Blind spots in biodefense.

In October, the Biden administration released its National Biodefense Strategy (NBS-22), the first update since the COVID-19 pandemic began. Although the document notes that one of the lessons of the pandemic is that threats originating anywhere are threats everywhere, it frames threats as largely external to the United States. NBS-22 focuses primarily on bioterrorism and laboratory accidents, neglecting threats posed by routine practices of animal use and production inside the United States. NBS-22 references zoonotic disease but assures readers that no new legal authorities or institutional innovations are needed. Although the US is not alone in failing to confront these risks, its failure to comprehensively address them echoes across the globe.

Emergency preparedness, resilience and response to a biological outbreak.

Major disease outbreaks continue to be a significant risk to public health, with pandemic influenza or an emerging infectious disease outbreak at the top of the UK National Risk Register. The risk of deliberate release of a biological agent is lower but remains possible and may only be recognised after casualties seek medical attention. In this context the emergency preparedness, resilience and response (EPRR) process protects the public from high consequence infectious diseases, other infectious disease outbreaks and biological agent release. The core elements of the EPRR response are recognition of an outbreak, isolation of patients, appropriate personal protective equipment for medical staff and actions to minimise further disease spread. The paper discusses how high-threat agents may be recognised by clinicians, the initial actions to be taken on presentation and how the public health system is notified and responds. It draws on the national pandemic influenza plans to describe the wider response to a major disease outbreak and discusses training requirements and the potential role of the military.

Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Science and the CBRNE Science Medical Operations Science Support Expert (CMOSSE).

A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.

Evaluación del riesgo biológico en laboratorios de Control de la Calidad del Instituto Finlay / Evaluation of biological risk in quality control laboratories of the Finlay Institute

El Instituto Finlay dedicado a producir vacunas empleando agentes biológicos, durante años, viene capacitando al personal de las áreas que presentan mayor potencial de riesgos, dada la importancia de proteger a sus trabajadores, instalaciones, equipos y producciones. Por ello se comenzaron a realizar evaluaciones de riesgos según métodos empleados por otros países, como España. Este trabajo tuvo como objetivo principal evaluar el riesgo biológico en laboratorios de Control de la Calidad, tales como el laboratorio de Bacteriología y el laboratorio de Pruebas Biológicas. Otros objetivos fueron, analizar la aplicación de la legislación nacional vigente de Bioseguridad y proponer un programa de acciones. El estudio se realizó en el último trimestre del año 2011 y primer semestre del año 2012. Se utilizaron como instrumentos de calidad, el método de la observación, listas de chequeo, entrevistas, tormentas de ideas y análisis documental. Los resultados mostraron que: ambos laboratorios cumplieron la legislación vigente de Bioseguridad, se identificaron los factores de riesgos más frecuentes, de ellos los de mayor nivel de riesgo y se obtuvo un programa de acciones correctivas encaminado a la solución de problemas detectados. Se demostró la posibilidad de la aplicación de un método cuantitativo, escogido para evaluar el riesgo y la implementación del programa de acciones correctivas con resultados satisfactorios(AU)

The Finlay Institute, dedicated to producing vaccines using biological agents, has for years been training personnel in the areas with the greatest risk potential, given the importance of protecting its workers, facilities, equipment and production. Therefore, risk assessments were started according to methods used by other countries, such as Spain. The main objective of this work was to evaluate the biological risk in Quality Control laboratories, such as the Bacteriology laboratory and the Biological Testing laboratory. Other objectives were to analyze the application of the current national Biosecurity legislation and propose a program of actions. The study was conducted in the last quarter of 2011 and the first semester of 2012. The observation method, checklists, interviews, storms of ideas and documentary analysis were used as quality instruments. The results showed that: both laboratories complied with the current Biosafety legislation, the most frequent risk factors were identified, including those with the highest level of risk and a program of corrective actions aimed at solving problems detected was obtained. The possibility of the application of a quantitative method, chosen to evaluate the risk and the implementation of the program of corrective actions with satisfactory results was demonstrated(AU)

Analysis of polyvinyl alcohol release from commercially available daily disposable contact lenses using an in vitro eye model.

The purpose of this work was to determine the release of polyvinyl alcohol (PVA) from etafilcon A, omafilcon A, and nelfilcon A daily disposable hydrogel contact lenses using a novel in vitro model. PVA is an ocular lubricant that can be found in multiple formulations of artificial tears. Nelfilcon A innately contains PVA, so only the release of PVA from this lens was evaluated. Etafilcon A and omafilcon A lenses were incubated in a PBS solution containing PVA. The release of PVA was evaluated using a novel in vitro blink platform with Milli-Q water and PBS under various blink conditions and flow rates. Nelfilcon A lenses significantly released more PVA than other lenses at 0.5 and 1.5 h in both PBS and Milli-Q water (p < 0.001). For nelfilcon A, there was no statistical significance between the release profiles of PVA between the blink and no-blink conditions, or for the various flow rates (p > 0.05). All tested groups and lenses showed a burst release within the first 4.5 h and rapidly plateaued thereafter. The current study demonstrates that releasable PVA (whether through uptake or through being inherently available from the material) is loosely bound on hydrogel lenses, and the majority is released within 4.5 h. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1662-1668, 2019.

Dispositivos de bioseguridad y formación para prevenir las exposiciones biológicas accidentales en el ámbito hospitalario / Biosafety devices and training to prevent accidental biological exposures in hospitals

No disponible

Inoculating science against potential pandemics and information hazards.

The recent de novo assembly of horsepox is an instructive example of an information hazard: published methods enabling poxvirus synthesis led to media coverage spelling out the implications, efficiently disseminating true information that might be used to cause harm. Whether or not the benefits justified the risks, the horsepox saga provides ample reason to upgrade the current system for screening synthesized DNA for hazardous sequences, which does not cover the majority of firms and cannot reliably prevent the assembly of potentially pandemic pathogens. An upgraded system might leverage one-way encryption to confidentially scrutinize virtually all commercial production by a cooperative international network of servers whose integrity can be verified by third parties. Funders could support participating institutions to ease the transition or outright subsidize the market to make clean DNA cheaper, while boycotts by journals, institutions, and funders could ensure compliance and require hardware-level locks on future DNA synthesizers. However, the underlying problem is that security and safety discussions among experts typically follow potentially hazardous events rather than anticipating them. Changing norms and incentives to favor preregistration and advisory peer review of planned experiments could test alternatives to the current closeted research model in select areas of science. Because the fields of synthetic mammalian virology and especially gene drive research involve technologies that could be unilaterally deployed and may self-replicate in the wild, they are compelling candidates for initial trials of early-stage peer review.

Crenças da equipe multiprofissional da atenção primária à saúde sobre o risco biológico ocupacional / Creencias del equipo multidisciplinario de atención primaria de salud en el trabajo de riesgo biológico / Beliefs of the multidisciplinary team of primary health care on occupational biohazard

RESUMO Introdução: A saúde do trabalhador tem despertado preocupação, uma vez que quanto maior a elucidação do risco e a adoção de medidas de biossegurança, menor a possibilidade de doenças ocupacionais adquiridas por meio da exposição a material biológico. Objetivo: Caracterizar as crenças da equipe multiprofissional do trabalhador da atenção primária à saúde frente ao risco biológico. Métodos: Estudo descritivo qualitativo em sete unidades de atenção primária à saúde de Goiânia-GO, em 2014, por meio de entrevistas na técnica do incidente crítico, analisados segundo Bardin, e como referencial o Modelo de Crenças em Saúde. Resultados: A susceptibilidade percebida sobre os riscos biológicos surgiu a partir da exposição ao sangue, evidenciando falta de percepção; a severidade foi percebida a partir da vivência de situações concretas de acidentes com perfurocortantes; as barreiras percebidas à adoção das medidas preventivas relacionaram-se à indisponibilidade de equipamentos de proteção individual, qualificação na temática e estrutura física adequada. Benefícios foram percebidos pela adoção de comportamentos seguros. Conclusão: As crenças dos trabalhadores expressaram conceitos elementares, inconsistentes, inseguros, com desvalorização dos riscos intrínsecos ao processo de trabalho e ao ambiente laboral(AU)

RESUMEN Introducción: El trabajador de la salud ha despertado preocupación, ya que cuanto mayor es la elucidación de riesgo y la adopción de medidas de bioseguridad, menor será la posibilidad de enfermedades profesionales adquiridas a través de la exposición a material biológico. Objetivo: Caracterizar las creencias del equipo multidisciplinario de trabajadores de la salud primaria sobre riesgo biológico. Métodos: Estudio descriptivo cualitativo en siete unidades de atención primaria de salud en Goiânia-GO en 2014, a través de entrevistas en la técnica del incidente crítico, según Bardin, y como referencia el Modelo de Creencias de Salud. Resultados: La susceptibilidad percibida de los riesgos biológicos surgió de la exposición a la sangre, que muestra la falta de conciencia; la severidad fue percibido de la experiencia de situaciones concretas de lesiones cortopunzantes; barreras percibidas para la adopción de medidas preventivas relacionadas con la disponibilidad de equipo de protección personal, calificación en la estructura física sujeto y apropiada. Los beneficios fueron percibidos por la adopción de comportamientos seguros. Conclusión: Las creencias de los trabajadores expresan conceptos elementales, inconsistente, insegura, con la depreciación de los riesgos inherentes al proceso de trabajo y el entorno de trabajo(AU)

ABSTRACT Introduction: The health worker has aroused concern, since the higher the elucidation of risk and adoption of biosecurity measures, the lower the possibility of occupational diseases acquired through exposure to biological material. Objective: Characterize the beliefs of the multidisciplinary team of workers of primary health in the biological risk. Methods: Qualitative descriptive study in seven units of primary health care in Goiânia-GO in 2014, through interviews in the technique of critical incident, analyzed according to Bardin, and as a reference the Health Belief Model. Results: The perceived susceptibility of the biological risks arose from exposure to blood, showing lack of awareness; the severity was perceived from the experience of concrete situations of sharps injuries; perceived barriers to the adoption of preventive measures related to the availability of personal protective equipment, qualification in the subject and appropriate physical structure. Benefits were perceived by the adoption of safe behaviors. Conclusion: The beliefs of workers express elementary concepts, inconsistent, insecure, with depreciation of the risks inherent to the work process and working environment(AU)

Work incidents with biological material in the nursing team of a hospital in Mid-Western Brazil / Trabajar accidentes con material biológico en el personal de enfermería en un hospital de la región central de Brasil / Acidentes de trabalho com material biológico na equipe de enfermagem de um hospital do Centro-Oeste brasileiro

Abstract Objectives: To investigate and describe the occurrence and characteristics of Work Incidents (WI) with Potentially Contaminated Biological Material (PCBM), the frequency and variables related to this occurrence among nursing categories. Methods: A descriptive and cross-sectional study with a quantitative approach was performed at a referral hospital in the State of Mato Grosso, Mid-Western Brazil. Results: Women represented 90.5% of all participants and the mean age was 42.59 years. A total of 46.6% of professionals reported having undergone exposure to PCBM, 60.9% stated not having made a report, and 42.6% reported having participated in training courses on this subject. Comparing the occurrence of WI between nursing assistants and nurses, nursing assistants were more affected (p = 0.022). Conclusions: Among nursing professionals, the number of WI is high, recurrent and underreported. Continuing education on this theme is required to ensure the quality of care and promote workers' health.

Resumen Objetivos: Evaluar y describen la ocurrencia y características de los accidentes industriales (AT) potencialmente contaminados con material biológico (MBPC), la frecuencia y las variables relacionadas con la aparición de la categoría de enfermería. Método: Estudio descriptivo transversal, con abordaje cuantitativo, realizado en Hospital referencia en el Estado de Mato Grosso, Brasil. Resultados: Las mujeres representaban el 90,5% de los participantes; la edad media fue de 42,59 años. Un total de 46,6% de los encuestados reportó haber sufrido exposición a MBPC, y el 60,9% no había hecho la notificación, el 42,6% dijo que había participado en una formación sobre el tema. La comparación de la ocurrencia de AT entre los grupos de las enfermeras y auxiliares de enfermería, auxiliares fueron los más afectados (p = 0,022). Conclusión: En los profesionales de enfermería, el número de AT es elevado, recurrente y subnotificado. La educación permanente relacionada con la temática es necesaria para garantizar la calidad de la asistencia y promover la salud del trabajador.

Resumo Objetivos: Investigar e descrever a ocorrência e as características dos Acidentes de Trabalho (AT) com Material Biológico Potencialmente Contaminado (MBPC), a frequência e as variáveis relacionadas à ocorrência entre as categorias de enfermagem. Método: Estudo descritivo, transversal, de abordagem quantitativa, realizado em um hospital referência no estado de Mato Grosso, Brasil. Resultados: As mulheres representaram 90,5% dos participantes e a média de idade foi de 42,59 anos. Um total de 46,6% dos profissionais relatou já ter sofrido exposição a MBPC, e 60,9% referiram não ter realizado a notificação e 42,6% afirmaram terem participado de treinamentos sobre a temática. Na comparação entre a ocorrência de AT entre os grupos de enfermeiros e auxiliares de enfermagem, os auxiliares foram mais acometidos (p = 0,022). Conclusão: Nos profissionais de enfermagem, o número de AT é elevado, recorrente e subnotificado. A educação permanente relacionada à temática é necessária para garantir a qualidade da assistência e promover a saúde do trabalhador.

Agravos relacionados ao trabalho: perfil das notificações no RS, 2017 / Work-related diseases: profile of notifications in RS, 2017

Análise do perfil dos agravos relacionados ao trabalho notificados no Rio Grande do Sul, no SIST/RS e no SINAN/MS, em 2017. (AU)

Biosecurity Implications for the Synthesis of Horsepox, an Orthopoxvirus.

This article examines the biosecurity and biodefense implications resulting from the recent creation of horsepox virus, a noncirculating (extinct) species of orthopoxvirus. Here we examine the technical aspects of the horsepox virus synthesis and conclude that orthopox synthesis experiments currently remain technically challenging-and will continue to be so, even once this work is published in the scientific literature. This limits potential misuse by some types of nefarious actors. We also examine the implications of one stated purpose for the recreation of horsepox virus: the development of a smallpox vaccine. If the development is successful, it could take advantage of US government incentives for the priority FDA review of medical countermeasures (MCMs) against biosecurity threats. However, if this case leads to the determination that this incentive is counterproductive for security, the newly created priority review voucher program should be more clearly defined or limited based on need. Limiting the program could have costs that require further consideration, however, as general incentives for biodefense medical countermeasure development are required for MCMs to be available. Finally, while the recreation of horsepox virus was not technically trivial, nor was it cell-free, this experiment was a de facto demonstration of already-assumed scientific capabilities. The ability to recreate horsepox, or smallpox, will remain no matter what policy controls are put into place. It will be impossible to close off all avenues for nefarious misuse of gene synthesis, or misuse of biological materials more broadly. As a result, we advocate for the implementation of policy, regulations, and guidance that will make illicit recreation harder, more burdensome, more detectable, and, thus, more preventable without having sweeping negative consequences for the research enterprise. As part of our biosecurity efforts, we must also encourage and enable scientists to participate actively and to do all they can to safeguard their technical fields from irresponsible or illicit actions.

The De Novo Synthesis of Horsepox Virus: Implications for Biosecurity and Recommendations for Preventing the Reemergence of Smallpox.

In March 2017, the American biotech company Tonix announced that a Canadian scientist had synthesized horsepox virus as part of a project to develop a safer vaccine against smallpox. The first de novo synthesis of an orthopoxvirus, a closely related group of viruses that includes horsepox and the variola virus that causes smallpox, crosses an important Rubicon in the field of biosecurity. The synthesis of horsepox virus takes the world one step closer to the reemergence of smallpox as a threat to global health security. That threat has been held at bay for the past 40 years by the extreme difficulty of obtaining variola virus and the availability of effective medical countermeasures. The techniques demonstrated by the synthesis of horsepox have the potential to erase both of these barriers. The primary risk posed by this research is that it will open the door to the routine and widespread synthesis of other orthopoxviruses, such as vaccinia, for use in research, public health, and medicine. The normalization and globalization of orthopoxvirus synthesis for these beneficial applications will create a cadre of laboratories and scientists that will also have the capability and expertise to create infectious variola virus from synthetic DNA. Unless the safeguards against the synthesis of variola virus are strengthened, the capability to reintroduce smallpox into the human population will be globally distributed and either loosely or completely unregulated, providing the foundation for a disgruntled or radicalized scientist, sophisticated terrorist group, unscrupulous company, or rogue state to recreate one of humanity's most feared microbial enemies. The reemergence of smallpox-because of a laboratory accident or an intentional release-would be a global health disaster. International organizations, national governments, the DNA synthesis industry, and the synthetic biology community all have a role to play in devising new approaches to preventing the reemergence of smallpox.

Riesgos laborales en la profesión podológica. Cómo detectarlos y prevenirlos / Occupational hazards in the podiatrist profession. How to detect and prevent

Desarrollamos, con ésta revisión bibliográfica, un análisis de los riesgos laborales que sufren los profesionales sanitarios, en particular, los podólogos. En este campo de la sanidad, el podólogo está expuesto a diversos factores, que pueden causar en él, una serie de problemas, alteraciones o patologías, que ante todo, con conocimiento sobre a lo que se está expuesto en la jornada laboral, se puede llegar a conseguir su prevención. Destacaremos las alteraciones que se pueden sufrir al estar expuesto a ruido constante como con los micromotores y turbinas, las alergias al látex, riesgos biológicos, violencia ocupacional, entre otros; La salud, juega un papel importante, básico y esencial, para conseguir que el profesional sanitario obtenga la mayor eficacia y rendimiento, en las mejores condiciones de trabajo (AU)

Develop, with this review, an analysis of the occupational risk faced by health professionals, in particular, the podiatrists. In the field of health, the podiatrists is exposed to various factors, which can cause it, a number of problems, disorders or diseases, which primarily with knowledge of what is stated in the working day can be able to get its prevention. Highlight the changes that can suffer when exposed to constant noise as micromotors and turbines, latex allergies, biological risks, workplace violence, among others; Health, play an important role in basic and essential to ensure that healthcare professionals get the most efficiency and effectiveness, in the best conditions (AU)