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DAILY UPDATE

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October 23, 2014   Download print version

U.S. plans 21-day monitoring of people who arrive from Ebola-stricken nations

Official WHO Ebola toll near 5,000 with true number nearer 15,000

Aesculap, Inc. launches online Surgical Asset Management Resource Center for central service professionals

'Man Flu' is real: Estrogen makes women more resistant to respiratory diseases than men

New hospital accreditation chapter puts heightened focus on safety

1 in 5 physicians unaware their patients have central venous catheters

Study links Enterovirus in kids to T1D

Ansell introduces new single-use glove with a better grip for wet, oily objects

 
 
 


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U.S. plans 21-day monitoring of people who arrive from Ebola-stricken nations

Every airline passenger who arrives in the United States from one of the three West African nations hardest hit by Ebola will be monitored by state and local health authorities for 21 days, the Centers for Disease Control and Prevention said Wednesday.

The travelers will be required to report their temperature daily and call a state hotline if they show any symptoms of the illness. The program will begin in six states — including Maryland and Virginia — on Monday and will expand to other states later, CDC Director Thomas Frieden said.

“We’re tightening the process by establishing active monitoring of every traveler who returns to this country from one of the three infected countries,” Frieden said in a conference call with reporters.

The monitoring plan was the administration’s latest step to intercept travelers who may have been exposed to the lethal virus in the three countries affected most by the outbreak — Guinea, Liberia and Sierra Leone. Fending off critics who have demanded an outright entry ban on people traveling from those countries, the White House has tried to allay domestic fears by ramping up protections in the United States.

Airline passengers are being screened for symptoms of the illness as they board planes in those countries headed to the United States, during their flight and upon their arrival in the United States at five designated airports that are the required entry points for travelers from those countries.

Now, those who arrive without exhibiting any sign of the illness will be followed for 21 days — Ebola’s incubation period — in the event they develop the virus.

The burden of monitoring will fall to state and local health officials, who have legal authority to control infectious disease, Frieden said. Those health departments can choose to monitor people with daily visits, through electronic media like Skype or by contacting health offices at their jobs.

The number of people arriving in the United States from the Ebola-stricken countries has dwindled from an average of 150 a day to roughly 80 a day in recent weeks, most likely because U.S. residents have postponed trips to see relatives there for fear of the illness. Still, that translates into thousands of people for local authorities to screen and follow in coming months.

The CDC guidelines require arriving passengers to provide detailed information on where they plan to be for the following 21 days, including their addresses, e-mail contacts and telephone numbers for themselves and a relative or friend in the United States.

That information will be forwarded to officials in New York, Pennsylvania, New Jersey, Georgia, Maryland and Virginia. Four of those states are home to the international gateway airports where travelers from the affected countries are required to enter the United States.

Frieden said that most people who arrive from the three African countries are U.S. citizens or long-term residents of the United States. He said about 70 percent of them live in or are visiting the states where the monitoring program will debut Monday.

“State and local officials will maintain daily contact with all travelers from the affected countries for the entire 21 days following the last possible date of exposure to the Ebola virus,” Frieden said. “If a traveler doesn’t report in, the state or local public official will take immediate steps to find the person and make sure the tracking continues on a daily basis.”

Starting Monday, each traveler from one of the impacted countries who arrives in the United States will be handed an Ebola care kit at the airport after being screened by U.S. Customs and Border Protection, which is responsible for the enhanced airport screening. The kit includes instructions, a digital thermometer, a 21-day log sheet for recording morning and evening temperatures, a display card that shows the nine symptoms of the illness, and a list of telephone numbers for the CDC and state health departments.

Healthcare workers — including those from the CDC — U.S. military and journalists returning from those countries also will face 21 days of monitoring.

Travelers with no known exposure to the illness while in West Africa will be permitted to travel within the United States provided they keep health officials informed of their whereabouts and maintain the 21-day health reporting. Those deemed high-risk, even though they have no symptoms, because of contact with an Ebola victim will not be allowed to travel on planes, trains or public buses. Those who ignore the no-travel edict could be prosecuted in some states under state laws intended to impede the spread of infectious diseases.

Frieden said the monitoring effort will allow authorities to react quickly if a person shows any signs of the illness.

Local health officials would develop contingency plans to transport those with symptoms to a medical facility, he said.

“There is a possibility that other individuals with Ebola will come to this country,” Frieden said. “We’re undertaking a series of measures to increase the likelihood that if individuals arrive here and develop Ebola, they’ll be rapidly identified and isolated and will not spread Ebola.”

The pharmaceutical company Johnson & Johnson said Wednesday that in January, it plans to begin testing a vaccine combination that could protect people from one strain of Ebola. The company described the vaccine as potentially effective against a strain “highly similar” to the one causing the epidemic. There are no proven vaccines or drugs for Ebola, and the New Jersey-based company is one of several racing to develop an effective means of defeating it.

Working with Danish company Bavarian Nordic, Johnson & Johnson said it will spend up to $200 million to speed the program. It involves two vaccines given two months apart. Visit the Washington Post for the article.

 

 

Official WHO Ebola toll near 5,000 with true number nearer 15,000

At least 4,877 people have died in the world's worst recorded outbreak of Ebola, and at least 9,936 cases of the disease had been recorded as of Oct. 19, the World Health Organization (WHO) said on Wednesday, but the true toll may be three times as much.

The WHO has said real numbers of cases are believed to be much higher than reported: by a factor of 1.5 in Guinea, 2 in Sierra Leone and 2.5 in Liberia, while the death rate is thought to be about 70 percent of all cases. That would suggest a toll of almost 15,000.

Liberia has been worst hit, with 4,665 recorded cases and 2,705 deaths, followed by Sierra Leone with 3,706 cases and 1,259 deaths. Guinea, where the outbreak originated, has had 1,540 cases and 904 deaths.

In the past week, transmission of the disease was most intense in the capital cities of Monrovia and Freetown, while Guinea's capital Conakry reported 18 confirmed cases, its second highest weekly total since the outbreak began.

Although Ebola has been contained in Nigeria and Senegal, the disease is spreading towards Ivory Coast in both Liberia and Guinea, including in Guinea's Kankan district on a major trade route with Mali. Kankan saw its first case in the past week.

However, the WHO said the Liberian district of Lofa had seen a third consecutive week of decline in the number of cases, which reports from observers suggested was a result of disease control measures.

Among the thousands of cases are 443 healthcare workers, 244 of whom have died. The WHO said it was undertaking extensive investigations to determine why so many had caught the disease.

"Early indications are that a substantial proportion of infections occurred outside the context of Ebola treatment and care," it said.

A U.N. plan to stop the epidemic, known as 70-70-60, involves isolating at least 70 percent of cases and safely burying at least 70 percent of those who die by Dec. 1, a 60-day deadline from the start of the plan. That is supposed to rise to 100 percent by the 90-day deadline on Jan. 1.

The number of isolation beds had increased substantially to 1,126 but remained only 25 percent of the 4,388 expected to be needed in 50 Ebola treatment units. There were also firm commitments from foreign medical teams to staff only 30 units.

Without those beds in those units, families have to care for sick relatives at home and risk infection.

The WHO also estimates 28 laboratories are needed in the three worst-hit countries, with 12 now in place, and 20,000 staff will be needed to keep track of people who have had contact with Ebola patients and may be at risk.

The three worst-hit countries will also need 230 dead-body-management teams by Dec. 1, it said. They have 140.

Visit Reuters for the article.

 

 

Aesculap, Inc. launches online Surgical Asset Management Resource Center for central service professionals

Aesculap, Inc. announced it has officially launched its online educational Surgical Asset Management Resource Center. Dedicated to helping Central Service professionals excel at their jobs and in their careers, Aesculap’s Surgical Asset Management Resource Center houses tools, insights and resources relevant to CS departments.

The information provided on the site includes both original content, written by Aesculap’s expert CS consultants who all have extensive experience working in CS departments, and industry news, which is aggregated from the industry’s top publications. The site functions as a comprehensive resource for CS professionals looking to expand their CS knowledge.

All original Aesculap expert-produced commentary pieces are research and experience-based insights – written as unbiased news articles. Information on the Resource Center is categorized into the 10 content areas most relevant to CS professionals.

Aesculap’s Surgical Asset Management Resource Center can be accessed at www.aesculapresourcecenter.com.

 

 

'Man Flu' is real: Estrogen makes women more resistant to respiratory diseases than men

Men have been called out by women for faking it in the bedroom as they lay helplessly after catching a case of the sniffles. The moaning, complaining, and whining that describes the characteristics of the “man flu,” however, may not be a myth after all. According to a recent study published in the journal Life Sciences, estrogen allows women to have stronger immune systems that are more resistant to respiratory illnesses compared to their testosterone-filled counterparts.

Men are thought to have a complete system breakdown when they get a cold as they react differently to women. The tongue-in-cheek expression — man flu — has been coined to describe a man’s way of dealing with the common cold.

Professor Lester Kobzik at Harvard University’s School of Public Health and his colleagues sought to investigate whether gender differences do exist when it comes to the resistance of respiratory infections. In the first round, the researchers tested the effect of bacterial pneumonia on mice by introducing the infection to their lungs. The female mice were found to be naturally more resistant to the condition due to the release of the enzyme nitric oxide synthase 3 (NOS3) — activated by the release of estrogen.

In the second round, the researchers took another set of male and female mice and removed the gene responsible for the production of NOS3. The researchers found deleting this gene would no longer make the female mice resistant to infection. A simple dose of estrogen was administered to both males and females in this group. The findings revealed both sexes showed a greater resistance to pneumococcal pneumonia with greater bacterial clearance, diminished lung inflammation and better survival.

This discovery could be used to improve resistance to common and serious lung infections, and possibly prevent the flu from developing into pneumonia.

Visit Medical Daily for the study.

 

 

New hospital accreditation chapter puts heightened focus on safety

The Joint Commission announces publication of the new “Patient Safety Systems” chapter in the 2015 Comprehensive Accreditation Manual for Hospitals. The purpose of the chapter is to inform and educate hospital leaders about the importance and structure of an integrated patient-centered system that aims to improve quality of care and patient safety.

There are no new requirements in the Patient Safety Systems chapter. Instead, the standards are culled from existing chapters including Leadership, Rights and Responsibilities of the Patient, Performance Improvement, Medication Management and Environment of Care. The standards will continue to be published in their respective chapters as well as in the Patient Safety Systems chapter. During on-site surveys, the standards will be scored in their originating chapter.

To underscore the importance of a patient-centered safety system, The Joint Commission will make this new chapter available online indefinitely for customers and non-customers alike.

“For the first time, The Joint Commission is providing a standards chapter on our website because this information is so important that we want everyone to have access to it. A solid foundation for patient safety is a safety culture. For leaders, our hope is they will study this chapter and use it as a tool to build or improve their safety culture program,” says Ana Pujols McKee, M.D., executive vice president and chief medical officer, The Joint Commission. “Developing a culture of safety starts at the top of the chain of command, and then works its way through the layers of management and employees to build trust which is an essential ingredient for improvement. In order for improvement to take root and spread, leaders need to be engaged and know the current state of the culture in their organization."

The chapter is oriented to leadership because leader engagement is imperative to the trust-report-improve cycle of establishing a safety culture. The standards are intended to assist leaders in creating a culture of safety that equates to an environment where staff and leaders work together to eliminate complacency, promote collective mindfulness, treat one another with respect and learn from patient safety events.

The chapter has three guiding principles:

·         Aligning existing Joint Commission standards with daily work in order to engage patients and staff throughout the health care system, at all times, on reducing harm.

·         Assisting health care organizations with advancing knowledge, skills and competence of staff and patients by recommending methods that will improve quality and safety processes.

·         Encouraging and recommending proactive methods and models of quality and patient safety that will increase accountability, trust and knowledge while reducing the impact of fear and blame.

The chapter is included only in the hospital accreditation manual; however, other health care settings may benefit from applying the patient safety strategies discussed in the chapter.

Visit the Joint Commission for the chapter.

 

 

1 in 5 physicians unaware their patients have central venous catheters

One in five physicians was unaware a hospitalized patient had a central venous catheter, which is commonly used for laboratory monitoring or to administer life-saving treatments such as IV delivery of antibiotics, nutrition, and other medications.

Surprisingly, attending physicians were least likely to know of the device’s presence, followed by interns and residents, according to the new research led by the University of Michigan and VA Ann Arbor Healthcare System. The findings appear in the Annals of Internal Medicine.

While the benefits of such catheters have been widely-touted, research also shows that these devices may lead to life-threatening, hospital-acquired complications, including bloodstream infections. The longer they are left in, the higher the risk.

“We know that central venous catheters are invaluable for the safe and comprehensive care of some hospitalized patients, but just as they are helpful they can be harmful,” says lead author Vineet Chopra, M.D., M.Sc., a hospitalist and assistant professor of Internal Medicine at the U-M Medical School and research scientist at the VA Ann Arbor Healthcare System.

“The key to preventing complications is to remove devices when they are no longer necessary, but that requires knowing they are there in the first place. Our findings suggest that patient safety may be jeopardized if medical providers don’t improve their practices regarding device awareness.”

Catheter-related bloodstream infection is a common cause of healthcare-associated infection. Many patients who acquire such infections require extended hospital stays and increased overall treatment costs. Central venous catheters may also cause the formation of blood clots, some of which can be fatal. Both infections and clots can be prevented by removal of catheters that are no longer necessary.

The study included 990 patients and interviews with more than 1,000 medical providers at three academic medical centers in the U.S. Attending physicians and hospitalists in general medicine services were twice as likely to be unaware of the presence of a central venous catheter compared to interns and residents.

Critical care physicians were most likely to know which patients had a device in place and awareness was better among specialties that used central venous catheters more often, such as cardiology and oncology. Lack of awareness was greatest for peripherally inserted central catheters (or, PICCs) which are often placed by specially trained nurses or interventional radiologists.

Visit University of Michigan for the study.

 

 

Study links Enterovirus in kids to T1D

Enterovirus infection may be tied to the development of type 1 diabetes, Taiwanese researchers found. In a retrospective analysis of national insurance data, children younger than age 18 who had been infected with enterovirus were 48% more likely to develop type 1 diabetes, Tsai-Chung Li, MD, of China Medical University in Taiwan, and colleagues reported online in Diabetologia.

The results "suggest that a preventive strategy, such as an effective vaccine against enterovirus infection, may lessen the incidence of type 1 diabetes in Taiwan," the researchers wrote.

It's well known that type 1 diabetes is caused by a complex interaction between genetic susceptibility, the immune system, and environmental factors. Genetic predisposition to type 1 diabetes has been elucidated, Chung-Li and colleagues said, but environmental triggers are less understood.

It's become important to investigate that aspect because type 1 diabetes incidence has grown, and genetic factors alone don't explain the rise, they said.

Some work has suggested that infection with enterovirus -- which includes Coxsackievirus A, Coxsackievirus B, and echovirus -- may play a role. They looked at data from Taiwan's national health insurance system from 2000-2007.

They found that the overall incidence of type 1 diabetes was higher in kids who'd been infected by enterovirus (5.73 versus 3.89 per 100,000), for an incidence rate ratio 1.48 of among infected children (95% CI 1.19-1.83).

Adjusted analyses showed that enterovirus infection and older age were associated with a higher risk of type 1 diabetes. Specifically, kids who were older than age 10 had an increased risk of type 1 diabetes.

There was no relationship, however, between type 1 diabetes and either allergic rhinitis or bronchial asthma.

Chung-Li and colleagues noted that The Environmental Determinants of Diabetes in the Young (TEDDY) study is ongoing and aims to determine how environmental factors influence the onset of type 1 diabetes in susceptible patients. It has already shown, for instance, that Coxsackievirus B1 is associated with an increased risk of type 1 diabetes in Finland. Visit MedPage Today for the study.

 

 

Ansell introduces new single-use glove with a better grip for wet, oily objects

Ansell is giving workers a better grip, especially for wet and oily objects, with the new TouchNTuff 93-250 gloves. Made of a nitrile polymer with an innovative texture treatment, the gloves are proven in tests to deliver a significant improvement in grip for wet and dry objects compared to standard nitrile gloves, and were the only disposable gloves tested capable of gripping oily objects.

ANSELL GRIP Technology, one of six Ansell technologies, gives workers the confidence to handle wet and slippery objects. The 93-250 TouchNTuff gloves provide latex-free comfort, chemical splash resistance and proven grip performance for a safer, more productive workplace.

The 93-250 TouchNTuff Grip Glove is ideal for reducing hand and arm fatigue in environments where users are handling wet and greasy parts and materials, and tools requiring tactility and precision, such as compounding, fastening and assembly in manufacturing and laboratory operations.

Visit Ansell for more information.