NEWS SCAN: Avian flu in Russia, drug-resistant hospital infections, tainted antiseptics, emergency response in Africa

Dec 5, 2012

Low-path flu virus blamed for wild-duck deaths in southern Russia
The influenza virus that killed hundreds or thousands of ducks in Russia's Krasnodar region near the Black Sea was not highly pathogenic H5N1, Bloomberg News reported yesterday. Tests showed that the virus, which killed "hundreds" of ducks in coastal lakes last week, was a low-pathogenicity strain, said Alexei Alekseenko, a spokesman for Rosselkhoznadzor, Russia's federal agency for animal and plant disease surveillance. A Nov 30 report from Agence France-Presse (AFP) had said about 4,000 wild ducks in Krasnodar died from infection with an H5 virus. The affected lakes are near the Black Sea resort town of Anapa. Krasnodar officials said no poultry for human consumption were hit by the outbreak, according to the Bloomberg story. Alekseenko said Rosselkhoznadzor would eliminate dead birds from the area but would not cull other ducks. Krasnodar officials ordered a quarantine of the affected areas and banned hunting there.
Dec 4 Bloomberg story
Nov 30 AFP story

Experts say systematic approach key to fighting drug-resistant hospital infections
Hospitals can combat outbreaks caused by multidrug-resistant organisms (MDROs) by promoting hand hygiene of healthcare workers, meticulous cleaning and disinfection of equipment, adherence to established infection-control practices, and better screening, two Harvard infectious disease experts said today. Writing in the New England Journal of Medicine (NEJM), Thomas J. Sandora, MD, MPH, and Donald A. Goldmann, MD, of Boston Children's Hospital and the Department of Pediatrics at Harvard Medical School, said, "Reliable adherence to basic infection control practices is the key to interrupting transmission in our hospitals." They add, "We urgently need screening media (or real-time genomic tests) that can be deployed quickly to identify patients who are colonized with MDROs that surveillance networks have identified as emerging threats." They also encourage hospitals to design systems to facilitate adherence to best practices for stopping MDROs—such as "de-escalation" of antibiotic treatment—rather than to approach each infection individually.
Dec 6 NEJM perspective

FDA cites possible risk of infection from topical antiseptics
Contaminated topical antiseptic products have occasionally caused serious infections in patients, leading the US Food and Drug Administration (FDA) to ponder imposing stricter rules for manufacturers, two FDA officials wrote in an NEJM commentary today. Christina Y. Chang, MD, MPH, and Lesley-Anne Furlong, MD, cite cases in which contaminated iodophors, chlorhexidine gluconate, and quaternary ammonium compounds caused infections with various bacterial species. In decades past, it was assumed that the pharmacologic activity of topical antiseptics prevented contamination, they write. But contamination may occur during manufacture or during handling by users, and the scope of the problem is probably broader than it appears from postmarketing reports and the medical literature, they write. In 2009 an FDA advisory committee considered whether the agency should require sterile manufacturing conditions for topical antiseptics, but the panel found that the extent of the problem was unclear and reached no decision. The FDA is continuing to consider the question, and it will hold a public hearing on Dec 12 and 13.
Dec NEJM commentary
Information on FDA public hearing

Zambia meeting addresses health emergency response gaps in Africa
A 4-day regional forum for African governments, agencies, and other stakeholders is under way in Zambia to discuss unmet needs in surveillance and response capacities for public health emergencies in Africa. A press release yesterday from the World Health Organization Regional Office for Africa (WHO/AFRO) says that many African countries were unable to meet the original Jun 15, 2012, deadline set under the International Health Regulations (IHR) for developing core capacities for all-hazards emergency response, and the deadline has been extended until Jun 15, 2014. The WHO said gaps and weaknesses exist in core capacities, including legislation, preparedness, risk communication, human resources, food safety, and chemical and radionuclear attack. The goal of the meeting, which brings together 80 participants from 22 countries, is to allow the sharing of experiences and challenges in IHR implementation and to identify priorities and next steps where gaps exist. Dr. Patrick Chikusu, deputy minister of health in Zambia, said the delay in strengthening the region's core capacities is a major concern for global health security.
Dec 4 WHO/AFRO press release

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