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SIGNpost 00849

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00849   Notes + Abstracts + News   20 April 2016

CONTENTS
1. Abstract: Notes from the Field: Injection Safety and Vaccine
Administration Errors at an Employee Influenza Vaccination Clinic–New
Jersey, 2015
2. Abstract: The impact of an automatic syringe dispensing machine in
inner-city Sydney, Australia: No evidence of a ‘honey-pot’ effect
3. Abstract: Prevention knowledge, risk behaviours and seroprevalence
among nonurban injectors of southwest Connecticut
4. Abstract: Emerging Risks Due to New Injecting Patterns in Hungary
During Austerity Times
5. Abstract: Oxytocin for preventing postpartum haemorrhage (PPH) in non-
facility birth settings
6. Abstract: Use of injectable hormonal contraception and women’s risk of
herpes simplex virus type 2 acquisition: a prospective study of couples
in Rakai, Uganda
7. Abstract: Prevalence and factors associated with occupational burnout
among HIV/AIDS healthcare workers in China: a cross-sectional study
8. Abstract: APIC professional and practice standards
9. Abstract: A sustained release formulation of novel quininib-hyaluronan
microneedles inhibits angiogenesis and retinal vascular permeability in
vivo
10. Abstract: Ethanol and ethyl glucuronide urine concentrations after
ethanol-based hand antisepsis with and without permitted alcohol
consumption
11. Abstract: Zika Virus and Birth Defects – Reviewing the Evidence for
Causality
12. Abstract: Knowledge and occupational hazards of barbers in the
transmission of hepatitis B and C was low in Kumasi, Ghana
13. News
– Australia: Hunter mum and son receive needlestick injuries in McDonald’s
– China: China’s Vaccine Scandal Threatens Public Faith in Immunizations
– USA: NJ hospital exposed workers to needle-sticks, bloodborne pathogens,
feds say
– Australia: Hepatitis B-infected worker little danger to patients –
Victorian health chief
– Cameroon: Cameroon alarmed by fake yellow fever vaccine
– USA: Sandwich Fire Dept. Tests Needle, Medical Waste Disposal Machine

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__________________________________________________________________
________________________________*_________________________________

1. Abstract: Notes from the Field: Injection Safety and Vaccine
Administration Errors at an Employee Influenza Vaccination Clinic–New
Jersey, 2015
__________________________________________________________________

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6449a3.htm Free Full Text

MMWR Morb Mortal Wkly Rep. 2015 Dec 18;64(49):1363-4.
Notes from the Field: Injection Safety and Vaccine Administration Errors
at an Employee Influenza Vaccination Clinic–New Jersey, 2015.

Taylor L, Greeley R, Dinitz-Sklar J, Mazur N, Swanson J, Wolicki J, Perz
J, Tan C, Montana B.

On September 30, 2015, the New Jersey Department of Health (NJDOH) was
notified by an out-of-state health services company that an experienced
nurse had reused syringes for multiple persons earlier that day.

This occurred at an employee influenza vaccination clinic on the premises
of a New Jersey business that had contracted with the health services
company to provide influenza vaccinations to its employees. The employees
were to receive vaccine from manufacturer-prefilled, single-dose syringes.
However, the nurse contracted by the health services company brought three
multiple-dose vials of vaccine that were intended for another event. The
nurse reported using two syringes she found among her supplies to
administer vaccine to 67 employees of the New Jersey business. She
reported wiping the syringes with alcohol and using a new needle for each
of the 67 persons.

One of the vaccine recipients witnessed and questioned the syringe reuse,
and brought it to the attention of managers at the business who, in turn,
reported the practice to the health services company contracted to provide
the influenza vaccinations.

Free full text http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6449a3.htm
__________________________________________________________________
________________________________*_________________________________

2. Abstract: The impact of an automatic syringe dispensing machine in
inner-city Sydney, Australia: No evidence of a ‘honey-pot’ effect
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27073122

Drug Alcohol Rev. 2016 Apr 13.
The impact of an automatic syringe dispensing machine in inner-city
Sydney, Australia: No evidence of a ‘honey-pot’ effect.

Day CA1, White B1, Haber PS1,2.

1Discipline of Addiction Medicine, Central Clinical School, Sydney Medical
School, The University of Sydney, Sydney, Australia.
2Drug Health Services, Sydney Local Health District, Sydney, Australia.

INTRODUCTION AND AIMS: Needle and syringe automatic dispensing machines
(ADM) aim to increase needle/syringe distribution to people who inject
drugs. ADM implementation has been met with community concern about
potential perceived increases in crime and drug use and that they will
attract non-resident drug users-the ‘honey-pot effect’. In April 2013, an
ADM commenced operation in inner-city Sydney. We assessed the impact of
the ADM on crime and examined its use by non-resident drug users (the
honey-pot effect).

DESIGN AND METHODS: Fixed-site needle and syringe program (n?=?207) and
ADM clients (n?=?55) were surveyed to determine whether they lived within
1?km of the ADM. Police-recorded offences between January 2012 and March
2014 across six crime categories for the local and surrounding areas were
assessed for trend to measure impact on crime.

RESULTS: The majority (78%) of needle and syringe program clients reported
residing within 1?km of the service. Most (95%) ADM users were fixed-site
service clients. The 2?year trend for crime categories remained stable or
decreased, except for fraud, which increased significantly (P?<?0.05).

DISCUSSION AND CONCLUSION: Automatic dispensing machine users were largely
clients of the existing fixed-site service and lived locally. There was no
apparent concurrent increase in crime or a honey-pot effect. It is
important that services continue to be aware of community concerns and
respond to them appropriately.[Day CA, White B, Haber PS. The impact of an
automatic syringe dispensing machine in inner-city Sydney, Australia: No
evidence of a ‘honey-pot’ effect. Drug Alcohol Rev 2016;00:000-000].

© 2016 Australasian Professional Society on Alcohol and other Drugs.

KEYWORDS: automatic dispensing machine; crime; harm reduction; needle and
syringe program
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Prevention knowledge, risk behaviours and seroprevalence
among nonurban injectors of southwest Connecticut
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27073014

Drug Alcohol Rev. 2016 Apr 13.
Prevention knowledge, risk behaviours and seroprevalence among nonurban
injectors of southwest Connecticut.

Grau LE1, Zhan W1,2, Heimer R1.

1Department of Epidemiology of Microbial Diseases, Yale School of Public
Health, New Haven, USA.
2Department of Children and Families, Hartford, USA.

INTRODUCTION AND AIMS: Little is known about injection-associated risk
behaviours, knowledge and seroprevalence of viral infections among people
who inject drugs (PWID) in nonurban locales in the US. Harm reduction
services are more available in urban locales. The present study examined a
cohort of active PWID residing in non urban areas of Connecticut to
investigate how primarily injecting in urban or non urban areas was
associated with injection-associated risk behaviours, knowledge and
prevalence of blood-borne viruses.

DESIGN AND METHODS: We described the sample and performed bivariate and
multivariable analyses on injection-associated risk behaviours,
HIV/hepatitis/overdose knowledge and baseline serological data to identify
differences between individuals who injected primarily in nonurban locales
and those who did not.

RESULTS: Harm reduction knowledge and use of harm reduction services were
poor in both groups. Those injecting most often in urban settings were
1.88 (1.19, 2.98 95% confidence interval) times more likely to engage in
at least one injection-associated risk behaviour than their nonurban
counterpart. Seroprevalence rates (23.6% for hepatitis B virus, 39.2% for
hepatitis C virus, and 1.1% for HIV) were no different between the two
groups.

DISCUSSION AND CONCLUSIONS: The data provided little evidence that the
benefits of urban harm reduction programs, such as syringe exchange, risk
reduction interventions and education programs have penetrated into this
nonurban population, even among those who injected in urban locales where
such programs exist. Harm reduction interventions for nonurban communities
of PWID are needed to reduce HIV and hepatitis B and C transmission. [Grau
LB, Zhan W, Heimer R. Prevention knowledge, risk behaviours and
seroprevalence among nonurban injectors of southwest Connecticut. Drug
Alcohol Rev 2016;00:000-000].

© 2016 Australasian Professional Society on Alcohol and other Drugs.

KEYWORDS: HIV/AIDS; hepatitis; injection drug use; prevalence; risk
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Emerging Risks Due to New Injecting Patterns in Hungary
During Austerity Times
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25775136

Subst Use Misuse. 2015;50(7):848-58.

Emerging Risks Due to New Injecting Patterns in Hungary During Austerity
Times.

Tarján A1, Dudás M, Gyarmathy VA, Rusvai E, Tresó B, Csohán Á.

1Hungarian Reitox National Focal Point, National Centre for Epidemiology,
Budapest, Hungary.

As a consequence of the massive restructuring of drug availability, heroin
injection in Hungary was largely replaced by the injecting of new
psychoactive substances (NPS) starting in 2010.

In the following years in our sero-prevalence studies we documented higher
levels of injecting paraphernalia sharing, daily injection-times, syringe
reuse, and HCV prevalence among stimulant injectors, especially among NPS
injectors.

Despite the increasing demand, in 2012 the number of syringes distributed
dropped by 35% due to austerity measures.

Effects of drug market changes and the economic recession may have future
epidemiological consequences. Study limitations are noted and future
needed research is suggested.

KEYWORDS: Injecting drugs use; economic recession; harm reduction;
hepatitis C; heroin shortage; new psychoactive substances; risk behaviors;
synthetic cathinones; syringe sharing; syringe-exchange program
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Oxytocin for preventing postpartum haemorrhage (PPH) in non-
facility birth settings
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27078125

Cochrane Database Syst Rev. 2016 Apr 14;4:CD011491.
Oxytocin for preventing postpartum haemorrhage (PPH) in non-facility birth
settings.

Pantoja T1, Abalos E, Chapman E, Vera C, Serrano VP.

1Department of Family Medicine, Faculty of Medicine, Pontificia
Universidad Católica de Chile, Centro Medico San Joaquin, Vicuña Mackenna
4686, Macul, Santiago, Chile.

BACKGROUND: Postpartum haemorrhage (PPH) is the single leading cause of
maternal mortality worldwide. Most of the deaths associated with PPH occur
in resource-poor settings where effective methods of prevention and
treatment – such as oxytocin – are not accessible because many births
still occur at home, or in community settings, far from a health facility.
Likewise, most of the evidence supporting oxytocin effectiveness comes
from hospital settings in high-income countries, mainly because of the
need of well-organised care for its administration and monitoring.

Easier methods for oxytocin administration have been developed for use in
resource-poor settings, but as far as we know, its effectiveness has not
been assessed in a systematic review.

OBJECTIVES: To assess the effectiveness and safety of oxytocin provided in
non-facility birth settings by any way in the third stage of labour to
prevent PPH.

SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group’s
Trials Register, the WHO International Clinical Trials Registry Platform
(ICTRP), ClinicalTrials.gov (12 November 2015), and reference lists of
retrieved reports.

SELECTION CRITERIA: All published, unpublished or ongoing randomised or
quasi-randomised controlled trials comparing the administration of
oxytocin with no intervention, or usual/standard care for the management
of the third stage of labour in non-facility birth settings were
considered for inclusion.Quasi-randomised controlled trials and randomised
controlled trials published in abstract form only were eligible for
inclusion but none were identified. Cross-over trials were not eligible
for inclusion in this review.

DATA COLLECTION AND ANALYSIS: Two review authors independently assessed
studies for eligibility, assessed risk of bias and extracted the data
using an agreed data extraction form. Data were checked for accuracy.

MAIN RESULTS: We included one cluster-randomised trial conducted in four
rural districts in Ghana that randomised 28 community health officers
(CHOs) (serving 2404 potentially eligible pregnant women) to the
intervention group and 26 CHOs (serving 3515 potentially eligible pregnant
women) to the control group. Overall, the trial had a high risk of bias.
CHOs delivered the intervention in the experimental group (injection of 10
IU (international units) of oxytocin in the thigh one minute following
birth using a prefilled, auto-disposable syringe). In the control group,
CHOs did not provide this prophylactic injection to the women they
observed. CHOs had no midwifery skills and did not in any way manage the
birth. All other CHO activities (outcome measurement, data collection, and
early treatment and referral when necessary) were identical across the
control and oxytocin CHOs. Although only one of the nine cases of severe
PPH (blood loss greater or equal to 1000 mL) occurred in the oxytocin
group, the effect estimate for this outcome was very imprecise and it is
uncertain whether the intervention prevents severe PPH (risk ratio (RR)
0.16, 95% confidence interval (CI) 0.02 to 1.30; 1570 women (very low-
quality evidence)). Similarly, because of the lack of cases of severe
maternal morbidity (e.g. uterine rupture) and maternal deaths, it was not
possible to obtain effect estimates for those outcomes (both very low-
quality evidence).Oxytocin compared with the control group decreased the
incidence of PPH (> 500 mL) in both our unadjusted (RR 0.48, 95% CI 0.28
to 0.81; 1569 women) and adjusted (RR 0.49, 95% CI 0.27 to 0.90; 1174
women (both low-quality evidence)) analyses.

There was little or no difference between the oxytocin and control groups
on the rates of transfer or referral of the mother to a healthcare
facility (RR 0.72, 95% CI 0.34 to 1.56; 1586 women (low-quality
evidence)), stillbirths (RR 1.27, 95% CI 0.67 to 2.40; 2006 infants (low-
quality evidence)); and early infant deaths (0 to three days) (RR 1.03,
95% CI 0.35 to 3.07; 1969 infants (low-quality evidence)).

* There were no cases of needle-stick injury or any other maternal major
or minor adverse event or unanticipated harmful event.

There were no cases of oxytocin use during labour.There were no data
reported for some of this review’s secondary outcomes: manual removal of
placenta, maternal anaemia, neonatal death within 28 days, neonatal
transfer to health facility for advanced care, breastfeeding rates.
Similarly, the women’s or the provider’s satisfaction with the
intervention was not reported.

AUTHORS’ CONCLUSIONS: It is uncertain if oxytocin administered by CHO in
non-facility settings compared with a control group reduces the incidence
of severe PPH (>1000 mL), severe maternal morbidity or maternal deaths.
However, the intervention probably decreases the incidence of PPH (> 500
mL).The quality of the one trial included in this review was limited
because of the risk of attrition and recruitment biases related to
limitations in the follow-up of pregnant women in both arms of the trials
and some baseline imbalance on the size of babies at birth.

Additionally, there was serious imprecision of the effect estimates for
most of the primary outcomes mainly because of the size of the trial, very
few or no events and CIs around both relative and absolute estimates of
effect that include both appreciable benefit and appreciable harm.
Although the trial presented data both for primary and secondary outcomes,
it seemed to be underpowered to detect differences in the primary outcomes
that are the ones more relevant for making judgments about the potential
applicability of the intervention in other settings (especially severe
PPH).

Therefore, taking into account the extreme setting where the intervention
was implemented, the limited role of the CHO in the trial and the lack of
power for detecting effects on primary (relevant) outcomes, the
applicability of the evidence found seems to be rather limited.

Further well-executed and adequately-powered randomised controlled trials
assessing the effects of using oxytocin in pre-filled injection devices or
other new delivery systems (spray-dried ultrafine formulation of oxytocin)
on severe PPH are urgently needed. Likewise, other important outcomes like
possible adverse events and acceptability of the intervention by mothers
and other community stakeholders should also be assessed.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Use of injectable hormonal contraception and women’s risk of
herpes simplex virus type 2 acquisition: a prospective study of couples
in Rakai, Uganda
__________________________________________________________________

http://dx.doi.org/10.1016/S2214-109X(15)00086-8 Open Access

Lancet Glob Health. 2015 Aug;3(8):e478-86.
Use of injectable hormonal contraception and women’s risk of herpes
simplex virus type 2 acquisition: a prospective study of couples in Rakai,
Uganda.

Grabowski MK1, Gray RH2, Makumbi F3, Kagaayi J3, Redd AD4, Kigozi G3,
Reynolds SJ5, Nalugoda F3, Lutalo T3, Wawer MJ2, Serwadda D6, Quinn TC7,
Tobian AA8.

1Department of Epidemiology, Bloomberg School of Public Health, Johns
Hopkins University, Baltimore, MD, USA.
2Department of Epidemiology, Bloomberg School of Public Health, Johns
Hopkins University, Baltimore, MD, USA; Rakai Health Sciences Program,
Entebbe, Uganda.
3Rakai Health Sciences Program, Entebbe, Uganda.
4Division of Intramural Research, National Institute of Allergy and
Infectious Diseases, US National Institutes of Health, Bethesda, MD, USA.
5Department of Medicine, School of Medicine, Johns Hopkins University,
Baltimore, MD, USA; Rakai Health Sciences Program, Entebbe, Uganda;
Division of Intramural Research, National Institute of Allergy and
Infectious Diseases, US National Institutes of Health, Bethesda, MD, USA.
6Rakai Health Sciences Program, Entebbe, Uganda; School of Public Health,
Makerere University, Kampala, Uganda.
7Department of Medicine, School of Medicine, Johns Hopkins University,
Baltimore, MD, USA; Division of Intramural Research, National Institute of
Allergy and Infectious Diseases, US National Institutes of Health,
Bethesda, MD, USA.
8Department of Pathology, School of Medicine, Johns Hopkins University,
Baltimore, MD, USA; Rakai Health Sciences Program, Entebbe, Uganda.
Electronic address: atobian1@jhmi.edu.

BACKGROUND: The injectable hormonal contraceptive depo-medroxyprogesterone
acetate (DMPA) has been associated with increased risk of HIV acquisition,
but findings are inconsistent. Whether DMPA increases the risk of other
sexually transmitted viral infections is unknown. We assessed the
association between DMPA use and incident herpes simplex virus type 2
(HSV2) infection in women.

METHODS: In this prospective study, we enrolled HIV-negative and HSV2-
negative women aged 15-49 years whose HIV-negative male partners were
concurrently enrolled in a randomised trial of male circumcision in Rakai,
Uganda. We excluded women if either they or their male partners HIV
seroconverted. The primary outcome was HSV2 seroconversion, assessed
annually. The male circumcision trial was registered with
ClinicalTrials.gov, number NCT00425984.

FINDINGS: Between Aug 11, 2003, and July 6, 2006, we enrolled 682 women in
this study. We noted HSV2 seroconversions in 70 (10%) women. Incidence was
13·5 per 100 person-years in women consistently using DMPA (nine incident
infections per 66·5 person-years), 4·3 per 100 person-years in pregnant
women who were not using hormonal contraception (18 incident infections
per 423·5 person-years), and 6·6 per 100 person-years in women who were
neither pregnant nor using hormonal contraception (35 incident infections
per 529·5 person-years). Women consistently using DMPA had an adjusted
hazard ratio for HSV2 seroconversion of 2·26 (95% CI 1·09-4·69; p=0·029)
compared with women who were neither pregnant nor using hormonal
contraception. Of 132 women with HSV2-seropositive partners,
seroconversion was 36·4 per 100 person-years in consistent DMPA users
(four incident infections per 11 person-years) and 10·7 per 100 person-
years in women who were neither pregnant nor using hormonal contraception
(11 incident infections per 103 person-years; adjusted hazard ratio 6·23,
95% CI 1·49-26·3; p=0·012).

INTERPRETATION: Consistent DMPA use might increase risk of HSV2
seroconversion; however, study power was low. These findings should be
assessed in larger populations with more frequent follow-up than in this
study, and other contraceptive methods should also be assessed. Access to
a wide range of highly effective contraceptive methods is needed for
women, particularly in sub-Saharan Africa.

FUNDING: Bill and Melinda Gates Foundation, Doris Duke Charitable
Foundation, US National Institutes of Health, and Fogarty International
Center.

Copyright © 2015 Grabowski et al. Open access article published under the
terms of CC BY-NC-ND. Published by Elsevier Ltd.. All rights reserved.

Comment in Contraception and sexually transmitted infections: risks and
benefits, hypotheses and evidence. [Lancet Glob Health. 2015]
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Prevalence and factors associated with occupational burnout
among HIV/AIDS healthcare workers in China: a cross-sectional study
__________________________________________________________________

Free PMC Article
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832489/

BMC Public Health. 2016 Apr 14;16(1):335.
Prevalence and factors associated with occupational burnout among HIV/AIDS
healthcare workers in China: a cross-sectional study.

Qiao Z1, Chen L2, Chen M1, Guan X3, Wang L1, Jiao Y4, Yang J1, Tang Q5,
Yang X1, Qiu X1, Han D1, Ma J1, Yang Y6, Zhai X7.

1Department of Medical Psychology, Public Health Institute of Harbin
Medical University, Harbin, China.
2Department of Endocrinology, Peking Union Medical College Hospital,
Beijing, China.
3Department of infection control, the First Affiliated Hospital of Harbin
Medical University, Harbin, China.
4Department of Immunization Programs, Heilongjiang Province Center for
Disease Control and Prevention, Harbin, China.
5Guangxi University of Chinese Medicine, Nanning, China.
6Department of Medical Psychology, Public Health Institute of Harbin
Medical University, Harbin, China. yanjie1965@163.com.
7Daqing LongNan Hospital, Daqing, China. scorpion1121CMQ@163.com.

BACKGROUND: Burnout is a psychosomatic syndrome characterized by three
dimensions (emotional exhaustion [EE], feelings of depersonalization [DP],
and reduced personal accomplishment [PA]). We determined the prevalence of
burnout and mental health status between HIV/AIDS healthcare workers and
other healthcare workers, and determined the factors associated with
burnout of HIV/AIDS healthcare workers.

METHODS: All participants were asked to complete a self-administered
questionnaire. The participants were recruited from the departments of
infectious diseases in four hospitals which treated HIV/AIDS. The
questionnaire included demographics, the Maslach Burnout Inventory-General
Survey (MBI-GS), the Symptom Checklist 90 (SCL-90), the Eysenck
Personality Questionnaire (EPQ), and the Trait Coping Style Questionnaire
(TCSQ).

RESULTS: A total of 512 questionnaires were distributed; 501
questionnaires were completed and collected (the response rate was 97.9
%). After eliminating nine invalid questionnaires (1.80 %), 264 physicians
and nurses caring for HIV/AIDS and 228 physicians and nurses caring for
other infectious diseases provided valid responses (98.2 %). The HIV/AIDS
healthcare workers’ scores on the emotional exhaustion (F?=?6.350,
p?=?0.012) and depersonalization dimensions (F?=?8.533, p?=?0.004) were
significantly higher than other healthcare workers. The HIV/AIDS
healthcare workers had higher total scores and positive items on the
Symptom Checklist 90 (SCL-90) compared with other healthcare workers. Low
job satisfaction, serious somatization, interpersonal sensitivity, poor
quality of sleep, high psychoticism scores, and use of negative coping
styles were frequently associated with burnout.

CONCLUSIONS: Burnout was shown to be highly prevalent in HIV/AIDS
healthcare workers, 76.9 % of whom met the accepted criteria for burnout.
In addition, compared with other healthcare workers, HIV/AIDS healthcare
workers experienced lower levels of psychological health. Interventions
should be targeted at reducing the occurrence of burnout and alleviating
psychological pressure amongst HIV/AIDS healthcare workers.

KEYWORDS: Burnout; China; HIV/AIDS healthcare workers; Psychology

Free PMC Article
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832489/
__________________________________________________________________
________________________________*_________________________________

8. Abstract: APIC professional and practice standards
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27079245

Am J Infect Control. 2016 Apr 11. pii: S0196-6553(16)00155-3.
APIC professional and practice standards.

Bubb TN1, Billings C2, Berriel-Cass D3, Bridges W4, Caffery L5, Cox J6,
Rodriguez M7, Swanson J8, Titus-Hinson M9.

1Infection Prevention and Control, Westchester Medical Center, Valhalla,
NY. Electronic address: tania.bubb@wmchealth.org.
2Infection Prevention and Control, Mission Health System, Asheville, NC.
3Infection Control and Prevention, Spectrum Health, Grand Rapids, MI.
4Education and Instructional Design, Association for Professionals in
Infection Control and Epidemiology, Washington, DC.
5Infection Prevention and Control, Genesis Health System, Davenport, IA.
6Infection Prevention and Control, Kaiser Permanente Downey Medical
Center, Downey, CA.
7Infection Control, Miami Veterans Affairs Healthcare System, Miami, FL.
8Hennepin County Medical Center, Minneapolis, MN.
9Quality Division, Infection Prevention, Carolinas HealthCare System,
Charlotte, NC.

Professional and practice standards for IPs have existed since 2008. The
expanding, evolving, and increasingly critical role of the profession
demanded they be updated. The standards emphasize flexibility and
applicability across a multitude of domains and settings and provide the
profession with a rigorous, well-defined set of expectations,
competencies, and practices.

The result is a succinct set of precepts that encapsulates the field of
IPC in the present and foreseeable future.

Copyright © 2016 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Infection preventionist; Performance; Scope of practice
__________________________________________________________________
________________________________*_________________________________

9. Abstract: A sustained release formulation of novel quininib-hyaluronan
microneedles inhibits angiogenesis and retinal vascular permeability in
vivo
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27086168

J Control Release. 2016 Apr 13. pii: S0168-3659(16)30191-2.
A sustained release formulation of novel quininib-hyaluronan microneedles
inhibits angiogenesis and retinal vascular permeability in vivo.

Galvin O1, Srivastava A2, Carroll O2, Kulkarni R3, Dykes S3, Vickers S3,
Dickinson K3, Reynolds A1, Kilty C1, Redmond G1, Jones R3, Cheetham S3,
Pandit A2, Kennedy BN4.

1UCD School of Biomolecular & Biomedical Science, UCD Conway Institute,
University College Dublin, D4, Ireland.
2Centre for Research in Medical Devices, Bioscience Building, National
University of Ireland, Galway, Ireland.
3RenaSci Ltd, BioCity, Pennyfoot Street, Nottingham NG1 1GF, UK.
4UCD School of Biomolecular & Biomedical Science, UCD Conway Institute,
University College Dublin, D4, Ireland. Electronic address:
brendan.kennedy@ucd.ie.

Pathologic neovascularisation and ocular permeability are hallmarks of
proliferative diabetic retinopathy and age-related macular degeneration.
Current pharmacologic interventions targeting VEGF are effective in only
30-60% of patients and require multiple intraocular injections associated
with iatrogenic infection. Thus, our goal is to develop novel small
molecule drugs that are VEGF-independent are amenable to sustained ocular-
release, and which reduce retinal angiogenesis and retinal vascular
permeability.

Here, the anti-angiogenic drug quininib was formulated into hyaluronan
(HA) microneedles whose safety and efficacy was evaluated in vivo.
Quininib-HA microneedles were formulated via desolvation from quininib-HA
solution and subsequent cross-linking with 4-arm-PEG-amine prior to
freeze-drying. Scanning electron microscopy revealed hollow needle-shaped
particle ultrastructure, with a zeta potential of -35.5mV determined by
electrophoretic light scattering. The incorporation efficiency and
pharmacokinetic profile of quininib released in vitro from the
microneedles was quantified by HPLC. Quininib incorporation into these
microneedles was 90%.

In vitro, 20% quininib was released over 4months; or in the presence of
increasing concentrations of hyaluronidase, 60% incorporated quininib was
released over 4months. Zebrafish hyaloid vasculature assays demonstrated
quininib released from these microneedles significantly (p<0.0001)
inhibited ocular developmental angiogenesis compared to control.

Sustained amelioration of retinal vascular permeability (RVP) was
demonstrated using a bespoke cysteinyl leukotriene induced rodent model.
Quininib-HA microparticles significantly inhibited RVP in Brown Norway
rats one month after administration compared to neat quininib control (p=
0.0071).

In summary, quininib-HA microneedles allow for sustained release of
quininib; are safe in vivo and quininib released from these microneedles
effectively inhibits angiogenesis and RVP in vivo.

Copyright © 2015. Published by Elsevier B.V.

KEYWORDS: Angiogenesis; Blindness; Novel drug therapy; Vascular
permeability

Requires payment or subscription
http://www.sciencedirect.com/science/article/pii/S0168365916301912
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Ethanol and ethyl glucuronide urine concentrations after
ethanol-based hand antisepsis with and without permitted alcohol
consumption
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27079243

Am J Infect Control. 2016 Apr 11. pii: S0196-6553(16)00197-8.
Ethanol and ethyl glucuronide urine concentrations after ethanol-based
hand antisepsis with and without permitted alcohol consumption.

Gessner S1, Below E2, Diedrich S3, Wegner C4, Gessner W1, Kohlmann T5,
Heidecke CD3, Bockholdt B4, Kramer A1, Assadian O6, Below H1.

1Institute of Hygiene and Environmental Medicine, University Medicine
Greifswald, Greifswald, Germany.
2Institute of Forensic Science, University Medicine Greifswald,
Greifswald, Germany.
3Department of Surgery, Clinic of General, Visceral, Vascular and Thoracic
Surgery, University Medicine Greifswald, Greifswald, Germany.
4Department for Information Technology Systems, University Medicine
Greifswald, Greifswald, Germany.
5Institute for Community Medicine, University Medicine Greifswald,
Greifswald, Germany.
6Institute for Skin Integrity and Infection Prevention, School of Human &
Health Sciences, University of Huddersfield, Huddersfield, UK. Electronic
address: o.assadian@hud.ac.uk.

BACKGROUND: During hand antisepsis, health care workers (HCWs) are exposed
to alcohol by dermal contact and by inhalation. Concerns have been raised
that high alcohol absorptions may adversely affect HCWs, particularly
certain vulnerable individuals such as pregnant women or individuals with
genetic deficiencies of aldehyde dehydrogenase.

METHODS: We investigated the kinetics of HCWs’ urinary concentrations of
ethanol and its metabolite ethyl glucuronide (EtG) during clinical work
with and without previous consumption of alcoholic beverages by HCWs.

RESULTS: The median ethanol concentration was 0.7?mg/L (interquartile
range [IQR], 0.5-1.9?mg/L; maximum, 9.2?mg/L) during abstinence and
12.2?mg/L (IQR, 1.5-139.6?mg/L; maximum, 1,020.1?mg/L) during alcohol
consumption. During abstinence, EtG reached concentrations of up to
958?ng/mL. When alcohol consumption was permitted, the median EtG
concentration of all samples was 2,593?ng/mL (IQR, 890.8-3,576?ng/mL;
maximum, 5,043?ng/mL). Although alcohol consumption was strongly
correlated with both EtG and ethanol in urine, no significant correlation
for the frequency of alcoholic hand antisepsis was observed in the linear
mixed models.

CONCLUSIONS: The use of ethanol-based handrub induces measurable ethanol
and EtG concentrations in urine. Compared with consumption of alcoholic
beverages or use of consumer products containing ethanol, the amount of
ethanol absorption resulting from handrub applications is negligible. In
practice, there is no evidence of any harmful effect of using ethanol-
based handrubs as much as it is clinically necessary. Copyright © 2016
Association for Professionals in Infection Control and Epidemiology, Inc.
Published by Elsevier Inc. All rights reserved.

KEYWORDS: Absorption; Alcohol dehydrogenase; Alcohol-based handrub; Hand
hygiene; Pregnant
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Zika Virus and Birth Defects – Reviewing the Evidence for
Causality
__________________________________________________________________

http://www.nejm.org/doi/full/10.1056/NEJMsr1604338 Free Full Text

N Engl J Med. 2016 Apr 13. [Epub ahead of print]
Zika Virus and Birth Defects – Reviewing the Evidence for Causality.

Rasmussen SA1, Jamieson DJ1, Honein MA1, Petersen LR1.

1From the Division of Public Health Information Dissemination, Center for
Surveillance, Epidemiology, and Laboratory Services (S.A.R.), Division of
Reproductive Health, National Center for Chronic Disease Prevention and
Health Promotion (D.J.J.), and Division of Congenital and Developmental
Disorders, National Center on Birth Defects and Developmental Disabilities
(M.A.H.), Centers for Disease Control and Prevention, Atlanta; and the
Division of Vector-Borne Diseases, National Center for Emerging and
Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,
Fort Collins, CO (L.R.P.).

The Zika virus has spread rapidly in the Americas since its first
identification in Brazil in early 2015. Prenatal Zika virus infection has
been linked to adverse pregnancy and birth outcomes, most notably
microcephaly and other serious brain anomalies. To determine whether Zika
virus infection during pregnancy causes these adverse outcomes, we
evaluated available data using criteria that have been proposed for the
assessment of potential teratogens. On the basis of this review, we
conclude that a causal relationship exists between prenatal Zika virus
infection and microcephaly and other serious brain anomalies. Evidence
that was used to support this . . .
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Knowledge and occupational hazards of barbers in the
transmission of hepatitis B and C was low in Kumasi, Ghana
__________________________________________________________________

Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484403/

Pan Afr Med J. 2015 Mar 18;20:260.
Knowledge and occupational hazards of barbers in the transmission of
hepatitis B and C was low in Kumasi, Ghana.

Mutocheluh M1, Kwarteng K2.

1Department of Clinical Microbiology, School of Medical Sciences, Kwame
Nkrumah University of Science and Technology, Kumasi, Ghana.
2Komfo Anokye Teaching Hospital, Kumasi, Ghana.

INTRODUCTION: Blood borne viral hepatitis transmission still ranges
between 4-20% in many Ghanaian communities. Hepatocellular carcinoma (HCC)
also called liver cancer is reported as the leading cause of cancer
mortality among males in Ghana. We studied the knowledge and risk factors
associated with barbers’ occupation in the transmission of hepatitis B
virus (HBV) and hepatitis C virus (HCV).

METHODS: A randomized cross-sectional survey of 200 barbershops was
conducted in Kumasi between January and August 2013. Barbershops, which
operated continuously for more than 8 months, were selected for the study.
Structured questionnaires were administered to the study participants.
Data was entered and analysed in Microsoft Excel spread sheet and SPSS
v12. The percentage value of each question was calculated.

RESULTS: All the barbers involved in this study used a new razor blade on
every client and claimed to sterilize the hair trimmers after use on every
client. The methods of sterilization; 46.5% of the barbers used the
ultraviolet radiation sterilizer cabinet, 29% used 70% alcohol and 23%
used antiseptic solutions. More than thirty-six percent (36.5%) and 5% of
the barbers had heard of HBV and HCV respectively. Only 7% and none knew
the route of transmission of HBV and HCV respectively, whereas 7% knew
sharing razor blade or hair trimmer could transmit both HBV and HCV. More
so, 2% knew HBV and HCV could cause cancer and 2% had received the HBV
vaccine. The majority of barbers (63%) had education up to the junior
secondary school level. None of the barbers used a new apron nor washed
their hands after work on each client.

CONCLUSION: Awareness of barbers about HBV or HCV and job-related factors
contributing to spread of infections was very poor among the vast majority
of the barbers studied. Thus, giving training for the barbers is required
toward prevention of blood- borne infections associated to their
profession.

KEYWORDS: Awareness; barbers; hair trimmers; razor blade; viral hepatitis
__________________________________________________________________
________________________________*_________________________________

13. News

– Australia: Hunter mum and son receive needlestick injuries in McDonald’s

– China: China’s Vaccine Scandal Threatens Public Faith in Immunizations

– USA: NJ hospital exposed workers to needle-sticks, bloodborne pathogens,
feds say

– Australia: Hepatitis B-infected worker little danger to patients –
Victorian health chief

– Cameroon: Cameroon alarmed by fake yellow fever vaccine

– USA: Sandwich Fire Dept. Tests Needle, Medical Waste Disposal Machine
Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
www.theherald.com.au/story/3849520/mum-son-injured-by-needle-at-mcdonalds/
Australia: Hunter mum and son receive needlestick injuries in McDonald’s

By Helen Gregory, Newcastle Herald, Australia (19.04.16)

AN Aberglasslyn mother is investigating taking legal action against
McDonald’s, after she and her four year old son sustained needle-stick
injuries in its King Street, Newcastle, restaurant.

Amanda Van Der Veen alleged the company failed in its duty of care by not
removing the needle in its disabled bathroom and provided an “inadequate”
response to the traumatic incident.

“This event has changed everything,” she said. “I’m housebound, I don’t
use public bathrooms and I have my third appointment with a psychologist
coming up. I’m unlikely to return to my job as a lab technician.”

Mrs Van Der Veen was 17 weeks pregnant and dining with her son Aspen on
November 7, when he pricked his hand on a needle he picked up in the
locked bathroom, which had a sharps container.

When Mrs Van Der Veen instinctively lunged at her son to snatch the
needle, it also punctured her hand. “I just got this overwhelming,
devastated feeling,” she said. “I thought, ‘This could have anything in
it, I could get a disease – what about the baby?’”

The store manager brought the pair to the women’s bathroom to wash their
hands and took her details for an incident report.

Mrs Van Der Veen said she was shaking, crying and physically sick before
paramedics arrived to assess the pair and advised them the risk of disease
transmission was low. They were tested at John Hunter Hospital and told to
return after three and six months.

Mrs Van Der Veen called McDonald’s head office two days later, which
confirmed it had received the report and would be in touch. When she
reached the store manager on the third day of calling, he advised her to
ring him back if head office did not contact her. She did not hear from
either again.

Mrs Van Der Veen became unable to inject herself with insulin required for
her gestational diabetes and was admitted to hospital over concerns for
her blood sugar levels and mental state. She slammed McDonald’s for
waiting five months before calling her last week, minutes after the Herald
contacted the company. “We tried to reach out and get help but felt so
alone,” she said. “We will be going back to our solicitor.”

A McDonald’s spokesperson said the incident was ‘not acceptable’. “Our
restaurant was in contact with the customer on a number of occasions; but
we certainly apologise if the customer feels she has not been
appropriately supported. We have again reached out to offer any further
assistance we can.” A Community Sharps Management Program fact sheet said
it was “very rare” to get HIV, hepatitis B or hepatitis C from a used
needle.

“These viruses usually do not survive for long periods outside the body,”
it said.
__________________________________________________________________
__________________________________________________________________

www.nytimes.com/2016/04/19/world/asia/china-vaccine-scandal.html
China: China’s Vaccine Scandal Threatens Public Faith in Immunizations

Read in Chinese at the link

By Chris Buckley, New York Times, NY USA (18.04.16)

Photo
Officials with the China Food and Drug Administration checking vaccines
last month at a clinic in Rong’an County, in the southern region of
Guangxi. Credit Tan Kaixing/European Pressphoto Agency

HEZE, China — First the news rippled across China that millions of
compromised vaccines had been given to children around the country. Then
came grim rumors and angry complaints from parents that the government had
kept them in the dark about the risks since last year.

Now, the country’s immunization program faces a backlash of public
distrust that critics say has been magnified by the government’s ingrained
secrecy.

Song Zhendong, like many parents here, said he was reluctant to risk
further vaccinations for his 10-month-old son.

“If he can avoid them in the future, we will not get them,” said Mr. Song,
a businessman. “Why didn’t we learn about this sooner? If there’s a
problem with vaccines for our kids, we should be told as soon as the
police knew. Aren’t our children the future of the nation?”

The faulty vaccines have become the latest lightning rod for widespread,
often visceral distrust of China’s medical system, and a rebuff to what
many Chinese critics see as President Xi Jinping’s bulldozing, top-down
rule.

The scandal is just the latest crisis to shake public faith in China’s
food and medicine supplies, but it is the first big scare under Mr. Xi,
who had vowed to be different. He came into office promising to “make
protecting the people’s right to health a priority.”

“If our party can’t even handle food safety properly while governing
China, and this keeps up, some will wonder whether we’re up to the job,”
Mr. Xi said in 2013, the year he became president.

Chinese Respond to Vaccine Crisis Online
“Our kid is one and a half this year, and goes for vaccine shots almost
every month, including just last month… I don’t know if they’ve all been
fake, all these one and a half years. Really I can’t trust in anything.”
– “Cold Long Dream” on Weibo

“As soon as there is panic across all society, people won’t dare get
vaccinated, or they’ll lose confidence in our country’s vaccines, and that
would be an even bigger threat to people’s lives.”

– “Listening to the Thunder Storm From a Quiet Place” on Weibo
About two million improperly stored vaccines were sold around the country
from an overheated, dilapidated storeroom. The main suspect in the case is
a hospital pharmacist from Heze who had been convicted of trading in
illegal vaccines in 2009 and was doing it again two years later.

Many parents said they were especially alarmed that nearly a year had
elapsed from the time the police uncovered the illicit trade and the time
the public first learned about it in February.

“Withholding information doesn’t maintain public credibility,” said Li
Shuqing, a lawyer in Jinan, the capital of Shandong Province, who is one
of about 90 attorneys who have volunteered to represent possible victims
in the case. “In the end, it makes people more distrustful.”

To many here, the combination of lax regulation and the secrecy
surrounding a potential public health crisis seems like déjà vu.

In the SARS crisis of 2003, 349 people died across mainland China and
hundreds more died elsewhere after officials hid the extent of its spread.
In a scandal that came to light in 2008, at least six children died and
300,000 fell ill with kidney stones and other problems from infant formula
adulterated with melamine, an industrial chemical.

“The customers worry about fake milk powder, fake medicine, fake vaccines,
fake everything,” said Ma Guohui, the owner of a shop on the rural fringe
of Heze that sells baby products. “This is certainly going to affect
people’s thinking. My boy got all his vaccination shots. If he were born
now, I’d worry.”

Despite such fears, the tainted vaccines are more likely to be ineffective
than harmful.

The World Health Organization has said that outdated or poorly stored
vaccines rarely if ever trigger illness or toxic reactions. Chinese
government investigators said last week that they had not found any cases
of adverse reactions or spikes in infections linked to ineffective
vaccines.

The greater danger may be more insidious. The erosion of public trust
could damage China’s immunization program, which has been credited with
significant declines in measles and other communicable diseases.

Photo
A child being vaccinated last year in Hebei Province, China. A scandal
exposed several weeks ago over faulty vaccines was the latest blow to
public faith in China’s food and medicine supplies. Credit Hao Qy/European
Pressphoto Agency

“Confidence is easy to shake, and that’s happened across the world and has
happened here,” said Lance Rodewald, a doctor with the World Health
Organization’s immunization program in Beijing. “We hear through social
media that parents are worried, and we know that when they’re worried,
there’s a very good chance that they may think it’s safer not to vaccinate
than to vaccinate. That’s when trouble can start.”

After unfounded reports of deaths caused by a hepatitis B vaccine in 2013,
such vaccinations across 10 provinces fell by 30 percent in the days
afterward, and the administration of other mandatory vaccines fell by 15
percent, according to Chinese health officials.

The illicit vaccines in the current case were not part of China’s
compulsory, state-financed vaccination program, which inoculates children
against illnesses such as polio and measles at no charge.

The illegal trade dealt in so-called second-tier vaccines — including
those for rabies, influenza and hepatitis B — which patients pay for from
their own pockets.

The pharmacist named in the investigation, Pang Hongwei, bought cheap
vaccines from drug companies and traders — apparently batches close to
their expiration dates — and sold them in 23 provinces and cities,
according to drug safety investigators.

She began the business in 2011, just two years after she had been
convicted on charges of illegally trading in vaccines and sentenced to
three years in prison, which was reduced to five years’ probation.
Officials have not explained how she was able to avoid prison and resume
her business.

Ms. Pang, in her late 40s, and her daughter, who has been identified only
by her surname, Sun, kept the vaccines in a rented storeroom of a disused
factory in Jinan. The storeroom lacked refrigeration, which may have
damaged the vaccines’ potency. The police have detained them but not
announced specific charges, and neither suspect has had a chance to
respond publicly to the accusations.

Lax regulation in the second-tier commercial system allowed Ms. Pang’s
business to grow, several medical experts said. Local government medical
agencies and clinics were able to increase their profits by turning to
cheap, illegal suppliers, People’s Daily, the official party paper,
reported on Tuesday.

Police investigators discovered Ms. Pang’s storehouse last April, but word
did not get out to the public until a Shandong news website reported on
the case in February of this year. Most Chinese had still heard nothing
about it until another website, The Paper, published a report that drew
national attention a month later.

It was the government’s intolerance of public criticism, critics said,
that kept the scandal under wraps, a delay that now makes it harder to
track those who received the suspect injections.

“We’ve seen with these problem vaccines that without the right to know,
without press freedom, the public’s right to health can’t be assured,”
said Wang Shengsheng, one of the lawyers pressing the government for more
answers and redress over the case.

In the last few weeks, official reticence has been supplanted by daily
announcements of arrests, checks and assurances as the central government
has scrambled to dampen public anger and alarm.

Premier Li Keqiang ordered central ministries and agencies in March to
investigate what had gone wrong.

Last week, the investigators reported that 202 people had been detained
over the scandal, and 357 officials dismissed, demoted or otherwise
punished. Health and drug officials promised to tighten vaccine purchase
rules to stamp out under-the-counter trade.

“How could this trafficking in vaccines outside the rules spread to so
many places and go on for so long?” Mr. Li said, according to an official
account. Without decisive action, he said, “ordinary people will vote with
their feet and go and buy the products they trust.”

Mr. Xi has so far not publicly commented on the scandal.

Dr. Rodewald, the World Health Organization expert, said the proposed
changes were promising and would mean clinics would not have to rely on
selling patient-paid vaccines for their upkeep.

Xu Huijin, a doctor in Heze, said that the concern over the scandal — and
unfounded rumors of deaths — had depressed the number of parents bringing
children to her clinic for inoculations.

“This was badly handled,” she said. “There was a lack of coordination, not
enough information. We should have found out about this long ago. Doctors
are taught to tell patients the full facts.”

Adam Wu contributed research from Beijing.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/z4n5c4r
USA: NJ hospital exposed workers to needle-sticks, bloodborne pathogens,
feds say

By Toniann Antonelli April 14, 2016 3:32 PM

A New Jersey hospital is facing $55,000 in penalties after an OSHA
inspector looking into a separate matter discovered that a large number of
workers had been accidentally stuck with needles and exposed to bloodborne
pathogens.

A total of nine citations classified as “serious” were issued to Cooper
Hospital in Camden while six additional citations were also issued for
safety and health violations classified as “other-than-serious,” the U.S
Department of Labor said.

Officials said Occupational Safety and Health Administration inspectors
issued citations indicating that the hospital failed to provide employees
with training about the hazards of the cancer-causing chemical methylene
chloride. According to OSHA, the chemical is a liquid with a chloroform-
like odor that’s used for paint stripping, pharmaceutical manufacturing,
metal cleaning and degreasing.

Click the link above to view the citations

Inspectors also cited the hospital for alleged violations regarding
safeguards that are supposed to be in place to protect workers from
exposure to needles. OSHA on Thursday said that Cooper Hospital allegedly
failed to “immediately discard” contaminated needles in appropriate sharps
containers. The medical facility also was negligent in making sure the
procedure used to prevent needlesticks included “engineering controls.”
Specifically, one citation states that in operating rooms the hospital
allegedly didn’t institute “work practice controls” for employees that
passed contaminated sharps, such as needles, to and from the surgeons. As
a result, employees suffered puncture wounds. Similar instances allegedly
occurred throughout the hospital with suture needles used for stitches.
“The citations and proposed penalties in this case reflect the seriousness
of Cooper Hospital’s failure to protect its employees from needle-stick
injuries and bloodborne pathogen hazards,” Paula Dixon-Roderick, OSHA’s
area director in Marlton, said in a statement. “The hospital must continue
monitoring and investing in sustained efforts to prevent these injuries
from jeopardizing worker safety and health.”

One of the citations indicates that the hospital did not provide training
to employees charged with tasks such as emptying drains, clearing
ventilators, cleaning tracheotomies, removing IV lines and Foley
catheters. OSHA’s citation indicates that those employees should have been
instructed to wear eye and face protection to keep them from coming in
contact with bloodborne pathogens.

Wendy Marano, a spokesperson for Cooper University Hospital, said the
hospital is taking the citations very seriously and they plan to address
the problems cited by OSHA.

“Cooper University Health Care is committed to the health and safety of
our patients and employees,” Marano said in a statement on behalf of the
hospital. “Cooper is driving a culture of safety with numerous, long-
standing initiatives and ongoing education and training with the input of
employees, physicians and leadership. We are taking the report seriously
and will actively address these issues.”

The U.S. Department of Labor is proposing $55,000 in penalties in
connection with the citations. According to a statement, the hospital has
15 business days from the time the citations and proposed penalties were
received to either comply or request to meet with OSHA officials. Cooper
can also contest the investigator’s findings withe OSHA’s Review
Commission, the agency stated.

Toniann Antonelli is a social content producer for NJ 101.5.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/j8h7wy9
Australia: Hepatitis B-infected worker little danger to patients –
Victorian health chief

Health department offers blood test to 654 Melbourne patients who came
into contact with healthcare worker over past three years

The Guardian, Australian Associated Press, Australia (14.04.16)

Victoria’s top health officer says the chance of someone contracting
hepatitis B from an infected Melbourne healthcare worker is less than 1%.

The Department of Health and Human Services is contacting 654 patients in
Melbourne after a health worker was diagnosed with hepatitis B.

“My professional judgment here is that the risk is going to be less than
1% and that’s based on historical investigations of this nature in other
countries,” the acting chief health officer, Dr Roscoe Taylor, told 3AW on
Thursday.

Hepatitis B is a blood-borne virus spread through unsafe sex with an
infected person, and less frequently through blood-to-blood incidents such
as needle-stick injuries.

Taylor said there had been a methodical examination to find all patients
the health worker had been in contact with over the past three years.

“The heartening thing at the moment is so far there haven’t been any
hepatitis B notifications [in the group of patients] for that period of
contact with the health worker,” Taylor said.

The department is arranging for all 654 patients to have a blood test.
They started receiving letters earlier this week.

Only patients who had been contacted directly by the department needed to
take any action, Taylor said.

Healthcare workers are obliged to know their own blood-borne virus status
and declare it every year. Most health facilities also require staff to be
vaccinated against hepatitis B.

Taylor said if a worker knew they had a virus and failed to disclose it,
“that is professionally inappropriate and it should not happen”.

• People wanting information about viral hepatitis can call Hepatitis
Victoria’s infoline on 1800 703 003.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/zochu3l
Cameroon: Cameroon alarmed by fake yellow fever vaccine

by APA, StarAfrica.com, (30.03.16)

The Cameroonian government has issued a warning, urging officials of the
national drugs supply structures and public and management of private
health facilities to ensure that the falsified versions of the vaccine
“Amaril stabilized” against yellow fever is not in their stocks.

Coming from the Pasteur Institute in Dakar under the lot number 2265 and
June 2017 as expiry date, the manufacturer said he has found errors and
other irregularities on the package, which results laboratory tests are
not known yet.

The institutions having such product in their stocks are invited to stop
distributing and to isolate the vaccine, authorities urged.

Copyright : © APA
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/h5lxcsa
USA: Sandwich Fire Dept. Tests Needle, Medical Waste Disposal Machine

By Karen B. Hunter, CapeNews.net, Cape Cod MA (25.03.16)

Cape Cod’s heroin crisis is producing what experts call a “secondary
opioid crisis: the dirty needle epidemic.” Paraphernalia from drug
addicts, however, is not the only dirty needle problem.

Sandwich Fire Department held a press conference last Friday morning led
by Deputy Fire Chief John J. Burke, to announce the success of its six-
month pilot program using a Sterilis machine to sterilize, grind, and
render harmless dirty needles and other medical waste on-site.

Dep. Chief Burke, who is also associate director and professor of Boston
University’s Healthcare Emergency Management Graduate Program, opened his
remarks by pointing out that 80 percent of needle users, such as diabetics
and those in need of B-12 injections, dispose of their needles properly.
Of the 20 percent of needle users who are “non-compliant,” many have good
intentions but simply don’t know where to dispose of their needles. This
can be especially true of people who, following a growing trend, are
receiving healthcare treatments at home. The result is that used needles
are often stored in coffee cans or milk cartons, sometimes for months,
thrown into household trash (potentially endangering anyone who handles or
collects the trash) or flushed down toilets. This problem, in addition to
the more publicized public health hazard of dirty needles left on school
grounds, beaches, parking lots, and along roads, creates the crisis.

While approximately 100 needles are dropped off at the Sandwich Fire
Station each week, many community residents are not aware that this
service is available. Dep. Chief Burke, realizing the need for a better
on-site disposal system, approached the Sterilis company six months ago
about trying a pilot program to test the company’s machine at the fire
station.

Sterilis, a Massachusetts-based company, spent about four years
researching and developing its machine to process medical waste on-site.
Usually placed in healthcare facilities, medical labs, small hospitals,
and dialysis centers, this is the company’s first use of the machine at a
community drop center.

Before Sterilis, when the fire department transported patients to Boston,
medical waste would be disposed of at the hospitals there. When not going
to Boston, bloody bandages and IV needles from local accidents, for
example, came back to the station to be “red bagged” and stored in the 60-
year-old, two-car garage at the station, before transport elsewhere. “We
are in a floodplain,” said Dep. Chief Burke. “When a storm is coming, we
have to worry about moving all the equipment but we also have, sitting in
that garage at flood level, medical waste that could end up floating
downstream in case of flooding. We would be liable for that.”

Bob Winskowicz, chief executive officer of Sterilis, explained with
enthusiasm the effectiveness and efficiency of the Sterilis machine. “This
is a seven-gallon vessel,” he explained regarding the pilot program.
“Typical sharps containers are one and two gallons in size, so the machine
can accommodate multiple containers. A typical red bag of bio-waste is
five gallons, so the machine can accommodate one of those.”

The Sterilis steam-sterilizes needles and medical waste via an autoclaving
system, which heats the waste to 132 degrees centigrade. The material is
then released into a grinding mechanism that spits it out as “confetti,”
which is completely safe to throw into the regular trash. The cycle is
less than 60 minutes long and the machine is small (about the size of the
photocopy machine at the fire department), portable, quiet, odorless, and
simple. It has one plug.

The Sterilis machine is fail-safe with redundancies; nothing can be put
into or taken out of the machine without the proper access code, and there
is no risk to anyone using the machine at any time. One of the key
components of the machine is that it tracks all required regulatory data
in the WiFi system. “With cloud-based tracking of the waste,” Dep. Chief
Burke said, “the old handwritten stuff is gone. I can log on and see how
much waste we are generating, which is important from a regulatory point
of view.”

At the fire station, the distance between the ambulance bay and the
Sterilis machine is about 12 feet. Medical waste can be taken directly
from the ambulance and dropped into the machine; it never touches the
ground, and there is no need to store it. The same is true when members of
the public drop off used needles—the needles are disposed of immediately.
“Every June,” Dep. Chief Burke said, “we get calls from the three Sandwich
schools asking us to pick up used needles from the many diabetic students
in the school system. We used to have to take them to Spaulding; now we
can dispose of them right here.”

The Sterilis machine costs $35,000 and Sterilis has lease-to-own programs
available. State Representative Randy Hunt (R-Sandwich) mentioned the
possibility of other Cape Cod towns using this on-site disposal system.
Dep. Chief Burke agreed that it would be good to have on-site “hubs” in
strategic locations around the Cape, as the Sterilis is a safe, efficient,
and cost-effective way to dispose of medical waste at sites such as police
and fire stations.
__________________________________________________________________
________________________________*_________________________________

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]
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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
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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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