Preview of “asymptomatic Beijing H7N9 raises pandemic concerns” copy
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Emergency management of agitation: Reuben Strayer
Rueben Strayer provides a masterclass in droperidol for emergency management of agitation. He discusses sedation in three patient groups.
Agitated but cooperative
If the patient is agitated but cooperative there is no concern for a dangerous condition. They respond well to some company and a sandwich. Drug therapy in this group is relatively straightforward.
Disruptive without danger
You can converse and engage with this group; however, they are not responsive to suggestion. They are loud and disruptive and need to be sedated. You can do a history and exam and be fairly confident that there is no dangerous underlying condition.
There is no threat to themselves or others. They can be managed by observation in an unmonitored bed. So, you can sacrifice speed of sedation to ensure safety. Simple and well worn, tried and tested methods of mixed medical sedation are fine in this situation. And Reuben stresses this… it is fine. To be better than fine, consider a single agent - droperidol. Droperidol is the most effective and safest agent for undifferentiated agitation.
If droperidol is unavailable the next best choice is midazolam intramuscularly. Be careful. Dosage is trickier in this situation. You need to monitor for respiratory depression and ne prepared to manage it. It works quickly but has a narrow therapeutic window. As such, for unmonitored patients, Reuben combines drugs to get away with smaller doses. Listen in to learn how!
Excited delirium
This patient is rare. But this is a dangerous situation. A few clues are the patients who are thrashing, angry, incoherent, un-engageable. They may have a fluctuating level of consciousness. Have a low threshold if you are not sure – err on the side of caution and treat as excited delirium.
How do you treat this person? Five strong people are needed (not including those administering care), one for each limb plus one at the head. Administer high flow oxygen via a mask immediately. Do not wait for sats or vitals. This stops spit and provides oxygen! Get the patient out of dangerous positions such as the “hogtie” position and ensure no one is applying pressure to the chest or neck.
Next chemical restraint – IM shot as soon as possible. This is as opposed to any mechanical restraints. The priority is immediate control. This allows you time to properly assess and treat the patient whilst ensuring their safety and the safety of the treating team.
Join Reuben for a no nonsense run through of managing the agitated patient.
Rtpcr
The laboratory report summarizes a COVID-19 test for a patient named C K Wasiq. The test was for SARS-CoV-2 detection using real-time PCR on a nasopharyngeal/oropharyngeal swab sample. The test result was negative, indicating that SARS-CoV-2 RNA was not detected in the sample. The report provides background information on coronaviruses and COVID-19, and notes that a negative result does not rule out infection and should be considered with the patient's clinical history and presentation. The report was reviewed and signed by two consulting microbiologists.
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The document is a laboratory report for a COVID-19 test. It reports that the SARS-CoV-2 test for the patient Abdul Nishad U H was negative. The test was performed using a nasopharyngeal/oropharyngeal swab sample with real-time polymerase chain reaction (RT-PCR) methodology. Coronaviruses can cause illness ranging from the common cold to more severe diseases. SARS-CoV-2 is a new coronavirus identified as the cause of the COVID-19 outbreak. A negative test result does not rule out infection and should be considered with the patient's clinical history and presentation.
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The laboratory report summarizes a COVID-19 test for a patient named Ebrahim Sanooj. The test was performed on a nasopharyngeal/oropharyngeal swab sample collected on December 9, 2021 and reported on September 13, 2021. The test result was negative for SARS-CoV-2. The report provides information on the test method, the pathogen, and interpretations for positive and negative results. It concludes there is no presence of the SARS-CoV-2 virus in the patient's given specimen.
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Emergency management of agitation: Reuben Strayer
Rueben Strayer provides a masterclass in droperidol for emergency management of agitation. He discusses sedation in three patient groups.
Agitated but cooperative
If the patient is agitated but cooperative there is no concern for a dangerous condition. They respond well to some company and a sandwich. Drug therapy in this group is relatively straightforward.
Disruptive without danger
You can converse and engage with this group; however, they are not responsive to suggestion. They are loud and disruptive and need to be sedated. You can do a history and exam and be fairly confident that there is no dangerous underlying condition.
There is no threat to themselves or others. They can be managed by observation in an unmonitored bed. So, you can sacrifice speed of sedation to ensure safety. Simple and well worn, tried and tested methods of mixed medical sedation are fine in this situation. And Reuben stresses this… it is fine. To be better than fine, consider a single agent - droperidol. Droperidol is the most effective and safest agent for undifferentiated agitation.
If droperidol is unavailable the next best choice is midazolam intramuscularly. Be careful. Dosage is trickier in this situation. You need to monitor for respiratory depression and ne prepared to manage it. It works quickly but has a narrow therapeutic window. As such, for unmonitored patients, Reuben combines drugs to get away with smaller doses. Listen in to learn how!
Excited delirium
This patient is rare. But this is a dangerous situation. A few clues are the patients who are thrashing, angry, incoherent, un-engageable. They may have a fluctuating level of consciousness. Have a low threshold if you are not sure – err on the side of caution and treat as excited delirium.
How do you treat this person? Five strong people are needed (not including those administering care), one for each limb plus one at the head. Administer high flow oxygen via a mask immediately. Do not wait for sats or vitals. This stops spit and provides oxygen! Get the patient out of dangerous positions such as the “hogtie” position and ensure no one is applying pressure to the chest or neck.
Next chemical restraint – IM shot as soon as possible. This is as opposed to any mechanical restraints. The priority is immediate control. This allows you time to properly assess and treat the patient whilst ensuring their safety and the safety of the treating team.
Join Reuben for a no nonsense run through of managing the agitated patient.
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The laboratory report summarizes a COVID-19 test for a patient named C K Wasiq. The test was for SARS-CoV-2 detection using real-time PCR on a nasopharyngeal/oropharyngeal swab sample. The test result was negative, indicating that SARS-CoV-2 RNA was not detected in the sample. The report provides background information on coronaviruses and COVID-19, and notes that a negative result does not rule out infection and should be considered with the patient's clinical history and presentation. The report was reviewed and signed by two consulting microbiologists.
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The document is a laboratory report for a COVID-19 test. It reports that the SARS-CoV-2 test for the patient Abdul Nishad U H was negative. The test was performed using a nasopharyngeal/oropharyngeal swab sample with real-time polymerase chain reaction (RT-PCR) methodology. Coronaviruses can cause illness ranging from the common cold to more severe diseases. SARS-CoV-2 is a new coronavirus identified as the cause of the COVID-19 outbreak. A negative test result does not rule out infection and should be considered with the patient's clinical history and presentation.
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The laboratory report summarizes a COVID-19 test for a patient named Ebrahim Sanooj. The test was performed on a nasopharyngeal/oropharyngeal swab sample collected on December 9, 2021 and reported on September 13, 2021. The test result was negative for SARS-CoV-2. The report provides information on the test method, the pathogen, and interpretations for positive and negative results. It concludes there is no presence of the SARS-CoV-2 virus in the patient's given specimen.
The star planet “ moon “ in orbitary movements “ different findings .
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In conclusion, Quinine is impactful with positive outcomes for severe or advanced COVID-19 especially after the Cytokine Storm, with 5-7 days total recovery after the onset of the cytokine storm.Due to small preliminary sample size with 100% positive outcome, a full study shoud be commissioned to establish and quantify the impact of Quinine on thousands in a population. This will help to prevent further morbidity in COVID-19 and the cytokine storm will be greatly overcome.
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1. A novel H1N1 influenza virus emerged in Mexico and the US in April 2009 that was a triple reassortment of human, avian, and swine influenza viruses.
2. Researchers developed PCR tests to identify confirmed cases of the virus and help track the outbreak. Health authorities worldwide are monitoring and trying to control the outbreak.
3. As of early May 2009, the virus was causing mild to moderate illness in most patients. However, some hospitalized patients developed pneumonia or other complications, and two deaths occurred in high-risk patients. The age distribution and symptoms resembled typical seasonal influenza.Respiratory.ppt
espiratory?
Respiration consists of 4 distinct processes:
Pulmonary Ventilation. moving air into and out of the lungs. ...
External Respiration.
Transport. transport of oxygen and carbon dioxide between the lungs and tissues.
Internal Respiration. diffusion of gases between the blood of the systemic capillaries and cells.
2019-nCoV
1. The study evaluated the antiviral effects of remdesivir and chloroquine against 2019-nCoV in vitro.
2. Both remdesivir and chloroquine potently blocked infection at low micromolar concentrations and showed clear dose-dependent antiviral effects.
3. Time-of-addition experiments indicated that both drugs targeted the early stages of the 2019-nCoV life cycle.
Covid 19 in children consensus statement
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2. Os usuários podem personalizar imagens, logotipos e texto nos materiais, salvar seu trabalho como rascunhos, baixar provas em PDF ou solicitar impressões.
3. Ao solicitar impressões, os usuários adicionam itens a um carrinho de compras, revisam e finalizam seu pedido, incluindo endereço e pagamento online.
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This is a presentation in Microsof Power Point dedicated to the user-genereted content on-line and the strategies that the publishing industry adopts and could adopt, in order to take advantage of these contents and increase their own business.
ПФР. Отчетность.
Единая форма отчетности плательщиков страховых взносов в органы ПФР по обязательному пенсионному и медицинскому страхованию, начиная с полугодия 2015 года. Особенности заполнения формы РСВ-1.
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6 a jenny mcknight
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Similar to Preview of “asymptomatic Beijing H7N9 raises pandemic concerns” copy
Dethroning CORONA virus
This presentation showed the impact and the challenges of facing COVID-19 Pandemic and how the world becomes morbid, while the healthcare workforce tries to flatten the "curve".
Quinine for covid 19 a case presentation for low and middle income economies
LiveWell Initiative LW, a self funded nonprofit social enterprise which thrives on innovation. (www.livewellng.org) has recommended the use of repurposed Quinine for Moderate to Severe COVID-19 by compiling three (3) sets of STUDY PROTOCOLS in response to the COVID-19 RESPONSE with a goal to arriving at a practical and affordable solution to the pandemic. The Protocols underwent debates and Hypothesis testing among Physicians, Researchers and Virologitsts. They are still undergoing random Physician – Patient Trials at the discretion of Prescribing Clinicians and Clinical Researchers, they are as recommended in a compilation of recent findings by LiveWell Initiative LWI on COVID-19. LiveWell Initiative LWI, a nonprofit organisation, takes no liability for damage from the use of the above suggested STUDY PROTOCOLS FOR COVID-19 RESPONSE. It is a Study Protocol designed to ‘evolve’ as a Solution to COVID-19 Response.
The Protocols strongly suggest the use of Quinine for COVID-19 Treatment in moderate to advanced disease, recommending intravenous infusion of Quinine for critical care in COVID-19. The sample size is small and further studies are recommended but the result is significant. The preliminary results were positive, and posted online even as the concurrent study continues.
In conclusion, Quinine is impactful with positive outcomes for severe or advanced COVID-19 especially after the Cytokine Storm, with 5-7 days total recovery after the onset of the cytokine storm.Due to small preliminary sample size with 100% positive outcome, a full study shoud be commissioned to establish and quantify the impact of Quinine on thousands in a population. This will help to prevent further morbidity in COVID-19 and the cytokine storm will be greatly overcome.
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H1 n1 influenza a disease information for health professionals lindsey_nejm 2009
H1 n1 influenza a disease information for health professionals lindsey_nejm 2009Ruth Vargas Gonzales
1. A novel H1N1 influenza virus emerged in Mexico and the US in April 2009 that was a triple reassortment of human, avian, and swine influenza viruses.
2. Researchers developed PCR tests to identify confirmed cases of the virus and help track the outbreak. Health authorities worldwide are monitoring and trying to control the outbreak.
3. As of early May 2009, the virus was causing mild to moderate illness in most patients. However, some hospitalized patients developed pneumonia or other complications, and two deaths occurred in high-risk patients. The age distribution and symptoms resembled typical seasonal influenza.Respiratory.ppt
espiratory?
Respiration consists of 4 distinct processes:
Pulmonary Ventilation. moving air into and out of the lungs. ...
External Respiration.
Transport. transport of oxygen and carbon dioxide between the lungs and tissues.
Internal Respiration. diffusion of gases between the blood of the systemic capillaries and cells.
2019-nCoV
1. The study evaluated the antiviral effects of remdesivir and chloroquine against 2019-nCoV in vitro.
2. Both remdesivir and chloroquine potently blocked infection at low micromolar concentrations and showed clear dose-dependent antiviral effects.
3. Time-of-addition experiments indicated that both drugs targeted the early stages of the 2019-nCoV life cycle.
Covid 19 in children consensus statement
This document presents an experts' consensus statement on the diagnosis, treatment, and prevention of 2019 novel coronavirus (2019-nCoV) infection in children. It summarizes the current strategies based on previous diagnosis and treatment of pediatric virus infections. The key points are: 1) 2019-nCoV infections in children can range from asymptomatic to mild or severe pneumonia, with most cases being mild; 2) Diagnosis is based on epidemiological history, clinical manifestations, and laboratory tests detecting 2019-nCoV nucleic acid; 3) Treatment involves supportive care, symptom relief, oxygen therapy, and antiviral drugs like interferon-α; 4) Prevention focuses on isolation of suspected cases and treatment of confirmed cases.
Nipah virus
The document discusses Nipah virus, a zoonotic virus that causes severe disease in humans and animals. It originated in Malaysia in 1998. Bats are natural reservoirs, transmitting the virus to pigs who act as amplifying hosts. Humans contract it through contact with infected bats, pigs, or other humans. Symptoms include fever, cough, vomiting and neurological issues like altered mental status. There is no treatment, only supportive care. Outbreaks have occurred in Bangladesh and India. Prevention involves avoiding contact with bats/pigs and their secretions, proper hygiene and isolation protocols for patients.
Covid-19 Navigating the Uncharted
The editorial discusses the Covid-19 outbreak caused by a novel coronavirus. It summarizes a study describing the first 425 cases in Wuhan, China, noting the median age was 59 and higher mortality in the elderly and those with preexisting conditions. While the current fatality rate is around 2%, it may ultimately be closer to seasonal flu if asymptomatic cases are accounted for. The virus has an estimated reproduction number of 2.2, indicating rapid spread. Countries have implemented travel restrictions and should prepare for broader community spread, potentially using social distancing and isolation measures. Research efforts are underway to develop treatments and a vaccine.
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This study investigated potential serological cross-reactivity between COVID-19 and dengue patients. Among 32 COVID-19 positive serum samples, no positive dengue virus (DENV) IgG/IgM results were observed. However, one false-positive result was observed among 44 DENV-positive serum samples tested for COVID-19 antibodies using two different rapid tests. While cross-reactivity between the viruses appears low based on this limited study, more data is needed on the accuracy of COVID-19 diagnostic tests, especially in regions where multiple tropical diseases are endemic.
Development of Henoch-Schonlein Purpura Post COVID-19 Vaccination: A Case Report
This is a case involving the development of fever, joint pain, and
bilateral lower limb rashes an hour after COVID-19 vaccination,
and subsequently diagnosed with Henoch- Schonlein Purpura
COVID-19: An Approach for EMS
This document provides an overview of COVID-19 for EMS providers, including terminology, the origins and spread of the virus, clinical presentation, screening and risk assessment, treatment considerations, infection control protocols, and recommendations for interacting with the public. Key points covered include how the virus is transmitted, projected disease course, limitations of current testing and treatment options, importance of PPE and prenotification, and dispelling common myths. The goal is to equip EMS with up-to-date facts and best practices for responding safely and effectively during the pandemic.
COVID-19
An evidence based approach to dealing with the novel coronavirus. This will be continually updated as new evidence arises.
FOURNIER’S GANGRENE: REVIEW OF 57 CASES IN TERTIARY INSTITUTION
Fournier’s gangrene which is a rapidly progressive, fulminant polymicrobial synergistic infection of the perineum and genitals is now changing its pattern. Both genders can be affected and the mortality is still high (around10%). The clinical presentation in many patients in early stage may not be prominent. Thus rapid and accurate diagnosis is must for prompt treatment. Extensive surgical debridement and broad spectrum intravenous antibiotic remains the mainstay of treatment in order to reduce the morbidity and mortality.
Peds.2020 07021
This study examined the epidemiological characteristics of 2143 pediatric patients with COVID-19 in China. The key findings were:
1) Children of all ages appeared susceptible to COVID-19, with the median age being 7 years and no significant gender difference.
2) Over 90% of pediatric cases were asymptomatic, mild, or moderate in severity. However, young children and infants were more vulnerable to infection.
3) The number of pediatric cases rapidly increased in early January and peaked around February 1st before declining, indicating person-to-person transmission. Most cases were in Hubei province and surrounding areas.
Peds.2020 07020
This study examined the epidemiological characteristics of 2143 pediatric patients with COVID-19 in China. The key findings were:
1) Children of all ages appeared susceptible to COVID-19, with the median age being 7 years and no significant gender difference.
2) Over 90% of pediatric cases were asymptomatic, mild, or moderate in severity. However, young children and infants were more vulnerable to infection.
3) The number of pediatric cases rapidly increased in early January and peaked around February 1st before declining, indicating person-to-person transmission. Most cases were in Hubei province and surrounding areas.
Persistant pneumonia
This document discusses persistent pneumonia, defined as the persistence of symptoms and radiographic abnormalities for more than 1 month. It lists common causes like congenital malformations of the airways and lungs, aspirations, defects in airway secretions clearance, and disorders of immunity. Investigations discussed include hematological tests, chest X-ray, sputum tests, and bronchoscopy if abnormalities are suspected. Treatment involves therapy for current infections and any underlying diseases.
COVID 19
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, in the Hubei Province of China. It is rapidly spreading, resulting in an epidemic throughout china, followed by an increasing number of cases in other countries throughout the world. In February 2020, the WHO designated the disease COVID 19, which stands for corona viruses 2019. The virus that causes COVID 19 is designated severe acute respiratory syndrome coronavirus 2 SARS COV 2 previously, it was referred to as 2019 nCoV. Anushka Bharti | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandul "COVID-19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46439.pdf Paper URL : https://www.ijtsrd.com/pharmacy/pharmaceutics/46439/covid19/anushka-bharti
HIV ITS PREVENTION AND CONTROL
HIV ITS PREVENTION AND CONTROL is a presentation that aim to introduce HIV(Human immunodeficiency Virus),its pathogenesis, clinical manifestation, diagnosis, treatment, prevention and control
Similar to Preview of “asymptomatic Beijing H7N9 raises pandemic concerns” copy (20)
Quinine for covid 19 a case presentation for low and middle income economies
Quinine for covid 19 a case presentation for low and middle income economies
Yale - Tulane ESF-8 MOC Brief Special Report - A(H7N9) 15 April 2013
Yale - Tulane ESF-8 MOC Brief Special Report - A(H7N9) 15 April 2013
H1 n1 influenza a disease information for health professionals lindsey_nejm 2009
H1 n1 influenza a disease information for health professionals lindsey_nejm 2009
CORONAVIRUS RESEARCH ,ASPECTS, SYMPTOMS, CURE, PRECAUTION MEASURES
CORONAVIRUS RESEARCH ,ASPECTS, SYMPTOMS, CURE, PRECAUTION MEASURES
Low risk of serological cross-reactivity between dengue and COVID-19.pdf
Low risk of serological cross-reactivity between dengue and COVID-19.pdf
Development of Henoch-Schonlein Purpura Post COVID-19 Vaccination: A Case Report
Development of Henoch-Schonlein Purpura Post COVID-19 Vaccination: A Case Report
FOURNIER’S GANGRENE: REVIEW OF 57 CASES IN TERTIARY INSTITUTION
FOURNIER’S GANGRENE: REVIEW OF 57 CASES IN TERTIARY INSTITUTION
More from Harm Kiezebrink
Low Atmospheric Pressure Stunning is not a humane alternative to Carbon Dioxi...
I would like express gratitude to the HSA for their 20 years of tireless advocacy for improving pigs' welfare. Their efforts have empowered those seeking alternatives to carbon dioxide stunning. Over nearly 30 years, I've worked on animal welfare friendly stunning applications, particularly regarding stunning/slaughtering using nitrogen foam, and I believe I've found the definitive answer.
The industry originally adopted large-scale carbon dioxide stunning to optimize food production, reduce costs, and lower meat prices, which is only feasible with parallel processing (simultaneously stunning groups of pigs) rather than serial processing (stunning each pig individually). Electrocution is not viable for large-scale operations due to this need for parallel processing. Therefore, a replacement gas that lacks carbon dioxide's detrimental properties is needed, but only a few gases are suitable.
Additionally, the application of an alternative gas must adhere to several fundamental principles:
a) Applicability of the methods for stunning and killing pigs, including their scalability for large-scale application.
b) Description of the technical.
c) Animal welfare consequences associated with specific techniques, including welfare hazards (ABMs), animal-based indicators (ABIs), preventive and corrective measures, and the sufficiency of scientific literature in describing these consequences.
d) Applicability under field conditions.
Introducing a novel application for large-scale pig slaughter is complex and time-consuming before it can be expected, especially given the substantial economic and financial impact for the industry. However, there is hope on the horizon.
The alternative gas is nitrogen, and the application is based on using high-expansion foam filled with 100% nitrogen, applied in a closed container. Within a minute, all air is displaced by the foam, after which the container is sealed, and the foam is broken down with a powerful nitrogen pulse. This ensures that the foam does not affect the stunning process; the entire process can be visually and electronically monitored, and the residual oxygen level in the container is consistently below 2%. The container dimensions are identical to the gondolas used in the globally implemented carbon dioxide gondola system.
The integration of nitrogen foam technology into European regulation EU1099/2009 is nearing completion. All scientific and technical procedures have been submitted to the EU Commission, with finalization awaiting the presentation of EFSA's scientific opinion to the Commission and subsequent approval for inclusion. This final phase is anticipated to occur during the general meeting slated for June 2024.
This marks the first step toward replacing carbon dioxide in 25 years. Fingers crossed for the EU Commission's decision in June 2024!
Harm Kiezebrink
Independent Expert
Preventief ruimen bij vogelgriep in pluimveedichte gebieden en mogelijkheden ...
New Risk assessment model
The applications designed for farrow-to-weaner pig farms rely on a novel risk assessment model. This model, developed from a recent study, indicates that the likelihood of an undetected infection on nearby farms notably diminishes 7 to 14 days following the identification of the source farm.
This risk assessment model is based a Dutch study that is published by T.J. Hagenaars et al on June 30, 2023: “Preventief ruimen bij vogelgriep in pluimveedichte gebieden en mogelijkheden voor aanvullende bemonstering” (Preventive culling in areas densely populated with poultry, and possibilities for additional sampling).
According to this premise, instead of the standard depopulation approach of euthanizing pigs on-site, pigs beyond the immediate vicinity of infected farms are slaughtered.
Animal Health Canada is currently evaluating new strategies and technologies for managing large-scale emergency situations involving pigs. I have been actively involved in developing strategies and procedures aimed at implementing strict control measures for pig euthanasia during emergencies, with a focus on substantially reducing costs by avoiding unnecessary culling and destruction of healthy animals.
Opting for slaughtering over on-farm euthanasia not only reduces the operational burden on farms but also repurposes the pigs as a valuable protein source rather than considering them as animal waste. This approach assists in crisis management during widespread outbreaks, significantly reduces expenses, and simultaneously mitigates risks.
While this approach is influenced by the new EU regulations implemented since May 2022, it can be adapted for implementation within the context of any EU Member state, as well as in the USA and Canada.
Managing large-scale outbreaks at Farrow-to-Weaner Farms
In the face of large-scale outbreaks of swine Influenza A Virus (swIAV), there's a call for exploring various strategies conducive to managing emergencies in field conditions.
Through subdivision, a customized approach can be embraced to enhance operational efficiency and effectiveness while mitigating the impact on individual farms. This tactic maximizes emergency deployment capacity and streamlines standard procedures. Moreover, leveraging the existing capacity of farming aids in alleviating scrutiny on animal welfare standards, presenting a notable advantage.
Nitrogen filled high expansion foam in open Containers
On March 31, 2023 the US National Pork Board validated a study by Todd Williams, of Pipestone Veterinary Services, based on the use of high expansion nitrogen foam for the large-scale depopulation of all classes of swine, utilizing Livetec Systems Nitrogen Foam Delivery System (NFDS).
The high expansion foam produced by the Livetec Systems NFDS surrounds the animal in large bubbles filled with nitrogen with a base expansion ration of between 300 and 350 to 1, as mentioned on the information provided by the producer of the firefighting foam.
The Livetec technology, based on using Compressed Air Foam (CAF) filled with nitrogen instead of air for depopulating pigs, emerges within a critical landscape. The complexities of implementing effective emergency depopulation strategies for livestock, particularly swine, present multifaceted challenges. Livetec's approach relies on high expansion firefighting foam, aiming to euthanize pigs by submerging them in foam.
The Livetec system's claims about the effectiveness of nitrogen-filled high expansion foam for depopulating market pigs lack substantial evidence upon analysis. The discrepancy between the actual foam produced during field trials and the promised high expansion foam, coupled with the absence of concrete proof supporting the method's efficacy, discredits the technology's claims.
World bank evaluating the economic consequences of avian influenza
Pandemics cause very serious loss of life, restrictions of freedom and serious economic damage. Potential pandemics all are related to our dealing with animals, both wild and domesticated.
In this Word Bank study of 2006, the effects of a severe HPAI pandemic (with a highly pathogenic avian influenza virus crossing the species barrier and infecting humans) predicted economic losses from 2-10% of the world economy.
The economic impact of the present COVID-19 crisis, caused by the SARS-CoV2 virus spreading from wild animals to humans, probably will reach the upper limits of this prediction even if the losses of life might be near the lower limits mentioned in the report (1,4 millions rather than 71 millions).
A common observation is that governments were late to react on the COVID-19 outbreak.
Pandemics are rare, so due to cost-benefit considerations emergency preparations do usually not get beyond an advisory (paperwork) phase. When an emergency eventually arises, the response is too late, too little, and with disastrous effects on animal and/or human welfare that could have been avoided. Relatively small, short-term financial savings result in big, long-term losses.
Protection against outbreaks cannot be achieved by political decisions during a crisis. Our dealing with animals, especially in animal production, must be inherently safe so that animal health and public health are protected.
This is recognized in the One Health strategy that has been adopted internationally.
An outbreak of animal disease occurs should be contained at a very early stage. This can only be realized if all farms have their own emergency plans, with equipment to deal with contagious diseases already present at the farm.
Gas alternatives to carbon dioxide for euthanasia a piglet perspective
The use of nitrous oxide as an anesthetic/euthanasia agent may prove to be affordable, feasible and more humane than other alternatives.
The neonatal stage is a critical time in the life of a pig, when they are prone to become sick or weak. This is the stage at which most euthanasia procedures are required if the pig is judged unable to recover. Any euthanasia method should be humane, practical, economical and socially acceptable to be universally accepted.
They found that nitrous oxide in oxygen appeared to be less aversive than nitrous oxide, nitrogen, or argon all combined with low (30%) concentrations of carbon dioxide or 90% carbon dioxide by itself.
This study is the first to investigate the use of nitrous oxide at sufficiently high concentrations to cause anesthesia. Nitrous oxide, commonly referred to as laughing gas, has been widely used in human surgery and dental offices for its pain-relieving, sedative and anxiolytic effects. It is cheap, non-flammable, non-explosive, legally accessible and not classified as a drug in the U.S., and already commonly used in the food industry as a propellant for food products.
Development of its use into an automated procedure will allow producers to implement it with little effort. Thus its use as an anesthetic/euthanasia agent may prove to be affordable, feasible and more humane than other alternatives.
Anoxia - applying the technique
Anoxia: High expansion foam
The Anoxia method is unique for creating an environment without oxygen under atmospheric circumstances. High expansion foam is produced by mixing nitrogen and a mixture of water and specially developed high expansion detergent, with an expansion rate upto 1:1000, meaning that 1 litre of water/foam agent mix expands up to 1 m3 foam. Due to the specially designed foam generator, the high expansion foam bubbles are filled with a > 99% concentration of nitrogen. The oxygen level surrounding the animal drops from 21% in atmospheric air to < 1 % once the animal is submerged in the foam.
Anoxia: convulsions, but no stress or pain
The animals need a constant supply of oxygen to the brain. Applying Anoxia foam, the oxygen is replaced by nitrogen. As a result the nitrogen level is raised to > 99% and the oxygen level is lowered to < 1%. Considering the natural reaction to sudden lack of oxygen the animal is rendering quickly into unconsciousness. As a consequence, behavioral indicators like loss of posture and convulsions will appear. With this in mind, unconscious animals are insensitive to perceive unpleasant sensations like pain.
Anoxia: How Anoxia foam is created
A mixture of 97% water and 3% high expansion foam agent is sprayed into the Anoxia foam generator, creating a thin film on the outlet of the generator. At the same time, nitrogen is added with overpressure into the foam generator. The nitrogen expands when it exits the generator, creating robust high expansion foam. The high expansion foam bubbles are filled with > 99% nitrogen.
Anoxia: Single foam generator systems
In practice, one Anoxia foam generator creates a volume of up to 750 liter of high expansion foam per minute. This volume is more than sufficient to fill a wheelie-bin container within 30 seconds. The most common container volumes are: M size - 240 liter; L size - 340 liter; and XL size - 370 liter. The choice of the volume of the container depends of the size of the animal and/or the number of animals that need to be stunned/killed. A lid with a chiffon that seals the container. As soon as the foam exits the chiffon, the gas supply is stopped and the chiffon is closed. The nitrogen gas concentration in the container remains at 99%.
Animal Euthanasia: What are the challenges?
Although commonly used in other settings, defining animal welfare as part of a corporate CSR setting is not new.
There are many ways to define CSR. What they have in common is that CSR describes how companies manage their business processes to produce an overall positive impact on society. The phenomenon CSR is a value concept that is susceptible to particular ideological and emotional interpretations. Different organizations have framed different definitions - although there is considerable common ground between them.
Some important national players of the food chain at different steps (mainly food retailers and food services) have included animal welfare in their CSR.
Anoxia: what is it?
The Anoxia technique is developed as alternative for existing animal stunning methods that are based on the use of CO2, electrocution, neck dislocation, captive-bolt, as well as killing methods like de-bleeding and maceration.
In the past 10 years, Wageningen University and University of Glasgow conducted several studies that proved that the technique could be applied successfully for culling poultry (Proof of Principle Anoxia Technique). This was the start of the development of several applications based on the Anoxia principle, using high expansion foam filled with >99% Nitrogen that are now introduced for:
1. Stunning and killing of sick and cripple killing piglets less than 5 kg
2. Stunning and killing of sick or cripple poultry (especially poultry > 3kg) who need to be killed on the farm by the staff for welfare purposes (avoiding unnecessary stress or pain)
3. Stunning and killing poultry that arrives on the slaughterhouse but that are unfit to be slaughtered (due to injuries occurred during transportation – providing signs of possible illness etc.)
4. Stunning and killing of male pullets at the hatchery
5. Stunning and killing of half-hatched chickens and embryos in partly-hatched eggs, before destruction
6. Stunning and killing parent stock poultry
7. Killing of animals that has been stunned (captive bolt – blow-on-the-head method, etc.) replacing killing by de-bleeding
8. Culling of ex-layers
9. Culling of poultry for disease control purposes
Last November we started the launch of the commercialization of the Anoxia applications in Holland, Germany and Sweden, focusing on the areas where a solution is most needed: piglets (< 5kg) and poultry (> 3kg) on farms.
Since November 2016, the introduction of these applications took place in Holland, Germany, Sweden and Denmark
WHO warns of H7 N9 pandemic
World Health Organization director- general Margaret Chan Fung Fu-chun warns bird flu H7N9 is particularly worrying as it could be a flu pandemic strain. This is because H7N9 is unique as it does not make chickens sick but is deadly in humans. Sick birds could usually provide early warning for imminent outbreaks, Chan told The Standard. This comes as Macau reported its first human case of H7N9 yesterday. "The biggest challenge for the world is the next influenza pandemic," Chan said.
Laves presentation practical experiences in the culling of poultry in germany
This presentation, based on the practical experiences in culling poultry in Germany, gives an overview of the culling techniques currently in use in Germany. It is presented by dr. Ursula Gerdes, dr. Josef Diekmann and ing. Rainer Thomes.
LAVES is the Lower Saxony State Office for Consumer Protection and Food Safety, located in Oldenburg, Germany. With around 900 employees they are entrusted with tasks in the areas of food and utensil inspection, feed inspection, meat hygiene, veterinary drug monitoring, eradication of animal diseases, disposal of animal by-products, animal welfare, ecological farming, market surveillance and technical process monitoring.
Berg et al. 2014 killing of spent laying hens using co2 in poultry barns
September 2015: In Sweden, spent laying hens are killed either by traditional slaughter; on-farm with CO2 in a mobile container combined with a grinder; or with CO2 stable gassing inside the barn. The number of hens killed using the latter method has increased. During these killings a veterinarian is required to be present and report to the Swedish Board of Agriculture.
Data were registered during four commercial killings and extracted from all official veterinary reports at CO2 whole-house killings in 2008–2010. On-farm monitoring showed that temperature decreased greatly and with high variability. The time until birds became unconscious after coming into contact with the gas, based on time until loss of balance, was 3–5 min.
Veterinary reports show that 1.5 million laying hens were killed, in 150 separate instances. The most common non-compliance with legislation was failure to notify the regional animal welfare authorities prior to the killings. Six out of 150 killings were defined as animal welfare failures, eg delivery of insufficient CO2 or failure to seal buildings to achieve adequate gas concentration.
Eleven were either potentially or completely unacceptable from the perspective of animal welfare. We conclude that, on the whole, the CO2 whole-house gas killing of spent hens was carried out in accordance with the appropriate legislation. Death was achieved reliably.
However, there remain several risks to animal welfare and increased knowledge would appear vital in order to limit mistakes related to miscalculations of house volume, improper sealing or premature ventilation turn-off.
Neutralizing risks instead of stamping-out
The latest outbreak of High Pathogen Avian Influenza in the USA and Canada in the spring of this year and the inability to avoid animal welfare catastrophes ultimately proves that new emergency response strategies are needed. Strategies that are based on taking away the source of infection instead of killing as many animals as possible within 24 hours, regardless the consequences.
The statement that “It’s possible that human infections with these viruses may occur” and that “these viruses have not spread easily to other people” is confusing. Humans can become infected without showing clinical signs. They can become the major carrier of the infection.
Especially during depopulation activities, viruses easily transmit through responders. Tasks like taking layers out of their cages and transport the birds manually through the narrow walkways between the cages, and disposal of infected animals are specific risks that need to be avoided. Simply switching of the electricity so that sick birds don’t have to be handled is not the solution.
Although humans are supposed to be less susceptible, they can become carrier of the virus. Only the highest level of biosecurity could prevent the transmission through the humans and materials that have been in direct contact with infected animals and materials.
Simply switching of the electricity so that sick birds don’t have to be handled is not the solution. Avoid killing animals is always the better option and in Germany, the discussion on the strategy based on neutralizing risks and is in the making. Avoiding situations demands a proactive role of the poultry industry.
Ventilation Shutdown: who takes the responsibility to flip the switch?
On September 18, 2015 the USA Government and the American egg producers announced that they would accept the Ventilation shutdown method as a method of mass destruction of poultry when other options, notably water-based foam and CO2, are not available for culling at the farm within 24-36 hours. This is actually the case on all caged layer farms in the USA, in particular in Iowa.
The Ventilation shutdown method consists of stopping ventilation, cutting off drinking water supply, and turning on heaters to raise the temperature in the poultry house to a level between 38 Celsius and 50 Celsius. Birds die of heat stress and by lack of oxygen in a process that easily takes over after a period of at least 3 days. Ventilation shutdown is a killing method without prior stunning of the birds, and as such is contrary to all international Animal Welfare standards.
Animal welfare specialists in disease control strongly oppose this introduction of the cruelest method of killing poultry that lost their economic value. The Humane Society (HSUS) described it as the “inhumane mass baking of live chickens”. With adequate preparation the alternative methods, like the water-based Anoxia foam method, can be available at each farm for immediate use in case of an outbreak. The ban of the Ventilation shutdown method should therefore be maintained and the Anoxia method should be further developed so that is suitable for application to caged layers and turkeys. In Germany, such a system is currently under development and will become commercially available soon.
The poultry industry in the USA ignores this development and asks for a formal approval of the Ventilation Shutdown method. Speaking on August 19, 2015, during the United Egg Producers (UEP) national briefing webinar, UEP President Chad Gregory explained that much research is being done concerning the feasibility of such a depopulation program.
“The government, the producers, the states and UEP, we all recognize that depopulation is going to have to happen faster and ideally within 24 hours.”
Quick depopulation of affected flocks is important, Gregory said, because the sooner a flock is depopulated, the risk of the virus going into fans and out into the atmosphere becomes smaller. Gregory said ventilation shutdown – if approved – would probably only be used in a worst-case scenario or when all other euthanasia options have been exhausted. Gregory did not elaborate on how to adequately prevent outbreaks and how to promote more animal-friendly methods.
Stamping out strategy failed
In order to become one step ahead of an outbreak of high pathogen diseases like the current H5N2, the veterinary authorities need to stop the outbreak immediately after the first signals occur. Strict and thorough biosecurity measures are the most fundamental feature to protect poultry flocks on farms.
Without functional culling techniques, the options to effectively and efficiently cull in average more than 925,000 chickens per farm (in Iowa, USA) are limited: either by macerating the chickens alive – or by ventilation shut-down (closing down all ventilation, placing heaters inside the house, and heat the entire house to a temperature higher than 600 C).
Although both methods cause death of the birds, it has not been proven to be effective nor efficient. The primary goal to slowdown outbreaks and bring it to a complete stop but macerating live birds and killing them by heat stress and lack of oxygen would be against all International Animal Welfare standards.
Animal welfare specialists in disease control strongly oppose against the introduction of these most cruel methods of killing poultry and argue that the ban on these methods should be maintained and alternative methods need to be considered.
FLI Seminar on different response strategies: Stamping out or Neutralization
During this spring, American poultry producers are losing birds by the millions, due to the High Pathogenic Avian Influenza outbreaks on factory farms. USDA APHIS applied the stamping out strategy in an attempt to prevent the flu from spreading.
With stamping out as the highest priority of the response strategy, large numbers of responders are involved. With in average almost 1 million caged layers per farm in Iowa, there is hardly any room for a proper bio security training for these responders. And existing culling techniques had insufficient capacity, the authorities had to decide to apply drastic techniques like macerating live birds in order to take away the source of virus reproduction.
This strategy didn't work; on the contrary. Instead of slowing down the spreading of the virus, the outbreaks continue to reoccur and have caused death and destruction in 15 USA states, killing almost 50 million birds on mote than 220infected commercial poultry farms, all within a very small time frame.
The question is whether the priority of the response strategy should be on neutralizing the transmission routes instead of on stamping out infections after they occur. All indicators currently point out into the direction that the industry should prioritize on environmental drivers: the connection between outbreaks and wild ducks; wind-mediated transmission; pre-contact probability; on-farm bio security; transmission via rodents etc.
Once the contribution of each transmission route has been determined, a revolutionary new response strategy can be developed based on the principle of neutralizing transmission routes. Neutralizing risks means that fully new techniques need to be developed, based on culling the animals without human – to – animal contact; integrating detergent application into the culling operations; combining culling & disposal into one activity.
This new response strategy will be the main subject of the FLI Animal Welfare and Disease Control Seminar, organized at September 23, 2015 in Celle, Germany
Dossier transmission: Transmission of Avian Influenza Virus to Dogs
This document reports on the transmission of an avian influenza virus (H3N2) to dogs in South Korea. Several dogs exhibited severe respiratory disease and three genetically similar canine influenza virus strains were isolated. Experimental infection of beagles demonstrated that the virus could be transmitted between dogs and cause clinical signs like fever and lung lesions. The canine respiratory tract was found to contain receptors for binding avian influenza viruses, suggesting potential for direct transmission from poultry. This provides evidence that dogs may play a role in interspecies transmission of influenza viruses.
Spatio temporal dynamics of global H5N1 outbreaks match bird migration patterns
This document analyzes the spatiotemporal patterns of H5N1 avian influenza outbreaks globally between 2003 and 2006. It identifies three phases of the H5N1 epidemic and uses space-time cluster analysis to detect six disease cluster patterns along major bird migration flyways. The matching of outbreak clusters with wild bird migration patterns suggests wild birds may play an important role in long-distance spread of H5N1. Short-distance spread is also potentially linked to wild birds spreading the virus at sites where they overwinter or migrate through.
Spatial, temporal and genetic dynamics of H5N1 in china
The spatial spread of H5N1 avian influenza, significant ongoing mutations, and long-term persistence of the virus in some geographic regions has had an enormous impact on the poultry industry and presents a serious threat to human health.
This study revealed two different transmission modes of H5N1 viruses in China, and indicated a significant role of poultry in virus dissemination. Furthermore, selective pressure posed by vaccination was found in virus evolution in the country.
Phylogenetic analysis, geospatial techniques, and time series models were applied to investigate the spatiotemporal pattern of H5N1 outbreaks in China and the effect of vaccination on virus evolution.
Results showed obvious spatial and temporal clusters of H5N1 outbreaks on different scales, which may have been associated with poultry and wild-bird transmission modes of H5N1 viruses. Lead–lag relationships were found among poultry and wild-bird outbreaks and human cases. Human cases were preceded by poultry outbreaks, and wild-bird outbreaks were led by human cases.
Each clade has gained its own unique spatiotemporal and genetic dominance. Genetic diversity of the H5N1 virus decreased significantly between 1996 and 2011; presumably under strong selective pressure of vaccination. Mean evolutionary rates of H5N1 virus increased after vaccination was adopted in China.
Different environmental drivers of H5N1 outbreaks in poultry and wild birds
Different environmental drivers operate on HPAI H5N1 outbreaks in poultry and wild birds in Europe. The probability of HPAI H5N1 outbreaks in poultry increases in areas with a higher human population density and a shorter distance to lakes or wetlands.
This reflects areas where the location of farms or trade areas and habitats for wild birds overlap. In wild birds, HPAI H5N1 outbreaks mostly occurred in areas with increased NDVI and lower elevations, which are typically areas where food and shelter for wild birds are available. The association with migratory flyways has also been found in the intra-continental spread of the low pathogenic avian influenza virus in North American wild birds. These different environmental drivers suggest that different spread mechanisms operate.
Disease might spread to poultry via both poultry and wild birds, through direct (via other birds) or indirect (e.g. via contaminated environment) infection. Outbreaks in wild birds are mainly caused by transmission via wild birds alone, through sharing foraging areas or shelters. These findings are in contrast with a previous study, which did not find environmental differences between disease outbreaks in poultry and wild birds in Europe.
More from Harm Kiezebrink (20)
Low Atmospheric Pressure Stunning is not a humane alternative to Carbon Dioxi...
Low Atmospheric Pressure Stunning is not a humane alternative to Carbon Dioxi...
Preventief ruimen bij vogelgriep in pluimveedichte gebieden en mogelijkheden ...
Preventief ruimen bij vogelgriep in pluimveedichte gebieden en mogelijkheden ...
Managing large-scale outbreaks at Farrow-to-Weaner Farms
Managing large-scale outbreaks at Farrow-to-Weaner Farms
Nitrogen filled high expansion foam in open Containers
Nitrogen filled high expansion foam in open Containers
World bank evaluating the economic consequences of avian influenza
World bank evaluating the economic consequences of avian influenza
Gas alternatives to carbon dioxide for euthanasia a piglet perspective
Gas alternatives to carbon dioxide for euthanasia a piglet perspective
Laves presentation practical experiences in the culling of poultry in germany
Laves presentation practical experiences in the culling of poultry in germany
Berg et al. 2014 killing of spent laying hens using co2 in poultry barns
Berg et al. 2014 killing of spent laying hens using co2 in poultry barns
Ventilation Shutdown: who takes the responsibility to flip the switch?
Ventilation Shutdown: who takes the responsibility to flip the switch?
FLI Seminar on different response strategies: Stamping out or Neutralization
FLI Seminar on different response strategies: Stamping out or Neutralization
Dossier transmission: Transmission of Avian Influenza Virus to Dogs
Dossier transmission: Transmission of Avian Influenza Virus to Dogs
Spatio temporal dynamics of global H5N1 outbreaks match bird migration patterns
Spatio temporal dynamics of global H5N1 outbreaks match bird migration patterns
Spatial, temporal and genetic dynamics of H5N1 in china
Spatial, temporal and genetic dynamics of H5N1 in china
Different environmental drivers of H5N1 outbreaks in poultry and wild birds
Different environmental drivers of H5N1 outbreaks in poultry and wild birds
Preview of “asymptomatic Beijing H7N9 raises pandemic concerns” copy
- 1. Asymptomatic Beijing H7N9 Raises Pandemic Concerns http://www.recombinomics.com/News/04141302/H7N9_Beiji... Home Founder What's New In The News Consulting H1N1 Consulting Audio:Feb11 Feb21 Mar21 Apr4 twitter Paradigm Shift Viral Evolution Commentary Asymptomatic Beijing H7N9 Raises Pandemic Concerns Intervention Monitoring Recombinomics Commentary 21:13 Vaccine Screening April 14, 2013 active screening monitoring 4-year-old bamboo surname boys H7N9 Vaccine Development avian influenza virus nucleic acid positive. The boy is currently no clinical Expression Profiling symptoms Drug Discovery The above translation describes an asymptomatic contact (4M) of the index case (7F) in Beijing. The case was identified through screening of Custom Therapies contacts of the earlier case. The detection of H7N9 is an asymptomatic contacts raises concerns that H7N9 is far more widespread than Patents represented by the 61 confirmed cases (see map), which includes 13 fatalities. The confirmed cases have a case fatality are of more than 92% (13 fatalities out of 14 outcomes). All of the other confirmed cases are hospitalized, including the above case who was hospitalized for observation. Sequences from this case would be useful. There are 4 public sequences and all 4 have E627K. These sequences are from fatal cases. Avian isolates are lacking E627K, but have Q226L. Differences between severe / fatal cases and mild / asymptomatic cases remain to be determined. However, the detection of H7N9 in an asymptomatic contact raises serious pandemic concerns. Media Link Recombinomics Presentations Recombinomics Publications Recombinomics Paper at Nature Precedings 1 of 2 4/15/13 5:22 PM
- 2. Asymptomatic Beijing H7N9 Raises Pandemic Concerns http://www.recombinomics.com/News/04141302/H7N9_Beiji... Home | Founder | What's New | In The News | Contact Us Webmaster: webmaster@recombinomics.com © 2013 Recombinomics. All rights reserved. 2 of 2 4/15/13 5:22 PM