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Prehosp Disaster Med 2018 Oct;33(5):543-549

Loughborough Design School,Loughborough University,Leicestershire,UK.

IntroductionA Chemical, Biological, Radiological, Nuclear, and explosive (CBRNe) event is an emergency which can result in injury, illness, or loss of life. The emergency department (ED) as a health system is at the forefront of the CBRNe response with staff acting as first receivers. Emergency departments are under-prepared to respond to CBRNe events - recognizing key factors which underlie the ED CBRNe response is crucial to provide evidence-based knowledge to inform policies and, most importantly, clinical practice. Read More

J Nurs Scholarsh 2018 Sep 17. Epub 2018 Sep 17.

Director, Hospital Readiness and Health Care Coalitions, Office of Emergency Preparedness and Response, New York City Department of Health and Mental Hygiene, New York, NY, USA.

Purpose: Many nurses are trained inadequately in emergency preparedness (EP), preventing them from effectively executing response roles during disasters, such as chemical, biological, radiological, nuclear, and explosive (CBRNE) events. Nurses also indicate lacking confidence in their abilities to perform EP activities. The purpose of this article is to describe the phased development of, and delivery strategies for, a CBRNE curriculum to enhance EP among nursing professionals. Read More

Eur J Clin Pharmacol 2018 Sep 22. Epub 2018 Sep 22.

Clinical Toxicology, Guy's and St Thomas' Hospitals NHS Foundation Trust, and King's Health Partners, London, UK.

Background: Non-medical use of benzodiazepines and Z-drugs is common; however, there is limited information available on the extent of harm related to this in Europe, as well as the relationship between misuse and availability.

Aim: To describe presentations to the emergency department in Europe related to the recreational use of benzodiazepines and Z-drugs and compare regional differences in these presentations with legal drug sales of benzodiazepines and Z-drugs within each country.

Methods: Emergency department presentations with recreational misuse of benzodiazepines and Z-drugs were obtained from the Euro-DEN dataset for the period from October 2013 to September 2015; data extracted included demographics, clinical features, reported coused drugs, and outcome data. Read More

J Med Toxicol 2018 Jul 31. Epub 2018 Jul 31.

Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.

Introduction: Polydrug use involving heroin and benzodiazepines is common. The potential risk of additive pharmacological effects may be associated with poorer outcomes in patients who use benzodiazepines together with heroin. The aim of this study was to determine the clinical picture of patients presenting to the emergency department following acute drug toxicity involving heroin and benzodiazepines. Read More

BMC Health Serv Res 2018 07 6;18(1):528. Epub 2018 Jul 6.

European Centre for Disease Prevention and Control, Granits väg 8, 171 65, Solna, Sweden.

Background: EU Decision 1082/2013/EU on serious cross-border health threats provides a legal basis for collaboration between EU Member States, and between international and European level institutions on preparedness, prevention, and mitigation in the event of a public health emergency. The Decision provides a context for the present study, which aims to identify good practices and lessons learned in preparedness and response to Middle East Respiratory Syndrome (MERS) (in UK, Greece, and Spain) and poliomyelitis (in Poland and Cyprus).

Methods: Based on a documentary review, followed by five week-long country visits involving a total of 61 interviews and group discussions with experts from both the health and non-health sectors, this qualitative case study has investigated six issues related to preparedness and response to MERS and poliomyelitis: national plans and overall preparedness capacity; training and exercises; risk communication; linking policy and implementation; interoperability between the health and non-health sectors; and cross-border collaboration. Read More

Basic Clin Pharmacol Toxicol 2018 Dec 23;123(6):749-755. Epub 2018 Jul 23.

Department of Acute Medicine, Division of Medicine, Oslo University Hospital, Oslo, Norway.

Methanol mass poisoning is a global problem with high fatality rates and often severe sequelae in survivors. Patients typically present late to the hospital with severe metabolic acidosis followed by a rapid deterioration in their clinical status. The hypothesis 'Circulus hypoxicus' describes the metabolic acidosis following methanol poisoning as a self-enhancing hypoxic circle responsible for methanol toxicity. Read More

J Spec Oper Med Summer 2018;18(2):133-135

Objective: Review clinical thought process and key principles for diagnosing weaponized chemical and biologic injuries. Clinical Context: Special Operation Forces (SOF) team deployed in an undisclosed, austere environment. Organic Expertise: Two SOF Soldiers with civilian EMT-Basic certification. Read More

Eur J Public Health 2018 Aug;28(4):730-734

Crisis Management and Preparedness in Health Unit, Public Health Directorate, Directorate-General for Health and Food Safety (DG SANTE), European Commission, Luxembourg, Luxembourg.

Background: All European Union (EU) and European Economic Area (EEA) Member States have pledged to ensure political commitment towards sustaining the region's poliomyelitis-free status and eliminating measles. However, there remain significant gaps between policy and practice in many countries. This article reports on an assessment conducted for the European Commission that aimed to support improvements in preparedness and response to poliomyelitis and measles in Europe. Read More

Scand Cardiovasc J 2018 06 16;52(3):141-148. Epub 2018 Mar 16.

d Department of Cardiology, Division of Medicine , Oslo University Hospital , Oslo , Norway.

Objectives: Haemodynamic monitoring during post arrest care is important to optimise treatment. We compared stroke volume measured by minimally-invasive monitoring devices with or without thermodilution calibration, and transthoracic echocardiography (TTE), and hypothesised that thermodilution calibration would give stroke volume index (SVI) more in agreement with TTE during targeted temperature management (TTM).

Design: Comatose out-of-hospital cardiac arrest survivors receiving TTM (33 °C for 24 hrs) underwent haemodynamic monitoring with arterial pulse contour analyses with (PiCCO2®) and without (FloTrac/Vigileo monitor) transpulmonary thermodilution calibration. Read More

J Spec Oper Med Spring 2018;18(1):118-123

The authors would like to introduce TCCC [Tactical Combat Casualty Care] + CBRN [chemical, biological, radiological, and nuclear] = (MARCHE)2 as a conceptual model to frame the response to CBRN events. This model is not intended to replace existing and well-established literature on CBRNE events but rather to serve as a response tool that is an adjunct to agent specific resources. Read More

Medicine (Baltimore) 2018 02;97(5):e9784

Division of Clinical Pharmacology and Toxicology, Basel University Hospital and University of Basel, Basel, Switzerland.

The aim of the study was to compare self-reported and analytically confirmed substance use in cases of acute recreational drug toxicity.We performed a retrospective analysis of emergency department presentations of acute recreational drug toxicity over 2 years (October 2013 to September 2015) within the European Drug Emergencies Network Plus project.Among the 10,956 cases of acute recreational drug toxicity during the study period, 831 could be included. Read More

Acta Anaesthesiol Scand 2017 Oct 17;61(9):1142-1154. Epub 2017 Aug 17.

Faculty of Medicine, University of Oslo, Oslo, Norway.

Background: Acute fire smoke inhalation injury involves inflammatory mediators whose roles are poorly understood. We carried out a prospective observational study of fire smoke victims to identify clinical and biochemical markers that may predict pulmonary dysfunction and investigated possible correlations between dysfunction and cytokines in bronchoalveolar lavage (BAL) fluid and blood.

Methods: Forty patients with respiratory and/or neurological symptoms following acute fire smoke inhalation had pulmonary function tests and blood gas analyses performed on admission, at discharge, and after 3 months. Read More

Stand Genomic Sci 2017 15;12:47. Epub 2017 Aug 15.

Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI USA.

strain Hulk is a newly sequenced strain isolated from chimney samples collected from the Hulk sulfide mound on the main Endeavour Segment of the Juan de Fuca Ridge (47.9501 latitude, -129.0970 longitude, depth 2200 m) in the Northeast Pacific Ocean. Read More

Ann Intensive Care 2017 Dec 20;7(1):77. Epub 2017 Jul 20.

The Norwegian CBRNE Centre of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

Background: Intermittent hemodialysis (IHD) is the modality of choice in the extracorporeal treatment (ECTR) of acute methanol poisoning. However, the comparative clinical effectiveness of intermittent versus continuous modalities (CRRT) is unknown. During an outbreak of mass methanol poisoning, we therefore studied the effect of IHD versus CRRT on mortality and the prevalence of visual/central nervous system (CNS) sequelae in survivors. Read More

Prehosp Disaster Med 2017 Dec 4;32(6):596-603. Epub 2017 Jul 4.

1Phillip R. Lee Institute for Health Policy Studies,School of Medicine,University of California,San Francisco,San Francisco,CaliforniaUSA.

Introduction Members of faith-based organizations (FBOs) are in a unique position to provide support and services to their local communities during disasters. Because of their close community ties and well-established trust, they can play an especially critical role in helping communities heal in the aftermath of a mass-fatality incident (MFI). Faith-based organizations are considered an important disaster resource and partner under the National Response Plan (NRP) and National Response Framework; however, their level of preparedness and response capabilities with respect to MFIs has never been evaluated. Read More

Toxicol Lett 2017 Aug 1;277:84-91. Epub 2017 Jun 1.

Pomeranian Centre of Toxicology, Gdansk, Poland; Medical University Gdansk, Department of Clinical Toxicology, Gdansk, Poland.

Objective: To study the profile of European gamma-hydroxybutyrate (GHB) and gammabutyrolactone (GBL) intoxication and analyse the differences in the clinical manifestations produced by intoxication by GHB/GBL alone and in combination with other substances of abuse.

Method: We prospectively collected data on all the patients attended in the Emergency Departments (ED) of the centres participating in the Euro-DEN network over 12 months (October 2013 to September 2014) with a primary presenting complaint of drug intoxication (excluding ethanol alone) and registered the epidemiological and clinical data and outcomes.

Results: We included 710 cases (83% males, mean age 31 years), representing 12. Read More

Clin Toxicol (Phila) 2017 Aug 13;55(7):636-644. Epub 2017 Apr 13.

f The Norwegian CBRNe Centre of Medicine, Department of Acute Medicine , Oslo University Hospital , Oslo , Norway.

Context: Recreational drug toxicity is frequent. Availability of new psychoactive substances is steadily increasing. However, data with verified analyses from clinical settings are limited. Read More

Clin Toxicol (Phila) 2017 04;55(4):306-307

c The Norwegian CBRNe Centre of Medicine, Department of Acute Medicine , Oslo University Hospital , Oslo , Norway.

Tidsskr Nor Laegeforen 2017 02 7;137(3):205-207. Epub 2017 Feb 7.

Infeksjonsmedisinsk avdeling Oslo universitetssykehus, Ullevål og Nasjonal behandlingstjeneste for CBRNE-medisin Oslo universitetssykehus.

PLoS One 2016 21;11(12):e0167754. Epub 2016 Dec 21.

Norwegian University of Life Sciences, Department of Food Safety and Infection Biology, Oslo, Norway.

Background: The novel A/J Min/+ mouse, which is a model for human Familial Adenomatous Polyposis (FAP), develops spontaneously multiple adenocarcinomas in the colon as well as in the small intestine. Agaricus blazei Murill (AbM) is an edible Basidiomycetes mushroom that has been used in traditional medicine against cancer and other diseases. The mushroom contains immunomodulating β-glucans and is shown to have antitumor effects in murine cancer models. Read More

Prehosp Disaster Med 2017 Feb 14;32(1):33-45. Epub 2016 Dec 14.

3Harvard Medical Faculty Physicians Fellowship in Disaster Medicine, an affiliated fellowship of the Harvard Humanitarian Initiative,Harvard University,Boston,Massachusetts,USA.

Background: Makkah (Mecca) is a holy city located in the western region of the Kingdom of Saudi Arabia. Each year, millions of pilgrims visit Makkah. These numbers impact both routine health care delivery and disaster response. Read More

BMC Psychiatry 2016 11 16;16(1):405. Epub 2016 Nov 16.

Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.

Mil Med 2016 11;181(11):e1675-e1684

1st Area Medical Laboratory Building 5116, Bel Air Street, Aberdeen Proving Ground, MD 21005.

Background: The U.S. Army 1 Area Medical Laboratory (1 AML) is currently the only deployable medical CBRNE (Chemical, Biological, Radiological, Nuclear, and Explosives) laboratory in the Army's Forces Command. Read More

Clin Toxicol (Phila) 2017 Feb 7;55(2):123-132. Epub 2016 Nov 7.

u Department of Acute Medicine , The Norwegian CBRNe Centre of Medicine, Oslo University Hospital , Oslo , Norway.

Context: Acidemia is a marker of prognosis in methanol poisoning, as well as compounding formate-induced cytotoxicity. Prompt correction of acidemia is a key treatment of methanol toxicity and methods to optimize this are poorly defined.

Objective: We studied the efficiency of acidemia correction by intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) in a mass outbreak of methanol poisoning. Read More

Crit Care 2016 10 5;20(1):314. Epub 2016 Oct 5.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Background: Post-resuscitation care after out-of-hospital cardiac arrest (OHCA) is challenging due to the threat of organ failure and difficult prognostication. Our aim was to examine whether urine biomarkers could give an early prediction of acute kidney injury (AKI) and outcome.

Methods: This was a prospective observational study of comatose OHCA patients at Oslo University Hospital Ullevål, Norway. Read More

BMC Psychiatry 2016 08 18;16:293. Epub 2016 Aug 18.

Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.

Background: Psychosis can be associated with acute recreational drug and novel psychoactive substance (NPS) toxicity. However, there is limited data available on how common this is and which drugs are most frequently implicated. We describe a European case series of psychosis associated with acute recreational drug toxicity, and estimate the frequency of psychosis for different recreational drugs. Read More

Prehosp Disaster Med 2016 Oct 17;31(5):547-50. Epub 2016 Aug 17.

1Emergency Medical Center,Fujisawa City Hospital,Kanagawa,Japan.

This report outlines the need for the development of an advanced course in mass-casualty life support (MCLS) and introduces the course content. The current problems with education on disasters involving chemical agents, biological agents, radiation/nuclear attacks, or explosives (CBRNE) in Japan are presented. This newly developed "MCLS-CBRNE" program was created by a Ministry of Health, Labour, and Welfare (Tokyo, Japan) research group based on these circumstances. Read More

Acta Anaesthesiol Scand 2016 Sep 16;60(8):1170-81. Epub 2016 Jun 16.

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

Background: Kidney disease after out-of-hospital cardiac arrest (OHCA) is incompletely described. We examined the occurrence of acute kidney injury (AKI) in OHCA patients and impact of AKI, with or without renal replacement therapy (RRT), on 6-month mortality and neurological outcome.

Methods: Prospective study at Oslo University Hospital, Oslo, Norway. Read More

PLoS One 2016 31;11(3):e0152676. Epub 2016 Mar 31.

Médecins Sans Frontières, Oslo, Norway.

Background: Outbreaks of methanol poisoning occur frequently on a global basis, affecting poor and vulnerable populations. Knowledge regarding methanol is limited, likely many cases and even outbreaks go unnoticed, with patients dying unnecessarily. We describe findings from the first three large outbreaks of methanol poisoning where Médecins Sans Frontières (MSF) responded, and evaluate the benefits of a possible future collaboration between local health authorities, a Non-Governmental Organisation and international expertise. Read More

Epidemiol Infect 2016 05;144(7):1463-72

International Master Courses in Protection Against CBRNe events,Department of Industrial Engineering and School of Medicine and Surgery,University of Rome Tor Vergata,Italy.

Mathematical modelling is an important tool for understanding the dynamics of the spread of infectious diseases, which could be the result of a natural outbreak or of the intentional release of pathogenic biological agents. Decision makers and policymakers responsible for strategies to contain disease, prevent epidemics and fight possible bioterrorism attacks, need accurate computational tools, based on mathematical modelling, for preventing or even managing these complex situations. In this article, we tested the validity, and demonstrate the reliability, of an open-source software, the Spatio-Temporal Epidemiological Modeler (STEM), designed to help scientists and public health officials to evaluate and create models of emerging infectious diseases, analysing three real cases of Ebola haemorrhagic fever (EHF) outbreaks: Uganda (2000), Gabon (2001) and Guinea (2014). Read More

Ann Emerg Med 2016 07 11;68(1):52-61. Epub 2016 Feb 11.

Norwegian CBRNe Center of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

Study Objective: Methanol poisoning outbreaks are a global public health issue, with delayed treatment causing poor outcomes. Out-of-hospital ethanol administration may improve outcome, but the difficulty of conducting research in outbreaks has meant that its effects have never been assessed. We study the effect of out-of-hospital ethanol in patients treated during a methanol outbreak in the Czech Republic between 2012 and 2014. Read More

J Med Toxicol 2016 06;12(2):192-8

Department of Emergency Medicine and Medical Toxicology, University of Colorado School of Medicine, Aurora, CO, USA.

Cyanide toxicity is common after significant smoke inhalation. Two cases are presented that provide framework for the discussion of epidemiology, pathogenesis, presenting signs and symptoms, and treatment options of inhalational cyanide poisoning. An evidence-based algorithm is proposed that utilizes point-of-care testing to help physicians identify patients who benefit most from antidotal therapy. Read More

J AOAC Int 2016 02;99(1):308-312

AOAC INTERNATIONAL.

J AOAC Int 2016 02;99(1):298-302

AOAC INTERNATIONAL.

Conn Med 2015 Nov-Dec;79(10):581-5

Unlabelled: September 11, 2001 saw the dawn of the US-led global war on terror, a combined diplomatic, military, social, and cultural war on terrorist activities. Chemical, biological, radiological, nuclear, and high-yield explosives (CBRNE), as a group of tactics, are often the preferred weapons of terrorists across the globe. We undertook a survey of US medical schools to determine what their self-reported level of training for terrorist events encompasses during the four years of undergraduate medical education. Read More

Am J Disaster Med 2015 ;10(3):189-204

Primary Investigator, Fellow, EMS and Disaster Medicine, Newark Beth Israel Medical Center, Newark, New Jersey.

Introduction: Emergency healthcare providers are required to care for victims of Chemical, Biological, Radiologic, Nuclear, and Explosive (CBRNE) agents. However, US emergency departments are often ill prepared to manage CBRNE casualties. Most providers lack adequate knowledge or experience in the areas of patient decontamination, hospital-specific disaster protocols, interagency familiarization, and available supply of necessary medical equipment and medications. Read More

Tidsskr Nor Laegeforen 2015 Dec 1;135(22):2067-70. Epub 2015 Dec 1.

Nasjonal behandlingstjeneste for CBRNe-medisin og Akuttmedisinsk avdeling Oslo universitetssykehus, Ullevål.

Br J Clin Pharmacol 2016 Mar 4;81(3):505-15. Epub 2016 Jan 4.

The Norwegian CBRNe Centre of Medicine, Department of Acute Medicine, Division of Medicine, Oslo University Hospital, NO-0424, Oslo, Norway.

The alcohols, methanol, ethylene glycol and diethylene glycol, have many features in common, the most important of which is the fact that the compounds themselves are relatively non-toxic but are metabolized, initially by alcohol dehydrogenase, to various toxic intermediates. These compounds are readily available worldwide in commercial products as well as in homemade alcoholic beverages, both of which lead to most of the poisoning cases, from either unintentional or intentional ingestion. Although relatively infrequent in overall occurrence, poisonings by metabolically-toxic alcohols do unfortunately occur in outbreaks and can result in severe morbidity and mortality. Read More

Disaster Med Public Health Prep 2015 Dec;9(6):666-80

4SSRS,Media,Pennsylvania.

Objective: To provide a more comprehensive view than previously available of US physician preparedness for public health emergencies, this study examined physicians' assessments of their preparedness, training, participation in institutional activities, information practices, and experiences with patient education. Four kinds of public health emergencies were considered: natural disasters, major airborne infections, major foodborne illness outbreaks, and chemical, biological, radiological, nuclear, or explosives (CBRNE) incidents.

Methods: Between October 19, 2011, and January 11, 2012, researchers conducted a national poll among 1603 practicing physicians in a range of specialties in hospital and nonhospital settings. Read More

J Emerg Manag 2015 Sep-Oct;13(5):431-46

Primary Investigator, Fellow, EMS and Disaster Medicine, Newark Beth Israel Medical Center, Newark, New Jersey.

Introduction: Emergency healthcare providers are required to care for victims of Chemical, Biological, Radiologic, Nuclear, and Explosive (CBRNE) agents. However, US emergency departments are often ill prepared to manage CBRNE casualties. Most providers lack adequate knowledge or experience in the areas of patient decontamination, hospital-specific disaster protocols, interagency familiarization, and available supply of necessary medical equipment and medications. Read More

Clin Toxicol (Phila) 2015 Nov;53(9):893-900

a Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners , London , UK.

Context: Despite the potential for recreational drugs and new psychoactive substances (NPSs) to cause significant morbidity and mortality, there is limited collection of systematic data on acute drug/NPS toxicity in Europe.

Objective: To report data on acute drug/NPS toxicity collected by a network of sentinel centres across Europe with a specialist clinical and research interest in the acute toxicity of recreational drugs and NPS to address this knowledge gap.

Methods: Sixteen sentinel centres in 10 European countries (Denmark, Estonia, France, Germany, Ireland, Norway, Poland, Spain, Switzerland and the UK) collected data on all acute drug toxicity presentations to their Emergency Rooms (ERs) for 12 months (October 2013-September 2014); information on the drug(s) involved in the presentations was on the basis of patient self-reporting. Read More

Clin Toxicol (Phila) 2015 Nov 12;53(9):884-92. Epub 2015 Sep 12.

k The Norwegian CBRNe Centre of Medicine, Department of Acute Medicine , Oslo University Hospital , Oslo , Norway.

Context: Visual disturbances due to the toxic effect of formic acid in acute methanol poisonings are generally transient. The subjective symptoms of visual toxicity may resolve within few weeks and fundoscopic signs of acute optic neuropathy subside within 1-2 months; therefore, the prevalence of long-term visual sequelae in the population of survivors of poisonings may be underestimated.

Objective: To study the prevalence and character of long-term visual sequelae of acute methanol poisonings based on the data from the Czech mass methanol outbreak in 2012. Read More

Virus Res 2015 Dec 8;210:318-26. Epub 2015 Sep 8.

Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy; Didactical Board of the International Master Courses in Protection Against CBRNe events, Department of Industrial Engineering and School of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.

Among the potential biological agents suitable as a weapon, Ebola virus represents a major concern. Classified by the CDC as a category A biological agent, Ebola virus causes severe hemorrhagic fever, characterized by high case-fatality rate; to date, no vaccine or approved therapy is available. The EVD epidemic, which broke out in West Africa since the late 2013, has got the issue of the possible use of Ebola virus as biological warfare agent (BWA) to come to the fore once again. Read More

Scand J Clin Lab Invest 2015 Nov 25;75(7):610-4. Epub 2015 Jul 25.

a The Norwegian CBRNe Centre of Medicine, Department of Acute Medicine , Oslo University Hospital , Ullevaal , Norway.

Background: The standard diagnostic approach to methanol poisoning is chromatographic measurement of methanol on centrally placed stationary equipment. Methanol poisoning in places where such equipment is unavailable is thus often not diagnosed. Methanol is metabolized to a toxic metabolite, formate; the presence of this compound indicates methanol poisoning. Read More

J Trauma Acute Care Surg 2015 Oct;79(4 Suppl 2):S152-6

From the Gordon Center for Research in Medical Education (I.M., A.A.B., R.D.R., H.F.R., S.B.I.), and William Lehman Injury Research Center (K.F.W., S.H. C.I.S.), Department of Surgery, University of Miami Miller School of Medicine (W.A.B.), Miami, Florida.

Background: Chemical, biologic, radiologic, nuclear, and explosive (CBRNE) incidents require specialized training. The low frequency of these events leads to significant skill decay among first responders. To address skill decay and lack of experience with these high-impact events, educational modules were developed for mobile devices to provide just-in-time training to first responders en route to a CBRNE event. Read More

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015 Jul;58(7):699-704

Zentrum für Biologische Gefahren und Spezielle Pathogene, Informationsstelle des Bundes für Biologische Gefahren und Spezielle Pathogene, Robert Koch-Institut, Berlin, Deutschland,

The discovery of undefined powders that are content of letters or parcels with or without threats in writing addressed to institutions, groups or persons, often raises the suspicion of an attack involving biological agents such as anthrax. Subsequent investigations and analyses by local authorities often aim at excluding anthrax or anthrax spores. Suspicion and actions are then mistakenly justified by referring to the 2001 anthrax letter attacks in the USA, which now lie more than 10 years in the past. Read More

Prehosp Disaster Med 2015 Jun 11;30(3):259-63. Epub 2015 May 11.

1Department of Emergency Medicine,Mayo Clinic,Rochester,MinnesotaUSA.

Introduction: Management of contaminated patients in the decontamination corridor requires the use of hazardous material (HazMat) personal protective equipment (PPE). Previous studies have demonstrated that HazMat PPE may increase the difficulty of airway management. This study compared the efficiency of video laryngoscopy (VL) with traditional direct laryngoscopy (DL) during endotracheal intubation (ETI) while wearing HazMat PPE. Read More

Int J Microbiol 2015 17;2015:769121. Epub 2015 Mar 17.

Department of Industrial Engineering, University of Rome Tor Vergata, Via del Politecnico 1, 00173 Rome, Italy ; International Master Courses in Protection against CBRNe Events, Department of Industrial Engineering and School of Medicine and Surgery, University of Rome Tor Vergata, Via del Politecnico 1, 00173 Rome, Italy.

The Ebola virus epidemic burst in West Africa in late 2013, started in Guinea, reached in a few months an alarming diffusion, actually involving several countries (Liberia, Sierra Leone, Nigeria, Senegal, and Mali). Guinea and Liberia, the first nations affected by the outbreak, have put in place measures to contain the spread, supported by international organizations; then they were followed by the other nations affected. In the present EVD outbreak, the geographical spread of the virus has followed a new route: the achievement of large urban areas at an early stage of the epidemic has led to an unprecedented diffusion, featuring the largest outbreak of EVD of all time. Read More