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The enigmatic virus of the great pandemic 1916
–
1924
John Oxford.
Virology, Queen Mary
’
s School of Medicine and Dentistry
The Influenza virus arising from Europe as early as 1916, spread widely
in 1918 as soldiers and airmen, including my father, returned to the
four corners of the world on the ships of the British Navy. Global case
fatality figures of around 7% are widely accepted although there are
serious gaps in our knowledge especially in China and India. But
unexpectedly regions of two continents experienced the extremes
namely zero deaths in American Samoa, and a death rate of greater
than 79% in Okak, Labrador. Major factors here are social including
colonisation and religion which impinged on the societies. We have
exhumed Phyllis Burns and Richard Sykes to obtain clinical samples
from 1916
–
1924 and have also searched pathology museums for lung
blocks as has J.Taubenberger. But to date no single gene of the virus
has been shown to correlate with virulence leading to conclusions
about the importance of co-infection with pneumococcus and to the
importance of social behaviour. The emergence of influenza from
initial clusters in the British Army at Aldershot Barracks and at Etaple-
sur-mer in 1916 could have occurred via short term contract doctors
and nurses from Harvard Medical School USA who criss-crossed the
Atlantic and worked at Etaples.
Methods to evaluate quality indicators
Pierre Parneix.
French Society for Hospital Hygiene (SF2H)
Since ten years, quality indicators (QI) are mandatorily measured in all
French hospitals. They are used for hospital quality improvement,
public disclosure and regulation goals. After a decade of use, the
Ministry of Health and the French National Authority for Health set up
a task force to evaluate these QI. The goal was to provide a decision tool
to help the authorities in terms of withdrawing, revising or continuing
their use. From a literature review and a review of national initia-
tives, we identified potential criteria for assessment. The taskforce
extracted a list of criteria for each goal using a modified Rand/UCLA
Appropriateness Method. Each criterion was assessed using a
quantitative approach or a qualitative approach: This integrated tool
was tested on four national process QIs related to healthcare-
associated infections (HAI) management. Three major international
experiences were studied. Among the fourteen retrieved potential
criteria, 12 were selected as appropriate for the evaluation of QIs for
regulation use including: benefit; side effects, feasibility, barriers to
Implementation and current metrological performances. Among
these, 11 were selected for hospital improvement and 7 for public
disclosure. Applied to the four HAI QIs, the task force proposed to
withdraw the indicator related to multidrug-resistant bacteria
management and to undertake major revision on the three others.
What
’
s new in vaccines?
Andrew Pollard.
Paediatric Infection and Immunity, University of Oxford
Immunisation is the cornerstone of public health policy globally
and vaccine programmes in developed countries have provided a
remarkable range of protection against serious infections that were
once themajor causes of early childhoodmorbidity andmortality. New
vaccines have been introduced in the past 15 years which have had
profound impact on child health. New candidates for high burden
difficult infections such as malaria and dengue are now available
and funding for control of outbreak pathogens (e.g. Ebola, plague) has
been released to improve future preparedness. There has been little
attention to understanding strategies for boosting the immune system
of the growing population of elderly adults, and the prevention of
nosocomial infection through vaccination has become a major focus of
attention for developers. Despite the many successes, there remain
some important gaps in the protection of children against infectious
diseases which cause serious morbidity and have a massive burden
on the health system (e.g. respiratory syncytial virus), or are
rare but responsible for high morbidity and mortality (neonatal
Group B streptococcal infection and adolescent capsular group B
meningococcal vaccination). However, international efforts are
expected to lead to new comprehensive programmes in the next
decade.
Quality indicators: healthcare organizations and Insurances
Walter Popp.
German Society for Hospital Hygiene
Quality indicators: healthcare organizations and insurances in the last
years, there are a lot of new law and other regulations regarding
Hospital Hygiene in Germany. The actual situation will be presented,
especially regarding benchmarking of hospitals and discussion about
future regulations. Also the role of healthcare organizations and
insurances will be included.
Does education really change IPC behaviour?
Jacqui Reilly.
Health Protection Scotland
It is often assumed that providing information on a topic will lead to
knowledge gain and practice improvement. This assumption is flawed.
A review of the evidence from IPC published literature on using
education and training to change behaviour indicates variation in
applied definitions of education and inconsistent reporting of
educational interventions. Nonetheless there is evidence that educa-
tion is an important component of a multimodal strategy for
behaviour change in IPC. However the evidence indicates that single
education sessions are unlikely to be successful and any positive
change identified in the short term might not be reported long term
pointing to the complexity of attitudes and behaviour. There is a need
for the theory of andragogy to be considered by IPC professionals
developing IPC training and education interventions as optimising the
learning experience is key to maximising the potential for education
and training to impact on behaviour.
Reducing sepsis mortality at scale
Kevin Rooney.
Anaesthesia and Intensive Care Medicine, Royal Alexandra
Hospital
Sepsis is an indiscriminate killer of people of any age, background and
social status. Survivors of sepsis are also at increased risk of cognitive
decline and account for a significant proportion of healthcare
expenditure. In this presentation, Professor Rooney will share the
National Strategy to fight Sepsis in Scotland which resulted in a 21%
reduction in Sepsis Mortality. Hewill explain the
‘
What, HowandWhy
’
of the campaign, paying particular emphasis on the key attributes of
reducing mortality at scale as well as any unanticipated consequences.
The role of intersectional innovations in preventing infection
Sanjay Saint.
Department of Internal Medicine, University of Michigan;
VA Ann Arbor Healthcare System University of Michigan
Professor Sanjay Saint, the George Dock Professor of Internal Medicine
at the University of Michigan Medical School, Chief of Medicine at the
VA Ann Arbor Healthcare System, and a Special Correspondent to the
New England Journal of Medicine, will give the Lowbury Lecture
entitled
‘
The Role of Intersectional Innovations in Preventing
Infection.
’
He will make the following key points during this lecture.
First, hewill discuss the importance of infection prevention, in general,
and catheter-associated urinary tract infection (CAUTI), in particular.
Second, he will provide an overview of how to prevent CAUTI with a
focus on recent data, and describe both technical and socio-adaptive
aspects to reducing healthcare-associated infection. Third, he will
define
‘
intersectional innovations
’
and distinguish intersectional
innovations from
‘
directional innovations
’
. Fourth, he will provide an
overview of the intersectional innovations that could impact infection
prevention efforts such as human factors engineering, cognitive
psychology, sociology, and management science. Finally, he will
discuss future directions in infection prevention, including the
possible role of mindfulness.
Abstracts of FIS/HIS 2016
–
Invited Speaker Abstracts / Journal of Hospital Infection 94S1 (2016) S1
–
S10
S7