Inc. risk to newly circ'ed baby boys from hospital infections, hepatitis etc.

[Minuteman]

Just a couple of HHS.gov links I want to put somewhere so I can find them again.

Healthcare-Associated Infections:
http://www.hhs.gov/ash/initiatives/hai/index.html

Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care and Treatment of Viral Hepatitis:
http://www.hhs.gov/ash/initiatives/hepatitis/

[Minuteman]

From the HHS.gov Newsroom (12 May 2011):

http://www.hhs.gov/news/press/2011pr...20110512a.html

News Release

FOR IMMEDIATE RELEASE
May 12, 2011


Contact: OASH Press Office
(202) 205-0143
HHS Announces Action Plan to Prevent and Treat Viral Hepatitis

The U.S. Department of Health and Human Services today launched its action plan to prevent and treat viral hepatitis, a silent epidemic affecting 3.5 – 5.3 million Americans.

Though viral hepatitis is a leading infectious cause of death in the U.S., many people who have it don’t know they are infected, so they are at greater risk for severe – or even fatal – complications of the disease. Exacerbating the problem is the fact that health care providers often lack the appropriate training to conduct risk assessments, offer prevention counseling, provide diagnoses and treat viral hepatitis.

“These infections have fueled a tragic cascade of human suffering,” said Howard K. Koh, MD, MPH. “The new HHS action plan on viral hepatitis represents an unprecedented call to action for better education, treatment and prevention.”

In January 2010, the Institute of Medicine (IOM) released a report on hepatitis, highlighting barriers that impede efforts for hepatitis prevention and control. The new HHS plan -- Combating the Silent Epidemic: US Department of Health and Human Services Action Plan for the Prevention, Care and Treatment of Viral Hepatitis -- is a response to the IOM report. It outlines a comprehensive action plan to raise awareness about viral hepatitis; creates more opportunities to train health professionals to diagnose, treat, vaccinate, and ultimately save lives; and builds upon the new health insurance reform law to improve patient access to comprehensive viral hepatitis-related prevention and treatment services through expanded coverage.

The plan’s success is contingent on leadership of government at all levels and the active and informed participation of communities, non-governmental organizations, health care providers, and the private sector.

“No one government agency can fight viral hepatitis alone, and here at CDC, we believe this action plan will not only strengthen the work we’ve been doing, but help all of us across the government collaborate to take our nation’s prevention efforts to the next level,” said CDC Director Thomas R. Frieden, MD, MPH. “Far too many Americans are unaware of the serious impact of viral hepatitis and the devastating consequences that can result from leaving it untreated. The time for action is now.”

“We have seen the increasing prevalence of viral hepatitis in our network of health centers and among people living with HIV/AIDS in underserved areas and we know that minorities and medically vulnerable populations are disproportionately affected,” said Health Resources and Services Administrator Mary K. Wakefield, RN, PhD. “This action plan is our best chance at stopping the disease with increased access to information and quality care for those at risk and those who are already infected.

HHS is committed to ensuring that new cases of viral hepatitis are prevented and that persons who are already infected are tested, informed about their infection, and provided with optimal counseling, care and treatment. This increasing commitment is evidenced in the new Healthy People 2020 plan, the first Healthy People publication to document increasing viral hepatitis awareness among infected persons as a formal HHS objective.

To read the plan, see http://www.hhs.gov/ash/initiatives/hepatitis. For more information on viral hepatitis, see http://www.cdc.gov/hepatitis/


###

[Minuteman]

"The Impact of HIV-Hepatitis Co-Infection" (blog.AIDS.gov 19 May 2011):

http://blog.aids.gov/2011/05/the-imp...og.AIDS.gov%29

The Impact of HIV-Hepatitis Co-Infection

By John W. Ward, M.D., Director, Division of Viral Hepatitis, CDC

May is Hepatitis Awareness Month, an observance intended to remind us of the high, under-recognized hepatitis-associated disease burden in this country and of the often neglected opportunities for prevention and care. An estimated 3.5-5.3 million Americans have chronic viral hepatitis, which is a leading cause of primary liver cancer. People living with HIV are disproportionately affected by viral hepatitis and the related adverse health outcomes. Of those infected with HIV, more than 25% are coinfected with Hepatitis C and an estimated 10% with Hepatitis B. While highly active antiretroviral therapy has extended the life expectancy of HIV-infected persons, liver disease–much of which is related to Hepatitis C–has become the most common non-AIDS-related cause of death of among this population.

HIV, Hepatitis B, and Hepatitis C share common modes of transmission. People living with HIV who are also living with viral hepatitis are at increased risk for serious, life threatening complications. As a result, all persons living with HIV should be tested for Hepatitis B and Hepatitis C by their doctors. Co-infection with hepatitis may also complicate the management of HIV infection.

In order to prevent co-infection with Hepatitis B, the Advisory Committee on Immunization Practices recommends universal Hepatitis B vaccination of susceptible patients with HIV/AIDS. Hepatitis A and Hepatitis B vaccines are also recommended for all men who have sex with men, users of illicit drugs, and others at increased risk of infection. There is no vaccine for Hepatitis C.

In 2010, an interagency work group of U.S. Department of Health and Human Services (HHS) experts was created to develop a comprehensive strategic action plan to respond to the viral-hepatitis-associated disease burden. The HHS Action Plan for the Prevention, Care and Treatment of Viral Hepatitis describes opportunities to improve coordination of viral hepatitis prevention activities across HHS, and the framework needed to engage other agencies and nongovernmental organizations in prevention and care. Various strategies throughout the plan outline methods of integration of HIV and viral hepatitis in education, prevention and services. The HHS Action Plan was released last week on May 12.

To learn more about the Viral Hepatitis Action Plan or Hepatitis Awareness Month, visit the Viral Hepatitis Web site and follow CDC’s viral hepatitis Twitter account @CDChep Exit Disclaimer.

Posted in: HIV Policy & Programs, Viral Hepatitis

[Minuteman]

"View HHS Release of the Viral Hepatitis Action Plan" (blog.AIDS.gov 19 May 2011):

http://blog.aids.gov/2011/05/view-hh...og.AIDS.gov%29

By Miguel Gomez, AIDS.gov Director

Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care & Treatment of Viral HepatitisIn a blog post on May 12, we reported on the HHS’s release of the Action Plan for the Prevention, Care & Treatment of Viral Hepatitis (Action Plan) (PDF 672KB) at the National Press Club in Washington, D.C. If you missed the event, we encourage you to watch a live webcast Exit Disclaimer of the release of the Action Plan.

Signaling the commitment of HHS to combating and treating viral hepatitis, the Action Plan will help HHS improve its current efforts to prevent new cases of viral hepatitis and related disease by 1) identifying steps that can be taken to reach specific goals; 2) leveraging opportunities to improve coordination of viral hepatitis activities across HHS operating divisions; 3) setting priorities for HHS to develop public-health and primary-care infrastructure needed for viral hepatitis prevention and care at the federal, state, and local levels; and 4) providing a framework for HHS to engage other governmental agencies and nongovernmental organizations in viral hepatitis prevention and care.

To download a copy of the plan, click here (PDF 672 KB).

Posted in: HIV Policy & Programs, LGBTQ Health, Viral Hepatitis

[Minuteman]

"FDA Approves Second New Treatment for Hepatitis C" (blog.AIDS.gov)

http://blog.aids.gov/2011/05/fda-app...og.AIDS.gov%29

By Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services

On May 23, the U.S. Food and Drug Administration (FDA) announced the approval of telaprevir for the treatment of chronic viral hepatitis C. According to the U.S. Centers for Disease Control and Prevention, chronic viral hepatitis C affects 3.2 million Americans. Left untreated, chronic viral hepatitis C can lead to cirrhosis, liver cancer, and unwitting transmission to others.

The approval of telaprevir marks the second new treatment approved for chronic hepatitis C. On May 13, the FDA announced the approval of boceprevir. Edward Cox, M.D., M.P.H., director, Office of Antimicrobial Products in FDA’s Center for Drug Evaluation and Research, calls the new treatments “a major step forward in the battle against chronic hepatitis C”, offering patients with this condition a greater chance at a cure.

In a major initiative to bring attention to combating viral hepatitis, the U.S. Department of Health and Human Services recently released the Action Plan for the Prevention, Care & Treatment of Viral Hepatitis (PDF 672KB). Among its goals, the Action Plan calls for a 25% reduction in the number of new cases of hepatitis C and an increase in the proportion of persons who are aware of their hepatitis C virus infection.

Read the FDA’s full announcement on the approval of telaprevir.

Posted in: FDA, Hepatitis, HIV Policy & Programs, LGBTQ Health, People Living With HIV, Research

[Minuteman]

"Transfusion-transmitted hepatitis B virus infection"

http://www.jhep-elsevier.com/article...391-2/abstract

ABSTRACT:

Volume 51, Issue 4, Pages 798-809 (October 2009)

Transfusion-transmitted hepatitis B virus infection☆

Daniel Candotti [1] Corresponding Author Informationemail address, Jean-Pierre Allain [2]

published online 10 June 2009.

Hepatitis B virus (HBV) remains a major risk of transfusion-transmitted infection due to the pre-seroconversion window period (WP), infection with immunovariant viruses, and with occult carriage of HBV infection (OBI). Reduction of HBV residual risk depends upon developing more sensitive HBV surface antigen (HBsAg) tests, adopting anti-HBc screening when appropriate, and implementing HBV nucleic acid testing (NAT), either in minipools or more efficiently in individual samples. HBV NAT combines the ability to significantly reduce the window period and to detect occult HBV carriage substantiating decades of clinical observation that HBsAg-negative/anti-HBc-positive blood could transmit HBV. Clinical observations suggest limited transmission rate of occult HBV compared to WP. Low transmission rate might be related to low viral load observed in OBIs or to the presence of mutants associated with occult carriage. OBIs carrying detectable anti-HBs (∼50%) are essentially not infectious by transfusion. However, recent data suggest that the neutralizing capacity of low anti-HBs may be inefficient when overcome by exposure to high viral load. Anti-HBc blood units without detectable anti-HBs appear moderately infectious except in immunocompromised recipients. Immunodeficient elderly and patients receiving immunosuppressive treatments may be susceptible to infection with lower infectious dose even in the presence of anti-HBs. The immune status of blood recipients should be taken into consideration when investigating “post-transfusion” HBV infection. Pre-transfusion testing and post-transfusion long-term follow-up of recipients, and molecular analysis of the virus infecting both donor and recipient are critical to definitively incriminate transfusion in the transmission of HBV.

Associate Editor: M. Colombo
Keywords: Hepatitis B virus, Transfusion, Transmission, Occult HBV infection, Immunosuppression
Abbreviations: HBV, hepatitis B virus, WP, window period, OBI, occult HBV infection, HBsAg, HBV surface antigen, NAT, nucleic acid testing, EIA, enzyme immunoassay, ELISA, enzyme-linked immunosorbent assay, CLIA, chemiluminescence immunoassay, CLEIA, chemiluminescent enzyme immunoassay, FFP, fresh-frozen plasmas, RBC, red blood cells, PC, platelet concentrates

1 National Health Service Blood & Transplant, Cambridge Blood Centre, Long Road, Cambridge CB2 2PT, UK

2 Department of Haematology, University of Cambridge, Cambridge, UK

PubMed citation / Link:

J Hepatol. 2009 Oct;51(4):798-809. Epub 2009 Jun 10 http://www.ncbi.nlm.nih.gov/pubmed/19615780

[Minuteman]

From the FDA NCTR Research Highlights 17 June 2011.

http://www.fda.gov/AboutFDA/CentersO.../ucm076767.htm

Drug-Induced Hepatotoxicity in Pediatric Patients—June 8

William Salminen, Ph.D., presented an invited talk at the 10th Annual World Pharma Congress, Drug Safety Summit: New Assays and Tools for Predicting Hepatotoxicity in Philadelphia, Pennsylvania. The presentation reviewed the major developmental phases of the maturing liver with an emphasis on phases that may pose unique sensitivities to drug-induced liver injury in children, which is an underserved area of research.

For additional information or a copy of the PowerPoint presentation, “Pediatric Drug-Induced Liver Injury – Children Are Not Just Small Adults,” please contact Dr. William Salminen, Division of Systems Biology, FDA/NCTR.

[Minuteman]

"Healthcare-Associated Infections (HAIs) and AHRQ's Role in their Prevention"

http://www.ahrq.gov/about/nac2011/na...nierslides.htm

On April 8, 2011, William B. Munier, MD, made this presentation at the meeting of the National Advisory Council.

1. Healthcare-Associated Infections and AHRQ's Role in their Prevention
2. Magnitude of the Problem
3. New CLABSI Estimates
4. AHRQ's Central Role
5. AHRQ's Role in the National Effort
6. AHRQ's Role in the National Effort
7. Five Phases of Translational Research1
8. Michigan Keystone ICU Project
9. AHRQ HAI Investments
10. Infection Types—Major Focus Areas
11. Healthcare Settings
12. AHRQ HAI Projects—FY 2010
13. Illustrative HAI Projects
14. Nationwide Implementation of CUSP for CLABSI—Interim Report
15. Expanding the Impact of CUSP Beyond CLABSI
16. Facing Forward
17. AHRQ HAI Investments

Current as of April 2011

Internet Citation:

Healthcare-Associated Infections and AHRQ's Role in their Prevention. Slide Presentation from the April 8, 2011, Meeting of the National Advisory Council (Text Version). Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/nac2011/na...nierslides.htm

You can download the PPT slideshow here (366 KB):

http://www.ahrq.gov/about/nac2011/na...nierslides.ppt

[Minuteman]

Surgical Site Infections links on the Institute for Healthcare Improvement website:

http://www.healthcare.gov/center/pro...nfections.html

Surgical Site Infections
# SHEA and IDSA Compendium on Surgical Site Infections: http://www.jstor.org/stable/10.1086/591064
# The Surgical Care Improvement Project (SCIP) is a national quality partnership of organizations interested in improving surgical care by significantly reducing surgical complications. http://www.qualitynet.org/dcs/Conten...rentName=Topic
# American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP): http://www.acsnsqip.org/
# Institute for Healthcare Improvement on Surgical Site Infections: http://www.ihi.org/IHI/Topics/Patien...iteInfections/

Posted on: April 12, 2011

[Minuteman]

"How to not get invasive group A strep" HHS HealthBeat 24 August 2011.

http://www.hhs.gov/news/healthbeat/2...20110824a.html

From the U.S. Department of Health and Human Services, I’m Ira Dreyfuss with HHS HealthBeat.

Invasive group A streptococcal disease can be anywhere from minor to fatal. At the Centers for Disease Control and Prevention, Chris Van Beneden says the bacteria are spread through mucus, or contact with infected wounds or sores. She says otherwise healthy people can carry the bacteria without symptoms. But she also says the germs can lead to conditions such as pneumonia and bloodstream infection.

``The spread of all types of group A strep infection can be reduced by good hand washing, especially after coughing and sneezing, and before preparing foods or eating.’’ (9 seconds)

Van Beneden says antibiotics can treat the disease. People also can control their risk of infection.

An article on invasive group A strep is in the CDC’s journal Emerging Infectious Diseases.

Learn more at hhs.gov.

HHS HealthBeat is a production of the U.S. Department of Health and Human Services. I’m Ira Dreyfuss.

Last revised: August 24, 2011