 Jun 29;9:207. doi: 10.3389/fgene.2018.00207. eCollection 2018. Review.


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Oropharyngeal #Tularemia from Freshly Pressed Grape Must

In high-income countries, oropharyngeal tularemia is associated with hunting or eating infected game or drinking contaminated water.1,2 We describe a cluster of cases of oropharyngeal tularemia that appears to have been caused by the consumption of freshly pressed grape must by grape harvesters volunteering at a vineyard in Rhineland-Palatinate, Germany, in October 2016. 

Reference: 

N Engl J Med 2018; 379:197-199. https://www.nejm.org/doi/full/10.1056/NEJMc1800353

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Priones, prionoides y enfermedades por mal plegamiento de proteínas / Prions, prionoids and protein misfolding disorders #PMD

Prion diseases are progressive, incurable and fatal neurodegenerative conditions. The term ‘prion’ was first nominated to express the revolutionary concept that a protein could be infectious. We now know that prions consist of PrPSc, the pathological aggregated form of the cellular prion protein PrPC. Over the years, the term has been semantically broadened to describe aggregates irrespective of their infectivity, and the prion concept is now being applied, perhaps overenthusiastically, to all neurodegenerative diseases that involve protein aggregation. Indeed, recent studies suggest that prion diseases (PrDs) and protein misfolding disorders (PMDs) share some common disease mechanisms, which could have implications for potential treatments. Nevertheless, the transmissibility of bona fide prions is unique, and PrDs should be considered as distinct from other PMDs.

REFERENCES:

• Protein misfolding in neurodegenerative diseases: implications and strategies
• Prions, prionoids and protein misfolding disorders.

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#Puzzle / Sopa de letras

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Transmisión iatrogénica de priones

FRAGMENTO:
Iatrogenic Creutzfeldt-Jakob Disease (CJD) is simply CJD (most likely sporadic CJD) that is transmitted from one person to another by medical or surgical treatment (table 2) [20]. It is important to note that all forms of prion disease are potentially transmissible, even, remarkably, autosomal dominantly inherited genetic diseases. In addition, there are increasing concerns that variant CJD will lead to significant secondary transmission, with 2 reported cases of probable blood transmission [21, 22].
REFERENCE:
Richard Knight; Creutzfeldt-Jakob Disease: A Rare Cause of Dementia in Elderly Persons, Clinical Infectious Diseases, Volume 43, Issue 3, 1 August 2006, Pages 340–346,

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#Prions: Beyond a Single Protein

Since the term protein was first coined in 1838 and protein was discovered to be the essential component of fibrin and albumin, all cellular proteins were presumed to play beneficial roles in plants and mammals. However, in 1967, Griffith proposed that proteins could be infectious pathogens and postulated their involvement in scrapie, a universally fatal transmissible spongiform encephalopathy in goats and sheep. Nevertheless, this novel hypothesis had not been evidenced until 1982, when Prusiner and coworkers purified infectious particles from scrapie-infected hamster brains and demonstrated that they consisted of a specific protein that he called a “prion.” Unprecedentedly, the infectious prion pathogen is actually derived from its endogenous cellular form in the central nervous system. Unlike other infectious agents, such as bacteria, viruses, and fungi, prions do not contain genetic materials such as DNA or RNA. The unique traits and genetic information of prions are believed to be encoded within the conformational structure and posttranslational modifications of the proteins. Remarkably, prion-like behavior has been recently observed in other cellular proteins—not only in pathogenic roles but also serving physiological functions. The significance of these fascinating developments in prion biology is far beyond the scope of a single cellular protein and its related disease.
REFERENCIA:
Das AS, Zou W-Q. Prions: Beyond a Single Protein. Clinical Microbiology Reviews. 2016;29(3):633-658.

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The Characterization of #Surgical Smoke from Various Tissues and Its Implications for #Occupational #Safety

Electrosurgery produces surgical smoke. Different tissues produce different quantities and types of smoke, so we studied the particle characteristics of this surgical smoke in order to analyze the implications for the occupational health of the operation room personnel. We estimated the deposition of particulate matter (PM) from surgical smoke on the respiratory tract of operation room personnel using clinically relevant tissues from Finnish landrace porcine tissues including skeletal muscle, liver, subcutaneous fat, renal pelvis, renal cortex, lung, bronchus, cerebral gray and white matter, and skin. In order to standardize the electrosurgical cuts and smoke concentrations, we built a customized computer-controlled platform. The smoke particles were analyzed with an electrical low pressure impactor (ELPI), which measures the concentration and aerodynamic size distribution of particles with a diameter between 7 nm and 10 μm. There were significant differences in the mass concentration and size distribution of the surgical smoke particles depending on the electrocauterized tissue. Of the various tissues tested, liver yielded the highest number of particles. In order to better estimate the health hazard, we propose that the tissues can be divided into three distinct classes according to their surgical smoke production: 1) high-PM tissue for liver; 2) medium-PM tissues for renal cortex, renal pelvis, and skeletal muscle; and 3) low-PM tissues for skin, gray matter, white matter, bronchus, and subcutaneous fat.
REFERENCE:
Karjalainen, Markus et al. “The Characterization of Surgical Smoke from Various Tissues and Its Implications for Occupational Safety.” Ed. Sachiko Matsuzaki. PLoS ONE 13.4 (2018): e0195274. PMC. Web. 4 June 2018.

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Potential Impact of a 2-Person Security Rule on #BioSafety Level 4 #Laboratory Workers

Directors of all major BioSafety Level 4 (BSL-4) laboratories in the United States met in 2008 to review the current status of biocontainment laboratory operations and to discuss the potential impact of a proposed 2-person security rule on maximum-containment laboratory operations. Special attention was paid to the value and risks that would result from a requirement that 2 persons be physically present in the laboratory at all times. A consensus emerged indicating that a video monitoring system represents a more efficient, economical standard; provides greater assurance that pathogens are properly manipulated; and offers an increased margin of employee safety and institutional security. The 2-person security rule (1 to work and 1 to observe) may decrease compliance with dual responsibilities of safety and security by placing undue pressure on the person being observed to quickly finish the work, and by placing the observer in the containment environment unnecessarily.
REFERENCE:
LeDuc, James W. et al. “Potential Impact of a 2-Person Security Rule on BioSafety Level 4 Laboratory Workers.” Emerging Infectious Diseases 15.7 (2009): e081523. PMC. Web. 4 June 2018.

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Surveillance of #laboratory exposures to human #pathogens and toxins: #Canada 2016

BACKGROUND: Canada recently enacted legislation to authorize the collection of data on laboratory incidents involving a biological agent. This is done by the Public Health Agency of Canada (PHAC) as part of a comprehensive national program that protects Canadians from the health and safety risks posed by human and terrestrial animal pathogens and toxins.
OBJECTIVE: To describe the first year of data on laboratory exposure incidents and/or laboratory-acquired infections in Canada since the Human Pathogens and Toxins Regulations came into effect.
METHODS: Incidents that occurred between January 1 and December 31, 2016 were self-reported by federally-regulated parties across Canada using a standardized form from the Laboratory Incident Notification Canada (LINC) surveillance system. Exposure incidents were described by sector, frequency of occurrence, timeliness of reporting, number of affected persons, human pathogens and toxins involved, causes and corrective actions taken. Microsoft Excel 2010 was used for basic descriptive analyses.
RESULTS: In 2016, 46 exposure incidents were reported by holders of 835 active licences in Canada representing 1,352 physical areas approved for work involving a biological agent, for an overall incidence of 3.4%. The number of incidents was highest in the academic (n=16; 34.8%) and hospital (n=12; 26.1%) sectors, while the number of reported incidents was relatively low in the private industry sector. An average of four to five incidents occurred each month; the month of September presented as an outlier with 10 incidents.​: A total of 100 people were exposed, with no reports of secondary exposure. Four incidents led to suspected (n=3) or confirmed (n=1) cases of laboratory-acquired infection. Most incidents involved pathogens classified at a risk group 2 level that were manipulated in a containment level 2 laboratory (91.3%). Over 22 different species of human pathogens and toxins were implicated, with bacteria the most frequent (34.8%), followed by viruses (26.1%). Eleven (23.9%) incidents involved a security sensitive biologic agent. Procedure breaches (n=15) and sharps-related incidents (n=14) were the most common antecedents to an exposure. In 10 (21.7%) cases, inadvertent possession (i.e., isolation of an unexpected biological agent during routine work) played a role. Possible improvements to standard operating procedures were cited in 71.7% of incidents. Improvements were also indicated for communication (26.1%) and management (23.9%).
CONCLUSIONS: The Laboratory Incident Notification Canada is one of the first surveillance systems in the world to gather comprehensive data on laboratory incidents involving human pathogens and toxins. Exposure incidents reported in the first year were relatively rare, occurring in less than 4% of containment zones within laboratory settings.

REFERENCE:
Bienek, A, M Heisz, and M Su. “Surveillance of Laboratory Exposures to Human Pathogens and Toxins: Canada 2016.” Canada Communicable Disease Report 43.11 (2017): 228–235. Print.

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Coltivirus-related virus isolated from bats infect human cells in vitro

BACKGROUND: Zoonotic transmission events play a major role in the emergence of novel diseases. While such events are virtually impossible to predict, wildlife screening for potential emerging pathogens can be a first step. Driven by recent disease epidemics like severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and Ebola, bats have gained special interest as reservoirs of emerging viruses.
METHODS: As part of a bigger study investigating pathogens in African bats we screened animals for the presence of known and unknown viruses.
RESULTS: We isolated and characterised a novel reovirus from blood of free-tailed bats (Chaereophon aloysiisabaudiae) captured in 2006 in Côte d'Ivoire. The virus showed closest relationship with two human pathogenic viruses, Colorado tick fever virus and Eyach virus, and was able to infect various human cell lines in vitro.
CONCLUSION: The study shows the presence of a coltivirus-related virus in bats from Sub-Sahara Africa. Serological studies could help to assess its impact on humans or wildlife health.

REFERENCE:

Weiss S, et al. A novel Coltivirus-related virus isolated from free-tailed bats from Côte d'Ivoire is able to infect human cells in vitro. Virol J. 2017 Sep 18;14(1):181.


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Regulatory oversight of human pathogens and toxins in Canada

From 1994 to 2009, federal oversight of human pathogens and toxins was limited to facilities importing human pathogens and toxins into Canada under the Human Pathogens Importation Regulations (HPIR). This narrow focus of authority restricted the Government of Canada’s ability to regulate and monitor a full range of activities, including those involving human pathogens and toxins acquired from domestic sources. In 2009, the Human Pathogens and Toxins Act (the Act) received Royal Assent to establish a national safety and security regime and expand oversight through a national, standardized process to verify safe and secure use of human pathogens and toxins in Canada. The Act and the Human Pathogens and Toxins Regulations (the Regulations), in full force since December 1, 2015, provides legislative and statutory requirements for the comprehensive oversight of the control of human pathogens and toxins in Canada. Expanded regulation and monitoring program activities aim to reduce the risks posed by human pathogens and toxins and strengthen biosafety management systems that serve to protect the health of Canadians.
REFERENCE:
Labrie, C, and S Lecordier. “Regulatory Oversight of Human Pathogens and Toxins in Canada.” Canada Communicable Disease Report 41.Suppl 6 (2015): 14–18. Print.

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Epidemiology, Pathogenesis, and Control of a Tick-Borne Disease Kyasanur Forest Disease

In South Asia, Haemaphysalis spinigera tick transmits Kyasanur Forest Disease Virus (KFDV), a flavivirus that causes severe hemorrhagic fever with neurological manifestations such as mental disturbances, severe headache, tremors, and vision deficits in infected human beings with a fatality rate of 3-10%. The disease was first reported in March 1957 from Kyasanur forest of Karnataka (India) from sick and dying monkeys. Since then, between 400 and 500 humans cases per year have been recorded; monkeys and small mammals are common hosts of this virus. KFDV can cause epizootics with high fatality in primates and is a level-4 virus according to the international biosafety rules. The density of tick vectors in a given year correlates with the incidence of human disease. The virus is a positive strand RNA virus and its genome was discovered to code for one polyprotein that is cleaved post-translationally into 3 structural proteins (Capsid protein, Envelope Glycoprotein M and Envelope Glycoprotein E) and 7 non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5). KFDV has a high degree of sequence homology with most members of the TBEV serocomplex. Alkhurma virus is a KFDV variant sharing a sequence similarity of 97%. KFDV is classified as a NIAID Category C priority pathogen due to its extreme pathogenicity and lack of US FDA approved vaccines and therapeutics; also, the infectious dose is currently unknown for KFD. In India, formalin-inactivated KFDV vaccine produced in chick embryo fibroblast is being used. Nevertheless, further efforts are required to enhance its long-term efficacy. KFDV remains an understudied virus and there remains a lack of insight into its pathogenesis; moreover, specific treatment to the disease is not available to date. Environmental and climatic factors involved in disseminating Kyasanur Forest Disease are required to be fully explored. There should be a mapping of endemic areas and cross-border veterinary surveillance needs to be developed in high-risk regions. The involvement of both animal and health sector is pivotal for circumscribing the spread of this disease to new areas.
REFERENCE:
Shah, Syed Z. et al. “Epidemiology, Pathogenesis, and Control of a Tick-Borne Disease- Kyasanur Forest Disease: Current Status and Future Directions.” Frontiers in Cellular and Infection Microbiology 8 (2018): 149. PMC. Web. 11 June 2018.
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Routes of influenza transmission

Remarkably little is known definitively about the modes of influenza transmission. Thus, important health policy and infection control issues remain unresolved. These shortcomings have been exposed in national and international pandemic preparedness activities over recent years. Indeed, WHO, CDC, ECDC and the U.S. Institute of Medicine have prioritised understanding the modes of influenza transmission as a critical need for pandemic planning. Studying influenza transmission is difficult; seasonality, unpredictable attack rates, role of environmental parameters such as temperature and humidity, numbers of participants required and confounding variables all present considerable obstacles to the execution of definitive studies. A range of investigations performed to date have failed to provide definitive answers and key questions remain. Reasons for this include the fact that many studies have not sought to investigate routes of transmission as a primary objective (instead, they have evaluated specific interventions) and that fieldwork in natural settings, specifically assessing the dynamics and determinants of transmission between humans, has been limited. The available evidence suggests that all routes of transmission (droplet, aerosol and contact) have a role to play; their relative significance will depend on the set of circumstances acting at a given time. Dictating the process are factors related to the virus itself, the host and the environment.
REFERENCES:
Killingley, Ben, and Jonathan Nguyen‐Van‐Tam. “Routes of Influenza Transmission.” Influenza and Other Respiratory Viruses 7.Suppl Suppl 2 (2013): 42–51. PMC. Web. 18 May 2018.

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Assessment of a respiratory face mask for capturing air pollutants and pathogens including human influenza and rhinoviruses

Background. Prevention of infection with airborne pathogens and exposure to airborne particulates and aerosols (environmental pollutants and allergens) can be facilitated through use of disposable face masks. The effectiveness of such masks for excluding pathogens and pollutants is dependent on the intrinsic ability of the masks to resist penetration by airborne contaminants. This study evaluated the relative contributions of a mask, valve, and Micro Ventilator on aerosol filtration efficiency of a new N95 respiratory face mask.
Methods. The test mask was challenged, using standardized methods, with influenza A and rhinovirus type 14, bacteriophage ΦΧ174, Staphylococcus aureus (S. aureus), and model pollutants. The statistical significance of results obtained for different challenge microbial agents and for different mask configurations (masks with operational or nonoperational ventilation fans and masks with sealed Smart Valves) was assessed.
Results. The results demonstrate >99.7% efficiency of each test mask configuration for exclusion of influenza A virus, rhinovirus 14, and S. aureus and >99.3% efficiency for paraffin oil and sodium chloride (surrogates for PM2.5). Statistically significant differences in effectiveness of the different mask configurations were not identified. The efficiencies of the masks for excluding smaller-size (i.e., rhinovirus and bacteriophage ΦΧ174) vs. larger-size microbial agents (influenza virus, S. aureus) were not significantly different.
Conclusions. The masks, with or without features intended for enhancing comfort, provide protection against both small- and large-size pathogens. Importantly, the mask appears to be highly efficient for filtration of pathogens, including influenza and rhinoviruses, as well as the fine particulates (PM2.5) present in aerosols that represent a greater challenge for many types of dental and surgical masks. This renders this individual-use N95 respiratory mask an improvement over the former types of masks for protection against a variety of environmental contaminants including PM2.5 and pathogens such as influenza and rhinoviruses.
REFERENCES:
Zhou, S. Steve et al. “Assessment of a Respiratory Face Mask for Capturing Air Pollutants and Pathogens Including Human Influenza and Rhinoviruses.” Journal of Thoracic Disease 10.3 (2018): 2059–2069. PMC. Web. 18 May 2018.

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