News Scan for Sep 04, 2014

WHO funding cuts and Ebola
Lab safety breaches in 2012 death
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Funding, focus hamper WHO response to West Africa Ebola outbreak

Response to the West African Ebola outbreak and other global health emergencies by the World Health Organization (WHO) has been hampered by substantial budget cuts in recent years, The New York Times reported yesterday.

The agency has had to slash its outbreak and emergency response teams, eliminate scores of positions, and witness the departure of veteran leaders who have led previous Ebola outbreak response efforts, the story said.

The WHO is not geared to be a first responder against deadly outbreaks, said Director-General Margaret Chan, MD, MPH. It does not have the staffing or ability to flood the Ebola epidemic region with help, she said, so it must rely on assistance from leaders of the affected nations and from countries around the world.

The global financial crisis several years back hit the WHO hard, the story said. The agency was forced to cut nearly $1 billion from its 2-year budget, which now stands at just under $4 billion. In contrast, the US Centers for Disease Control and Prevention's (CDC's) 2-year budget is about three time that.

In addition, the WHO has recently placed more emphasis on chronic diseases, such as heart disease and diabetes.

WHO experts acknowledged, however, that the agency could have responded earlier to West Africa's Ebola outbreak. "There's no doubt we've not been as quick and as powerful as we might have been," said Marie-Paule Kieny, PhD, an assistant director-general.

"Of course in retrospect I really wish that we had jumped much higher much earlier," said Keiji Fukuda, MD, MPH, assistant director-general in charge of outbreak response. But he added, "If this outbreak had been a typical outbreak, nobody would be saying we did too little, too late."
Sep 3 New York Times story


Report notes serious breaches in 2012 meningococcal lab death

Several lab safety breaches were noted in the 2012 death of a California lab worker who developed meningococcal disease from work exposure, California and CDC public health experts noted in a report today.

Writing in the CDC's Morbidity and Mortality Weekly Report (MMWR), the investigators said that infractions at the lab included manipulation of Neisseria meningitidis isolates on an open lab bench, improper use of personal protective equipment (PPE), and failure to offer quadrivalent meningococcal vaccine to microbiologists.

The report did not name the lab worker who died or the facility, but media at the time reported that he was 25-year-old Richard Din, a microbiologist at the San Francisco Veterans Affairs Medical Center. He died on Apr 28, 2012, 3 hours after arriving at the emergency department of the medical center where he worked, the MMWR report said. His symptoms began the night before.

The report said that in almost all previous cases of lab-acquired meningococcal disease, infected microbiologists had manipulated isolates on an open bench instead of using a biosafety cabinet. Although the report did not specify the practices Din had used, it said he had worked with N meningitidis serogroup B isolates in the weeks before his death. That strain is not covered in the US-approved quadrivalent meningococcal vaccine.

The report lists seven infractions related to safety procedures and four related to PPE. It said the Occupational Safety and Health Administration (OSHA), after its safety inspection, issued three citations for serious failures to protect lab workers.
Sep 5 MMWR report


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