Biosecurity BriefingSubscribe | About | Current Issue | RSS | Archive December 22, 2008
HHS Issues Guidance on Antiviral Drug Use During a PandemicOn December 16, 2008, HHS released a revised version of its Guidance on Antiviral Drug Use during an Influenza Pandemic. This document replaces HHS’s 2005 pandemic influenza plan.1 HHS makes the following recommendations, which are designed to slow the spread of disease, reduce health effects, and minimize societal and economic disruption during a pandemic: - Focus treatment and post-exposure prophylaxis (PEP) on targeted individuals and geographic locations
- Employ border policies to reduce introduction of infection into the U.S.
- Administer early treatment to those who present for care
- Use prophylaxis to protect high-risk healthcare workers and emergency services personnel throughout the pandemic
- Offer PEP to healthcare and emergency services workers who are not high-risk; to immune-compromised individuals less likely to benefit from a vaccine; and to individuals in group homes, nursing homes, prisons and other facilities should infection occur.1
The new guidance also offers a strategy for stockpiling antivirals. The Strategic National Stockpile (SNS) currently holds 81 million regimens of influenza antiviral drugs for the public, 6 million of which are specifically intended to contain and slow the entry of pandemic disease into the U.S.1 The SNS supply of antiviral drugs is approximately 80% oseltamivir (Tamiflu®) and 20% zanamivir (Relenza®), both of which are neuraminidase inhibitors. The SNS also includes several million doses of rimantadine, an M2 inhibitor. However, M2 inhibitors are not a major part of the strategy because of existing M2 resistance in circulating influenza A strains.1 Additionally, HHS recommends that governments, healthcare organizations, businesses, and families stockpile antiviral drugs as well. Some guidance on prioritization of antiviral use when supplies are limited is provided. Finally, HHS suggests steps to further improve the strategy and recommendations. Kunal Rambhia References - U.S. Department of Health and Human Services. Guidance on Antiviral Drug Use during an Influenza Pandemic. December 16, 2008. http://www.pandemicflu.gov/vaccine/antiviral_use.pdf. Accessed December 19, 2008.
IOM Recommends that HHS Define a 21st Century Vision to Meet U.S. Healthcare Challenges
On December 12, 2008, the Institute of Medicine (IOM) released a report titled HHS in the 21st Century: Charting a New Course for a Healthier America, which evaluates the department’s ability to meet both continued and emerging health challenges faced by the U.S.; the evaluation was prompted by the U.S. House of Representatives Committee on Government Reform. The IOM concluded that, while HHS has many important programs in place to improve health and protect the U.S. against disease, there are also many obstacles affecting the department’s ability to carry out its responsibilities, mission, and goals.1 Major obstacles identified in the report include: the rising cost of healthcare and insurance; an ever expanding list of healthcare issues that HHS is responsible for; difficulty retaining quality government employees; divergence of missions and limited communication among agencies and offices within the department; divergence of missions and limited communication among HHS and other departments; and difficulties in forging partnerships with the private sector, among other obstacles. The IOM recommends that in order for HHS to meet the nation’s twenty-first century healthcare challenges, the department must be more “optimally organized” and work more closely with Congress and other federal agencies and departments. IOM cautions that HHS should not undertake a reorganization of the entire department, but rather should focus on revitalizing the department through the following processes: - Define a 21st century vision
- Foster adaptability and alignment among agencies
- Promote effectiveness and efficiency in the healthcare system
- Strengthen HHS and U.S. public health workforces
- Improve accountability and decision-making within the agency.1
Crystal Franco References - HHS in the 21st Century: Charting a New Course for a Healthier America. Institute of Medicine. December 12, 2009. http://www.iom.edu/CMS/28312/55311/60704.aspx. Accessed December 19, 2008.
Newsworthy
The Malaysian government recently released Yazid Sufaat and 4 other alleged terrorists known to be affiliated with al Qaeda from jail. According to the 9/11 Commission Report, Sufaat hosted terrorists in his home as they planned both the 9/11 and the USS Cole attacks. He also hosted convicted al Qaeda terrorist Zacarias Moussaoui while Moussaoui visited Malaysia. Sufaat, whose background is in the biological/chemical sciences, is believed to have been assisting al Qaeda in developing anthrax. Malaysia officials detained Sufaat in 2001, but the reason for his release remains unclear. The CDC released a flu surveillance report indicating that 45 of 46 A/H1N1 influenza viruses tested were found to be resistant to the antiviral drug oseltamivir (brand name Tamiflu®), but susceptible to zanamavir (brand name Relenza®). All of the A/H3N2 and B viruses tested were susceptible to both oseltamivir and oseltamivir. The WHO made progress last week in its efforts to secure international agreements on sharing of H5N1 influenza virus samples. Representatives from more than 100 countries met in Geneva to negotiate agreements and mechanisms for sharing samples. The group will convene next in 2009 to discuss intellectual property issues and methods to ensure that countries providing virus samples derive appropriate benefits. The U.S. and Panama have announced that radiation detection equipment has been installed at the Ports of Balboa and Cristobal, the two busiest seaports in the world. The effort is part of the Megaport Initiative of National Nuclear Security Administration’s (NNSA) Second Line of Defense Program. The Megaport Initiative aims to strengthen foreign governments’ ability to deter, detect, and interdict illicit trafficking in nuclear and other radioactive materials across international borders and through the global maritime shipping system. As part of its long-term effort to improve food safety, China’s Ministry of Health recently made public a list of illegal food additives that have been used in food production. Among insecticides, drain cleaners, and industrial dyes are included boric acid, an insecticide that was added to noodles and meatballs to increase elasticity, and formaldehyde and lye, which are used to make soap and drain cleaner, but were also added to seafood products to make them appear larger and fresher. The GAO issued a report on the status of insurance coverage availability for nuclear, biological, chemical, or radiological attacks (NBCR). The GAO found that property and casualty insurers seek to exclude NBCR terrorism coverage from their commercial policies, and commercial property and casualty policyholders generally reported that they could not obtain such coverage.
New on the Center's Website: Preventing and Deterring Biological Attacks: Priorities that Should Emerge From the WMD Commission Report, a memo from the Center for Biosecurity in response to the WMD Commission Report, World At Risk. Winter Break for the Biosecurity briefing. The Biosecurity Briefing will be on winter break until Monday, February 2, 2009. We wish all of our readers a very happy New Year!
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