Day 2 :
Keynote Forum
Stef Stienstra
Dutch Armed Forces, Netherlands
Keynote: Managing bio-threat information under the WHO international health regulations of biosecurity
Biography:
Strategic and creative consultant in biomedical science, with a parallel career in the Dutch Civil-Military Interaction Command in which he has responsibility for the counter measures in CBNRe threats and (medical) consequence management both in a military and a civilian (terrorism) setting. He was the director of the 2014 & 2016 World Congress of CBRNe Science & Consequence Management in Tbilisi, Georgia. He works internationally as consultant or scientific supervisory board member for several medical and biotech companies, merely involved in biodefense, clinical diagnostics and therapies. He is also visiting professor for Punjab University in Pakistan and Rhein-Waal University in Germany and visiting professor at the University of Rome Tor Vergata. He has finished both his studies in Medicine and in Biochemistry at the University of Groningen in The Netherlands and has extensive practical experience in cell biology, immuno-haematology, biodefense and transfusion medicine. His natural business acumen and negotiation competence helps to initiate new successful businesses, often created out of unexpected combinations of technologies. His thorough understanding of abstract science combined with excellent skills in the communication of scientific matters to non-specialists, helps him with strategic consulting at top level management.
Abstract:
Sharing security threat information is a challenge for governments and their agencies. Especially in biotechnology and microbiology the agencies do not know how to classify or to disclose collected information on potential bio-threats. There is vague border between man-made and natural biological threats. An example is the several month delay of the publication of research on the transmissibility of H5N1 avian influenza virus in the leading scientific journal science by researchers of the Erasmus Medical Centre in Rotterdam, the Netherlands. The publication was delayed in 2012 by several months due to the fact that various organizations first wanted to investigate whether the details could be misused by malicious individuals. In the study the researchers show that only a small number of mutations were necessary to change the H5N1 virus so that it can spread through the respiratory system between mammals. This implies that the risk of a H5N1 pandemic cannot be ruled out. On the other hand, this information can be used to develop new therapies and/or vaccines for influenza. It gives also insight into the disease mechanism, which helps in the prevention. The same arguments are valid for therapeutic antibodies, like the antibodies, which are developed to treat anthrax. They have an extreme high affinity for the lethal factors of the bacterium and stop the disease, but the same antibodies could be misused to select the most pathogenic strains. Microorganisms have from nature itself the capacity to reorganize and change their pathogenicity, which could lead to a pandemic spread of a disease. But if the disease is too infectious and too deadly, like some stains of Ebola virus are, the lethality will be locally limited. But if the incubation time is longer in a certain strain of an Ebola virus, the risks on epidemics and even a pandemic is much higher. The knowledge of these natural mutation mechanisms could be misused to weaponries micro-organisms. It enables the engineering of the lethality like it is done with some anthrax strains. Are these laboratory techniques considered as public science or should it be classified? Academics want to publish and to share information for the progress of science and to find useful applications. The Rotterdam scientists were really annoyed when their research was blocked for publication and feared that other groups would be first in publishing a part of their obtained experimental results. Biosafety is already common practice in micro-biology, but biosecurity is often still questionable. A ‘Code of Conduct’, like the Dutch Academy of Science has developed, would help; especially for the so-called insider risk. Educational programs for the identification and assessment of risks and threats to security have to be developed to give scientists bio-threat awareness and for government officials to rationalize the real threat, without damaging the progress of science.
Keynote Forum
Tahseen J Siddiqui
Norwegian American Hospital, USA
Keynote: Bugs can be busted: How to prevent healthcare acquired infections?
Biography:
Dr. Siddiqui is an American board-certified Internist and Infectious Disease specialist. Graduated from University of Karachi, Pakistan (1986), and postgraduate diplomate (MRCP) from the Royal College of Physicians of Ireland (1997). He completed residency training in Internal Medicine from University of Iowa Hospitals & Clinics, Iowa City, IA, U.S.A (2001) and specialized in adult Infectious Diseases from Loyola University Medical Center, Maywood, IL, U.S.A (2003) He also acquired postgraduate medical education and training from UK/Ireland by completing fellowship training in General Medicine/Pulmonary Diseases from Beaumont Hospital, affiliated with the Royal College of Surgeons of Ireland, Dublin. (1998), and practiced medicine for a decade in Europe. He is currently a practicing Infectious Disease specialist in the U.S in both the clinical as well as academic settings and holds various leadership positions including Chair, Infection Prevention & Department of Medicine, Clinical & Teaching Faculty of Family Medicine & Podiatry Residency Programs at Norwegian American Hospital, Chicago, IL; Medical Director of Clinical Excellence at Saint Bernard Hospital, Chicago, IL, Clinical & Teaching Faculty of Family Medicine Residency Program at Jackson Park Hospital & Medical Center, Chicago; Asst. Professor of Medicine at St. George University Medical School, and President of Chicago Infectious Disease Physicians Group.
Abstract:
No one likes bugs! Especially when they are acquired and transmitted to affect the most vulnerable patient population that reside in a healthcare setting. HAIs can have devastating effects on physical, mental/emotional and financial well-being of patients as well as costing billions of dollars to the healthcare system. Additionally, growing number of HAIs are caused by antibiotic resistant pathogens. In the U.S, there were an estimated 687,000 Healthcare Acquired Infections (HAIs) in acute care hospitals were reported to CDC each year. About 72,000 hospital patients with HAIs died during their hospitalization. On any given day, about 1 in 31 hospital patients have at least one healthcare-associated infection. At Norwegian American Hospital, a 200-bed nonprofit safety-net community hospital in Chicago, IL, USA, we have been able to significantly reduce the rates of HIAs, especially catheter-associated UTIs (CAUTI), Central Line-Associated Blood Stream Infections (CLABSI), MRSA infections and C. Difficle Infections (CDI) by creatively developing and successfully implementing preventive strategies and infection prevention tools. As a result, in 2014, Norwegian American Hospital was recognized for having the lowest rate based on publicly available data of hospital-acquired infections of the 67 hospitals in the greater Chicago area. It was also recognized as top 10% in the country for patient safety by health grades and received an honorary Gage Award from America’s Essential Hospitals in 2015.
- Tropical Diseases | Respiratory and Pulmonary Infectious Diseases | Veterinary Infectious Diseases | Infectious Diseases and Cancer | Microbial InfectionsTropical Diseases | Respiratory and Pulmonary Infectious Diseases | Veterinary Infectious Diseases | Infectious Diseases and Cancer | Microbial Infections
Session Introduction
Anita P D Nugroho
Sulianti Saroso Infectious Disease Hospital, Indonesia
Title: Surveillance of under investigated Middle East respiratory syndrome coronavirus cases in the framework of public health emergency of international concern at Sulianti Saroso Infectious Diseases Hospital period from 2014-2018
Biography:
Anita P D Nugroho has her expertise in surveillance and research in epidemiology field. She has completed her Master of Health at University of Respati, Indonesia. She has worked at Sulianti Saroso Infectious Diseases Hospital since 2001 and from 2014 as an Epidemiology Staff at Directorate of Infectious and Communicable Diseases Research.
Abstract:
Middle East Respiratory Syndrome Corona Virus (MERS-CoV) is a new strain of the corona virus, approximately 80% of human cases reported by Saudi Arabia Kingdom. Cases identified outside the Middle East are people who were infected in the Middle East and travelled to areas outside the Middle East. In Public Health Emergency of International Concern (PHEIC), MERS case requires assessment of risk to human health, risk of international spread of disease and risk of interference with international travel. Early detection of MERS case is through surveillance at the entrance of the country and regional surveillance. Indonesia is the country with the majority Muslim population has a high history travel to Saudi Arabia for Hajj and Umrah. Sulianti Saroso Infectious Diseases Hospital (SSIDH) is national referral hospital for infectious and communicable diseases in Indonesia has task to organize management and surveillance of infectious diseases including new emerging, re-emerging and tropical disease. For MERS case, SSIDH implementing case management and surveillance case for under investigated MERS cases hospitalized. The objective of the study is to describe disease under investigated MERS cases whose hospitalized period 2014-2018. The method includes the passive surveillance. The results of the study are the trend of under investigated MERS cases hospitalized has decreased. The number of hospitalized cases based on sex was 52% for male, 82% was 45 years old above. Based on travel history was 66.7% for Umrah, region origin were 31% cases from areas outside Jakarta. Most patients referenced from hospital and final diagnosis was pneumonia (66%). The laboratory results for all cases period 2014-2018 were negative MERS-CoV. This study concluded that there are no positive of MERS-CoV, most of under investigated MERS cases with pneumonia. Sustainable surveillance is needed as early warning for emerging and reemerging diseases especially MERS.
Zarema Obradovic
University of Sarajevo, Bosnia and Herzegovina
Title: Tropical diseases-challenge for Bosnia and Herzegovina
Biography:
Zarema Obradovic is currently working as a Professor of Epidemiology, Faculty for Health Studies, University of Sarajevo, Bosnia and Herzegovina. He has completed his PhD in Epidemiology and published over 220 scientific papers in different publication, medical journals, national and international symposiums and congresses. He serves as the President of Association of Epidemiologists of FB&H, Member of Bosnian-Herzegovinian American Academy of Arts and Sciences (BHAAAS), Member of International Society of Travel Medicine (ISTM) and also Editorial Board Member for Journal of Health Sciences.
Abstract:
According to WHO tropical diseases encompass all diseases that occur solely, or principally, in the tropics. In practice, the term is often taken to refer to infectious diseases that thrive in hot, humid conditions, such as malaria, leishmaniasis, schistosomiasis, onchocerciasis, lymphatic filariasis, Chagas disease, African trypanosomiasis and dengue. How to connect tropical diseases and Bosnia and Herzegovina? This is a small country in the heart of Europe, with a predominantly continental climate and only in the southern regions, along the Adriatic coast, the climate is Mediterranean, similar to the tropical. However, tropical diseases becoming more significant for several reasons: Increasing number of B&H travelers traveling to the tropics, increasing number of travelers arriving to B&H from the tropics countries, the globalization of all kinds of goods and climate change and habitat change for vectors (reservoirs and disease carriers). In the past, until 1970, there was indigenous malaria in B&H, then it was eradicated, but we have anopheles, disease transmitters and imported cases of malaria as reservoirs of the disease, which means we have a risk for occurrence new malaria cases. We have also some sporadically cases of leishmaniasis. The common fact is that tropical diseases are significant for B&H and therefore we need to do more to educate health professionals how to prevent, to recognize and treat patients with tropical diseases. It is also important to make the general population aware of these diseases and the measures to prevent them.
Jamiatul Hoer
Sulianti Saroso Infectious Disease Hospital, Indonesia
Title: Surveillance report of rabies transmitting animal bite case at Sulianti Saroso Infectious Diseases Hospital in 2015-2018
Biography:
Jamiatul Hoer has expertise in surveillance and research in epidemiology field. He has completed his Bachelor of Public Health and worked at Sulianti Saroso Infectious Diseases Hospital as an Epidemiology Staff at Directorate of Infectious and Communicable Diseases Research.
Abstract:
Rabies is an infectious acute disease in the central nervous system (brain) caused by the rabies virus. It is transmitted through mucosal exposure to infected animals, such as rabid dogs, cats, apes/monkeys and sometimes other species. Dogs were the most common rabies-transmitting animals in Indonesia, followed by cats and apes/monkeys. To support rabies-free program in Indonesia by 2020, rabies surveillance is needed to find out the distribution and cases enhancement. The aim of this study is to provide a comprehensive picture of rabies-transmitting animals bite cases during 2015-2018 at Sulianti Saroso Infectious Disease Hospital. This report used the passive and active surveillance method by retrieving data from emergency installation unit register book and hospital data system. The results showed that the rabies-transmitting animal’s bite cases from 2015 to 2018 has increased while for VAR used has decreased. By age, most cases occur at 20-64 years, both men and women. Most types of rabies-transmitting animals were dogs. The biggest patient domicile is from the North Jakarta area. From 2015-2018, the number of cases of rabies-transmitting animals bites cases increased and the use of VAR decreased.
Ali A Ghweil
South Valley University, Egypt
Title: Reactivation of herpes virus in patients with hepatitis C treated with direct-acting antiviral agents
Biography:
Ghweil Ali Abdelrahman was a Resident of (Tropical medicine and Gastroenterology) for three years. He worked as a Clinical demonstrator and assistant lecturer of Tropical medicine and Gastroenterology, Sohag University. He was working as a Lecturer of Tropical medicine and Gastroenterology, South Valley University. Currently, he is the Head of Tropical Medicine and Gastroenterology department, South Valley University. He is also a member of the European Society of Liver Diseases (EASL).
Abstract:
We performed a case-series analysis of reactivation of herpes virus in patients with Hepatitis C Virus (HCV) infection treated with Direct-Acting Antiviral (DAA) agents. Eight cases were detected among 100 treated patients with direct acting antiviral regimens in Qena University Hospital from June 2016 to June 2017. Herpes virus was reactivated in 8 patients who received DAA therapy. None of the cases had risk factor for HZ reactivation. The DAAs used regimens were Sofosbuvir/Daclatasvir in 6 cases and Sofosbuvir/ Ledipasvir in 2 cases. Immune changes that follow HCV clearance might lead to reactivation of other viruses, such as herpes virus. Patients with HCV infection suspected of having herpes virus infection should be treated promptly.
Biography:
Abstract:
A birthmark is a marking on the skin present at birth or which appears shortly after birth. Birthmarks vary in size and shape, and can be blue, black, tan, brown, pink, red, purple and even white. Some are smooth, and some are raised and rough, but mostly, birthmarks are painless and harmless. They are not punishment for anything you or your baby did at any point, and don't indicate a latent power. Growing up with a visual birthmark is often emotionally embarrassing and upsetting as peer pressure and name-calling occur which causes self-esteem issues that often persist into adulthood. Some birthmarks may even serve as indicators of underlying health issues. To be extra safe, it's important to have a doctor check your baby's birthmarks, if rapid changes are seen. You do have options when it comes to removal of vascular birthmarks. It is congenital, benign irregularity on the skin, occur anywhere on the skin. They may be caused by overgrowth of blood vessels, melanocytes (as a result of inconsistencies in pigmentation), smooth muscle, fat, fibroblasts, or keratinocytes. Some kids have small marks and others have bigger ones. Some go away on their own, and others stick around whole life. The dermatologist can decide if treatable or just to leave it alone. They are of two types: Pigmented and vascular. If born with a mole, it is considered a birthmark or beauty marks. Moles usually are small, brown spots, sometimes can be larger and of different colors, like pink, skin-colored or black. Some are flat and smooth; some are raised above the skin like a slight bump. If a mole itches or bleeds, than have to be checked out to make sure it is benign.
Anita P D Nugroho
Sulianti Saroso Infectious Disease Hospital, Indonesia
Title: Surveillance of under investigated Middle East respiratory syndrome coronavirus cases in the framework of public health emergency of international concern at Sulianti Saroso Infectious Diseases Hospital period from 2014-2018
Biography:
Abstract:
Middle East Respiratory Syndrome Corona Virus (MERS-CoV) is a new strain of the corona virus, approximately 80% of human cases reported by Saudi Arabia Kingdom. Cases identified outside the Middle East are people who were infected in the Middle East and travelled to areas outside the Middle East. In Public Health Emergency of International Concern (PHEIC), MERS case requires assessment of risk to human health, risk of international spread of disease and risk of interference with international travel. Early detection of MERS case is through surveillance at the entrance of the country and regional surveillance. Indonesia is the country with the majority Muslim population has a high history travel to Saudi Arabia for Hajj and Umrah. Sulianti Saroso Infectious Diseases Hospital (SSIDH) is national referral hospital for infectious and communicable diseases in Indonesia has task to organize management and surveillance of infectious diseases including new emerging, re-emerging and tropical disease. For MERS case, SSIDH implementing case management and surveillance case for under investigated MERS cases hospitalized. The objective of the study is to describe disease under investigated MERS cases whose hospitalized period 2014-2018. The method includes the passive surveillance. The results of the study are the trend of under investigated MERS cases hospitalized has decreased. The number of hospitalized cases based on sex was 52% for male, 82% was 45 years old above. Based on travel history was 66.7% for Umrah, region origin were 31% cases from areas outside Jakarta. Most patients referenced from hospital and final diagnosis was pneumonia (66%). The laboratory results for all cases period 2014-2018 were negative MERS-CoV. This study concluded that there are no positive of MERS-CoV, most of under investigated MERS cases with pneumonia. Sustainable surveillance is needed as early warning for emerging and reemerging diseases especially MERS.
Herlina
Sulianti Saroso Infectious Disease Hospital, Indonesia
Title: Surveillance of diphtheria cases, inpatient in Sulianti Saroso Infectious Diseases Hospital from 2015-2018 Herlina, Sulianti
Biography:
Herlina is currently working as an Epidemiology Staff at Sulianti Saroso Infectious Diseases Hospital and also a Lecturer at UHAMKA Faculty of Pharmacy and Science.
Abstract:
Diphtheria is caused by Corynebacterium diphtheriae and almost all over the world causes an outbreak. This disease mainly attacks children aged 1-12 years. Easy to spread and transmitted by direct contact with droplet. Diphtheria prevention is conducting an immunization program. The objective of the study is to obtain an overview of the epidemiological surveillance of diphtheria inpatients period 2015-2018 at Sulianti Saroso Infectious Diseases Hospital based on person, place and time. The method of this study includes passive surveillance by taking patient data from medical record status. The results showed that the there was an increase in cases of hospitalized diphtheria period 2015-2018. Diphtheria cases in patient based on sex and age from 2015-2018 were children (408 cases) bigger than adult (203 cases) and male (318 cases) bigger than female (293 cases). Based on the origin of referrals were hospital 247 cases; health center 171 cases; come alone 06 cases and clinic 87 cases. Based on domicile, the biggest from outside Jakarta with 236 cases and North Jakarta with 126 cases. Based on laboratory culture confirmation were 2 (2015); 5 (2016); 7 (2017) and 45 (2018). Based on life status (death) were 2 (2016); 3 (2017) and 10 (2018). Diphtheria cases based on epidemiology criteria: Total patients come with suspected diphtheria (sign and symptoms like diphtheria) from 2015-2018 were 611 cases, consist of 211 patients were non-diphtheria (sign and symptoms like diphtheria but final diagnosed not diphtheria) and 400 patient’s diagnosed to probable diphtheria (clinical diphtheria). From probable diphtheria, 69 patients diagnosed to confirmed diphtheria (clinical diphtheria and positive laboratory diphtheria). This study concluded that the diphtheria hospitalized at SSIDH was increased. National preparedness of diphtheria is needed, especially case finding in community to break the chain transmission of diphtheria, strengthening surveillance networking regarding follow-up of the diphtheria patients.
- Microbial Infections | Antimicrobials/ Antibiotics/ Antibacterials | Respiratory Diseases
Session Introduction
Heri Sutanto
Universitas Brawijaya, Indonesia
Title: Correlation between leukopenia and hospital length of stay in dengue infection
Biography:
Heri Sutanto MD, staff of Tropical and Infectious Disease Division in Internal Medicine of Brawijaya University – Saiful Anwar Hospital, Malang – Indonesia. Board Certified in Internal Medicine (2014-present). Graduate from Medical Faculty of Brawijaya University. Experience as a site investigator for malaria therapy research base arthesunate combination in 2008 at Sikka-South East Nusa and site investigator for phase III using of Biological Agent in Rheumatoid Arthritis in 2013 at Saiful Anwar Hospital – Malang. Work as a Physisian in state of Malang East Java Since 2007, and Lecturer in Medical Faculty Brawijaya University since 2015.
Abstract:
Dengue infection is a disease caused by dengue virus. Dengue infection sometimes requires hospital admission and even intensive care observation. There is evidence of dengue virus replication in bone marrow leukocytes. Low leukocyte level is associated with more complicated dengue infection. The aim of this study is to determine the relationship between leukocyte levels and Length of Stay (LOS) in patients with dengue infection. This research was conducted at Marsudi Waluyo Singosari Hospital. Data was taken from medical records through 2016-2019, with 201 patients who met WHO clinical criteria for dengue infection. The effect of leukopenia on hospital length of stay, platelet counts and hematocrit levels of the patients was analyzed by the Mann-Whitney method. There was correlation between leukopenia and length of stay (p≤0.001) on patients with dengue infection but not related to platelet counts (p=0.350) and hematocrit levels (p=0.467). The correlation was LOS (day) =3.051+0.516(Diagnosis) + (-.000011)(Lowest Thrombocyte)+0.793 (Leucopenia)(Diagnosis 1=Dengue Fever, 2=Dengue Hemorraghic Fever), lowest thrombocyte (score), Leucopenia (0 =Leucopenia(-), 1=Leucopenia (+)). Leukopenia correlated hospital length of stay in patients with dengue infection.
Ghweil Ali Abdelrahman
South Valley University, Egypt
Title: Liver stiffness predicts relapse after direct acting antiviral therapy against chronic hepatitis C virus infection
Biography:
Ghweil Ali Abdelrahman was a Resident of (Tropical medicine and Gastroenterology) for three years .He worked as a Clinical demonstrator and assistant lecturer of Tropical medicine and Gastroenterology, Sohag University. He was working as a Lecturer of Tropical medicine and Gastroenterology, South Valley University. Currently, he is the Head of Tropical Medicine and Gastroenterology department, South Valley University. He is also a member of the European Society of Liver Diseases (EASL).
Abstract:
Introduction & Objective: Assessment of fibrosis in chronic hepatitis has always been considered of utmost relevance for patient care in clinical hepatology. Over the last years, multiple non-invasive methods were used for diagnosis of hepatic fibrosis, including transient Elastography in addition to clinical and biochemical parameters or combinations of both methods. Serum markers and elastography are considered useful techniques for diagnosing severe liver fibrosis and cirrhosis and for excluding significant fibrosis in hepatitis C virus infected patients. Also, liver stiffness may help to foretell treatment response to antiviral therapy. The objective of this study is to evaluate changes of Transient elastography values as well as serum fibronectin and AST to Platelet Ratio Index in patients (APRI) treated with Sofosbuvir-based treatment regimen. Method: This is a follow-up study including 100 chronic HCV Egyptian patients treated with Sofosbuvirbased treatment regimen. Transient elastography values were recorded as well as serum fibronectin and APRI were calculated at baseline and SVR12. Results: There was a significant improvement of platelets counts, ALT and AST levels, which in turn cause significant improvement in APRI scores at SVR12. Liver stiffness measurements were significantly lower at SVR12 (15.40±8.96 vs. 8.82±4.74 kPa, P=0.000). There was significant decline in serum fibronectin from baseline to SVR 12 (524.14±237.61 vs. 287.48±137.67, P=0.000).