Interventions to Control Virus Transmission During an Outbreak of Ebola Hemorrhagic Fever: Experience from Kikwit, Democratic Republic of the Congo, 1995.

On 6 May 1995, the Médecins sans Frontières (MSF) coordinator in Kinshasa, Democratic Republic of the Congo (DRC), received a request for assistance for what was believed to be a concurrent outbreak of bacillary dysentery and viral hemorrhagic fever (suspected Ebola hemorrhagic fever [EHF]) in the town of Kikwit, DRC. On 11 May, the MSF intervention team assessed Kikwit General Hospital. This initial assessment revealed a nonfunctional isolation ward for suspected EHF cases; a lack of water and electricity; no waste disposal system; and no protective gear for medical staff. The priorities set by MSF were to establish a functional isolation ward to deal with EHF and to distribute protective supplies to individuals who were involved with patient care. Before the intervention, 67 health workers contracted EHF; after the initiation of control measures, just 3 cases were reported among health staff and none among Red Cross volunteers involved in body burial

Field guide for didymo DNA sample collection

This protocol is designed for work in two-person teams for both safety and to maximise sample integrity

Biosafety and Biohazards: Understanding Biosafety Levels and Meeting Safety Requirements of a Biobank.

When it comes to biobanking and working with different types of laboratory specimens, it is important to understand potential biohazards to ensure safety of the operator and laboratory personnel. Biological safety levels (BSL) are a series of designations used to inform laboratory personnel about the level of biohazardous risks in a laboratory setting. There are a total of four levels ranked in order of increasing risk as stipulated by the Center of Disease Control and Prevention (CDC) (Biosafety in microbiological and biomedical laboratories, 5th edn. HHS publication no. (CDC) 21-1112. https://www.cdc.gov/biosafety/publications/bmbl5/bmbl.pdf . Accessed 2 Jan 2016, 2009). We will address the main distinctions between these levels including briefly introducing hazards characteristics that classify biohazardous agents, as well as define the essentials in meeting safety requirements

14C contamination testing in natural abundance laboratories: a new preparation method using wet chemical oxidation and some experiences

Substances enriched with radiocarbon can easily contaminate samples and laboratories used for natural abundance measurements. We have developed a new method using wet chemical oxidation for swabbing laboratories and equipment to test for 14C contamination. Here, we report the findings of 18 months’ work and more than 800 tests covering studies at multiple locations. Evidence of past and current use of enriched 14C was found at all but one location and a program of testing and communication was used to mitigate its effects. Remediation was attempted with mixed success and depended on the complexity and level of the contamination. We describe four cases from different situations

Use of ultraviolet-fluorescence-based simulation in evaluation of personal protective equipment worn for first assessment and care of a patient with suspected high-consequence infectious disease

Background: Variations currently exist across the UK in the choice of personal protective equipment (PPE) used by healthcare workers when caring for patients with suspected high-consequence infectious diseases (HCIDs). Aim: To test the protection afforded to healthcare workers by current PPE ensembles during assessment of a suspected HCID case, and to provide an evidence base to justify proposal of a unified PPE ensemble for healthcare workers across the UK. Methods: One ‘basic level’ (enhanced precautions) PPE ensemble and five ‘suspected case’ PPE ensembles were evaluated in volunteer trials using ‘Violet’; an ultraviolet-fluorescence-based simulation exercise to visualize exposure/contamination events. Contamination was photographed and mapped. Findings: There were 147 post-simulation and 31 post-doffing contamination events, from a maximum of 980, when evaluating the basic level of PPE. Therefore, this PPE ensemble did not afford adequate protection, primarily due to direct contamination of exposed areas of the skin. For the five suspected case ensembles, 1584 post-simulation contamination events were recorded, from a maximum of 5110. Twelve post-doffing contamination events were also observed (face, two events; neck, one event; forearm, one event; lower legs, eight events). Conclusion: All suspected case PPE ensembles either had post-doffing contamination events or other significant disadvantages to their use. This identified the need to design a unified PPE ensemble and doffing procedure, incorporating the most protective PPE considered for each body area. This work has been presented to, and reviewed by, key stakeholders to decide on a proposed unified ensemble, subject to further evaluation

Nosocomial Infection Prevention Through Universal Precaution in YOGYAKARTA Muhammadiyah Hospital

Prevention of nosocomial infections in hospitals can be done through the implementation of universal precaution program or action asepsis and antisepsis tapping. These actions undertaken by health workers, both nurses and physicians, universal precaution measures include: hand washing, use of gloves, use aseptic liquid, processing of used equipment and waste disposal. The purpose of this study to determine the prevention of nosocomial infections in hospitals through universal precautions in hospitals Muhammadiyah Yogyakarta area. Design of this research is descriptive qualitative case study approach. Collecting data used techniques focus group discussions. Data analyzed using content analysis. The application of universal precautions in hospitals throughout Yogyakarta PKU show that health workers have attempted to implement universal precautions including hand washing action on the water flow, perform hand hygiene, and always tries to wear personal protective equipment. Nurses knowledge about nosocomial infections has been well and for prevention need to implement universal precautions. The attitude of nurses in implementing universal precautions have been good, to the extent responsible. Most hospitals have had the availability of facilities and support the implementation of universal precaution well, and partly still exist limitations in the availability of facilities and support the implementation of universal precaution

Sources of DNA contamination and decontamination procedures in the forensic laboratory

The sensitivity of forensic DNA typing techniques can cause problems when evidence samples are inadvertently contaminated with DNA from another source. Therefore, precautions need to be taken to minimize the risk of contamination. In this study, laboratory air and surfaces, tools and equipment were evaluated as potential sources of contaminating DNA. Subsequently, two decontamination procedures, i.e. the conventionally used sodium hypochlorite and the commercially available DNA decontamination solution DNA ZAPTM (Applied Biosystems), were compared for their use in removing potentially contaminating DNA from the laboratory working environment. From our results, it can be concluded that air is unlikely to be the source of observed DNA contamination in the laboratory whereas DNA accumulating on surfaces, tools and equipment within the laboratory environment may potentially be transferred to evidence samples. DNA ZAPTM outperformed the conventionally used sodium hypochlorite decontamination procedure. Stringent preventive measures and decontamination of equipment and laboratory surfaces is important to avoid secondary transfer of this contaminating DNA to evidence samples

Lifting the lid: a clinical audit on commode cleaning

Many healthcare-associated infections (HCAIs) are preventable by infection control procedures designed to interrupt the transmission of organisms from a source. Commodes are in use constantly throughout healthcare facilities. Therefore commode surfaces are constantly handled, and any pathogens present have the potential to be transferred to not only other surfaces but also, more importantly, to patients, thus compromising patient safety. In order to examine the effectiveness and thoroughness of cleaning commodes an audit was undertaken to assess compliance with evidence-based practice. This audit demonstrates a cycle which includes defining best practice, implementing best practice, monitoring best practice and taking action to improve practice. The audit results confirmed an issue that the authors had long suspected. That is, that commodes allocated to individual patients are not always cleaned after every use. Using adenosine triphosphate (ATP) bioluminescence as an indicator of organic soiling also demonstrated that commodes that were considered clean were not always cleaned to a high standard. Implementing the audit recommendations improves staff knowledge through education, standardises cleaning procedures and ultimately improves patient safety