Infection Control Articles

Clinical Features: Most people infected with E. coli 0157:H7 develop diarrhea (often bloody) and abdominal cramps 2-8 days after swallowing the organism, but some illnesses last longer and are more severe.  Infection is usually diagnosed by culture of a stool sample.  Most people recover within a week, but some develop a severe infection.  A type of kidney failure called hemolytic uremic syndrome can begin as the diarrhea is improving; this can occur in people of any age but is most common in children under 5 years old and the elderly.

Advise to Comsumers:  The FDA and  the CDC are warning consumers not to eat any varieties of prepackaged Nestle Toll House refrigerated cookie dough due to the risk of contamination with E. coli 0157:H7.  If consumers have any prepackaged, refrigerated Nestle Tool House cookie dough products in their home they should throw them away.  Cooking the dough is not recommended. 

Individuals who have recently eaten prepackaged, refrigerated Toll House cookie dough and have experienced any of these symptoms should contact their doctor immediately.

InCo and Associates will be listing a Pandemic Preparedness Plan for healthcare facilities in the next few days.  This item will be listed in our product section.  Coming soon Pandemic Preparedness for the physician office and for the general public.  How can you be prepared for the upcoming flu season.

CDC is currently investigating cases of respiratory illnesses in the states of California and Texas.  The individuals who have become ill are between the ages of 7 and 55.  63% of the cases are male.  Treatment for anyone suspected of having this illness (swine influenza) are oseltamivir and zanamivr.  Symptoms of the illness include cold symptoms, fatigue, loss of appetite and fever.  Individuals should see their physician to have a nasal culture tested for influenza and stay at home until symptoms have passed, usually 5-7 days.  Travel to the affected areas in Mexico is being discouraged.

16oo cases of swine flu reported in Mexico with 103 deaths.  Cases reported in the US include 7 in California, 2 in Kansas, 1 in Ohio, 8 in NYC (among a group of students who recently returned from Mexico), 2 in Texas.  Cases have also been reported in Canada, British Columbia, Nov Scotia, France, Spain, Scotland, and Israel.

Protecting yourself and your family:  Stay away from large groups of people.  Stay at least 6 feet away from individuals who have a respiratory tract infection.  Wear a mask if you have to be close to someone with a respiratory tract infection including someone who is living in your house.  If you are experiencing a fever greater than 100 try to get an influenza culture done and take antiviral medication within 48 hours of onset of symptoms.  Antivirals may not help if not started within 48 hour of onset of illness.

Person infected with the swine flu should be considered infectious up to 7 days after onset of symptoms.  People who are continue to be sick after 7 days should be considered infectious.  Especially children.

Infection control and health care epidemiology is the discipline concerned with preventing the spread of infections within the health-care setting. As such, it is a practical (rather than an academic) sub-discipline of epidemiology. It is an essential (though often underrecognized and undersupported) part of the infrastructure of health care. Infection control and hospital epidemiology are akin to public health practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.

Infection control concerns itself both with prevention (hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance) and with investigation and management of demonstrated or suspected spread of infection within a particular health-care setting (e.g. outbreak investigation). It is on this basis that the common title being adopted within health care is “Infection Prevention & Control”.

Hand hygiene

Independent studies by Ignaz Semmelweis in 1847 in Vienna and Oliver Wendell Holmes in 1843 in Boston established a link between the hands of health care workers and the spread of hospital-acquired disease. The Centers for Disease Control and Prevention (CDC) has stated that “It is well-documented that the most important measure for preventing the spread of pathogens is effective handwashing.” In the United States, hand washing is mandatory in most health care settings and required by many different state and local regulations as well as good sense.

In the United States, Occupational Safety and Health Administration (OSHA) standards require that employers must provide readily accessible hand washing facilities, and must ensure that employees wash hands and any other skin with soap and water or flush mucous membranes with water as soon as feasible after contact with blood or other potentially infectious materials (OPIM).

Cleaning, disinfection and sterilization…

Personal protective equipment

Personal protective equipment (PPE) is specialized clothing or equipment worn by a worker for protection against a hazard. The hazard in a health care setting is exposure to blood, saliva, or other bodily fluids or aerosols that may carry infectious materials such as Hepatitis C, HIV, or other blood borne or bodily fluid pathogen. PPE prevents contact with a potentially infectious material by creating a physical barrier between the potential infectious material and the healthcare worker. In the United States, the Occupational Safety and Health Administration (OSHA) requires the use of Personal protective equipment (PPE) by workers to guard against blood borne pathogens if there is a reasonably anticipated exposure to blood or other potentially infectious materials.

Components of Personal protective equipment (PPE) include gloves, gowns, bonnets, shoe covers, face shields, CPR masks, goggles, surgical masks, and respirators. How many components are used and how the components are used is often determined by regulations or the infection control protocol of the facility in question. Many or most of these items are disposable to avoid carrying infectious materials from one patient to another patient and to avoid difficult or costly disinfection. In the United States, OSHA requires the immediate removal and disinfection or disposal of worker’s PPE prior to leaving the work area where exposure to infectious material took place.

Vaccination of health care workers

Health care workers may be exposed to certain infections in the course of their work. Vaccines are available to provide some protection to workers in a healthcare setting. Depending on regulation, recommendation, the specific work function, or personal preference, healthcare workers or first responders may receive vaccinations for hepatitis B; influenza; measles, mumps and rubella; Tetanus, diphtheria, pertussis; N. meningitidis; and varicella. In general, vaccines do not guarantee complete protection from disease, and there is potential for adverse effects from receiving the vaccine.

Surveillance for emerging infections

Surveillance is the act of infection investigation using the CDC definitions. Determining an infection requires an ICP to review a patient’s chart and see if the patient had the signs and symptom of an infection. Surveillance definition cover infections of the bloodstream, Urinary tract, pneumonia, and sugical sites.

Surveillance traditionally involved significant manual data assessment and entry in order to assess preventative actions such as isolation of patients with an infectious disease. Increasingly, integrated computerised software solutions are becoming available, such as Infection Monitor Pro. Such products actively assess incoming risk messages from microbiology and other online sources. By reducing the need for data entry, this software significantly reduces the data workload of Infection Control Practitioners (ICP), freeing them to concentrate on clinical surveillance.

As approximately one third of healthcare acquired infections are preventable , surveillance and preventative activities are increasingly a priority for hospital staff. In the United States, a study on the Efficacy of Nosocomial Infection Control Project (SENIC) by the CDC found that hospitals reduced their nosocomial infection rates by approximately 32 per cent by focusing on surveillance activities and prevention efforts.

Outbreak investigation

When an unusual cluster of illness is noted, infection control teams undertake an investigation to determine whether there is a true outbreak, a pseudo-outbreak (a result of contamination within the diagnostic testing process), or just random fluctuation in the frequency of illness. If a true outbreak is discovered, infection control practitioners try to determine what permitted the outbreak to occur, and to rearrange the conditions to prevent ongoing propagation of the infection. Often, breaches in good practice are responsible, although sometimes other factors (such as construction) may be the source of the problem.

Bloodborne Pathogens

A Bloodborne Pathogens or blood-borne disease is one that can be spread by contamination by blood.

The most common examples are HIV, hepatitis B, hepatitis C and viral haemorrhagic fevers.

Diseases that are not usually transmitted directly by blood contact, but rather by insect or other vector, are more usefully classified as vector-borne disease, even though the causative agent can be found in blood. Vector-borne diseases include West Nile virus and malaria.

Many blood-borne diseases can also be transmitted by other means.

Since it is difficult to determine what pathogens any given blood contains, and some blood-borne diseases are lethal, standard medical practice regards all blood (and any body fluid) as potentially infective. Blood and Body Fluid precautions are a type of infection control practice that seeks to minimize this sort of disease transmission.

Blood for blood transfusion is screened for many blood-borne diseases.

Needle exchanges are an attempt to reduce the spread of blood-borne diseases in intravenous drug users.

Sharps Waste and Blood-Borne Disease

Sharps waste is a form of medical waste composed of used sharps, which includes any device or object used to pucture or lacerate the skin. Sharps waste is classified as biohazardous waste and must be carefully handled. Common medical materials treated as sharps waste are:

• Syringes & injection devices
• Blades
• Contaminated glass & some plastics
• Qualifying materials

In addition to syringes and injection devices anything attached to them will also be considered sharps waste. Examples of such attachments could be a syringe, tube, or vacutainer. The entire complex is treated as one unit of sharps waste, even though the attached item cannot puncture or lacerate the skin.

The category of blades can include razors, scalpels, x-acto knives, scissors, or any other medical items used for cutting in the medical setting.

Both needles and blades are always treated and handled with the highest concern as sharps waste. This is regardless of if they have been contaminated with biohazardous material. While glass and plastic are considered sharps waste, their handling methods can vary.

Glass and plastic items, which have been contaminated with a biohazardous material, will be treated with the same concern as needles and blades (even if unbroken). If not contaminated, broken glass and plastic is still a sharp waste but does not pose the same public health risk. Therefore broken glass and plastic that has not been contaminated is not handled as delicately. Some common medical items of this category are test tubes, microscope slides, culture dishes, pipettes, and vials.

It should be noted that individual facilities have detailed definitions of specific materials that qualify. The treatment of a particular material as sharps waste may vary from one facility to the next.

Dangers involved in sharps waste

As a biohazardous material, injuries from sharps waste can pose a large public health concern. By penetrating the skin it is possible for this waste to spread blood-borne pathogens. The spread of these pathogens is directly responsible for the transmission of blood-borne diseases such as Hepatitis B (HBV), Hepatitis C (HCV), and HIV. Health care professionals expose themselves to the risk of transmission of these diseases when handling sharps waste.

The large volume handled by health care professionals on a daily basis increases the chance that an injury may occur. Contraction of disease through such an injury will inhibit health care workers from providing their services. This is a cost incurred by society in the promotion of public health. As trained professionals their services are not easily replaced.

The general public can be at direct risk to injuries from sharps waste as well. If these hazardous materials are not separated from standard waste, individuals can unknowingly come in contact with them. In addition, if sharps waste is not disposed, and removed from the environment, then it can be subject to reuse and misuse (both intentional and unintentional). This is especially applicable in the areas of hypodermic needles and blades. The spread of disease through sharps waste is preventable through proper management and disposal.

Sharps waste management & disposal

Extreme care must be taken in the management and disposal of sharps waste. The main goal in sharps waste management is to safely handle all materials until they can be properly disposed. The final step in the disposal of sharps waste is to dispose of them in an autoclave. A less common approach is to incinerate them, typically only chemotherapy sharps waste is incinerated. Steps must be taken along the way to minimize the risk of injury from this material, while maximizing the amount of sharps material disposed. From the moment sharps waste is produced it is to be handled as little as possible. Health care workers are to minimize their interaction with sharps waste by disposing of it in a sealable container. If the sharps waste incorporates an additional part, such as a syringe, tube, or handle the whole unit is disposed together. Attempts by health care workers to disassemble sharps waste is kept to a minimum. Strict hospital protocols and government regulations ensure that hospital workers handle sharps waste safely and dispose effectively.

The self locking and sealable containers are made of plastic so that the sharps waste can not easily penetrate through the sides. The unit is designed so that the whole container can be disposed of with the other biohazardous waste. Single use sharps containers of various sizes are sold throughout the world. These are colored red and labeled for biohazardous sharps waste. They are now commonplace in clinics and hospitals. Large medical facilities may have their own ‘mini’ autoclave in which these sharps containers are disposed of with other medical wastes. This minimizes the distance the containers have to travel and the number of people to come in contact with the sharps waste. Smaller clinic or offices without such facilities are required by federal regulations to hire the services of a company that specializes in transporting and properly disposing of the hazardous wastes.

Some companies, such as BioSystems, provide sharps management and disposal with special re-usable containers in an effort to reduce landfill waste, increase safety and help hospitals and clinics save money by cutting the cost of expensive one use containers.

Bloodborne Pathogens From Wikipedia

For more detailed Bloodborne Pathogen, Bloodborne Disease & Sharps Waste information see Blood-borne disease on Wikipedia.

Bioterrorism

Bioterrorism is terrorism by intentional release or dissemination of biological agents (bacteria, viruses or toxins); these may be in a naturally-occurring or in a human-modified form.

Definition

According to the U.S. Centers for Disease Control and Prevention (CDC):

A bioterrorism attack is the deliberate release of viruses, bacteria, or other germs (agents) used to cause illness or death in people, animals, or plants. These agents are typically found in nature, but it is possible that they could be changed to increase their ability to cause disease, make them resistant to current medicines, or to increase their ability to be spread into the environment. Biological agents can be spread through the air, through water, or in food. Terrorists may use biological agents because they can be extremely difficult to detect and do not cause illness for several hours to several days. Some bioterrorism agents, like the smallpox virus, can be spread from person to person and some, like anthrax, can not.

History

Biological terrorism dates as far back as ancient Roman civilization, where dead and rotting animals were thrown into wells to poison water supplies. (Bock,2001) This early version of biological terrorism was used to destroy enemy forces covertly. It continued on into the 14th century where the bubonic plague was used to infiltrate enemy cities by both instilling the fear of infection in residences, in hopes that they would evacuate, and also to destroy defending forces that would not yield to the attack. The use of disease as a weapon in this stage of history exhibited a lack of control aggressors had over their own biological weapon. Primitive medical technology provided limited means of protection for the aggressor and a battles surrounding geographical regions. After the battle was won, the inability to contain enemies who escaped death lead to wide spread epidemics affecting not only the enemy forces, but also surrounding regions inhabitants. Due to the use of these biological weapons, and the apparent lack of medical advancement necessary to defend surrounding regions from them, wide spread epidemics such as the bubonic plague quickly moved across all of Western Europe, destroying a large portion of its population. The victims of biological terrorism in fact became weapons themselves. This was noted in the Middle Ages, but medical advancements had not progressed far enough to prevent the consequences of a weapons use. (Eitzen and Takafuji, 1997)

In the 15th century, smallpox was used on contaminated clothing to defeat South American and Native American forces. (Bock, 2001) Again, the use of biological weapons for which limited protection and containment was available, lead to casualties on both sides of battles. Bioterrorism continued to be an effective method of weakening an adversary but it was also difficult to contain. In the Revolutionary War, colonists were vaccinated from the small-pox virus and then used the virus to intentionally infect enemies. This demonstrates a major advancement in the evolution of bioterrorism. Once the ability to defend from biological warfare became possible through medical advancement, the weapons became far more valuable.

As time continued the use of biological warfare became more and more sophisticated. Countries were developing weapons that delivered much higher effectiveness and less chance of infecting the wrong party. One significant enhancement in biological weapon development was the first use of Anthrax. Anthrax effectiveness was initially limited to victims of large dosages. This became a weapon of choice because it is easily transferred, has a high mortality rate, and can be easily obtained. Also, variants of the Anthrax bacterium can be found all around the world making it the biological weapon of choice in the early 19th century. Another property of Anthrax that helped fuel its use as a biological weapon is its poor ability to spread far beyond the targeted population.

By the time World War I began, attempts to use anthrax were directed at animal populations. This was ineffective. Instead, the use of poisonous mustard gas became the biological weapon of choice. The sheer horror of its affects lead to a treaty called the Geneva Protocol of 1925. The treaty was created to prevent the use of asphyxiating gas as a method of biological warfare. (Brooks, 2001) While this was a significant advancement toward the prevention of biological weapon use, the treaty said nothing about weapon development. Secretly, biological weapon development programs existed in many nations. While no documented instances of biological weapon use exist it is believed that this was primarily due to the programs immaturity and not the unwillingness to use them.

American biological weapon development began in 1942. President Franklin D. Roosevelt placed George W. Merck in charge of the effort to create a development program. You may recognize the name Merck, Mr. Merck is also the founder of Merck Pharmaceuticals. These programs continued until 1969, when by executive order President Richard Nixon shut down all programs related to American offensive use of biological weapons. (http://fas.org/nuke/guide/usa/cbw/bw.html)

Accusations of the use of biological weapons against North Korea were spread during Viet Nam, however it is believed that those accusations were propaganda developed by the North Korean regime to villainize American Armed Forces. As the 70’s passed, global efforts to prevent the development of biological weapons and their use were widespread. In 1972 the prohibition of development, production and stockpiling biological weapons was developed.

In the 1980’s Iraq made substantial efforts to develop and stockpile large amounts of biological weapons. By the end of the 80’s Iraq had several sites dedicated to the research and development of biological warfare. They began to test their findings in the late 80’s. These actions lead to the first Gulf war in which Iraq’s biological weapons were dismantled and destroyed.

Since that time, efforts to use biological warfare has been more apparent in small radical organizations attempting to create fear in the eyes of large groups. Some efforts have been partially effective in creating fear, due to the lack of visibility associated with modern biological weapon use by small organizations. In 1995 a small terrorist group launched a terrorist attack aboard a Tokyo subway. The attack killed twelve and affected more than 5000. The response of Japanese emergency services successfully prevented an outcome with much higher mortality rates.

In the United States a more recent biological terrorism attack occurred in 2001 when letters laced with infectious anthrax were delivered to news media offices and the U.S Congress. (Johnston,2005) The letters killed 5. While many believed this attack to be in relation to Iraq’s development of biological weapons, tests on the anthrax strand used in the attack pointed to a domestic source.

Types of biological agents

The CDC has defined and categorized bioterrorism agents according to priority 2 as follows:

Category A agents

These are biological agents with both a high potential for adverse public health impact and that also have a serious potential for large-scale dissemination. The Category A agents are anthrax, smallpox, plague, botulism, tularemia, and viral hemorrhagic fevers.

Anthrax
Anthrax is a non-contagious disease. An anthrax vaccine does exist but requires many injections and has side effects that render it unsuitable for general use.

Smallpox
Smallpox is a highly contagious virus. It transmits easily through the atmosphere and has a high mortality rate (20-40%). Smallpox was eliminated in the world in the 1970s, thanks to a worldwide vaccination program. However, some virus samples are still available in Russian and American laboratories. Some believe that after the collapse of the Soviet Union, cultures of smallpox have become available in other countries. Although people born pre-1970 will have been vaccinated for smallpox under the WHO program, the effectiveness of vaccination is limited since the vaccine provides high level of immunity for only 3 to 5 years. As a biological weapon smallpox is dangerous because of the highly contagious nature of both the infected and their pox. Smallpox occurs only in humans, and has no external hosts or vectors.

Botulinum toxin
Botulinum toxin is one of the deadliest toxins known, and is produced by the bacterium Clostridium botulinum. Botulism causes death by respiratory failure and paralysis. It is also easy to obtain since it is found in the cosmetic products Botox and Dysport.

Ebola
Ebola is a viral hemorrhagic fever, with fatality rates ranging from 50-90%. No cure currently exists, although vaccines are in development. The United States and the erstwhile Soviet Union both investigated the use of ebola for biological warfare, and the Aum Shinrikyo group possessed cultures of the virus. Ebola kills its victims through multiple organ failure and hypovolemic shock.

Plague
Plague is a disease caused by the Yersinia pestis bacterium. Rodents are the normal host of plague, and the disease is transmitted to humans by flea bites and occasionally by aerosol in the form of pneumonic plague. The disease has a history of use in biological warfare dating back many centuries, and is considered a threat due to its ease of culture and ability to remain in circulation among local rodents for a long period of time.

Marburg
Marburg is a viral hemorrhagic fever virus first discovered in Marburg, Germany. Fatality rates range from 25-100%, and although a vaccine is in development, no treatments currently exist aside from supportive care. As with ebola, basic barrier nursing significantly reduces the virulence of the virus.

Tularemia
Tularemia, or rabbit fever, is a generally non-lethal and severely incapacitating disease caused by the Francisella tularensis bacterium. It has been widely produced for biological warfare due to its highly infective nature, and ease of aerosolization.

Category B agents

Category B agents are moderately easy to disseminate and have low mortality rates.

Brucellosis (Brucella species) Brucellosis is an infectious disease caused by the bacteria of the genus Brucella. These bacteria are primarily passed among animals, and they cause disease in many different vertebrates. Various Brucella species affect sheep, goats, cattle, deer, elk, pigs, dogs, and several other animals. Humans become infected by coming in contact with animals or animal products that are contaminated with these bacteria. In humans brucellosis can cause a range of symptoms that are similar to the flu and may include fever, sweats, headaches, back pains, and physical weakness. Severe infections of the central nervous systems or lining of the heart may occur. Brucellosis can also cause long-lasting or chronic symptoms that include recurrent fevers, joint pain, and fatigue

• Epsilon toxin of Clostridium perfringens
• Food safety threats (e.g., Salmonella species, E coli O157:H7, Shigella, Stash)
• Glanders (Burkholderia mallei)
• Melioidosis (Burkholderia pseudomallei)
• Psittacosis (Chlamydia psittaci)
• Q fever (Coxiella burnetii)
• Ricin toxin from Ricinus communis (castor beans)
• Staphylococcal enterotoxin B
• Typhus (Rickettsia prowazekii)
• Viral encephalitis (alphaviruses, e.g.: Venezuelan equine encephalitis, eastern equine encephalitis, western equine encephalitis)
• Water supply threats (e.g., Vibrio cholerae, Cryptosporidium parvum, Cholera )

Category C agents

Category C agents are pathogens that might be engineered for mass dissemination because they are easy to produce and have potential for high morbidity or mortality (examples: nipah virus, hantavirus and multi-drug resistant Tuberculosis (MTB).

Bioterrorism on Wikipedia

For more information about Bioterrorism please visit Bioterrorism on Wikipedia.

Avian Influenza

Avian influenza, sometimes Avian flu, and commonly bird flu refers to “influenza caused by viruses adapted to birds.”

“Bird flu” is a phrase similar to “Swine flu”, “Dog flu”, “Horse flu”, or “Human flu” in that it refers to an illness caused by any of many different strains of influenza viruses that have adapted to a specific host. All known viruses that cause influenza in birds belong to the species: Influenza A virus. All subtypes (but not all strains of all subtypes) of Influenza A virus are adapted to birds, which is why for many purposes avian flu virus is the Influenza A virus (note that the “A” does not stand for “avian”).

Adaption is non-exclusive. Being adapted towards a particular species does not preclude adaptions, or partial adaptions, towards infecting different species. In this way strains of influenza viruses are adapted to multiple species, though may be preferential towards a particular host. For example, viruses responsible for influenza pandemics are adapted to both humans and birds. Recent influenza research into the genes of the Spanish Flu virus shows it to have genes adapted to both birds and humans; with more of its genes from birds than less deadly later pandemic strains.

Influenza Pandemic

For more details on this topic, see Influenza pandemic. Pandemic flu viruses have some avian flu virus genes and usually some human flu virus genes. Both the H2N2 and H3N2 pandemic strains contained genes from avian influenza viruses. The new subtypes arose in pigs coinfected with avian and human viruses and were soon transferred to humans. Swine were considered the original “intermediate host” for influenza, because they supported reassortment of divergent subtypes. However, other hosts appear capable of similar coinfection (e.g., many poultry species), and direct transmission of avian viruses to humans is possible. The Spanish flu virus strain may have been transmitted directly from birds to humans.

In spite of their pandemic connection, avian influenza viruses are noninfectious for most species. When they are infectious they are usually asymptomatic, so the carrier does not have any disease from it. Thus while infected with an avian flu virus, the animal doesn’t have a “flu”. Typically, when illness (called “flu”) from an avian flu virus does occur, it is the result of an avian flu virus strain adapted to one species spreading to another species (usually from one bird species to another bird species). So far as is known, the most common result of this is an illness so minor as to be not worth noticing (and thus little studied). But with the domestication of chickens and turkeys, humans have created species subtypes (domesticated poultry) that can catch an avian flu virus adapted to waterfowl and have it rapidly mutate into a form that kills in days over 90% of an entire flock and spread to other flocks and kill 90% of them and can only be stopped by killing every domestic bird in the area. Until H5N1 infected humans in the 1990s, this was the only reason avian flu was considered important. Since then, avian flu viruses have been intensively studied; resulting in changes in what is believed about flu pandemics, changes in poultry farming, changes in flu vaccination research, and changes in flu pandemic planning.

H5N1 has evolved into a flu virus strain that infects more species than any previously known flu virus strain, is deadlier than any previously known flu virus strain, and continues to evolve becoming both more widespread and more deadly causing Robert Webster, a leading expert on avian flu, to publish an article titled “The world is teetering on the edge of a pandemic that could kill a large fraction of the human population” in American Scientist. He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives. Since the article was written, the world community has spent billions of dollars fighting this threat with limited success.

H5N1

For more details on this topic, see H5N1 and Transmission and infection of H5N1.
The highly pathogenic Influenza A virus subtype H5N1 virus is an emerging avian influenza virus that has been causing global concern as a potential pandemic threat. It is often referred to simply as “bird flu” or “avian influenza” even though it is only one subtype of avian influenza causing virus.

H5N1 has killed millions of poultry in a growing number of countries throughout Asia, Europe and Africa. Health experts are concerned that the co-existence of human flu viruses and avian flu viruses (especially H5N1) will provide an opportunity for genetic material to be exchanged between species-specific viruses, possibly creating a new virulent influenza strain that is easily transmissible and lethal to humans.

Since the first H5N1 outbreak occurred in 1997, there has been an increasing number of HPAI H5N1 bird-to-human transmissions leading to clinically severe and fatal human infections. However, because there is a significant species barrier that exists between birds and humans, the virus does not easily cross over to humans, though some cases of infection are being researched to discern whether human to human transmission is occurring. More research is necessary to understand the pathogenesis and epidemiology of the H5N1 virus in humans. Exposure routes and other disease transmission characteristics such as genetic and immunological factors, that may increase the likelihood of infection, are not clearly understood.

Although millions of birds have become infected with the virus since its discovery, 206 humans have died from the H5N1 in twelve countries according to WHO data as of November 2007. (View the most current WHO Data regarding Cumulative Number of Human Cases.)

The Avian Flu claimed at least 200 humans in romainia, Greece, Turkey and Russia. Epidemioloigists are afraid that the next time such a virus mutates, it could pass from human to human. If this form of transmission occurs, another big pandemic could result. However, disease-control centers around the world are making avian flu their top priority.

Avian influenza From Wikipedia

For more information about Avian Influenza please visit Avian Influenza on Wikipedia.

Anthrax Information

Anthrax (Greek Άνθραξ for coal) is an acute disease in humans and animals that is caused by the bacterium Bacillus anthracis and is highly lethal in some forms. Anthrax is one of only a few bacteria that can form long-lived spores. When the bacteria’s life cycle is threatened by factors such as lack of food caused by their host dying or by a change of temperature, the bacteria turn themselves into more or less dormant spores to wait for another host to continue their life cycle.

On breathing, ingesting or getting spores in a cut in the skin, a new host allows these spores to reactivate themselves and multiply in their new host very rapidly. The anthrax spores in soil are very tough and can live many decades and perhaps centuries and are known to occur on all continents except Antarctica. Anthrax most commonly occurs in wild and domestic grass-eating mammals (ruminants) who ingest or breathe in the spores while eating grass. Anthrax can also be caught by humans when they are exposed to dead infected pigs, eat tissue from infected animals, or are exposed to a high density of anthrax spores from an animal’s fur, hide, or wool. Anthrax spores can be grown outside the body and used as a biological weapon. Anthrax cannot spread directly from human to human; but anthrax spores can be transported by human clothing, shoes etc. and if a person dies of anthrax their body can be a very dangerous source of anthrax spores. The word anthrax is the Greek word for coal, the germ’s name is derived from anthrakitis, the Greek word for anthracite, in reference to the black skin lesions victims develop in a cutaneous skin infection.

Anthrax Overview

Anthrax is one of the oldest recorded diseases of grazing animals such as sheep and cattle and is believed to be the Sixth Plague mentioned in the Book of Exodus in the Bible. Anthrax is also mentioned by Greek and Roman authors such as Homer (in The Iliad), Virgil (Georgics), and Hippocrates. Anthrax can also infect humans, usually as the result of coming into contact with infected animal hides, fur, wool (”Woolsorter’s disease”), leather or contaminated soil. Anthrax (”siberian ulcer”) is now fairly rare (a few to no cases per year in the developed world) in humans although it still occasionally occurs in ruminants, such as cattle, sheep, goats, camels, wild buffalo, and antelopes.

Bacillus anthracis bacteria spores are soil-borne and because of their long lifetime they are still present globally and at animal burial sites of anthrax-killed animals for many decades; spores have been known to have reinfected animals over 70 years after burial sites of anthrax-infected animals were disturbed.

Before the last century anthrax infections were a source of many thousands of dead animals and thousands of people dying each year in Europe, Asia and North America. French scientist Louis Pasteur developed the first effective vaccine for anthrax in 1881. Thanks to over a century of animal vaccination programs, sterilization of raw animal waste materials and anthrax eradication programs in North America, Australia, New Zealand, Russia, Europe and parts of Africa and Asia anthrax infection is now rare in domestic animals with normally only a few dozen cases reported every year. Anthrax is even rarer in dogs and cats where there was only one documented case in the USA in the last 15 years. Anthrax outbreaks do occur in a few wild animal populations with some regularity. The disease is more common in developing countries without widespread veterinary or human public health programs.

There are 89 known strains of anthrax, the most widely recognized being the virulent Ames strain used in the 2001 anthrax attacks in the United States. The Ames strain is extremely dangerous, though not quite as virulent as the Vollum strain which was successfully developed as a biological weapon during the Second World War, but never used. The Vollum (also incorrectly referred to as Vellum) strain was isolated in 1935 from a cow in Oxfordshire, UK. This is the same strain that was used during the Gruinard bioweapons trials. A variation of Vollum known as “Vollum 1B” was used during the 1960s in the US and UK bioweapon programs. Vollum 1B was isolated from William A. Boyles, a 46-year-old USAMRIID scientist who died in 1951 after being accidentally infected with the Vollum strain. The Sterne strain, named after a South African researcher, is an attenuated strain used as a vaccine.

Anthrax From Wikipedia

For more detailed Anthrax information see the Anthrax wiki on Wikipedia.