According to an article in the Morbidity and Mortality Weekly Report (MMWR) released last month by the Centers for Disease Control and Prevention (CDC), pilot projects between CDC and Uganda and CDC and Vietnam have resulted in improvements in disease detection and response that may serve as a model for increasing global health security in the rest of the world. Global health security – keeping the U.S. and the world safe and secure from infectious disease threats – is achieved by preventing, detecting and responding to outbreaks as early and effectively as possible.

During six months of intensive collaboration, CDC worked with Uganda’s Ministry of Health and Vietnam’s Ministry of Health to modernize diagnostic testing for high-risk pathogens, develop real-time information systems for faster outbreak response, and improve emergency operations procedures including safe packaging and transport of potentially infectious samples.  Improvements include clinicians’ ability to report and track suspected high-risk pathogen cases by text message; expansion of specimen referral and transportation systems supported by the President’s Emergency Plan for AIDS Relief (PEPFAR); and confirmation of Zika virus, Crimean-Congo hemorrhagic fever virus, hepatitis E virus, meningococcal disease, yellow fever, and multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) cases in Uganda

“The health security of the United States is only as strong as the health security of all nations around the world. We are all connected by the food we eat, the water we drink, and air we breathe,” said CDC Director Tom Frieden, M.D., M.P.H. “Stopping outbreaks where they start is the most effective and least costly way to prevent disease and save lives at home and abroad – and it’s the right thing to do. Progress in Uganda in less than a year shows how effective strategic investments can be.”

Threats to global health security include new and re-emerging pathogens, increasing antibiotic resistance and intentionally created bioweapons. Although countries were required to meet updated World Health Organization (WHO) International Health Regulations (IHR) requirements for responding to public health emergencies by July 2012, less than 1 in 5 countries have been able to meet that level of preparedness.

The CDC global health security projects aimed to demonstrate that intensive efforts to improve surveillance, laboratory and emergency response systems in Uganda and Vietnam could contribute to meeting the IHR requirements. From March to September 2013, CDC and the ministries of health worked to strengthen disease detection and response capacities at local, regional and national levels, as well as at designated international ports, airports and ground crossings.

“Uganda and Vietnam have faced unique health challenges. Uganda has experienced Ebola, Marburg, cholera and MDR-TB outbreaks, and Vietnam has experienced SARS and H5N1 outbreaks,” said CDC Director for Global Health, Tom Kenyon, M.D, M.P.H. “Their success at rapidly adding new disease detection and response skills suggests that similar efforts could work for other countries. This is important in a world that regularly sees new pathogens, such as Middle East Respiratory Syndrome Coronavirus and H7N9 influenza.”    

The Uganda project focused on three priority diseases—MDR and XDR-TB, cholera, and viral hemorrhagic fever caused by Ebola virus—to measure the project’s impact. In addition to performing a public health preparedness exercise, the Uganda Ministry of Health also activated its Emergency Operations Center (EOC) for a mass gathering at a solar eclipse in Northern Uganda and to support international airport screening for illness consistent with MERS-CoV infection among individuals returning from the Hajj. 

For the Vietnam project, 30 Vietnamese officials received training in their country, at CDC’s EOC in Atlanta, and at the WHO Western Pacific Regional Office. Laboratory staff was trained in the following methods: WHO and CDC-approved real-time reverse transcription polymerase chain reaction (PCR) assay for H7N9 detection; pathogen testing using real-time PCR detection of enterovirus 71; and multiplex PCR for detection of seven respiratory pathogens. Project enhancements were built on existing Vietnam Ministry of Health systems and structures that will support Vietnam’s plans to develop their own EOC.

The Global Health Security demonstration projects culminated with a series of inter-related drills that measured improvements of laboratory testing, trained Uganda and Vietnam Ministry of Health staff, and confirmed interoperability of information and management systems contributing to meeting core IHR requirements. For more information about the agency’s global health security work, visit CDC's website. 

Global Health Security, Securing our Global Health Borders, Disease can spread nearly anywhere within 24 hours https://www.cdc.gov/media/dpk/2013/dpk-2013-review.html#ghs.

David F. Halpern, D.M.D., FAGD, FACD, has been elected to the DALE Foundation’s Board of Trustees.

Dr. Halpern has served the oral healthcare community in many ways throughout his career. He has been an active member of the Academy of General Dentistry (AGD) for more than 35 years and is a recipient of the AGD Distinguished Service Award. He has held numerous national leadership positions within AGD, including serving on AGD’s Board of Trustees as Trustee for Region 5, and as AGD secretary (2003-2007) and president (2009-2010).

Dr. Halpern holds Fellowship in AGD, and is also a Fellow of the American College of Dentists, the International College of Dentists, and the Pierre Fauchard Academy. He is also a longtime member of the American Dental Association, and has been involved at the local and state levels; he is currently the president of the Howard County Dental Association in Maryland, and previously served as president of the Charitable and Educational Foundation for the Maryland State Dental Association.

Dr. Halpern received his Bachelor of Arts in biology from Franklin & Marshall College in 1972 and earned a Master of Science in physiology and endocrinology from Rutgers University in 1974. In 1978, he received his Doctor of Dental Medicine from Fairleigh Dickinson University School of Dentistry and then completed a general practice residency at Sinai Hospital of Baltimore. He has maintained his private dental practice in Columbia, Md., since 1982.

Recognizing the importance of lifelong learning for dental auxiliaries, Dr. Halpern encourages his dental team to continue their education and earn professional certification. “I am only as good as my dental team,” he says. “Educating auxiliaries and increasing their knowledge and skill sets enhances the overall professionalism of the oral healthcare community, and the public benefits from a higher quality of services.”

“Dr. Halpern’s many years of experience and strategic leadership roles in the oral healthcare community make him a great fit for the DALE Foundation’s Board of Trustees,” notes Cindy Durley, M.Ed., MBA, Executive Director of the DALE Foundation. “His personal and professional commitment to lifelong learning and his encouragement of dental auxiliaries to grow in their careers align with the mission of the DALE Foundation. We are excited to welcome him to the Board.”

(HealthDay News) -- Adults at high risk for hepatitis B should be screened for the viral infection, according to a draft recommendation from the U.S. Preventive Services Task Force.

Click here for the article.

Inside Dental Assisting is looking for your news and pictures from Dental Assistants Recognition Week, which is March 2 through 7. Share with us how you celebrated, and you could see your office or dental assisting program in the next issue of Inside Dental Assisting.

Please contact the editor, Melissa Tennen, at mtennen@aegiscomm.com for more information or to submit your information and photos. Inside Dental Assisting is all about you. Make sure you share your world with other readers.

Every parent knows that a healthy smile is a sign of a happy child, and oral health experts agree that creating those healthy smiles begins in infancy. CDC experts have developed a set of pediatric oral health tips.

Print out this PDF and share it with the parents of pediatric patients. Click here for the PDF.

Dental assistants are a key part of the dental practice year-round, but they get a special week dedicated to them each year for all the great work they do.

Click here to read the ADA article.

By the National Institutes of Health

For nearly a century, bacteria-fighting drugs known as antibiotics have helped to control and destroy many of the harmful bacteria that can make us sick. But in recent decades, antibiotics have been losing their punch against some types of bacteria. In fact, certain bacteria are now unbeatable with today’s medicines. Sadly, the way we’ve been using antibiotics is helping to create new drug-resistant “superbugs.”

Superbugs are strains of bacteria that are resistant to several types of antibiotics. Each year these drug-resistant bacteria infect more than 2 million people nationwide and kill at least 23,000, according to the U.S. Centers for Disease Control and Prevention (CDC). Drug-resistant forms of tuberculosis, gonorrhea, and staph infections are just a few of the dangers we now face.

Antibiotics are among the most commonly prescribed drugs for people. They’re also given to livestock to prevent disease and promote growth. Antibiotics are effective against bacterial infections, such as strep throat and some types of pneumonia, diarrheal diseases, and ear infections. But these drugs don’t work at all against viruses, such as those that cause colds or flu.

Unfortunately, many antibiotics prescribed to people and to animals are unnecessary. And the overuse and misuse of antibiotics helps to create drug-resistant bacteria.

Here’s how that might happen. When used properly, antibiotics can help destroy disease-causing bacteria. But if you take an antibiotic when you have a viral infection like the flu, the drug won’t affect the viruses making you sick. Instead, it’ll destroy a wide variety of bacteria in your body, including some of the “good” bacteria that help you digest food, fight infection, and stay healthy. Bacteria that are tough enough to survive the drug will have a chance to grow and quickly multiply. These drug-resistant strains may even spread to other people.

Over time, if more and more people take antibiotics when not necessary, drug-resistant bacteria can continue to thrive and spread. They may even share their drug-resistant traits with other bacteria. Drugs may become less effective or not work at all against certain disease-causing bacteria. 

“Bacterial infections that were treatable for decades are no longer responding to antibiotics, even the newer ones,” says Dr. Dennis Dixon, an NIH expert in bacterial and fungal diseases. Scientists have been trying to keep ahead of newly emerging drug-resistant bacteria by developing new drugs, but it’s a tough task.

“We need to make the best use of the drugs we have, as there aren’t many in the antibiotic development pipeline,” says Dr. Jane Knisely, who oversees studies of drug-resistant bacteria at NIH. “It’s important to understand the best way to use these drugs to increase their effectiveness and decrease the chances of resistance to emerge.”

You can help slow the spread of drug-resistant bacteria by taking antibiotics properly and only when needed. Don’t insist on an antibiotic if your health care provider advises otherwise. For example, many parents expect doctors to prescribe antibiotics for a child’s ear infection. But experts recommend delaying for a time in certain situations, as many ear infections get better without antibiotics.

NIH researchers have been looking at whether antibiotics are effective for treating certain conditions in the first place. One recent study showed that antibiotics may be less effective than previously thought for treating a common type of sinus infection. This kind of research can help prevent the misuse and overuse of antibiotics.

“Treating infections with antibiotics is something we want to preserve for generations to come, so we shouldn’t misuse them,” says Dr. Julie Segre, a senior investigator at NIH.

In the past, some of the most dangerous superbugs have been confined to health care settings. That’s because people who are sick or in a weakened state are more susceptible to picking up infections. But superbug infections aren’t limited to hospitals. Some strains are out in the community and anyone, even healthy people, can become infected.

One common superbug increasingly seen outside hospitals is methicillin-resistant Staphylococcus aureus (MRSA). These bacteria don’t respond to methicillin and related antibiotics. MRSA can cause skin infections and, in more serious cases, pneumonia or bloodstream infections.

A MRSA skin infection can appear as one or more pimples or boils that are swollen, painful, or hot to the touch. The infection can spread through even a tiny cut or scrape that comes into contact with these bacteria. Many people recover from MRSA infections, but some cases can be life-threatening. The CDC estimates that more than 80,000 aggressive MRSA infections and 11,000 related deaths occur each year in the United States.

When antibiotics are needed, doctors usually prescribe a mild one before trying something more aggressive like vancomycin. Such newer antibiotics can be more toxic and more expensive than older ones. Eventually, bacteria will develop resistance to even the new drugs. In recent years, some superbugs, such as vancomycin-resistant Enterococci bacteria, remain unaffected by even this antibiotic of last resort.

“We rely on antibiotics to deliver modern health care,” Segre says. But with the rise of drug-resistant bacteria, “we’re running out of new antibiotics to treat bacterial infections,” and some of the more potent ones aren’t working as well.

Ideally, doctors would be able to quickly identify the right antibiotic to treat a particular infection. But labs need days or even weeks to test and identify the bacteria strain. Until the lab results come in, antibiotic treatment is often an educated guess.

“We need to know how to treat for a favorable outcome, but knowledge about the infection can be several days away,” explains Dr. Vance Fowler, an infectious disease expert at Duke University School of Medicine.

Fowler says faster diagnostic testing offers one of the best hopes for treating infectious diseases. Technology is catching up, he says, and new research in this area looks promising.

Genetic studies by NIH-supported researchers such as Segre and Fowler are also helping us understand the unique characteristics of antibiotic-resistant bacteria. Their findings could point the way to innovative new treatments.

While scientists search for ways to beat back these stubborn bacteria, you can help by preventing the spread of germs so we depend less on antibiotics in the first place.

The best way to prevent bacterial infections is by washing your hands frequently with soap and water. It’s also a good idea not to share personal items such as towels or razors. And use antibiotics only as directed. We can all do our part to fight drug-resistant bacteria.

Source: National Institutes of Health, https://newsinhealth.nih.gov/issue/Feb2014/Feature1

Mental health might be improved with quitting smoking, according to a new study. The researchers say the effect sizes are equal or larger than those of antidepressant treatment for mood and anxiety disorders.

It is well known that stopping smoking substantially reduces major health risks, such as the development of cancers, cardiovascular and respiratory diseases. But the association between smoking and mental health is less clear cut.

Many smokers want to stop but continue smoking as they believe smoking has mental health benefits. And health professionals are sometimes reluctant to deal with smoking in people with mental disorders in case stopping smoking worsens their mental health.

So researchers from the universities of Birmingham, Oxford, and King's College London set out to investigate changes in mental health after smoking cessation compared with continuing to smoke.

They analysed the results of 26 studies of adults that assessed mental health before smoking cessation and at least six weeks after cessation in the general population and clinical populations (patients with chronic psychiatric and/or physical conditions).

Differences in study design and quality were taken into account to minimise bias.

Measures of mental health included anxiety, depression, positivity, psychological quality of life, and stress. Participants had an average age of 44, smoked around 20 cigarettes a day, and were followed up for an average of six months.

The research team found consistent evidence that stopping smoking is associated with improvements in depression, anxiety, stress, psychological quality of life, and positivity compared with continuing to smoke.

The strength of association was similar for both the general population and clinical populations, including those with mental health disorders. And there was no evidence that study differences could have skewed the results.

Although observational data can never prove causality, "smokers can be reassured that stopping smoking is associated with mental health benefits," say the authors.

"This could overcome barriers that clinicians have toward intervening with smokers with mental health problems," they add. "Furthermore, challenging the widely held assumption that smoking has mental health benefits could motivate smokers to stop."

CHICAGO  – Improper handling of intravenous saline at a West Virginia outpatient oncology clinic was linked with the first reported outbreak of Tsukamurella spp., gram-positive bacteria that rarely cause disease in humans, in a new report from the Centers for Disease Control and Prevention (CDC). The report was published in the March issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

"This outbreak illustrates the need for outpatient clinics to follow proper infection control guidelines and medication preparation practices to minimize the risk of infection for patients with weakened immune systems," said Isaac See, MD, lead author of the study. "A combination of careful descriptive epidemiology with attention to outlier cases, direct observations, and analytic studies were needed to support this investigation, which pointed to deficiencies in medication preparation practices as the cause of these unusual infections."

From September 2011-May 2012, 15 immunocompromised patients developed Tsukamurella bloodstream infections. All patients had received a diagnosis of malignancy, and had an indwelling central line, although central line types varied. A case-control study determined that the only risk factor for developing Tsukamurella infection was the receipt of saline flush, prepared by the clinic staff from large preservative-free bags of saline, from the clinic during September-October 2011.

Investigations by the West Virginia Bureau of Public Health (WVBPH) and the CDC found several lapses in infection control procedures relating to the care of long-term intravenous catheters and preparation of chemotherapy for patients at the clinic. These investigations also suggested that saline flush syringes were the likely source of infection.

Following the recommendations of WVBPH and CDC, the clinic instituted several changes to its infection prevention and control practices; including using pre-packaged manufactured saline flushes. After the clinic changed this practice, Tsukamurella bloodstream infections stopped occurring, further supporting the saline flush as the source of infection.

To help outpatient oncology facilities establish appropriate infection control strategies, the CDC developed a basic infection control plan tailored to these settings outlining key policies and procedures needed to meet minimal requirements for patient safety. These include the proper use and handling of injectable medications and correct procedures for assessing central lines. Outpatient oncology facilities without an existing plan are encouraged to use this document as a starting point.

Crosstex International, Inc., a recognized leader in infection prevention and control products and services, is

proud to announce the launch of 8558-STERILE, a new toll-free Infection Control helpline.

The Infection Control helpline was established after several infection control breaches made top news headlines

in the dental sector. This spotlight on infection control protocol had many practices reviewing their procedures

and also turning to manufacturers to ensure they understood product IFUs (Instructions for Use) and the

frequency required to meet physical, chemical and biological monitoring CDC compliance guidelines.

In response to these questions, Crosstex established a dedicated Helpline. This Helpline, unlike other Crosstex

customer service phone numbers, is answered only by clinicians. These clinicians work on behalf of Crosstex to

help educate the industry on proper sterility assurance and infection control processes, and they can identify

with callers as they’ve “been in their shoes”.

Also, it is important to note that although Crosstex is a well-known industry leader for its line of personal

protection equipment (face masks, bibs, gloves), what some may not know is that Crosstex has two testing

laboratories that process over 2.5 million mail-in spore tests annually! These spore tests are received from a

diverse range of customers (Distributors, Medical Institutions, Physicians, Veterinarians, Teaching Universities,

Dentists, Dental Service Organizations, Group Purchasing Organizations and Government Agencies). As part

of this mail-in service, Crosstex calls its customers to alert them of a failed test in order to advise and address

any questions. Crosstex is, therefore, in a unique position to counsel customers and help ensure safety through

compliance as a result of these daily consultations.

The Infection Control Helpline is open to anyone - not just Crosstex customers. Calls can range from the

simplest of product inquiries to serious infection control protocol concerns. It is important for practices to

understand that if they fail to follow compliance regulations, they face the danger of an audit, or worse, infection

to their patients or staff members. Crosstex is urging healthcare workers: “Don’t Risk It”. Call the Infection

Control Helpline at 8558-STERILE, (855) 878-3745. Monday - Friday, 8am to 5pm MST and let Crosstex

assist with infection control product and process inquiries.