scholarly journals Design and Construction of a Biosafety Level-3 Autopsy Laboratory

2020 ◽  
Author(s):  
Kurt B. Nolte ◽  
Timothy B. Muller ◽  
Adam M. Denmark ◽  
Ron Burstein ◽  
Yvonne A. Villalobos
Keyword(s):  
Public Health ◽  
Health Concern ◽  
Medical Examiner ◽  
Emerging Infections ◽  
Laboratory Design ◽  
Control And Prevention ◽  
Level 3 ◽  
Medical Examiners ◽  
Biosafety Level ◽  
Design And Construction

ABSTRACT Context: Autopsy pathologists including medical examiners provide valuable public health support for infectious disease deaths through surveillance for deaths of public health concern including emerging infections, identifying causative organisms for unexplained deaths, and providing insights into the pathology and pathogenesis of novel or unusual infections. However, autopsy poses biosafety risks to workers within and outside the laboratory. The highest rates of laboratory acquired infections occur in autopsy workers. Objective: To design and construct an appropriately biosafe autopsy laboratory. Design: We conducted a biosafety risk assessment for autopsy workers using the process developed by the U.S. Centers for Disease Control and Prevention and National Institutes of Health and applied these findings as the basis of laboratory design and construction. Results: Autopsy workers are unpredictably exposed to a variety of infectious organisms including hepatitis C virus, HIV and M. tuberculosis. Hazardous autopsy procedures include using and encountering sharp objects, and the generation of aerosols from dissection, fluid aspiration, rinsing tissues, and dividing bone with an oscillating saw. Conclusions: Exposure to bloodborne and airborne pathogens from procedures that can cause cutaneous inoculation and inhalation of aerosols indicates that human autopsies should be performed at Biosafety Level 3. We designed a large entirely Biosafety Level 3 medical examiner autopsy laboratory using design principles and characteristics that can be scaled to accommodate smaller academic or other hospital-based autopsy spaces. Containment was achieved through a concentric ring design, with access control at interface zones. As new autopsy laboratories are planned, we strongly recommend that they be designed to function uniformly at Biosafety Level 3.

Role of the Medical Examiner in Zika Virus and Other Emerging Infections

2016 ◽  
Vol 141 (1) ◽  
pp. 82-84 ◽  
Author(s):  
Veena D. Singh ◽  
Sarah L. Lathrop
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Zika Virus ◽  
Emerging Infectious Diseases ◽  
Hantavirus Pulmonary Syndrome ◽  
Medical Examiner ◽  
Public Health Approach ◽  
Emerging Infections ◽  
Medical Examiners

Context.—Medical examiners and coroners have long been an integral component of public health, often being the first to recognize and describe emerging infectious diseases. Given their experience and access, medical examiners and coroners will provide valuable contributions to better understanding Zika virus infection and its sequelae. Objective.—To review past examples of medical examiner/coroner involvement in recognition of emerging infectious diseases and describe how medical examiners and coroners will be critical in understanding the pathophysiology of Zika infections. Design.—Review of the existing literature on the role of medical examiners and coroners in the identification of emergent infections and the available literature on Zika virus. Results.—Medical examiners and coroners have played a crucial role in identifying numerous emerging infectious diseases such as hantavirus pulmonary syndrome and West Nile virus, and have the expertise and experience to aid in elucidating the pathophysiologic effects of Zika virus and tracking its distribution and risk factors. Conclusions.—Medical examiners and coroners will be a significant factor in the unified public health approach needed to mitigate the effects of Zika virus and other, heretofore unrecognized, infectious diseases.

scholarly journals COVID-19 and the rise of social activism in Southeast Asia: a public health concern

2021 ◽  
Author(s):  
Jeff Clyde G Corpuz
Keyword(s):  
Public Health ◽  
Southeast Asia ◽  
Social Activism ◽  
The Philippines ◽  
World Health ◽  
Health Concern ◽  
Human Right ◽  
Health Crisis ◽  
Control And Prevention ◽  
Health Organization

Abstract The current public health crisis has radically altered the social and civic involvement in Southeast Asia. Although the virus has shifted the landscape of engagement, it has not dampened the enthusiasm of the public. In 2020–2021, more people than ever seem to be paying attention and even getting involved in activism. Many dramatic events happened during the coronavirus crisis such as from protests in support of the Black Lives Matter movement, public activism around the environment, economic inequality, authoritarianism and human rights violations. In Indonesia, the Philippines, Malaysia, Thailand and just recently Myanmar. The journal has lately published about the ‘Relationship of George Floyd protests to increases in COVID-19 cases using event study methodology’ and it has rightly expressed that the Centers for Disease Control and Prevention (CDC)-recommended social distancing guidelines must be followed in a protest situation. In response to the situation of social activism in Southeast Asia, one must follow the CDC-recommended and World Health Organization (WHO) guidelines in the Region. Although protesting is an individual human right, one must also be cautious and be aware of the deadly virus since we are still in a pandemic and the COVID-19 virus continues to mutate.

Biosafety considerations for in vivo work with risk group 3 pathogens in large animals and wildlife in North America

2013 ◽  
Vol 14 (1) ◽  
pp. 2-10 ◽  
Author(s):  
S. C. Olsen
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Basic Knowledge ◽  
Zoonotic Pathogens ◽  
Natural Hosts ◽  
Domestic Livestock ◽  
Level 3 ◽  
Large Animals ◽  
Biosafety Level

AbstractRegulations in the United States require animal biosafety level 3 (ABSL-3) or biosafety level 3 agriculture (BSL-3-Ag) containment for many endemic zoonotic pathogens and etiologic agents of foreign animal diseases. In an effort to protect public health, billions of dollars were invested in regulatory programs over many years to reduce the prevalence of zoonotic pathogens such as Brucella and Mycobacterium bovis in domestic livestock. In addition to research needs in domestic livestock hosts, the establishment of brucellosis and tuberculosis in wildlife in the United States has created a need for research studies addressing these zoonotic diseases. As guidelines in the Biosafety in Microbiological and Biomedical Laboratories (BMBL, 2009) for BSL-3 and BSL-3-Ag facilities are primarily directed toward laboratory or vivarium facilities, additional issues should be considered in designing large animal containment facilities for domestic livestock and/or wildlife. Flight distance, herd orientation, social needs, aggressiveness, and predictability are all factors we considered on a species by species basis for designing our containment facilities and for work practices with large ruminants. Although safety risk cannot be completely eliminated when working with large animals, studies in natural hosts are critical for advancing vaccine and diagnostic development, and providing basic knowledge of disease pathogenesis in natural hosts. Data gathered in these types of studies are vital for state and national regulatory personnel in their efforts to design strategies to control or eradicate diseases such as brucellosis and tuberculosis in their natural hosts, whether it is domestic livestock or wildlife. It is likely that failure to address the prevalence of disease in wildlife reservoirs will lead to re-emergence in domestic livestock. The overall benefit of these studies is to protect public health, provide economic benefits to producers, and protect the economic investment made in regulatory programs.

Medical Examiners, Coroners, and Public Health: A Review and Update

2006 ◽  
Vol 130 (9) ◽  
pp. 1274-1282 ◽  
Author(s):  
Randy Hanzlick
Keyword(s):  
Public Health ◽  
Criminal Justice ◽  
The United States ◽  
Background Information ◽  
Medical Examiner ◽  
Epidemiologic Research ◽  
The Public ◽  
Death Investigation ◽  
Medical Examiners

Abstract Context.—Traditionally, the emphasis of work done by medical examiners, coroners, and the death investigation community has been viewed as serving the criminal justice system. During the last several decades, however, an important role for these 3 groups has emerged within public health. Objective.—To provide important background information on death investigation systems, the evolution and framework of public health entities that rely on information gathered by medical examiners and coroners, and the role of medical examiners and coroners in epidemiologic research, surveillance, and existing public health programs and activities. Data Sources.—Previous articles on epidemiologic aspects of forensic pathology and the role of medical examiners and coroners in epidemiologic research and surveillance; a review of the Web sites of public health and safety agencies, organizations, and programs that rely on medical examiner and coroner data collected during medicolegal investigations; and a review of recent public health reports and other publications of relevance to medical examiner and coroner activities. Conclusions.—The role of medical examiners and coroners has evolved from a criminal justice service focus to a broader involvement that now significantly benefits the public safety, medical, and public health communities. It is foreseeable that the public health role of medical examiners and coroners may continue to grow and that, perhaps in the not-too-distant future, public health impact will surpass criminal justice as the major focus of medicolegal death investigation in the United States.

Counts of Campylobacter spp. on U.S. Broiler Carcasses

2006 ◽  
Vol 69 (5) ◽  
pp. 1034-1039 ◽  
Author(s):  
NORMAN J. STERN ◽  
STEPHEN PRETANIK
Keyword(s):  
Public Health ◽  
Human Disease ◽  
Broiler Chickens ◽  
Health Concern ◽  
Public Health Concern ◽  
Before And After ◽  
Control And Prevention ◽  
Public Exposure ◽  
Raw Poultry ◽  
Campylobacter Spp

Foodborne Campylobacter-associated gastroenteritis remains a public health concern, and the Centers for Disease Control and Prevention suggests that improperly handled poultry is the most important source of this human disease. In response to these concerns, 10 of the largest U.S. poultry integrators cooperatively determined the incidence and counts of Campylobacter on processed broiler carcasses. Prior to conducting the survey, laboratory personnel were trained in a direct Campy-Cefex plating procedure for enumeration of the organism. Before and after the survey enumeration, consistency in reporting was compared among the participating laboratories. Participating laboratories were able to consistently estimate inoculated concentrations of Campylobacter in carcass rinses. Within the central study, we determined the potential exposure of U.S. consumers to Campylobacter spp. associated with broiler carcasses during a 13-month period. Among each of the 13 participating poultry complexes, rinses from 25 randomly selected fully processed carcasses were sampled monthly from individual flocks. Among 4,200 samples, approximately 74% of the carcasses yielded no countable Campylobacter cells. Campylobacter spp. were isolated from approximately 3.6% of all commercially processed broiler carcasses at more than 105 CFU per carcass. Acceptable counts of these organisms on raw poultry carcasses remain to be determined. Nevertheless, this survey indicates industry recognition of its responsibility to assess and reduce public exposure to Campylobacter through broiler chickens.

scholarly journals Medicolegal Death Scene Investigations after Natural Disaster- and Weather-Related Events: A Review of the Literature

2017 ◽  
Vol 7 (2) ◽  
pp. 221-239 ◽  
Author(s):  
Luciana A. Rocha ◽  
Catharine Q. Fromknecht ◽  
Sarah Davis Redman ◽  
Joanne E. Brady ◽  
Sarah E. Hodge ◽  
...  
Keyword(s):  
Data Collection ◽  
Grey Literature ◽  
Vital Statistics ◽  
Red Cross ◽  
Medical Examiner ◽  
Death Scene ◽  
Reporting Practices ◽  
Control And Prevention ◽  
Death Investigation ◽  
Medical Examiners

Background The number of disaster-related deaths recorded by vital statistics departments often differs from that reported by other agencies, including the National Oceanic and Atmospheric Administration-National Weather Service storm database and the American Red Cross. The Centers for Disease Control and Prevention (CDC) has launched an effort to improve disaster-related death scene investigation reporting practices to make data more comparable across jurisdictions, improve accuracy of reporting disaster-related deaths, and enhance identification of risk and protective factors. We conducted a literature review to examine how death scene data are collected and how such data are used to determine disaster relatedness. Methods Two analysts conducted a parallel search using Google and Google Scholar. We reviewed published peer-reviewed articles and unpublished documents including relevant forms, protocols, and worksheets from coroners, medical examiners, and death scene investigators. Results We identified 177 documents: 32 published peer-reviewed articles and 145 other documents (grey literature). Published articles suggested no consistent approach for attributing deaths to a disaster. Researchers generally depended on death certificates to identify disaster-related deaths; several studies also drew on supplemental sources, including medical examiner, coroner, and active surveillance reports. Conclusions These results highlight the critical importance of consistent, accurate data collection during a death investigation. Review of the grey literature found variation in use of death scene data collection tools, indicating the potential for widespread inconsistency in data captured for routine reporting and public health surveillance. Findings from this review will be used to develop guidelines and tools for capturing disaster-related death investigation data.

scholarly journals Penicillin-Susceptible, Oxidase-Negative, Nonhemolytic, NonmotileBacillus megateriumin Disguise ofBacillus anthracis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Shih Keng Loong ◽  
Boon Teong Teoh ◽  
Jefree Johari ◽  
Chee Sieng Khor ◽  
Juraina Abd-Jamil ◽  
...  
Keyword(s):  
Public Health ◽  
Environmental Conditions ◽  
Health Management ◽  
Bacterial Pathogen ◽  
16S Rdna Sequencing ◽  
Diagnostic Laboratory ◽  
Rdna Sequencing ◽  
Level 3 ◽  
Level 2 ◽  
Biosafety Level

Bacillus anthracisis a bacterial pathogen of major concern. The spores of this bacteria can survive harsh environmental conditions for extended periods and are well recognized as a potential bioterror weapon with significant implications. Accurate and timely identification of thisBacillusspecies in the diagnostic laboratory is essential for disease and public health management. Biosafety Level 3 measures and ciprofloxacin treatment were instituted whenB. anthraciswas suspected from a patient with gangrenous foot. 16S rDNA sequencing was performed to accurately identify the suspected bacterium, due to the superiority of this method to accurately identify clinically isolated bacteria.B. megateriumwas identified as the causative agent and the organism was subsequently treated as a Biosafety Level 2 pathogen.

Superbugs: Antibiotic Resistance Is Becoming a Major Public Health Concern

2016 ◽  
Vol 29 (2) ◽  
pp. 130-133 ◽  
Author(s):  
Patricia T. Alpert
Keyword(s):  
Public Health ◽  
Antibiotic Resistance ◽  
Clostridium Difficile ◽  
Current Treatment ◽  
Health Concern ◽  
Treatment Modalities ◽  
Public Health Concern ◽  
Carbapenem Resistant ◽  
Control And Prevention ◽  
Carbapenem Resistant Enterobacteriaceae

Antibiotic resistance has led to the development of so-called “superbugs” that no longer respond to the current treatment modalities. The array of antibiotics available to treat these infections is dwindling with very few antibiotics in the pipeline. This article discussed the pathogens the Centers for Disease Control and Prevention (CDC) has placed in their urgent category: (1) Clostridium difficile, (2) Carbapenem-resistant Enterobacteriaceae, and (3) Neisseria gonorrhoeae. In addition, a few suggestions for prevention of resistance are offered.

Prevalence of Overweight and Obesity In School-aged Children

2006 ◽  
Vol 67 (3) ◽  
pp. 125-129 ◽  
Author(s):  
Meizi He ◽  
Charlene Beynon
Keyword(s):  
Public Health ◽  
Overweight And Obesity ◽  
Health Concern ◽  
Obesity Prevalence ◽  
Anthropometric Data ◽  
Obesity Epidemic ◽  
School Aged Children ◽  
Children Obesity ◽  
Control And Prevention ◽  
Study Population

Purpose: Childhood obesity is a public health concern in Canada. Few published anthropometric data are available to indicate obesity prevalence in Canadian children. Obesity prevalence is reported for school-aged children in 11 London, Ontario, schools. Methods: Data on body weight and height were obtained using standardized procedures. United States Centers for Disease Control and Prevention (CDC) body mass index (BMI)-for-age references and Cole’s international BMI reference were used to classify the children’s weight categories. Results: The study included 1,570 pupils aged six to 13. The CDC BMI references categorized 16.6% and 11.8% of children as overweight and obese, respectively. In comparison, when the Cole BMI reference and cut-off points were used, 17.5% and 7.6% of children were classified as overweight and obese, respectively. Conclusion: Overweight is prevalent in the study population. Public health interventions are warranted to curb the obesity epidemic in school-aged children.

scholarly journals Education of medical examiners qualified for death certification

2006 ◽  
Vol 134 (Suppl. 2) ◽  
pp. 135-138 ◽  
Author(s):  
Djordje Alempijevic ◽  
Slobodan Savic
Keyword(s):  
Public Health ◽  
National Level ◽  
City Council ◽  
Public Health Care ◽  
Medical Examiner ◽  
Death Certification ◽  
Public Health Perspective ◽  
Professional Career ◽  
The Republic ◽  
Medical Examiners

INTRODUCTION. Death certification is very important from public health perspective, in particular, referring to gathering of data for mortality statistics on local and national level. When examining the deceased, medical examiner is capable of detecting indications of violent death and report the case for further inquest. The Public Health Care Act of the Republic of Serbia defines the responsibilities of medical examiner (ME) to certify death and estimate the time and cause of death. On the territory of Belgrade, this Service is organized by Department of Public Health of the City Council. Education of doctors-medical examiners certifying death in Belgrade area was organized during 2002 and 2003. OBJECTIVE. Demonstrate the structure of the Program of continual medical education (CME) of medical examiners in Belgrade area, to look into some aspects of their professional career, and to analyze the results of their testing. METHOD. Based on the Program of CME for medical examiners, test consisting of 13 questions was prepared. These questions were related to thanatology and current legislation. The evaluation of test results as well as particular characteristics (age, duration of professional engagement, etc.) of tested doctors was carried out. RESULTS. A total of 138 participants of CME Program were subjected to test. Mean age of tested MEs was 40.27?8.06 years, while an average duration of professional engagement was 13.43?8.00 years. Almost 2/3 of tested MEs were employed as general practitioners, while the rest were specialists, mainly in internal medicine and emergency medicine. Slightly more than 1/5 of tested MEs (21.7%) failed on the test (less than 60% of maximum score). CONCLUSION. Given the fact that slightly more than 1/5 of tested MEs (21.7%), regardless of duration of their professional engagement, did not pass the test, the level of their specific knowledge of death certification was not sufficient. Therefore, it is necessary to organize periodical CME on specific topics, including practice related to death certification. Accordingly, the Institute of Forensic Medicine in cooperation with Center for CME, Faculty of Medicine, University of Belgrade, has created a specific program of CME whose realization is in progress.

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