This fall, Wall Street and the U.S. Department of Treasury organized an international “avian flu outbreak” simulation. The drill – which lasted for three weeks and started in early October – took 1,800 companies through scenarios which simulated what would happen to them if a massive outbreak of the H5N1 bird flu struck trading floors on Wall Street, or on the bourses of Singapore and other, emerging markets.  Results of the simulation will be reported publicly in the coming weeks, experts tell Infection Protection. “If a pandemic flu hits, there could be a most significant impact on global financial markets,” says Dr. Myles Druckman, vice president of medical services for International SOS, a consulting company, helping stage the simulations for the financial industry and U.S. government, with U.S. headquarters in Philadelphia. “Everyone is sensitized, post-9-11, to being very aggressive in managing threats.” The major companies on Wall Street – many household names, and members of the Fortune 100 – are looking not just at plans for communicating during a crisis like massive outbreak of the bird flu, which first appeared on the scene a few years ago in China. They are also seriously examining how they would continue in operation if hundreds of their employees, at various locations around the globe, were either ill with the bird flu, caring for someone who was ill, or too afraid to come to work because of the number of others at the office who had been diagnosed as having the virus. “It’s a real challenge,” says Druckman, a medical doctor. “There are a lot of tough questions to answer. A pandemic lasts for weeks and months, not a day like an earthquake. There might be days when everyone with the last names beginning with H, J and K in your offices are sick and can’t work.” Druckman says that financial companies and the government are dealing with the possibility of a global avian flu outbreak as they do for other, natural disasters. They work among various levels of the company, from the president and CEO down to the HR, to create a strategy. Then they work with various, regional offices to implement the strategy. The local offices are responsible for developing the tactics to implement the strategy. “You may create an isolation room,” says Druckman, of a possible quarantine situation at work. “Or you may say, ‘We need gloves and face masks. But then you need to make sure you buy the gloves and face masks.’” Adds Druckman: “Getting gloves and masks for everyone in the company is not a cheap option. But it is the responsible thing to do.” International SOS has worked on about 50 simulations for various infectious diseases during the last few years, says Druckman, and the company provides medical services and clinics in foreign countries for multi-national corporations and their traveling executives and professionals.Companies need to develop detailed plans to cope with the avian flu – as well as MRSA and other infectious diseases – as the Centers for Disease Control and World Health Organization cannot do it for them. What’s more, Druckman says, during a crisis, the CDC and WHO may issue “conflicting” advice, which confuses, rather than clarifies, the situation for industry. Insurance companies are also getting involved, trying to manage the risk too, now that Wall Street and the government have shown that planning is necessary. Aon Corp., the business insurance firm, says that it has seen strands of the avian flu recently in the U.K. in “Suffolk, Merseyside and North Wales,” a spokesman says. Before the next virus outbreak occurs there, the insurer is writing policies to cover farmers, who may have to cull their flocks of birds, and lose millions of dollars in inventory, when the flu strikes. –by Gene J. Koprowski, Editor-in-ChiefSee, http://www.internationalsos.com/pandemicpreparedness/SubCatLevel.aspx?li=2&languageID=ENG&subCatID=47

Posted: November 28th, 2007 under Avian Flu, Developing Diseases, News.
Comments: 3

The Minneapolis Star-Tribune is reporting: The District of Columbia has the highest rate of HIV infection of any city in the U.S., nearly twice that of New York City, and the dreaded disease is being transmitted to babies, older adults, women and heterosexual men at a rapid pace, a report released Monday by city health officials said. One in 20 city residents is estimated to have HIV, the virus that causes AIDS, and 1 in 50 have AIDS, the report said.

See,

http://www.startribune.com/1244/story/1574703.html

From what we’ve heard, from public health experts, the HIV infection rate now at an “epidemic” level in Washington D.C. — something not seen by government officials in years. – The Editors

Posted: November 27th, 2007 under HIV, News.
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Lyndsay Moss reports: Patients carrying MRSA are taking the super-bug out of the hospital and spreading it in the community, a new study has revealed. Researchers now believe patients should be tested for MRSA when they leave hospital to halt infection levels.

A study at Aberdeen Royal Infirmary found that incidents of MRSA diagnosed in the local community increased with a rise in cases at the hospital. The research, published in the Journal of Hospital Infection, estimated that for every ten cases of MRSA occurring in hospital, there would be one extra case in the community a month later.

See,

http://news.scotsman.com/health.cfm?id=1856092007

This confirms what we’ve been hearing from other public health experts around the globe. Patients should be examined — and families, vigilant — when they come home from the hospital, so they do not infect their children, or spouses, with this deadly, drug-resistant bug.

– The Editors

Posted: November 27th, 2007 under MRSA, News.
Comments: none

TORONTO — The war against the “viral time bomb” Hepatitis C virus (HCV), an infection that afflicts nearly 180 million worldwide, has become clinically imperative.  The U.S. Centers for Disease Control – and its counterpart in Canada, the Public Health Agency — recommend that home health care providers and health care workers use latex gloves, wash their hands regularly and sterilize instruments to reduce the risk of spreading HCV, which can cause liver cancer and cirrhosis of the liver. Experts, including Dr. Tom Wong, Center for Infectious Disease Prevention and Control, Public Health Agency of Canada, also advise infected patients not to donate blood, organs, tissues or semen, or share sharp items potentially contaminated with blood — e.g., razors, nail clippers, scissorsand toothbrushes. As no laboratory parameters definitively predict which persons infected with HCV will develop cirrhosis or will respond to medical therapy, according to the National Institutes of Health, prevention has become the key to successful management. 

Like HIV/AIDS, HCV is, at this stage, more concentrated among specific vulnerable populations including injecting drug users (IDUs), and those who received blood transfusions, including those who regularly undergo dialysis, says Stefan Beral, a medical doctor and epidemiologist at the Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore. 

Recent global estimates, released this fall, by the London School of Tropical Medicine  indicate that at least 50% of all IDUs in 49 countries or territories had HCV infection. As a result of this, the U.S. Food and Drug Administration is now requiring blood collecting establishments to “quarantine” blood and blood components from HCV infected donors, and to appropriately notify consignees of such infected materials.   According to the CDC estimates, injection drug use accounts for 60% of all new cases of hepatitis C in the country that is home to nearly 3.2 million chronic cases of the 4.1 million infected individuals. And, there is increasing evidence of transmission relatively efficiently through male sexual contact, says Dr. Beral. As nearly 70% of all new infections progress toward chronic hepatitis, 10% to 20% develop cirrhosis, and up to 5% end up in liver cancer and death over a period of two to three decades. HCV accounts for 50% to 76% of all liver cancer cases, and a majority of all liver transplants in the developed nations. In the U.S. alone, of the 18,000 Americans waiting for a transplant, an estimated 40% to 60% have Hepatitis C.  Prevention, through good sanitation, and cleanliness, is the best measure. That’s because the treatment needed—pegylated interferon-alpha and ribavirin combination—to rid the body of the virus generally takes a full year of therapy. Thus, most people fail because of the toxicity, intensity and duration of care, laments Dr. Beral. “Cure is not a guarantee with success in approximately 60%-80% of the cases, depending on which serotype of virus that you have.” One of the most promising new drugs in development for treatment of chronic HCV is Telaprevir (VX-950), an inhibitor of HCV protease, reported at the 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in Chicago last September.  –by Sridhar Nadamuni, Toronto Correspondent 

 

Posted: November 26th, 2007 under Feature Stories, Hepatitis.
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Paul Vitello of The New York Times reports,

The Nassau County district attorney, Kathleen Rice, said yesterday that she would investigate “the entirety of the circumstances” that led a patient to be infected with Hepatitis C and hundreds more to be placed at risk by the improper infection-control practices of an anesthesiologist on Long Island.

See,

http://www.nytimes.com/2007/11/22/nyregion/22doctor.html

Reports indicate that more than 600 patients may have been exposed to Hepatitis C and possibly HIV, from 2000 to 2005, by a physician in the New York City metro area. But another outrage — little reported – is that the state government knew about the infections for more than two years, yet failed to warn patients until last week. That’s not acceptable.  – The Editors

Posted: November 25th, 2007 under Infection Protection, News.
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Mary Gallagher, of Global Traveler USA, reports,

Suddenly, tuberculosis, a highly contagious life-threatening illness that’s been on the decline in the U.S. since the 1950s, is a pressing concern. Globally, new infections and deaths from tuberculosis are increasing, most acutely in sub-Saharan Africa and Southeast Asia. Worldwide, tuberculosis kills 2 million people yearly. About one-third of the human population is infected with TB, with a new infection occurring every second.

See,

http://www.globaltravelerusa.com/showarticle.php?id=2812

With easy air travel today, this is not just a concern for the third world. This is a pressing public health interest for everyone.

– The Editors

Posted: November 23rd, 2007 under News, Tuberculosis.
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Leading scientific researchers indicate that antibacterial soaps and wipes are particularly useful when there are medically vulnerable people in the house, those who are ill, immune-compromised, newborn, or elderly. Increasingly, the front-line in the battle against bacteria is in our homes, not just in hospitals, researchers are telling Infection Protection.   “You cough or sneeze, and catch it with your hands,” says Dr. Robert S. Burlage, of the University of Wisconsin, Milwaukee, College of Health Sciences, relating the routine scene that plays out, daily, in homes and schools and workplaces. “Then you wipe it off with a hanky. That’s what your mom always told you to do. But guess what, staph and strep are harboring in your naso-pharynx, or nose.”That’s how disease is spread. So, prevention is emerging as the key medical intervention in infection control. “Some are trying to cause a scandal, and get funding for their research, and are saying that wipes and anti-bacterial soaps are not needed, and that they actually increase the resistance of bacteria,” says Craig Dees, who has a doctorate in clinical microbiology, and is president and CEO of drug developer, ProvectusPharma. “That’s been in the news lately. But the data is very clear. The fewer microbes on you, the better. I’ve been using anti-bacterial soaps and wipes for 20 years. I’ve never seen any resistance.” According to Dees, use of anti-bacterial wipes and soaps is mandated in many hospitals already. That has been shown to have dropped the infection rates there. “That’s what stops MRSA (multi-drug resistant staph infections) from going hog wild,” said Dees, whose company is developing an anti-biotic for cancer treatment. “Generally, the wipes or soaps are used in combination during the day. The bacteria have no chance against that.” Experts recommend that you use a “systems approach” when caring for elderly relatives at home. “Rather than just use an anti-bacterial wipe, once in a while, look at all the touch-points in the home,” says  Allen P. Rathey, president of the Healthy House Institute, based in Boise, Idaho. “You need to figure out what is going on in the microbial world there.”This may entail beginning a new routine in the home, but it will lead to a healthier lifestyle.  Researchers at the Centers for Disease Control (CDC) and scientists, published in journals like the Annals of Internal Medicine, have been promoting this for years. But with the outbreaks of MRSA and bird flu, the populace is starting to listen. There are many surfaces to clean, from countertops to sinks to doorknobs, that will stop the spread of disease.  “You need to be conscious of contagions,” says Rathey. “The bottom line is not just clean hands – but clean everything.” – by Gene J. Koprowski, Editor-in-Chief “http://www.healthyhouseinstitute.com/”>Further Reading Online: http://www.healthyhouseinstitute.com/ 

Posted: November 20th, 2007 under Anti-Bacterial Resources, Hand Hygiene, Infection Protection, News.
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     The risk of new cases of the deadly H5N1 bird flu virus “remains high,” said Chief Veterinary Officer of the U.K., Fred Landeg. The virulent strain of influenza has killed more than 200 people worldwide since 2003 and millions of birds either have died from it or been killed to prevent its spread.

     An outbreak has been confirmed near London, which has caused the death of 30 turkeys. That outbreak led Britain’s farm ministry on Thursday to issue a “slaughter-on-suspicion” order for the site.

      “The preliminary test results show no evidence of avian influenza on the premises,” Landeg told reporters. “We are still at a very early stage of the spread. The next few days is a very high risk period then the risk of finding new cases gradually diminishes.”

     To contain the outbreak, Britain’s farm ministry is culling free range turkeys at three farms operated by Redgrave Poultry. A total of 28,000 birds will be culled, mostly turkeys with some geese and ducks.

     “We still do not know the origin of the outbreak,” Landeg said, adding that the investigation included taking samples and testing droppings of wild birds in the area. There have not yet been any positive tests.

     Britain’s farm ministry has imposed a 2-mile “quarantine” zone, 4-mile surveillance zone and a wider restricted zone. In these areas, poultry must be isolated from wild birds and there are movement restrictions. Britain had an outbreak of the H5N1 virus strain in February at a turkey farm in Suffolk, eastern England.

– by Gene J. Koprowski, Editor-in-Chief

Further Reading Online: 

http://www.nlm.nih.gov/medlineplus/birdflu.html

Posted: November 20th, 2007 under Avian Flu, Feature Stories.
Comments: 2

      KIGALI — Rwanda’s Ministry of Health last month formally banned the traditional “sharing of straws” that locals here employ to drink beer. The age-old tradition is suspected in the spread of tuberculosis, or TB. The sharing of the straw spreads the tubercle bacilli-laden saliva into the beer, infecting others, who subsequently sip from the same container, the MOH in Rwanda said.   The MOH has also expressed a desire to discourage hand-shaking for greeting, to ban the conventional cloth handkerchief – which retains the bacteria-laden nasal mucus — in favor of the disposable paper tissues, and has promoted hand washing as a way to disinfect oneself, and stop the spread of TB.     Just a week after the Rwandan developments, Thami Mseleku, the director general of the South African Department of Health told the 38th Union World Conferences on Lung Health in Cape Town, South Africa, that the government was enacting legislation to confine those TB patients that did not follow their treatment regularly.       Both scenarios demonstrate the struggle against the TB epidemic in Africa, the international implications of which have been aptly illustrated by Howard Markel, author of, “When Germs Travel: Six Major Epidemics That Have Invaded America And The Fears they Have Unleashed.” Markel tells the frightening story of a young Korean woman who spreads TB to 20 of her fellow airline passengers as she travels from Seoul to Baltimore, simply by coughing during the flight. “The global village is a far smaller and more infectious place than it has ever been in human history,” concludes Markel.       There are many new concerns in today’s global village about stopping the spread of TB. Some specialists at the South Africa conference averred that the rise of Multi-Drug Resistant (MDR) TB was mainly due to TB programs that did not “sufficiently encourage” the patients to finish the first line treatment. Others blamed century-old diagnostic methods, a vaccine that is more than 80 years old and drug therapy combinations four decades old.  

     A representative of Doctors Without Borders in South Africa, Eric Goemaere, says the 9,000 MDR tuberculosis cases currently reported in South Africa  are “only the tip of the iceberg.” Doctors Without Borders in South Africa is using a decentralized treatment strategy which is more responsive to the TB prone population. TB patients recently took to the streets denouncing government centralised care there as ‘a death sentence.’      In eastern Africa, MDR-tuberculosis is increasing in Kenyan slums according to Doctors Without Borders. MDR-tuberculosis may be contracted due to failure in the treatment program or directly from another person with the same MDR-tuberculosis strand.  Treating TB with first line drugs is estimated to cost about $20 while MDR-tuberculosis treatment may go up to between $ 3,000 to $6,000.Demographic trends in Nairobi show that the poorer quarters of the city have the highest MDR-TB cases. In Nairobi’s infamous Mathare slum, 70% of the TB cases are also HIV and there is the problem of stigmatization because of the double infection.  In Rwanda where officially only 3% of about 9 million total population are HIV positive, MDR- TB (to rifampicine and isoniazide, deemed most powerful anti TB drugs), 60% of TB patients also have HIV.      According to a 2005 study, 3.9% of new TB cases and 9.4% of re-treatment cases are MDR-TB.  Rwanda has secured funding for strengthening MDR-TB control from the Global Fund, acquired second line treatment drugs and established pavilions for cases at Kabutare near the National University of Butare and another at the CHUK, a university teaching hospital in Kigali.M. Raviglione of the Stop TB program of the WHO says globally there are 880 new infections, more than 1.6 million deaths and 2 billion have latent TB which can transform into active TB once immunity is enfeebled.

 –by Damas M. Museminari, West Africa Correspondent

Further Resources Online:  http://www.who.int/mediacentre/factsheets/fs104/en/ 

Posted: November 19th, 2007 under Feature Stories, Tuberculosis.
Comments: none