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Vol 16 no 51 |
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Final Issue: Volume 16 Number 51 |
Published on: 21 December 2006 |
Final Issue in PDF |
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News Archives
Last updated: Volume 14, No.6 (PDF file, 131 KB)
Archives | News Archives 2004: Page 1| News 9 February 2006
News Archives: | 2006 | 2005 | 2004 | 2003
Update on avian influenza (H5N1) among poultry in south east and east Asia, and humans in Viet Nam and Taiwan
On 4 February 2004, the World Health Organization (WHO) has confirmed outbreaks of avian influenza (H5N1) among poultry in nine countries in south east and East Asia (Cambodia, China, Hong Kong, Indonesia, Japan, Laos, South Korea, Thailand, and Viet Nam). Outbreaks among poultry are now widespread in some countries, with confirmed or suspected outbreaks of highly pathogenic H5N1 avian influenza reported on poultry farms in 12 of China's 31 provinces, autonomous regions, and municipalities, and in 445 different locations in Viet Nam.
As of 4 February 2004, human cases of infection have only been reported in Viet Nam and Thailand. Viet Nam has reported 13 cases, nine of whom have died, and Thailand has reported four cases, all of whom have died. The infection of two sisters who died in the Thai Binh province of Viet Nam are being investigated as part of a cluster of four cases of severe respiratory illness in a family. The cluster includes the two sisters, their brother, and his wife. The brother died on 12 January but no samples were available for testing. His wife has fully recovered. To date, the investigation has not been able to conclusively identify the source of infection for the two sisters and the WHO has stated that limited human-to-human transmission is being considered as the possible route of infection. With the exception of this family cluster, all other human cases in the Viet Nam outbreak have been linked to contact with infected poultry. No outbreaks have been reported in human populations. Further information is available from WHO at: <http://www.who.int/csr/don/2004_02_02/en/>.
A joint United Nations Food and Agriculture Organisation (FAO), World Organisation for Animal Health (OIE), and WHO emergency meeting on avian influenza has been convened in Rome. It will set policies and strategies for controlling the disease and will develop action plans to address the animal as well as public health concerns in each affected country <http://www.fao.org/>.
The threat of avian influenza A (H5N1) to the United Kingdom remains low at this time. The Health Protection Agency (HPA) is maintaining close contact with the Department of Health, the Department for Environment Food and Rural Affairs (DEFRA), and WHO to monitor the situation. Updated information will be available on the HPA website as it becomes available <http://www.hpa.org.uk/infections/topics_az/avianinfluenza/menu.htm>.
New laboratory-confirmed case of SARS in Guangdong Province, China
On 31 January 2004, the World Health Organization (WHO) reported a further laboratory-confirmed case of SARS coronavirus (SARS-CoV) infection in Guangdong province, China. This is the fourth case (three confirmed and one probable) detected in China since 16 December 2003. The case, a male aged 40 years, is a director of a hospital and a practicing physician in Guangdong Province. He was admitted to hospital on 16 January. He has now fully recovered and was discharged from hospital on 30 January.
The source of the infection of this most recent case is currently unknown. The Ministry of Health in China is undertaking epidemiological investigations into the possible sources of transmission, and contact tracing. To date, none of the contacts identified have developed symptoms of SARS. Further information is available from WHO at: <http://www.who.int/csr/don/2004_01_31/en/>.
Report of the systems evaluation project for infection control (ASEPTIC)
The Systems Evaluation Project for Infection Control (ASEPTIC) was commissioned by the Health Protection Agency (HPA) under the terms of a service level agreement between the Department of Health (DoH) and the Public Health Laboratory Service, which required 'a fixed term project to review existing healthcare associated infections (HCAI) surveillance systems for local use and evaluate whether they may be suitable for wider application across the NHS'. (The Public Health Laboratory Service officially became part of the Health Protection Agency on 1 April 2003.) The ASEPTIC project was contracted to the South Devon Health Informatics Service (SDHIS) after a tendering process, and was managed by a project board whose members were drawn from the HPA, SDHIS, and a representative from the DoH. Part of the project remit was to establish a stakeholder group that included infection control practitioners, microbiologists, users of the surgical site infection surveillance scheme and relevant HPA staff.
The project undertook to define and make recommendations on:
1. the user requirements relating to surveillance and management of infection control functions in acute hospitals (reported on the project web site as user requirement documents [URDs]);
2. an assessment against the URD of the currently available computer-based infection control systems;
3. a recommendation from the project team as to which currently available computer-based infection control systems were suitable to pilot in acute hospitals;
4. the design of a suitable 'pilot' and the resources needed to undertake 'pilot' testing.
Since the project was commissioned, the DoH has instituted a National Programme for IT in the NHS, part of which, is the National Care Record Service.
The report has identified that a suitable system would need to meet a range of infection control teams' requirements, defined in the URD . These include: collection of local surveillance data including those required by the DoH in the mandatory surveillance initiative (surgical site infection surveillance, mandatory bacteraemia surveillance of methicillin resistant Staphylococcus aureus (MRSA) and glycopeptide resistant enterococci (GRE), and surveillance of Clostridium difficile); infection control aspects of case-management; analysis of information required for outbreak investigation; and an ability to document and report serious untoward events.
Nine IT systems for infection control were reviewed to establish whether they met the required surveillance and management outputs defined in the user requirement documents, which are available at <www.swdhis.nhs.uk/aseptic>.
The key recommendations of the ASEPTIC project team, endorsed by the Project Board, were that:
- Three systems should be piloted as soon as practicable.
- The inclusion of three systems was dependent on some further development in the case of one supplier, which was subsequently undertaken.
- The three systems were: EpiQuest, ICEnterprise, and ICNet
Members of the ASEPTIC project board met with DoH colleagues and a representative from the Information Authority to discuss how the results and recommendations in the report of the ASEPTIC project could be taken forward. Subsequently, it has been agreed that an evaluation of the three systems could be undertaken and agreement reached with the suppliers, to support a managed implementation and evaluation of their HCAI software systems.
In the meantime, the suppliers will continue to respond to enquiries from other hospitals and regions so that they can make individual purchase decisions when funding is available. It is hoped to post any relevant updates on the HPA website in due course so as to inform local and regional procurement decisions made prior to the publication of the evaluation.
The report of the project is available on the Health Protection Agency website at <www.hpa.org.uk/infections/publications/pdf/aseptic_Report.pdf>.
