Final Issue: Volume 16 Number 51	Published on: 21 December 2006	Final Issue in PDF PDF format (283 Kb)

News Archives

Last updated: Volume 15, No.22. (PDF file, 101 KB)

Archives | News Archives 2006: Page 1| 3 June 2005

News Archives: | 2006 | 2005 | 2004 | 2003

• Interim guidance on the control of multi-resistant acinetobacter outbreaks
• First serotine bat from southern England found to be positive for EBLV1 antibodies
• Poliomyelitis in Yemen: update

Interim guidance on the control of multi-resistant acinetobacter outbreaks

Interim guidance on the control of multi-resistant acinetobacter outbreaks has been published on the Health Protection Agency (HPA) website at <http://www.hpa.org.uk/infections/topics_az/acinetobacter_b/guidance.htm>. Multiple-antibiotic resistant Acinetobacter species (MRAB) have emerged as important pathogens and caused outbreaks in hospitals in England in recent years (1-3). A working party was convened by the HPA with representation from the Association of Medical Microbiology (AMM), British Society for Antimicrobial Chemotherapy (BSAC), Hospital Infection Society (HIS), Infection Control Nurses Association (ICNA) and Department of Health (DH) to address this problem, and it is this group which has issued the interim control guidance. The working prarty has defined MRAB as Acinetobacter spp. isolates that are resistant to any aminoglycoside (eg gentamicin) AND to any third generation cephalosporin (eg ceftazidime, cefotaxime). An even more multi-resistant Acinetobacter spp, designated MRAB-C, is defined as an MRAB that is also resistant to carbapenems (imipenem or meropenem).

Microbiologists have been asked to report outbreaks of MRA under the serious untoward reporting scheme to their regional epidemiologists and to send isolates to the HPA Laboratory of Healthcare-Associated Infection at Colindale for typing and further investigation.

Comments on the interim guidance should be sent to the Group’s chairman, Barry Cookson: email <barry.cookson@hpa.org.uk>, before the end of August 2005.

References

1.Cookson B. Tackling multi-resistant bacteria in hospitals. Health Protection Matters 2005; 1(1): 16-17. Available at <http://www.hpa.org.uk/hpa/publications/HPM/spring_2005.pdf>.

 

2.HPA. Acinetobacter spp bacteraemia, England, Wales, and Northern Ireland: 2003. Commun Dis Rep CDR Wkly [serial online] 2004 [cited 23 May 2005]; 14(47): Bacteraemia. Available at <http://www.hpa.org.uk/cdr/archives/2004/cdr4704.pdf>.

3.HPA. Multi-resistant Acinetobacter baumannii: update. Commun Dis Rep CDR Wkly [serial online] 2004 [cited 23 May 2005]; 14(1): news. Available at <http://www.hpa.org.uk/cdr/archives/2004/cdr0104.pdf>.

First serotine bat from southern England found to be positive for EBLV1 antibodies

A three-year prevalence study of European Bat Lyssaviruses (EBLV), or bat rabies, in the United Kingdom (UK) bat population undertaken by the Veterinary Laboratories Agency has identified one (of 51 examined) serotine bat (Eptesicus serotinus) from southern England to be antibody positive for EBLV1 (1). This EBLV-1 strain is the predominant type in bats throughout continental Europe, especially in serotine bats. Previously in the UK, only Daubenton’s bats (Myotis daubentonii) have been found to be positive for EBLV, and only for the rarer type EBLV-2 (2-4). The presence of EBLV-2 antibodies, but not the virus, in Daubenton bats has previously been estimated at between 6 and 15% in the UK bat population. Just over 4% of the Daubenton’s bats were antibody positive in this recent study. The presence of EBLV2 virus have been detected previously in four (of 113 examined) Daubenton’s bats in the UK. The Pipistrelle bat (Pipistrellus pipistrellus), the most common bat in the UK, has not been found to carry EBLV in the UK.

The risk to the general public from EBLV remains low. Only volunteer or licensed bat handlers will routinely come into contact with bats. This new finding increases the very limited understanding of EBLVs in bats and surveillance in bats should be continued. The presence of antibodies and not virus may indicate that the bats were not infectious. The natural history of EBLV infection in bats may include full recovery with sterilising immunity.

These findings do not change the previous public health advice. Clinicians do, however, need to be aware of the risk of rabies after significant exposure to bats. If a person is bitten, scratched, or there is direct contact with a bat to mucosa or broken skin, the area should be cleaned thoroughly with water and soap and medical advice should be sought urgently and expert assessment performed. Post-exposure prophylaxis (vaccination and possibly administration of immunoglobulins) is recommended. Any member of the public finding a bat behaving abnormally, found in an unusual place, or under unusual circumstances, should not attempt to handle or move the animal, but contact their local bat conservation group or the Bat Conservation Trust (details can be found on the Trust’s website at http://www.bats.org.uk/). All bat handlers and other people likely to be at risk of exposure through the close handling of bats should be vaccinated against rabies and this is provided free of charge by the Health Protection Agency through the NHS. The awareness in the general public and health care professionals of this small risk needs to be addressed without creating unnecessary fear of these endangered and protected animals.

Further information on EBLV

http://www.hpa.org.uk/infections/topics_az/rabies/menu.htm

http://www.defra.gov.uk/animalh/diseases/notifiable/q&a/rabiesq&a.htm

 

References

 

1.Preliminary results of study into bat rabies (European bat lyssavirus) in England.
press release 215/05. London: DEFRA, 21 May 2005. Available at <http://www.defra.gov.uk/news/2005/050521a.htm>.

2.Smith A, Morris J, Crowcroft N. Bat rabies in the United Kingdom. BMJ, 2005, 330: 491-2.

3.Brookes SM, Aegerter JN, Smith GC, Healy DM, Jolliffe T, Swift SM. Prevalence of antibodies to European Bat Lyssavirus type-2 in Scottish bats. Emerg Infect Dis 2005, 11(4); 572-8.

4.Fooks AR, Brookes SM, Johnson N, McElhinney LM, Hutson AM. European bat lyssaviruses: an emerging zoonosis. Epidemiology and Infection 2003, 131(3): 1029-39.

 

Poliomyelitis in Yemen: update

An outbreak of polio in Yemen which started in February, and was first reported to the World Health Organization (WHO) in April (1), has grown to include 179 cases. Most have occurred in the same area – the Hudaida governate on the Red Sea coast, although eleven governates are affected (2).

A nationwide house-to-house vaccination campaign for children under five years of age was conducted from 29 May to 2 June. The Yemeni Ministry of Health has also strengthened surveillance of acute flaccid paralysis since the outbreak began. The second round National Immunization Day will be on 11 July.

The Yemeni Ministry of Health is working with UN organisations led by WHO and UNICEF to make these polio vaccination campaigns a UN priority in Yemen.

References

1.HPA. Poliomyelitis in Yemen. Commun Dis Rep CDR Wkly [serial online] 2005 [cited 2 June 2005]; 15 (17): news. Available at <http://www.hpa.org.uk/cdr/archives/2005/cdr1705.pdf>.

2.Poliomyelitis in Yemen – update. WHO Communicable Disease Surveillance and Response [online] 30 May 2005 [cited 2 June 2005]. Available at <http://www.who.int/csr/don/2005_05_30/en/index.html>.