online canadian pharmacy http://www.canadianpharmacy365.net/ pharmacy ratings phentermine no prescription

SIGNpost 00858

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00858 World Health Stats + Abstracts + Outbreak News  22 June 2016

CONTENTS
0. Moderators Note
1. New: World Health Statistics 2016: Monitoring health for the SDGs”
2. Abstract: Cumulative impact of periodic top-down communications on
infection prevention practices and outcomes in two units
3. Abstract: Risk of Injection-Site Abscess among Infants Receiving a
Preservative-Free, Two-Dose Vial Formulation of Pneumococcal Conjugate
Vaccine in Kenya
4. Abstract: Knowledge of occupational exposure to HIV: a cross sectional
study of healthcare workers in Tumbi and Dodoma hospitals, Tanzania
5. Abstract: Postexposure prophylaxis after hepatitis C occupational
exposure in the interferon-free era
6. Abstract: Safety of the reuse of needles for subcutaneous insulin
injection: A systematic review and meta-analysis
7. Abstract: Low knowledge and perceived Hepatitis C risk despite high
risk behaviour among injection drug users in Kathmandu, Nepal
8. Abstract: Nonthermal plasma–A tool for decontamination and
disinfection
9. Abstract: Plant-made oral vaccines against human infectious diseases-
Are we there yet?
10. Abstract: Evaluation of the effect of hand hygiene reminder signs on
the use of antimicrobial hand gel in a clinical skills center
11. Abstract: Hand hygiene compliance before and after wearing gloves
among intensive care unit nurses in Iran
12. Abstract: Promoting Hand Hygiene With a Lighting Prompt
13. No Abstract: Current Methods to Reduce Endophthalmitis After
Intravitreal Injection
14. News
– India: Mahbubnagar tops in Hepatitis infection in Telangana: Survey
– West Virginia USA: Hepatitis outbreak at Raleigh Heart Clinic widens
– USA: Woman infected with Zika in Pittsburgh lab accident
– USA: Maine reports hepatitis B outbreak, Injection drug use the main
risk factor
– Israel: CT contrast medium possibly linked to hepatitis C outbreak at
Jerusalem hospital
– West Virginia USA: Officials: 12 cases of hepatitis linked to West
Virginia clinic

The web edition of SIGNpost is online at:

SIGNpost 00858

More information follows at the end of this SIGNpost!

Please send your requests, notes on progress and activities, articles,
news, and other items for posting to: sign.moderator@gmail.com

Normally, items received by Tuesday will be posted in the Wednesday
edition.

Subscribe or unsubscribe by email: signmoderator@googlegroups.com

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

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

Like SIGNpost on Facebook at: https://www.facebook.com/SIGN.Moderator
and get updates on your device!
__________________________________________________________________
________________________________*_________________________________

0. Moderators Note
__________________________________________________________________

The change over to google groups has fairly problem free.

Please let us know if your colleagues and friends are missing the weekly
email delivery of SIGNpost from sign.moderator@gmail.com

Subscribe or unsubscribe by email: signmoderator@googlegroups.com
__________________________________________________________________
________________________________*_________________________________

1. New: World Health Statistics 2016: Monitoring health for the SDGs”

Download the full free Document. It can also be downloaded as separate
chapters.

http://www.who.int/gho/publications/world_health_statistics/2016/en/

There is a useful Data Visualization Dashboard:
www.who.int/gho/publications/world_health_statistics/2016/en/#story-02
__________________________________________________________________

www.who.int/mediacentre/news/releases/2016/health-inequalities-persist/en/
WHO: Life expectancy increased by 5 years since 2000, but health
inequalities persist

News Release

19 May 2016 | GENEVA – Dramatic gains in life expectancy have been made
globally since 2000, but major inequalities persist within and among
countries, according to this year’s “World Health Statistics: Monitoring
Health for the SDGs”.

Life expectancy increased by 5 years between 2000 and 2015, the fastest
increase since the 1960s. Those gains reverse declines during the 1990s,
when life expectancy fell in Africa because of the AIDS epidemic and in
Eastern Europe following the collapse of the Soviet Union. The increase
was greatest in the African Region of WHO where life expectancy increased
by 9.4 years to 60 years, driven mainly by improvements in child survival,
progress in malaria control and expanded access to antiretrovirals for
treatment of HIV.

“The world has made great strides in reducing the needless suffering and
premature deaths that arise from preventable and treatable diseases,” said
Dr Margaret Chan, Director-General of WHO. “But the gains have been
uneven. Supporting countries to move towards universal health coverage
based on strong primary care is the best thing we can do to make sure no-
one is left behind.”

Global life expectancy for children born in 2015 was 71.4 years (73.8
years for females and 69.1 years for males), but an individual child’s
outlook depends on where he or she is born. The report shows that newborns
in 29 countries – all of them high-income — have an average life
expectancy of 80 years or more, while newborns in 22 others – all of them
in sub-Saharan Africa — have life expectancy of less than 60 years.

With an average lifespan of 86.8 years, women in Japan can expect to live
the longest. Switzerland enjoys the longest average survival for men, at
81.3 years. People in Sierra Leone have the world’s lowest life-expectancy
for both sexes: 50.8 years for women and 49.3 years for men.

Healthy life expectancy, a measure of the number of years of good health
that a newborn in 2015 can expect, stands at 63.1 years globally (64.6
years for females and 61.5 years for males).
Targets of Sustainable Development Goals

This year’s “World Health Statistics” brings together the most recent data
on the health-related targets within the Sustainable Development Goals
(SDGs) adopted by the United Nations General Assembly in September 2015.
The report highlights significant data gaps that will need to be filled in
order to reliably track progress towards the health-related SDGs. For
example, an estimated 53% of deaths globally aren’t registered, although
several countries – including Brazil, China, the Islamic Republic of Iran,
South Africa and Turkey – have made considerable progress in that area.

World Health Statistics 2016: Monitoring health for the SDGs

While the Millennium Development Goals focused on a narrow set of disease-
specific health targets for 2015, the SDGs look to 2030 and are far
broader in scope. For example, the SDGs include a broad health goal,
“Ensure healthy lives and promote well-being for all at all ages”, and
call for achieving universal health coverage. This year’s “World Health
Statistics” shows that many countries are still far from universal health
coverage as measured by an index of access to 16 essential services,
especially in the African and eastern Mediterranean regions. Furthermore,
a significant number of people who use services face catastrophic health
expenses, defined as out-of-pocket health costs that exceed 25% of total
household spending.

The report includes data that illustrate inequalities in access to health
services within countries –between a given country’s poorest residents and
the national average for a set of reproductive, maternal and child health
services. Among a limited number of countries with recent data, Swaziland,
Costa Rica, Maldives, Thailand, Uzbekistan, Jordan and Mongolia lead their
respective regions in having the most equal access to services for
reproductive, maternal, newborn and child health.

The “World Health Statistics 2016” provides a comprehensive overview of
the latest annual data in relation to the health-related targets in the
SDGs, illustrating the scale of the challenge. Every year:

303 000 women die due to complications of pregnancy and childbirth;
5.9 million children die before their fifth birthday;
2 million people are newly infected with HIV, and there are 9.6
million new TB cases and 214 million malaria cases;
1.7 billion people need treatment for neglected tropical diseases;
more than 10 million people die before the age of 70 due to
cardiovascular diseases and cancer;
800 000 people commit suicide;
1.25 million people die from road traffic injuries;
4.3 million people die due to air pollution caused by cooking fuels;
3 million people die due to outdoor pollution; and
475 000 people are murdered, 80% of them men.

Addressing those challenges will not be achieved without tackling the risk
factors that contribute to disease. Around the world today:

1.1 billion people smoke tobacco;
156 million children under 5 are stunted, and 42 million children
under 5 are overweight;
1.8 billion people drink contaminated water, and 946 million people
defecate in the open; and
3.1 billion people rely primarily on polluting fuels for cooking.

Note to editors

Published every year since 2005, WHO’s “World Health Statistics” is the
definitive source of information on the health of the world’s people. It
contains data from 194 countries on a range of mortality, disease and
health system indicators, including life expectancy, illness and death
from key diseases, health services and treatments, financial investment in
health, and risk factors and behaviours that affect health.

WHO’s Global Health Observatory updates health statistics year round of
more than 1000 health indicators. Members of the public can use it to find
the latest health statistics on global, regional and country levels.
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Cumulative impact of periodic top-down communications on
infection prevention practices and outcomes in two units
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25120195

Health Care Manage Rev. 2015 Oct-Dec;40(4):324-36.
Cumulative impact of periodic top-down communications on infection
prevention practices and outcomes in two units.

Rangachari P1, Madaio M, Rethemeyer RK, Wagner P, Hall L, Roy S, Rissing
P.

1Pavani Rangachari, PhD, is Associate Professor and MPH Program Director,
Department of Health Management and Informatics, Georgia Regents
University, Augusta. E-mail: prangachari@gru.edu. Michael Madaio, MD, is
Professor of Medicine and Chair, Department of Medicine, Medical College
of Georgia, Georgia Regents University, Augusta. R. Karl Rethemeyer, PhD,
is Associate Dean and Chair, Department of Public Administration and
Policy, Rockefeller College of Public Affairs and Policy, University at
Albany, State University of New York. Peggy Wagner, PhD, is Clinical
Professor and Director, Institute for Advancement of Healthcare, School of
Medicine-Greenville, University of South Carolina. Lauren Hall, MPH, is
Graduate Research Assistant, Department of Health Management and
Informatics, Georgia Regents University, Augusta. Siddharth Roy, MPH, is
Graduate Research Assistant, Department of Health Management and
Informatics, Georgia Regents University, Augusta. Peter Rissing, MD, is
Professor of Medicine and Section Chief, Infectious Diseases, Department
of Medicine, Medical College of Georgia, Georgia Regents University,
Augusta.

BACKGROUND: The problem of interest in this study is the challenge of
consistent implementation of evidence-based infection prevention practices
at the unit level, a challenge broadly characterized as “change
implementation failure.” The theoretical literature suggests that periodic
top-down communications promoting tacit knowledge exchanges across
professional subgroups may be effective for enabling change in health care
organizations. However, gaps remain in understanding the mechanisms by
which top-down communications enable practice change at the unit level.
Our study sought to both validate the theoretical literature and address
this gap.

PURPOSE: Correspondingly, this study posed two research questions. (1)
What is the impact of periodic “top-down” communications on practice
change at the unit level? (2) What are the “unit-level” communication
dynamics enabling practice changes? Whereas this article focuses on
addressing the first question, the second question has been addressed in
an earlier Health Care Management Review article (Rangachari et al.,
2013).

METHODS: A prospective study was conducted in two intensive care units at
an academic health center. Both units had low baseline adherence to
central line bundle (CLB) and higher-than-expected catheter-related
bloodstream infections (CRBSIs). Periodic top-down communication
interventions were conducted over 52 weeks to promote CLB adherence in
both units. Simultaneously, the study examined (a) unit-level
communication dynamics related to CLB through weekly “communication logs,”
completed by unit physicians, nurses, and managers, and (b) unit outcomes,
that is, CLB adherence and CRBSI rates.

FINDINGS: Both units showed increased adherence to CLB and significant,
sustained declines in CRBSIs. Results showed that the interventions
cumulatively had a significant negative (desired) impact on “catheter
days,” that is, central catheter use.

PRACTICE IMPLICATIONS: Results help validate the theoretical literature
and identify evidence- based management strategies for practice change at
the unit level.

They suggest that periodic top-down communications have the potential to
modify interprofessional knowledge exchanges and enable practice change at
the unit level, leading to significantly improved outcomes and reduced
costs.
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Risk of Injection-Site Abscess among Infants Receiving a
Preservative-Free, Two-Dose Vial Formulation of Pneumococcal Conjugate
Vaccine in Kenya
__________________________________________________________________

http://dx.doi.org/10.1371/journal.pone.0141896

PLoS One. 2015 Oct 28;10(10):e0141896. Open Access Full Free Text
Risk of Injection-Site Abscess among Infants Receiving a Preservative-
Free, Two-Dose Vial Formulation of Pneumococcal Conjugate Vaccine in
Kenya.

Burton DC1, Bigogo GM1, Audi AO1, Williamson J2, Munge K3, Wafula J3, Ouma
D1, Khagayi S4, Mugoya I5, Mburu J3, Muema S1, Bauni E3, Bwanaali T3,
Feikin DR1, Ochieng PM1, Mogeni OD1, Otieno GA1, Olack B1, Kamau T5, Van
Dyke MK6, Chen R7, Farrington P8, Montgomery JM1, Breiman RF9, Scott JA10,
Laserson KF2.

1Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and
Prevention (CDC) Research and Public Health Collaboration, Kisumu and
Nairobi, Kenya; International Emerging Infections Program, Global Disease
Detection Response Center, CDC, Kisumu and Nairobi, Kenya.
2Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and
Prevention (CDC) Research and Public Health Collaboration, Kisumu and
Nairobi, Kenya; Center for Global Health, CDC, Atlanta, Georgia, United
States of America.
3KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
4Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and
Prevention (CDC) Research and Public Health Collaboration, Kisumu and
Nairobi, Kenya.
5Division of Vaccines and Immunization, Ministry of Public Health and
Sanitation, Nairobi, Kenya.
6GlaxoSmithKline Vaccines, Wavre, Belgium.
7National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention,
CDC, Atlanta, Georgia, United States of America.
8Open University, Buckinghamshire, United Kingdom.
9International Emerging Infections Program, Global Disease Detection
Response Center, CDC, Kisumu and Nairobi, Kenya; Center for Global Health,
CDC, Atlanta, Georgia, United States of America.
10KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; London School of
Hygiene & Tropical Medicine, London, United Kingdom.

There is a theoretical risk of adverse events following immunization with
a preservative-free, 2-dose vial formulation of 10-valent-pneumococcal
conjugate vaccine (PCV10).

We set out to measure this risk. Four population-based surveillance sites
in Kenya (total annual birth cohort of 11,500 infants) were used to
conduct a 2-year post-introduction vaccine safety study of PCV10.
Injection-site abscesses occurring within 7 days following vaccine
administration were clinically diagnosed in all study sites (passive
facility-based surveillance) and, also, detected by caregiver-reported
symptoms of swelling plus discharge in two sites (active household-based
surveillance). Abscess risk was expressed as the number of abscesses per
100,000 injections and was compared for the second vs first vial dose of
PCV10 and for PCV10 vs pentavalent vaccine (comparator).

A total of 58,288 PCV10 injections were recorded, including 24,054 and
19,702 identified as first and second vial doses, respectively (14,532
unknown vial dose).

The risk ratio for abscess following injection with the second (41 per
100,000) vs first (33 per 100,000) vial dose of PCV10 was 1.22 (95%
confidence interval [CI] 0.37-4.06).

The comparator vaccine was changed from a 2-dose to 10-dose presentation
midway through the study.

The matched odds ratios for abscess following PCV10 were 1.00 (95% CI
0.12-8.56) and 0.27 (95% CI 0.14-0.54) when compared to the 2-dose and 10-
dose pentavalent vaccine presentations, respectively.

In Kenya immunization with PCV10 was not associated with an increased risk
of injection site abscess, providing confidence that the vaccine may be
safely used in Africa.

The relatively higher risk of abscess following the 10-dose presentation
of pentavalent vaccine merits further study.

Free Open Access Article
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Knowledge of occupational exposure to HIV: a cross sectional
study of healthcare workers in Tumbi and Dodoma hospitals, Tanzania
__________________________________________________________________

https://tinyurl.com/jplfzv2

BMC Health Serv Res. 2015 Jan 22;15:29. Free Open Access Article
Knowledge of occupational exposure to HIV: a cross sectional study of
healthcare workers in Tumbi and Dodoma hospitals, Tanzania.

Mashoto KO1, Mubyazi GM2, Mushi AK3,4.

1National Institute for Medical Research, P.O. Box 9653, Dar es Salaam,
Tanzania. kmashoto@nimr.or.tz.
2National Institute for Medical Research, P.O. Box 9653, Dar es Salaam,
Tanzania. gmubyazi@nimr.or.tz.
3National Institute for Medical Research, P.O. Box 9653, Dar es Salaam,
Tanzania. adiel.mushi@gmail.com.
4Tanzania National Health Research Forum, P.O. Box 9653, Dar es Salaam,
Tanzania. adiel.mushi@gmail.com.

BACKGROUND: Insufficient knowledge on blood-borne pathogens has been
identified as a factor that influences occupational exposure to needle
stick and sharps injuries. The objective of this study was to assess
healthcare workers’ knowledge on occupational exposure to HIV.

METHODS: A cross sectional survey was conducted at Tumbi designated
regional hospital and Dodoma regional hospital, Tanzania in February 2012.
A self- administered questionnaire was used to capture information on
knowledge of occupational exposure to HIV infection.

RESULTS: A total of 401 healthcare workers responded to a self-
administered questionnaire. High proportion of healthcare workers (96.3%)
understood that they are at risk of occupational exposure to HIV. The
majority of healthcare workers trained on post exposure prophylaxis
procedure and use of personal protective equipment were clinicians (87.1%
and 71.4% respectively) and nurses (81.8% and 74.6% respectively). Over a
quarter of the healthcare workers were not aware of whom to contact in the
event of occupational exposure. One third of healthcare workers did not
have comprehensive knowledge on causes of occupational HIV transmission
and did not know when post exposure prophylaxis is indicated. Healthcare
workers not trained on the use of person protective equipment were less
likely to have comprehensive knowledge on occupational exposure to HIV
(OR?=?0.5; 95% CI 0.3 – 0.9). Knowledge on causes of occupational exposure
varied with the cadre of healthcare workers. Nurses were more likely to
have comprehensive knowledge on occupational exposure to HIV than non-
clinical staff (OR?=?2.6; 95% CI 1.5 – 4.5).

CONCLUSION: A substantial proportion of studied healthcare workers had
little knowledge on occupational exposure to HIV and was not aware of a
contact person in the event of occupational exposure to HIV. Training on
post exposure prophylaxis and infection prevention and control including
the use of person protective equipment provided to nurses and clinicians
should be extended to other clinical and non-clinical hospital staff.

PMC Article https://tinyurl.com/jplfzv2
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Postexposure prophylaxis after hepatitis C occupational
exposure in the interferon-free era
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27306563

Curr Opin Infect Dis. 2016 Jun 13.
Postexposure prophylaxis after hepatitis C occupational exposure in the
interferon-free era.

Hughes HY1, Henderson DK.

1aCharlie Norwood VA Medical Center, Augusta, Georgia, USA bClinical
Center, National Institutes of Health, Bethesda, Maryland, USA.

PURPOSE OF REVIEW: Healthcare personnel are at risk for occupational
exposures to bloodborne pathogens. Primary prevention remains the first
line of defense, but secondary prevention measures known to be effective
should be implemented when percutaneous exposures occur. Hepatitis C virus
(HCV) is a major infectious cause of liver-related morbidity and
mortality. Chronic HCV treatment has changed dramatically, with many all-
oral directly acting anti-HCV antiviral (DAA) regimens now available.
Evidence for the use of DAAs as postexposure prophylaxis (PEP) after
occupational exposures to HCV is summarized here.

RECENT FINDINGS: Little new evidence supports the use of antivirals in
acute HCV infection. Several preliminary studies have examined the use of
DAAs or host target agents in chronic HCV treatment. Effective HCV PEP
requirements likely include pan-genotypic activity and a high barrier to
resistance. One investigational DAA has shown promising results as an
efficacious option for all genotypes in chronic HCV treatment and may
ultimately represent a potential HCV PEP agent.

SUMMARY: Insufficient supporting data exist to endorse the use of DAAs for
PEP after HCV occupational exposures; additional studies examining
efficacy, duration, and cost-effectiveness are needed. Development of more
oral drugs possessing a high barrier of resistance and equal activity
against all HCV genotypes is anticipated.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Safety of the reuse of needles for subcutaneous insulin
injection: A systematic review and meta-analysis
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27297374
Int J Nurs Stud. 2016 Aug;60:121-32.
Safety of the reuse of needles for subcutaneous insulin injection: A
systematic review and meta-analysis.

Zabaleta-Del-Olmo E1, Vlacho B2, Jodar-Fernández L3, Urpí-Fernández AM4,
Lumillo-Gutiérrez I5, Agudo-Ugena J6, Morros-Pedrós R7, Violán C8.

1Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi
Gol, Gran Via Corts Catalanes, 587 àtic, 08007 Barcelona, Spain;
Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès,
Spain; Department of Nursing, Universitat de Girona, c/ Emili Grahit 77,
17071 Girona, Spain. Electronic address: ezabaleta@idiapjgol.org.
2Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi
Gol, Gran Via Corts Catalanes, 587 àtic, 08007 Barcelona, Spain.
Electronic address: bogdan.vlacho@hotmail.com.
3Primary Health Care Centre Cornellà 2 (Sant Ildefons), Direcció d’Atenció
Primària Costa de Ponent, Institut Català de la Salut, Av. República
Argentina s/n (cantonada Av. de Sant Ildefons), 08940 Cornellà de
Llobregat, Spain. Electronic address: ljodar74@gmail.com.
4Primary Health Care Centre Carles I, Àmbit d’Atenció Primària Barcelona-
Ciutat, Institut Català de la Salut, c. de la Marina, 168, 08018
Barcelona, Spain. Electronic address: amurpi.bcn.ics@gencat.cat.
5Emergency Primary Care Centre El Castell, Consorci Castelldefels Agents
de Salut (CASAP), c. Guillermo Marconi, 9 bxs, 08860 Castelldefels, Spain.
Electronic address: irislumillo@gmail.com.
6Primary Health Care Centre La Mina, Àmbit d’Atenció Primària Barcelona-
Ciutat, Institut Català de la Salut, c. del Mar, s/n, 08930 Sant Adrià de
Besòs, Spain. Electronic address: jagudo.bcn.ics@gencat.cat.
7Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi
Gol, Gran Via Corts Catalanes, 587 àtic, 08007 Barcelona, Spain;
Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès,
Spain. Electronic address: rmorros@idiapjgol.org.
8Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi
Gol, Gran Via Corts Catalanes, 587 àtic, 08007 Barcelona, Spain;
Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès,
Spain. Electronic address: cviolan@idiapjgol.org.

OBJECTIVE: Many people with diabetes often reuse disposable needles for
subcutaneous insulin injection. We aimed to identify, critically appraise
and summarize the available evidence about the safety of this practice.

DESIGN: Systematic review in accordance with the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses statement. DATA SOURCES:

MEDLINE (via PubMed), CINALH (via EBSCO), SCOPUS, Web of Science, Cochrane
Central Register of Controlled Trials and Open Grey were searched from
their inception to December 2015, with no language restrictions.

REVIEW METHODS: Epidemiologic and experimental studies assessing adverse
effects of reusing needles in people of any age or sex, with or without
diabetes, were included. Two reviewers independently assessed the
methodological quality of included studies using a multi-design tool.

RESULTS: In total, 25 studies were included. All studies had a high risk
of bias and data from only nine studies could be pooled. Five studies
showed no association between infection at site of injection and reuse of
needles (risk difference=-0.00; 95% confidence interval=-0.12-0.11;
P=0.99); heterogeneity between these studies was substantial (I(2)=66%;
P=0.02). Five cross-sectional studies showed an association between
lipohypertrophy and needle reuse (risk difference=0.16, 95% confidence
interval=0.05-0.28, P=0.006); there was strong evidence of heterogeneity
between these studies (I(2)=87%; P<0.001). Pooled data of two studies with
no evidence of heterogeneity between them showed more perceived pain among
reusers (risk difference=0.24; 95% confidence interval=0.06-0.43;
P=0.006). Reusing a pen needle or disposable syringe-needle was not
associated with worse glycaemic control.

CONCLUSIONS: There is currently no clear scientific evidence to suggest
for or against the reuse of needles for subcutaneous insulin injection.
This practice is very common among people with diabetes; consequently,
further research is necessary to establish its safety.

Copyright © 2016 Elsevier Ltd. All rights reserved.

KEYWORDS: Equipment reuse; Insulin; Meta-analysis; Needles; Patient
safety; Systematic review
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Low knowledge and perceived Hepatitis C risk despite high
risk behaviour among injection drug users in Kathmandu, Nepal
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27318773

Int J Drug Policy. 2016 May 17. pii: S0955-3959(16)30158-X.
Low knowledge and perceived Hepatitis C risk despite high risk behaviour
among injection drug users in Kathmandu, Nepal.

Loewinger G1, Sharma B2, Karki DK3, Khatiwoda P4, Kainee S5, Poudel KC6.

1Jhamsikhel, Lalitpur, Nepal. Electronic address: gloewinger@gmail.com.
2Richmond Fellowship Nepal, Chobar, Kathmandu, Nepal.
3Nepal Health Economics Association, Kathmandu, Nepal; Nobel College,
Kathmandu, Nepal.
4Global Health Institute, Duke University, Durham, NC, USA.
5Rural Environment Development Center (REDC), Dadeldhura, Nepal.
6Department of Health Promotion and Policy, School of Public Health and
Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA.

BACKGROUND: In Nepal, prevalence of Hepatitis C (HCV) among injecting drug
users (IDUs) has been measured at 50% and knowledge of the virus is low.
Rehabilitation and harm reduction attendees constitute populations to whom
health care providers can deliver services. As such, characterizing their
drug use and risk profiles is important for developing targeted service
delivery. We measured drug use and risk patterns of IDUs participating in
residential rehabilitation as well as those contacted through needle
exchanges to identify correlates of drug use frequency, risky injection
practices as well as HCV testing, knowledge and perceived risk.

METHODS: We collected cross-sectional data from one-on-one structured
interviews of IDUs contacted through needle-exchange outreach workers
(n=202) and those attending rehabilitation centres (behaviour immediately
prior to joining rehabilitation) (n=167).

RESULTS: Roughly half of participants reported injecting at least 30 times
in the past 30 days and individuals with previous residential
rehabilitation experience reported frequent injection far more than those
without it. About one in fourteen respondents reported past week risky
injection practices. Participants were over three times as likely to
report risky injection if they consumed alcohol daily (17.2%) than if they
did not (5.0%) (p=0.002). Those who reported injecting daily reported
risky injection practices (11.9%) significantly more than non-daily
injectors (1.8%) (p<0.001). Respondents reported high HCV infection rates,
low perceived risk, testing history and knowledge. HCV knowledge was not
associated with differences in risky injecting.

CONCLUSION: Treatment centres should highlight the link between heavy
drinking, frequent injection and risky injecting practices. The link
between rehabilitation attendance and frequent injection may suggest IDUs
with more severe use patterns are more likely to attend rehabilitation.
Rehabilitation centres and needle exchanges should provide testing and
education for HCV. Education alone may not be sufficient to initiate
change since knowledge did not predict lower risk.

Copyright © 2016 Elsevier B.V. All rights reserved.

KEYWORDS: Addiction; Harm reduction; Hepatitis C risk; Injecting drug use;
Needle exchange centres; Nepal; Residential drug rehabilitation; South
Asia
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Nonthermal plasma–A tool for decontamination and
disinfection
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25595663

Biotechnol Adv. 2015 Nov 1;33(6 Pt 2):1108-19.
Nonthermal plasma–A tool for decontamination and disinfection.

Scholtz V1, Pazlarova J2, Souskova H3, Khun J4, Julak J5.

1Department of Physics and Measurements, University of Chemistry and
Technology, Prague, Czech Republic. Electronic address:
vladimir.scholtz@vscht.cz.
2Department of Biochemistry and Microbiology, University of Chemistry and
Technology, Prague, Czech Republic.
3Department of Computing and Control Engineering, University of Chemistry
and Technology, Prague, Czech Republic.
4Department of Physics and Measurements, University of Chemistry and
Technology, Prague, Czech Republic.
5Institute of Immunology and Microbiology, 1st Faculty of Medicine,
Charles University in Prague, Czech Republic.

By definition, the nonthermal plasma (NTP) is partially ionized gas where
the energy is stored mostly in the free electrons and the overall
temperature remains low.

NTP is widely used for many years in various applications such as low-
temperature plasma chemistry, removal of gaseous pollutants, in gas-
discharge lamps or surface modification.

However, during the last ten years, NTP usage expanded to new biological
areas of application like plasma microorganisms’ inactivation, ready-to-
eat food preparation, biofilm degradation or in healthcare, where it seems
to be important for the treatment of cancer cells and in the initiation of
apoptosis, prion inactivation, prevention of nosocomial infections or in
the therapy of infected wounds.

These areas are presented and documented in this paper as a review of
representative publications.

Copyright © 2015 Elsevier Inc. All rights reserved.

KEYWORDS: Biofilm inactivation; Biotechnology application; Disinfection;
Food safety; Medical application; Microbial decontamination; Microbicidal
effect; Nonthermal plasma; Water cleaning
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Plant-made oral vaccines against human infectious diseases-
Are we there yet?
__________________________________________________________________

Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769796/

Plant Biotechnol J. 2015 Oct;13(8):1056-70.
Plant-made oral vaccines against human infectious diseases-Are we there
yet?

Chan HT1, Daniell H1.

1Department of Biochemistry, School of Dental Medicine, University of
Pennsylvania, Philadelphia, PA, USA.

Although the plant-made vaccine field started three decades ago with the
promise of developing low-cost vaccines to prevent infectious disease
outbreaks and epidemics around the globe, this goal has not yet been
achieved.

Plants offer several major advantages in vaccine generation, including
low-cost production by eliminating expensive fermentation and purification
systems, sterile delivery and cold storage/transportation. Most
importantly, oral vaccination using plant-made antigens confers both
mucosal (IgA) and systemic (IgG) immunity.

Studies in the past 5 years have made significant progress in expressing
vaccine antigens in edible leaves (especially lettuce), processing leaves
or seeds through lyophilization and achieving antigen stability and
efficacy after prolonged storage at ambient temperatures. Bioencapsulation
of antigens in plant cells protects them from the digestive system; the
fusion of antigens to transmucosal carriers enhances efficiency of their
delivery to the immune system and facilitates successful development of
plant vaccines as oral boosters.

However, the lack of oral priming approaches diminishes these advantages
because purified antigens, cold storage/transportation and limited shelf
life are still major challenges for priming with adjuvants and for antigen
delivery by injection.

Yet another challenge is the risk of inducing tolerance without priming
the host immune system. Therefore, mechanistic aspects of these two
opposing processes (antibody production or suppression) are discussed in
this review.

In addition, we summarize recent progress made in oral delivery of vaccine
antigens expressed in plant cells via the chloroplast or nuclear genomes
and potential challenges in achieving immunity against infectious diseases
using cold-chain-free vaccine delivery approaches.

© 2015 Society for Experimental Biology, Association of Applied Biologists
and John Wiley & Sons Ltd.

KEYWORDS: bioencapsulation; human infectious diseases; molecular farming;
mucosal immune response; oral delivery; plant transformation

Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769796/
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Evaluation of the effect of hand hygiene reminder signs on
the use of antimicrobial hand gel in a clinical skills center
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25682193

J Infect Public Health. 2015 Sep-Oct;8(5):425-31.
Evaluation of the effect of hand hygiene reminder signs on the use of
antimicrobial hand gel in a clinical skills center.

Wearn A1, Bhoopatkar H2, Nakatsuji M3.

1Clinical Skills Centre, Faculty of Medical and Health Sciences, The
University of Auckland, Auckland, New Zealand. Electronic address:
a.wearn@auckland.ac.nz.
2Clinical Skills Centre, Faculty of Medical and Health Sciences, The
University of Auckland, Auckland, New Zealand. Electronic address:
h.bhoopatkar@auckland.ac.nz.
3Clinical Skills Centre, Faculty of Medical and Health Sciences, The
University of Auckland, Auckland, New Zealand. Electronic address:
m.nakatsuji@auckland.ac.nz.

Hand hygiene is a critical element of patient care, which needs to be
learned and reinforced to become an autonomous behavior. Previous studies
have explored aspects of hand hygiene behavior in the clinical workplace,
but not in controlled learning environments with health professional
students.

Development of good hand hygiene behavior requires a multi-
faceted approach, including education, reinforcement, feedback and audit.

Our study aimed to identify the effect of unannounced hand hygiene
reminder signs on the use of antimicrobial hand gel in a clinical skills
center.

Year 2 MBChB students received practical learning regarding hand
hygiene in their clinical skills sessions. Baseline hand gel use was
measured using before and after weighing of the bottles. An A5 sign was
created to remind the students to hand cleanse and was used as an
unannounced intervention.

In semester 2 (2012), the student groups were randomly allocated as
intervention (signs) or control (no signs). Hand gel use at all sessions
was measured. Data were compared between groups and over time.

In total, 237 students attended the skills sessions twice during the
study. Hand gel use was not significantly different between the two study
arms. Overall use was low, typically 1-2 hand gel pumps per student per
session. In addition, hand gel use fell over time. A visual reminder to
cleanse hands did not appear to have any effect on behavior.

These findings may have implications for their value in a clinical
setting. Low overall use of hand gel may be context-dependent. Students
are in a simulated environment and examine ‘healthy’ peers or actors.

There may have been inconsistent tutor role-modeling or problems with the
educational approach to the skill. Analysis at the level of the group, and
not the individual, may have also limited our study.

Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences.
Published by Elsevier Ltd. All rights reserved.

KEYWORDS: Evaluation; Hand hygiene; Human factors; Medical students
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Hand hygiene compliance before and after wearing gloves
among intensive care unit nurses in Iran
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27311508

Am J Infect Control. 2016 Jun 13. pii: S0196-6553(16)30417-5.
Hand hygiene compliance before and after wearing gloves among intensive
care unit nurses in Iran.

Ghorbani A1, Sadeghi L2, Shahrokhi A2, Mohammadpour A3, Khodadadi E4.

1Metabolic Diseases Research Center, School of Nursing and Midwifery,
Qazvin University of Medical Sciences, Qazvin, Iran.
2School of Nursing and Midwifery, Qazvin University of Medical Sciences,
Qazvin, Iran.
3Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
4School of Nursing and Midwifery, Tabriz University of Medical Sciences,
Tabriz, Iran. Electronic address: esmailkhodadadi11@gmail.com.

Nosocomial infections are considered a major risk factor in hospital
wards, and hand hygiene is the first step in their control.

An observational study was conducted in 2015 with 200 nurses working in
intensive care units in teaching hospitals of Tabriz, Iran. Data were
collected by using the Hand Hygiene Observation Tool questionnaire. The
researchers monitored nurses’ opportunities for hand hygiene during the 8-
week period from February 3-April 4, 2015.

A total of 1,067 opportunities occurred for hand hygiene before and after
wearing gloves. The results show that hand hygiene compliance before
wearing gloves is poor among nurses who work in intensive care units
(14.8%).

Therefore it is necessary to conduct effective interventions through
continuing education programs to improve hand hygiene compliance.

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

KEYWORDS: Nosocomial infection
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Promoting Hand Hygiene With a Lighting Prompt
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27302470

HERD. 2016 Jun 14. pii: 1937586716651967.
Promoting Hand Hygiene With a Lighting Prompt.

Diegel-Vacek L1, Ryan C2.

1University of Illinois at Chicago College of Nursing, Chicago, IL, USA
ljvacek@uic.edu.
2University of Illinois at Chicago College of Nursing, Chicago, IL, USA.

OBJECTIVES: The objective of this pilot study was to assess an automatic
sink light design intervention as a prompt for clinician hand hygiene (as
defined by World Health Organization [WHO]).

BACKGROUND: Healthcare-associated infections (HAIs) are still leading
causes of morbidity and mortality and contribute to burdens on our
healthcare system. Hand hygiene has been related to reducing the rate of
HAIs and positively impacting both patient and hospital outcomes.

METHODS: This pilot study was a prospective, longitudinal observational
study of a convenience sample of healthcare clinicians. In one inpatient
room, clinicians were exposed to a hand hygiene reminder that consisted of
a light turning on over the sink as they entered. A control room (the
adjacent inpatient room) did not have the intervention.

RESULTS: A total of 88 clinician encounters were monitored during the
study. On the first observation day at the initial activation of the
signal light system, the percentage of clinicians performing hand hygiene
upon entering a room was only 7% in the control room and 23% in the
intervention room. During the second observation (Day 14), those
percentages were 16% in the control room and 30% in the intervention room.
During the third observation (Day 21), those percentages were 23% in the
control room and 23% in the intervention room.

CONCLUSIONS: The healthcare system frequently relies on expensive
technology to improve healthcare delivery, but implementation of low-cost,
low-technology methods such as this light may be effective in prompting
hand hygiene.

© The Author(s) 2016.

KEYWORDS: HAI; handwashing; healthcare-associated infection; infection
control; medical/surgical unit; nurses in design; quality improvement
__________________________________________________________________
________________________________*_________________________________

13. No Abstract: Current Methods to Reduce Endophthalmitis After
Intravitreal Injection
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26599240

Ophthalmic Surg Lasers Imaging Retina. 2015 Nov-Dec;46(10):996-1000.
Current Methods to Reduce Endophthalmitis After Intravitreal Injection.

Kim SJ, Fine HF.
__________________________________________________________________
________________________________*_________________________________

14. News

– India: Mahbubnagar tops in Hepatitis infection in Telangana: Survey

– West Virginia USA: Hepatitis outbreak at Raleigh Heart Clinic widens

– USA: Woman infected with Zika in Pittsburgh lab accident

– USA: Maine reports hepatitis B outbreak, Injection drug use the main
risk factor

– Israel: CT contrast medium possibly linked to hepatitis C outbreak at
Jerusalem hospital

– West Virginia USA: Officials: 12 cases of hepatitis linked to West
Virginia clinic

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/j235ke4
India: Mahbubnagar tops in Hepatitis infection in Telangana: Survey

Prabeerkumar Sikdar, TNN, Times of India (21.06.16)

HYDERABAD: Hepatitis infection is highest in Telangana’s Mahbubnagar
district with 13.5% of the population under its grip, finds a year long
study that is still underway since July last year.

The prevalence rate of Hepatitis disease, which mainly includes infection
caused by Hepatitis A and C viruses, has been found to be particularly
very high in Mahbubnagar villages including Eiza with infection rate of
20.34% followed by Tharoor village with 15.17% infection rate and
Vavilalla village with 14.41% infection rate, a survey by Apollo hospital
revealed.

In the year-long study led by research team headed by Dr K Somasekhar,
senior consultant, gastroenterologist, Apollo hospitals, the district
fared the worst as 2,251 individuals out of total 5,139 people in
Telangana whose blood samples were screened, 304 people were found
carrying Hepatitis viruses.

**** “The high prevalence in Mahabubnagar district may be because of usage
of unsterilised needles as we found 95% needles that the individuals were
found using, to be unsafe.

The other reasons could be high incidence of tattooing and body piercing
with infected instruments,” said Dr K Somasekhar.

There are several other causes leading to infection from Hepatitis viruses
among people in Telangana that includes consumption of contaminated
drinking water, food and repeat use of a single filter for different
kidney patients at dialysis centres.

This was officially stated by Telangana state health minister Dr C Laxma
Reddy ahead of the launch of mass population based Hepatitis awareness and
screening camps across twenty nine centers in three states of Telangana,
Andhra Pradesh and Karnataka in the city by Apollo Hospitals and Grace
Foundation on Saturday.

When it comes to most rampant form of Hepatitis virus infection, experts
point towards Hepatitis A as more prevalent in Telangana.

“Hepatitis B appears to be less in Telangana compared to rest of India,
but hepatitis C has very high prevalence compared to rest of India,” added
Dr K Somasekhar.

However, the survey found Hyderabad, Warangal, Khammam and Nizamabad
districts having negligible prevalence of Hepatitis infection with only
five cases (0.2%) reported positive out of 2,359 blood samples screened in
eight locations in Hyderabad, six positive (4%) out of 144 samples in
Khammam and zero case in 306 samples and 79 samples in Nizamabad and
Warangal respectively.

So, what are best methods for diagnosis of Hepatitis infection?
“The diagnostic techniques used for detecting Hepatitis infection can use
Rapid Immunochromatography, ELISA,(enzyme linked Immunoassay)
ECLIA(Electro chemilumniscence Immunoassay),” said Dr E Bhavani,
consultant microbiologist, Continental Hospitals, while advising health
care workers, pregnant women and those exposed to a needle prick to get
vaccinated.

For the record, Hepatitis infection comes with disatrous consequences with
Hepatitis A & E viruses may lead to acute liver failure while Hepatitis B
& C can lead to chronic liver failure.

Though preventive vaccines in the form of HBsAg for hepatitis B and
AntiHCV for hepatitis C are available, those already confirmed positive
are treated with several anti-viral drugs like Entecavir, Tenofovir,
sofosbuvir, ledipasvir and declatasvir.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/jnpl7lf
West Virginia USA: Hepatitis outbreak at Raleigh Heart Clinic widens

By Annie Moore, WVVA, Beckley West Virginia USA (18.06.16)

BECKLEY (WVVA) –
The Hepatitis outbreak that officials said started with 12 patients at the
Raleigh Heart Clinic in Beckley has widened.

According to Beckley attorney Stephen New, his law firm has 60 clients who
he believes contracted Hepatitis from the clinic. “The majority of them,
if not all, had zero risk factors. They were going there strictly to have
a stress test. But for unknown reasons, they contracted Hepatitis.”

Twenty-three hundred patients of the clinic received letters from the
Dept. of Health and Human Resources in March, saying they may have been
exposed to Hepatitis B, C, and HIV.

At the time, health officials said they believed the outbreak was confined
to two clusters of 12 patients. But after more positive tests following
the letters, Health and Human Resources officials announced they were
widening the notification pool to anyone who received a stress test at the
clinic.

“My heart breaks for anybody who goes in for medical treatment and simply
simply because the physician and his clinic didn’t follow the proper
protocol, they’re now having to deal with disease and treatment,” said
New.

New filed a class action lawsuit on behalf of clients who tested negative,
but after consulting an infectious disease expert, he recently withdrew
the suits for those who tested negative. “According to our expert, if
someone is testing positive for Hepatitis or HIV six to eight months out
from their last exposure, they have a one in something like a millionth
chance of contracting HIV or Hepatitis.”

The next challenge for New’s firm will be to find out whether a judge will
allow the positive cases to be tried as part of a class action lawsuit or
to proceed individually. Either way, he said he is moving forward to
justice.

Raleigh County Commissioners have also been working to recover some of the
costs of testing at the Beckley Raleigh County Health Dept. In May,
commissioners billed the Raleigh Heart Clinic for $8,607 to cover the cost
of equipment, additional staffing, and shipping costs. As of Friday, they
said their office had yet to receive a payment.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/zlg6b5m
USA: Woman infected with Zika in Pittsburgh lab accident

Liz Szabo, USA TODAY , USA (09.06.16)

A female lab researcher in the University of Pittsburgh area has been
infected with the Zika virus from an accidental needle stick, in what
federal health officials believe may be the U.S.’s first case of the
disease contracted through a laboratory.

The needle stick occurred May 23, according to a university statement. The
woman developed symptoms of Zika June 1, including a fever. Symptoms of
Zika can include fever, rash, joint pain, headache and pink eye. The
university learned that the blood test was positive for Zika virus June 8.

The woman’s fever disappeared June 6, and she returned to work the same
day, according to the University of Pittsburgh.

Zika primarily spreads through the bite of infected Aedes aegypti or Aedes
albopictus mosquitoes. The woman has agreed to wear long sleeves, pants
and insect repellent for three weeks to prevent mosquitoes from biting
her, according to the university.

The woman doesn’t pose a health risk to her coworkers, because the virus
doesn’t spread from person to person through casual contact, like a cold.
Although men can transmit the virus through sex, it’s not known if women
can transmit the virus through sex.

In order for the woman to spread the virus, an Aedes mosquito would have
to bite her, incubate the virus for several days, then bite someone else,
said Amesh Adalja, a senior associate the Center for Health Security at
the University of Pittsburgh Medical Center who has no personal knowledge
of the woman’s case. A mosquito who bites an infected person is not
immediately contagious.

Most people face no serious risk from Zika infections. Only 20% of
patients develop any symptoms, which are usually mild, according to the
Centers for Disease Control and Prevention. In rare cases, Zika can cause
Guillain-Barre syndrome, a type of paralysis that occurs when the body’s
immune system attacks the nerves. Zika also can cause devastating birth
defects in fetuses.

The woman’s case appears to be the first time that a U.S. lab worker has
been infected with Zika during the current outbreak, according to the CDC.

More than 600 Americans in the continental U.S. have been infected with
Zika, including 195 cases in pregnant women. All of those cases were
related to travel to an outbreak area or sex with an infected traveler.
More than 1,100 people have been diagnosed with Zika in Puerto Rico,
including 146 pregnant women, where the disease is spreading among local
mosquitoes, according to the CDC.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/hkzagrn
USA: Maine reports hepatitis B outbreak, Injection drug use the main risk
factor

Outbreak News Today (16.06.16)

Between Jan. 1 and May 16, 2015, the state of Maine reported no cases of
acute hepatitis B. But things have changed during the same period this
year.

According to the Maine Centers for Disease Control (CDC), 15 confirmed
cases of acute hepatitis B cases confirmed in Maine between January 1 and
May 16, a rate of 1.1 cases per 100,000 persons.

The primary risk factor for new cases of acute hepatitis B in Maine in
2016 is injection drug use. Hepatitis B virus (HBV) is 100 times more
infectious than HIV and 10 times more infectious than hepatitis C virus.

In addition, HBV can survive on open air surfaces for up to seven days and
in sealed containers for up to three months. If individuals are injecting
drugs, it is important that they maintain their own injection kit and do
not: Share injection equipment, inject others and then inject self or
inject on contaminated surfaces.

Health officials say that persons at high risk for hepatitis B should be
screened and vaccinated for hepatitis A and hepatitis B, if susceptible.
In addition, patients diagnosed with hepatitis C should be vaccinated for
hepatitis A and B.

No cost hepatitis A and B vaccine is available for high risk patients
through the Maine CDC Adult Viral Hepatitis Program in 13 counties.
Please contact the Viral Hepatitis Coordinator for more information:
207-287-3817.
__________________________________________________________________
__________________________________________________________________
https://tinyurl.com/glyacdq
Israel: CT contrast medium possibly linked to hepatitis C outbreak at
Jerusalem hospital

by Robert Herriman, http://outbreaknewstoday.com/ (10.05.16)

At least five have been diagnosed with Hepatitis C in Jerusalem after
being given a contrast medium fluid for a CT scan at a local hospital,
according to local media.

The investigation into the outbreak surrounds a CT scanner at Misgav
Ladach hospital where the patients were given the contrast medium in mid-
March.

The CT scanner has been placed out of use as the investigation continues.
Hepatitis C is a liver disease that results from infection with the
Hepatitis C virus. It can range in severity from a mild illness lasting a
few weeks to a serious, lifelong illness. Hepatitis C is usually spread
when blood from a person infected with the Hepatitis C virus enters the
body of someone who is not infected. Today, most people become infected
with the Hepatitis C virus by sharing needles or other equipment to inject
drugs.

Hepatitis C can be either “acute” or “chronic.” Acute Hepatitis C virus
infection is a short-term illness that occurs within the first 6 months
after someone is exposed to the Hepatitis C virus. For most people, acute
infection leads to chronic infection. Chronic Hepatitis C is a serious
disease than can result in long-term health problems, or even death.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/jptlhuw
West Virginia USA: Officials: 12 cases of hepatitis linked to West
Virginia clinic

Associated Press, USA (26.)3.16)

BECKLEY, W.Va. – Officials have investigated at least 12 cases of
hepatitis linked to a heart clinic in West Virginia.

The viruses have been linked to injectable medications given during
cardiac stress tests at the Raleigh Heart Clinic, local news media outlets
reported.

Eight patients receiving cardiac stress tests have tested positive for
hepatitis C and four others have tested positive for hepatitis B, said
Allison Adler, director of communications for the Department of Health and
Human Resources. Adler said there has been no evidence of HIV
transmission.

The investigation started in November 2014, after a patient with no risk
factors for hepatitis C was diagnosed with the virus.

State Health Commissioner Dr. Rahul Gupta said Thursday that during
inspections, Department of Health and Human Resources investigators
witnessed several areas of improvement for the clinic.

“There are single-use vials,” he said of the clinic. “You have a drug in
one vial for a patient’s one-time use. But we find that it is often used
for multiple uses. So that’s one way of transmitting it because you can
change the needle but there’s always a risk with the vial.”

Gupta said the extent of how many individuals were exposed to the
pathogens is unknown.

Officials are now urging about 2,300 patients of the Raleigh Heart Clinic
to be tested for hepatitis B and C as well as HIV.

A class-action lawsuit has been filed by patient Pamela Vines against the
clinic on behalf of patients who had cardiac stress tests.

The Charleston Gazette-Mail reports that the Raleigh Heart Clinic has not
commented on the matter.
__________________________________________________________________
________________________________*_________________________________

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
__________________________________________________________________
________________________________*_________________________________
* 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
__________________________________________________________________
________________________________*_________________________________
________________________________*_________________________________
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 unsubscribe by email: signmoderator@googlegroups.com

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.
__________________________________________________________________
________________________________*_________________________________

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 GoogleGroups

Subscribe or unsubscribe by email: signmoderator@googlegroups.com
__________________________________________________________________
__________________________________________________________________

Comments are closed.