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SIGNpost 00791

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00791 Making all injections safe 2020 + Abstracts + News 04 March 2015

CONTENTS
1. New WHO Injection Safety Guidelines
2. Making all injections safe brochure
3. Abstract: Comparison of routes for achieving parenteral access with a
focus on the management of patients with Ebola virus disease
4. Abstract: High HIV burden among people who inject drugs in 15 Indian
cities
5. Abstract: Association of opioid agonist therapy with lower incidence of
hepatitis C virus infection in young adult injection drug users
6. Abstract: Subcutaneous Injection Depth Does Not Affect the
Pharmacokinetics or Glucodynamics of Insulin Lispro in Normal Weight or
Healthy Obese Subjects
7. Abstract: Systemic mistakes in hand hygiene practice in Ukraine:
detection, consequences and ways of elimination
8. Abstract: Transmission of hepatitis C virus associated with surgical
procedures – new jersey 2010 and wisconsin 2011
9. No Abstract: Ebola and compliance with infection prevention measures in
Nigeria
10. News
– Global: WHO calls for worldwide use of smart syringe
– India: 59 kids injected with single needle!
– Pakistan: Pakistan wastes $3.7 million worth of donated vaccine,
official says
– Global: New WHO policy to promote switch to ‘smart’ syringes
– Global: WHO calls for “smart” syringes following continued hepatitis
and HIV infections from reuse
– Global: WHO adopts new safety needle policy, calling smart syringes an
‘urgent priority’
– Indiana USA: HIV outbreak tied to painkiller, dirty needles
– Global: WHO urges shift to single-use smart syringes
– Global: Single-Use Smart Syringes Stops risk of Contamination, More
than Anything Else They Save Lives
– Australia: Mike steps on needle getting out of car, now he’s in limbo
– USA: Man Says He Was Sickened by Falling Needle
– Maylasia: Malaysia is ‘world leader’ in battling HIV spread with
needles, says UK report

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__________________________________________________________________
________________________________*_________________________________

1. New WHO Injection Safety Guidelines
__________________________________________________________________
New WHO Injection Safety Guidelines

WHO is urging countries to transition, by 2020, to the exclusive use of
the new “smart” syringes, except in a few circumstances in which a syringe
that blocks after a single use would interfere with the procedure.

The new guideline is “Who guideline on the use of safety-engineered
syringes for intramuscular, intradermal and subcutaneous injections in
health care”.

It is available for free download or viewing at the link:
www.who.int/injection_safety/global-campaign/injection-safety_guidline.pdf

PDF Requires Adobe Acrobat Reader [620 KB]

__________________________________________________________________
________________________________*_________________________________

2. Making all injections safe brochure
__________________________________________________________________
Making all injections safe brochure

This is an illustrated summary brochure for the general public.

www.who.int/injection_safety/global-campaign/injection-safety_brochure.pdf
pdf, 554kb [6 pages]

Media Release:
http://www.who.int/mediacentre/news/releases/2015/injection-safety/en/
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Comparison of routes for achieving parenteral access with a
focus on the management of patients with Ebola virus disease
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25714073

Cochrane Database Syst Rev. 2015 Feb 26;2:CD011386.

Comparison of routes for achieving parenteral access with a focus on the
management of patients with Ebola virus disease.

Ker K1, Tansley G, Beecher D, Perner A, Shakur H, Harris T, Roberts I.

1Cochrane Injuries Group, London School of Hygiene & Tropical Medicine,
Room 186, Keppel Street, London, UK, WC1E 7HT.

BACKGROUND: Dehydration is an important cause of death in patients with
Ebola virus disease (EVD). Parenteral fluids are often required in
patients with fluid requirements in excess of their oral intake. The
peripheral intravenous route is the most commonly used method of
parenteral access, but inserting and maintaining an intravenous line can
be challenging in the context of EVD. Therefore it is important to
consider the advantages and disadvantages of different routes for
achieving parenteral access (e.g. intravenous, intraosseous, subcutaneous
and intraperitoneal).

OBJECTIVES: To compare the reliability, ease of use and speed of insertion
of different parenteral access methods.

SEARCH METHODS: We ran the search on 17 November 2014. We searched the
Cochrane Injuries Group’s Specialised Register, Cochrane Central Register
of Controlled Trials (CENTRAL, The Cochrane Library), Ovid MEDLINE(R) In-
Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily, Ovid
MEDLINE(R) and Ovid OLDMEDLINE(R), Embase Classic + Embase (OvidSP),
CINAHL (EBSCOhost), clinicaltrials.gov and screened reference lists.

SELECTION CRITERIA: Randomised controlled trials comparing different
parenteral routes for the infusion of fluids or medication.

DATA COLLECTION AND ANALYSIS: Two review authors examined the titles and
abstracts of records obtained by searching the electronic databases to
determine eligibility. Two review authors extracted data from the included
trials and assessed the risk of bias.

Outcome measures of interest were success of insertion; time required for
insertion; number of insertion attempts; number of dislodgements; time
period with functional access; local site reactions; clinicians’
perception of ease of administration; needlestick injury to healthcare
workers; patients’ discomfort; and mortality. For trials involving the
administration of fluids we also collected data on the volume of fluid
infused, changes in serum electrolytes and markers of renal function.

We rated the quality of the evidence as ‘high’, ‘moderate’, ‘low’ or ‘very
low’ according to the GRADE approach for the following outcomes: success
of insertion, time required for insertion, number of dislodgements, volume
of fluid infused and needlestick injuries.

MAIN RESULTS: We included 17 trials involving 885 participants. Parenteral
access was used to infuse fluids in 11 trials and medications in six
trials. None of the trials involved patients with EVD. Intravenous and
intraosseous access was compared in four trials; intravenous and
subcutaneous access in 11; peripheral intravenous and intraperitoneal
access in one; saphenous vein cutdown and intraosseous access in one; and
intraperitoneal with subcutaneous access in one. All of the trials
assessing the intravenous method involved peripheral intravenous access.

We judged few trials to be at low risk of bias for any of the assessed
domains.Compared to the intraosseous group, patients in the intravenous
group were more likely to experience an insertion failure (risk ratio (RR)
3.89, 95% confidence interval (CI) 2.39 to 6.33; n = 242; GRADE rating:
low). We did not pool data for time to insertion but estimates from the
trials suggest that inserting intravenous access takes longer (GRADE
rating: moderate). Clinicians judged the intravenous route to be easier to
insert (RR 0.15, 95% CI 0.04 to 0.61; n = 182). A larger volume of fluids
was infused via the intravenous route (GRADE rating: moderate).

There was no evidence of a difference between the two routes for any other
outcomes, including adverse events.Compared to the subcutaneous group,
patients in the intravenous group were more likely to experience an
insertion failure (RR 14.79, 95% CI 2.87 to 76.08; n = 238; GRADE rating:
moderate) and dislodgement of the device (RR 3.78, 95% CI 1.16 to 12.34; n
= 67; GRADE rating: low).

Clinicians also judged the intravenous route as being more difficult to
insert and patients were more likely to be agitated in the intravenous
group.

Patients in the intravenous group were more likely to develop a local
infection and phlebitis, but were less likely to develop erythema, oedema
or swelling than those in the subcutaneous group. A larger volume of
fluids was infused into patients via the intravenous route.

There was no evidence of a difference between the two routes for any other
outcome. There were insufficient data to reliably determine if the risk of
insertion failure differed between the saphenous vein cutdown (SVC) and
intraosseous method (RR 4.00, 95% CI 0.51 to 31.13; GRADE rating: low).
Insertion using SVC took longer than the intraosseous method (MD 219.60
seconds, 95% CI 135.44 to 303.76; GRADE rating: moderate).

There were no data and therefore there was no evidence of a difference
between the two routes for any other outcome.There were insufficient data
to reliably determine the relative effects of intraperitoneal or central
intravenous access relative to any other parenteral access method.

AUTHORS’ CONCLUSIONS: There are several different ways of achieving
parenteral access in patients who are unable meet their fluid requirements
with oral intake alone.

The quality of the evidence, as assessed using the GRADE criteria, is
somewhat limited because of the lack of adequately powered trials at low
risk of bias. However, we believe that there is sufficient evidence to
draw the following conclusions: if peripheral intravenous access can be
achieved easily, this allows infusion of larger volumes of fluid than
other routes; but if this is not possible, the intraosseous and
subcutaneous routes are viable alternatives. The subcutaneous route may be
suitable for patients who are not severely dehydrated but in whom ongoing
fluid losses cannot be met by oral intake.

A film to accompany this review can be viewed here

Free Full Text at the link
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011386.pub2/full
__________________________________________________________________
________________________________*_________________________________

4. Abstract: High HIV burden among people who inject drugs in 15 Indian
cities
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25715105

AIDS. 2015 Mar 13;29(5):619-28.

High HIV burden among people who inject drugs in 15 Indian cities.

Lucas GM1, Solomon SS, Srikrishnan AK, Agrawal A, Iqbal S, Laeyendecker O,
McFall AM, Kumar MS, Ogburn EL, Celentano DD, Solomon S, Mehta SH.

1aJohns Hopkins University School of Medicine, Department of Medicine,
Baltimore, Maryland, USA bY.R. Gaitonde Centre for AIDS Research and
Education, Chennai, Tamil Nadu cAll India Institute of Medical Sciences,
Department of Psychiatry, New Delhi, India dLaboratory of
Immunoregulation, National Institute of Allergy and Infectious Diseases,
National Institutes of Health eJohns Hopkins University Bloomberg School
of Public Health, Baltimore, Maryland, USA.

BACKGROUND: Injecting drug use has historically been the principal driver
of the HIV epidemic in the northeast states of India. However, recent data
indicate growing numbers of people who inject drugs (PWIDs) in north and
central Indian cities.

METHODS: We conducted face-to-face surveys among PWIDs in seven northeast
and eight north/central Indian cities using respondent-driven sampling. We
used a rapid HIV-testing protocol to identify seropositive individuals and
multiassay algorithm to identify those with recent infection. We used
multilevel regression models that incorporated sampling weights and had
random intercepts for site to assess risk factors for prevalent and
incident (recent) HIV infection.

RESULTS: We surveyed 14?481 PWIDs from 15 Indian cities between January
and December 2013. Participants reported high rates of needle/syringe
sharing. The median (site range) estimated HIV prevalence and incidence
were 18.1% (5.9, 44.9) and 2.9 per 100 person-years (0, 12.4),
respectively. HIV prevalence was higher in northeast sites, whereas HIV
incidence was higher in north/central sites. The odds of prevalent HIV
were over three-fold higher in women than in men. Other factors associated
with HIV prevalence or incidence included duration since first injection,
injection of pharmaceutical drugs, and needle/syringe sharing.

CONCLUSIONS: The burden of HIV infection is high among PWIDs in India, and
may be increasing in cities where injecting drug use is emerging. Women
who inject drugs were at substantially higher risk for HIV than men – a
situation that may be mediated by dual injection-related and sexual risks.
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Association of opioid agonist therapy with lower incidence of
hepatitis C virus infection in young adult injection drug users
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25347412

JAMA Intern Med. 2014 Dec;174(12):1974-81.

Association of opioid agonist therapy with lower incidence of hepatitis C
virus infection in young adult injection drug users.

Tsui JI1, Evans JL2, Lum PJ3, Hahn JA4, Page K5.

1Clinical Addiction Research and Education Unit, Section of General
Internal Medicine, Department of Medicine, Boston University School of
Medicine, Boston, Massachusetts2Department of Medicine, Boston Medical
Center, Boston, Massachusetts.
2Department of Epidemiology and Biostatistics, University of California,
San Francisco.
3Department of Medicine, University of California, San Francisco.
4Department of Epidemiology and Biostatistics, University of California,
San Francisco4Department of Medicine, University of California, San
Francisco.
5Division of Epidemiology, Biostatistics and Preventive Medicine,
Department of Internal Medicine, University of New Mexico Health Sciences
Center, Albuquerque.

IMPORTANCE: Injection drug use is the primary mode of transmission for
hepatitis C virus (HCV) infection. Prior studies suggest opioid agonist
therapy may reduce the incidence of HCV infection among injection drug
users; however, little is known about the effects of this therapy in
younger users.

OBJECTIVE: To evaluate whether opioid agonist therapy was associated with
a lower incidence of HCV infection in a cohort of young adult injection
drug users.

DESIGN, SETTING, AND PARTICIPANTS: Observational cohort study conducted
from January 3, 2000, through August 21, 2013, with quarterly interviews
and blood sampling. We recruited young adult (younger than 30 years)
injection drug users who were negative for anti-HCV antibody and/or HCV
RNA.

EXPOSURES: Substance use treatment within the past 3 months, including
non-opioid agonist forms of treatment, opioid agonist (methadone
hydrochloride or buprenorphine hydrochloride) detoxification or
maintenance therapy, or no treatment.

MAIN OUTCOMES AND MEASURES: Incident HCV infection documented with a new
positive result for HCV RNA and/or HCV antibodies. Cumulative incidence
rates (95% CI) of HCV infection were calculated assuming a Poisson
distribution. Cox proportional hazards regression models were fit
adjusting for age, sex, race, years of injection drug use, homelessness,
and incarceration.

RESULTS: Baseline characteristics of the sample (n?=?552) included median
age of 23 (interquartile range, 20-26) years; 31.9% female; 73.1% white;
39.7% who did not graduate from high school; and 69.2% who were homeless.
During the observation period of 680 person-years, 171 incident cases of
HCV infection occurred (incidence rate, 25.1 [95% CI, 21.6-29.2] per 100
person-years). The rate ratio was significantly lower for participants who
reported recent maintenance opioid agonist therapy (0.31 [95% CI,
0.14-0.65]; P?=?.001) but not for those who reported recent non-opioid
agonist forms of treatment (0.63 [95% CI, 0.37-1.08]; P?=?.09) or opioid
agonist detoxification (1.45 [95% CI, 0.80-2.69]; P?=?.23). After
adjustment for other covariates, maintenance opioid agonist therapy was
associated with lower relative hazards for acquiring HCV infection over
time (adjusted hazard ratio, 0.39 [95% CI, 0.18-0.87]; P?=?.02).

CONCLUSIONS AND RELEVANCE: In this cohort of young adult injection drug
users, recent maintenance opioid agonist therapy was associated with a
lower incidence of HCV infection. Maintenance treatment with methadone or
buprenorphine for opioid use disorders may be an important strategy to
prevent the spread of HCV infection among young injection drug users.

Free Full Text http://www.natap.org/2014/HCV/ioi140105.pdf
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Subcutaneous Injection Depth Does Not Affect the
Pharmacokinetics or Glucodynamics of Insulin Lispro in Normal Weight or
Healthy Obese Subjects
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25697717

J Diabetes Sci Technol. 2015 Feb 19. pii: 1932296815573865.

Subcutaneous Injection Depth Does Not Affect the Pharmacokinetics or
Glucodynamics of Insulin Lispro in Normal Weight or Healthy Obese
Subjects.

de la Peña A1, Yeo KP2, Linnebjerg H3, Catton E3, Reddy S3, Brown-
Augsburger P3, Morrow L4, Ignaut DA3.

1Eli Lilly and Company, Indianapolis, IN, USA de_la_pena_amparo@lilly.com.
2Lilly-NUS Centre for Clinical Pharmacology, Singapore.
3Eli Lilly and Company, Indianapolis, IN, USA.
4Profil Institute for Clinical Research, Chula Vista, CA, USA.

An 8-mm needle length is commonly used for insulin injections; however,
recent recommendations suggest shorter needles may help patients avoid
intramuscular injections and reduce pain, while maintaining adequate
glucose control.

The goal of these analyses was to compare the pharmacokinetics (PK) and
glucodynamics (GD) of insulin lispro after a 5-mm or an 8-mm injection
depth administration in 2 populations: normal weight (study 1) or obese
(study 2).

In both open-label, randomized, 2-period crossover euglycemic clamp
studies, subjects received single 0.25 U/kg insulin lispro doses on 2
occasions (at 5-mm and 8-mm injection depths); samples for PK and GD
analyses were collected up to 6 hours postdose. Noncompartmental PK
parameters AUC0-tlast, AUC0-8, Cmax and GD parameters Gtot, Rmax, tRmax
were log-transformed prior to analysis using a mixed effects model.

There were no apparent differences between PK profiles at the 5-mm or 8-mm
injection depth in either study, demonstrated by the ratios of geometric
means of AUC0-tlast, AUC0-8, and Cmax being close to 1, with 90%
confidence intervals (CI) within (0.80, 1.25). There were no apparent
differences between GD profiles at either injection depth with the ratios
of Gtot and Rmax near unity and 90% CIs that included 1. In both studies,
the tRmax values were similar between injection depths, with a small
median of pairwise differences and a 90% CI that included zero.

Injection depths in the 5-8 mm range did not affect the PK or GD of
insulin lispro in normal weight or obese subjects.

© 2015 Diabetes Technology Society.

KEYWORDS: glucodynamics; injection depth; insulin lispro; pharmacokinetics
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Systemic mistakes in hand hygiene practice in Ukraine:
detection, consequences and ways of elimination
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25699224

GMS Hyg Infect Control. 2015 Jan 14;10:Doc01.

Systemic mistakes in hand hygiene practice in Ukraine: detection,
consequences and ways of elimination.

Klymenko I1, Kampf G2.

1Organization and Economy Department, P.L. Shupyk National Medical Academy
of Postgraduate Education, Kiev, Ukraine.
2Bode Science Center, Bode Chemie GmbH, Hamburg, Germany ; Institute of
Hygiene and Environmental Medicine, University Medicine, Greifswald,
Germany.

AIM: Every year, millions of people around the world suffer from different
infectious diseases, considerable part of which are hospital-acquired
infections. WHO considers hand hygiene as a priority measure aimed to
reduce the level of infection. We evaluated various aspects related to the
situational behavior and prioritization regarding hand hygiene measures
among the healthcare workers of Ukraine.

METHOD: Identification of system mistakes in hand hygiene was carried out
first of all by direct and indirect observation of the activities of
medical and pharmaceutical personnel in their everyday practice as well as
during their participation in trainings on routine hand hygiene.
Questionnaires also were used to estimate the level of hand hygiene
compliance of participants of the study. During this period 112 training
courses, 315 master-classes and presentations on proper hand hygiene were
realized. The target audience included health care workers of medical
centers, clinics, maternity hospitals, health care organizations and staff
of pharmacies and pharmaceutical manufacturing enterprises in all regions
of Ukraine. 638 respondents took part in anonymous survey on hand hygiene
practice.

RESULTS: The most common mistakes were to regard hand washing and hand
disinfection equally, to wash hands before doing a hand disinfection, to
neglect the five moments for hand hygiene and to ignore hand hygiene
before and after wearing protective gloves. Practitioners, medical
attendants, pharmacy and pharmaceutical industry workers highlighted the
need for practical and understandable instructions of various hand hygiene
procedures, including the clarification of the possible technical
mistakes. This became a ground for us to create individual master classes
on hand hygiene for each cluster of healthcare workers.

CONCLUSIONS: Changing hand hygiene behavior and attitude is possible by
beginning to observe clinical practice and by involving healthcare workers
in teaching and training.

KEYWORDS: Ukraine; compliance; hand care; hand disinfection; hand hygiene;
hand washing; healthcare settings; medical staff

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332274/
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Transmission of hepatitis C virus associated with surgical
procedures – new jersey 2010 and wisconsin 2011
__________________________________________________________________
Free Full Text http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6407a1.htm

MMWR Morb Mortal Wkly Rep. 2015 Feb 27;64(7):165-70.

Transmission of hepatitis C virus associated with surgical procedures –
new jersey 2010 and wisconsin 2011.

Apostolou A, Bartholomew ML, Greeley R, Guilfoyle SM, Gordon M, Genese C,
Davis JP, Montana B, Borlaug G.

Incidents of health care-associated hepatitis C virus (HCV) transmission
that resulted from breaches in injection safety and infection prevention
practices have been previously documented.

During 2010 and 2011, separate, unrelated, occurrences of HCV infections
in New Jersey and Wisconsin associated with surgical procedures were
investigated to determine sources of HCV and mechanisms of HCV
transmission.

Molecular analyses of HCV strains and epidemiologic
investigations indicated that transmission likely resulted from breaches
of infection prevention practices.

Health care and public health professionals should consider health care-
associated transmission when evaluating acute HCV infections.

Free full text http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6407a1.htm
__________________________________________________________________
________________________________*_________________________________

9. No Abstract: Ebola and compliance with infection prevention measures in
Nigeria
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25282666

Lancet Infect Dis. 2014 Nov;14(11):1045-6.

Ebola and compliance with infection prevention measures in Nigeria.

Yusuf I1, Adam RU2, Ahmad SA3, Yee PL3.

1Microbiology and Medical Laboratory Sciences, Bayero University, 3011,
Kano, Nigeria. Electronic address: iyusuf.bio@buk.edu.ng.
2Pathology Department, Sir Muhammad Sunusi Specialist Hospital Kano,
Nigeria.
3Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra
Malaysia, Selangor, Malaysia.
__________________________________________________________________
________________________________*_________________________________

10. News

– Global: WHO calls for worldwide use of smart syringe
– India: 59 kids injected with single needle!
– Pakistan: Pakistan wastes $3.7 million worth of donated vaccine,
official says
– Global: New WHO policy to promote switch to ‘smart’ syringes
– Global: WHO calls for “smart” syringes following continued hepatitis
and HIV infections from reuse
– Global: WHO adopts new safety needle policy, calling smart syringes an
‘urgent priority’
– Indiana USA: HIV outbreak tied to painkiller, dirty needles
– Global: WHO urges shift to single-use smart syringes
– Global: Single-Use Smart Syringes Stops risk of Contamination, More
than Anything Else They Save Lives
– Australia: Mike steps on needle getting out of car, now he’s in limbo
– USA: Man Says He Was Sickened by Falling Needle
– Maylasia: Malaysia is ‘world leader’ in battling HIV spread with
needles, says UK report

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
www.thedailystar.net/who-calls-for-worldwide-use-of-smart-syringe-67083

Global: WHO calls for worldwide use of smart syringe

The Daily Star, Dhaka Bangladesh (04.03.15)

Use of the same syringe or needle to give injections to more than one
person is driving the spread of a number of deadly infectious diseases
worldwide. Millions of people could be protected from infections acquired
through unsafe injections if all healthcare programmes switched to
syringes that cannot be used more than once. For these reasons, the World
Health Organisation (WHO) is launching a new policy on injection safety to
help all countries tackle the pervasive issue of unsafe injections.

A 2014 study sponsored by WHO, which focused on the most recent available
data, estimated that in 2010, up to 1.7 million people were infected with
hepatitis B virus, up to 315,000 with hepatitis C virus and as many as
33,800 with HIV through an unsafe injection. New WHO injection safety
guidelines and policy released provide detailed recommendations
highlighting the value of safety features for syringes, including devices
that protect health workers against accidental needle injury and
consequent exposure to infection.

The study, “Evolution of the Global Burden of Viral Infections from Unsafe
Medical Injections, 2000–2010”, was authored by J Pépin et al.

WHO stresses the need to reduce the number of unnecessary injections as a
critical way of reducing risk. There are 16 billion injections
administered every year. Around 5% of these injections are for immunising
children and adults, and 5% are for other procedures like blood
transfusions and injectable contraceptives. The remaining 90% of
injections are given into muscle (intramuscular route) or skin
(subcutaneous or intradermal route) to administer medicines. In many cases
these injections are unnecessary or could be replaced by oral medication.

Transmission of infection through an unsafe injection occurs all over the
world. The new smart syringes WHO recommends for injections into the
muscle or skin have features that prevent re-use. Some models include a
weak spot in the plunger that causes it to break if the user attempts to
pull back on the plunger after the injection. Others have a metal clip
that blocks the plunger so it cannot be moved back, while in others the
needle retracts into the syringe barrel at the end of the injection.

Syringes are also being engineered with features to protect health workers
from “needle stick” injuries and resulting infections. A sheath or hood
slides over the needle after the injection is completed to protect the
user from being injured accidentally by the needle and potentially exposed
to an infection.

WHO is urging countries to transition, by 2020, to the exclusive use of
the new smart syringes, except in a few circumstances in which a syringe
that blocks after a single use would interfere with the procedure. One
example is when a person is on an intravenous pump that uses a syringe.

The organisation is also calling for policies and standards for
procurement, safe use and safe disposal of syringes that have the
potential for re-use in situations where they remain necessary, including
in syringe programmes for people who inject drugs. Continued training of
health workers on injection safety – which has been supported by WHO for
decades – is another key recommended strategy.

Source: World Health Organisation
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/lugd5ej

India: 59 kids injected with single needle!

Times of India, TNN, India (03.03.15)

HYDERABAD: In an incident that throws light on the alarming state of
government-run hospitals, 59 children were injected an antibiotic __ all
with a single syringe and needle__ on Sunday night at Niloufer Hospital in
the city.

Such unsafe practices raise the risk of acquiring blood-borne infections
like Hepatitis B, Hepatitis C and HIV. “The incident clearly shows
violation of the fundamental rule in safe injection practices: one needle,
one syringe and to be used only one time,” said Dr Mahesh Joshi, head of
emergency services, Apollo Hospitals.

As the news broke early on Monday morning, Niloufer Hospital witnessed
chaotic scenes as irate parents staged protests. An immediate probe
revealed that a staff nurse, identified as Prameela, who was on night
shift at the hospital on Sunday, injected ‘Monocef’ antibiotic to treat
infections, following prescription by doctors attending on the children,
aged mostly between three months and four years.

These children were suffering from various illnesses, including pneumonia,
respiratory infections, diarrhoea, and viral fever, among other
infections, for which they were being examined.

Parents and relatives protested after they noticed rashes on the skin and
swelling on the arms of children soon after they were given the injection.
“My 11-month-old daughter was continuously crying after she was
administered the injection. When I questioned the nurse why she was using
a common syringe and needle for all, she brushed aside my objections,”
said P Ramakrishna, a resident of Mahbubnagar, whose daughter was referred
to Niloufer following a serious bout of pneumonia.

Insiders said the nurse, in the absence of duty resident medical officer
Dr J Krishna and lack of proper supervision by nursing superintendent Jude
Smith, used the common syringe and needle for injecting all the ailing
children with the drug.

“I protested looking at the way the kids were being injected, but to no
avail. Luckily, when my ailing five-month-old baby boy’s turn came to take
the injection, the nurse ran out of the antibiotic,” said a relieved Anwar
Pasha, father of the boy, who was referred to Niloufer from Kothagudem,
Khammam recently.

The incident comes three days after World Health Organisation (WHO) urged
India to use ‘auto-disable smart syringes’ after it pointed to unsafe
injection practices for the rise in hepatitis B and HIV cases.

Niloufer superintendent Dr K Devaraj ordered an inquiry, and moved all the
children to its emergency block on Monday morning. Devaraj said all the
children were in stable condition and the hospital would take action based
on the probe report to be submitted by resident medical officer Dr J
Krishna, who was allegedly absent from duty at the time of the incident.

Worried doctors said state-run hospitals must immediately ensure that
nurses were properly trained and doctors available throughout their duty
hours. “Even for administering Monocef, it should not be given through a
rapid mode by directly injecting the antibiotic through IV cannulation.
Instead, the ideal way is to give it through a drip mode within a span of
15-30 minutes from a normal saline bottle. Otherwise, it would result in
irritation and unbearable pain in any case,” said Dr Altaf Naseem,
consultant pediatrician, Candy Children’s Hospital, Tolichowki.
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/lhsldf3

Pakistan: Pakistan wastes $3.7 million worth of donated vaccine, official
says

By Syed Raza Hassan, Reuters, Pakistan (02.03.15)

ISLAMABAD(Reuters) – Pakistan has wasted $3.7 million worth of vaccines
donated to protect children from deadly diseases because officials failed
to store them properly, a senior health official told Reuters on Monday.

The scandal is the latest problem to be exposed in Pakistan’s poorly run
public health services.

“We have suspended the officials concerned and are conducting an inquiry,”
Saira Afzal Tarar, minister of state for national health services, told
Reuters.

The ruined vaccines were pentavalent vaccines, which combine different
vaccines in one injection and are supposed to protect children against
diphtheria, tetanus, whooping cough, hepatitis B and a bacteria that
causes meningitis and pneumonia.

It must be stored at cold temperatures to remain effective but Pakistan’s
power sector is chronically mismanaged and the country suffers several
hours of power cuts a day.

Officials said the vaccines were exposed to fluctuating temperatures,
possibly because of faulty generators.

“There may have been issue with the generators, but the facts will become
clear after the inquiry,” said Dr Saqlain Ahmad Gilani, the national
program manager at the Expanded Program on Immunization.

He said 1.3 million doses of vaccine worth $3.7 million had been wasted.
They had been donated by the United Nations Children’s Fund (UNICEF).

UNICEF says one in 10 Pakistani children does not survive their fifth
birthday. The majority of deaths are due to easily treatable diseases.

Last year, an international agency branded the government’s management of
a national polio campaign “disastrous”.

Doctors also say patients are regularly exposed to infected blood as
authorities fail to monitor blood banks.

(Editing by Katharine Houreld, Robert Birsel)
__________________________________________________________________
__________________________________________________________________
Global: New WHO policy to promote switch to ‘smart’ syringes

India Gazette (26.02.15)

• A WHO study has revealed in 2010, up to 1.7 million people were infected
with hepatitis B virus, up to 315, 000 with hepatitis C virus and as many
as 33, 800 with HIV through an unsafe injection

• Underlining the need to reduce the number of unnecessary injections as a
critical way of reducing risk, the WHO points out that there are 16
billion injections administered every year.

• 90% of injections are given into muscle (intramuscular route) or skin
(subcutaneous or intradermal route) to administer medicines; in many cases
these injections are unnecessary or could be replaced by oral medication.

GENEVA – World Health Organisaiton (WHO) has launched a new policy on
injection safety to help all countries switch to new “smart” syringes by
2020 to tackle the pervasive issue of unsafe injections leading to spread
of a number of deadly infectious diseases worldwide.

The UN organisation has called on manufacturers to begin or expand
production as soon as possible of “smart” syringes that meet its standards
for performance, quality and safety.

A 2014 WHO sponsored study”Evolution of the Global Burden of Viral
Infections from Unsafe Medical Injections, 20002010″, authored by J Ppin
et al, which focused on the most recent available data, estimated that in
2010, up to 1.7 million people were infected with hepatitis B virus, up to
315, 000 with hepatitis C virus and as many as 33, 800 with HIV through an
unsafe injection.

New WHO injection safety guidelines and policy released Monday provide
detailed recommendations highlighting the value of safety features for
syringes, including devices that protect health workers against accidental
needle injury and consequent exposure to infection.

“The new policy represents a decisive step in a long-term strategy to
improve injection safety by working with countries worldwide,” says Dr
Edward Kelley, Director of the WHO Service Delivery and Safety Department.
Underlining the need to reduce the number of unnecessary injections as a
critical way of reducing risk, the WHO points out that there are 16
billion injections administered every year.

Around 5% of these injections are for immunizing children and adults, and
5% are for other procedures like blood transfusions and injectable
contraceptives.

The remaining 90% of injections are given into muscle (intramuscular
route) or skin (subcutaneous or intradermal route) to administer
medicines. In many cases these injections are unnecessary or could be
replaced by oral medication.

The WHO study points to some progress made between 2000 and 2010 due to
the injection safety campaigns which has resulted in re-use of injection
devices in developing countries falling by a factor of 7.
Over the same period, unnecessary injections also fell: the average number
of injections per person in developing countries decreased from 3.4 to
2.9.

In addition, since 1999, when WHO and its partner organizations urged
developing countries to vaccinate children only using syringes that are
automatically disabled after a single use, the vast majority have switched
to this method.

Syringes without safety features cost US$ 0.03 to 0.04 when procured by a
UN agency for a developing country. The new “smart” syringes cost at least
twice that much. WHO is anticipating that prices will decline over time as
demand increases.

The UN organisation underscores that transmission of infection through an
unsafe injection is not restricted to the developing countries. For
example, a 2007 hepatitis C outbreak in the state of Nevada, United
States, was traced to the practices of a single physician who injected an
anaesthetic to a patient who had hepatitis C.
The doctor then used the same syringe to withdraw additional doses of the
anaesthetic from the same vial which had become contaminated with
hepatitis C virus – and gave injections to a number of other patients.
In Cambodia, a group of more than 200 children and adults living near the
country’s second largest city, Battambang, tested positive for HIV in
December 2014. The outbreak has been since been attributed to unsafe
injection practices.

“Adoption of safety-engineered syringes is absolutely critical to
protecting people worldwide from becoming infected with HIV, hepatitis and
other diseases. This should be an urgent priority for all countries,” says
Dr Gottfried Hirnschall, Director of the WHO HIV/AIDS Department.
The new “smart” syringes WHO recommends for injections into the muscle or
skin have features that prevent re-use.
Some models include a weak spot in the plunger that causes it to break if
the user attempts to pull back on the plunger after the injection. Others
have a metal clip that blocks the plunger so it cannot be moved back,
while in others the needle retracts into the syringe barrel at the end of
the injection.

Syringes are also being engineered with features to protect health workers
from “needle stick” injuries and resulting infections. A sheath or hood
slides over the needle after the injection is completed to protect the
user from being injured accidentally by the needle and potentially exposed
to an infection.
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/pw35meh

Global: WHO calls for “smart” syringes following continued hepatitis and
HIV infections from reuse

by Nicole Oran, MEDCITY News, USA (26.02.15)

People can do their best to protect themselves from things like hepatitis
and HIV by being responsible and aware, but when doctors reuse syringes,
all efforts can fall by the wayside.

Situations like this have prompted a global campaign from the World Health
Organization this week.

As NPR reported Tuesday, an 82-year-old celibate Buddhist abbot from
Cambodia was recently diagnosed with HIV because his doctor was reusing
syringes which led to the infection of 272 people, including babies and
children.

This horror story resonates around the world. More than 2 million people
were infected in 2010 alone, according to the most recent World Health
Organization research, with hepatitis B, hepatitis C and HIV because of
injections with previously used syringes or needles. While data are not
available for transmission of all diseases, unsafe needle practices could
also put people at risk for bloodborne illnesses, such as Ebola and
malaria, according to WHO.

The WHO is recommending that countries begin using “smart” syringes, which
are designed to prevent reuse.

“With one injection, the new-style syringes disable themselves,” said Dr.
Selma Khamassi, the head of the WHO team for injection safety. “Some have
a metal clip that blocks the plunger and you cannot pull it back to give
another injection. Some have a weak point, so if you try to pull it back,
it breaks.”

With about 70 manufacturers beginning to make versions of the smart
syringes, according to NPR, there is definite potential for a shift in
these unfortunate situations, even for low-income countries.

The cost of traditional syringes without safety features is about 3 to 4
cents each; syringes that automatically disable themselves when used range
from 4 to 8 cents each. “They are moving toward affordability. Once the
demand increases, the price will decrease,” says Khamassi.
Regardless of cost, the problem with reusing syringes is happening in
places that don’t have much of an excuse. Places like the U.S.

The Centers for Disease Control and Prevention reported more than 50
outbreaks in the U.S. since 2001 of hepatitis B and C as well as
bloodborne diseases because health workers reused needles, syringes or
vials designed for single use.

In other instances of reuse, there was no transmission of disease but
patients had to be notified for possible testing. Examples include a
urology clinic in Nevada using the same needle for prostate biopsies on
more than one patient; a pediatric clinic in Denver reusing syringes to
administer flu vaccines; a pain clinic in Los Angeles reusing syringes
that exposed patients to hepatitis C; and a health fair in New Mexico that
reused finger stick devices to test for blood glucose levels.
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/kyphhlh

Global: WHO adopts new safety needle policy, calling smart syringes an
‘urgent priority’

By Michael Gibney, FierceDrugDelivery, USA (25.02.15)

Citing rampant use of the same needle to inject more than one person, the
World Health Organization has–some might say finally–launched a new
policy to make unsafe injections less prevalent. Part of this policy
involves adopting up-to-date measures in syringe engineering, promoting
the use of “smart” needles with precautions against unsafe use.

In a release, the WHO cited several cases in which unsafe injection
protocol led to the unnecessary outbreak of infectious diseases. In 2007,
a doctor in Nevada double-dipped hep C-contaminated syringes. In Cambodia,
more than 200 children and adults tested positive for HIV, an outbreak
that is thought to have occurred due to unsafe injections. In fact, a
study mentioned by the Washington Post estimated that about a quarter of
the 18 billion medical injections are performed with dirty needles.

To bring that number down, the WHO is now urging the adoption of syringes
designed to protect both patients and physicians from contamination.
Several options exist, including a syringe with a plunger that breaks if
the user attempts to pull it back a second time. Some have a clip that
blocks the same movement. And retracting needles can also prevent a second
use.

“Adoption of safety-engineered syringes is absolutely critical to
protecting people worldwide from becoming infected with HIV, hepatitis and
other diseases,” WHO HIV/AIDS director Gottfried Hirnschall said in a
statement. “This should be an urgent priority for all countries.”

The WHO has set a quick recommended deadline of 2020 for countries to
transition to the new needles, calling on manufacturers to immediately
expand production. Among the recommendations are standards for
procurement, safe use and safe disposal for current syringe models.

The Washington Post looked into one Seattle nonprofit that has developed
one of these technologies. Path, with its metal-clip syringe Soloshot, hit
the market all the way back in 1990 and has been used to deliver more than
6 billion vaccine injections, according to the Post. But vaccines account
for less than 10% of all injections worldwide.

The industry itself has been developing and selling these syringes for
decades, with more than 70 suppliers out there for non-reusable models.
And now that the WHO has boarded that ship after 25 years on the
sidelines, that is now likely to pay off.

– here’s the WHO release
– and the Washington Post story
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/n5z9bg4

Indiana USA: HIV outbreak tied to painkiller, dirty needles

A quickly spreading outbreak of HIV in Southeastern Indiana is being
linked to injection of the powerful painkiller Opana — raising concern
among health officials across the region and nation as they face an
epidemic of prescription drug abuse.

Indiana state health officials said Wednesday that they have confirmed 26
cases, and four more preliminary cases, since mid-December, most linked to
Opana injection and a few spread through sexual transmission. The cases
were in Scott, Clark, Washington, Jackson and Perry counties, and
officials said this is the largest HIV outbreak the state has ever
experienced in one region.

“Addicts use and misuse needles,” said Karyn Hascal, president of The
Healing Place in Louisville, which serves Southern Indiana addicts. “When
you have injectible drugs like prescription pills and other narcotics
being abused as much as they have been, (Hepatitis) C and HIV are soon to
follow. … I knew that HIV and Hep C would come back.”

That’s a concern nationally as well. Officials at the U.S. Centers for
Disease Control and Prevention say injection drug use is a well-known
route of transmission for blood-borne infections such as HIV, and
injection drug users represent 8 percent of new HIV infections each year
and 15 percent of those living with HIV, which causes AIDS.

Jerome Adams, Indiana state health commissioner, said he’s especially
concerned because most of the residents who tested positive for HIV just
recently contracted the virus and may spread it to others.

“Because prescription drug abuse is at the heart of this outbreak, we are
not only working to identify, contact and test indivdiuals who may have
been exposed, but also to connect community members to resources for
substance abuse treatment and recovery,” Adams said.

Prescription drug abuse has skyrocketed in the past two decades in
Indiana, Kentucky and across the nation. Nationally, public health
officials said, someone dies of a prescription drug overdose every 25
minutes. The CDC said drug overdoses were the leading cause of injury
death in 2012, causing more deaths among 25- to 64-year-olds than motor
vehicle crashes.

Drug overdoses kill about 1,000 people a year in Kentucky and about the
same number in Indiana. And according to the U.S. Substance Abuse and
Mental Health Services Administration, 5.68 percent of Hoosiers and 4.48
percent of Kentuckians used prescription painkillers nonmedically in
2010-11, the latest year for which statistics are available.

Health officials for the state of Kentucky and Jefferson County said they
have not seen any recent surges in new cases of HIV but are concerned they
may as the epidemic continues. “Injection drug use is always a concern,”
said Dave Langdon, spokesman for the Metro Louisville Department of Public
Health and Wellness.

Brandon Holman of Louisville, a recovering Opana and heroin addict who has
been at the Healing Place for three months, said he sometimes used to
worry about contracting HIV, “but at the time I was just maintaining a
drug habit,” and spent most of his energy on getting the drugs he craved.
Holman, 24, said he never contracted a blood-borne disease, and “I
consider myself real blessed.”

Holman said he shot up Opana between 2009 and 2011, when it was relatively
easy to find, crush and shoot up. But in late 2011, the U.S. Food and Drug
Administration approved a new, crush resistant formulation of Opana ER, an
opioid containing oxymorphone. Two years later, the FDA rejected a
petition by Opana drugmaker Endo Pharmaceuticals, clearing the way for
generic versions of the original formulation to be approved and marketed.

FDA officials argue that the generic product is a useful therapy for pain
if used correctly, and that abuse-deterrent properties don’t make an
opioid impossible to abuse.

“While there is an increased ability of the reformulated ‘abuse deterrent’
version of Opana ER to resist crushing relative to the original
formulation, study data show that the reformulated version’s extended-
release features can be compromised when subjected to other forms of
manipulation, such as cutting, grinding, or chewing, followed by
swallowing,” FDA officials said in a statement. “Development of abuse-
deterrent technologies is a priority for FDA, and we strongly encourage
companies to continue innovating in this area. However, abuse-deterrent
science is still in the early stages. …”

Meanwhile, Indiana health officials are warning people to take measures to
stay safe by not injecting drugs, sharing or re-using needles, engaging in
unprotected sex or having sex with commercial sex workers. They are also
encouraging people to get tested for HIV and seek help if they are
struggling with substance abuse.

Holman, the recovering addict, suggested people may want to visit needle
exchange programs, where they can get clean needles in exchange for dirty
ones — and seek treatment for their substance abuse. If someone does
contract HIV, he said it shouldn’t be viewed as a death sentence. He said
he learned that from a friend who contracted HIV through drug use and is
now keeping it under control with medications.

“I’m grateful I didn’t pick (HIV) up,” he said. “But for those who have
it, there’s still hope.”
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/pfjr9qt

Global: WHO urges shift to single-use smart syringes

Kounteya Sinha, Times of India, TNN (24.02.15)

LONDON: The World Health Organisation has called for junking of multiple
usage syringes and a carpet usage of smart syringes that break after one
use by 2020. Reusing syringes leads to more than two million people being
infected with diseases, including HIV and hepatitis, each year.

More than 16 billion injections are administered annually. WHO believes
smart injections will help eliminate the 1.7 million new hepatitis B
cases, the 300,000 hepatitis C cases and the 35,000 HIV cases every year.
The WHO on Monday launched a new policy on injection safety to help all
countries tackle the pervasive issue of unsafe injections.

New WHO injection safety guidelines stressed the need to reduce the number
of unnecessary injections as a critical way of cutting risk.

Of the 16 billion injections administered every year, 5% are for
immunization purpose and 5% are for other procedures like blood
transfusions and injectable contraceptives.

The remaining 90% are given into muscle or skin to administer medicines.
In many cases these injections are unnecessary or could be replaced by
oral medication.

The new “smart” syringes WHO recommends have features that prevent re-use.
Some models include a weak spot in the plunger that causes it to break if
the user attempts to pull back on the plunger after the injection. Others
have a metal clip that blocks the plunger so it cannot be moved back,
while in others the needle retracts into the syringe barrel at the end of
the injection.

Syringes are also being engineered with features to protect health workers
from “needle stick” injuries and resulting infections.

A sheath or hood slides over the needle after the injection is completed.
WHO is urging countries to transition by 2020 to the exclusive use of the
new “smart” syringes.

WHO is calling on donors to support the transition to these devices,
anticipating that prices will decline over time as demand increases.
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/lqpd6xr

Global: Single-Use Smart Syringes Stops risk of Contamination, More than
Anything Else They Save Lives

Empire State Tribune, NY USA (24.02.15)

Many have lost their lives due to reused contaminated needles. More than
1.3 million people every year, an estimated five percent being caused by
HIV.

Marc Koska who came from England had read in the newspaper a report on how
the reusing of needles has spread the HIV virus around the world. Koska
began his mission in 1984 while he was in the Caribbean. He spent 30 years
of his endeavor to promote consciousness on the advantages of single-use
needles.

“All the media could talk about was this new killer disease that was going
to wipe out the planet,” Koska stated.

The World Health Organization declared new regulations to make certain
that injections being used worldwide should be carefully monitored and
based on sanitary standards. In the past, the WHO had recommended that
healthcare workers reuse needles up to 200 times. The WHO health care now
realizes that up to 40 percent of the 16 billion injections that they have
administered around the world each year may be unsafe.

“A 2014 study sponsored by WHO, which focused on the most recent available
data, estimated that in 2010, up to 1.7 million people were infected with
hepatitis B virus, up to 315 000 with hepatitis C virus and as many as 33
800 with HIV through an unsafe injection,” WHO officials announced.

The group also advised that physicians and other health care professionals
minimize the number of injections they dispense. About 90 percent of all
injections that they give to patients include medicines administered under
the skin known as intradermal injections through a muscular route.

Most patients prefer injections when they see a doctor at their office or
clinic thinking that injections are a more effective treatment than any
medication taken. As a result, most health care workers give shots that
are partly placebo even when oral medication is just as effective. In the
developing world, health care workers who have minimal incomes may receive
extra earnings when they give injections.

Smart syringes are intended to be impossible to reuse and to protect those
who give the injections. Some models feature needles that retract into the
syringe after the drug is injected and others give clips or plungers that
break, keeping it from being retracted.

Officials now at the WHO are urging health workers to deliver injections
through the new smart syringes by the year 2020.
__________________________________________________________________
__________________________________________________________________
http://www.northernstar.com.au/news/mikes-life-remains-in-limbo/2556353/

Australia: Mike steps on needle getting out of car, now he’s in limbo

Rodney Stevens, Northern Star, Australia (26.02.15)

MIKE EVANS feels like his life is in limbo for six months after he stepped
on an uncapped used syringe in one of Lismore’s most popular car parks.

Although it is highly unlikely he will be HIV positive, that’s how long
the Tregeagle man will have to wait to be 100% he is not.

“On Monday I parked in the Kirkland car park next to a jacaranda tree and
the ground was pretty uneven so I was struggling with door to get out,” he
said. “I stepped out and then I felt a stab in my right foot and then I
took another step and went ‘Ouch’!”

When he looked down, Mr Evans said he saw the syringe hanging from the
sole of his shoe. “I felt like spewing on the spot,” he said. “When I’d
calmed down after the initial panic. I looked around and there were
syringes everywhere.”

Mr Evans’ injury comes less than a month after the Lismore community was
outraged at the discovery of a blood-filled syringe dumped at Blair Oval.
After taking his shoe and sock off and squeezing what blood he could out
of the needlestick injury, he went straight to his GP.

“He said needlestick injuries weren’t common but they saw people suffering
from them from time to time,” he said. “I was put on an accelerated
hepatitis B and C program, given a tetanus shot and then had blood testing
for HIV.

“The hepatitis series of injections goes for three weeks but the HIV
testing spans six months. “In six months if there is no trace of the virus
you’re in the clear.”

What has riled Mr Evans is that as a long-term blood donor he won’t be
able to give two donations of valuable blood during the HIV testing
period.

“It pisses me off because they make a fuss about how every donation you
make saves five lives,” he said. “That means theoretically there are 10
people that are going to die because I can’t make two donations.”

He is used to checking for snakes when he jumps off the tractor on his
property. Mr Evans warned people to be careful in car parks.
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http://tinyurl.com/mkgxag2

USA: Man Says He Was Sickened by Falling Needle

By Izzy Kapnick, Courthouse News Service, USA (27.02.15)

FORT PIERCE, Fla. (CN) – A Florida man says a dirty needle fell from the
ceiling of a motel and pricked him, infecting him with hepatitis C.

In a lawsuit in St. Lucie County Court, Joseph Carpenter claims he had
just gotten out of the shower in his room at the Fort Pierce Motel 6, when
“a syringe with a needle in it fell out of the popcorn board ceiling,
struck him on the right shoulder and drew blood.”

Carpenter says he took the syringe to the front desk and showed it to a
motel employee, who “indicated it was not uncommon for syringes to fall
from the ceilings in the motel’s rooms.”

The employee “pulled out a plastic syringe disposal container and placed
the syringe into it,” Carpenter claims.

The incident happened on January 6, 2014, according to the lawsuit.
The next day, Carpenter “felt feverish, had a cough and was nauseous,” he
says.

He later went to a veteran’s clinic to get tested, and “on January 22 …
the lab work came back positive for Hepatitis C,” according to the
lawsuit.

The sole defendant, Motel 6 Operating LP, had “failed to warn Plaintiff
Carpenter and/or similarly situated invitees, that concealed behind the
popcorn ceiling tiles in the guest rooms were contaminated syringes,” the
lawsuit states.

The lawsuit suggests that the needle had been hidden in the ceiling tiles
by a motel employee or previous guest.

The current manager of Motel 6’s Fort Pierce location declined to comment
on the case.

Carpenter is represented by Jeffrey Rollins, a St. Lucie County personal
injury attorney.
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__________________________________________________________________
http://tinyurl.com/kxzu9jm

Maylasia: Malaysia is ‘world leader’ in battling HIV spread with needles,
says UK report

The Malay Mail Online, Malaysia (17.02.15)

[Graphic: The success of Malaysia’s controversial needle exchange and
methadone programme has won praise from Harm Reduction International
(HRI). — MMOL graphics]

KUALA LUMPUR, Feb 17 — A UK-based group has commended Malaysia as a “world
leader” in harm reduction for the country’s controversial needle exchange
and methadone programme hailed for its relative success in combating the
HIV epidemic caused mainly by injecting drug use.

Harm Reduction International (HRI), a non-governmental organisation that
promotes the prevention of harm as opposed to the prevention of drug use
itself, said in its Global State of Harm Reduction 2014 report that
Malaysia, along with Iran and Australia, had made the largest increase in
the number of needle and syringe exchange programmes.

“Although few countries in the region receive national government funding
support for harm reduction, Malaysia and India are examples of where the
government supports an almost fully fledged harm reduction programme,”
said HRI in the report.

Malaysia more than doubled the number of needle exchange programmes from
297 sites in 2012 to 728 last year.

The number of methadone programmes, or opioid substitution therapy, in
Malaysia also went up from 674 to 811 sites in the same period.
The report noted that although substitution therapy has been expanded in
prisons in Malaysia from one prison in 2008 to 18 by 2013, methadone is
unavailable in pre-trial police detention.

HRI said in a statement that HIV rates among people who inject drugs are
low – and even almost negligible in some cases – when comprehensive harm
reduction is implemented.

“It was the primary reason that HIV/AIDS epidemics amongst drug users in
cities like London, Glasgow, New York, Sydney, Amsterdam and Berlin were
avoided when AIDS first surfaced in the early 1980s,” said HRI today.

“It is also the reason that countries like Malaysia have been largely
successful over the past seven years in turning around what was an
injecting drug led HIV/AIDS epidemic by introducing government-led harm
reduction initiatives throughout the country,” the NGO added.
Malaysian AIDS Council (MAC) president Datuk Dr Raj Karim said challenges
still remained in the areas of HIV and drug treatment access, as well as
diagnosis and treatment for related infections like tuberculosis and viral
hepatitis.

“Practices and policies that stigmatise and criminalise drug users must be
removed and replaced with measures to divert arrests to voluntary drug
treatment,” Raj told Malay Mail Online.

“Leadership on all levels is key in sustaining the positive outcomes of
the harm reduction programme, and there needs to be continued financial
commitment by the government on harm reduction,” she added.
The MAC chief said last December that Malaysia’s harm reduction programme
has decreased new HIV infections among people who inject drugs by 50 per
cent.

“We would not have been able to achieve the results that we are seeing
today without the visionary leadership of our Prime Minister, Datuk Seri
Najib Razak, who in his capacity as the chair of the Cabinet Committee on
Drugs in 2005 took the bold step to green light the harm reduction
programme against much public opposition,” said Raj in her World AIDS Day
Message on December 1.

A research study by the Centre of Excellence for Research in AIDS (CERiA)
in Universiti Malaya, in collaboration with Australia’s Kirby Institute,
released last December showed that Malaysia’s needle exchange and
methadone programme – which was once criticised for encouraging drug use –
has prevented about 39 per cent of new infections and saved RM47 million
in healthcare costs during the first eight years of implementation.
The study also said the programme would prevent a whopping 87 per cent of
new HIV infections and save about RM210 million in healthcare costs if
continued for another 10 years till 2023.

According to HRI, which cited information from Malaysia’s Global AIDS
Response Progress Reports in Geneva in 2012 and 2014, there are 170,000
people who inject drugs in Malaysia and the HIV prevalence among injecting
drug users is almost one out of five people, or 18.9 per cent.
HRI also said in its report that although Putrajaya announced more funding
for drug control last year, the money was likely targeted at abstinence-
based programmes and primary prevention, rather than harm reduction.
__________________________________________________________________
________________________________*_________________________________

New WHO Injection Safety Guidelines

WHO is urging countries to transition, by 2020, to the exclusive use of
the new “smart” syringes, except in a few circumstances in which a syringe
that blocks after a single use would interfere with the procedure.

The new guideline is:

WHO Guideline on the use of Safety-Engineered Syringes for Intramuscular,
Intradermal and Subcutaneous Injections in Health Care

It is available for free download or viewing at this link:
www.who.int/injection_safety/global-campaign/injection-safety_guidline.pdf

PDF Requires Adobe Acrobat Reader [620 KB]
__________________________________________________________________
________________________________*_________________________________
Making all injections safe brochure

This is an illustrated summary brochure for the general public.

www.who.int/injection_safety/global-campaign/injection-safety_brochure.pdf
pdf, 554kb [6 pages]

Media Release:
http://www.who.int/mediacentre/news/releases/2015/injection-safety/en/
__________________________________________________________________
________________________________*_________________________________

SIGN Meeting 2015

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

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

A report of the meeting will be posted ASAP
__________________________________________________________________
________________________________*_________________________________
* SAFETY OF INJECTIONS brief yourself at: www.injectionsafety.org

A fact sheet on injection safety is available at:
http://www.who.int/mediacentre/factsheets/fs231/en/index.html

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

* Download the WHO Best Practices for Injections and Related Procedures
Toolkit March 2010 [pdf 2.47Mb]:
http://whqlibdoc.who.int/publications/2010/9789241599252_eng.pdf

Use the Toolbox at: http://www.who.int/injection_safety/toolbox/en/

Get SIGN files on the web at: http://signpostonline.info/signfiles-2
get SIGNpost archives at: http://signpostonline.info/archives-by-year

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The SIGN Secretariat, the Department of Health Systems Policies and
Workforce, WHO, Avenue Appia 20, CH-1211 Geneva 27, Switzerland.
Facsimile: +41 22 791 4836 E- mail: sign@who.int
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The SIGN Forum is moderated by Allan Bass and is hosted on the University
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