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PubMed1997

Advisory Committee on Dangerous Pathogens (ACDP). Seminar on microbiological risk assessment, 28 January 1997.

Microbiological risk assessment is an area of growing importance and significant potential, where the underlying science, software systems and databases are developing to the point of real and useful application. It is also an area where the developing science is posing as many questions as it is presenting answers. Key issues emerging from the day included: the need for more sophisticated management of uncertainty, which is much more relevant to microbiological risk analysis than to other applications; the need for global surveillance systems with better compatibility and appropriate peer review; considered assessment of the impact of new molecular-based diagnostic and screening techniques; the explosion of relevant information available, particularly on the Internet, which makes computer literacy essential both to professionals and 'laymen'; and the appearance of software systems which are either tailored for microbiological application or have the potential for this use. The closely associated issues of risk communication and perception also emerged as being vital to the effective application of microbiological risk management to public health issues. Overall, the majority of participants considered the event to have been valuable and stimulating and thought that it would lead to improvements in the use of microbiological risk assessment. The Advisory Committee on Dangerous Pathogens is committed to taking this topic forward and will be both taking up the messages from this seminar and encouraging development of suitable databases and software systems.

Bacterial Infections↗
PubMed2000

[Measures for the disposal of non-regulated alternative medical wastes--prion protein-polluted medical waste].

Transmissible spongiform encephalopathy (TSE), sometimes known as prion diseases, are fatal degenerative brain diseases. From epidemiological evidence and many investigations of data, the risk that TSE agents will be transmitted from TSE patients to other humans, is very low, but TSE agents comprise one of the very severe bio-medical hazards. Although government agencies, world organization and other institutions have distributed some guidances for safe working and prevention of infection, these guidances are not compulsory and no globally harmonized guidelines is present to date. Therefore, medical staff particularly in hospitals individually take countermeasures for safety against TSE agents by using these guidelines, and both the level and method differ in each hospital. In this chapter, transmission of TSE and related parts of guidelines from the Advisory Committee on Dangerous Pathogens and Spongiform Encephalopathy Advisory Committee in the United Kingdom recommending relatively strict standards are described.

Animals↗
PubMed1992

Melioidosis and safety in the clinical laboratory.

Human infection with Pseudomonas pseudomallei, the causative agent of melioidosis, typically produces subclinical disease and an asymptomatic carrier state; occasionally clinical illness, frequently with a fatal outcome, may occur. Consequently, to help protect staff from laboratory-acquired melioidosis, microbiological and biomedical laboratories must have adequate facilities for safe work procedures and laboratory staff must engage in safe work practices. Recommendations from a melioidosis-endemic, diagnostic laboratory for the prevention of laboratory-acquired infection with this bacterium are essentially Category 3 (Advisory Committee on Dangerous Pathogens), Risk Group 3 (Australian Standards) or Biosafety Level 2 (National Institutes of Health) precautions. These include safeguards for centrifugation, prohibiting the 'sniff' test and the use of a biological safety cabinet for sputum processing, for subculture of stock strains, for preparation of antigen and for research studies but not for routine diagnostic techniques with P. pseudomallei.

Hospital Bed Capacity, 500 and over↗
PubMed1998

The new viral haemorrhagic fever infection control guidelines.

This paper is a critical review of the infection control guidelines on the Management and Control of Viral Haemorrhagic Fevers issued in 1997 by the Advisory Committee on Dangerous Pathogens. It is suggested that these guidelines are not realistic. An alternative set of more workable guidelines, possibly approved by one of the microbiological associations or one of the regional microbiology groups, should be the way forward.

Guidelines as Topic↗
PubMedDate not supplied

Ethics of xenotransplantation: animal issues, consent, and likely transformation of transplant ethics.

The shortage of organs, breakthroughs in research, involvement of biotechnology companies, absence of ethically more acceptable alternatives, and a vaguely perceived "time to put man on the moon" feeling have contributed to the current reawakening of interest in xenotransplantation. The focus of ethical attention has changed from the moral correctness of using animals for research/therapy to an increasingly appreciated danger of the establishment and spread of xenozoonoses in recipients, their contacts, and the general public. The United Kingdom has established an embargo on clinical trials and has set up a national regulatory authority to oversee and coordinate the development of research, establish guidelines, and decide on when trials can proceed. In the United States, on the other hand, the overall attitude is to "proceed with caution," and the Food and Drug Administration has approved a number of xenotransplant studies. The Public Health Service guidelines on reducing infection risk are still evolving and are likely to end up being more cautions than they are currently. There are a number of reasons for not using subhuman primates for xenotransplantation, including their closeness to humans, the likelihood of passing on infections, their depletability (gorillas, chimpanzees), their slow breeding, and the expense of breeding them under specified-pathogen free conditions. The pig, although domesticated and familiar, is too distant to evoke the same feelings we have for primates, has the correct-size organs, is probably less likely to pass on infections, breeds rapidly, and is not endangered; moreover, millions of them are eaten every year. Although drawing ethical conclusions is difficult, at this stage of knowledge and debate it seems acceptable to manipulate pigs genetically and to proceed to using their organs for xenotransplantation trials when infection control measures and the scientific base justify it. The question of informed consent is likely to be a vexing one. It might end up more of a binding legal contract than consent as we understand it now. Xenotransplantation is also unlikely to cost less than, or significantly alleviate the shortage of, cadaveric organs in the short term. The international dimension of the risk of infection is becoming obvious, but there has so far been no effort to convene an international forum to agree on universally acceptable guidelines.

Advisory Committees↗