Bioterrorism and children: unique concerns with infection control and vaccination

APIC State-of-the-Art Report: the role of the infection preventionist in emergency management

BACKGROUND

This report summarizes the scope and role of infection preventionists in emergency management for all types of disasters. Preventing the transmission of infectious agents during a disaster is an essential component of emergency management. Previous disasters have illustrated the need for better infection prevention and the involvement of an infection prevention professional in planning for and responding to such events.

METHODS

An evidence-based approach was used, consisting of a literature review and review by members of the Association for Professionals in Infection Control and Epidemiology, Inc, Emergency Preparedness Committee.

RESULTS

Nine domains were identified that describe the role of the infection preventionist in emergency management: knowledge of disasters and emergency management, assessing readiness and emergency management plans, infection prevention coverage, participation in disaster response and recovery, health care policy development, surveillance, patient management, physical plant issues, and infection preventionist as educator. Details for each domain are provided.

CONCLUSION

Infection preventionists need to become more involved in emergency management at the personal, facility, and community level. This report outlines the infection preventionist's responsibilities related to emergency management.

5-(Dimethoxymethyl)-2'-deoxyuridine: a novel gem diether nucleoside with anti-orthopoxvirus activity

To provide potential new leads for the treatment of orthopoxvirus infections, the 5-position of the pyrimidine nucleosides have been modified with a gem diether moiety to yield the following new nucleosides: 5-(dimethoxymethyl)-2'-deoxyuridine (2b), 5-(diethoxymethyl)-2'-deoxyuridine (3b), 5-formyl-2'-deoxyuridine ethylene acetal (4b), and 5-formyl-2'-deoxyuridine propylene acetal (5b). These were evaluated in human foreskin fibroblast cells challenged with the vaccinia virus or cowpox virus. Of the four gem diether nucleosides, only the dimethyl gem diether congener showed significant antiviral activity against both viruses. This antiviral activity did not appear to be related to the decomposition to the 5-formyl-2'-deoxyuridine, which was itself devoid of anti-orthopoxvirus activity in these assays. Moreover, at the pH of the in vitro assays, 2b was very stable with a decomposition (to aldehyde) half-life of >15 d. The anti-orthopoxvirus activity of pyrimidine may be favored by the introduction of hydrophilic moieties to the 5-position side chain.