Catching Flu From Money

From the NY Times (Well blog):

The influenza virus can survive on paper money for 10 or more days — suggesting that when we shop, spend and bank, there’s more than cash that is changing hands.

The link between flu virus and paper currency is explained this week in a story on The findings don’t mean we should fret about handling currency — but it does illustrate why health officials repeatedly tell people to wash hands frequently. From the SmartMoney report:

Generally speaking, scientists interviewed by SmartMoney estimate the lifetime of a plain flu virus deposited on money at an hour or so. But mix in some human nasal mucus, and the potential for the virus to hang on long enough to find a victim increases, according to one of the few scientific studies done on flu transmission through cash.

In a study conducted at Switzerland’s Central Laboratory of Virology at the University Hospitals of Geneva, researchers tested to see what would happen when flu virus was placed on Swiss franc notes. In some of these tests, researchers placed flu virus mixed in with nasal secretions from children on banknotes —and saw some unexpected results.

When protected by human mucus, the flu cells were much hardier—in some cases, lasting up to 17 days on the franc notes. The virus that persisted for 17 days was a form of influenza A called H3N2. In an e-mail interview, Dr. Yves Thomas said samples of an influenza A strain called H1N1 also endured for quite a bit — in some cases, up to 10 days. That bug was similar but not identical to the virus at the center of the current swine flu outbreak, which is considered a new strain of H1N1.

Humeral Intraosseous Access

From Emergency Physicians Monthly’s “Tech Doc”:

While interosseous (IO) access is not a new topic, its use in adults is still not widely utilized.  I cannot count the number of times I’ve seen individuals struggle for peripheral or central access in an unstable patient when all they really need are a few seconds and an IO device. Several adult IO devices have hit the market in the past few years, and in my opinion the cream of the crop is Vidacare’s EZ-IO. It is faster and easier to insert than a Jamshidi and has more control than a BIG.  If you can handle an electric drill then you can use an EZ-IO.

The standard approach with adult IO needle insertion is to find the flat portion of the tibial plateau and insert the needle. While this is usually the fastest and easiest option it is not always available. The tibial approach should be avoided if there is overlying infection, trauma or recent orthopedic intervention in close proximity to the insertion site, fracture of the tibia, inability to locate landmarks, or significant trauma above the level of the tibial insertion site.  If any of the above are the case you must look for alternative approaches. With the EZ-IO this leaves you three options: sternum, malleolus, and humerus.

Use of Rapid Influenza Diagnostic Tests for Patients with Influenza-like Illness during the Novel H1N1 Influenza Virus (Swine Flu) Outbreak

A recent update on the CDC site.

Rapid influenza diagnostic tests can help in the diagnosis and management of patients who present with signs and symptoms compatible with influenza. Such tests detect seasonal influenza A and B viral nucleoprotein antigens in respiratory specimens. The currently circulating novel H1N1 influenza virus (also referred to as swine flu) is an influenza A virus. Data are not yet available to inform recommendations on the use of rapid influenza diagnostic tests in patients with novel H1N1 virus infection. It is reasonable to assume that rapid diagnostic tests that detect influenza A viral nucleoprotein antigen can detect novel H1N1 flu infection in respiratory specimens as these nucleoprotein antigens are highly conserved across influenza A viruses. However, the sensitivity and specificity of the different rapid tests is not yet known for this novel virus. CDC has received anecdotal reports of false positive and false negative results. Clinicians may consider using rapid diagnostic tests as part of their evaluation of patients with signs and symptoms compatible with influenza, but results should be interpreted with caution. Confirmation of novel H1N1 flu infection can only be made by reverse-transcription polymerase chain reaction (RT-PCR) or viral culture.

VA Breach in Prescription Monitoring Program

From the Virginia Department of  Health Professions:

Statement by DHP Director Sandra Ryals on Potential Breach of
Security for Prescription Monitoring Program

RICHMOND – Sandra Whitley Ryals, Director of the Virginia Department of Health Professions (DHP), issued the following statement today regarding a potential breach of security for the Prescription Monitoring Program mandated by Virginia state law: “A criminal investigation is currently underway regarding a potential security breach of the Virginia Department of Health Profession’s (DHP) Prescription Monitoring Program on Thursday, April 30. While DHP cannot comment directly on an ongoing investigation, we can assure the public that all precautions are being taken for DHP operations to continue safely and securely.

“Since last week, when DHP recognized an unauthorized message was posted on the Prescription Monitoring Program website, we have been working very closely and cooperatively with federal and state law enforcement to resolve the situation. The entire DHP system has been shut down since Thursday to protect the security of the program data, and state authorities including the

Virginia Information Technologies Agency (VITA) and the Virginia State Police were notified immediately upon identifying the potential breach.We are satisfied that all data was properly backed up and that these backup files have been secured.

“As the criminal investigation permits, we will be sharing additional details in the coming days on the agency’s website ( including questions and answers for concerned program participants.”

About the Prescription Monitoring Program:

Mandated by Virginia law, the Prescription Monitoring Program collects required prescription information from pharmacies across the state for certain types of drugs, such as highly addictive pain killers. Designed to help reduce drug abuse, theft, and illegal sale of prescription drugs, the prescription information is made available only to registered users of the system, including licensed drug prescribers. The program does not collect or maintain medical histories of patients.