New AMMI Antiviral Guidance for Influenza OutbreaksJan062016

In December 2015, the Association of Medical Microbiology and Infectious Disease Canada (AMMI) published an updated guidance document for the use of antivirals in the management of care facility influenza outbreaks for the 2015-16 season.

Given the potential for low vaccine effectiveness of this season’s influenza vaccine, the AMMI guidance document states that, at the discretion of the local health authority or Medical Health Officer, antiviral prophylaxis may be extended beyond unvaccinated health care providers to also include vaccinated health care providers, in the context of care facility influenza outbreaks. Notably this applies to outbreaks caused by H3N2 viruses.

Excerpt from the document:

“[Current] measures for facility influenza outbreak control that are considered the ongoing standard of care include: seasonal influenza vaccination of staff and residents (preferably pre-season); antiviral prophylaxis of all non-ill residents; early antiviral treatment of symptomatic individuals (workers or residents both vaccinated and unvaccinated); reinforced infection control measures including respiratory etiquette and use of personal protective equipment; and exclusion of ill staff or visitors and new admission deferral. Outbreak control measures also include antiviral chemoprophylaxis for unvaccinated staff; this may be extended to vaccinated staff as an option or at the discretion of the local health authority/Medical Officer of Health during outbreaks, notably those due to H3N2 viruses that may otherwise be poorly controlled by standard measures.” 

What does this mean for you?

Currently the provincial guidance on the prophylactic use of antivirals for healthcare providers pertains only to unvaccinated healthcare providers. Therefore, if you have questions about how the new AMMI recommendations may affect your facility, for residential care sites you can contact your local Medical Health Officer or designate, and for acute care sites you can contact your local Infection Control Practitioner.

You can read the AMMI guidance document here; supplementary documents can be found on the AMMI website Guidelines page.

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MCR-1 gene in CanadaJan062016

The discovery that the MCR-1 gene — which makes E. coli and some other species of bacteria resistant to colistin — has been in Canada for at least five years has scientists wondering when it first emerged and how to stop its spread.

ecoli 12166_loresThe existence of the plasmid-mediated colistin resistance, or MCR-1, gene was first reported in November 2015 in the medical journal the Lancet after scientists identified it in E. coli samples taken from farm animals, meat sold in markets and hospital patients in China. MCR-1 is located on a plasmid, a free-floating snippet of DNA that bacteria can easily share, thus spreading the resistance to other organisms.

Since the Lancet paper, at least a dozen other countries have also found the MCR-1 gene. Scientists, looking through databases of bacterial samples, detected the gene everywhere from Denmark and Algeria to Laos.

Among them is Canada, where an investigation was triggered in December by the Public Health Agency of Canada. The Canadian findings have not yet been published, but a case report has been submitted to the Lancet, according to Dr. Michael Mulvey, chief of antimicrobial resistance with the PHAC’s lab in Winnipeg.

The superbug gene was found in three different samples of E. coli, all previously collected for special research projects: one from a 62-year-old patient in Ottawa and two from ground beef sold in Ontario.

“To see it show up was a surprise for me,” Mulvey said. “It supports that there’s global dissemination of this gene already … we’re now going to have to look back even prior to (2010), because maybe it’s been around for even longer.”

Read the full stories on CTV.ca and The Toronto Star

 

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Study links IBS to Vitamin D deficiencyDec232015

A study published in the British Medical Journal has shown a link between Irritable Bowel Syndrome (IBS) and lack of vitamin D.

There is no single known cause and no single known cure for IBS, although food and stress have been identified as aggravating factors.

In the study by the University of Sheffield’s Molecular Gastroenterology Research Group, 82 per cent of the 52 IBS sufferers tested had insufficient levels of vitamin D.

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Bandage that signals infectionDec212015

Researchers in the United Kingdom recently unveiled a prototype “intelligent” dressing that turns fluorescent green to signal the onset of an infection. The color-changing bandage contains a gel-like material infused with tiny capsules that release nontoxic fluorescent dye in response to contact with populations of bacteria that commonly cause wound infections.

Led by Toby Jenkins, a professor of biophysical chemistry at the University of Bath, the inventors of the new bandage, which has not yet been tested in humans, say it could be used to alert health-care professionals to an infection early enough to prevent the patient from getting sick. In some cases it may even be able help avoid the need for antibiotics, says Jenkins.

Read the full article and watch the video segment.

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