OIE/FAO/WHO/IVPHC Background Discussion

27 July 2010

Humanitarian Resource Institute
Phone: (203) 668-0282
Url: www.humanitarian.net

Pathobiologics International:
Url: www.pathobiologics.org

HRI:UNArts - Millennium Medicine Project
Url: www.unarts.org/mmp




EID Surveillance Notes
MMP:  Hospital Acquired Infections - Surveillance, Containment & Control

Dear Colleagues:

According to the Clinicians Biosecurity Network, Airborne Spread of Current  U.S. healthcare discussions are focused on insurance companies denying coverage for hospital-acquired conditions [1], rather than taking full responsibility for a lack of biosecurity measures and compensation for the victim of resultant complications.  In 2002, an estimated 1.7 million healthcare-associated infections occurred in the United States, resulting in 99,000 deaths. [2]  Methicillin-resistant Staphylococcus aureus (MRSA) was reported to have killed 48000 Americans in one year  [3] and Clostridium Difficile [4,5,6,7] being more common than MRSA in Southeast Community Hospitals. [8]  Clostridium difficile [9] represents a major problem at hospitals across the United States.

The true spectrum of pathogens associated with clinical disease was a topic at "The Future of Biodetection Systems Workshop" sponsored by Los Alamos National Laboratory in 2006. [10] The conference brought together industry, academia, national labs, and federal agency personnel in an interactive process, to develop a roadmap for research and development investment in biodetection.  In my presentation, DNA-based Detection Technologies [11] included a focus on full spectrum pathogen detection, [12] including tools that could be used for environmental analysis of hospitals.

Today, veterinary medicine is the lead academic reference point for environmental contamination and agricultural impact of high consequence pathogens that contribute to the landscape of human disease. Recent discussions regarding Zoonotic diseases [13,14] include:

• Methicillin-resistant Staphylococcus aureus in Horses and Horse Personnel. [15,16]
  
• Presence of vancomycin-resistant enterococci in farm and pet animals. [17]
• National Antimicrobial Resistance Monitoring System (NARMS): [18]
• Life-Threatening Infantile Diarrhea from Fluoroquinolone-Resistant Salmonella enterica Typhimurium with Mutations in Both gyrA and parC. [19]
• Nosocomial Outbreak of Fluoroquinolone-Resistant Salmonella Infection. [20]
• Co-Infection A-Fujian-H3N2 - Methicillin Resistant Staphylococcus Aureus: VRE, MRSA, and Influenza. [21]

Antibiotic Sensitivity: Salmonella U.S. Test: Agricultural Operations February 2005  Embracing challenges associated with drug resistant pathogens,  water conservation initiatives, environmental contamination,  agricultural and public health impact. Veterinarians note that human physicians have no clue regarding the true scope of pathogens with full antibiotic resistance in the clinical disease landscape.

Today, the "One Health Initiative," is a movement to forge co-equal, all inclusive collaborations between physicians, veterinarians, and other scientific-health related disciplines, has been endorsed by various major medical organizations and health agencies, including the American Veterinary Medical Association, the American Medical Association, the American Society of Tropical Medicine and Hygiene, the American Society for Microbiology and the Centers for Disease Control and Prevention (CDC). Additionally, more than 400 prominent scientists, physicians and veterinarians worldwide have endorsed the initiative.  --  HRI:UNArts: One Health Initiative Unites Human and Veterinary Medicine. [22]

Surveillance, containment and control of high consequence pathogens in the world's wealthiest countries, highlight the difficult task of strategic planning and development to optimize public health infrastructure, for the 5 billion target demographic of the Millennium Medicine Project.

Corporations, physicians, veterinarians, scientists that would like to serve in an advisory or low cost product development role (included in the Millennium Medicine Project medical equipment and supplies portal), are asked to contact:

Stephen M. Apatow
Millennium Medicine Project
Corporate, NGO, Field Operations Liaison




References:

1. HM Takes the Lead on Interventions and Lessens Financial Impact on Institutions' Bottom Line: The Hospitalist, Medscape Today, 23 July 2010. Url: http://www.medscape.com/viewarticle/724087
2.  Klevens RM, Edwards JR, Richards CL, et al. Estimating healthcare-associated infections in US hospitals, 2002. Public Health Rep. Mar 2007;122(2):160-6.
3. Hospital-Acquired Infections, MRSA, Killed 48,000 Americans In One Year: Medical News Today. 23 February 2010. Url: http://www.medicalnewstoday.com/articles/180065.php
4. Clostridium difficile in broiler chickens sold at market places in Zimbabwe and their antimicrobial susceptibility: International Journal of Food Microbiology
Volume 124, Issue 3, 10 June 2008, Pages 268-270. Full text preview:  http://www.springerlink.com/content/125323n1x35176n4/
5. A possible role for Clostridium difficile in the etiology of calf enteritis: Vet Microbiol. 2008 Mar 18;127(3-4):343-52. Epub 2007 Sep 18. http://www.ncbi.nlm.nih.gov/pubmed/17964088
6. Molecular characterization of Clostridium difficile isolates from horses in an intensive care unit and association of disease severity with strain type: Url: http://avmajournals.avma.org/doi/abs/10.2460/javma.228.5.751?journalCode=javma
7. Clostridium difficile in Retail Meat Products, USA, 2007: Songer JG, Trinh HT, Killgore GE, Thompson AD, McDonald LC, Limbago BM. Clostridium difficile in retail meat products, USA, 2007. Emerg Infect Dis. 2009 May; [Epub ahead of print]. Url: http://www.cdc.gov/eid/content/15/5/pdfs/08-1071.pdf
8. 4. In Southeast Community Hospitals Clostridium Difficile Is More Common Than MRSA: Medical News Today, 23 March 2010. http://www.medicalnewstoday.com/articles/183170.php
9.  Airborne Spread of Clostridium difficile: Clinicians Biosecurity Network, 14 May 2010. Url: http://www.upmc-cbn.org/report_archive/2010/05May_2010/cbnreport_05142010.html
10. The Future of Biodetection Systems Workshop sponsored by Los Alamos National Laboratory, 2006. Url: http://www.lanl.gov/bioscience/biodetection.shtml
11. DNA-based Detection Technologies: Stephen M. Apatow, PPT Presentation The Future of Biodetection Systems Workshop hosted by  the Los Alamos National Laboratory, 2006. Url: http://www.pathobiologics.org/btac/lanl/bioscience/ref/SMABDS_Final.pdf
12. Optimization and clinical validation of a pathogen detection microarray: Genome Biology 2007, 8:R93.  Url: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.139.4456&rep=rep1&type=pdf
13: One Medicine: One Health (Zoonotic Disease) Online Course: Medicine: Humanitarian Resource Institute, Pathobiologics International. Url: http://www.humanitarian.net/biodefense/fazdc/zdc1/
14. Antibiotic Resistance - Enteric Disease:  Equestrian Industry, Pathobiologics International. Url: http://www.pathobiologics.org/ivphc/ar362005.html
15. Methicillin-resistant Staphylococcus aureus in Horses and Horse Personnel, 2000–2002: CDC Emerging Infectious Disease, Vol. 11, No. 3, March 2005. Url: http://www.cdc.gov/ncidod/EID/vol11no03/04-0481.htm
16. Methicillin-resistant Staphylococcus aureus: An emerging problem in horses?: JAVMA, 15 November 2003. Url: http://www.avma.org/onlnews/javma/nov03/031115a.asp
17. Presence of vancomycin-resistant enterococci in farm and pet animals:  Antimicrobial Agents and Chemotherapy, Oct 1996, 2285-2287, Vol 40, No. 10. Url: http://aac.asm.org/cgi/content/abstract/40/10/2285
18. National Antimicrobial Resistance Monitoring System (NARMS): A list of all publications from peer-reviewed medical literature using NARMS data. Url:  http://www.cdc.gov/NARMS/
19. Life-Threatening Infantile Diarrhea from Fluoroquinolone-Resistant Salmonella enterica Typhimurium with Mutations in Both gyrA and parC: CDC Emerging Infectious Diseases, Vol. 9, No. 2, February 2003. Url: http://www.cdc.gov/ncidod/EID/vol9no2/02-0185.htm
20. Nosocomial Outbreak of Fluoroquinolone-Resistant Salmonella Infection, NEJM, Volume 344:1572-1579, Number 21, May 24, 2001. Url:  http://content.nejm.org/cgi/content/abstract/344/21/1572?view=abstractpmid=11372008
21. Co-Infection A-Fujian-H3N2 - Methicillin Resistant Staphylococcus Aureus: VRE, MRSA, and Influenza: Emergence of Methicillin-Resistant Staphylococcus aureus as a Cause of Community-Acquired Pneumonia During the Influenza Season, 2003-2004. Url: http://www.humanitarian.net/biodefense/fazdc/influenza_mrsa12903.html
22. HRI:UNArts: One Health Initiative Unites Human and Veterinary Medicine: Humanitarian Resource Institute, 23 February 2010. Url: http://www.unarts.org/news/onehealth_2222010.html