Infection Control Today

OCT 2018

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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28 ICT October 2018 www.infectioncontroltoday.com NuShield Screen Protector Prevents Germ Growth on Electronic Device Surfaces LCD displays are a breeding ground for germs. You can't clean it enough to stay ahead of germs. The NuShield ® Triple A ™ over- lay film has been designed with antibacterial properties to pre- vent the growth of bacteria on the surface and will stand up to the harshest disinfectants, even bleach. It also eliminates glare and makes the screen easy to read. The film can be applied to any LCD surface and will protect it without sacrificing image clarity. Use on tablets, laptops, instru- ments, computer and monitors around your healthcare facility. Film availabe in sizes up to 80 inch diagonal. For more information visit: www.NuShield.com or call 877-900-9192 Hu utilized IDM's Epidemiological MODeling software (EMOD) to determine the likely outcome for the spread of an airborne virus. To capture the risk of a global pandemic, the model was confgured to simulate what would happen if a newly emerged virus—i.e., one in which health systems are not prepared for and likely do not have a vaccine to prevent—appeared in southeast Asia. The model utilized typical SIR (Susceptible-Infectious-Recovered) dynamics: all individuals were assumed to be susceptible, and immunity to the virus did not wane. The virus was given an R0 (the basic reproductive rate, or the number of secondary infections caused by a typical case) of 2.1. For comparison, seasonal fu has an R0 of 0.9 – 2.1, with a mean of 1.3; the R0 of the 1918-1919 pandemic-causing Spanish fu is estimated to have ranged from 1.4 – 2.8, with a mean of 2. Individuals in the model could travel both locally and by airplane, thereby moving the virus within and across countries. With an initial seeding of about 800 infections, the simulation demonstrated how an unchecked epidemic can very quickly evolve into a pandemic within a wholly susceptible population. The Lancet Infectious Diseases editorial (2018) says that improving the preparedness of the global health community to a pandemic, requires diligence in three arenas: vaccination, surveillance, and building response capacity. The development of a universal infuenza vaccine has been the focus of the most recent infuenza research, but the development of an effective vaccine is expected to take another fve to 10 years. Regarding surveillance for infuenza, The Lancet Infectious Diseases editorial (2018) says this crucial task is complex because "it needs to cover two key populations: animals and humans. It is expected that the next pandemic infuenza virus will originate from a spillover from birds, the natural reservoir of all infuenza viruses, or pigs, in which avian and human viruses can coexist, thus favoring recombination." And fnally, the editorial notes, "In case of an infuenza pandemic, the capacity to respond promptly will play a key part because of airborne transmission. Antivirals and antibiotics to prevent secondary bacterial infections will be important, while awaiting development of an effective vaccine, but stockpiles of these are currently insuffcient. Moreover, there is need to invest in strengthening health systems and microbiological capacities on the ground to enhance the rapid response to any outbreak." Expectations for management of outbreaks are greater than ever before. As Gamhewage (2018) observes, "During the last two decades, several high-profle disease outbreaks have had a profound effect on public health's response to epidemics and pandemics. Today, in sharp contrast to the last century, there is an expectation that we detect outbreaks faster and manage them better. The response to health emergencies today is vastly different from previous eras where containment was a pre-dominant strategy. Today, for any outbreak, we need to systematically use the combination of modern epidemiology utilizing the power of technology; new and easy-to -use feld-based rapid diagnostic tools; clinical care even in the harshest of conditions, vaccines and other medical counter-measures, rapidly developing them if they don't already exist; real-time training of front-line responders; and effective risk communication and community engagement. This new recognition that we need to marry the social aspects of epidemic and pandemic response with an ever-stronger bio-medical response is changing the way disease outbreaks are being managed." Dzau and Sands (2016) described the response effort to the most recent outbreak challenge, Ebola virus infection, "The battle to contain and ultimately defeat the Ebola epidemic of 2014-2015 has been vividly described. Caught off guard from the start and hindered by myriad coordination, communication, and other problems, a combination of local and international teams fought back with determination, courage, and eventually the deployment of substantial resources to stem the contagion and save lives. Yet more than 11,000 people died, and local economies were brought to a halt. The battle was won, but at immense cost. With the immediate crisis over, the world's attention has moved on. Ebola has vanished from the headlines and seemingly from policymakers' to-do lists. Attention has shifted to Zika and other competing priorities. Yet it would be a huge mistake to turn away and declare the war over, for West Africa remains vulnerable to a resurgence of Ebola. There will undoubtedly be new outbreaks; the only question is how well they will be contained." Continued vigilance is key. In a report, Global Health and the Future Role of the United States, the Committee on Global Health and the Future of the United States, part of the National Academies of Sciences, Engineering and Medicine, made the case for the continued commitment to global health: "The tremendous growth in international travel and trade that has occurred over the last several decades heightens the urgency of continued investments in global health. The resulting increased interconnectedness of the world and interdependency of countries, economies, and cultures have brought improved access to goods and services, but also a variety of health threats." Based on a rigorous and evidence-based consensus process, committee members formulated recommendations that, if implemented, would deliver a strong global health strategy and allow the United States to maintain its role as a global health leader. Let's examine a few of these recommendations: • Achieve global health security: In the last 10 years, outbreaks of potentially pandemic infuenza, Middle East respiratory syndrome coronavirus (MERS-CoV), Ebola, and most recently Zika have threatened populations around the world. In each case, global and national responses, including those of the United States, have been reactionary, uncoordinated, ineffective, and highly costly. Absent the establishment of fundamental public health protections and preparedness capabilities at home and abroad, the world will never be ready to prevent, detect, and respond to such outbreaks. A solid commitment in the form of a sustainable mechanism for addressing these global threats is a critical need. The committee urges the administration to create a coordinating

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