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Archive for the ‘ProMED-Mail’ Category

Patients may have been exposed to HIV and hepatitis at Florida hospital


Nosocomial_copy

The title above was the heading of a ProMED-Mail post in which stated that “More than 1800 patients treated by one nurse at a South Florida hospital may have been exposed to HIV [human immunodeficiency virus] and hepatitis [B and C virus infection]. Broward General Medical Center said Monday [5 Oct 2009] that a nurse reused saline bags andtubing during cardiac stress tests involving the injection of fluids.

The hospital has sent letters to all 1851 people who may’ve been affected between January 2004 and early September [2009?]. Hospital officials say the risk of exposure is low, but all affected patients should be tested for HIV and hepatitis B and C [virus infection].

The nurse, who has not been identified(!!!), resigned and was reported to the Board of Nursing. The hospital discovered the problem after a patient noticed the nurse misusing the equipment and anonymously called in.”

The comment from ProMEd “The risk of transmission of infection in this incident would seem to be low since apparently the 1st patients were exposed as long ago as 2004 and no cases of infection have been identified up to the present.

The extent of exposure, involving reuse of saline bags and tubing by a single nurse, is also likely to have been low compared with other incidents where there has been direct transmission of blood or re-use of contaminated needles and syringes. However continued vigilance is clearly necessary.”

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Virus Hunters Find Ebola, Marburg Source in Fruit Bat: Scientists are closing in on the source of Ebola and Marburg [hemorrhagic fevers], 2 of the world’s most-lethal infectious diseases. After a 5-year search in the jungles of Africa, an international team of virus hunters has identified a fruit bat that may be the natural host for both hemorrhage-causing diseases. Also, these viruses are more widespread than previously thought, according to their research, which will be published via an open-access BioMed Central journal.

The study, based on blood tests on more than 2000 bats in Gabon and the Republic of Congo, will help scientists solve a mystery that has confounded them for more than 30 years: which species harbor Ebola and Marburg [viruses] without getting sick. The answer may explain how the viruses persist in the environment and point to ways humans can avoid a disease that causes fatal bleeding and organ failure in at least half of cases.”

“Of all the bats sampled in significant numbers, only specimens of the cave-roosting Egyptian fruit bat, or _Rousettus aegyptiacus_, were found to harbor antibodies against both ebolavirus and marburgvirus, the authors wrote, “suggesting that this species may be a natural host of both viruses.” The Egyptian rousette, with a doglike face and ears, is found along the Nile River in Egypt, across Sub-Saharan Africa, eastern Mediterranean and the Middle East. While some groups may occasionally roost outside in trees, the bats of this species prefer to inhabit caves, mines and tombs, and feast on fruit trees at night. These preferences give it a stronger link with the circulation of ebolavirus and marburgvirus more frequently found in rain forests, said Pierre Formenty, leader of the emerging and dangerous pathogens team at the World Health Organization (WHO) in Geneva.”

“Once a human is infected, there is no cure for ebolavirus or marburgvirus infection. After an incubation period of about a week, victims rapidly develop high fever, diarrhea, vomiting, respiratory disorders and hemorrhaging. Death can ensue within a few days. About a quarter of Marburg hemorrhagic fever cases are fatal, whereas case fatality rates range from 50 to 80 percent with Ebola hemorrhagic fever in Africa”

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This was the ProMED-Mail moderator’s comment on what came out in the post entitled

INFLUENZA PANDEMIC (H1N1) 2009 (04): PANDEMIC ORIGINS

alluding to the paper entitled

Dating the emergence of pandemic influenza viruses

[These authors have carried out phylogenetic analyses of all available influenza virus sequences by an alternate methodology. In the case of influenza genome sequences, establishing the times of most recent common ancestor (TMRCA) can provide an estimate of when virus genes emerged in a given host that allows the time of interspecies transmission to be inferred.

The authors have used this approach to investigate the possible date of introduction to humans of each of the genes for all available 20th century pandemic influenza strains.

The mean TMRCA estimates of each gene segment of H1N1 viruses shows that the components of the 1918 pandemic strain were circulating in mammalian hosts, i.e., swine and humans, at least 2 to 15 years prior to the pandemic.

The phylogenetic analyses suggest that the 1918 H1N1 pandemic virus most likely was generated by reassortment between mammalian viruses and a previous human strain and was not a pure avian virus, likewise that seasonal and classic swine H1N1 viruses were not derived directly from the 1918 virus but rather their precursors co-circulated during the pandemic.

Furthermore, mean TMRCA estimates also suggest that the avian-derived genes of the H2N2 and H3N2 pandemic strains may have been introduced to humans on multiple occasions over a number of years.

These conclusions regarding the origin of the pandemic viruses of the 20th century are somewhat different from the outcome of previous analyses, and in the absence of isolates from earlier years, are likely to remain controversial. – Mod.CP]

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This came out recently ind a ProMED-Mail post under the title of “OSELTAMIVIR CONTAMINATION, RIVERS – JAPAN”

“Tamiflu [oseltamivir], the primary flu-fighting drug, is getting into surface waters where ducks and other water birds may pick it up. If the birds host influenza viruses, which many normally do, those viruses may develop a resistance to the drug, scientists now worry. The premier flu-fighting drug is contaminating rivers downstream of sewage-treatment facilities, researchers in Japan confirm. The source: urinary excretion by people taking oseltamivir phosphate, better known as Tamiflu.

Concerns are now building that birds, which are natural influenza carriers, are being exposed to waterborne residues of Tamiflu’s active form and might develop and spread drug-resistant strains of seasonal and avian flu.”

The team collected samples before, during and after the season of the flu of the year 2008/2009, and they found that “Values were in the low nanograms per litre [ng/l] range during the 1st and last samplings, and reached a high of almost 300 ng/l at one outflow during the flu’s peak, a week when there were 1738 recorded flu cases in Kyoto”

It was also mentioned in the post that “Once ingested, virtually all Tamiflu will end up in the environment in the active form, notes environmental chemist Jerker Fick of Umea University in Sweden. The reason: Tamiflu becomes active once the body converts it into a carboxylate form. Roughly 80 per cent of an ingested dose becomes this OC, which the body eventually excretes. The body sheds the remaining 20 per cent of Tamiflu in its original form, but this phosphate form is immediately turned into the active, carboxylate form when it reaches a water treatment plant, he says.”

I think that this article is so important, and it clearly reflects the importance of science journalism, I mean there are many points of research that could emerge from just piece of info, for example; people who work on sewage treatment can search for any chelating chemicals that could bind tamiflu in the treatment plants, also innovations in treatment processes could eliminate such chemical traces, search for antibiotics in rivers for the same reason, and, and …

think of it, and don’t miss to leave a comment!

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FLAARDS!

This came in a recent ProMED-Mail post under the title of “INFLUENZA PANDEMIC (H1N1) 2009 (61): FLU A-ASSOCIATED ACUTE RESPIRATORY DISEASE SYNDROME

“Swine flu [influenza pandemic (H1N1) 2009 virus infection] is most dangerous when it causes the lungs to become inflamed, flood with fluid, and fail to function, doctors in Australia and New Zealand have found. While a majority of people infected with the virus have a mild illness, a small number develop life-threatening disease, intensive care specialists Steven Webb and Ian Seppelt said. They described the most common of 3 main complications from the pandemic 2009 strain as “flu A-associated acute respiratory disease syndrome”, or “FLAARDS.”

“Intensive care doctors in Australia and New Zealand are pooling data on more than 400 swine flu cases to describe disease patterns and treatment strategies, and inform the Northern Hemisphere countries about what to expect this winter [2009-10]. “ICUs [intensive care units] are the ‘canary in the coal mine’,” Webb and Seppelt wrote in the editorial. “It is only by documenting the severe cases requiring intensive care that it is possible to get an idea of the overall impact of this new disease.”

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