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March 31st, 2007 posted by Paul Rega, MD, FACEP March 31, 2007 @ 9:48 am

Doc falls ill after treating H5N1 victim

Intro:  It’s a little premature to conclude that the physician has H5N1 and that he caught it from the kid.  But it may get out into the media and speculation could run wild.  We certainly don’t want to theorize that this is a case of human-to-human transmission.

CIDRAP News, 3/30/07:  A doctor who treated an Indonesian boy who died of suspected H5N1 avian influenza is now being treated for suspicious symptoms himself, according to media reports today.

The doctor had treated a 15-year-old boy who died on Mar 25 at a hospital in Bandung. Reuters reported. Indonesian officials said 3 days ago that initial tests indicated the boy had the H5N1 virus.

Yusuf Hadi, head of the bird flu department at Hasan Sadikin hospital in Bandung, told Reuters that 2 or 3 days after treating the boy, the doctor fell ill with a sore throat, fever, and respiratory symptoms, despite having worn protective equipment.

“He is in an isolation room, doing fine,” Hadi told Reuters, adding that the doctor no longer has a fever.

Test results are pending for the doctor, along with three other patients, a woman and two children, Reuters reported.

By the World Health Organization (WHO) count, Indonesia has had 81 H5N1 cases with 63 deaths. But since Jan 29, Indonesia has reported at least nine cases not yet recognized by the WHO. Those include five reported this week in which further test results were awaited.

In other news, Bangladesh officials said avian flu has spread to five more farms, bringing the number to 16 in five districts, Reuters reported today. The country has culled 60,000 birds so far, the report said.

A report yesterday from Indonesia’s Antara news agency said the Bangladeshi army had been called out to supervise and monitor the culling.

According to a report today from Bangladeshi officials to the World Organization for Animal Health (OIE), the country’s first H5N1 outbreaks began on Feb 2 and were confirmed on Mar 22. The report, which covers the first three outbreaks, says affected birds included layer flocks on poultry farms, all in Dhaka province near the Bangladeshi capital. The source of the outbreaks is unknown.

The Asian Development Bank has been called in to help Bangladesh control the outbreaks, Reuters reported. The main laboratory at the Bangladesh Livestock Research Institute can’t conduct the range of H5N1 tests, and samples need to be sent to Bangkok for confirmation, the report said.

So far, 100 poultry workers have tested negative for H5N1 infection, and 30 more from the newly affected farms are being monitored, Reuters reported. No human cases have been reported.

Meanwhile, Egypt is considering banning the trade and transport of live birds to stem the spread of avian flu. Egyptian president Hosni Mubarak sent the law to the upper house of Egypt’s parliament for consideration 2 days ago, Reuters reported.

Human H5N1 cases in Egypt have surged this year, with 12 so far. The country’s official WHO total stands at 29 cases, the third most, after Vietnam and Indonesia. Thirteen cases have been fatal.



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March 31st, 2007 posted by Paul Rega, MD, FACEP @ 7:19 am

FL To Reject Federal assistance During Pandemic?

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Homeland Security daily Wire, 3/30/07: 

Speaking of a thumb in the eye. Florida’s Office of Public Health Emergency Preparedness may decide to be the only state to reject federal assistance in preparing for the next flu epidemic — all this despite the risk that such an event could kill 128,000 Floridians and send another 640,000 to hospitals. (Florida, the retiree capital of the world, is particularly vulnerable.) At issue is the availability of $36 million in discounted Tamiflu intended to create a state stockpile. But although Governor Charlie Crist considers the drugs “essential”, the chairman of the state legislative committee overseeing the budget is resistant. “It just doesn’t rank as one of my priorities,” said state Representative Aaron Bean, pointing out that the drug’s shelf life has been questioned.

 

This position, say experts, is intolerable and shortsighted, as Tamiflu and its competitor Relenza are the only suitable drugs on the market. “If the medicine is provided to patients who are suffering from influenza within 24 to 48 hours after they begin to show symptoms, it has the potential to greatly decrease how sick someone would get,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It would also decrease the amount of time they would be sick.” But if there was no stockpile, manufacturing requirements would result in a delay of four to six months, and the world production capacity is only 350 million per year — reasons, any sensible person would think, to buy some now, especially when the federal government is offering it at a discount. A five day treatment of Tamiflu costs $110 at retail but only $15 at the federal rate. All told, the failure to buy the drugs now could end up costing the state $130 million in the future.



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March 31st, 2007 posted by Paul Rega, MD, FACEP @ 7:14 am

Pet Food and Melamine Update

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NY Times, 3/31/07: 

The Food and Drug Administration said yesterday that it had not found rat poison in pet food that has been killing animals, but that it had found melamine, a chemical commonly used to make plastic cutlery that is also used in fertilizer.

Hours after the announcement, the nationwide pet food recall, which had involved only so-called wet foods — all manufactured by Menu Foods and sold under a variety of brand names — was expanded to include one brand of dry cat food, Prescription Diet m/d Feline, made by Hills Pet Nutrition.

The brand was found to have been made with a batch of wheat gluten shipped to the United States from China that the F.D.A. said was laced with melamine.

Scientists found melamine, which is used as a slow-release fertilizer in Asia, in the urine of cats sickened by the recalled pet foods made by Menu Foods, officials said at a news conference

The recalled pet food has been blamed for at least 16 deaths of pets.

Officials said they were still tracing the distribution of the tainted wheat gluten to all the companies that had received it. A complete list of pet foods affected by the recall can be found at www.fda.gov.

Additionally, F.D.A. officials said that they did not believe the contaminated wheat gluten had entered the human food supply, but that they were testing all wheat gluten imported from China for melamine.

Imports of wheat gluten from China have sharply increased in recent years, said James F. Frahm, vice president for planning at U.S. Wheat Associates, an industry trade group. In 2006, 13 percent of wheat gluten in the United States was imported from China, according to Customs data.

The F.D.A.’s focus on melamine was contested by the New York State Food Laboratory, the testing facility that announced last Friday that it had identified aminopterin, a rat poison, in samples of recalled cat food made by Menu Foods.

“We don’t think this is the final conclusion,” said Jessica A. Chittenden, a spokeswoman for the New York State Departmention Agriculture and Markets. “Melamine is not a known toxin. There’s not enough data to show that it is toxic to cats.”

“We are confident we found aminopterin, and it makes sense with the pathology,” Ms. Chittenden added. She also said another laboratory, Animal Health Laboratory at the University of Guelph in Canada, had also confirmed the presence of aminopterin in the samples.

Patrick Hooker, the New York State agricultural commissioner, said, “We believe the laboratories involved in this investigation should continue to maintain an open forum to definitively identify the one or more agents that are causing the deaths and illnesses of cats and dogs so that they do not enter the animal or human food chain in the future.” But F.D.A. officials said they had been unable to find aminopterin in the pet food samples they had tested.

Researchers at Cornell University in Ithaca, N.Y., also said they were unable to find evidence of the rat poison in the pet food samples they tested.

“At this point in the investigation, we are not focusing on aminopterin,” said Dr. Stephen F. Sundlof, director of the Center for Veterinary Medicine at the F.D.A. But he added that he was not certain melamine was the chemical causing illness in dogs and cats.

“There is little information in the scientific literature on melamine exposure on dogs and cats,” Dr. Sundlof said. “So it’s very difficult to determine a level that would be harmful or even lethal.”

The lack of information about melamine’s toxicity left some scientists who have worked with the chemical skeptical about its involvement in poisoning pets.

“It’s not what I would consider to be a particularly toxic material,” said Daniel R. Shelton, a scientist at the federal Department of Agriculture, who published a study on melamine’s potential to be a slow release fertilizer in 1997.

“It doesn’t compute for me” that the melamine would sicken pets, Dr. Shelton said.

The confusion has left veterinarians unsure of how best to advise pet owners.

“We’re being vigilant,” said Sharon Curtis Granskog, assistant director of communications for the American Veterinary Medical Association, the largest professional organization for veterinarians in the United States. “We’re listening to everything that comes out,” Ms. Granskog said.

“Basically, if it’s not on the list of recalled pet foods, we’re hoping it’s safe,” Ms. Granskog said.

She said the most important thing was for owners to keep a close watch on pets for the first signs of renal failure, which include decreased appetite, vomiting, diarrhea, lethargy and increased thirst.

“If it’s caught early,” she said, “they’re having some success with it. Hopefully, there will be a decrease because these products are off the shelves.”

In a news conference yesterday, Paul Henderson, the chief executive officer of Menu Foods, said he was confident that all of the company’s products made after March 6 were “safe and healthy.”

Mr. Henderson said only wheat gluten obtained from one supplier was found to be adulterated.

“The source of that adulteration was identified and eliminated from our system,” Mr. Henderson said.

Officials from Menu Foods said they were working with the company’s insurance company to compensate owners for veterinary bills, and in some cases, for the death of their pets.



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March 31st, 2007 posted by Paul Rega, MD, FACEP @ 7:11 am

British Hostage Crisis Update

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Intro:  I certainly hope that these letters were extracted under duress.

CNN, 3/31/07:  Iran on Friday released a third letter purportedly written by detained British sailor Faye Turney, in which she claims to have been “sacrificed” by British and U.S. policies and urges both countries to withdraw their troops from Iraq.

“We were arrested after entering Iranian waters by the Iranian forces. For this I am deeply sorry,” the letter states.

“I am writing to you as a British service person who has been sent to Iraq, sacrificed due to the intervening policies of the Bush and Blair governments.

“I believe that for our countries to move forward, we need to start withdrawing our forces from Iraq, and leave the people of Iraq to start rebuilding their lives.”

The letter, the authenticity of which cannot be independently determine by CNN, follows two previous letters said to be written by Turney and released separately this week.

Friday’s letter was released just hours after Turney appeared with two other Britons in new video aired by Arabic language network Al Alam. (Text of letters)

In the video, one the 15 detained service personnel held in Iran for the past week confessed to “entering your waters without permission.”

“On the 23rd of March 2007 in Iranian waters we trespassed without permission,” said Nathan Thomas Summers. The third detainee in the video has not been identified. Summers said the Britons were being treated well, as did the Turney letter.

There has been no official reaction by the British government to the letter.

Prime Minister Tony Blair, speaking to reporters after the video was aired said: “All this does is enhance people’s sense of disgust. Captured personnel being paraded and manipulated in this way doesn’t fool anyone.

“What the Iranians have to realize is that if they continue in this way they will face continuing isolation.”

Blair called for “patience” in dealing with the crisis, adding: “The most important thing is to ensure people are returned safe.”

Earlier Friday, Britain’s Foreign Office responded to the video, telling CNN that “using our servicemen in this way for propaganda reasons is outrageous.”

Meanwhile, EU foreign ministers on Friday demanded Iran release 15 Britons, though some warned against escalating the dispute and said their diplomatic ties with Tehran would not be immediately affected, AP reported.

Friday’s video was the second so-called confession by a British detainee to be aired by Al Alam this week.

On Wednesday, it showed a video of Turney wearing a black scarf covering her hair, “admitting” that she and her crew had gone into Iranian waters. “Obviously we trespassed into their waters,” she said.

Footage in the video also showed the other 14 British detainees eating.

The video caused outrage in London and Britain’s ambassador to Iran visited the foreign ministry Thursday to protest its broadcast, Britain’s Foreign Office confirmed.

Blair called it “completely wrong — a disgrace, actually — when people are used in that way. It’s contrary to all international law and convention.”

British Foreign Minister Margaret Beckett announced Wednesday that Britain was freezing all bilateral diplomatic business with Iran until the 15 Britons were freed.

Security Council appeals for release

On Thursday, the UN Security Council expressed concern for the marines and sailors and appealed for their early release.

The U.N. statement fell short of a full condemnation sought by the British government.

On Friday, Turkey’s government said it had spoken with Iran’s President Mahmoud Ahmedinejad, who suggested Tehran was willing to reconsider an offer to release Turney, The Associated Press reported.

In footage aired Thursday, said to be of the capture operation, gunshots could be heard on the tape and a helicopter was shown above inflatable boats in choppy seas.

Iranian guard boats were seen cruising around while a couple of Iranian guardsmen shot into the air.

Then the video showed some of the British troops — including Turney — seated in a boat with an Iranian flag, presumably after their capture.

An Iranian military official also appeared on state television giving a briefing about the incident, indicating on a map where he said it happened.

The demonstration looked similar to a Wednesday briefing on the incident by British Vice Admiral Charles Style, who released a map of the Shatt al-Arab purporting to show the coordinates of the British boat when it was captured, along with pictures of handheld GPS devices showing the location. Release delayed

Earlier Thursday, Iran said the British personnel entered its waters six times before they were arrested.

Officials also announced that the promised release of Turney was suspended because of Britain’s “behavior” in the matter.

“The wrong behavior of those who live in London caused the suspension,” Iranian military commander Alireza Afshar said, according to the Mehr news agency.

Ali Larijani, the secretary of Iran’s Supreme National Council, warned that Britain’s tough stance in the matter was causing a delay in the release of Turney.

On Wednesday, Iranian Foreign Minister Manouchehr Mottaki had said Turney would be released “very soon.”

Larijani said Tehran would like to resolve the issue through bilateral discussions and an investigation of legal and technical issues, and again asserted that the British patrol boats entered Iranian waters illegally.

In London on Thursday, the British Foreign Ministry said the Iranian government had sent a formal note to the British Embassy in Tehran.

“Such exchanges are always confidential, so we cannot divulge any details,” a Foreign Ministry spokeswoman said. “But we’re giving the message serious consideration and will soon respond formally to the Iranian government.”



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March 31st, 2007 posted by Paul Rega, MD, FACEP @ 7:07 am

Hicks Update

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CNN, 3/31/07:  A U.S. military tribunal sentenced Australian al Qaeda trainee
David Hicks, gray suit at left, to seven years in prison, but he
will only have to serve nine months of the sentence.



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March 31st, 2007 posted by Paul Rega, MD, FACEP @ 7:05 am

Volleyball Violence Update

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BBC, 3/31/07:  Greek authorities have cancelled all team sports matches for two weeks after a mass brawl between rival women’s volleyball fans left one man dead. “All team sports will be suspended… until 13 April,” a government spokesman said after a cabinet meeting called to discuss the violence.

The pitched battle took place between fans of Olympiakos Piraeus and Panathinaikos near Athens.

Witnesses say about 300 fans fought using clubs, knives and stones.

Police detained 18 people during the violence, which Greek media reports suggested had been arranged by fans ahead of the match.

The 25-year-old man who died had head injuries and stab wounds, doctors said. Several other people were injured in the brawl in the Peania area outside Athens.

“They were jumping on our car for five minutes, they were asking for our mobile phones and stabbed our driver,” one witness said.

The deadly brawl, which dominated Greek newspapers and television news, prompted immediate calls for action and criticism that more had not been done to prevent the violence.

“We had warned that this game was dangerous,” the head of Greece’s volleyball federation, Thanassis Beligratis, was quoted by the AFP news agency as saying.

Greek Prime Minister Costas Karamanlis called an emergency cabinet meeting on Thursday.

“Violence in sport is something that affects our entire society… and cannot be tolerated,” said government spokesman Theodoros Roussopoulos.

He said the government had agreed on a series of measures, including enforcing a law which would see fans convicted of violence sent to jail rather than serving suspended sentences.

Mandatory surveillance cameras would also be in place at all main football stadiums by 2008, he said.

Endemic violence

The Greek decision to suspend team sports until 13 April echoes similar moves in Italy in February after a policeman was killed in rioting at a football match in Sicily.

 

All football in Italy’s top divisions was suspended for a week and stadiums not meeting safety standards were closed.

The suspension in Greece will actually halt matches only for a week, as it includes the Orthodox Easter weekend on 8 April, during which no games are played anyway.

The authorities have long tried to eradicate the violence that is endemic in Greek sport, correspondents say.

Hooliganism mainly affects football and basketball but also breaks out occasionally at other sports such as volleyball and water polo.

Both Olympiakos Piraeus and Panathinaikos have major teams in football, basketball and other sports.

There have been clashes between rival supporters in the past.



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March 30th, 2007 posted by Kelly Burkholder-Allen, RN, MSEd March 30, 2007 @ 9:10 am

NFPA Standards for first reponder PPE adopted by DHS

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News Releases

NFPA standards for first responder personal protective equipment adopted by U.S. Department of Homeland Security
March 26, 2007 – The U.S Department of Homeland Security (DHS) adopted eight National Fire Protection Association (NFPA) standards for first responder personal protective equipment. Three of the eight documents were adopted for the first time by DHS and the remaining five were re-adoptions of the latest editions of standards currently being recognized by DHS. The requirements set by the documents aid state and local procurement officials in selecting the best protective equipment available.

The standards will better protect first responders in emergencies involving chemical, biological and other hazards. They will also provide manufacturers with the necessary guidelines for designing, testing and certifying this equipment.

“NFPA has long been a strong advocate for equipment and protective clothing standards for first responders and continues to lead efforts in this area,” said James M. Shannon, NFPA’s president. “These latest adoptions by DHS will go a long way in ensuring the safety of emergency personnel.”

The three newly adopted standards are:

NFPA 1982, Standard on Personal Alert Safety Systems (PASS)
NFPA 2112, Standard on Flame-Resistant Garments for Protection of Industrial Personnel Against Flash Fire
NFPA 2113, Standard on Selection, Care, Use, and Maintenance of Flame-Resistant Garments for Protection of Industrial Personnel Against Flash Fire
The five standards re-adopted to the current editions are:

NFPA 1951, Standard on Protective Ensembles for Technical Rescue Operations
NFPA 1971, Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting
NFPA 1981, Standard on Open-Circuit Self-Contained Breathing Apparatus (SCBA) for Emergency Services
NFPA 1991, Standard on Vapor-Protective Ensembles for Hazardous Materials Emergencies
NFPA 1994, Standard on Protective Ensembles for First Responders to CBRN Terrorism Incidents
“DHS is committed to ensuring that the equipment which is purchased to protect first responders is the very best available.” said Bert M. Coursey, director of DHS Office of Standards. “The adoption of these NFPA standards sets requirements that help those manufacturing and purchasing this necessary equipment as well as those who depend on this equipment for their personal safety.”

In addition to the latest adoptions and re-adoptions, DHS previously adopted several NFPA documents that remain in use today. They are:

NFPA 1851, Standard on Selection, Care and Maintenance of Structural Fire Fighting Protective Ensembles
NFPA 1975, Standard on Station/Work Uniforms for Fire and Emergency Services
NFPA 1992, Standard on Liquid Splash-Protective Ensembles and Clothing for Hazardous Materials Emergencies
NFPA 1999, Standard on Protective Clothing for Emergency Medical Operations
NFPA has incorporated NFPA 1976, Standard on Protective Ensemble for Proximity Fire Fighting, previously adopted by DHS, into the 2007 edition of NFPA 1971, which was included in recent adoptions by DHS.

All NFPA safety codes and standards are developed through a process accredited by the American National Standards Institute (ANSI). The 200 technical committees responsible for developing and updating all 300 codes and standards include 7,000 volunteers, representing enforcing authorities, installation and maintenance, labor, research and testing, insurance, special experts, consumers and other users.

NFPA has been a worldwide leader in providing fire, electrical, building, and life safety to the public since 1896. The mission of the international nonprofit organization is to reduce the worldwide burden of fire and other hazards on the quality of life by providing and advocating consensus codes and standards, research, training, and education.

Contact: Lorraine Carli, Public Affairs Office: +1-617-984-7275

NFPA standards adopted by Department of Homeland Security

NFPA 1851, Standard on Selection, Care and Maintenance of Structural Fire Fighting Protective Ensembles (2001 Edition)
This document specifies minimum selection, care, and maintenance requirements for structural fire fighting protective ensembles, and the individual ensemble elements that include coats, trousers, coveralls, helmets, gloves, footwear, and interface components that are compliant with NFPA 1971. This first edition of NFPA 1851, issued in 2001, was developed to be a companion document for NFPA 1971, Standard on Protective Ensemble for Structural Fire Fighting.

NFPA 1852, Standard on Selection, Care, and Maintenance of Open-Circuit Self-Contained Breathing Apparatus (SCBA) (2002 Edition)
This standard establishes procedures as part of a program to provide care and maintenance for open-circuit SCBA and combination SCBA/SAR in order to reduce the safety risks and potential health risks associated with poorly maintained, contaminated, or damaged SCBA. The edition of NFPA 1852 issued in 2002 was the first.

NFPA 1951, Standard on Protective Ensemble for Technical Rescue Operations (2007 Edition)
Based on work begun in 1997, this standard answers the need for personal protective equipment for fire and emergency services personnel operating at technical rescue incidents involving building or structural collapse, vehicle accidents, confined spaces, trench cave-ins, scaffolding collapses, high angle climbing accidents, and similar incidents. The first edition of NFPA 1951 was issued in July 2001.

NFPA 1971, Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting (2007 Edition)
Based on work begun in 1973, this standard establishes minimum levels of protection for fire fighting personnel assigned to fire department operations including but not limited to structural fire fighting, proximity fire fighting, rescue, emergency medical, and other emergency first responder functions. The first edition of NFPA 1971 was issued in 1975.

NFPA 1975, Standard on Station/Work Uniforms for Fire and Emergency Services (2004 Edition)
Based on work begun in 1975, this standard specifies requirements for the design, performance, testing, and certification of non-primary protective station/work uniforms and the individual garments comprising station/work uniforms. The document sets requirements for fire and emergency services personnel station/work uniforms that will not contribute to burn injury severity. The first edition of NFPA 1975 was issued in 1985.

NFPA 1981, Standard on Open-Circuit Self-Contained Breathing Apparatus (SCBA) for Emergency Services (2007 Edition)
Based on work begun in 1975, this standard specifies the minimum requirements for the design, performance, testing, and certification of open-circuit self-contained breathing apparatus (SCBA) and combination open-circuit self-contained breathing apparatus and supplied air respirators (SCBA/SAR) for the respiratory protection of fire and emergency responders where unknown, IDLH (immediately dangerous to life and health), or potentially IDLH atmospheres exist. The first edition of NFPA 1981 was issued in 1981.

NFPA 1982, Standard on Personal Alert Safety Systems (PASS) (2007 Edition)
Based on work begun in 1980, this standard was developed in response to requests from the fire service to establish requirements for a device that would sound an audible signal for aid if a fire fighter became incapacitated while operating at an emergency. This standard specifies minimum requirements for the design, performance, testing, and certification for all Personal Alert Safety Systems (PASS) for emergency services personnel. The first edition of NFPA 1982 was issued in 1983.

NFPA 1991, Standard on Vapor-Protective Ensembles for Hazardous Materials Emergencies (2005 Edition)
Based on work begun in 1986, this standard specifies the minimum requirements for the design, performance, testing, and certification of vapor-protective ensembles and individual protective elements for chemical vapor protection for fire and emergency service personnel. Additional optional criteria are provided for ensembles and individual protective elements that provide protection for chemical flash fire escape, liquefied gas, chemical and biological warfare agents, and chemical and biological terrorism incidents. The first edition of NFPA 1991 was issued in 1990.

NFPA 1992, Standard on Liquid Splash-Protective Ensembles and Clothing for Hazardous Materials Emergencies (2005 Edition)
Based on work begun in 1985, this standard specifies minimum requirements for the design, performance, testing, documentation, and certification for liquid splash-protective ensembles, ensemble elements, and protective clothing used by emergency response personnel during hazardous materials incidents. The first edition of NFPA 1992 was issued in 1990.

NFPA 1994, Standard on Protective Ensembles for First Responders to CBRN Terrorism Incidents (2007 Edition)
Based on work begun in 1998, this standard specifies the minimum requirements for the design, performance, testing, and certification of protective ensembles for fire and emergency services personnel operating at domestic terrorism incidents involving dual-use industrial chemicals, chemical terrorism agents, or biological terrorism agents. The intent is that the ensembles would be available in quantity, easily donned and used, and designed for single exposure use. The first edition of NFPA 1994 was issued in 2001.

NFPA 1999, Standard on Protective Clothing for Emergency Medical Operations (2003 Edition)
Based on work begun in 1990, this standard specifies the minimum documentation, design, performance, testing, and certification requirements for new single-use and new multiple-use emergency medical protective clothing, including garments, gloves, footwear, and face protection devices, used by fire and emergency services personnel during emergency medical operations. The purpose of the standard is to establish a minimum level of protection from contact with blood and body fluid-borne pathogens for personnel performing patient care during emergency medical operations. The first edition of NFPA 1999 was issued in 1992.

NFPA 2112, Standard on Flame-Resistant Garments for Protection of Industrial Personnel Against Flash Fire (2007 Edition)
Based on work begun in 1999, this standard shall provide minimum requirements for the design, construction, evaluation, and certification of flame-resistant garments for use by industrial personnel, with the intent of providing a degree of protection to the wearer and reducing the severity of burn injuries resulting from accidental exposure to hydrocarbon flash fires. The first edition of NFPA 2112 was issued in 2001.

NFPA 2113, Standard on Selection, Care, Use, and Maintenance of Flame-Resistant Garments for Protection of Industrial Personnel Against Flash Fire (2007 Edition)
Based on work begun in 1999, the purpose of this standard is to reduce the health and safety risks associated with the incorrect selection and use of flame-resistant garments and those risks associated with incorrectly maintained, contaminated, or damaged flame-resistant garments. The first edition of NFPA 2113 was issued in 2001.

URL: http://www.nfpa.org/newsReleaseDetails.asp?categoryid=488&itemId=33627&cookie%5Ftest=1

NFPA (National Fire Protection Association)
1 Batterymarch Park, Quincy, MA 02169-7471 USA
Telephone: +1 617 770-3000 Fax: +1 617 770-0700



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March 30th, 2007 posted by Kelly Burkholder-Allen, RN, MSEd @ 8:48 am

Fuzzy little chicks may look cute in the Easter Basket….but why risk salmonella?

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CDC warns Easter chicks can be salmonella risk

ATLANTA With Easter coming up, government health officials are warning about the risk of salmonella from baby chicks.

The risk is greatest for young children, to whom the chicks are often given. Officials say children under five should not handle baby birds.

The Centers for Disease Control and Prevention says last spring, 81 people in 22 states got salmonella from chicks. Sixteen people were hospitalized.

Salmonella causes diarrhea, fever, and vomiting. The bacteria live in the intestines of chickens and spread through their feces, which can cling to a bird’s feet or feathers even if it looks clean.

Some states have laws to discourage giving small birds as Easter gifts. Twelve states limit the youngest age at which live poultry can be sold.

Source: KOLD.com
http://www.kold.com



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March 30th, 2007 posted by Paul Rega, MD, FACEP @ 7:24 am

More on the British Ambush & Kidnapping

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Intro:  The following is the 3/23 briefing given by  Vice Admiral Charles Style, Deputy Chief of the Defence Staff. The briefing was conducted at defence headquarters in London.  A couple of points:  1)  The incident occurred sometime after 9AM local time; 2)  The evidence that the incident occurred in Iraqi waters seems overwhelming; 3)  The Iranians were confused as to where the Brits were located when they protested to the British government.  Their first complaint was about a location inside Iraqi waters.  Then when this was pointed out to them, they amended their position and the ambush position.

Style’s Briefing:  “The aim of this brief is to provide a factual account of the incident during which fifteen Royal Naval personnel were seized by the Iranians last Friday. By way of background, HMS CORNWALL was in charge of the coalition force, which – alongside the Iraqi Navy – is operating in the Northern Persian Gulf.

“This force maintains the sovereignty and integrity of Iraqi territorial waters under UN Security Council Resolution 1723, and with the approval of the Iraqi Government. The ship – and others in the coalition – maintain a presence patrolling there. They are also charged with protection of the Iraqi offshore oil infrastructure – economically very important – and the security of merchant vessels.

“On 23 March a boarding team consisting of seven Royal Marines and eight sailors – who were embarked in two of HMS CORNWALL’s boats – conducted a routine boarding of an Indian flagged Merchant Vessel which was cooperative throughout. They investigated this vessel after witnessing her unloading cars into two barges secured alongside. Since early March the force has conducted 66 routine boardings. So the one that I’m talking about was entirely routine business, and conducted in a particular area where four other boardings have been completed recently.

“As shown on the chart, the merchant vessel was 7.5 nautical miles south east of the Al Faw Peninsula and clearly in Iraqi territorial waters. Her master has confirmed that his vessel was anchored within Iraqi waters at the time of the arrest. The position was 29 degrees 50.36 minutes North 048 degrees 43.08 minutes East. This places her 1.7 nautical miles inside Iraqi territorial waters. This fact has been confirmed by the Iraqi Foreign Ministry.

“The Iranian government has provided us with two different positions for the incident. The first we received on Saturday and the second on Monday. As this map shows, the first of these points still lies within Iraqi territorial waters. We pointed this out to them on Sunday in diplomatic contacts.

“After we did this, they then provided a second set of coordinates that places the incident in Iranian waters over two nautical miles from the position given by HMS CORNWALL and confirmed by the merchant vessel. The two Iranian positions are just under a nautical mile apart – 1800 yards or so. It is hard to understand a reason for this change of coordinates. We unambiguously contest both the positions provided by the Iranians.

“I should just explain at this point that the boats remained connected at this point. One of the seaboats was connected via data link, which communicated its position continually to the ship where it was displayed, superimposed on an electronic chart, on a purpose built console. During the boarding this console was constantly monitored and indicated, throughout, that the boats had remained well within Iraqi territorial waters.

“Our boarding started at 0739 local time and was completed at 0910 with the merchant vessel having been cleared to continue with her business. Communications were lost with the boarding team as the boarding was finishing … at 0910. HMS CORNWALL’s Lynx helicopter, which had been covering the initial stages of the boarding, immediately returned to the scene to locate the boarding team.

“The helicopter reported that the two seaboats were being escorted by Iranian Islamic Revolutionary Guard Navy vessels towards the Shatt ‘Al Arab Waterway and were now inside Iranian territorial waters. Debriefing of the helicopter crew and a conversation with the master of the merchant ship both indicate that the boarding team were ambushed while disembarking from the merchant vessel. Both boats were equipped with a GPS chart plotter.

“On Sunday morning, 25 March, HMS CORNWALL’s Lynx conducted an overflight of the merchant vessel, which was still at anchor, and once again confirmed her location on Global Positioning System equipment. Her Master confirmed that his vessel had remained at anchor since Friday, and was in Iraqi territorial waters.

“Ladies and Gentlemen, my primary message is clear. HMS CORNWALL with her boarding party was going about her legal business – in Iraqi Territorial waters, under a United Nations Security Council Resolution, with the explicit approval of the Iraqi government.

“The action by Iranian forces in arresting and detaining our people is unjustified and wrong. As such it is a matter of deep concern to us and the families of the people who have been taken. We continue not only to call for their safe, but for their safe and speedy, return, and we continue to seek immediate consular access to them as a prelude to their release.”



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March 30th, 2007 posted by Paul Rega, MD, FACEP @ 7:03 am

On TIDE, the Terrorist Identities Datamart Environment

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Intro:  It’s called the Terrorist Identities Datamart Environment or TIDE and it started as a noble effort after 9/11 to accumulate information on terrorists all in one place and to be shared by diverse agencies.  Now, it’s growing like Aspergillus in a diabetic’s ear, threatening to overwhelm oversight, privacy, and security concerns.  Overall, I’d say it’s a good thing.  There are going to be problems with any new system, but let’s improve the product, not assign it to oblivion.

Washington Post, 3/25/07:  Each day, thousands of pieces of intelligence information from around the world — field reports, captured documents, news from foreign allies and sometimes idle gossip — arrive in a computer-filled office in McLean, where analysts feed them into the nation’s central list of terrorists and terrorism suspects.

Called TIDE, for Terrorist Identities Datamart Environment, the list is a storehouse for data about individuals that the intelligence community believes might harm the United States. It is the wellspring for watch lists distributed to airlines, law enforcement, border posts and U.S. consulates, created to close one of the key intelligence gaps revealed after Sept. 11, 2001: the failure of federal agencies to share what they knew about al-Qaeda operatives.

But in addressing one problem, TIDE has spawned others. Ballooning from fewer than 100,000 files in 2003 to about 435,000, the growing database threatens to overwhelm the people who manage it. “The single biggest worry that I have is long-term quality control,” said Russ Travers, in charge of TIDE at the National Counterterrorism Center in McLean. “Where am I going to be, where is my successor going to be, five years down the road?”

TIDE has also created concerns about secrecy, errors and privacy. The list marks the first time foreigners and U.S. citizens are combined in an intelligence database. The bar for inclusion is low, and once someone is on the list, it is virtually impossible to get off it. At any stage, the process can lead to “horror stories” of mixed-up names and unconfirmed information, Travers acknowledged.

The watch lists fed by TIDE, used to monitor everyone entering the country or having even a casual encounter with federal, state and local law enforcement, have a higher bar. But they have become a source of irritation — and potentially more serious consequences — for many U.S. citizens and visitors.

In 2004 and 2005, misidentifications accounted for about half of the tens of thousands of times a traveler’s name triggered a watch-list hit, the Government Accountability Office reported in September. Congressional committees have criticized the process, some charging that it collects too much information about Americans, others saying it is ineffective against terrorists. Civil rights and privacy groups have called for increased transparency.

“How many are on the lists, how are they compiled, how is the information used, how do they verify it?” asked Lillie Coney, associate director of the Washington-based Electronic Privacy Information Center. Such information is classified, and individuals barred from traveling are not told why.

Sen. Ted Stevens (R-Alaska) said last year that his wife had been delayed repeatedly while airlines queried whether Catherine Stevens was the watch-listed Cat Stevens. The listing referred to the Britain-based pop singer who converted to Islam and changed his name to Yusuf Islam. The reason Islam is not allowed to fly to the United States is secret.

So is the reason Maher Arar, a Syrian-born Canadian, remains on the State Department’s consular watch list. Detained in New York while en route to Montreal in 2002, Arar was sent by the U.S. government to a year of imprisonment in Syria. Canada, the source of the initial information about Arar, cleared him of all terrorism allegations last September — three years after his release — and has since authorized $9 million in compensation.

TIDE is a vacuum cleaner for both proven and unproven information, and its managers disclaim responsibility for how other agencies use the data. “What’s the alternative?” Travers said. “I work under the assumption that we’re never going to have perfect information — fingerprints, DNA — on 6 billion people across the planet. . . . If someone actually has a better idea, I’m all ears.”

The electronic journey a piece of terrorism data takes from an intelligence outpost to an airline counter is interrupted at several points for analysis and condensation.

President Bush ordered the intelligence community in 2003 to centralize data on terrorism suspects, and U.S. agencies at home and abroad now send everything they collect to TIDE. It arrives electronically as names to be added or as additional information about people already in the system.

The 80 TIDE analysts get “thousands of messages a day,” Travers said, much of the data “fragmentary,” “inconsistent” and “sometimes just flat-out wrong.” Often the analysts go back to the intelligence agencies for details. “Sometimes you’ll get sort of corroborating information,” he said, “but many times you’re not going to get much. What we use here, rightly or wrongly, is a reasonable-suspicion standard.”

Each TIDE listee is given a number, and statistics are kept on nationality and ethnic and religious groups. Some files include aliases and sightings, and others are just a full or partial name, perhaps with a sketchy biography. Sunni and Shiite Muslims are the fastest-growing categories in a database whose entries include Saudi financiers and Colombian revolutionaries. U.S. citizens — who Travers said make up less than 5 percent of listings — are included if an “international terrorism nexus” is established. A similar exception for the administration’s warrantless wiretap program came under court challenge from privacy and civil rights advocates.

Every night at 10, TIDE dumps an unclassified version of that day’s harvest — names, dates of birth, countries of origin and passport information — into a database belonging to the FBI’s Terrorist Screening Center. TIDE’s most sensitive information is not included. The FBI adds data about U.S. suspects with no international ties for a combined daily total of 1,000 to 1,500 new names.

Between 5 and 6 a.m., a shift of 24 analysts drawn from the agencies that use watch lists begins a new winnowing process at the center’s Crystal City office. The analysts have access to case files at TIDE and the original intelligence sources, said the center’s acting director, Rick Kopel.

Decisions on what to add to the Terrorist Screening Center master list are made by midafternoon. The bar is higher than TIDE’s; total listings were about 235,000 names as of last fall, according to Justice Department Inspector General Glenn A. Fine. The bar is then raised again as agencies decide which names to put on their own watch lists: the Transportation Security Administration’s “no-fly” and “selectee” lists for airlines; Consular Lookout and Support System at the State Department; the Interagency Border and Inspection System at the Department of Homeland Security; and the Justice Department’s National Crime Information Center. The criteria each agency use are classified, Kopel said.

Some information may raise a red flag for one agency but not another. “There’s a big difference between CLASS and no-fly,” Kopel said, referring to State’s consular list. “About the only criteria CLASS has is that you’re not a U.S. person. . . . Say ‘a Mohammed from Syria.’ That’s useless for me to watch-list here in the United States. But if I’m in Damascus processing visas . . . that might be enough for someone to . . . put a hold on the visa process.”

All of the more than 30,000 individuals on the TSA’s no-fly list are prohibited from entering an aircraft in the United States. People whose names appear on the longer selectee list — those the government believes merit watching but does not bar from travel — are supposed to be subjected to more intense scrutiny.

With little to go on beyond names, airlines find frequent matches. The screening center agent on call will check the file for markers such as sex, age and prior “encounters” with the list. The agent might ask the airlines about the passenger’s eye color, height or defining marks, Kopel said. “We’ll say, ‘Does he have any rings on his left hand?’ and they’ll say, ‘Uh, he doesn’t have a left hand.’ Okay. We know that [the listed person] lost his left hand making a bomb.”

If the answers indicate a match, that “encounter” is fed back into the FBI screening center’s files and ultimately to TIDE. Kopel said the agent never tells the airline whether the person trying to board is the suspect. The airlines decide whether to allow the customer to fly.

TSA receives thousands of complaints each year, such as this one released to the Electronic Privacy Information Center in 2004 under the Freedom of Information Act: “Apparently, my name is on some watch list because everytime I fly, I get delayed while the airline personnel call what they say is TSA,” wrote a passenger whose name was blacked out. Noting that he was a high-level federal worker, he asked what he could do to remove his name from the list.

The answer, Kopel said, is little. A unit at the screening center responds to complaints, he said, but will not remove a name if it is shared by a terrorism suspect. Instead, people not on the list who share a name with someone listed can be issued letters instructing airline personnel to check with the TSA to verify their identity. The GAO reported that 31 names were removed in 2005.

A Process Under Fire


 

A recent review of the entire Terrorist Screening Center database was temporarily abandoned when it proved too much work even for the night crew, which generally handles less of a workload. But the no-fly and selectee lists are being scrubbed to emphasize “people we think are a danger to the plane, and not for some other reason they met the criteria,” Kopel said.

A separate TSA system that would check every passenger name against the screening center’s database has been shelved over concern that it could grow into a massive surveillance program. The Department of Homeland Security was rebuked by Congress in December for trying to develop a risk-assessment program to profile travelers entering and leaving the United States based on airline and financial data.

Kopel insisted that private information on Americans, such as credit-card records, never makes it into the screening center database and that “we rely 100 percent on government-owned information.”

The center came in for ridicule last year when CBS’s “60 Minutes” noted that 14 of the 19 Sept. 11 hijackers were listed — five years after their deaths. Kopel defended the listings, saying that “we know for a fact that these people will use names that they believe we are not going to list because they’re out of circulation — either because they’re dead or incarcerated. . . . It’s not willy-nilly. Every name on the list, there’s a reason that it’s on there.”



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