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SIGNpost 00705

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *

Post00705 IC Teaching&Learning + NSI + Abstracts + News 03 July 2013

CONTENTS
1. Abstract: Infection control practices in health care: Teaching and
learning requirements of medical undergraduates
2. Summary: French Researchers Share Results of National Audit on Standard
Precautions
3. Abstract: Unsafe injection practices in Hodeidah governorate, Yemen
4. Abstract: Sharps injuries among health care workers in Cairo University
Hospitals
5. Abstract: Awareness of medical students in a medical college in
Mangalore, Karnataka, India concerning infection prevention practices
6. Abstract: Occupational Exposure to Hepatitis C Virus: Early T-Cell
Responses in the Absence of Seroconversion in a Longitudinal Cohort
Study
7. Abstract: Work safety among Polish health care workers in respect of
exposure to bloodborne pathogens
8. Abstract: Knowledge of infection control practices among intensive care
nurses in a tertiary care hospital
9. Abstract: Hepatitis B vaccination status among healthcare workers in a
tertiary care hospital in Tripoli, Libya
10. Abstract: Patients-to-healthcare workers HIV transmission risk from
sharp injuries, Southern Ethiopia
11. Abstract: Managing healthcare waste in Ghana: a comparative study of
public and private hospitals
12. Extract: Norjizak injection: a critical risk for transmitting blood-
borne infectious diseases
13. Abstract: An observational study of the hand hygiene initiative: a
comparison of preintervention and postintervention outcomes
14. Abstract: One hundred fifty years of infection prevention and control:
still searching for the cure
15. Abstract: Study on the natural history of HIV among former commercial
plasma donors caused by contaminated plasma donation in central China
16. Abstract: Emerging viral infections–a potential threat for blood
supply in the 21st century
17. No Abstract: Pyomyositis due to anabolic steroid injection
18. No Abstract: Needlestick injuries continue to be a challenge in
healthcare facilities
19. Vaccines Not Linked to Guillain-Barré, Asserts 13-Year Trial
20. Non Sterile Gloves: Study suggests inadequate hand hygiene practice
21. 16th ICID – CAPE TOWN • SOUTH AFRICA – APRIL 2~5, 2014
22. News
– Canada: Harm Reduction More Effective than War on Drugs: Study
– Guillain-Barre Syndrome and Vaccines Not Linked
– Global: Record Seizure of Illicit Medicines in Africa

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1. Abstract: Infection control practices in health care: Teaching and
learning requirements of medical undergraduates

Full free text
http://www.mjafi.net/article/S0377-1237(12)00175-X/fulltext

Full free PDF http://tinyurl.com/lk993zw

Moderators thanks to the authors for this post
__________________________________________________________________
Infection control practices in health care: Teaching and learning
requirements of medical undergraduates

Med Cdt Afreen Ayub, Ashish Goyal, Anupam Kotwal, Aniket Kulkarni, Col
Atul Kotwal, SM, Air Cmde Ajoy Mahen

Received 2 July 2012; accepted 31 July 2012. published online 03 September
2012.

Background Compliance and implementation of infection control guidelines
have been recognized as efficient means to prevent and control hospital
acquired infections.

Objectives To evaluate knowledge and practices about infection control
guidelines amongst medical students and to explore their education needs
as perceived by them and faculty.

Methods A total of 160 final year students and 100 faculty members of one
of the top medical colleges in India were selected by simple random
sampling in each group as per sample size of 143 students (alpha 0.05,
error 7%, prevalence 60%) and 99 (error 7.5%) faculty. Data collected by
pilot-tested, unlinked, anonymous questionnaire.

Results Amongst students, knowledge (77.50%; 95% CI, 70.24–83.72) was
mixed with misconceptions. Only 31.25% always followed hand hygiene
procedure; 50% recapped needles; disposal of hazardous material into
designated containers always was low (sharps 20%, contaminated items 25%).
Despite experiencing needle stick injury (6.25%) and splashes (40%), less
than 30% reported these as 44% were unaware of reporting procedure. The
discord between the perceptions of faculty regarding students and
students’ own perceptions was clearly evident (all Kappa values less than
0.50). Students and faculty agreed on workshops (58.13% and 58%) and
reinforcement by colleagues (51% and 54%) but not on on-job training (51%
and 34%) and part of curriculum (48% and 40%) for teaching–learning
infection control.

Conclusion Tackling disconnect between students and faculty perceptions
and empowering students with knowledge and skills in infection control is
important. Approach needs to be researched and formulated as current
methods seem to be inadequate.

Keywords: Standard precautions, Medical students, Medical faculty,
Infection control, Hand hygiene, Teaching–learning

PII: S0377-1237(12)00175-X

doi:10.1016/j.mjafi.2012.07.021

© 2012 Published by Elsevier Inc.
__________________________________________________________________
________________________________*_________________________________

2. Summary: French Researchers Share Results of National Audit on Standard
Precautions
__________________________________________________________________
http://tinyurl.com/l4z6ljn

French Researchers Share Results of National Audit on Standard Precautions
Infection Control Today (03.07.13)

Standard precautions (SP) aim to protect healthcare workers (HCWs) and
patients from infectious diseases arising from bloodborne pathogens and
reduce the risk of cross-transmission of microorganisms. They must be
applied in all circumstances, regardless of the infectious status of the
patient. Giard et al. (2013) conducted a study to assess institutional
policies for SP promotion; available resources for SP implementation; and
education of HCWs and their compliance with SP.

The study was a mixed audit of procedures, resources and attitudes,
conducted between Feb. 1, 2011 and Dec. 31, 2011, supported by the
Ministry of Health. Inclusion criteria were voluntary public and private
hospitals in France, medical, surgical and medico-technical wards therein
and HCWs working with patients in these wards. Self-assessment
questionnaires were administered at three levels: institutional, ward and
HCWs. At institutional and ward levels, results were given as a percentage
of objectives attained; at professional level, percentages of responses
reported as never, sometimes, often or always were calculated for each
question.

A total of 1,599 hospitals participated, including 14,968 wards and
203,840 HCW. At the institutional level, the overall score was 88%,
covering: SP promotion (91%), procedures (99%) and SP evaluation (63%). At
the ward level, the overall score was 94%, covering: procedures (95%) and
resources (93%).

Among the 165,722 (81.3%) HCWs who reported having participated in a
training session on SP, 69.6% had had it in the last five years.

A total of 88.1% of HCWs knew where to find the appropriate written
procedure in the event of a blood exposure. HCWs reported the best
compliance for glove changing between two patients (94.5% “always”).

The less respected criteria were glove use for intramuscular or
subcutaneous injection and eye protection use in the event of blood
exposure risk (34.5% and 24.4% “always,” respectively).

Reference: Giard M, Laprugne-Garcia E, et al. Oral presentation O005 at
2nd International Conference on Prevention and Infection Control (ICPIC
2013): Results of the French national audit on standard precautions.
Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):O5
doi:10.1186/2047-2994-2-S1-O5.
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Unsafe injection practices in Hodeidah governorate, Yemen
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23806699

J Infect Public Health. 2013 Aug;6(4):252-60.

Unsafe injection practices in Hodeidah governorate, Yemen.

Abkar MA, Wahdan IM, Sherif AA, Raja’a YA.

Department of Epidemiology, High Institute of Public Health, Alexandria
University, Alexandria, Egypt; Department of Nursing, Faculty of Medicine
and Health Sciences, Hodeidah University, Hodeidah, Yemen. Electronic
address: mabkar2006@yahoo.com.

BACKGROUND: Unsafe injection practices are a major public health problem
and can lead to the transmission of bloodborne pathogens, including
hepatitis B virus (HBV), hepatitis C virus (HCV) and human
immunodeficiency virus (HIV).

METHODS: The present study was conducted to determine the nature and
magnitude of unsafe injection practices in healthcare facilities in
Hodeidah governorate, Yemen. The study was conducted in two hospitals and
a representative sample of the governorate’s health centers. A total of
1600 injections were observed in these facilities.

RESULTS: This study revealed several unsafe practices, particularly the
recapping of needles after use, which occurred in 61.1% and 36.8% of the
observations in the hospitals and the health centers, respectively.

CONCLUSION: This study showed that most healthcare workers (HCWs) followed
the proper injection protocols but performed some procedures that exposed
themselves and the community to the risk of needlestick injuries (NSIs)
and bloodborne infections.

Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences.
Published by Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Sharps injuries among health care workers in Cairo University
Hospitals
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23796466

Int J Risk Saf Med. 2013 Jan 1;25(2):79-92.

Sharps injuries among health care workers in Cairo University Hospitals.

Zawilla NH, Ahmed D.

Department of Occupational and Environmental Medicine, Cairo University,
Cairo, Egypt.

BACKGROUND: Health care workers (HCWs) are exposed to blood borne
pathogens, through job-related risk factors like sharps injuries (SIs).
Sharps injuries can be prevented by safer devices and through education
and training of universal precautions and safe work practices.

OBJECTIVES: The present study aims to examine the current situation of
infection control at Cairo University Hospitals in Egypt, through studying
SIs among health care workers and evaluating the preventive measures.

SUBJECTS AND METHODS: The first part of this study was cross-sectional in
design. A self- administered Arabic questionnaire was designed for this
study based on EPINet (Exposure Prevention Information Network) Needle
Stick and Sharps injuries reporting Sheet. The second part of the study
was an interventional design to evaluate the effectiveness of preventive
measures which were introduced since the beginning of 2011.

RESULTS: Forty percent of the participants (416/1036) reported at least
one sharps injury in the preceding year (2010), of which more than 70%
(293/416) experienced more than one injury. 88.9% (370/416, p < 0.001) of
HCWs did not report their injury. Following intervention measures injury
rates were significantly reduced from 36.9/100 person in 2010 in the
intensive care units, to 12.4/100 person during 2011, (X2 = 21.419 and P
value < 0.001).

CONCLUSION: There is a high occurrence of sharps injuries in Cairo
University Hospitals. Implementation of safety devices and adequate
training will lead to reduction of SIs among HCWs.
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Awareness of medical students in a medical college in
Mangalore, Karnataka, India concerning infection prevention practices
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23806700

J Infect Public Health. 2013 Aug;6(4):261-8.

Awareness of medical students in a medical college in Mangalore,
Karnataka, India concerning infection prevention practices.

Kulkarni V, Papanna MK, Mohanty U, Ranjan R, Neelima V, Kumar N, Prasanna
Mithra P, Upadhyay RP, Unnikrishnan B.

Department of Community Medicine, Kasturba Medical College (Affiliated to
Manipal University), Mangalore 575001, India. Electronic address:
drvaman_83@hotmail.com.

BACKGROUND: Healthcare-associated infections (HCAIs) are an important
public health problem. It is estimated that approximately 1 out of every
20 hospitalized patients will contract an HCAI. The risk is substantial
not only to patients but also to healthcare workers, who may contract
deadly blood- borne infectious diseases. Hence, it is essential for
healthcare professionals to have adequate knowledge regarding infection
prevention practices (IPPs) to reduce the burden of these illnesses among
patients seeking care.

METHODS: This cross-sectional study was conducted among 268 medical
students at Kasturba Medical College, Mangalore. Information regarding
important IPPs such as hand hygiene (HH), needle-stick injuries (NSIs),
and standard precautions (SPs) was collected using a semi-structured
questionnaire. The collected information was analyzed using SPSS v.11.
Fisher’s exact test was used to test the association between variables of
interest.

RESULTS: Overall, knowledge levels regarding HH were low in aspects such
as healthcare workers’ hands as sources of infection (40%) and the minimum
time needed to apply hand rubs (45.7%), whereas knowledge levels were high
in aspects such as indications for using HH. Regarding NSI prevention,
knowledge levels were low in aspects such as activities with the highest
NSI risk (56%). However, knowledge levels were high in relation to SPs.

CONCLUSION: The knowledge levels regarding infection practices were not
adequate among the participants, particularly in the case of hand hygiene
methods. Other important aspects, such as needle-stick injuries and use of
standard precautions, were better understood, although many aspects still
require improvement. These findings suggest the need to consider
strengthening the training related to IPPs as a separate entity in the
existing curriculum.

Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences.
Published by Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Occupational Exposure to Hepatitis C Virus: Early T-Cell
Responses in the Absence of Seroconversion in a Longitudinal Cohort
Study
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23801608

J Infect Dis. 2013 Jun 28.

Occupational Exposure to Hepatitis C Virus: Early T-Cell Responses in the
Absence of Seroconversion in a Longitudinal Cohort Study.

Heller T, Werner JM, Rahman F, Mizukoshi E, Sobao Y, Gordon AM, Sheets A,
Sherker AH, Kessler E, Bean KS, Herrine SK, Stevens M, Schmitt J,
Rehermann B.

Liver Diseases Branch, National Institute of Diabetes and Digestive and
Kidney Diseases, National Institutes of Health, Department of Health and
Human Services, Bethesda, Maryland.

Background. T-cell responses have been described in seronegative patients
who test negative for hepatitis C virus (HCV) RNA despite frequent HCV
exposure. However, the cross-sectional design of those studies did not
clarify whether T cells were indeed induced by low-level HCV exposure
without seroconversion or whether they resulted from regular acute
infection with subsequent antibody loss.

Methods. Over a 10-year period, our longitudinal study recruited 72
healthcare workers with documented HCV exposure. We studied viremia and
antibody and T-cell responses longitudinally for 6 months.

Results. All healthcare workers remained negative for HCV RNA and
antibodies. However, 48% developed proliferative T-cell response and 42%
developed responses in interferon-gamma enzyme- linked immunosorbent spot
assays, with 29 healthy HCV-unexposed controls used to define assay
cutoffs. The response prevalence was associated with the transmission risk
score. T-cell responses peaked at week 4 and returned to baseline by week
12 after exposure. They predominantly targeted nonstructural HCV proteins,
which are not part of the HCV particle and thus must have been synthesized
in infected cells.

Conclusions. Subclinical transmission of HCV occurs frequently, resulting
in infection and synthesis of nonstructural proteins despite undetectable
systemic viremia. T-cell responses are more sensitive indicators of this
low-level HCV exposure than antibodies.

KEYWORDS:
T cell, antibody, exposure, healthcare worker, hepatitis, needlestick
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Work safety among Polish health care workers in respect of
exposure to bloodborne pathogens
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23650763

Med Pr. 2013;64(1):1-10.

Work safety among Polish health care workers in respect of exposure to
bloodborne pathogens.

Rybacki M, Piekarska A, Wiszniewska M, Walusiak-Skorupa J.

Department of Occupational Diseases and Toxicology, Nofer Institute of
Occupational Medicine, Lódz, Poland. mrybacki@imp.lodz.pl

OBJECTIVES: Viral hepatitis is the second most often identified infectious
illness acquired at work and it is mostly registered among health care
personnel. This group of workers is at greater risk of exposure to blood
and bloodborne pathogens, including hepatitis B and C viruses. The aims of
this study were to evaluate the efficacy of methods promoting work safety
in healthcare settings, to assess the frequency of exposures in the last
12 months prior to the study and to determine a rate of reporting them to
appropriate authorities.

METHODS: A total of 1138 Polish healthcare workers were interviewed during
the study period (between 2009 and 2010).

RESULTS: Sustaining accidental occupational percutaneous exposure during
last 12 months was declared by 242 workers (21% of the whole group). Only
in 146 cases these incidents were reported to authorities. Exposure
incidents were associated with self-perception of high risk of exposure
(OR = 3.69, p = 0.0027), employment in out-patient (vs. hospital-based)
healthcare setting (OR = 1.71, p = 0.0089), conviction that the level of
information about bloodborne infections conveyed at work was insufficient,
lack of both exposure reporting system and knowledge about the ways of
reporting.

CONCLUSIONS: Despite the different established proposals of the post-
exposure procedures, it turns out that particularly in small, not
providing 24 hours service healthcare settings these procedures are not
known or are not respected. More attention should be given to education,
especially in regard to the risk of infection, advantages of post-exposure
prophylaxis and reporting exposure incidents.
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Knowledge of infection control practices among intensive care
nurses in a tertiary care hospital
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23806701

J Infect Public Health. 2013 Aug;6(4):269-75.

Knowledge of infection control practices among intensive care nurses in a
tertiary care hospital.

Sodhi K, Shrivastava A, Arya M, Kumar M.

Consultant, Department of Critical Care, SPS Apollo Hospitals, Ludhiana,
India. Electronic address: drkanwal2006@yahoo.com.

BACKGROUND: The threat of hospital-acquired infections persists despite
advances in the health care system. A lack of knowledge regarding
infection control practices among health care workers decreases compliance
with these practices. We conducted a study to assess the knowledge of
infection control practices among nursing professionals at our hospital.

METHODS: In total, 100 nurses in the intensive care units at our hospital
were given a questionnaire with 40 multiple choice questions, including 10
questions each regarding hand hygiene, standard and transmission-based
precautions, care bundles and general infection control practices. The
responses were scored as percentages.

RESULTS: The overall knowledge and awareness regarding different infection
control practices were excellent (>90% positive responses) in 5% of the
nursing professionals, good (80-90% positive responses) in 37%, average
(70-80% positive responses) in 40% and below average (<70% positive
responses) in 18%.

CONCLUSION: The infection control knowledge among the nurses was fairly
good; however, there is still a wide scope of improvement with regular
educational programs and in-house training.

Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences.
Published by Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Hepatitis B vaccination status among healthcare workers in a
tertiary care hospital in Tripoli, Libya
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23806698

J Infect Public Health. 2013 Aug;6(4):246-51.

Hepatitis B vaccination status among healthcare workers in a tertiary care
hospital in Tripoli, Libya.

Ziglam H, El-Hattab M, Shingheer N, Zorgani A, Elahmer O.

Department of Infectious Diseases, Central Hospital, Tripoli, Libya.
Electronic address: hisham.ziglam@gmail.com.

BACKGROUND: The prevalence of hepatitis B virus (HBV) among healthcare
workers (HCWs) in hospitals in developing countries is high. However, the
vaccination status of these workers and its relationship with occupational
factors are not well documented.

AIM: The aim of this study was to evaluate the susceptibility of HCWs to
HBV infection in the representative Tripoli Central Hospital in Libya and
prepare a practical guideline to protect HCWs from occupational exposure.

METHOD: In this cross-sectional study, a questionnaire survey was
administered to 2705 healthcare workers of a university hospital in
Tripoli. The questionnaire included vaccination status. Compliance with
preventive practices against HBV infection was also assessed.

RESULT: The overall vaccination coverage (anti-HBs) was 78.1%.
Furthermore, 82.6% of HCWs had received at least one dose of vaccine, but
only 72% reported that they were fully vaccinated. The prevalence of
hepatitis B surface antigen was 1.1%. The mean prevalence of hepatitis B
core antibody (anti- HBc) was 17.3%.

CONCLUSION: HCWs at hospitals are frequently exposed to blood-borne
infections. Vaccines should be more readily available for Libyan HCWs, and
current vaccination programs should be enforced.

Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences.
Published by Elsevier Ltd. All rights reserved.

http://www.ncbi.nlm.nih.gov/pubmed/23806698
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Patients-to-healthcare workers HIV transmission risk from
sharp injuries, Southern Ethiopia
__________________________________________________________________
SAHARA J. 2012;9(1):1-5.

Patients-to-healthcare workers HIV transmission risk from sharp injuries,
Southern Ethiopia.

Desalegn B, Beyene H, Yamada R.

Kyoto University, Kyoto, Japan. biruck471@yahoo.ca

BACKGROUND: Accidental needlestick injury rate among healthcare workers in
Hawassa is extremely high. Epidemiological findings proved the infectious
potential of this injury contaminated with a Human Immunodeficiency Virus
(HIV)- infected patient’s blood.

OBJECTIVE: This study aimed at estimating the risk of HIV transmission
from patients to healthcare workers in Hawassa City, Ethiopia.

METHOD: A probabilistic risk model was employed. Scenario-based
assumptions were made for the values of parameters following a review of
published reports between 2007 and 2010.

PARAMETERS: HIV prevalence, needlestick injury rate, exposure rate, sero-
conversion rate, risk of HIV transmission and cumulative risk of HIV
transmission.

FINDING: Generally, healthcare workers in Hawassa are considered to be at
a relatively low (0.0035%) occupational risk of contracting HIV – less
than 4 in 100,000 of healthcare workers in the town (1 in 28,751 workers a
year).

The 30 years’ maximum cumulative risk estimate is approximately five
healthcare workers per 1000 workers in the study area. Still, this small
number should be considered a serious matter requiring post-exposure
prophylaxis following exposure to unsafe medical practice leading to HIV
infection.

Full free text:
www.tandfonline.com/doi/full/10.1080/17290376.2012.665252#.UdJ_2vkwdQU
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Managing healthcare waste in Ghana: a comparative study of
public and private hospitals
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23795428

Int J Health Care Qual Assur. 2013;26(4):375-86.

Managing healthcare waste in Ghana: a comparative study of public and
private hospitals.

Abor PA.

Department of Public Administration and Health Services Management,
University of Ghana Business School, Legon, Ghana. pabor@ug.edu.gh

PURPOSE: The paper aims to examine the healthcare waste management
practices of selected hospitals in Ghana. DESIGN/METHODOLOGYLAPPROACH: The
study adopted a multiple case approach, using two public and two private
hospitals.

FINDINGS: Findings indicate that both public hospitals and one private
hospital have a waste management policy. Public and private hospitals have
waste management plans and waste management teams. Public hospitals were
found to generate more waste than the private hospitals. One private
hospital and the public hospitals segregate their waste into different
categories. This is done by first identifying the waste type and then
separating non- infectious or general waste from infectious waste.

Both public and private hospitals have internal storage facilities for
temporarily storing the waste before they are finally disposed off-site.
On-site transportation in the public hospitals is done by using
wheelbarrows, while covered bins with wheels are used to transport waste
on-site in the private hospitals.

In public and private hospitals, off-site transportation of the hospital
waste is undertaken by Municipal Assemblies with the use of trucks. Both
public and private hospitals employ standard methods for disposing of
healthcare waste.

ORIGINALITYLVALUE: The article provides insights into healthcare waste
management from a Ghanaian perspective.
__________________________________________________________________
________________________________*_________________________________

12. Extract: Norjizak injection: a critical risk for transmitting blood-
borne infectious diseases
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23805160

Hepat Mon. 2013 Apr 6;13(4):e8272.

Norjizak injection: a critical risk for transmitting blood-borne
infectious diseases.

Alam Mehrjerdi Z.

Iranian National Center for Addiction Studies (INCAS), Tehran University
of Medical Sciences, Tehran, IR Iran.

KEYWORDS: Blood-Borne Pathogens, Infection, Injection

Free PMC Article

“Dear Editor,

Infectious diseases including HIV and viral hepatitis constitute a major
health concern with high prevalences among injecting drug users (IDUs) in
Iran IDUs that share needles and syringes and practice sexual behaviors
are at risk groups for being infected with blood-borne infectious diseases
such as HCV . The recent increasing use of opioids in Iran has been
strongly associated with health-related harms ) including transmitting
HIV, HCV, and HBV infections

In 2005, a new illicit opioid, named as Norjizak, was introduced in
Iran’s illicit drug market and it gained popularity in a short period of
time and contributed to transmitting blood-borne infectious diseases.
Norjizak which is also written as Norjizac, Norgesic, and Norchizack in
Iran is a narcotic drug which is a combination of several opioids with
Dexamethason or Benzodiazepines.

Its main route of administration is injection. Norjizak is also used
intramuscularly and/or subcutaneously. Its injection is associated with
several medical complications including abscess formation, development of
septic emboli and soft tissue infections in IDUs, but a few studies have
focused on Norjizak injection and its health-related problems in Iran”

Free full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693537/

__________________________________________________________________
________________________________*_________________________________

13. Abstract: An observational study of the hand hygiene initiative: a
comparison of preintervention and postintervention outcomes
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23793705

BMJ Open. 2013 May 28;3(5). pii: e003018.

An observational study of the hand hygiene initiative: a comparison of
preintervention and postintervention outcomes.

Mukerji A, Narciso J, Moore C, McGeer A, Kelly E, Shah V.

Department of Paediatrics, Mount Sinai Hospital, University of Toronto,
Toronto, Ontario, Canada.

OBJECTIVES: To evaluate the impact of implementing a simple, user-friendly
eLearning module on hand hygiene (HH) compliance and infection rates.

DESIGN: Preintervention and postintervention observational study.

PARTICIPANTS: All neonates admitted to the neonatal intensive care unit
(NICU) over the study period were eligible for participation and were
included in the analyses. A total of 3422 patients were admitted over a
36-month span (July 2009 to June 2012).

INTERVENTIONS: In the preintervention and postintervention periods (phases
I and II), all healthcare providers were trained on HH practices using an
eLearning module. The principles of the ‘4 moments of HH’ and definition
of ‘baby space’ were incorporated using interactive tools. The
intervention then extended into a long-term sustainability programme
(phase III), including the requirement of an annual recertification of the
module and introduction of posters and screensavers throughout the NICU.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was HH
compliance rates among healthcare providers in the three phases. The
secondary outcome was healthcare-associated infection rates in the NICU.

RESULTS: HH compliance rates declined initially in phase II then improved
in phase III with the addition of a long-term sustainability programme
(76%, 67% and 76% in phases I, II and III, respectively (p<0.01).
Infection rates showed an opposing, but concomitant trend in the overall
population as well as in infants <1500 g and were 4%, 6% and 4% (p=0.02),
and 11%, 21% and 16% (p<0.01), respectively, during the three phases.

CONCLUSIONS: Interventions to improve HH compliance are challenging to
implement and sustain with the need for ongoing reinforcement and
education.

KEYWORDS: Baby space, Hand hygiene compliance, Healthcare-associated
infection, Nosocomial infection

Free Article http://bmjopen.bmj.com/content/3/5/e003018
__________________________________________________________________
________________________________*_________________________________

14. Abstract: One hundred fifty years of infection prevention and control:
still searching for the cure
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23803350

Healthc Pap. 2013;13(1):24-9.

One hundred fifty years of infection prevention and control: still
searching for the cure.

Roth V.

FRCPC, MBA, Director, Physician Leadership Development and Physician
Engagement, Medical Director, Infection Prevention and Control Program,
The Ottawa Hospital.

In this issue, Zimmerman and colleagues propose a “cure” for our seeming
inability to deliver safer healthcare for patients. They suggest that the
solution lies in engaging front-line healthcare workers to generate ideas
for improving patient safety at the local level and empowering them to
implement these ideas – front-line ownership. H

owever, our current environment lacks performance measures and fails to
hold individuals and teams accountable for their performance in improving
patient safety.

Healthcare leaders must commit to supporting front-line workers by
providing performance measures and an accountability framework. Only then
can we achieve authentic and sustainable front-line ownership.

Copyright © 2013 Longwoods Publishing.
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Study on the natural history of HIV among former commercial
plasma donors caused by contaminated plasma donation in central China
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/21163092

Zhonghua Liu Xing Bing Xue Za Zhi. 2010 Jun;31(6):633-7.

[Study on the natural history of HIV among former commercial plasma donors
caused by contaminated plasma donation in central China].

[Article in Chinese]

Li DM, Wang L, Gao X, Wang Z, Cui ZL, Song LP, He WS, Wang SW, Chen CK,
Wang N.

National Center for AIDS/STD Control and Prevention, Chinese Center for
Disease Control and Prevention, Beijing 102206, China.

OBJECTIVE: To investigate the natural history of HIV infection caused by
contaminated plasma donation among former commercial plasma donors in
China.

METHODS: Ambispective cohort study among HIV/AIDS cases and suspected AIDS
deaths was conducted from January 1, 1995 to March 31, 2008 in 7
administrative villages in Shangcai county of Henan province. Information
regarding diagnostic criteria, deaths and anti-retrovirus treatment was
collected. Incubation and survival time were calculated using Kaplan-Meier
and life- tables method. Sensitive analysis on the time of outcome was
conducted.

RESULTS: A total number of 2569 cases of HIV infection including 483
suspected AIDS deaths were involved in a cohort. 200 patients with rapid
progress (7.8%) and 337 long-term but non-progressive patients (13.1%)
were identified. Results from the sensitive analysis showed that the
median incubation period from HIV infection to AIDS was between 8.5 and
8.9 years, with incidence as 11.7 – 12.0 cases/100 person-years and the
median survival time for HIV progression to death was from 8.8 to 10.7
years, with the death rate as 6.9 – 8.3 cases/100 person-years. The median
survival time for AIDS patient was from 1.2 to 2.0 years, with death rate
as 34.9 – 51.5 cases/100 person-years.

CONCLUSION: According to sensitive analysis, the incubation period for HIV
progression to AIDS, the median survival time for HIV progression to death
and the median survival time for AIDS patient to death were 8.8 years, 1.2
years and 9.8 years, respectively.
__________________________________________________________________
________________________________*_________________________________

16. Abstract: Emerging viral infections–a potential threat for blood
supply in the 21st century
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23258302

AIDS Rev. 2012 Oct-Dec;14(4):279-89.

Emerging viral infections–a potential threat for blood supply in the 21st
century.

de Mendoza C, Altisent C, Aznar JA, Batlle J, Soriano V.

Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain.
cmendoza@terra.es

During the last 25 years the safety of blood products has improved
dramatically with regard to infectious risk, notably to the threat
represented by retroviruses (HIV and human T-cell lymphotropic virus) and
hepatitis B and C viruses. However, both residual and emergent viral
infections are still responsible for contaminations in recipients of blood
products.

Along with other viruses (human herpesvirus-8, human parvovirus B19,
hepatitis A and E viruses, etc.), special attention has recently been paid
to emerging arboviruses, such as West Nile virus in North America, and
Dengue and Chikungunya viruses in Europe.

Another blood-linked risk, notably in the United Kingdom and France, is
the prion agent responsible for the variant form of the Creutzfeldt-Jakob
disease. Hemophilia care has been the model for improvements in the safety
and availability of safe blood components free of infectious agents.

In this regard, several measures aimed to halt transmission of viruses
have been implemented in blood banks, including the exclusion of at-risk
donors, specific sensitive diagnostic tests, leukocyte reduction of labile
blood products, and the physical or chemical treatments aiming at
nonspecific inactivation of infectious agents potentially present in blood
without impairing significantly its physiological properties.
__________________________________________________________________
________________________________*_________________________________

17. No Abstract: Pyomyositis due to anabolic steroid injection
__________________________________________________________________

J Emerg Med. 2013 Jan;44(1):e69-70.

Pyomyositis due to anabolic steroid injection.

Shiber JR.

University of Florida College of Medicine, Jacksonville, Florida 32206,
USA.
__________________________________________________________________
________________________________*_________________________________

18. No Abstract: Needlestick injuries continue to be a challenge in
healthcare facilities
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23798270

Ohio Nurses Rev. 2013 May-Jun;88(3):8.

Needlestick injuries continue to be a challenge in healthcare facilities.

Alexander D.

AFT Health and Safety Program.
__________________________________________________________________
________________________________*_________________________________

19. Vaccines Not Linked to Guillain-Barré, Asserts 13-Year Trial
__________________________________________________________________
Vaccines Not Linked to Guillain-Barré, Asserts 13-Year Trial
Fran Lowry, Medscape Medical News (26.06.13)

In a retrospective study spanning 13 years and more than 30 million
person-years, researchers found no evidence of an increased risk for
Guillain-Barré syndrome (GBS) after vaccinations of any type, including
influenza vaccination.

“If there is a risk of Guillain-Barré syndrome following any vaccine,
including influenza vaccines, it is extremely low,” lead author Roger
Baxter, MD, codirector of the Kaiser Permanente Vaccine Study Center,
Oakland, California, said in a Kaiser news release.

“GBS is an acute inflammatory polyradiculoneuropathy affecting primarily
motor neurons, which in severe cases can progress to complete paralysis
and even death,” write Dr. Baxter and colleagues in an article published
online April 11 and in the July 15 issue of Clinical Infectious Diseases.

“Estimates of GBS incidence are in the range of 1-2 cases per 100,000
person-years worldwide and increase with age,” cite the authors. Causes of
the syndrome are unknown, but are thought to involve an autoimmune process
triggered by antigenic stimulation that results in demyelination and
destruction of peripheral nerves, the authors explain.

About two thirds of cases are preceded by a gastrointestinal or
respiratory infection, with Campylobacter enteritis being the most common
trigger. Also implicated are influenza, cytomegalovirus, Epstein-Barr
virus, HIV, and Mycoplasma pneumonia.

Case reports have linked a variety of vaccine types to GBS. The only clear
association, however, has been with the 1976 A/New Jersey swine influenza
vaccine, when a small but significant increase in the number of GBS cases
was seen 6 weeks after vaccination. Since that time, investigations have
shown either no risk or a very small attributable risk of GBS in roughly 1
case per million doses. More recently, studies assessing the risk of GBS
after the 2009 H1N1 monovalent influenza vaccines in the United States
found a slightly higher attributable risk ranging from 1 to 5 per million
doses.

The aim of the current study was to further evaluate the possible
relationship between GBS and vaccinations, using retrospective data from
the Kaiser Permanente of Northern California healthcare plan accumulated
over many years.

Dr. Baxter and colleagues identified 415 confirmed cases of GBS during the
13-year period from 1994 to 2006. Most cases were male (58.6%), and the
mean age was 48.5 years (range, 5 – 87 years).

The researchers also found that 277 patients (66.7%) had a respiratory
and/or gastrointestinal illness in the 90 days preceding the onset of GBS.

Incidence was significantly more likely to occur in the winter months
(November – April), with a relative risk of 1.5, compared with in the
nonwinter months (P = .003), peaking in March.

Among the 415 patients with GBS, only 25 had received any vaccine in the 6
weeks before onset of the disease. The vaccines that were received
included trivalent inactivated influenza vaccine (n = 18 patients), 23-
valent polysaccharide pneumococcal vaccine (n = 2), tetanus-diphtheria
combination vaccines (n = 3), hepatitis A (n = 2), and hepatitis B (n =
1).

The other 390 patients with GBS received no vaccines in the 6 weeks before
onset.

The researchers also found no cases of GBS resulting from vaccines given
mainly in childhood, despite the large number of doses given. These
included the oral polio vaccine (1.2 million doses), measles-mumps-rubella
(1.6 million), conjugated pneumococcal (1.3 million), live attenuated
influenza (69,000), diphtheria-tetanus-acellular pertussis (1.9 million),
varicella (764,000), Haemophilus-diphtheria-tetanus-pertussis (525,000),
and Haemophilus B vaccines (1.2 million).

“For rabies vaccine (13 000 doses), there was 1 case of GBS, 7.5 weeks
after vaccination,” the authors add.

“Despite many years of review of a very large captured population, we are
unable to exclude any [and all] possible association between vaccines and
GBS,” the researchers note. This is in part because of the low power of
the study, given the infrequency with which GBS occurs.

Highlighting another potential study limitation, the authors point out
that their reviewer was able to see whether medical providers thought that
GBS was caused by a vaccine, which “could have influenced the reviewer in
some way.”

Nonetheless, “the low numbers of GBS cases that were temporally associated
with vaccination, coupled with our results, provide reassurance that the
risk of GBS following any vaccine, including influenza vaccines, is
extremely low,” conclude Dr. Baxter and colleagues.

Dispel Fears of Vaccination

“Studies such as this recent Kaiser Permanente trial showing lack of
relationship between vaccination and [GBS] are critical to help promote
immunizations and dispel fears,” said Marian Michaels, MD, from the
Division of Pediatric Infectious Diseases at Children’s Hospital of
Pittsburgh, University of Pittsburgh Medical Center, when Medscape Medical
News asked for her views on this article.

“Immunizations are the most important methods we have to prevent infection
and improve health,” she continued. “However, too often, people hear of
someone who had an illness temporarily associated with having received an
immunization. By nature, we as humans try to make associations, and
therefore the immunization often takes the blame, even if it had nothing
to do with the problem. Anecdotal cases always have this risk, so it is
important to look at large numbers, not just one person, to see if a
vaccine is truly to blame or not.”

The Kaiser Permanente study, “which has huge numbers of people involved,”
is extremely helpful, Dr. Michaels said.

“It gives us the data to say ‘no, there really doesn’t seem to be an
association.’ This should help doctors, nurses, and other healthcare
professionals…have the facts when they talk with families about the
importance of immunization.”

Others Say Study Not Convincing

All experts do not agree, however, with the conclusion of the report by
Dr. Baxter and colleagues.

Nobuhiro Yuki, MD, PhD, research professor in the Department of Medicine
at National University of Singapore, told Medscape Medical News he
believes a few vaccines could well have caused GBS, and he finds the paper
title (“Lack of Association of Guillain-Barré Syndrome With Vaccinations”)
misleading.

“A number of cases of GBS developing in patients who received the rabies
vaccine have been reported. GBS has been associated with 2 forms of rabies
vaccines, the Semple rabies vaccine and the suckling mouse brain vaccine,”
said Dr. Yuki, who researches GBS but was not involved in this study.
“According to their study in a small population, they could not find the
association of GBS with vaccines. That’s all. The title is too catchy, and
I have no idea why this journal accepted their paper.”

The study was supported by America’s Health Insurance Plans and the
Centers for Disease Control. Dr. Baxter and one coauthor report financial
relationships with Merck & Company, Pfizer, Sanofi-Pasteur, Novartis
Vaccines, GlaxoSmithKline, and Med-Immune. Dr. Yuki has disclosed no
relevant financial relationships.
__________________________________________________________________
________________________________*_________________________________

20. Non Sterile Gloves: Study suggests inadequate hand hygiene practice
__________________________________________________________________
Study suggests inadequate hand hygiene practice
Otago University
Monday 01 July 2013, 2:35PM
Media release from Otago University

Gloves used commonly in general hospital wards throughout New Zealand are
frequently contaminated with bacteria before coming into contact with
patients, with poor glove box design and inadequate hand washing by
hospital staff the likely culprits, a new University of Otago study has
found.

The Otago researchers, whose study was published Sunday 30 June, 4pm NZT
in the Australasian Medical Journal, tested non-sterile disposable gloves,
finding they more than live up to their name.

Poor hand hygiene by hospital staff, coupled with a flaw in the design of
the boxes, are strongly suspected as causes of the contamination by
different kinds of bacteria, including faecal bacteria.

The bacteria involved are responsible for some of the nosocomial
(hospital-acquired) infections that are acquired by people admitted to
hospital. These potentially fatal infections are known to cost New Zealand
health budgets around $136 million a year.

Lead author Dr Heather Brooks from the Department of Microbiology and
Immunology says she and collaborators Dr Jon Cornwall from the Department
of Anatomy, Masters student Kim Hughes and Professor Jean-Claude Theis
(Department of Surgical Sciences), assessed whether the non-sterile gloves
were capable of transferring potential disease-causing bacteria in a large
hospital ward.

“We wanted to find out whether gloves used every day for procedures such
as removing drains, catheters or removing dressings from wounds, could be
a vehicle for transmission of bugs around the ward,” says Dr Brooks.

“We wanted to find out how ‘non-sterile’, non-sterile actually is.”

The World Health Organization guidelines say proper hand hygiene must be
carried out before gloves are retrieved from boxes, often located on walls
in wards. However, the researchers found that hand hygiene must have been
inadequate after they found several different kinds of bacteria after
testing unused gloves in boxes located in one large general ward at
Dunedin Hospital.

Dr Cornwall says that effective hand hygiene is a basic protective concept
that has been known for a long time. He was hopeful the study would lead
to a return to basics in hospitals.

“It seems there is a lot of emphasis on protecting healthcare staff from
the patient, but perhaps not enough effort going into protecting the
patient from the healthcare staff and potential cross-transmission of
bugs,” he says.

Kim Hughes, who tested 10 boxes of gloves and 38 glove samples (each
sample containing three gloves) from the hospital ward, found the
pathogens on the unused gloves, including a small number of faecal
organisms.

“I was very surprised to see so many bacteria and different types,
including pathogens,” she says.

Dr Brooks believes the gloves become contaminated when medical staff
search in the box for new gloves and their hands come into contact with
the ones that are not selected.

Failure to properly wash their hands prior to accessing the glove boxes
most likely accounted for the presence of faecal bacteria on the gloves.
Reducing the contamination likely requires improved and proper hand
washing technique, and a design change in the box that reduces the size of
the hole through which the gloves are retrieved, allowing the gloves to
come out more easily without the need for reaching into the box to access
new gloves.

“The findings highlight adherence to hand washing guidelines, common glove
retrieval practice, and glove-box design as targets for decreasing
bacteria transmission via gloves on hospital wards,” the study concludes.

Dr Brooks says the researchers believe it is highly likely that these
results would be replicated in other general wards in other hospitals
should tests be carried out.

The study backs up previous international studies which have also found
that hand-washing compliance by health professionals is generally poor.
For more information, contact:

Dr Heather Brooks
Department of Microbiology and Immunology
University of Otago
Tel 64 3 479 7826 or 64 3 481 1916

Dr Jon Cornwall
Department of Anatomy
University of Otago
Tel 64 3 479 5324
Mob 64 22 103 4550
__________________________________________________________________
________________________________*_________________________________

21. 16th ICID – CAPE TOWN • SOUTH AFRICA – APRIL 2~5, 2014
__________________________________________________________________

16th ICID – CAPE TOWN • SOUTH AFRICA
APRIL 2~5, 2014

New Plenary Speaker announced

Professor Peter Piot (United Kingdom): Old and New Global Challenges in
Infectious Diseases

Planned Symposium Topics:
Focus on HIV
Focus on TB
Focus on Tropical Diseases

Additional Topics:
Optimizing Tools for Antibiotic Stewardship
Infection Control: State of the Art and Daily Practice
Control of Highly Resistant Bacterial Pathogens
Carbapenemase-Resistant Enterobacteriaceae
MRSA
Highly Resistant Gonococcus
Emerging Infectious Diseases and Disease Surveillance in Africa
The Human-Animal Interface in Africa
Laboratory Diagnosis and Surveillance in LMICs
Gender Differences in Response to Infection
Genomics and the Microbiome
Responding to Complex ID Emergencies: Detection, Alerts and Interventions
Childhood Pneumonia in the Era of Conjugate Vaccines
Global Controversies in Management of Sepsis
Upper Respiratory Tract and Allied Infections
Public Health Challenges of Sexually Transmitted Diseases
Human Papilloma Virus: Health Impacts and Vaccine Utilization
Controversies in Vaccination: Pertussis, Polio, Rotavirus, Influenza
Diarrheal Diseases: Pathogens, Vaccines, Sanitation
Controlling Typhoid

The 16th ICID Second Announcement is now available at:
http://www.isid.org/icid/Downloads/16thICID_2ndAnnounce.pdf
__________________________________________________________________
________________________________*_________________________________

22. News

– Canada: Harm Reduction More Effective than War on Drugs: Study
– Guillain-Barre Syndrome and Vaccines Not Linked
– Global: Record Seizure of Illicit Medicines in Africa

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
Canada: Harm Reduction More Effective than War on Drugs: Study

By Dene Moore, Canadian Press, Canada (24.06.13)

The British Columbia Centre for Excellence in HIV/AIDS reported a 15-year
study demonstrated that a harm reduction initiative reduced drug use and
improved public safety in an impoverished area of Vancouver. When the
study began in 1996, the community had the “highest rates of HIV
infection” outside of sub-Saharan Africa and high mortality from drug
overdose.

Vancouver adopted a public health approach that included opening a
supervised drug injection site (Insite) in 2003. Dr. Thomas Kerr, co-
author of the report and co-director of the Centre’s Urban Health Research
Initiative, stated that the percentage of drug users sharing needles had
declined from 40 percent in 1996 to 1.7 percent in 2011, which resulted in
lower incidence of HIV and hepatitis C due to sharing needles. About one
quarter of Vancouver drug users were HIV-infected; approximately 90
percent had hepatitis C. Data also indicated that more drug users were
taking advantage of addiction treatment programs; only 12 percent of users
were on methadone in 1996 compared to 54.5 percent in 2008. Although the
report found less drug use in the community, illegal drugs are still
widely available in Vancouver, and mortality among drug users remains
eight times higher than the general population.

Opponents include Canada’s Conservative party—currently in power—and
several policing associations. Preferring a US-style “war on drugs,” the
federal government introduced the “Respect for Communities Act,” which
would require supervised injection sites to consult with community, law
enforcement, provincial, and municipal authorities before opening.
Although the Supreme Court of Canada has ordered that Insite remain open,
the legislation might prevent the establishment of similar sites.

The Centre does not support legalization of illicit drugs.

The Full Report, “Drug Situation in Vancouver,” was published online by
the British Columbia Centre for Excellence in HIV/AIDS at
http://uhri.cfenet.ubc.ca/images/Documents/dsiv2013.pdf.
__________________________________________________________________
__________________________________________________________________
Guillain-Barre Syndrome and Vaccines Not Linked
CBC News, Canada (24.06.13)

Researchers from the U.S. Centers for Disease Control and Prevention and
the Kaiser Permanente Vaccine Study Center studied cases of Guillain-Barre
syndrome (GBS) in California over a 13-year period and found no link
between the paralyzing syndrome and vaccines.

During the study period, only 25 of the 415 patients confirmed with GBS
had received a vaccine six weeks prior to the disease’s onset. “Although
we had limited power to fully assess the risk of GBS following vaccination
due to the rarity of the outcome, the low numbers of GBS cases that were
temporally associated with vaccination, coupled with our results, provide
reassurance that the risk of GBS following any vaccine, including
influenza vaccines, is extremely low,” say the researchers, led by Dr.
Roger Baxter, co-director of the Kaiser Permanente Vaccine Study Center.

The study is published in Clinical Infectious Diseases.
__________________________________________________________________
__________________________________________________________________
http://online.wsj.com/article/PR-CO-20130613-908669.html

Global: Record Seizure of Illicit Medicines in Africa
PRNewswire PRESS RELEASE (13.06.13)

More than 1 billion illicit products seized in 10 days, including 550
million medicines

The World Customs Organization (WCO) and the Institute of Research Against
Counterfeit Medicines (IRACM) issue a new warning about the health and
safety of African populations

PARIS, June 13, 2013 /PRNewswire/ — A customs operation of an unequalled
scale was carried out in April of this year in 23 African countries. More
than one billion articles and in particular 550 million doses of illicit,
potentially dangerous if not deadly medicines were intercepted including:
antibiotics, painkillers, anti-inflammatory drugs, medicines for high
blood pressure and diabetes and food supplements. The total value of the
medicines collected is estimated at more than $275 million US Dollars.
These results reveal the extent of the traffic of illicit medicines in
Africa and the danger this poses to the health of people across the
African continent.

— More than 1 billion illicit products seized in 10 days, of which 550
million were medicines.

Operation BIYELA was organized by the World Customs Organization (WCO) in
partnership with the Institute of Research Against Counterfeit Medicines
(IRACM). The customs administrations of Algeria, South Africa, Angola,
Benin, Cameroon, Democratic Republic of Congo, Republic of Congo,
Djibouti, Ivory Coast, Gabon, Gambia, Ghana, Guinea, Kenya, Madagascar,
Morocco, Mauritius, Mozambique, Namibia, Nigeria, Senegal, Tanzania and
Togo participated in the operation.

The results are alarming. More than one billion counterfeit or illicit
products were discovered inside 145 containers. The Democratic Republic of
Congo and Togo are the countries where the most significant results were
attained in terms of volume. The majority of intercepted shipments
originated from East and South Asia and the Middle East. “Operation BIYELA
has brought irrefutable proof of the major role that customs play in
protecting consumers,” declared Kunio Mikuriya, Secretary General of the
WCO. “Apart from the interception of dangerous products, this
international operation allows us to gather precious intelligence on the
traffic of these products, and therefore reinforce our inspections,” he
added. “The success of customs in only 10 days and at 23 African ports
provides a horrifying idea of the scourge that the traffic of fake
medicines represents on this continent. It is time that all national and
international authorities mobilize to protect the life of patients,”
declared Jacques Franquet, Director of the IRACM.

— Agents trained to recognize counterfeit medicines.
To prepare for the operation, customs agents were trained to recognize the
technical characteristics of products likely to be counterfeited, as well
as risk-analysis techniques. The training was provided by the WCO with the
support of the IRACM, Institute of Research Against Counterfeit Medicines
and experts of the concerned industrial sectors, such as the
pharmaceutical sector.

This advanced training was provided with the help of the IPM (Interface
Public Members), a tool developed by the WCO that provides fast detection
of counterfeited items. The IPM contains key information on the branded
products supplied by the licensees (photos, technical description,
transport itinerary, packaging characteristics, contact people for the
brand in question, etc.) and is accessible to customs agencies 24 hours a
day.

Operation BIYELA had several objectives:

— Detect new vectors and new fraud techniques in order to put into place
adapted means to fight the scourge,

— Train custom experts in new risk analysis techniques and targeting,

— Encourage customs agents to use the IPM system in real situations,

— Identify the types of counterfeit products and evaluate their risk
potential,

— Mobilize the actors in the fight, notably the licensees and the
regulatory agencies, so that they support and cooperate with customs.

The results presented in this press release are preliminary; all the data
concerning the interceptions has not yet been communicated.

About the World Customs Organization (WCO) is the only intergovernmental
organization exclusively specialized in customs issues. With members in
countries around the world, the WCO is today the voice of the
international customs community. The WCO is renowned for its work in
drafting international customs norms, simplifying and harmonizing customs
regimes, for supply chain logistics security, facilitating exchanges,
fighting against fraud, the public-private partnership, promoting ethics,
and durably reinforcing customs capabilities. In addition, the WCO manages
the international merchandise nomenclature of the harmonized system and
the technical aspects of the WCO Accord on customs evaluations and on the
rules of origin.

For more information visit: www.wcoomd.org.

About the Institute of Research Against Counterfeit Medicines (IRACM)

A non-profit association, the Institute of Research Against Counterfeit
Medicines (IRACM) was created in October 2010. Its mission: to raise
public and authorities awareness concerning the scourge that counterfeit
medicines represents, to train the committed actors in the fight against
fake medicines, to centralize knowledge, good practices and know-how and
to serve as a proactive interlocutor and advisory body proposing advice
and solutions to national and international political and judiciary
authorities. After more than two years, the IRACM has trained more than
one thousand senior customs managers, police and health agencies among 50
different nationalities, and it has raised awareness among thousands of
people about the dangers of fake medicines.

For more information visit: www.iracm.com.

U.S. Media Contact: Helena Brantley, Red Pencil PR + Marketing

510.316.3545 or HelenaBrantley@RedPencilPR.com

SOURCE Institute of Research Against Counterfeit Medicines (IRACM); World
Customs Organization (WCO)

/Web site: http://www.iracm.com

/Web site: http://www.wcoomd.org
__________________________________________________________________
________________________________*_________________________________
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__________________________________________________________________
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to 11 November 2010 in Dubai, The United Arab Emirates.

The SIGN 2010 meeting report pdf, 1.36Mb is available on line at:
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