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SIGNpost 00828

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00828 eLogistics + Injuries + Abstracts + News 11 November 2015

CONTENTS
1. New Guide for Selecting an Electronic Logistics Management Information
System
2. Abstract: Knowledge, attitude, and practice of needle stick and sharps
injuries among dental professionals of Bangalore, India
3. Abstract: Sharp Injuries Among Medical Students
4. Abstract: Qualitative content analysis of psychologic discomfort and
coping process after needlestick injuries among health care workers
5. Abstract: Healthcare waste management: qualitative and quantitative
appraisal of nurses in a tertiary care hospital of India
6. Abstract: Bacillus cereus panophthalmitis associated with injection
drug use
7. Abstract: Survival of Hepatitis C Virus in Syringes Is Dependent on the
Design of the Syringe-Needle and Dead Space Volume
8. Abstract: Injection of new psychoactive substance snow blow associated
with recently acquired HIV infections among homeless people who inject
drugs in Dublin, Ireland, 2015
9. Abstract: The use of the needle-free jet injection system with buffered
lidocaine device does not change intravenous placement success in
children in the emergency department
10. Abstract: Management of complications of injectable silicone
11. Abstract: Systematic qualitative literature review of health care
workers’ compliance with hand hygiene guidelines
12. Abstract: The role of message strategy in improving hand hygiene
compliance rates
13. Abstract: Inhaled antibiotics beyond aminoglycosides, polymyxins and
aztreonam: A systematic review
14. Abstract: Keyboard cleanliness: a controlled study of the residual
effect of chlorhexidine gluconate
15. No Abstract: Prevalence and factors associated with puncture injuries
among medical students
16. No Abstract: National Healthcare Safety Network report, data summary
for 2013, Device-associated Module
17. News
– Injected drug use rise linked to Hep C, HIV infections in Indigenous
Australians, new research says
– MA USA: Fire Department Outlines Policy For Needle Dropoff
– Utah USA: Ogden hospital may have exposed 4,800 patients to hepatitis C
– New Syringe Design Not Particularly Effective at Curbing Spread of
Hepatitis C Virus
– Singapore: Singapore Healthcare System Delayed Reporting Virus Outbreak
– Singapore: SGH Hepatitis C cluster update: 903 patients screened, no
new positives
– Philippines: Pakistani, Pinay wife nabbed for selling fake anti-rabies
vaccines
– Global: Health Care Workers Have Higher HCV Prevalence
– South Africa: Bio-hazardous waste piles up in warehouse of horrors
– USA: Halloween Toy Pens Resembling Syringes A Topic Of Debate

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__________________________________________________________________
________________________________*_________________________________

1. New Guide for Selecting an Electronic Logistics Management Information
System

Kindly posted by Holly Deaton @ the USAID | DELIVER PROJECT
__________________________________________________________________
from: Holly Deaton <holly_deaton[at]jsi.com>
to: Sign Moderator <sign.moderator@gmail.com>
date: Sat, Nov 7, 2015
subject: New Guide for Selecting an Electronic Logistics Management
Information System

A well-designed, well-operated supply chain that delivers health supplies
to patients and clients who need them is critical to the success of any
health system.

With an electronic logistics management information system (eLMIS),
logisticians can quickly access data they need to make informed decisions.
In the new eLMIS Selection Guide, published by the USAID | DELIVER
PROJECT, you can learn what it takes to be eLMIS ready.

The guide also includes profiles of eLMIS applications implemented in
Pakistan, Ethiopia, Tanzania, and Zambia.

Learn more at http://bit.ly/1kzbx7K
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Knowledge, attitude, and practice of needle stick and sharps
injuries among dental professionals of Bangalore, India
__________________________________________________________________

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606606/

J Int Soc Prev Community Dent. 2015 Sep-Oct;5(5):406-12.
Knowledge, attitude, and practice of needle stick and sharps injuries
among dental professionals of Bangalore, India.

Pavithran VK1, Murali R1, Krishna M2, Shamala A1, Yalamalli M1, Kumar AV1.

1Department of Public Health Dentistry, Krishnadevaraya College of Dental
Sciences, Bangalore, Karnataka, India.
2Narsinhbhai Patel Dental College and Hospital, Visnagar, Gujarat, India.

BACKGROUND: A needle stick injury (NSI) is an accidental skin-penetrating
stab wound from a hollow-bore needle containing another person’s blood or
body fluid. Healthcare workers (HCWs) including dental professionals are
at an occupational risk of exposure to blood-borne pathogens following
NSIs and sharps injuries (SIs). A thorough understanding of the safe
practices while handling needles and sharps is crucial for HCWs to create
a risk- free work place environment.

AIMS AND OBJECTIVES: To assess the knowledge, attitude, practice, and
prevalence of NSIs and SIs among dental professionals in a dental college
at Bangalore.

MATERIALS AND METHODS: A cross-sectional survey was conducted in September
2012 using a structured, pretested, guided interview-based questionnaire
that was administered to 200 dental professionals in a dental college at
Bangalore to assess the knowledge, attitude, practices, and self-report
information of NSIs.

RESULTS: In the present study, 81.5% of dental professionals were
vaccinated against hepatitis B. A total of 27.5% participants had an NSI
during the previous 12 months. About 41.80% of NSIs occurred during device
recapping. Most common reason for failure to report the incidents of NSIs,
as declared by 29.09% of the participants, included the fear of being
blamed or getting into trouble for having an NSI.

CONCLUSION: The knowledge of dental professionals on NSIs and their
preventive measures are inadequate; however, training on Universal
Precaution Guidelines, protocols regarding post-exposure prophylaxis, and
safety devices has to be provided to prevent such injuries in future among
the dental professionals.

KEYWORDS: Dental college; dental professionals; needle stick injury;
sharps injury

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606606/
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Sharp Injuries Among Medical Students
__________________________________________________________________

http://www.ccsenet.org/journal/index.php/gjhs/article/view/47047

Glob J Health Sci. 2015 Mar 30;7(5):320-5. Free full text
Sharp Injuries Among Medical Students.

Ghasemzadeh I1, Kazerooni M, Davoodian P, Hamedi Y, Sadeghi P.

1. imanghasem@gmail.com.

INTRODUCTION: Sharp injuries threaten the health of healthcare employees.
They cause the transmission of many diseases such as hepatitis B and C,
AIDS, etc., which can increase the associated costs associated with them.
The aim of this study was to investigate the frequency of sharp injuries
among the students of Hormozgan University of Medical Sciences.

METHOD: This cross-sectional study was conducted during 2012-2013 in
Hormozgan University of Medical Sciences, IR Iran. The target population
consisted of the medical, nursing, midwifery, operating room technician,
and medical laboratory students in the 2012-2013 academic year. Census
sampling was conducted, and accordingly, 500 students participated in the
study Data was collected using modified questionnaire of the University of
San Diego’s injury report form. The collected data were entered into SPSS
V.19 and analyzed using descriptive statistical tests.

FINDINGS: Finally 377 students (75.4%) returned the questionnaire. Among
the studied students, 184 students (39.3%) had had sharp injuries. The
frequency of damaging Vein puncture was the most common mechanism of
injury

DISCUSSION & CONCLUSION: The prevalence of sharp injuries is high among
students which can increase the risk of disease and its subsequent risks,
and thus, increase the cost and stress among students. It seems that
holding workshops and increasing students’ awareness and skills to face
these risks can be effective in mitigating them.
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Qualitative content analysis of psychologic discomfort and
coping process after needlestick injuries among health care workers
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/26526142

Am J Infect Control. 2015 Oct 30. pii: S0196-6553(15)00975-X.
Qualitative content analysis of psychologic discomfort and coping process
after needlestick injuries among health care workers.

Jeong JS1, Son HM1, Jeong IS2, Son JS3, Shin KS4, Yoonchang SW5, Jin HY6,
Han SH7, Han SH8.

1Department of Nursing, University of Ulsan, Ulsan, Republic of Korea.
2College of Nursing, Pusan National University, Busan, Republic of Korea.
Electronic address: jeongis@pusan.ac.kr.
3Department of Occupational and Environmental Medicine, Samsung Changwon
Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic
of Korea.
4Seegene Medical Foundation, Seoul, Republic of Korea.
5Department of Nursing, Chungwoon University, Chungnam, Republic of Korea.
6Department of Infection Control Office, Ajou University Hospital, Suwon,
Republic of Korea.
7Infection Prevention and Control Team, Dankook University Hospital,
Cheon-An, Republic of Korea.
8Infection Prevention and Control Team, Soonchunhyang University Bucheon
Hospital, Bucheon, Republic of Korea.

BACKGROUND: This study was designed to survey psychologic discomfort and
coping processes of health care workers that suffered needlestick injuries
(NSIs).

METHODS: This qualitative analysis was performed with 15 health care
workers who experienced NSIs. Data were collected using face-to-face
interviews. The study subjects were asked the following: please describe
the psychologic discomfort that you experienced after the NSI incidence.
Data were evaluated by qualitative content analysis.

RESULTS: Types of psychologic discomfort after NSI among health care
workers included anxiety, anger, and feelings of guilt. Some personnel
adopted active coping strategies, such as seeking first aid or reporting
the incident to a monitoring system, whereas others used passive coping
methods, such as avoidance of reporting the incident, vague expectancy to
have no problems, and reliance on religious beliefs. Recommended support
strategies to improve the prevention of NSIs were augmenting employee
education and increasing recognition of techniques for avoiding NSIs.

CONCLUSION: Medical institutions need to provide employees with repeated
education so that they are familiar with guidelines for preventing NSIs
and to stimulate their alertness to the risk of injuries at any time, in
any place, and to anybody.

Copyright © 2015 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Adaptation; Health personnel; Needlestick injuries; Psychologic;
Qualitative research
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Healthcare waste management: qualitative and quantitative
appraisal of nurses in a tertiary care hospital of India
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/25506075

ScientificWorldJournal. 2014;2014:935101.
Healthcare waste management: qualitative and quantitative appraisal of
nurses in a tertiary care hospital of India.

Shivalli S1, Sanklapur V2.

1Community Medicine, Yenepoya Medical College, Yenepoya University,
Deralakatte, Mangalore, Karnataka 575018, India.
2Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka
575018, India.

BACKGROUND: The nurse’s role in healthcare waste management is crucial.

OBJECTIVES: (1) To appraise nurses quantitatively and qualitatively
regarding healthcare waste management; (2) to elicit the determinants of
knowledge and attitudes of healthcare waste management.

METHOD: A cross-sectional study was undertaken at a tertiary care hospital
of Mangalore, India. Self-administered pretested questionnaire and
“nonparticipatory observation” were used for quantitative and qualitative
appraisals. Percentage knowledge score was calculated based on their total
knowledge score. Nurses’ knowledge was categorized as excellent (>70%),
good (50-70%), and poor (<50%). Chi square test was applied to judge the
association of study variables with their attitudes and knowledge.

RESULTS: Out of 100 nurses 47 had excellent knowledge (>70% score). Most
(86%) expressed the need of refresher training. No study variable
displayed significant association (P > 0.05) with knowledge. Apt
segregation practices were followed except in casualty. Patients and
entourages misinterpreted the colored containers.

CONCLUSION: Nurses’ knowledge and healthcare waste management practices
were not satisfactory. There is a need of refresher trainings at optimum
intervals to ensure sustainability and further improvement. Educating
patients and their entourages and display of segregation information board
in local language are recommended.

Free Article http://www.hindawi.com/journals/tswj/2014/935101/
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Bacillus cereus panophthalmitis associated with injection
drug use
__________________________________________________________________
http://www.ijidonline.com/article/S1201-9712(14)00056-3/abstract

Int J Infect Dis. 2014 Sep;26:165-6. Open Access

Bacillus cereus panophthalmitis associated with injection drug use.

Kumar N1, Garg N2, Kumar N3, Van Wagoner N4.

1Department of Medicine, Cambridge Health Alliance, Harvard Medical
School, 1493 Cambridge St, Cambridge, MA 02139, USA. Electronic address:
nilaykumar83@gmail.com.
2Department of Medicine, Beth Israel Deaconess Medical Center/Harvard
Medical School, Boston, Massachusetts, USA.
3Department of Medicine, Manipal University, Manipal, Karnataka, India.
4Division of Infectious Diseases, Department of Medicine, University of
Alabama at Birmingham, Birmingham, Alabama, USA.

We report a case of rapidly progressive vision loss in a young woman with
a history of injection drug use. Subsequent enucleation of the affected
eye was done and Bacillus cereus grew on tissue culture. B. cereus is a
rare cause of endogenous endophthalmitis due to hematogenous seeding of
the vitreous in the setting of injection drug use.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights
reserved.

KEYWORDS: Bacillus cereus; Endophthalmitis; Injection drug use;
Panophthalmitis

Free full text
http://www.ijidonline.com/article/S1201-9712(14)00056-3/abstract
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Survival of Hepatitis C Virus in Syringes Is Dependent on the
Design of the Syringe-Needle and Dead Space Volume
__________________________________________________________________

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0139737

PLoS One. 2015 Nov 4;10(11):e0139737. Open Access
Survival of Hepatitis C Virus in Syringes Is Dependent on the Design of
the Syringe-Needle and Dead Space Volume.

Binka M1, Paintsil E1,2,3, Patel A1, Lindenbach BD4, Heimer R1,3.

1Department of Epidemiology of Microbial Diseases, Yale School of Public
Health, New Haven, Connecticut, United States of America.
2Departments of Pediatrics & Pharmacology, Yale School of Medicine, New
Haven, Connecticut, United States of America.
3Center for Interdisciplinary Research on AIDS, Yale University, New
Haven, Connecticut, United States of America.
4Department of Microbial Pathogenesis, Yale School of Medicine, New Haven,
Connecticut, United States of America.

BACKGROUND: Many people who inject drugs (PWID) use syringes with
detachable needles, which have high dead space (HDS). Contaminated HDS
blood may substantially contribute to the transmission of HIV, hepatitis C
(HCV), and other blood-borne viruses within this population. Newly
designed low dead space (LDS) syringe-needle combinations seek to reduce
blood-borne virus transmission among PWID. We evaluated the infectivity of
HCV-contaminated residual volumes recovered from two LDS syringe-needle
combinations.

METHODS: We tested two different design approaches to reducing the dead
space. One added a piston to the plunger; the other reduced the dead space
within the needle. The two approaches cannot be combined. Recovery of
genotype-2a reporter HCV from LDS syringe-needle combinations was compared
to recovery from insulin syringes with fixed needles and standard HDS
syringe-needle combinations. Recovery of HCV from syringes was determined
immediately following their contamination with HCV-spiked plasma, after
storage at 22°C for up to 1 week, or after rinsing with water.

RESULTS: Insulin syringes with fixed needles had the lowest proportion of
HCV-positive syringes before and after storage. HCV recovery after
immediate use ranged from 47%±4% HCV-positive 1 mL insulin syringes with
27-gauge ½ inch needles to 98%±1% HCV-positive HDS 2 mL syringes with 23-
gauge 1¼ inch detachable needles. LDS combinations yielded recoveries
ranging from 65%±5% to 93%±3%. Recovery was lower in combinations
containing LDS needles than LDS syringes. After 3 days of storage, as much
as 6-fold differences in virus recovery was observed, with HCV recovery
being lower in combinations containing LDS needles. Most combinations with
detachable needles required multiple rinses to reduce HCV infectivity to
undetectable levels whereas a single rinse of insulin syringes was
sufficient.

CONCLUSIONS: Our study, the first to assess the infectivity of HCV in
residual volumes of LDS syringes and needles available to PWID,
demonstrates that LDS syringe-needle combination still has the greater
potential for HCV transmission than insulin syringes with fixed needles.
Improved LDS designs may be able to further reduce HCV recovery, but based
on the designed tested, LDS needles and syringes remain intermediate
between fixed-needle syringes and HDS combinations in reducing exposure to
HCV.

Free full text
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0139737
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Injection of new psychoactive substance snow blow associated
with recently acquired HIV infections among homeless people who inject
drugs in Dublin, Ireland, 2015
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26537764

Euro Surveill. 2015 Oct 8;20(40).

Injection of new psychoactive substance snow blow associated with recently
acquired HIV infections among homeless people who inject drugs in Dublin,
Ireland, 2015.

Giese C1, Igoe D, Gibbons Z, Hurley C, Stokes S, McNamara S, Ennis O,
O’Donnell K, Keenan E, De Gascun C, Lyons F, Ward M, Danis K, Glynn R,
Waters A, Fitzgerald M; outbreak control team.

1European Programme for Intervention Epidemiology Training (EPIET),
European Centre for Disease Prevention and Control, (ECDC), Stockholm,
Sweden.

In February 2015, an outbreak of recently acquired HIV infections among
people who inject drugs (PWID) was identified in Dublin, following similar
outbreaks in Greece and Romania in 2011.

We compared drug and risk behaviours among 15 HIV cases and 39 controls.

Injecting a synthetic cathinone, snow blow, was associated with recent HIV
infection (AOR: 49; p = 0.003).

Prevention and control efforts are underway among PWID in Dublin, but may
also be needed elsewhere in Europe.

KEYWORDS: People who Inject drugs; case-control study; human
immunodeficiency virus – HIV; new psychoactive substance; a-PVP
__________________________________________________________________
________________________________*_________________________________

9. Abstract: The use of the needle-free jet injection system with buffered
lidocaine device does not change intravenous placement success in
children in the emergency department
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/25779227

Acad Emerg Med. 2015 Apr;22(4):447-51.
The use of the needle-free jet injection system with buffered lidocaine
device does not change intravenous placement success in children in the
emergency department.

Lunoe MM1, Drendel AL, Brousseau DC.

1The Department of Pediatrics, Medical College of Wisconsin, Milwaukee,
WI.

OBJECTIVES: The needle-free jet injection system with buffered lidocaine
(J tip) has been shown to reduce pain for intravenous (IV) line insertion,
but its relationship with successful IV placement has not been well
studied. This study aimed to determine if J tip use is associated with
improved first- attempt IV placement success in children.

METHODS: This was a retrospective cohort study of children ages 1 to 18
years with need for emergent IV placement. Approximately 300 children were
selected from each of three separate age groups: 1 to 2, 3 to 6, and 7 to
18 years. The standard treatment group (no device) included children with
IV insertions from January 2009 through January 2010 with no J tip. The J
tip treatment group (device) included children with IV insertions from
December 2010 through December 2011 who received J tips. Successful IV
placement on first attempt was the primary outcome. A chi-square test was
used to compare the proportion of first-attempt success and logistic
regression was performed to assess the effect of device use and patient
age, sex, and race on first-attempt success.

RESULTS: A total of 958 children were identified, 501 in the no-device
group and 457 in the device group. The most common diagnoses were vomiting
or dehydration (30.3%), trauma or burn (20.0%), and infection (15.5%).
Overall, first-attempt success was 69.0% and was similar between the no-
device (68.7%) and device (69.4%) groups (p = 0.81). No difference in
first-attempt success with the use of the device was found in any of the
age groups. Multivariate analysis found that only age of 1 to 2 years was
associated with lower odds of first-attempt success when controlling for
patient characteristics and device use.

CONCLUSIONS: The use of the J tip did not affect first-attempt success for
IV placement in children.

© 2015 by the Society for Academic Emergency Medicine.
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Management of complications of injectable silicone
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25536128

Facial Plast Surg. 2014 Dec;30(6):623-7.

Management of complications of injectable silicone.

Hexsel D1, de Morais MR1.

1Brazilian Center for Studies in Dermatology, Porto Alegre, RS, Brazil.

Soft tissue augmentation is a common procedure, and a wide variety of
injectable fillers are used. Liquid injectable silicone (LIS) was the
first highly popularized injectable filler. LIS is a permanent filler and
can be used in the correction of facial furrows and wrinkles.

Some complications are inherent to the procedure and can resolve
spontaneously, such as redness, swelling, and immediate hypersensitivity
reactions.

Unintended reactions, such as granulomas, infections, vascular occlusion,
can also follow the treatment with LIS and may appear several years after
the injections.

These can be difficult to manage, show little or no tendency to
spontaneous resolutions, and rarely resolve completely.

Injecting physicians must be aware of these potential complications caused
by LIS because early medical care and treatment, including psychological
support for these patients, can minimize the consequences for patients and
physicians, and may also help obtaining better outcomes when treating
complications.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Systematic qualitative literature review of health care
workers’ compliance with hand hygiene guidelines
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/25728153
Am J Infect Control. 2015 Mar 1;43(3):269-74.

Systematic qualitative literature review of health care workers’
compliance with hand hygiene guidelines.

Smiddy MP1, O’ Connell R2, Creedon SA2.

1Department of Epidemiology and Public Health, University College Cork,
Cork, Ireland. Electronic address: m.smiddy@ucc.ie.
2Catherine McCauley School of Nursing and Midwifery, University College
Cork, Cork, Ireland.

BACKGROUND: Acquisition of a health care-associated infection is a
substantial risk to patient safety. When health care workers comply with
hand hygiene guidelines, it reduces this risk. Despite a growing body of
qualitative research in this area, a review of the qualitative literature
has not been published.

METHODS: A systematic review of the qualitative literature.

RESULTS: The results were themed by the factors that health care workers
identified as contributing to their compliance with hand hygiene
guidelines. Contributing factors were conceptualized using a theoretical
background. This review of the qualitative literature enabled the
researchers to take an inductive approach allowing for all factors
affecting the phenomenon of interest to be explored. Two core concepts
seem to influence health care workers’ compliance with hand hygiene
guidelines. These are motivational factors and perceptions of the work
environment. Motivational factors are grounded in behaviorism, and the way
in which employees perceive their work environment relates to structural
empowerment.

CONCLUSION: Noncompliance with hand hygiene guidelines remains a
collective challenge that requires researchers to adopt a consistent and
standardized approach. Theoretical models should be used intentionally to
better explain the complexities of hand hygiene.

Copyright © 2015 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Compliance; Guidelines; Hand hygiene; Qualitative; Systematic
review; Theory
__________________________________________________________________
________________________________*_________________________________

12. Abstract: The role of message strategy in improving hand hygiene
compliance rates
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/26521934

Am J Infect Control. 2015 Nov 1;43(11):1166-70.
The role of message strategy in improving hand hygiene compliance rates.

Taylor RE1.

1School of Advertising and Public Relations, University of Tennessee,
Knoxville, TN. Electronic address: retaylor@utk.edu.

BACKGROUND: Despite increased attention to hand hygiene over the past
decade compliance rates remain relatively low. Although there have been a
number of improvements in the science of hand hygiene, very little
attention has been devoted to the messages that promote it.

METHOD: A total of 86 health care workers who are members of Association
for Professionals in Infection Control and Epidemiology chapters
participated in an online evaluation of 6 message strategies. The
participants evaluated the strategies on ease of understanding,
believability, and whether the message strategies were likely to lead to
increased handwashing.

RESULTS: Of the 6 strategies-ego, social, sensory, routine, acute need,
and ration- the social strategy was rated the most likely to lead to
action. The sensory strategy was seen as not only least likely but also
counterproductive.

CONCLUSIONS: ICPs should add a social message strategy to communication
programs promoting hand hygiene. Although further testing is needed, ego,
routine, and acute need strategies show promise for tapping into
motivations that lead to improved compliance.

Copyright © 2015 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Communication models; Concept testing; Emotional appeals; Health
care- associated infections; Motivation; Persuasion; Promotion
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Inhaled antibiotics beyond aminoglycosides, polymyxins and
aztreonam: A systematic review
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/25533880

Int J Antimicrob Agents. 2015 Mar;45(3):221-33.
Inhaled antibiotics beyond aminoglycosides, polymyxins and aztreonam: A
systematic review.

Falagas ME1, Trigkidis KK2, Vardakas KZ3.

1Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece; Department
of Internal Medicine-Infectious Diseases, Iaso General Hospital, Athens,
Greece; Department of Medicine, Tufts University School of Medicine,
Boston, MA, USA. Electronic address: m.falagas@aibs.gr.
2Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.
3Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece; Department
of Internal Medicine-Infectious Diseases, Iaso General Hospital, Athens,
Greece.

We sought to evaluate published evidence regarding clinical or
microbiological outcomes related to the use of inhaled antibiotics other
than aminoglycosides, polymyxins and aztreonam.

A systematic search of PubMed and Scopus databases as well as
bibliographies of eligible articles was performed. In total, 34 eligible
studies were identified.

Among several inhaled ß-lactams, ceftazidime was used with varying success
in the prevention and treatment of ventilator-associated pneumonia (VAP)
and improved clinical outcomes in chronic Pseudomonas aeruginosa lower
respiratory tract infections (LRTIs) in patients with cystic fibrosis (CF)
or bronchiectasis. Inhaled vancomycin, as an adjunctive therapy, was
effective in treating Gram-positive VAP, whilst inhaled levofloxacin,
ciprofloxacin and an inhaled combination of fosfomycin and tobramycin were
associated with improved microbiological or clinical outcomes in chronic
LRTI in patients with CF or bronchiectasis.

In conclusion, published evidence is heterogeneous with regard to
antibiotics used, studied indications, patient populations and study
designs. Therefore, although the currently available data are encouraging,
no safe conclusion regarding the effectiveness and safety of the drugs in
question can be reached.

Copyright © 2014 Elsevier B.V. and the International Society of
Chemotherapy. All rights reserved.

KEYWORDS: Aerosolised antibiotics; Hospital-acquired pneumonia; Nebulised
antibiotics; Nosocomial pneumonia
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Keyboard cleanliness: a controlled study of the residual
effect of chlorhexidine gluconate
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/25728156

Am J Infect Control. 2015 Mar 1;43(3):289-91.
Keyboard cleanliness: a controlled study of the residual effect of
chlorhexidine gluconate.

Jones R1, Hutton A1, Mariyaselvam M1, Hodges E1, Wong K1, Blunt M1, Young
P2.

1Critical Care Department, The Queen Elizabeth Hospital NHS Foundation
Trust, King’s Lynn, Norfolk, England.
2Critical Care Department, The Queen Elizabeth Hospital NHS Foundation
Trust, King’s Lynn, Norfolk, England. Electronic address:
peteryoung101@gmail.com.

A controlled trial of once daily cleaning of computer keyboards in an
intensive care unit was performed comparing 2% chlorhexidine gluconate-70%
isopropyl alcohol (CHG) and a chlorine dioxide-based product used as a
standard in our hospital. A study before and after the introduction of
once daily keyboard cleaning with CHG in the wider hospital was also
completed. Cleaning with CHG showed a sustained and significant reduction
in bacterial colony forming units compared with the chlorine dioxide-based
product, demonstrating its unique advantage of maintaining continuous
keyboard cleanliness over time.

Copyright © 2015 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Chlorhexidine; Cross contamination; Disinfection; Keyboards;
Residual effect
__________________________________________________________________
________________________________*_________________________________

15. No Abstract: Prevalence and factors associated with puncture injuries
among medical students
__________________________________________________________________

https://tinyurl.com/q5jmbgm

Salud Publica Mex. 2014 Jan-Feb;56(1):1-2.
[Prevalence and factors associated with puncture injuries among medical
students].

[Article in Spanish] [Free Full Text]

Soria-Orozco M1, Padrón-Salas A2, Meave Gutiérrez-Mendoza L2, Torres-
Montes A1.

1Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis
Potosí, México.
2Departamento de Salud Pública y Epidemiología Clínica, Facultad de
Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí,
México, aldanely.padron@uaslp.mx.

Free full text https://tinyurl.com/q5jmbgm
__________________________________________________________________
________________________________*_________________________________

16. No Abstract: National Healthcare Safety Network report, data summary
for 2013, Device-associated Module
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/25575913

Am J Infect Control. 2015 Mar 1;43(3):206-21.

National Healthcare Safety Network report, data summary for 2013, Device-
associated Module.

Dudeck MA1, Edwards JR2, Allen-Bridson K2, Gross C2, Malpiedi PJ2,
Peterson KD2, Pollock DA2, Weiner LM2, Sievert DM2.

1Division of Healthcare Quality Promotion, National Center for Emerging,
Zoonotic, and Infectious Diseases, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human
Services, Atlanta, GA. Electronic address: mdudeck@cdc.gov.
2Division of Healthcare Quality Promotion, National Center for Emerging,
Zoonotic, and Infectious Diseases, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human
Services, Atlanta, GA.
__________________________________________________________________
________________________________*_________________________________

17. News

– Injected drug use rise linked to Hep C, HIV infections in Indigenous
Australians, new research says
– MA USA: Fire Department Outlines Policy For Needle Dropoff
– Utah USA: Ogden hospital may have exposed 4,800 patients to hepatitis C
– New Syringe Design Not Particularly Effective at Curbing Spread of
Hepatitis C Virus
– Singapore: Singapore Healthcare System Delayed Reporting Virus Outbreak
– Singapore: SGH Hepatitis C cluster update: 903 patients screened, no
new positives
– Philippines: Pakistani, Pinay wife nabbed for selling fake anti-rabies
vaccines
– Global: Health Care Workers Have Higher HCV Prevalence
– South Africa: Bio-hazardous waste piles up in warehouse of horrors
– USA: Halloween Toy Pens Resembling Syringes A Topic Of Debate

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________

https://tinyurl.com/ooa8qdg
Injected drug use rise linked to Hep C, HIV infections in Indigenous
Australians, new research says

By Eliza Laschon, ABC online, Australia (10.11.15)

New research has linked a rise in Indigenous Australians injecting drugs
and concerning rate of Hepatitis C and HIV.

Australian Health and Medical Research Institute (SAHMRI) associate
professor James Ward has found a higher prevalence of injected drug use in
Aboriginal populations, compared to non-Aboriginal populations.

Professor Ward estimated between 5 and 10 per cent of Aboriginal people
have injected drugs, compared to 2 per cent of non-Aboriginal people.

He said the rate of hepatitis C was three times that of non-Aboriginal
Australians, where it has “plateaued”.

“People may have an ubiquitous view that you are going to get hepatitis C
if you are injecting anyway.

Professor James Ward, Australian Health and Medical Research Institute
The research also showed the number of Aboriginal people accessing needle
syringe programs has jumped from 5 to 14 per cent over the past two
decades.

“That is good news on one side, that a large number of Aboriginal people
are accessing needles through syringe programs,” Professor Ward said.

“But something is going wrong after people collect the equipment.

“They are sharing with bigger groups…they are sharing with extended
family.

“People may have an ubiquitous view that you are going to get Hepatitis C
if you are injecting anyway.

“We have heard that anecdotally around the traps.”

Indigenous Australians reported injecting illicit drugs with extended
family members at five times the rate of non-Indigenous people.

Professor Ward said the most commonly-injected drug was methamphetamine.

He said the community needed innovative, prevention-focused programs to
target young Aboriginal and Torres Strait Islander people.

“We need further investments and continued efforts around primary
prevention,” Professor Ward said.

“While there is a contraction of drug and alcohol services in Australia in
terms of funding and resourcing, we have got an expansion of injecting in
Aboriginal and Torres Strait Islander communities.

“I think we really need to bite the bullet and go for a fairly big
investment, so that people are not turned away when they do want to seek
treatment for drug and alcohol services, as is often the case now.”

Professor Ward will present the findings at a drug and alcohol conference
in Perth today.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/owsv5hg
MA USA: Fire Department Outlines Policy For Needle Dropoff

By Michael J. Rausch, CapeNews.Net, Massachusetts USA (06.11.15)

[Photo] Sharps Disposal Container Dropped Of At Bourne Fire Department
COURTESY BOURNE FIRE RESCUE
[Caption] Sharps Disposal Container Dropped Of At Bourne Fire Department
Firefighters found this trash bag filled with two sharps containers and a
used laundry detergent bottle dropped off at the Main Street station. The
containers and bottle were each loaded with used hypodermic needles.
Department policy requires that the containers be handed to someone on
duty, not dropped off.

Last week, employees with the Bourne Fire Rescue & Emergency Services
arrived at work and found a box mailed to them, ostensibly by the Plymouth
Fire Department. Inside the box was a hard plastic “sharps container,”
filled with used hypodermic needles. A quick call to the fire department
in Plymouth revealed that the box had not been sent by them, Bourne Deputy
Fire Chief Joseph J. Carrara Jr. said. The actual sender remains unknown,
Dep. Carrara said. However, he does have a message for whoever did send
the package.

“Do not mail sharps containers,” he said.

Dep. Carrara said that two weeks ago, staff members found a white trash
bag sitting by the department’s engine room door. The bag held two sharps
containers and a laundry detergent bottle, each filled with used needles.
While the fire station does accept and dispose of used needles, whoever
dropped off the trash bag disregarded the department’s policy to always
use a sharps container for needle disposal, not a laundry bottle.

“It is totally unacceptable to get dirty, used needles in an unapproved
container,” he said.

The department’s policy also requires that any container being dropped off
at the station be handed directly to a staff member on duty and not just
left at the door of the station. If no one is on duty, he said, a return
trip will be necessary.

“It’s unfortunate that is it inconvenient, but they have to come back
until someone is here to accept the container,” Dep. Carrara said. For the
past five to 10 years, the fire department has participated in a needle
drop-off program in partnership with the Cape Cod Cooperative Extension.
Under the program, residents can bring their used hypodermic needles,
stored in an approved container, to the Main Street fire station, and only
the Main Street station.

When a container is dropped off, a replacement holder is given in return,
if one is necessary, Dep. Carrara said. The containers are provided free
of charge by the Cape Cod Cooperative Extension, which eventually picks up
the containers and disposes of the needles in a medically appropriate
manner.

The department’s procedure is designed to prevent either a staff member or
a visitor to the station house from being accidentally stuck by a needle
that may transmit an infectious disease or contain a dangerous drug, Dep.
Carrara said. He said that if people continue to drop off needles at the
station in a manner inconsistent with the department’s procedure, the
program will have to be suspended.

“We don’t want to do that. It’s a nice, non-emergency service available to
the community, but it has to be done safely and responsibly, if done at
all,” he said.

Dep. Carrara added that the service is limited only to residents and is
not for businesses, such as pharmacies. He said that there have been
instances in the past of businesses trying to drop off used needles at the
department. However, businesses have to make their own arrangements to
properly dispose of any collected sharps, he said.

Kalliope E. Egloff is a coordinator for the sharps collection program with
the Cape Cod Cooperative Extension. Ms. Egloff confirmed that the program
offers all the necessary containers and needle disposal free of charge.
Supplies and disposal costs run approximately $18,000 a year, she said.
Ms. Egloff said that the drop-off policies instituted by the Bourne Fire
Department are the department’s. She said that other departments across
the Cape have their own procedures for needle drop-offs that may differ
from Bourne’s. She did concur, however, that despite providing the
approved sharps disposal containers for free, people deposit used needles
in a wide range of items, including lunchboxes, baskets, and liquor and
beer bottles.

“People try to do the right thing but fall short. We’re glad that people
don’t just throw them away on the ground, where people can get jabbed,”
she said.
__________________________________________________________________
__________________________________________________________________

<http://kutv.com/news/local/hepatitis-in-the-mail>
Utah USA: Ogden hospital may have exposed 4,800 patients to hepatitis C

By Heidi Hatch, KUTV.com, Utah USA (04.11.15)

(KUTV) Bad news is arriving in the mail this week for nearly 5,000 people
treated in a Utah emergency room. The patients, most who live in Utah,
some out of state, could have been exposed to a rare strain of hepatitis
C, genotype 2b.

Hepatitis C is a chronic condition and can lay dormant for up to 25 years
and then cause serious liver problems such as liver failure and eventually
death.

The possible window for exposure was from June 2013 to November 2014 at
Ogden’s McKay-Dee hospital.

Hepatitis C is a reportable disease, so when the Utah State Health
Department received a hepatitis case last year, they started researching
its origins, The strain was a rare one, that when tracked, came up with a
match. It led to a nurse who was fired from McKay-Dee hospital.

The health department started looking at the Ogden hospital last year
after they’d ruled out every other possibility in a hepatitis C case they
were tracking. Doctor Angela Dunn with the health department notes that
the most common way of getting hepatitis C in the U.S is “through IV drug
use. And other less common ways are tattoos or piercings from unlicensed
parlors or being born to a mother with Hepatitis C.”

Anyone who received a blood transfusion prior to 1992 can also be at risk.
None of these risk factors were present with the man who tested positive
and that’s what led investigators to ER at McKay-Dee hospital where the
man had been admitted.

The time this patients was in the ER was the same time a nurse who has
since been fired was working. The health department asked the hospital to
test anyone they knew who had risk factors that could present with
hepatitis C. The former nurse was tested and came back positive with the
hepatitis C-2B strain, the same as the initial reported case.

Dunn says they “don’t know exactly how it happened in this case but that
is a concern that needles could be reused and spread infectious diseases.”

Hepatitis C is transferred in blood-to-blood contact. The former nurse was
let go for “divergence” or using what is assumed to be- hospital issued
drugs or syringes without a prescription. It is possible that needles or
syringes were used by the nurse and then re-used for patients though it is
tough to prove how the disease was spread.

The disease is serious and can spread to others even when symptoms are not
present and that’s why it is so important that anyone who was treated in
the time frame with certain medications be tested.

According to Dunn it “does not have symptoms usually at the beginning so
it is very important if you were exposed to get tested.”

Notifications, 4800 of them, were dropped in the mail on Friday. Dunn said
it is “out of an abundance of caution we cast a very broad net.” She and
hospital officials encourage “anyone who received a letter” to “definitely
get tested.”

If a test comes back positive, treatments can be administered before a
patient gets sick. Dunn says “there is really good treatment for hepatitis
C” and calls it a “curable disease.”

Intermountain Healthcare is not talking about the situation but released
the following statement:

Given the highly public nature of this situation we would not want these
individuals to be concerned in any way that their protected health
information could be shared. We are concerned that disclosing anything
about the testing of these individuals could cause a chilling effect on
their willingness to be tested. Our primary objective is to make sure
those who received a letter come in and get tested to make sure that we
have resolved any health concerns related to this incident.

A patient who received a letter from IHC sent us a copy, you can read what
the hospital is telling patients here:

Hepatitis C letter from McKay Dee Hospital:
www.scribd.com/doc/288404979/Hepatitis-C-letter-from-McKay-Dee-Hospital
__________________________________________________________________
__________________________________________________________________

http://publichealth.yale.edu/news/article.aspx?id=11491
New Syringe Design Not Particularly Effective at Curbing Spread of
Hepatitis C Virus

By Denise L Meyer, Yale School of Public Health, USA (04.11.15)

Researchers examined the internal design of syringes to see if variations
affected the transmission of hepatitis C virus.

As many as 21 million people worldwide inject drugs, putting them at
heightened risk for infection from blood-borne pathogens such as the
hepatitis C virus (HCV), especially if syringes are shared.

A newer type of syringe designed to reduce HCV transmission by decreasing
the so-called dead space—the volume that exists between the syringe hub
and needle in comparison to standard and widely used high dead space
designs—is not particularly effective, a new Yale School of Public Health-
led study has found.

The research is published today in the journal PLOS ONE.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0139737

The study’s lead author, Professor Robert Heimer, and colleagues from the
Yale schools of medicine and public health and the Center for
Interdisciplinary Research on AIDS at Yale, concluded that the best of the
low dead space (LDS) syringe-needle combinations still retained HCV
infection, though it reduced the percentage of contaminated syringes to 65
percent compared to 98 percent found for standard high dead space (HDS)
syringes.

None of the LDS syringes yielded percentages of comparable to insulin
syringes with fixed needles. This design had the lowest proportion of
hepatitis C infection; only 47 percent yielded viable HCV.

We would advise that all individuals be informed that they should, first
and foremost, always prepare drugs and inject them with new, sterile
syringes.” ROBERT HEIMER, PHD

“Attempts to reduce HCV transmission through engineering design seemed to
hold great promise to protect people who required syringes with larger
volumes or needles with higher gauges than are found on insulin syringes,”
said Heimer. “Unfortunately, none proved equal to the insulin syringes.”

The study is believed to be the first of its kind to assess the
infectivity of hepatitis C in different syringe designs.

The LDS syringe-needle combinations were created over the past several
years seeking a way to reduce virus transmission. Heimer and his team
wanted to determine their effectiveness compared to other designs and
whether they offer a safer alternative for people who inject drugs. They
have not finished testing the syringes’ effectiveness at reducing other
blood-borne pathogens such as HIV.

Providing comprehensive advice to prevent HCV transmission among people
who inject drugs can include using LDS syringes, but with major caveats,
Heimer said.

“We would advise that all individuals be informed that they should, first
and foremost, always prepare drugs and inject them with new, sterile
syringes,” he said.

Yale has been in the forefront of safer-needle programs to reduce the
transmission of AIDS and other life-threatening viruses for many years.
More than 25 years ago, a needle exchange program was initiated in New
Haven to provide clean syringes to injection drug users to slow the spread
of HIV/AIDS. That effort is still active and has been replicated in cities
around the country.

Other Yale researchers involved in the current study are Mawuena Binka,
Elijah Paintsil, Amisha Patel and Brett Lindenbach.

Tags:HIV/AIDSYSPH NewsFeatured

This article was submitted by Denise L Meyer on November 4, 2015.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/orvjtz5
Singapore: Singapore Healthcare System Delayed Reporting Virus Outbreak

By Y.K. Hu Economics/Business, The Asia Sentinel (10.11.15)

Officials hold off reporting Hepatitis C Cluster for months

For reasons that are unclear, Singapore’s leading public hospital – the
one that Patriarch Lee Kuan Yew died in – delayed for months telling the
public that an outbreak of hepatitis C had infected 23 kidney patients
while receiving treatment, and that five had died.

The episode marks a blip in the history of the nation’s healthcare system,
not helped by the delay in informing the public of the outbreak. The first
press conference on the issue was on Oct 6 when the hospital said in a
statement that 22 patients with renal diseases were hospitalized from mid-
April April to June 2015 were diagnosed with hepatitis C virus infection
and four of the 22 had died.

The announcement sent tremors through Singapore’s health care system,
often described as the best in the region. The flagship of the system,
Singapore General Hospital, is also the oldest and largest on the island.
The country has long prided itself on having an efficient and quality
health care system. The World Health Organization listed Singapore as
sixth in the world in overall healthcare in 2000.

It is a major destination for health tourists, especially the wealthy from
Indonesia and Malaysia who don’t trust their own health care systems.

For instance, Nina Gundowan (not her real name), an Indonesian who
sometimes travels to Singapore for medical treatment said, “The hospital
even filed a police report, compared to other countries, hospitals in
other countries won’t even admit” to a lapse in care.

Last year, Bloomberg picked Singapore as the “most efficient healthcare
system” in the world. It is also a notable medical tourism hub in the
region, with the tourism board of Singapore billing the country as a
“leading destination for advanced medical care” in Asia. Thus, publicity
over a major outbreak of a communicable disease in the island republic’s
most prominent public hospital was problematic to say the least.

The outbreak was first identified when abnormal clustering of seven cases
in four weeks was discovered in the same period. The hepatitis C virus is
largely transmitted by blood, acquired mainly through intravenous use,
sharing of syringe needles or exchange of bodily fluids.

The four patients who died had other serious conditions, but the hospital
was not able to rule out hepatitis C as a contributing factor for their
deaths. The cause of one other death was pending review has since been
concluded on Oct 19 that hepatitis C infection could have been a
contributing factor, bringing the total number of deaths to five.

Following additional screening of patients who had been at the two renal
wards during the period when the outbreak occurred, one of the 598
patients screened tested positive for the hepatitis C virus, bringing the
total number to 23, with 66 results pending as of Oct 21.

Social media began raising questions over the delays in informing the
public. The hospital first notified the health ministry of an “usually
large cluster” of Hepatitis C patients in late August, more than two
months after the 18th case was detected in June 26. The Health Minister
Gan Kim Yong was first notified on Sept 18, according to the health
ministry. The public was only informed almost five months after the first
indication of the abnormal cluster.

The delay in notifying the public has also drawn the comments from members
of opposition parties in Singapore. The Workers’ Party, Singapore’s main
opposition party, called on the government to set up a committee of
inquiry to investigate the delays from the hospital to the health ministry
and from the ministry to the Health Minister. The Singapore Democratic
Party, led by Chee Soon Juan, also called questioned whether there were
any “political consideration” in the delay in informing the public, as the
time lapse coincided with the Sept 11 general elections in Singapore.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/qxpd2f8
Singapore: SGH Hepatitis C cluster update: 903 patients screened, no new
positives

By Janice Heng, The Straits Times, Singapore (09.11.15)

SINGAPORE – As of 1pm on Monday (Nov 9), the Singapore General Hospital
(SGH) has screened a total 903 patients for hepatitis C, said the hospital
in an update on Monday evening.

This is up from 874 patients screened as of 1pm on Friday. The patients
had stayed in Wards 64A and 67, which were affected by the hepatitis C
outbreak, at some point from January and September this year.

Of the 903 patients screened so far, 854 were tested negative. Three
tested positive, as announced earlier. There are 46 test results pending,
said the SGH.

A total of 315 staff have been screened and all the results were negative.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/pr3p8lc
Philippines: Pakistani, Pinay wife nabbed for selling fake anti-rabies
vaccines

By Thom Andrade & Jaime Sinapit, InterAksyon.com, Philippines (04.11.15)

MANILA, Philippines — A Pakistani and his Filipino wife were arrested by
the police’s Criminal Investigation and Detection Group for allegedly
selling fake anti-rabies vaccines.

Kabir Ahmed Hajano and his wife, Shirley, were “caught in the act of
selling or distributing counterfeit and unregistered VERORAB vaccines”
during an entrapment operation in a mall in Paranaque City Monday
afternoon, Superintendent Bowenn Joey Masauding, chief of the CIDG’s Anti-
Fraud and Commercial Crimes Division, said.

The sting was mounted after lawyers of Sanofi Pastuer Inc. filed a
complaint over the unauthorized distribution of the vaccines.

Seized from the couple were 200 boxes of the vaccine with an estimated
market value of P320,000.

The suspects will be facing charges for violating the Intellectual
Property Code of the Philippines and the Food and Drug Administration Act.
__________________________________________________________________
__________________________________________________________________

http://www.medscape.com/viewarticle/853535?nlid=91246_1842
Global: Health Care Workers Have Higher HCV Prevalence

By Lisa Rapaport, Reuters Health Information (02.11.15)

NEW YORK (Reuters Health) – The prevalence of hepatitis c infection is
higher than average among health care workers, a research review suggests.

Compared to the general population, health workers had 60% greater odds of
having hepatitis C, and those who worked directly with blood had almost
triple the risk, in an analysis reported online October 5 in Occupational
and Environmental Medicine.

“Contact with blood . . . continues to be the major threat to the health
of health care workers,” lead author Claudia Westermann of the University
Medical Center Hamburg-Eppendorf in Germany told Reuters Health by email.

“Exposure to blood cannot completely be avoided when using `safe’
instruments, as they reduce the risk of needle-stick injuries but do not
completely prevent them,” Westermann added. “Therefore blood-borne virus
infections will remain a threat to health care workers for some time to
come.”

To assess the prevalence of HCV among health care workers, Westermann and
colleagues analyzed data from 44 published studies.

In the U.S. and Europe, where HCV prevalence is relatively low, health
care workers are more than twice as likely as other individuals to be
infected, the data showed.

The risk for health workers was also doubled in North Africa, the Middle
East, and South Asia, although infection rates in Japan were similar to
the rest of the population.

Male health workers had triple the odds of HCV infection, compared with a
50% greater risk for female workers.

Medical staff had 2.2 times the odds of HCV, while odds were 3.5 times
greater for dentists and increased by just 70% for nurses.

Professionals who came in regular contact with blood had 2.7 times the
risk of infections.

Limitations of the analysis include a lack of data on personal risk
factors such as use of injected drugs or engagement in sexual practices
such as anal intercourse, the authors acknowledge.

It is unlikely, however, that health workers have unprotected sex or use
injected drugs more often than the general population, Dr. William Buchta,
medical director of the occupational medicine practice at the Mayo Clinic
in Rochester, Minnesota, told Reuters Health by email.

“Inadvertent exposure to patients’ blood and other infectious fluids is
common among health care workers and grossly under-reported, so exposure
to infected patients is a far more credible cause for this disparity,”
said Dr. Buchta, who wasn’t involved in the study.

Virus transmission can be reduced in health care settings when proper
infection control practices are followed, including the use of personal
protective equipment, proper cleansing of infected tools, use of blunt
needles for certain surgical procedures, and many other practical and
relatively cheap and effective measures, Dr. Buchta added.

“We simply need to get the message out to health care workers that they
are at risk but can almost eliminate that risk without compromising the
care they deliver,” Dr. Buchta said.

The authors reported no funding or disclosures.

SOURCE: http://bit.ly/1Ml4OVx

Occup Environ Med 2015.
__________________________________________________________________
__________________________________________________________________

www.enca.com/south-africa/bio-hazardous-waste-piles-warehouse-horrors
South Africa: Bio-hazardous waste piles up in warehouse of horrors

eNCA, South Africa (30.10.15)

BLOEMFONTEIN, 30 October 2015 – A cesspool of dangerous and toxic medical
waste is discovered in a Bloemfontein warehouse, and a national medical
waste removal company could soon be facing criminal charges. Video: eNCA

A national medical waste removal company could soon be facing criminal
charges.

eNCA can reveal that a warehouse used by Solid Waste Technologies in
Bloemfontein, is filled with material thrown away by hospitals and labs –
some of it anatomical.

This is not the first time the company has found itself on the wrong side
of the law this year.

Inside the warehouse, which is easy to access, one finds bio-hazardous
waste packed to the rafters.

Soiled adult diapers, expired medication, used syringes and intravenous
tubes, some still filled with fluid, buckets brimming with waste,
including human tissue are just some of the items stored here — all
clearly in an advanced state of decomposition, judging by the stench and
the flies buzzing around.

The markings on the containers and boxes found inside, indicate they’ve
been brought in from hospitals across the province.

Solid Waste Technologies’ owner, Edgar Adams insists the facility is a
registered transfer station. He says waste stored here is transferred and
disposed of, on a daily basis.

The dates on containers tell a different story.

“It is completely unlawful. They are not supposed to be storing anatomical
waste or even pathological waste in that facility,” said Grant Walters of
the Department of Environmental Affairs.

“In terms of anatomical waste – it is incinerated all the time. There is
no other treatment potential,” he added.

In April this year, a court sentenced Solid Waste Technologies to a fine
of R200,000 after Inspectors at their Johannesburg City Deep facility
found tonnes of stockpiled medical waste.

*Watch the full report by Earl Coetzee in the gallery above.
__________________________________________________________________
__________________________________________________________________

http://www.alternet.org/drugs/halloween-toy-pens-syringes-topic-debate
USA: Halloween Toy Pens Resembling Syringes A Topic Of Debate

Do the play needles promote drug addiction?

By Vishakha Sonawane, International Business Times via Alternet (15.10.15)

Halloween toy pens resembling syringes have become a topic of debate among
Americans. Parents and drug abuse prevention advocates have voiced concern
over the pens amid a rising heroin and opioid addiction problem in the
country, the Associated Press (AP) reported Thursday.

The pens, which are widely available online and in Target stores for the
much-awaited holiday, come with a bright liquid filled in a transparent
plastic tube marked with measuring lines usually found on syringes.

“I think it’s an incredibly bad idea,” Celeste Clark, director of Raymond
Coalition for Youth, a New Hampshire organization that works toward
reducing substance abuse, according to AP. “Given today’s epidemic that
our state is in, it just seems like a no-brainer that something like that
shouldn’t be on the shelves.”

According to Clark, the pens could confuse children who are unaware of the
differences between a toy and a real needle. “It’s exposing kids to
hypodermic needles when we really should be raising awareness to their
danger, especially now when they’re finding them in parks, on walking
trails, on biking trails,” Clark said.

However, Nikki Shipley, a mother of two children, 7 and 12, said that the
concern over the pens is hyped. Shipley told AP that it was the
responsibility of parents to make sure that children did not use such
toys.

“Through time, society has found more ways to blame others for things,”
Shipley said, according to the AP. “A needle pen is not the cause of a
heroin epidemic, nor does it promote it.”

A spokeswoman for Minneapolis-based Target said that the company had heard
complaints from consumers but will leave the product on the shelves.

“We have not made any changes to our store Halloween assortment related to
this product,” Molly Snyder said. “At Target, our intent is never to
offend any of our guests, and we appreciate their feedback. We have shared
this feedback with the merchants for them to consider as they plan for
future merchandise assortment.”

North Hampton teacher Susan Haight was the first to talk about the
problems associated with the toy pens. “Syringes are being found on
beaches, playgrounds, parks, and parking lots across New Hampshire,”
Haight told AP in an email. “We do not need young children confusing real
syringes with the toys they got from Target.”
__________________________________________________________________
________________________________*_________________________________

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.

pdf, 554kb [6 pages]

www.who.int/injection_safety/global-campaign/injection-safety_brochure.pdf
__________________________________________________________________
________________________________*_________________________________

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
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* 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

Like on Facebook: http://facebook.com/SIGN.Moderator

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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All members of the SIGN Forum are invited to submit messages, comment on
any posting, or to use the forum to request technical information in
relation to injection safety.

The comments made in this forum are the sole responsibility of the writers
and does not in any way mean that they are endorsed by any of the
organizations and agencies to which the authors may belong.

Use of trade names and commercial sources is for identification only and
does not imply endorsement.

The SIGN Forum welcomes new subscribers who are involved in injection
safety.

* Subscribe or un-subscribe by email to: sign.moderator@gmail.com, or to
sign@who.int

The SIGNpost Website is http://SIGNpostOnline.info

The SIGNpost website provides an archive of all SIGNposts, meeting
reports, field reports, documents, images such as photographs, posters,
signs and symbols, and video.

We would like your help in building this archive. Please send your old
reports, studies, articles, photographs, tools, and resources for posting.

Email mailto:sign.moderator@gmail.com
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The SIGN Internet Forum was established at the initiative of the World
Health Organization’s Department of Essential Health Technologies.

The SIGN Secretariat home is the Service Delivery and Safety (SDS)
Health Systems and Innovation (HIS) at WHO HQ, Geneva Switzerland.

The SIGN Forum is moderated by Allan Bass and is hosted on the University
of Queensland computer network. http://www.uq.edu.au
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