Are Routine Healthcare Worker Hand Hygiene Protocols (soap/water, Alcohol-based Handrub) Effective Against Influenza?
Funder
National Health and Medical Research Council
Funding Amount
$99,950.00
Summary
Although influenza is mainly spread from person-to-person by aerosol transmission (coughing, sneezing etc), there is growing evidence that spread also occurs on the hands of infected patients and their carers (non-aerosol transmission). Because of this, health authorities now recommend the use of careful hand hygiene (HH: hand washing with soap-water or use of alcohol-based hand rub solutions [ABHRS]) by healthcare workers (HCWs) and patients. However, despite these recommendations, there are no ....Although influenza is mainly spread from person-to-person by aerosol transmission (coughing, sneezing etc), there is growing evidence that spread also occurs on the hands of infected patients and their carers (non-aerosol transmission). Because of this, health authorities now recommend the use of careful hand hygiene (HH: hand washing with soap-water or use of alcohol-based hand rub solutions [ABHRS]) by healthcare workers (HCWs) and patients. However, despite these recommendations, there are no data that demonstrate the effectiveness of such HH protocols. This project aims to assess the clinical effectiveness of four HH protocols (handwashing with soap-water, alcohol-only ABHRS, two alcohol-chlorhexidine ABHRS) in common use in Australian hospitals to see which protocol is best for killing influenza virus. We also plan to assess how long influenza virus remains infectious on HCWs hands if they fail to use appropriate HH. Since it could be dangerous to use live avian influenza virus in this study, we plan to use the H1N1 influenza A strain that was a component of the influenza vaccine administered to most HCWs in 2005. Thus, only HCWs with protective immunity to H1N1 will participate in a series of tests in which they will have their hands artificially contaminated with a known concentration of live H1N1 before using either no HH, or one of the four HH protocols, followed by an assessment (virus culture and molecular tests) or the amount of H1N1 surviving on their hands after each protocol. Some selected HCWs will also have the amount of surviving virus assessed 30 and 60 minutes after contamination to identify how long H1N1 survives on HCWs hands should they not use appropriate HH. Following all protocols, all HCWs will perform a detailed surgical scrub (similar to surgeons before an operation) to make certain that all H1N1 is killed to avoid any infection of themselves or their contacts. The study will be undertaken in special, secure, negative-pressure rooms at Austin Hospital away from patient care areas to provide maximum safety conditions. All virus culture and molecular tests will be performed in the virus Identification Laboratory at the Victorian Infectious Disease Reference Laboratory (VIDRL), Melbourne. Results of the study should help identify which HH protocol provides the most protection against influenza.Read moreRead less
Establishing The Capacity For H5N1 Challenge Of Ferrets Within Australia &optimizing Pandemic Vaccines In This Model
Funder
National Health and Medical Research Council
Funding Amount
$405,513.00
Summary
Australia is currently in the process of manufacturing vaccines for use in people against strains of avian influenza viruses circulating in South East Asia as part of a national preparedness program for an influenza pandemic. These particular avian flu viruses are capable of causing severe disease and death in humans as well as birds, although at present they are not highly transmissible between people. Should the avian influenza viruses mutate to gain this capability, it will be necessary to in ....Australia is currently in the process of manufacturing vaccines for use in people against strains of avian influenza viruses circulating in South East Asia as part of a national preparedness program for an influenza pandemic. These particular avian flu viruses are capable of causing severe disease and death in humans as well as birds, although at present they are not highly transmissible between people. Should the avian influenza viruses mutate to gain this capability, it will be necessary to institute widespread vaccination of the Australian population. It is not possible to test the vaccines in people for their effectiveness against avian influenza infection prior to a disease outbreak, so an animal model for the disease will be used to assist in optimizing the formulation of flu vaccines and in testing their efficacy in preventing infection or reducing the severity of disease. Ferrets are natural hosts for flu viruses, have similar responses to vaccination as people, and develop a similar disease to humans when infected with influenza. These animals will be used to assist vaccine manufacturers in providing the best type of vaccine for protection of Australians in the face of a global flu pandemic.Read moreRead less
Surveillance And Analysis Of Avian Influenza Viruses In Wild Birds In Australia
Funder
National Health and Medical Research Council
Funding Amount
$250,237.00
Summary
Birds are commonly infected with bird flu viruses but most of these viruses do not cause disease. However, certain types of bird flu viruses, such as the H5N1 strain, can cause severe illness and death in 100% of infected birds. There is currently an epidemic of H5N1 bird flu occurring in Asia. Occasionally humans become infected by bird to human transmission and since 2003, 130+ people have been infected with H5N1 resulting in 60+ deaths. There are 3 ways in which dangerous strains of the virus ....Birds are commonly infected with bird flu viruses but most of these viruses do not cause disease. However, certain types of bird flu viruses, such as the H5N1 strain, can cause severe illness and death in 100% of infected birds. There is currently an epidemic of H5N1 bird flu occurring in Asia. Occasionally humans become infected by bird to human transmission and since 2003, 130+ people have been infected with H5N1 resulting in 60+ deaths. There are 3 ways in which dangerous strains of the virus may be brought to Australia by; infected people, domestic birds and migratory wading birds. In order to monitor the import of these viruses by migratory birds we will catch and take samples from large numbers of these birds in important areas where they congregate close to humans and poultry farms. We will identify what types of bird flu viruses these birds are carrying and if the viruses are capable of causing disease in birds and humans. We will also see if they can be treated by the influenza drugs that we currently have and we will study these viruses to find new drug targets. These viruses are commonest in ducks. Migratory wading birds and local ducks live in the same habitats so there is the chance that the wading birds and ducks could pass the viruses to each other. There is an additional concern that non-disease causing viruses could mutate in ducks and become pathogenic and pass from bird to bird or even human to human transmission which could cause a major human epidemic of bird flu in Australia. So we will also take samples from local ducks that occur in the same areas as the wading birds and test them for viruses as well. Our results will show what kinds of viruses are being carried by wading birds and ducks and if these viruses are a danger to people and poultry. We can then manage important areas so that humans and poultry do not come into contact with these viruses.Read moreRead less
Determination Of The Efficacy And Resistance Profile Of A Long Acting Neuraminidase Inhibitor Against Several Avian Infl
Funder
National Health and Medical Research Council
Funding Amount
$91,350.00
Summary
Recent events have again highlighted influenza�s potential to cause a worldwide pandemic or be used as an agent of biowarfare. As of August 2005, the highly pathogenic Avian Flu sweeping through Asia has infected 112 people, killing 57. Over 150 million chickens have been slaughtered in an attempt to stop its spread, but with infection documented in migratory birds, containment may be difficult if not impossible. Experts believe that it is only a matter of time before the Avian Flu virus is capa ....Recent events have again highlighted influenza�s potential to cause a worldwide pandemic or be used as an agent of biowarfare. As of August 2005, the highly pathogenic Avian Flu sweeping through Asia has infected 112 people, killing 57. Over 150 million chickens have been slaughtered in an attempt to stop its spread, but with infection documented in migratory birds, containment may be difficult if not impossible. Experts believe that it is only a matter of time before the Avian Flu virus is capable of human to human transmission which could result in the deaths of hundreds of thousands of people worldwide. Should a pandemic arise, either through purposely-engineered or natural processes such as avian influenza, effective vaccines are unlikely to be available for at least 3-6 months. In such an event, treatment of infection and prevention of spread through post-exposure prophylaxis would be optimal, while pre-exposure prophylaxis would be most suited to key personnel such as army, medical and emergency-response staff. Biota is a world leading antiviral drug discovery company based in Melbourne, Australia with key expertise in viral respiratory diseases, particularly influenza. Biota developed the first in class neuraminidase inhibitors (NAI) drug, zanamivir (Relenza) and through a partnership with Glaxo Smith Kline (GSK) brought it to market. Biota also developed the FluOIA� for the rapid detection of Influenza A and B. Work has been underway at Biota for some time to develop a new generation of influenza drugs designed to be more active and longer acting than the first generation products. These long acting neuraminidase inhibitors (LANI) have the benefit of less frequent administration and a lower treatment dose making them an ideal choice for stockpiling. The proposed project aims to test the antiviral activity of LANI compound against the H5N1 influenza. The results of which could assist in a decision to fast track the clinical development of the compound with the aim of adding to the national stock pile of antivirals, thus helping Australia to prevent, prepare for and respond to a potential avian influenza-induced pandemic.Read moreRead less
A Prospective Study To Examine The Effectiveness And Safety Of Antivirals Against Pandemic Influenza
Funder
National Health and Medical Research Council
Funding Amount
$142,394.00
Summary
Pandemic influenza could cause significant mortality in populations of Australia and the south-east Asian region. Currently, avian influenza A (H5N1) is a concern to public health agencies because of its extreme pathogenicity. At present this strain is not transmitted readily between humans. A number of drugs are available to treat influenza infection in humans and research has shown these to be effective in preventing significant mortality in the setting of seasonal influenza epidemics (specifi ....Pandemic influenza could cause significant mortality in populations of Australia and the south-east Asian region. Currently, avian influenza A (H5N1) is a concern to public health agencies because of its extreme pathogenicity. At present this strain is not transmitted readily between humans. A number of drugs are available to treat influenza infection in humans and research has shown these to be effective in preventing significant mortality in the setting of seasonal influenza epidemics (specifically the influenza neuraminidase inhibitors _NIs). As a consequence public health agencies around the world have been stockpiling these drugs and developing sophisticated plans for their use if an influenza pandemic was announced. However, there are no data indicating that the neuraminidase inhibitors (NIs) are safe and effective when used to manage pandemic influenza. Neither are there any data to support the use of these drugs on a population basis. Genetic resistance to NIS has been described but it is not clear if this has any relevance to public health. Our research will clarify this issue. This project will develop a number of clinical trials that could be implemented rapidly should pandemic influenza ever be announced by health authorities in Australia-Singapore or Hong Kong. Patients with suspected influenza infection will be asked to provide informed consent prior to commencing NI therapy. Clinical information will then be collected for a period of approximately one month along with some blood samples and swabs from the throat and nasal passages. Data will be analysed as quickly as possible to help inform the continued use of NI therapy as a cornerstone of the public health agency response to pandemic influenza. In addition, the study team will prepare clinical trials to be conducted in essential workers who are likely to receive long-term NI preventive treatment as well as the immediate contacts of people with presumed influenza infection who are likely to receive short-term prophylaxis with NIs.Read moreRead less