DOCSLIB.ORG

Laser Treatment Shows Promise for Diabetic Macular Edema

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Laser Treatment Shows Promise for Diabetic Macular Edema VITREORETINAL SURGERY FEATURE STORY Laser Treatment Shows Promise for Diabetic Macular Edema A Q-switched Nd:YAG laser may allow treatment earlier and closer to the fovea than standard laser photocoagulation. BY JOHN MARSHALL, PHD, FRCPATH, FRCOPHTH(HON); LUCIA PELONSIS, MRCOPHTH; PETER HAMILTON, FRCS, FRCOPHTH; AND ROBIN HAMILTON, MBBS, MRCOPHTH s anyone in medical practice sees on a daily basis, there is an increase in the incidence of The history of this field has been diabetes and diabetes-related complications among our patients. This is due in part to a sequence of increasingly subtle Aearlier diagnosis and screening programs, but also to an treatments applied at earlier increase in obesity and life expectancy. So acute is the points in the disease process. problem that the World Health Organization added diabetic retinopathy to its priority list of diseases.1 Just 4 decades ago, most people diagnosed with dia- RETINA REGENERATION THERAPY betes would likely go blind if they lived long enough Nonthermal Retina Regeneration Therapy (2RT; Ellex, because there were no safe and effective treatments for Adelaide, Australia), is a short-pulsed laser treatment managing associated ocular diseases. Available treatments that is intended to treat diabetic maculopathy and were associated with risk of significant complications.2 macular edema at an earlier stage of the disease. The The advent of retinal photocoagulation heralded a therapy may also have application in the treatment of tremendous change in treatment; for the first time, early-stage age-related macular degeneration. (For more there was a way of at least managing the progression information, see 2RT in Treatment of Age-Related of retinal disease in patients with diabetes.3 Laser ther- Macular Degeneration.) apy combined with early screening and effective con- The laser used for 2RT is a Q-switched, green Nd:YAG trol of the disease led to a decrease in the number of laser with a wavelength of 532 nm. Its pulse duration is patients who required more severe treatments, such as 3 nanoseconds with energy of 1 µJ per pulse. The laser vitrectomy. treatment triggers what we describe as photoregenera- The history of this field has been a sequence of tion of the retinal pigment epithelium and Bruch’s increasingly subtle treatments applied at earlier points membrane—the areas responsible for keeping retinal in the disease process. Currently, retinal photocoagula- function optimized—without damaging peripheral tion remains an effective means of controlling the pro- areas. gression of diabetic retinopathy, maculopathy, and mac- The laser was developed as a result of preclinical ular edema; however, we are still unable to treat affect- proof-of-principle laboratory work at Saint Thomas’ ed areas located near the fovea. A research and clinical Hospital.4 Ellex has since received an Australian govern- study that we have embarked upon may lead to the ment grant to expand the laboratory and clinical development of a subtle laser treatment that may be research on the 2RT. used, even at the fovea, prior to the development of Not only can the laser treatment be placed closer to ischemia. the fovea; equally significant, the 2RT can be used earlier 74 IRETINA TODAYIJULY/AUGUST 2008 VITREORETINAL SURGERY FEATURE STORY in the disease process, offering the potential to preserve put significant limitations on the location and timing a greater degree of functional vision for a longer time. of laser photocoagulation—not too close to the fovea, not too early in the course of the disease. With CLINICAL RESULTS 2RT, there is potential to develop a laser treatment In the first clinical study of the procedure,4 29 eyes that affects only the RPE without damaging the pho- (18 patients) underwent 2RT for the treatment of dia- toreceptor cells, meaning that we can get closer to betic maculopathy and/or macular edema. Currently, the fovea without damaging central vision. For the patients are being followed for 1 year. Postoperative first time, there is the potential for a prophylactic testing includes optical coherence tomography and treatment approach in patients with diabetic macular microperimetry. edema or maculopathy. At 3 months, most patients showed improvement in Further clinical studies are under way in the United visual acuity and decrease in central macular thickness. Kingdom and Australia, with expansion to follow to Central macular thickness decreased in 55% of eyes and additional international sites throughout 2008. If these remained stable in 24%. The remaining 20% experienced additional clinical studies achieve the results seen in an increase in central macular thickness. There was a the London study, Ellex plans to move forward with mean improvement in logMAR visual acuity from commercial introduction of the technology. 0.3 to 0.1. Microperimetry demonstrated no laser dam- The promise of earlier therapeutic intervention for age to photoreceptor cells. diabetic maculopathy and macular edema is significant. The energy initially used in the 2RT treatment was The ability to treat the whole ischemic retina and pre- 120 mJ/cm2; however, it triggered a reaction in the reti- serve visual function for as long as possible is a long- nal pigment epithelium (RPE). The treatment was then sought goal whose time may soon arrive. ■ reduced by half to create the desired effect without causing a visible reaction in the RPE. Peter Hamilton, FRCS, FRCOphth, is an Honorary Consultant at Moorfields Eye Hospital DISCUSSION and Honorary Consultant at Saint Thomas’ Although this is a preliminary study, early results are Hospital. Dr. Hamilton states that he has no encouraging. Consider that in the past, preservation financial interest in the products or companies of central vision with laser photocoagulation mentioned. destroyed, to some extent, the peripheral vision. This Robin Hamilton, MBBS, MRCOphth, is a Fellow in Medical Retina at Moorfields Eye Hospital and an 2RT FOR TREATMENT OF AGE-RELATED Honorary Fellow at Saint Thomas’ Hospital. Dr. Hamilton MACULAR DEGENERATION states that he has no financial interest in the products or companies mentioned. In addition to showing promise for earlier treatment of dia- John Marshall, PhD, FRCPath, FRCOphth(Hon), betic eye disease, Retina Regeneration Therapy (2RT; Ellex, is the Frost Professor of Ophthalmology and Adelaide, Australia) may have similar potential in the treat- Chairman of the Academic Department of ment of early-stage age-related macular degeneration (AMD). Ophthalmology, Kings College London at Saint At the moment, therapies for AMD mainly address Thomas’ Hospital, and was Sembal Professor of Experimental Ophthalmology at the Institute of Ophthalmology newly formed vessels in the exudative stage of the disease. from 1982-1991. Professor Marshall states that he is a member It would be preferable to treat the underlying disease of the Ellex Board of Directors and is compensated in this role. processes, one of which is the problem of waste disposal in He may be reached at e-mail: [email protected]. the aging eye, particularly in the retinal pigment epithelium Lucia Pelonsis, MRCOphth, is a clinical fellow at Saint and Bruch’s membrane. The 2RT laser offers an interim Thomas’ Hospital. Dr. Pelonsis states that she has no finan- treatment potential that might rejuvenate these systems cial interest in the products or companies mentioned. concerned with waste disposal. 1. World Health Organization. Priority eye diseases: Diabetic retinopathy. WHO Web site. By slightly tweaking the retinal pigment epithelium with http://www.who.int/blindness/causes/priority/en/index6.html. Accessed May 15, 2008. the laser, surgeons may clean up and reset the aging 2. Pituitary ablation for diabetic retinopathy. Br Med J. 1970;3(5725):724. 3. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic process within the outer retina. This might delay the devel- macular edema: ETDRS report number 1. Arch Ophthalmol. 1985;103:1796-1806. opment of manifestations of the disease. 4. Hamilton P. Selective laser retinal pigment epithelium treatment for diabetic macular edema. Paper presented at: Retina Subspecialty Day, Annual Meeting of the American Academy of Ophthalmology; November 10, 2007; New Orleans, LA. JULY/AUGUST 2008 IRETINA TODAYI 75.
Load more

Recommended publications
  • EFFECTIVE NEBRASKA DEPARTMENT of 01/01/2017 HEALTH and HUMAN SERVICES 173 NAC 1 I TITLE 173 COMMUNICABLE DISEASES CHAPTER 1
    EFFECTIVE NEBRASKA DEPARTMENT OF 01/01/2017 HEALTH AND HUMAN SERVICES 173 NAC 1 TITLE 173 COMMUNICABLE DISEASES CHAPTER 1 REPORTING AND CONTROL OF COMMUNICABLE DISEASES TABLE OF CONTENTS SECTION SUBJECT PAGE 1-001 SCOPE AND AUTHORITY 1 1-002 DEFINITIONS 1 1-003 WHO MUST REPORT 2 1-003.01 Healthcare Providers (Physicians and Hospitals) 2 1-003.01A Reporting by PA’s and APRN’s 2 1-003.01B Reporting by Laboratories in lieu of Physicians 3 1-003.01C Reporting by Healthcare Facilities in lieu of Physicians for 3 Healthcare Associated Infections (HAIs) 1-003.02 Laboratories 3 1-003.02A Electronic Ordering of Laboratory Tests 3 1-004 REPORTABLE DISEASES, POISONINGS, AND ORGANISMS: 3 LISTS AND FREQUENCY OF REPORTS 1-004.01 Immediate Reports 4 1-004.01A List of Diseases, Poisonings, and Organisms 4 1-004.01B Clusters, Outbreaks, or Unusual Events, Including Possible 5 Bioterroristic Attacks 1-004.02 Reports Within Seven Days – List of Reportable Diseases, 5 Poisonings, and Organisms 1-004.03 Reporting of Antimicrobial Susceptibility 8 1-004.04 New or Emerging Diseases and Other Syndromes and Exposures – 8 Reporting and Submissions 1-004.04A Criteria 8 1-004.04B Surveillance Mechanism 8 1-004.05 Sexually Transmitted Diseases 9 1-004.06 Healthcare Associated Infections 9 1-005 METHODS OF REPORTING 9 1-005.01 Health Care Providers 9 1-005.01A Immediate Reports of Diseases, Poisonings, and Organisms 9 1-005.01B Immediate Reports of Clusters, Outbreaks, or Unusual Events, 9 Including Possible Bioterroristic Attacks i EFFECTIVE NEBRASKA DEPARTMENT OF
    [Show full text]
  • Viability of B. Typhosus in Stored Shell Oysters
    PUBLIC HEALTH REPORTS VOL. 40 APRIL 24, 1925 No. 17 VIABILITY OF B. TYPHOSUS IN STORED SHELL OYSTERS By CONRAD KINYOuN, Assistant Bacteriologist, hlygienic Laboratory, United Stztes Ptiblic Ilealti Serviee The object of this work was to determine whether oysters con- taminated with B. typhosuis and then stored unider uisual market conditions woul(l remain potentially infectious over a length of time sufficient to allow them to reach the consumer. Conflicting opinions are now current as to the length of time the causative agent of typhoid fever can remain viable in the oyster, and even as to whether the oyster can harbor the organisms at all. Obviouisly an oyster which harbors typhoidl organismns for as short a time as 24 hours becomes a potential infecting, agent for thlat time. Practi- cally it is of interest to know whether the time elapsing between the remov-al of the oyster from the bed and( actual consumption after passing through customary commercial channels is sufficient for oysters to rid themselves of possible infection. As early as 1603, oysters were incriminate(d in intestinal disor(lers, when suspicion was directed toward them by an illness of Henry IV of France (7). It was not uIntil the close of the nineteenth century, however, that oysters and shellfislh as agents of (lisease transmission receive(d particular attention. In October, 1894, Conn focused attention on the oyster by his investigation of the now famous Wesleyan outbreak, an(d thoughl only thlree outbreaks of typhoid fever were definitely traced to the oyster before 19,25, these stimulated wide interest and consequent study, with atten(lant epidemiological and bacteriological investigations.
    [Show full text]
  • Characterization of a Meiotic Recombination Hotspot in Arabidopsis Thaliana Hossein Khademian
    Characterization of a meiotic recombination hotspot in Arabidopsis thaliana Hossein Khademian To cite this version: Hossein Khademian. Characterization of a meiotic recombination hotspot in Arabidopsis thaliana. Agricultural sciences. Université Paris Sud - Paris XI, 2012. English. NNT : 2012PA112051. tel- 00800551 HAL Id: tel-00800551 https://tel.archives-ouvertes.fr/tel-00800551 Submitted on 14 Mar 2013 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. UNIVERSITE PARIS-SUD 11 U.F.R. Scientifique d’Orsay Thèse Présentée pour l’obtention du grade de Docteur en Sciences de l’Université Paris-Sud XI Spécialité : Sciences du Végétal par Hossein KHADEMIAN Caractérisation d’un point chaud de recombinaison méiotique chez Arabidopsis thaliana Composition du jury : Valérie BORDE Rapporteur Michel DRON Président du Jury Corinne GREY Examinateur Christine MEZARD Directeur de Thèse Minoo RASSOULZADEGAN Rapporteur Abstract Meiotic recombination initiated in prophase I of meiosis generates either crossovers (COs), which are reciprocal exchanges between chromosome segments, or gene conversion not associated to crossovers (NCOs). Both kinds of events occur in narrow regions (less than 10 kilobases) called hotspots, which are distributed non-homogenously along chromosomes. The aim of my PhD was the characterization of a hotspot of meiotic recombination (named 14a) in Arabidopsis thaliana (i) across different accessions (ii) in msh4 mutant, a gene involved in CO formation.
    [Show full text]
  • Eye Disease 1 Eye Disease
    Eye disease 1 Eye disease Eye disease Classification and external resources [1] MeSH D005128 This is a partial list of human eye diseases and disorders. The World Health Organisation publishes a classification of known diseases and injuries called the International Statistical Classification of Diseases and Related Health Problems or ICD-10. This list uses that classification. H00-H59 Diseases of the eye and adnexa H00-H06 Disorders of eyelid, lacrimal system and orbit • (H00.0) Hordeolum ("stye" or "sty") — a bacterial infection of sebaceous glands of eyelashes • (H00.1) Chalazion — a cyst in the eyelid (usually upper eyelid) • (H01.0) Blepharitis — inflammation of eyelids and eyelashes; characterized by white flaky skin near the eyelashes • (H02.0) Entropion and trichiasis • (H02.1) Ectropion • (H02.2) Lagophthalmos • (H02.3) Blepharochalasis • (H02.4) Ptosis • (H02.6) Xanthelasma of eyelid • (H03.0*) Parasitic infestation of eyelid in diseases classified elsewhere • Dermatitis of eyelid due to Demodex species ( B88.0+ ) • Parasitic infestation of eyelid in: • leishmaniasis ( B55.-+ ) • loiasis ( B74.3+ ) • onchocerciasis ( B73+ ) • phthiriasis ( B85.3+ ) • (H03.1*) Involvement of eyelid in other infectious diseases classified elsewhere • Involvement of eyelid in: • herpesviral (herpes simplex) infection ( B00.5+ ) • leprosy ( A30.-+ ) • molluscum contagiosum ( B08.1+ ) • tuberculosis ( A18.4+ ) • yaws ( A66.-+ ) • zoster ( B02.3+ ) • (H03.8*) Involvement of eyelid in other diseases classified elsewhere • Involvement of eyelid in impetigo
    [Show full text]
  • Managing Communicable Diseases in Child Care Settings
    MANAGING COMMUNICABLE DISEASES IN CHILD CARE SETTINGS Prepared jointly by: Child Care Licensing Division Michigan Department of Licensing and Regulatory Affairs and Divisions of Communicable Disease & Immunization Michigan Department of Health and Human Services Ways to Keep Children and Adults Healthy It is very common for children and adults to become ill in a child care setting. There are a number of steps child care providers and staff can take to prevent or reduce the incidents of illness among children and adults in the child care setting. You can also refer to the publication Let’s Keep It Healthy – Policies and Procedures for a Safe and Healthy Environment. Hand Washing Hand washing is one of the most effective way to prevent the spread of illness. Hands should be washed frequently including after diapering, toileting, caring for an ill child, and coming into contact with bodily fluids (such as nose wiping), before feeding, eating and handling food, and at any time hands are soiled. Note: The use of disposable gloves during diapering does not eliminate the need for hand washing. The use of gloves is not required during diapering. However, if gloves are used, caregivers must still wash their hands after each diaper change. Instructions for effective hand washing are: 1. Wet hands under warm, running water. 2. Apply liquid soap. Antibacterial soap is not recommended. 3. Vigorously rub hands together for at least 20 seconds to lather all surfaces of the hands. Pay special attention to cleaning under fingernails and thumbs. 4. Thoroughly rinse hands under warm, running water. 5.
    [Show full text]
  • ICD-10 International Statistical Classification of Diseases and Related Health Problems
    ICD-10 International Statistical Classification of Diseases and Related Health Problems 10th Revision Volume 2 Instruction manual 2010 Edition WHO Library Cataloguing-in-Publication Data International statistical classification of diseases and related health problems. - 10th revision, edition 2010. 3 v. Contents: v. 1. Tabular list – v. 2. Instruction manual – v. 3. Alphabetical index. 1.Diseases - classification. 2.Classification. 3.Manuals. I.World Health Organization. II.ICD-10. ISBN 978 92 4 154834 2 (NLM classification: WB 15) © World Health Organization 2011 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press through the WHO web site (http://www.who.int/about/licensing/copyright_form). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.
    [Show full text]
  • FAQ REGARDING DISEASE REPORTING in MONTANA | Rev
    Disease Reporting in Montana: Frequently Asked Questions Title 50 Section 1-202 of the Montana Code Annotated (MCA) outlines the general powers and duties of the Montana Department of Public Health & Human Services (DPHHS). The three primary duties that serve as the foundation for disease reporting in Montana state that DPHHS shall: • Study conditions affecting the citizens of the state by making use of birth, death, and sickness records; • Make investigations, disseminate information, and make recommendations for control of diseases and improvement of public health to persons, groups, or the public; and • Adopt and enforce rules regarding the reporting and control of communicable diseases. In order to meet these obligations, DPHHS works closely with local health jurisdictions to collect and analyze disease reports. Although anyone may report a case of communicable disease, such reports are submitted primarily by health care providers and laboratories. The Administrative Rules of Montana (ARM), Title 37, Chapter 114, Communicable Disease Control, outline the rules for communicable disease control, including disease reporting. Communicable disease surveillance is defined as the ongoing collection, analysis, interpretation, and dissemination of disease data. Accurate and timely disease reporting is the foundation of an effective surveillance program, which is key to applying effective public health interventions to mitigate the impact of disease. What diseases are reportable? A list of reportable diseases is maintained in ARM 37.114.203. The list continues to evolve and is consistent with the Council of State and Territorial Epidemiologists (CSTE) list of Nationally Notifiable Diseases maintained by the Centers for Disease Control and Prevention (CDC). In addition to the named conditions on the list, any occurrence of a case/cases of communicable disease in the 20th edition of the Control of Communicable Diseases Manual with a frequency in excess of normal expectancy or any unusual incident of unexplained illness or death in a human or animal should be reported.
    [Show full text]
  • Differences of Progressive Retinal Atrophy in Dogs
    Swedish University of Agricultural Sciences Faculty of Veterinary Medicine and Animal Science Differences of Progressive Retinal Atrophy in dogs Lisen Ekroth Examensarbete / Swedish University of Agricultural Examensarbete, 15 hp Sciences, Department of Animal Breeding and Genetics – Bachelor Thesis (Literature study) 416 Agriculture programme Uppsala 2013 – Animal Science Swedish University of Agricultural Sciences Faculty of Veterinary Medicine and Animal Science Department of Animal Breeding and Genetics Differences of Progressive Retinal Atrophy in dogs Skillnader i progressiv retinal atrofi hos hund Lisen Ekroth Supervisor: Tomas Bergström, SLU, Department of Animal Breeding and Genetics Examiner: Stefan Marklund, SLU, Department of Clinical Sciences Credits: 15 hp Course title: Bachelor Thesis – Animal Science Course code: EX0553 Programme: Agriculture programme – Animal Science Level: Basic, G2E Place of publication: Uppsala Year of publication: 2013 Cover picture: Lisen Ekroth Name of series: Examensarbete 416 Department of Animal Breeding and Genetics, SLU On-line publication: http://epsilon.slu.se Key words: Atrophy, Retina, Dog, PRA Contents Sammanfattning ......................................................................................................................... 2 Abstract ...................................................................................................................................... 2 Introduction ...............................................................................................................................
    [Show full text]
  • History of the Statistical Classification of Diseases and Causes of Death
    Copyright information All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated. Suggested citation Moriyama IM, Loy RM, Robb-Smith AHT. History of the statistical classification of diseases and causes of death. Rosenberg HM, Hoyert DL, eds. Hyattsville, MD: National Center for Health Statistics. 2011. Library of Congress Cataloging-in-Publication Data Moriyama, Iwao M. (Iwao Milton), 1909-2006, author. History of the statistical classification of diseases and causes of death / by Iwao M. Moriyama, Ph.D., Ruth M. Loy, MBE, A.H.T. Robb-Smith, M.D. ; edited and updated by Harry M. Rosenberg, Ph.D., Donna L. Hoyert, Ph.D. p. ; cm. -- (DHHS publication ; no. (PHS) 2011-1125) “March 2011.” Includes bibliographical references. ISBN-13: 978-0-8406-0644-0 ISBN-10: 0-8406-0644-3 1. International statistical classification of diseases and related health problems. 10th revision. 2. International statistical classification of diseases and related health problems. 11th revision. 3. Nosology--History. 4. Death- -Causes--Classification--History. I. Loy, Ruth M., author. II. Robb-Smith, A. H. T. (Alastair Hamish Tearloch), author. III. Rosenberg, Harry M. (Harry Michael), editor. IV. Hoyert, Donna L., editor. V. National Center for Health Statistics (U.S.) VI. Title. VII. Series: DHHS publication ; no. (PHS) 2011- 1125. [DNLM: 1. International classification of diseases. 2. Disease-- classification. 3. International Classification of Diseases--history. 4. Cause of Death. 5. History, 20th Century. WB 15] RB115.M72 2011 616.07’8012--dc22 2010044437 For sale by the U.S.
    [Show full text]
  • Developing Standards of Care for Marine Mammals in Captivity and Recommendations Regarding How Best to Ensure the Most Humane Treatment of Captive Cetaceans
    Developing Standards of Care for Marine Mammals in Captivity and Recommendations Regarding How Best to Ensure the Most Humane Treatment of Captive Cetaceans A report prepared for the Ontario Ministry of Community Safety and Correctional Services Final Report: May 30, 2014 Table of Contents Report Overview .......................................................................................................5 Purpose ................................................................................................................5 Report Structure ....................................................................................................5 Committee Members .............................................................................................6 Explanation of Key Terms .....................................................................................6 Executive Summary .................................................................................................7 Part 1: Recommendations for Standards of Care for Captive Marine Mammals in Ontario .....................................................................................................................9 1.1. Overview ....................................................................................................9 1.2 Approach ....................................................................................................9 1.3 Current regulations for the care of marine mammals in Ontario .................9 1.4 Recognized concerns associated with current
    [Show full text]
  • Infectious Diseases in Child Care and School Settings
    Infectious Diseases in Child Care and School Settings Guidelines for CHILD CARE PROVIDERS, SCHOOL NURSES AND OTHER PERSONNEL Communicable Disease Branch 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 Phone: (303) 692-2700 Fax: (303) 782-0338 Updated March 2016 1 Acknowledgements These guidelines were compiled by the Communicable Disease Branch at the Colorado Department of Public Health and Environment. We would like to thank many subject matter experts for reviewing the document for content and accuracy. We would also like to acknowledge Donna Hite; Rene’ Landry, RN, BSN; Kate Lujan, RN, MPH; Kathy Patrick, RN, MA, NCSN, FNASN; Linda Satkowiak, ND, RN, CNS, NCSN; Jennifer Ward, RN, BSN; and Cathy White, RN, MSN for their comments and assistance in reviewing these guidelines. Special thanks to Heather Dryden, Administrative Assistant in the Communicable Disease Branch, for expert formatting assistance that makes this document readable. Revisions / Updates Date Description of Changes Pages/Sections Affected 2012 Major revision to content and format; combine previous Throughout separate guidance documents for child care and schools into one document Dec 2014 Updated web links due to CDPHE website change; updated Throughout several formatting issues; added hyperlinks to table of contents; no content changes May 2015 Added updated FERPA letter from the CO Dept of Education; Introduction added links to additional info to the animal contact section in the introduction; added new bleach concentration disinfection guidance Oct 2015
    [Show full text]
  • Pacific Outbreak Manual
    PACIFIC OUTBREAK MANUAL Pacific Public Health Surveillance Network (PPHSN) March 2016 The information contained in this manual may be reproduced or translated for scientific or educational use, but not for sale or for use in conjunction with any commercial purpose. Any use of the information in the manual should be accompanied by an acknowledgment of the source. Acknowledgements This manual has been developed by the Pacific Public Health Surveillance Network (PPHSN). PPHSN is a voluntary network of countries and organisations dedicated to the promotion of public health surveillance and appropriate response to the health challenges of 22 Pacific island countries and areas. This guide was originally written by Anthony Kolbe, Jennie Musto, Boris Pavlin and Jacob Kool. The Pacific Public Health Surveillance Network (PPHSN) is particularly grateful to the range of clinicians and public health workers who have provided feedback during the updating of this edition of the manual. PPHSN would also like to thank the following organisations that have supported the development of this manual: • World Health Organization (WHO) • Pacific Community (SPC) • Hunter New England Local Health District and Hunter Medical Research Institute 2 PPHSN Pacific Outbreak Manual – March 2016 PACIFIC OUTBREAK MANUAL Contents Introduction ............................................................................................................................................ 5 Section 1: General guideline for response to outbreaks .......................................................................
    [Show full text]