ICAAC Video: How Quickly A Virus Can Spread In A Building

 

# 9051

 

The 54rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) runs through September 9th in Washington D.C. , and this morning we’ve an absolutely fascinating video sponsored by the American Society for Microbiology showing just how quickly a single introduction of a virus into an office environment can spread to contaminate an entire building.

 

Of particular interest, this conversation explores how their results relate to this week’s Enterovirus (HEV-D68) outbreak (see Enterovirus D-68 (HEV-D68) Update).

 

First, the press release on the study, then a link to the video on  MicrobeWorld’s Youtube channel.

 

How Quickly Viruses Can Contaminate Buildings and How to Stop Them

EMBARGOED UNTIL: Monday, September 8, 2014, 9:00 a.m. EDT

(Images are courtesy Gerba Lab and are free to use. First image is Gerba and a student working on samples and second is a sampling sponge.)

WASHINGTON, DC – September 8, 2014 – Using tracer viruses, researchers found that contamination of just a single doorknob or table top results in the spread of viruses throughout office buildings, hotels, and health care facilities. Within 2 to 4 hours, the virus could be detected on 40 to 60 percent of workers and visitors in the facilities and commonly touched objects, according to research presented at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), an infectious disease meeting of the American Society for Microbiology.

There is a simple solution, though, says Charles Gerba of the University of Arizona, Tucson, who presented the study.

“Using disinfecting wipes containing quaternary ammonium compounds (QUATS) registered by EPA as effective against viruses like norovirus and flu, along with hand hygiene, reduced virus spread by 80 to 99 percent,” he says.

(Continue . . . )

The video is available on the http://www.microbeworld.org/podcasts/asm-live website right now, but should be moved to the MicrobeWorld’s Youtube channel later today.

 

Monday, September 8

9:00 a.m. -- How Quickly Viruses Can Contaminate a Building
Using tracer viruses, researchers found that contamination of just a single doorknob or table top results in the spread of viruses throughout office buildings, hotels, and health care facilities. Within 2 to 4 hours, the virus could be detected on 40 to 60 percent of workers and visitors in the facilities and commonly touched objects. Simple use of common disinfectant wipes reduced virus spread by 80 to 99 percent.

Charles Gerba, University of Arizona, Tucson

 

 

Sigh.  Based on this, and the viral threats lining up, guess I’m gonna need to lay in a bigger supply of hand sanitizer.

ICACC 2014 Videos: Antibiotic Stewardship, Peramivir Study & More

Antibiotic Stewardship: Saving Drugs, Saving Money

 

#9047

 

The 54rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) runs through September 9th in Washington D.C. , and once again we’re fortunate to have videos of press conferences being webcast live and archived via MicrobeWorld’s Youtube channel.

 

On Saturday two videos were live streamed, and the schedule calls for 3 more today (Sunday) and four on Monday (Sept 8th).  Subjects range from antibiotics and antivirals to MERS and Ebola.

 

Some background and an abbreviated list of scheduled videos follow:

 

 

ASM Live at ICAAC - The Live Internet Talk Show

 

Participate in ASM Live at ICAAC 2014 in Washington, D.C., where we will be live streaming video interviews of select presenters with host Michael Schmidt, Professor and Vice Chairman of Microbiology and Immunology at the Medical University of South Carolina and co-host of the This Week in Microbiology podcast sponsored by the American Society for Microbiology.

Tapings will take place at the Walter E. Washington Convention Center, Room 146A, in Washington, D.C., and meeting registrants are encouraged to attend. You can watch ASM Live below and topics will be archived immediately on YouTube and MicrobeWorld for future viewing.

Saturday, September 6

9:00 a.m. -- Antibiotic Stewardship: Saving Drugs, Saving Money

.
Nishant Prasad, New York Hospital, Queens
Fredrik Resman, Lund University

11:00 a.m. -- New Single-Dose Influenza Drug

Bill Sheridan, BioCryst
Rich Whitley, University of Alabama at Birmingham

Sunday, September 7

10:00 a.m. -- Tests for Rapid Detection of Antibiotic Resistant Bacteria

Laurent Poirel, University of Fribourg, Switzerland
Karim Morey, Oregon State Public Health Lab

11:00 a.m. -- New Antifungal Option for Cancer Patients

Kieren Marr, Johns Hopkins University
Andrew Ullmann, Julius Maximilians University

12:00 noon -- Each Day in Hospital Increases Resistance Risk
 

John Bosso, Medical University of South Carolina

Monday, September 8

9:00 a.m. -- How Quickly Viruses Can Contaminate a Building
 

Charles Gerba, University of Arizona, Tucson

9:45 a.m. -- New Targets for SARS/MERS Drugs

Hao Lei, University of Illinois at Chicago
Hyun Lee, University of Illinois at Chicago
Jasper Chan, University of Hong Kong

10:30 a.m. -- New Antimicrobial Strategy Silences NDM-1 Resistance Gene in Pathogens
Bruce Geller, Oregon State University, Corvallis

12 noon -- MEDIA AVAILABILITY: Ebola Experts

Barbara Knust, Centers for Disease Control and Prevention, Atlanta, GA
Gary Kobinger; National Microbiology Lab., Winnipeg, Canada
Aneesh Mehta, Emory University School of Medicine

ASM Live Archives

To find an episode quickly please visit the ASM Live Archives.

 

ICAAC 2013 Videos: Triple Tamiflu In ICU & Interferon For H7N9

 

 

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The 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) was held this week in Denver Colorado, and once again we’re fortunate to have videos of press conferences being webcast live and archived via MicrobeWorld’s Youtube channel.

 

Two interviews of particular interest to Flublogia concern research on the use of Triple-dose Oseltamivir (Tamiflu ®) on critically ill patients during the 2009 pandemic,  and research looking at using alpha-Interferon for the treatment of H7N9.

 

The standard adult dose of Tamiflu for uncomplicated seasonal influenza  is 75mg, twice a day for 5 days – although higher doses over longer periods of time have been proposed (and even tried) when dealing with avian or severe pandemic flu.  

 

Last May, in Delving Into The Oseltamivir Dosage Study, we looked at a BMJ study that found No benefit of double dose antiviral drug for severe influenza.   This study, however, had a number of limitations:

• Most of the patients were children under 15
• Most of the patients had low or normal BMI
• Only about 1/5th had underlying conditions
• Very few adults were included in the study
• Only 17 (of 326 cases) were H5N1, and of those, only 3 survived to day 5 of the trial.
• The average delay for treatment for H5N1 patients was 7 days vs. 5 days for seasonal flu
• All H5N1 cases met the criteria for clinical failure

 

One is left to wonder how well these results would translate to a much older population, one likely to have a higher average BMI, far more (and different) underlying conditions, and in all likelihood would seek treatment sooner than did the patients in this study (average 5-7 days).

 

While this trial found no value to doubling the dose for seasonal flu, there is insufficient evidence to judge whether doubling the dose for H5N1 (or presumably H7N9) would improve patient survival. And in an accompanying editorial, Ian Barr and Aeron Hurt of the WHO Collaborating Centre for Reference and Research on Influenza, would appear to agree:

What is clear is that double dose oseltamivir is unlikely to significantly improve the clinical outcomes of severe cases of seasonal influenza, although there were probably insufficient data to determine if this was also true for people infected with A(H5N1).

It is worth noting that last April, in CDC Interim Guidance On H7N9 Antiviral Treatment, we saw the CDC’s recommendation that for hospitalized patients:

The optimal duration and dose of therapy are uncertain in severe or complicated influenza. Pending further data, longer courses of treatment (e.g., 10 days of treatment) should be considered for severely ill hospitalized H7N9 patients.

 

Earlier this summer, we looked at the general effectiveness of oseltamivir, and the need for maintaining stockpiles in New Scientist: Don’t Stop Stockpiling Tamiflu.

 

All of which brings us to the first ICAAC video:

High Dose Therapy for Influenza Drug - Watch Now

Critically ill patients  with the pandemic H1N1 influenza who received triple the standard dose of the influenza drug oseltamivir were 7 times more likely to completely clear the virus from their system in 5 days than those who received the standard dose. This discussion will address the healthcare implications of these findings, including a rationale for high dose therapy of sensitive strains of influenza.

• Anand Kumar, Hlth. Sci. Ctr., Winnipeg, MB, Canada

 

Dr. Kumar reports that the triple dose of Tamiflu was well tolerated, and believes higher doses may be appropriate for those severely ill from influenza.   For more on the topic of antivirals, and their use for pandemic or avian flu, you may wish to revisit Study: Antiviral Therapy For H5N1  and Hong Kong Finds Success With Higher Tamiflu Doses.

 

Our next stop is an interview with William M. Mitchell, Vanderbilt University, Nashville, TN who discusses the use of interferon Alpha as a possible treatment of oseltamivir-resistant H7N9.   You may recall that just last week, in Nature: Animal Testing Of Drug Combo Shows Potential For Treating MERS Interferon was also proposed as part of a cocktail to potentially treat the MERS Coronavirus.

 

According to a press release yesterday from Hemispherx Biopharma, Inc, their findings are based on in vitro experiments, directed against inhibiting the replication of two strains of H7N9 virus in A549 cell lines.  One H7N9 strain (A/Anhui/1/2013) was a `wild type’ that was susceptible to oseltamivir, while the other (A/Shanghai/1/2013) was a patient isolate that had developed Tamiflu resistance.

 

Dr. Mitchell describes the suppression of the wild-type virus as being roughly equal with both oseltamivir and interferon, but the resistant strain (which greatly thwarted the antivirals) showed an even greater response to interferon alpha.

 

The caveat here is, these are in vitro experiments.  Clinical trials have not been conducted, but these are promising – if very early – results.  Mitchell suggests that if the need arose during a pandemic outbreak, an Emergency Use Authorization (EUA) might be issued. 

 

In the following  ICAAC video Dr. Mitchell discusses this research and the potential of using interferon-alpha as a treatment for severe influenza. Note: Mitchell is a board member and shareholder of Hemispherx Biopharma of Philadelphia, which supported this research.

 

Human Interferon Kills Resistant H7N9 Influenza - Watch Now
During the April 2013 avian influenza A (H7N9) outbreak, more than 130 human infections with H7N9 were reported. Most patients had severe respiratory illness and 44 people have died. Studies suggest that the H7N9 virus has developed resistance to oseltamivir. A human interferon already in use for treatment of genital warts, alpha-n3, has been found to be active against the virus, even the oseltamivir-resistant isolate. Participants will discuss these findings and implications.

 

 

 

You’ll find more videos from this year’s ICAAC on this page, and many more offerings from the American Society for Microbiology Youtube Channel.

CDC & ICAAC Updates On H3N2v

 

 

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A bit of a twofer today, as we’ve two videos featuring the CDC’s Dr. Lyn Finelli discussing the recent emergence of the H3N2v swine-origin virus, and how to reduce the risk of it spreading.

 

First stop, a 6-minute  podcast, released earlier this week by the CDC, called:

 

CDC Recommendations to Reduce the Risk of H3N2v Flu Virus Infection for Fairgoers and Swine Exhibitors

You’ll find a video of this podcast, and the transcript, available at the above link.

 

The second video comes from the closing day of 2012’s ICAAC conference in San Francisco, where Dr. Finelli is interviewed by Jeff Fox in a 30 minute presentation.

 

 

Dr. Finelli indicates that, out of the 300 or so new human cases of H3N2v infection this summer, about 10 instances of human-to-human transmission have been detected.  

So far, the vast majority of cases have had direct, and prolonged contact with swine.

 

Complicating matters, we now have four cases of a different swine variant virus – H1N2v – recently detected in Minnesota. 

 

And much like the newly emergent H3N2v virus – this reassortant swine flu has picked up the M gene segment from the 2009 H1N1 virus (see CDC Updates Minnesota H1N2v Cases).

 

 

In another related story, on Monday we learned (see PNAS: Virulence & Transmissibility Of H1N2 Influenza Virus In Ferrets) that Korean researchers had detected a swine flu H1N2 strain that produced serious (even lethal) illness in ferrets, and spread easily among then. 

 

For more on this story, Robert Roos of CIDRAP wrote last night:

 

Ferret study underlines persistent threat of swine flu viruses

Robert Roos News Editor

Sep 11, 2012 (CIDRAP News) – A Korean-US research team has identified an H1N2 strain of swine influenza capable of killing ferrets and spreading among them by respiratory droplets, underlining the continuing threat of swine flu to humans amid a wave of swine-origin flu cases in Americans exposed to pigs at agricultural fairs.

(Continue . . . )

 

 

The concern has long been that swine are highly susceptible to the influenza virus, and are capable of serving as `mixing vessels’, allowing them to reassort into new hybrid strains. 

 

Since end of  the 2009 H1N1 pandemic we’ve begun to see reassortments of other swine flu viruses (H3N2 & H1N2) with genetic elements picked up from the previously `humanized’ H1N1 pandemic strain.

 

 

For now, these reassortant viruses haven’t evolved into efficiently transmitted human flu strains, and so their public health impact is limited. 

 

The caveat being, that as this virus jumps to humans it could begin to `figure us out’, and become more easily transmissible.

 

Which is why the CDC, along with local & state health departments, plan to remain vigilant this fall and winter as they look for any signs of increased human transmission.

ICAAC 2012: Streaming & Archived Videos

 

ICAAC Live Feed

 

# 6544

 

 

The 52th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) got underway today in San Francisco, and once again we’re fortunate to have videos of press conferences being webcast live and archived via MicrobeWorld’s Youtube channel.

 

You can visit MicrobeWorld for a complete schedule and links to the embedded videos, but briefly the 10 interview/press conferences scheduled over the next three days are:

 

   ICAAC Live 2012 San Francisco

Schedule

(Please note topics, guests and times are subject to change. This page may be updated frequently prior to ICAAC.)

Sunday, September 9

10:00 a.m. PDT - Seasonal Flu Vaccine and Pandemic Flu Severity

Danuta Skowronski, BC Center for Disease Control, Vancouver, BC, Canada

10:45 a.m., PDT - HIV Infection and Cardiovascular Health

Daniel Pearce, Loma Linda University, Loma Linda, CA, United States

Charles Hicks, Duke University Medical Center, Durham, NC, United States

12:00 noon, PDT - ICAAC Overview Briefing

M. Lindsay Grayson, Austin Hospital, Melbourne, Australia

• Craig E. Rubens, Seattle Children’s Hospital Research Institute, Seattle, WA
• Michael J. Pucci, Achillion Pharmaceuticals, New Haven, CT

1:00 p.m., PDT - Measles:  What's Next?

Jane Seward, Centers for Disease Control and Prevention, Atlanta, GA, United States

Gaston De Serres, Institute National de Santé Publique du Quebec, Quebec, Canada

Monday, September 10

10:30 a.m., PDT - Universal Influenza Vaccine Update

Wendy Keitel, Baylor College of Medicine, Houston, TX, United States

Zachary Shriver, Visterra, Inc., Cambridge, MA, United States

12:00 noon, PDT - Vaccine to Prevent Norovirus Infection

John Treanor, University of Rochester, Rochester, NY, United States

1:00 p.m., PDT - Do Cranberries Prevent UTIs? Suzanne Geerlings, Academic Medical Center, Amsterdam, Netherlands

2:00 p.m., PDT - ICAAC Live: This Week in Microbiology with Vincent Racaniello

Vincent Racaniello, Columbia University Medical Center, NY, United States

Michael Schmidt, Medical University of South Carolina, SC, UNited States

John Brownstein, Boston Children’s Hospital, Harvard Medical School, MA, United States

William Bishai, Johns Hopkins School of Medicine, MD, United States

Victor Nizet, University of California, San Diego School of Medicine, CA, United States

Tuesday, September 11

9:30 a.m., PDT - Antibody Therapies for C. difficile

Sylvia Wong, Donnelly Centre for Cellular & Biomolecular Research, University of Toronto, Toronto, ON, Canada

David Humphreys, UCB Pharma, Slough, United Kingdom

 

10:30 a.m., PDT - Emergence of Animal-Origin H3N2 Influenza

Lyn Finelli, CDC, Atlanta, GA, United States

11:30 a.m., PDT - The Emerging Role of Social Media in Public Health

John Brownstein, Children's Hospital Boston & Harvard Medical School, Boston, MA, United States

 

 

You can follow the ICAAC conference, and ask questions of these speakers, via Twitter by following, or using the #ICAAC hashtag, or by directing your question to @ASMNewsroom.

ICAAC: Press Conference Videos

 

 

# 4997

 

 

The 50th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) got underway in Boston on Sunday, and we are fortunate that videos of the press conferences are being webcast live and archived via uStream.

 

You can visit MicrobeWorld for a complete schedule and links to the embedded videos.

 

There are (as of this writing) 7 videos available for viewing, with 3 more expected tomorrow. 

 

Topics include:

 

What Big Pharma Wants and What Small Biotech Can Offer

Antimicrobial-Resistant Pathogens:  An Emerging Pediatric Threat

NDM-1:  The New Superbugs

Hand washing Survey Results

Emerging Issues in Infectious Disease

A Role for Statins in Infectious Disease?

Community-associated MRSA:  Why is it spreading so quickly?

Is the Era of Bacterial Culture Ending?

Weird Bugs, Weird Places:  The Microbial Risks of Taking a Shower

 

 

The big `buzz’ topic right now, of course, is the emergence of NDM-1 (New Dehli metallo-beta-lactamase-1). This is a newly discovered gene that can spread via a plasmid to a variety of bacteria, conveying to them multi-drug resistance. 

 

The panel discussing NDM-1 includes Professor Timothy Walsh (see NDM-1: Professor Timothy Walsh On Losing The Darwinian Battle), the lead author on the Lancet article last month that has sparked so much concern, along with Johann Pitout and Patrice Nordmann.

 

While it may be months or even years before the full impact of this type of antibiotic resistance is felt, the shared concern expressed by the panelists should serve as a wake up call for viewers.

 

WATCH NDM-1:  The New Superbugs

 

 

Kudos to ICAAC for making these videos available online.

 

I’ve only had time to watch the one presentation, but hope to view several more over the next couple of days.  

A Not Entirely Unexpected Result

 

 

 

# 4895

 

 

Science, as I’ve pointed out in the past, is messy and advances in knowledge are anything but linear. What we know, or at least -  what we think we know - is constantly changing. 

 

We often see conflicting studies published in respected journals or presented at major conferences, leaving us wondering exactly what to believe.

Depending on the study you embrace, statins either reduce pneumonia mortality or they don’t.  Surgical masks are as protective as N95 respirators, or they aren’t.  And Tamiflu is either lifesaving or a complete waste of time and money.

Take your pick.

 

One of the most vigorous subjects of debate has been the efficacy of hand washing and sanitizing as a flu preventative. And over the past year we’ve seen some studies that seem to show that it helps, and other studies that raise serious doubts.

 

Today, we’ve another study - presented yesterday at the ICAAC conference in Boston - (hat tip to Crof at Crofsblog for the head’s up) that suggests that using alcohol hand sanitizers `doesn’t help swine flu’.

 

And of all of the studies that I’ve seen so far, I can say without a doubt that . . .   this one is the most recent.

 

You can read the details of the story in an article appearing in World News Australia at:

 

Alcohol rub 'doesn't help swine flu'

13 September 2010 | 07:49:12 AM | Source: AAP

 

But the short version is test subjects sanitized their hands with alcohol gel roughly every 3 hours for 10-weeks last fall, during the height of pandemic outbreak.  

 

Out of 100 test subjects, 42 contracted rhinovirus (common cold) infections, compared to 51 out of 100 in the control group.

 

As for swine flu (H1N1), 12 in the hand disinfecting group contracted the virus, compared to 15 in the control group.

 

Suggesting to researchers that hand sanitizing may play less or a role in flu prevention than previously thought.

 

As the title of this blog suggests, this was not an entirely unexpected result.

 

As I wrote in September of 2009, in The Flaw In The Ointment:

 

Washing our hands is an important hygienic step, one that I wholeheartedly approve of (and want to encourage).  And it certainly has been shown to reduce the risks of some illnesses and diseases.

 

But there is precious little scientific evidence to support the notion that washing our hands will protect us against influenza.

 

It it helps at all, it probably doesn’t help much.

Influenzas and Rhinoviruses are, after all, respiratory diseases.  

 

While the exact mechanics of their spread are still being studied, the three main modes appear to be large droplets (coughs & sneezes), fine airborne particles, and fomites (contaminated inanimate objects we touch).

 

How much flu is spread by each of these methods is less clear, although large droplet spread is generally assumed to be the most common route.

 

In October of last year the CMAJ (Canadian Medical Association Journal) ran an article about the disconnect between the hand washing advice being offered by public health officials, and the currently available science (see Sanitized For Your Protection).

 

October 1, 2009

Conflict emerges over value of handwashing as a preventive flu transmission measure

Prominent microbiologist Dr. Donald Low argues that the Public Health Agency of Canada's hand hygiene recommendations "are not evidence-based."

 

 

In another study (see  Effectiveness of NPIs Against ILI's), conducted prior to the emergence of the novel H1N1 virus, Allison E. Aiello’s group at University of Michigan showed that Combined hand washing and facemask use lowered risks 35% to 51% over the control group.

 

The use of masks alone produced nearly the same results.

 

Although this study did not directly study the effectiveness of hand washing alone, once again the implication here is that alcohol sanitizers and hand washing alone may not be as protective as had been touted in the past.

 

 

Of course, good hand hygiene has been linked to the reduction of illness many times. Recently a study appeared in  BMC Infectious Diseases, which suggests hand hygiene can be effective even against the `common cold’.

 

 

Effectiveness of alcohol-based hand disinfectants in a public administration: Impact on health and work performance related to acute respiratory symptoms and diarrhoea

Nils-Olaf Hubner , Claudia Hubner , Michael Wodny , Gunter Kampf  and Axel Kramer

Results

Hand disinfection reduced the number of episodes of illness for the majority of the registered symptoms.

 

This effect became statistically significant for common cold (OR = 0.35 [0.17 - 0.71], p = 0.003), fever (OR = 0.38 [0.14-0.99], p = 0.035) and coughing (OR = 0.45 [0.22 - 0.91], p = 0.02).

 

 

So which is it?  Does hand washing help, or doesn’t it?

 

The answer to that question may depend upon exactly which virus we are talking about, your daily contacts, and even your individual environment.  

 

For example: I suspect if you live or work around small children (whose cold & flu etiquette may be lacking) that hand washing/sanitizing might be more advantageous than for someone whose daily contacts are a bit more fastidious.

 

But that’s just a guess on my part.

 

Nonetheless, good hand hygiene remains an incredibly important health habit, and can prevent a variety of illnesses. 

 

So I plan to continue to use my bottle of alcohol gel frequently during the upcoming cold and flu season.

 

Even though,  right now - when it comes to scientific proof of its efficacy - the evidence is a wash.