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SIGNpost00788

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00788 Waste x 4 + Abstracts + News 11 February 2015

CONTENTS
0. SIGN Meeting 2015
1. Abstract: An innovative national health care waste management system in
Kyrgyzstan
2. Abstract: Bio-medical waste management: situational analysis &
predictors of performances in 25 districts across 20 Indian States
3. Abstract: Hospital waste management in nonteaching hospitals of lucknow
city, India
4. Abstract: On the path of continual improvement: An evaluation of
biomedical waste management training
5. Abstract: Prevalence of unsafe conditions associated to non-intentional
needlestick injuries among trainee physicians
6. Abstract: Ebola virus disease in Africa: epidemiology and nosocomial
transmission
7. Abstract: Progress of vaccine and drug development for Ebola
preparedness
8. Abstract: Are needle and syringe programmes associated with a reduction
in HIV transmission among people who inject drugs: a systematic review
and meta-analysis
9. Abstract: Granulomatous reaction to liquid injectable silicone for
gluteal enhancement: review of management options and success of
doxycycline
10. News
– UK: BLOOD HAZARD: Angry home-patients left with bags of dangerous
clinical waste
– USA: Students poke each other with medical needles
– Ebola NSI: Two military medics back in UK for Ebola monitoring
– Ebola NSI: Ebola Medic Flown to Germany for Anonymity
– UK: Risk of blood-borne viruses from sharps injuries continues, report
claims

The web edition of SIGNpost is online at:
http://signpostonline.info/archives/1809

More information follows at the end of this SIGNpost!

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sign@who.int

Visit the WHO injection safety website and the SIGN Alliance Secretariat
at: http://www.who.int/injection_safety/en/

Visit the SIGNpostOnline archives at: http://signpostonline.info

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__________________________________________________________________
________________________________*_________________________________
0. SIGN Meeting 2015

The Safe Injection Global Network SIGN meeting is 23-24 February 2015 at
WHO Headquarters in Geneva Switzerland

The main topic of the meeting will be the new injection safety policy
recommendation and developing the appropriate strategies for
implementation in countries worldwide.

The Keynote speaker will be Dr Margaret Chan, the Director-General of WHO.

Dr. Chan will launch the new IS policy which recommends the use of safety
engineered injection devices for reuse prevention and sharps injury
protection.
__________________________________________________________________
________________________________*_________________________________

1. Abstract: An innovative national health care waste management system in
Kyrgyzstan
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25649402

Waste Manag Res. 2015 Feb;33(2):130-8.

An innovative national health care waste management system in Kyrgyzstan.

Toktobaev N1, Emmanuel J2, Djumalieva G3, Kravtsov A3, Schüth T4.

1Health Care Waste Management Project, financed by the Swiss Agency for
Development and Cooperation (SDC) and implemented by the Swiss Red Cross,
Bishkek, Kyrgyz Republic nurjan.toktobaev@gmail.com.
2E & ER Group, Hercules, CA, USA.
3Republican Centre for Infection Control, Ministry of Health of the Kyrgyz
Republic, Bishkek, Kyrgyzstan.
4Health Care Waste Management Project, financed by the Swiss Agency for
Development and Cooperation (SDC) and implemented by the Swiss Red Cross,
Bishkek, Kyrgyz Republic.

A novel low-cost health care waste management system was implemented in
all rural hospitals in Kyrgyzstan.

The components of the Kyrgyz model include mechanical needle removers,
segregation using autoclavable containers, safe transport and storage,
autoclave treatment, documentation, recycling of sterilized plastic and
metal parts, cement pits for anatomical waste, composting of garden
wastes, training, equipment maintenance, and management by safety and
quality committees.

The gravity-displacement autoclaves were fitted with filters to remove
pathogens from the air exhaust.

Operating parameters for the autoclaves were determined by thermal and
biological tests. A hospital survey showed an average 33% annual cost
savings compared to previous costs for waste management.

All general hospitals with >25 beds except in the capital Bishkek use the
new system, corresponding to 67.3% of all hospital beds.

The investment amounted to US$0.61 per capita covered. Acceptance of the
new system by the staff, cost savings, revenues from recycled materials,
documented improvements in occupational safety, capacity building, and
institutionalization enhance the sustainability of the Kyrgyz health care
waste management system.

© The Author(s) 2015.

KEYWORDS: Hospital/medical waste; Kyrgyzstan; autoclave treatment; cost
survey; recycling; sustainable healthcare waste management
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Bio-medical waste management: situational analysis &
predictors of performances in 25 districts across 20 Indian States
__________________________________________________________________
Full text http://www.ijmr.org.in/text.asp?2014/139/1/141/128373

Indian J Med Res. 2014 Jan;139(1):141-53.

Bio-medical waste management: situational analysis & predictors of
performances in 25 districts across 20 Indian States.

INCLEN Program Evaluation Network (IPEN) study group, New Delhi, India.

BACKGROUND & OBJECTIVES:
A legislative framework for bio-medical waste management (BMWM) was
established in the country more than a decade ago. Though some studies
have identified gaps at local levels, no systematic effort was done to
collect data from different parts of the country. The objective of this
nationwide study was to document existing resources, infrastructure and
practices related to BMWM across the study districts.

METHODS:
The study was conducted in 25 districts spread over 20 States of India
including urban and rural areas. Primary (n=388), secondary (n=25) and
tertiary care (n=24) health facilities from public (n=238) and private (n=
199) sector were assessed and scored for the state of BMWM through 9 items
representing system capacity, availability of resources and processes in
place. Health facilities were assigned into one of the three categories
(Red, Yellow and Green) based on the cumulative median scores.

RESULTS:
Around 82 per cent of primary, 60 per cent of secondary and 54 per cent of
tertiary care health facilities were in the ‘RED’ category. Multivariate
analysis indicated that charts at the point of waste generation,
availability of designated person, appropriate containers and bags,
availability of functional needle destroyers, availability of personal
protective gears, segregation of waste at point of generation and log book
maintenance were independently (OR-between 1.2-1.55; P <0.03 or less)
associated with better BMWM system in the health facilities. This was true
for both rural-urban and public or private health facilities.

INTERPRETATION & CONCLUSIONS:
The study highlighted the urgent need for greater commitments at policy
and programme levels for capacity building, and resource investments in
BMWM.

Free Full Article http://www.ijmr.org.in/text.asp?2014/139/1/141/128373
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Hospital waste management in nonteaching hospitals of lucknow
city, India
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25657950

J Family Med Prim Care. 2014 Oct-Dec;3(4):393-5.

Hospital waste management in nonteaching hospitals of lucknow city, India.

Manar MK1, Sahu KK2, Singh SK1.

1Department of Community Medicine and Public Health, King George’s Medical
University, Lucknow, Uttar Pradesh, India.
2Department of Community Medicine, Shrinivas Institute of Medical Sciences
and Research Centre, Karnataka, India.

OBJECTIVE: To assess hospital waste management in nonteaching hospitals of
Lucknow city.

MATERIALS AND METHODS: A cross-sectional, descriptive study was conducted
on the staffs of nonteaching hospitals of Lucknow from September 2012 to
March 2013. A total of eight hospitals were chosen as the study sample
size. Simple random sampling technique was used for the selection of the
nonteaching hospitals. A pre-structured and pre-tested interview
questionnaire was used to collect necessary information regarding the
hospitals and biomedical waste (BMW) management of the hospitals. The
general information about the selected hospitals/employees of the
hospitals was collected.

RESULTS: Mean hospital waste generated in the eight nonteaching hospitals
of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have
BMW department and colored dustbins. In 37.5% of the hospitals, there were
no BMW records and segregation at source. Incinerator was used only by
hospital A for treatment of BMW. Hospital G and hospital H had no
facilities for BMW treatment.

CONCLUSION: There is a need for appropriate training of staffs, strict
implementation of rules, and continuous surveillance of the hospitals of
Lucknow to improve the BMW management and handling practices.

KEYWORDS: Hospital waste management; India; Lucknow city; nonteaching
hospitals

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311349/
__________________________________________________________________
________________________________*_________________________________

4. Abstract: On the path of continual improvement: An evaluation of
biomedical waste management training
__________________________________________________________________
http://www.ijmm.org/text.asp?2015/33/5/119/150911

Indian J Med Microbiol. 2015 Feb;33 Suppl:S119-21.

On the path of continual improvement: An evaluation of biomedical waste
management training.

Krishnan KU1, Doris Devamani TS, Jayalakshmi G.

1Department of Microbiology, Institute of Microbiology, Madras Medical
College, Chennai, India.

Microbiologists play a pivotal role in the prevention of infection both at
hospital and community level. Biomedical waste management (BMWM) is one of
the aspects of infection control.

For the effective implementation of this, various training programmes have
been conducted at our regional training centre. This study evaluates the
impact of the BMWM training programme.

Knowledge on all parameters was significantly better at post-course
evaluation for all the participants (P value 0.001).

Evaluation of training is recommended to improve the effectiveness of
training method.

Full Free Text http://www.ijmm.org/text.asp?2015/33/5/119/150911
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Prevalence of unsafe conditions associated to non-intentional
needlestick injuries among trainee physicians
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25643887
Gac Med Mex. 2014 Dec;150 Suppl 3:347-57.

[Prevalence of unsafe conditions associated to non-intentional needlestick
injuries among trainee physicians].

[Article in Spanish]

Padrón Salas A, Soria Orozco M1, Gutiérrez Mendoza LM1,2, Torres Montes A,
Cossío Torres PE3, Yáñez Lane M1.
Author information
1Departamento de Salud Pública y Epidemiología Clínica, Facultad de
Medicina, Universidad Autónoma de San Luís Potosí, S.L.P.
2Subdirección de Calidad, Hospital Central «Dr. Ignacio Morones Prieto»,
San Luís Potosí, S.L.P.
3CIACYT-Facultad de Medicina, San Luís Potosí, S.L.P.

INTRODUCTION: Physicians in training face high-risk clinical situations
for needlestick injuries during their training.

OBJECTIVE: To determine the prevalence and establish behaviors associated
with needlestick injuries.

MATERIAL AND METHODS: A cross-sectional study was conducted during the
2012-2013 school year among undergraduate and graduate medical students of
a Faculty of Medicine in Mexico.

RESULTS: There were a total of 441 questionnaires completed, of which
56.7% of students reported having experienced at least one lesion, of
which only 44.5% reported it. The conditions and unsafe acts associated
were: female students had a greater risk for the first puncture, whereas
male students correlated with three or more punctures; third year
students, night shift rounds, the feeling of being rushed by someone else,
and the presence of fatigue were risk factors for the first puncture (p <
0.05).

CONCLUSIONS: The high prevalence and the underreporting of non-intentional
punctures places students at a higher risk of transmissible diseases.
Strategies focused on prevention, monitoring, and control of accidental
punctures should be implemented by hospitals, schools, and medical
schools.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Ebola virus disease in Africa: epidemiology and nosocomial
transmission
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25655197

J Hosp Infect. 2015 Jan 20. pii: S0195-6701(15)00046-8.

Ebola virus disease in Africa: epidemiology and nosocomial transmission.

Shears P1, O’Dempsey TJ2.

1Wirral University Teaching Hospital, Wirral, Merseyside, UK. Electronic
address: pshears2@gmail.com.
2Liverpool School of Tropical Medicine, Liverpool, UK.

The 2014 Ebola outbreak in West Africa, primarily affecting Guinea, Sierra
Leone, and Liberia, has exceeded all previous Ebola outbreaks in the
number of cases and in international response.

There have been 20 significant outbreaks of Ebola virus disease in Sub-
Saharan Africa prior to the 2014 outbreak, the largest being that in
Uganda in 2000, with 425 cases and a mortality of 53%.

Since the first outbreaks in Sudan and Zaire in 1976, transmission within
health facilities has been of major concern, affecting healthcare workers
and acting as amplifiers of spread into the community.

The lack of resources for infection control and personal protective
equipment are the main reasons for nosocomial transmission. Local
strategies to improve infection control, and a greater understanding of
local community views on the disease, have helped to bring outbreaks under
control.

Recommendations from previous outbreaks include improved disease
surveillance to enable more rapid health responses, the wider availability
of personal protective equipment, and greater international preparedness.

Copyright © 2015 The Healthcare Infection Society. Published by Elsevier
Ltd. All rights reserved.

KEYWORDS: Africa; Ebola virus disease; Healthcare workers; Nosocomial
transmission
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Progress of vaccine and drug development for Ebola
preparedness
__________________________________________________________________
Clin Exp Vaccine Res. 2015 Jan;4(1):11-6.

Progress of vaccine and drug development for Ebola preparedness.

Choi WY1, Hong KJ2, Hong JE3, Lee WJ1.

1Division of Arboviruses, Korea National Institute of Health, Korea
Centers for Disease Control and Prevention, Cheongju, Korea.
2Division of High-risk Pathogen Research, Korea National Institute of
Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
3Division of Bioterrorism Preparedness and Response, Korea Centers for
Disease Control and Prevention, Cheongju, Korea.

Since the first case of Ebola virus disease (EVD) in Guinea was reported
in March 2014 by World Health Organization (WHO), the outbreak has
continued through the year and the total number of 19,065 patients was
reported as the confirmed or suspected in the EVD-affected countries.
Among the cases, 7,388 patients were reported death by 19 December.

Currently, available therapeutics to treat the infected patients or
vaccines to prevent people from infection is not developed yet while viral
diagnostic methods were already developed and firmly established in a lot
of countries as a first step for the preparedness of Ebola outbreak. Some
potential therapeutic materials including ZMapp were supplied and the
treated people got over the EVD.

Several candidates of vaccines also were investigated their efficacy in
animal models by National Institute of Health (NIH) and Department of
Defense, and they are processing of clinical tests in West Africa aiming
to finish the development by the 2015.

Vaccine and therapeutic development is essential to stop the EVD outbreak
in West Africa, also to protect the world from the risk which can be
generated by potential spread of Ebola virus.

KEYWORDS: Drug development; Ebola hemorrhagic fever; Ebola virus; Vaccines

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4313103/
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Are needle and syringe programmes associated with a reduction
in HIV transmission among people who inject drugs: a systematic review
and meta-analysis
__________________________________________________________________
http://ije.oxfordjournals.org/content/43/1/235.long

Int J Epidemiol. 2014 Feb;43(1):235-48.

Are needle and syringe programmes associated with a reduction in HIV
transmission among people who inject drugs: a systematic review and meta-
analysis.

Aspinall EJ1, Nambiar D, Goldberg DJ, Hickman M, Weir A, Van Velzen E,
Palmateer N, Doyle JS, Hellard ME, Hutchinson SJ.

1School of Health and Life Sciences, Glasgow Caledonian University,
Glasgow, UK, Health Protection Scotland, Glasgow, UK, Centre for
Population Health, Burnet Institute, Melbourne, Australia, School of
Social and Community Medicine, University of Bristol, Bristol, UK,
Infectious Diseases Unit, Alfred Hospital, Melbourne, Australia and
Department of Epidemiology and Preventive Medicine, Monash University,
Melbourne, Australia.

BACKGROUND: Needle and syringe programmes (NSP) aim to reduce the risk of
HIV by providing people who inject drugs (PWID) with sterile injecting
equipment. A recent review of reviews (ROR) concluded that there was only
tentative evidence to support the effectiveness of NSP in reducing HIV. We
carried out a systematic review and meta-analysis to assess the
association between NSP and HIV transmission.

METHODS: Relevant primary articles presenting data on the risk of HIV
transmission associated with NSP were identified in two stages: (i) from
reviews identified in two published RORs (covering the period 1980-2008);
and (ii) a literature search of CINAHL, Cochrane Library, EMBASE, MEDLINE
and PsychINFO for primary articles published since the most recent high
quality review (covering the period 2008-12). Study results were
synthesized using random-effects meta-analysis.

RESULTS: There were 12 studies comprising at least 12 000 person-years of
follow- up. Exposure to NSP was associated with a reduction in HIV
transmission: pooled effect size 0·66 [95% confidence interval (CI) 0·43,
1·01] across all studies, and 0·42 (95% CI 0·22, 0·81) across six higher
quality studies (according to the Newcastle-Ottawa tool).

CONCLUSIONS: There is evidence to support the effectiveness of NSP in
reducing the transmission of HIV among PWID, although it is likely that
other harm reduction interventions have also contributed to the observed
reduction in HIV risk. NSP should be considered as just one component of a
programme of interventions to reduce both injecting risk and other types
of HIV risk behaviour.

KEYWORDS: HIV; needle-exchange programmes; people who inject drugs

Free full text http://ije.oxfordjournals.org/content/43/1/235.long
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Granulomatous reaction to liquid injectable silicone for
gluteal enhancement: review of management options and success of
doxycycline
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25649644

Dermatol Ther. 2015 Feb 3.

Granulomatous reaction to liquid injectable silicone for gluteal
enhancement: review of management options and success of doxycycline.

Paul S1, Goyal A, Duncan LM, Smith GP.

1Harvard Medical School, Boston, Massachusetts.

Liquid injectable silicone (LIS) for cosmetic purposes has been widely
available and commonly used for almost half a century. An increase in
buttock augmentation procedures because of patients wanting to emulate the
look of some celebrities has recently highlighted cases in the media of
unsafe administration of liquid silicone injections.

Severe complications including death have been reported.

In this article, we report a case in which liquid silicone was injected in
the patient’s gluteal tissue resulting in granulomatous reactions in the
surrounding tissues. The patient responded well to doxycycline, presumably
because of both its antimicrobial properties and immunomodulatory effects.

© 2015 Wiley Periodicals, Inc.
__________________________________________________________________
________________________________*_________________________________

10. News

– UK: BLOOD HAZARD: Angry home-patients left with bags of dangerous
clinical waste
– USA: Students poke each other with medical needles
– Ebola NSI: Two military medics back in UK for Ebola monitoring
– Ebola NSI: Ebola Medic Flown to Germany for Anonymity
– UK: Risk of blood-borne viruses from sharps injuries continues, report
claims

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
http://tinyurl.com/ncgn7gl
UK: BLOOD HAZARD: Angry home-patients left with bags of dangerous clinical
waste

Lancashire Telegraph, U.K (11.02.14)

ANGRY home-treatment patients have been left with bags of dangerous
clinical waste piling up in their homes after a specialist collection
contract was suddenly cancelled.

Items including needles and tubes contaminated with blood and soiled
bandages and pads are amongst the by-products which are involved.

NHS England has now promised to investigate after being contacted by the
Lancashire Telegraph.

The mainly kidney dialysis patients were unaware of the decision until by-
products of their therapy were not picked up in the New Year.

The move has outraged doctors and patients often unable to dispose of the
waste which is banned from domestic rubbish collection.

MPs Graham Jones, Gordon Birtwistle and Jack Straw have written to Health
Secretary Jeremy Hunt demanding he sort out the mess, branded a health
risk by Lancashire Telegraph doctor Tom Smith.

Karen Coupe, of Clayton-le-Moors, whose daughter Sarah’s home
haemodialysis for kidney disease produces plastic tubes and needles
contaminated with blood, said: “I am furious and distressed. “I have 30
bags of clinical waste I can’t get rid of. “We were given no warning of
this before it happened at Christmas. “The first I knew about it was when
it was not picked up in January and I rang the Royal Preston Hospital care
team who knew nothing about it and were angry and upset.”

Her GP Robert Grayson said: “This is unforgivable and I am deeply
concerned. “We have offered to dispose of it for her, but in the long-term
this is not an option.”

For years PHS Waste Management collected clinical waste from 20 patients
spread across six boroughs: Ribble Valley, Hyndburn, Blackburn with
Darwen, Pendle, Burnley and Rossendale.

The contract was managed by the NHS Property Services office in
Accrington, which in October was ordered to cancel it by NHS England.

Blackburn with Darwen, Hyndburn, Rossendale and Ribble Valley have no
existing service to collect clinical waste and no intention or cash to
develop one. Pendle and Burnley council’s, which collect some clinical
waste, have been forced to hastily re-jig rounds to cover the shortfall.

Burnley resident Robert Meadows, whose wife Rose is a haemodialysis
patient, had to make hasty arrangements with the council to collect 18
bags of clinical waste. He said: “I am angry and upset. This was a
disgraceful way to do it. “It came out of the blue to us, the Royal
Preston hospital and Burnley Council.”

Fred Jones, a 70-year-old home kidney dialysis patient, a former Burnley
resident living in Oswaldtwistle, said: “This is outrageous. “I am angry
and concerned, especially for other patients who need haemodialysis who
have an even bigger problem than I have, “It should not have been done
this way.”

Russ MacLean, chairman of Pennine Lancashire Patients’ Voice, said: “I am
very unhappy and angry. “It is the right hand of the NHS not knowing what
the left is doing and patients suffering. I shall be contacting NHS
England.” Dr Smith said: “This is clinical waste which could carry
infectious diseases including hepatitis. “This is an NHS and not a council
responsibility. “This could affect diabetics and others who inject and
those with chronic illnesses who use incontinence pads or have waste to
dispose of.”

Hyndburn MP Mr Jones said: “This another example of the fragmentation of
the NHS and an unnecessary burden patients and families to face.”
Blackburn MP Mr Straw said: “It looks to me like someone has made a
mistake which needs to be sorted out.” Burnley MP Mr Birtwistle said:
“Something has gone wrong and this is a decision with dangerous
implications “ Blackburn with Darwen environment boss Jim Smith said: “We
don’t collect clinical waste from homes and have no money to do so. That
is an NHS responsibility.”

A spokesperson for NHS England said: “NHS England currently commissions
dialysis services across the North West. However we do not commission
services for the collection of dialysis waste and understand that this is
usually a local council issue.

“We are currently liaising with the responsible renal centre, NHS Property
Services, local council and the CGG and will be investigating the issue
further during the next few days to ensure prompt resolution of this
situation.”

A spokesperson for NHS Property Services said: “NHS England advised us
that clinical waste was the responsibility of the local authority and all
partners were made aware of this. “We are concerned there has been a
problem.”

A spokesperson from the East Lancashire Clinical Commissioning Group said:
“The responsibility for commissioning these services is with NHS England.”
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/nrmlxwp
USA: Students poke each other with medical needles

Anastasiya Bolton &Jonathan Gonzalez, 9NEWS.com, Colorado USA (05.02.15)

JEFFERSON COUNTY – Several 5th graders at a Jefferson County elementary
school poked each other with medical needles that an 11-year-old student
brought to the school Thursday.

There are no obvious signs the 20 Lumberg Elementary students pricked by
the lancets were contaminated. None of the students stuck by the lancets
sustained any significant injuries.

Police say there is no evidence that force was used against the students
to inflict the lancet pricks.

Edgewater Police Chief John Hough told 9NEWS he did not know how the
Lumberg Elementary student got the lancet needles.

“Our understanding is that these were from a medical office, from a new
supply. These were not, we believe that these were not contaminated,” said
Lisa Pinto, district spokesperson. “They were brand new when they were
brought on campus, and that’s what we really want parents to understand.”

A lancet is a small, sharp needle normally used in a physician’s office to
prick an extremity of a patient to obtain a blood sample. Typically, a
lancet is used to prick the heel of an infant to obtain a blood sample.

The investigation into this incident is continuing, but at this point
there are no charges related to the lancet pricking immediately pending
against the 11-year-old student. However, the investigation is continuing
into how the student obtained the lancets.

Three of the needles were confiscated and taken for evidence.

Pinto says the student could face disciplinary action at the school.

“We are following our own protocols,” Pinto said. “We’re certainly in
touch with all the families, and the consequences are fairly severe.”

The parents of the students involved in this incident were immediately
notified of the incident by the Jefferson County School District following
their notification protocol.

(KUSA-TV © 2015 Multimedia Holdings Corporation)
__________________________________________________________________
__________________________________________________________________
http://www.medicalnewstoday.com/articles/288860.php
Ebola NSI: Two military medics back in UK for Ebola monitoring

Medical News Today (03.02.15)

Two UK military medics have been transported back to England after likely
exposure to Ebola from needle-stick injuries that occurred as they were
treating patients infected with the deadly virus in Sierra Leone.
phials and syringe

A needle-stick injury – where a needle used to treat a patient
accidentally pierces the skin of a health worker – is a potentially
serious source of infection.

The English authorities say the health care workers have been admitted for
assessment to the Royal Free Hospital in London. The hospital says they
are “likely to have been exposed” to the virus but have not been diagnosed
with Ebola and do not have symptoms.

According to Public Health England (PHE), the first individual arrived in
England on January 31st and the second on February 2nd.

They will be monitored for a total of 21 days of incubation period, in
line with PHE procedures for returning health care workers.

Both individuals were exposed to the virus in a frontline care setting in
Sierra Leone, via needle-stick injuries that occurred while treating
patients diagnosed with Ebola.

PHE say decisions on the immediate and ongoing care of the individuals
will be made by the clinical team at the Royal Free Hospital and ask that
their “confidentiality is respected at this time.”

The two Ebola needle-stick incidents “appear to be unrelated”
Professor Paul Cosford, Director for Health Protection and Medical
Director at PHE, says strict protocols were followed on bringing the
individuals back to England, and:

“We would like to emphasize that there is no risk to the general public’s
health. Our thoughts are with both of the health care workers, and their
families, affected at this time.”

Mark Francois, Minister of State for the Armed Forces, says the two
incidents – although similar and occurring within a short space of time –
appear to be unrelated, and notes:

“Our personnel receive the highest standard of training and briefing prior
to deployment, including on the use of the specialized personal protective
equipment.”

He says on a recent visit he witnessed “first-hand the bravery and
commitment of the personnel who are doing such a fantastic job in Sierra
Leone. Their efforts are deserving of the highest praise and we wish all
the best for their 2 colleagues who are now in the UK.”

Needle-stick injuries are a potentially serious source of infection

Needle-stick injuries are accidental wounds caused by needles puncturing
the skin. They can occur at any time when health care workers are treating
patients with hypodermic syringes or when they take the needles apart or
dispose of them.

Injuries caused by “sharps” such as needles, blades and scalpels are a
potentially serious source of infection because there is a high risk of a
blood-borne virus entering directly into the bloodstream.

The Ebola epidemic in West Africa is the largest since the virus was first
discovered in 1976. The countries worst affected are Guinea, Liberia and
Sierra Leone.

There have been over 22,000 probable and suspected cases of Ebola virus
disease and over 8,700 deaths since cases were first notified to WHO in
March 2014. Among these, 816 health workers have become infected and 488
have died.

Meanwhile, Medical News Today recently learned that the latest WHO
situation report says the number of new cases in a week in West Africa has
fallen below 100, the focus of the response to Ebola is now shifting from
slowing transmission to ending the epidemic.

Written by Catharine Paddock PhD

Copyright: Medical News Today
__________________________________________________________________
__________________________________________________________________
http://www.dddmag.com/news/2015/01/ebola-medic-flown-germany-anonymity
Ebola NSI: Ebola Medic Flown to Germany for Anonymity

by Frank Jordan – Associated Press (01.02.15)

A South Korean medic exposed to Ebola while working in West Africa has
been flown to Germany for treatment because the patient’s anonymity would
be better protected there, authorities in Berlin said Saturday.

Doctors at Berlin’s renowned Charite hospital said the medic, who had
worked for an aid group treating Ebola patients in Sierra Leone, arrived
in Berlin Saturday, five days after suffering an injury with a hypodermic
needle.

“The person wasn’t flown to South Korea because the Korean government
asked Europe step in,” said Dr. Frank Bergmann, who oversees the treatment
of highly infectious patients at Charite hospital. “First of all it’s good
from a transportation point of view to come here and secondly it’s better
for the person’s anonymity to be treated here in Europe.”

He said the South Korean government and the medic had requested that as
few details as possible be released, declining to give the person’s
profession, age, gender or employer.

Ebola can be transmitted through bodily fluids and persons suspected of
carrying the virus have been shunned in some countries by people fearful
of infection. Experts say, however, that with proper precautions patients
pose no risk to those around them.

The medic had been treating a delirious Ebola patient on Monday when the
patient jolted, causing the needle on a blood-filled syringe to pierce the
three plastic gloves the medic was wearing, said Bergmann.

“The patient had a very high viral load and died the next day, which means
that there was a very high risk of infection,” he said.

Bergmann said the medic currently shows no symptoms of Ebola, but the
incubation period will last a further 16 days, during which the person
will remain under close medical supervision.

Should symptoms develop, doctors could provide experimental drugs and
“with our European standards there should be a good prognosis,” he added.

Source: Associated Press
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__________________________________________________________________
http://tinyurl.com/nbsu2pv
UK: Risk of blood-borne viruses from sharps injuries continues, report
claims
By Nic Paton, Occupational health www.personneltoday.com (28.01.15)

Healthcare workers continue to be at risk of exposure to blood-borne
viruses through occupational sharps injuries, with reported cases
increasing, Public Health England (PHE) has warned in a damning report.

This is despite awareness of the risk of sharps injuries, safe practices
being much more widespread, and the fact safety-engineered devices to
prevent such injuries are now widely available, it has added.

In its latest report on exposures to a blood-borne virus (BBV), PHE said
cases reported had increased among healthcare workers from 373 in 2004 to
496 in 2013.

The updated Eye of the Needle report, which was first published in 2012,
found that, over this 10-year period, approximately 30% of exposures
involved a source patient infected with HIV; 54% involved hepatitis C
(HCV) and 9% hepatitis B (HBV).

Of these exposures, 81% were sustained by doctors, nurses and healthcare
assistants and 65% occurred during clinical procedures. A total of 78% of
exposures involved a percutaneous needlestick injury, the majority of
which were sharps injuries involving a hollow-bore needle, it added.

There have been numerous new laws to protect healthcare workers from
exposure to BBVs, notably the EU 2010 Sharps Directive and the UK 2013
Sharps Regulations.

Nevertheless, between 2004 and 2013, nine healthcare workers were infected
with HCV following occupational exposure in England, Wales and Northern
Ireland, said PHE.

Eight of these nine received antiviral therapy, of whom seven were known
to have achieved viral clearance.

One good bit of news was that HBV immunisation programmes across England,
Wales and Northern Ireland were effectively protecting healthcare workers,
with no new cases reported.

Furthermore, 97% of the healthcare workers who were exposed to HIV who
commenced post-exposure prophylaxis did so within 72 hours of exposure,
and no HIV infections to healthcare workers had been reported.

Dr Fortune Ncube, head of the BBV department at PHE, said: “It is a
disappointment that we still continue to see injuries to healthcare
workers occurring after the procedure, in the period prior to and during
disposal. These injuries are entirely preventable.

“We want to remind all healthcare employers to comply with the regulations
regarding safer working conditions and to provide safety devices to
healthcare workers in an effort to reduce sharps injuries and protect them
from infection.”

Jill Holmes, infection prevention control nurse specialist and Infection
Control Society representative on the Safer Needles Network, added:
“Safety-engineered devices are not foolproof. Unless they are used
correctly, these devices will not be effective or prevent sharps injuries.
It is vital that healthcare providers train new and existing staff in
their correct use. It is also essential for all staff to remember the
importance of basic sharps safety.”
__________________________________________________________________
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Facsimile: +41 22 791 4836 E- mail: sign@who.int
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The 2010 annual Safe Injection Global Network meeting to aid collaboration
and synergy among SIGN network participants worldwide was held from 9
to 11 November 2010 in Dubai, The United Arab Emirates.

The SIGN 2010 meeting report pdf, 1.36Mb is available on line at:
http://www.who.int/injection_safety/toolbox/sign2010_meeting.pdf

The report is navigable using bookmarks and is searchable. Viewing
requires the free Adobe Acrobat Reader at: http://get.adobe.com/reader/

Translation tools are available at: http://www.google.com/language_tools
or http://www.freetranslation.com
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