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

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

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

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SEMINARIO INTERNACIONAL

SEMINARIO INTERNACIONAL

Regulación de la protección
De los trabajadores de la salud

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

Instituto de Investigaciones Jurídicas, UNAM, Ciudad de México.

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

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

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

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

Strengths and limitations of this study:

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

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

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

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

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

REFERENCE:

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

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

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

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Effects of Disinfectants on Larval Development of #Ascaris suum Eggs

Ascaris suum eggs in various conditions. 

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

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Microbial Contamination on Used Surgical Masks

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

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

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

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Guía técnica de limpieza, desinfección y esterilización

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

DESCARGAR:  Guía técnica de limpieza, desinfección y esterilización

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Using a mHealth Tutorial Application for training Healthcare workers in Nigeria

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

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

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SEMINARIO: Uso adecuado del cloro como desinfectante.

CUPO LLENO PARA EL 11 DE MARZO. 

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

Usted puede elegir entre cualquiera de las fechas para participar:

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

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Quantification of Influenza Virus RNA in Aerosols in Patient Rooms

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

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

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Respirator masks protect health but impact performance

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

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

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Hospital Preparations for Viral Hemorrhagic Fever Patients #Ebola

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

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

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

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

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#Zika Virus Associated with Microcephaly

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

REFERENCE:

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

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

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

NPR AUDIO: Zika in Brasil

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

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

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

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

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Safe transportation of biomedical waste in a health care institution

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

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

8º Simposio de #Bioseguridad y Biocustodia 2016 

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

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What next for gain-of-function research in Europe?

A working group on gain-of-function research set up by the European Academies Science Advisory Council (EASAC) has emphasised the importance of ensuring that the necessary safeguards and policies are in place.

REFERENCE:
Fears R, Ter Meulen V. What next for gain-of-function research in Europe?  Elife. 2015 Dec 30;4. pii: e13035. doi: 10.7554/eLife.13035.

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Effectiveness of PPE for Healthcare Workers Caring for Patients with Filovirus Disease

Background: A rapid review, guided by a protocol, was conducted to inform development of the World Health Organization’s guideline on personal protective equipment in the context of the ongoing (2013–present) Western African filovirus disease outbreak, with a focus on health care workers directly caring for patients with Ebola or Marburg virus diseases.
Methods: Electronic databases and grey literature sources were searched. Eligibility criteria initially included comparative studies on Ebola and Marburg virus diseases reported in English or French, but criteria were expanded to studies on other viral hemorrhagic fevers and non-comparative designs due to the paucity of studies. After title and abstract screening (two people to exclude), full-text reports of potentially relevant articles were assessed in duplicate. Fifty-seven percent of extraction information was verified. The Grading of Recommendations Assessment, Development and Evaluation framework was used to inform the quality of evidence assessments.
Results: Thirty non-comparative studies (8 related to Ebola virus disease) were located, and 27 provided data on viral transmission. Reporting of personal protective equipment components and infection prevention and control protocols was generally poor.
Conclusions: Insufficient evidence exists to draw conclusions regarding the comparative effectiveness of various types of personal protective equipment. Additional research is urgently needed to determine optimal PPE for health care workers caring for patients with filovirus.

REFERENCE:
Hersi, Mona et al. “Effectiveness of Personal Protective Equipment for Healthcare Workers Caring for Patients with Filovirus Disease: A Rapid Review.” Ed. Jens H. Kuhn. PLoS ONE 10.10 (2015): e0140290. PMC. Web. 20 Jan. 2016.
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Family cases of lung injury associated with the use of humidifier disinfectants

Background: This study describes 17 families with 38 lung injury patients (14 males, 24 females; 22 preschool-age children less than six years of age and 16 individuals of 13–50 years) who used disinfectant added to humidifiers in the home.
Methods: Clinical examination and humidifier disinfectant-use histories were taken, and a thorough home investigation was performed to assess exposure to humidifier disinfectant.
Results: Nine of the patients (three pregnant females, six preschool-age children) died soon after they first developed lung damage. Six (16%) were pregnant females and 22 (58%) were preschool-aged children younger than six years. The patients used humidifier disinfectant products containing either polyhexamethylene guanidine phosphate (PHMG, n = 36) or oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH, n = 2). Twenty-six patients (68%) used the brand "Oxy"®, which contains PHMG. Of the ten patients with fatal lung injury, nine were found to have used PHMG.
Conclusions: Our findings suggest that the use of humidifier disinfectant products containing either PGH or PHMG can cause lung injury, especially in preschool-age children younger than six years and pregnant women.

REFERENCE:
Park, Donguk et al. “Exposure Characteristics of Familial Cases of Lung Injury Associated with the Use of Humidifier Disinfectants.” Environmental Health 13 (2014): 70. PMC. Web. 20 Jan. 2016.

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Building Infectious Disease Research Programs to Promote Security and Enhance Collaborations with Countries of the Former Soviet Union

Addressing the threat of infectious diseases, whether natural, the results of a laboratory accident, or a deliberate act of bioterrorism, requires no corner of the world be ignored. The mobility of infectious agents and their rapid adaptability, whether to climate change or socioeconomic drivers or both, demand the science employed to understand these processes be advanced and tailored to a country or a region, but with a global vision. In many parts of the world, largely because of economic struggles, scientific capacity has not kept pace with the need to accomplish this goal and has left these regions and hence the world vulnerable to infectious disease outbreaks. To build scientific capability in a developing region requires cooperation and participation of experienced international scientists who understand the issues and are committed to educate the next generations of young investigators in the region. These efforts need to be coupled with the understanding and resolve of local governments and international agencies to promote an aggressive science agenda. International collaborative scientific investigation of infectious diseases not only adds significantly to scientific knowledge, but it promotes health security, international trust, and long-term economic benefit to the region involved. This premise is based on the observation that the most powerful human inspiration is that which brings peoples together to work on and solve important global challenges. The republics of the former Soviet Union provide a valuable case study for the need to rebuild scientific capacity as they are located at the crossroads where many of the world's great epidemics began. The scientific infrastructure and disease surveillance capabilities of the region suffered significant decline after the breakup of the Soviet Union. The U.S. Cooperative Threat Reduction (CTR) Program, a part of the U.S. Department of Defense, together with partner countries, have worked diligently to improve the capabilities in this region to guard against the potential future risk from especially dangerous pathogens. The dissolution of the Soviet Union left behind many scientists still working to study pathogens using antiquated protocols in unsafe laboratories. To address this situation, the CTR program began improving laboratory infrastructure, establishing biosafety and biosecurity programs, and training scientists in modern techniques, with emphasis on biosurveillance and safe containment of especially dangerous pathogens. In the Republic of Georgia, this effort culminated in the construction of a modern containment laboratory, the Richard G. Lugar Center for Public Health Research in Tbilisi to house both isolated especially dangerous pathogens as well as the research to be conducted on these agents. The need now is to utilize and sustain the investment made by CTR by establishing strong public and animal health science programs in these facilities tailored to the needs of the region and the goals for which this investment was made. A similar effort is ongoing in other former Soviet Republics. Here, we provide the analysis and recommendations of an international panel of expert scientists appointed by the Cooperative Biological Engagement Program of the Defense Threat Reduction Agency to provide advice to the stakeholders on the scientific path for the future. The emphasis is on an implementation strategy for decision makers and scientists to consider providing a sustainable biological science program in support of the One Health initiative. Opportunities, potential barriers, and lessons learned while meeting the needs of the Republic of Georgia and the Caucasus region are discussed. It is hoped that this effort will serve as a model for similar scientific needs in not only the former Soviet Union republics but also other regions challenged by infectious diseases where the CTR program operates.

REFERENCE:
Bartholomew JC, et al. Building Infectious Disease Research Programs to Promote Security and Enhance Collaborations with Countries of the Former Soviet Union. Front Public Health.
2015 Nov 26;3:271.

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Nanoparticles as potential new generation broad spectrum antimicrobial agents

The rapid emergence of antimicrobial resistant strains to conventional antimicrobial agents has complicated and prolonged infection treatment and increased mortality risk globally. Furthermore, some of the conventional antimicrobial agents are unable to cross certain cell membranes thus, restricting treatment of intracellular pathogens. Therefore, the disease-causing-organisms tend to persist in these cells. However, the emergence of nanoparticle (NP) technology has come with the promising broad spectrum NP-antimicrobial agents due to their vast physiochemical and functionalization properties. In fact, NP-antimicrobial agents are able to unlock the restrictions experienced by conventional antimicrobial agents. This review discusses the status quo of NP-antimicrobial agents as potent broad spectrum antimicrobial agents, sterilization and wound healing agents, and sustained inhibitors of intracellular pathogens. Indeed, the perspective of developing potent NP-antimicrobial agents that carry multiple-functionality will revolutionize clinical medicine and play a significant role in alleviating disease burden.

REFERENCE:
Yah, Clarence S., and Geoffrey S. Simate. “Nanoparticles as Potential New Generation Broad Spectrum Antimicrobial Agents.” DARU Journal of Pharmaceutical Sciences 23 (2015): 43. PMC. Web. 20 Jan. 2016.
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The history of the Conference of Research Workers in Animal Diseases (CRWAD) 1920-2014.

The following history has been compiled and written by the authors. The historical facts are available from the Conference of Research Workers in Animal Diseases (CRWAD) archives, dating back to letters and summaries written by the founders, and by a few of the Secretary-Treasurers from the early decades through 2014. The Organization and Purpose: The CRWAD is a non-profit organization and has been since its origin. The sole purpose of CRWAD is to discuss and disseminate the most current research advances in animal diseases. Graduate students and industry and academic professionals present and discuss the most recent advances on subjects of interest to the CRWAD and of importance to the global livestock and companion animal industries. The oral and poster abstracts of new and unpublished data presented at the meeting sessions are published each year in the CRWAD Proceedings (formerly the CRWAD Abstracts). CRWAD publishes, copyrights, and distributes the Proceedings. The presentations are arranged into the following 10 sections, according to the primary topic of the presentation: Bacterial Pathogenesis, Biosafety and Biosecurity, Companion Animal Epidemiology, Ecology and Management of Foodborne Agents, Epidemiology and Animal Health Economics, Immunology, Pathobiology of Enteric and Foodborne Pathogens, Respiratory Diseases, Vector-Borne and Parasitic Diseases, and Viral Pathogenesis. Prospective members should be actively engaged in animal disease research or research administration. Meeting information and membership applications may be obtained by contacting the Executive Director or by visiting the CRWAD website. Annual abstracts are currently available on-line at the On-line Meeting Planner and Itinerary Builder, with access through the CRWAD website.

REFERENCE:
Ellis, Robert P., L. Susanne Squires Ellis, and Erwin M. Kohler. “The History of the Conference of Research Workers in Animal Diseases (CRWAD) 1920–2014.” Animal Health Research Reviews 16.2 (2015): 177–192. PMC. Web. 17 Jan. 2016.
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#Zika Virus in the Americas - Yet Another Arbovirus Threat

CDC

The explosive pandemic of Zika virus infection occurring throughout South America, Central America, and the Caribbean (see map) and potentially threatening the United States is the most recent of four unexpected arrivals of important arthropod-borne viral diseases in the Western Hemisphere over the past 20 years. It follows dengue, which entered this hemisphere stealthily over decades and then more aggressively in the 1990s; West Nile virus, which emerged in 1999; and chikungunya, which emerged in 2013. Are the successive migrations of these viruses unrelated, or do they reflect important new patterns of disease emergence? Furthermore, are there secondary health consequences?

REFERENCE:
Fauci AS, Morens DM. Zika Virus in the Americas - Yet Another Arbovirus Threat. N Engl J Med. 2016 Jan 13.

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Inactivation of Foot-and-Mouth Disease Virus by Commercially Available Disinfectants and Cleaners

Foot-and-mouth disease virus (FMDV) is an animal pathogen of great concern. It is contagious to cloven-hoofed animals and affects animals in extensive areas worldwide. In general, the primary eradication strategies for foot-and-mouth disease (FMD) in Japan are stamping out the disease and restriction of movement. It is also important to completely disinfect the infected area to prevent the spread of FMDV, including vehicles and people as well. However, there is no report on the effect of commercially available disinfectants against FMDV in a short contact time. In this study, we evaluated the virucidal effect of thirteen commercially available products, and got the following results: acidic ethanol disinfectants, alkaline cleaners and sodium hypochlorite had great effect (>3.0 log10 reduction in titer) against FMDV. On the other hand, neutral ethanol disinfectants, hand soaps, and quaternary ammonium compound sanitizers did not show great effect against FMDV. Therefore, it is presumed that acidic ethanol disinfectants are effective for human use and alkaline cleaners are effective for use in the infected environment for the control of a FMD outbreak.
REFERENCE:
Harada Y. et al. Inactivation of Foot-and-Mouth Disease Virus by Commercially Available Disinfectants and Cleaners. Biocontrol Science, 2015, Vol. 20, No. 3, 205－208.
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Capacity building in national influenza laboratories – use of laboratory assessments to drive progress

Background: Laboratory testing is a fundamental component of influenza surveillance for detecting novel strains with pandemic potential and informing biannual vaccine strain selection. The United States (U.S.) Centers for Disease Control and Prevention (CDC), under the auspices of its WHO Collaborating Center for Influenza, is one of the major public health agencies which provides support globally to build national capacity for influenza surveillance. Our main objective was to determine if laboratory assessments supported capacity building efforts for improved global influenza surveillance.
Methods: In 2010, 35 national influenza laboratories were assessed in 34 countries, using a standardized tool. Post-assessment, each laboratory received a report with a list of recommendations for improvement. Uptake of recommendations were reviewed 3.2 mean years after the initial assessments and categorized as complete, in-progress, no action or no update. This was a retrospective study; follow-up took place through routine project management rather than at a set time-point post-assessment. WHO data on National Influenza Centre (NIC) designation, External Quality Assessment Project (EQAP) participation and FluNet reporting was used to measure laboratory capacity longitudinally and independently of the assessments. All data was further stratified by World Bank country income category.
Results: At follow-up, 81 % of 614 recommendations were either complete (350) or in-progress (145) for 32 laboratories (91 % response rate). The number of countries reporting to FluNet and the number of specimens they reported annually increased between 2005, when they were first funded by CDC, and 2010, the assessment year (p < 0.01). Improvements were also seen in EQAP participation and NIC designation over time and more so for low and lower-middle income countries.
Conclusions: Assessments using a standardized tool have been beneficial to improving laboratory-based influenza surveillance. Specific recommendations helped countries identify and prioritize areas for improvement. Data from assessments helped CDC focus its technical assistance by country and region. Low and lower-middle income countries made greater improvements in their laboratories compared with upper-middle income countries. Future research could include an analysis of annual funding and technical assistance by country. Our approach serves as an example for capacity building for other diseases.
REFERENCE:
Lucinda E. A. Johnson, et al. Capacity building in national influenza laboratories – use of laboratory assessments to drive progress. BMC Infect Dis. 2015; 15: 501.
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Invitación al foro "Bioseguridad y Salud"

Microbial immigration across the Mediterranean via airborne dust

Dust particles lifting and discharge from Africa to Europe is a recurring phenomenon linked to air circulation conditions. The possibility that microorganisms are conveyed across distances entails important consequences in terms of biosafety and pathogens spread. Using culture independent DNA-based analyses via next generation sequencing of the 16 S genes from the airborne metagenome, the atmospheric microbial community was characterized and the hypothesis was tested that shifts in species diversity could be recorded in relation to dust discharge. As sampling ground the island of Sardinia was chosen, being an ideal cornerstone within the Mediterranean and a crossroad of wind circulation amidst Europe and Africa. Samples were collected in two opposite coastal sites and in two different weather conditions comparing dust-conveying winds from Africa with a control situation with winds from Europe. A major conserved core microbiome was evidenced but increases in species richness and presence of specific taxa were nevertheless observed in relation to each wind regime. Taxa which can feature strains with clinical implications were also detected. The approach is reported as a recommended model monitoring procedure for early warning alerts in frameworks of biosafety against natural spread of clinical microbiota across countries as well as to prevent bacteriological warfare.

REFERENCE:
Rosselli R, et al. Microbial immigration across the Mediterranean via airborne dust. Sci Rep. 2015 Nov 6;5:16306.

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A Relative Risk-Based Framework for Safer, More Secure, and Sustainable Laboratory Capacity Building

BACKGROUND: Laboratory capacity building is characterized by a paradox between endemicity and resources: countries with high endemicity of pathogenic agents often have low and intermittent resources (water, electricity) and capacities (laboratories, trained staff, adequate regulations). Meanwhile, countries with low endemicity of pathogenic agents often have high-containment facilities with costly infrastructure and maintenance governed by regulations. The common practice of exporting high biocontainment facilities and standards is not sustainable and concerns about biosafety and biosecurity require careful consideration.
METHODS: A group at Chatham House developed a draft conceptual framework for safer, more secure, and sustainable laboratory capacity building.
RESULTS: The draft generic framework is guided by the phrase "LOCAL - PEOPLE - MAKE SENSE" that represents three major principles: capacity building according to local needs (local) with an emphasis on relationship and trust building (people) and continuous outcome and impact measurement (make sense).
CONCLUSION: This draft generic framework can serve as a blueprint for international policy decision-making on improving biosafety and biosecurity in laboratory capacity building, but requires more testing and detailing development.

REFERENCE:
Dickmann P, Sheeley H and Lightfoot N (2015). Biosafety and biosecurity: a relative risk-based framework for safer, more secure, and sustainable laboratory capacity building. Front. Public Health 3:241.

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