The Zika virus has been located in the sperm of an Italian man six months after his first diagnosis; a significant recurrence as this is twice as long as in previous reported cases.
This suggests that Zika can survive for much longer periods than has generally been believed.
Doctors at the Spallanzani Institute for Infectious Diseases in Rome said it pointed to the possibility that the virus was reproducing itself in the male genital tract.
This is obviously of concern, suggesting that the viruses could spread more readily than was thought to be possible.
The Zika outbreak was originally declared a global public health emergency by the World Health Organisation in February.
There has been considerable controversy over the Rio Olympic Games in Brazil, with numerous competitors pulling out of the competition owing to fears over the Zika virus.
It now seems that sexual transmission of Zika could be far more feasible and widespread than was expected.
Current guidelines recommend infected patients should use condoms or abstain from sex for at least six months after the onset of symptoms.
But these may now need to be revised after this isolated cases, even if no other similar individuals are located.
Christian Lindmeier from the World Health Organisation indicated that the authoritative organisation is assessing its guidelines for Zika.
“The Zika outbreak is a constantly evolving situation and every new piece of evidence is looked into and evaluated as to whether or not guidelines will need to be revised.”
The patient, who was in his early 40s, first presented symptoms after returning to Italy after a two-week visit to Haiti in January.
Follow-up testing showed the Zika virus was still present in his urine, saliva and sperm, 91 days after the onset of symptoms.
This remained positive after 181 days, nearly doubling the previous longest registered symptoms in the span of an individual of 93 days, located in a younger Frenchman.
“The results of this study confirm that the virus could replicate specifically in the male genital tract and may persist in semen,” an Italian team working on Zika indicated.
Since this outbreak occurred, it has been discovered that Zika infections in adults can result in Guillain–Barré syndrome.
Prior to this outbreak, Zika was considered a mild infection, as most Zika virus infections are asymptomatic, making it difficult to determine precise estimates of the number of cases.
A report from the Worcestershire Acute Hospitals Trust condemns mistakes made at a Midlands hospital with regard to endoscopy.
As a result of the errors made at the Alexandra Hospital in Redditch, eleven patients were infected with poisonous bacteria.
The bug in question was potentially dangerous, and had emanated from unclean surgical equipment at the hospital.
The Worcestershire Acute Hospitals Trust noted that the endoscopy equipment in question was outdated.
Eleven patients were infected over two incidents related to problems with the decontamination of equipment.
A report from the acute hospitals trust indicated that the machines utilised by the hospital for the process of decontamination where more than eight years-old.
The report concluded that they were overdue for replacement.
“In addition, the environment of the endoscopy unit is outdated and due to the environment there is no clear separation between clean and dirty routes. The environmental issues including the age of the equipment have been on the directorate and divisional risk registers for a number of years,” the report outlined.
The problems had been originally uncovered back in March, when water sampling revealed bacterial growth.
Two probable cross-infection incidents also came to light at this time, both of which involved patients undergoing endobronchial biopsy to their lungs.
In the first incident, samples from seven patients grew the bacteria pseudomonas.
Although the pseudomonas bug can be harmless in some individuals, those contracting the virus suffering from illness, or in post-surgery condition, can experience serious problems.
In particular, the virus is one of the main causes of pneumonia in patients who are on ventilation machines, while patients with serious wounds can develop dangerous blood infections, or bone and urinary tract difficulties.
The second of the two incidents took place between June and July, when the virus serratia was isolated from four patients.
Investigations into the incident established that the patients in question had been examined with a wet instead of dry scope from the drying cabinet.
Serratia particularly thrives in moist conditions and can cause pneumonia and other infections.
The report noted that the “hazard of possible transmission of a highly resistant organism remains”, and that it had indeed already occurred in another hospital in the West Midlands.
Perhaps one of the more radical suggestions emanating from the report is the notion that decontamination facilities should be eliminated completely.
It suggests that “we have to consider that we are approaching the point” where such facilities should no longer be utilised.
The report was also by the Trust Infection Prevention and Control Committee, and could ultimately have far reaching consequences on the implementation of endoscopy in the NHS.
The journal BMJ Quality and Safety has published a study which suggests that an NHS trust has been particularly successful in dealing with the novovirus bug.
Portsmouth Hospitals NHS Trust has reportedly cut outbreaks of the winter bug that causes violent vomiting by more than 90 per cent over a five-year period.
The trust actually used a relatively simple system in order to achieve this eye-catching result.
Simple clinical measures combined with computer-based surveillance were utilised in order to identify and expediently manage patients who had been infected with the virus.
By treating people more rapidly, incidences of the virus were massively reduced.
In addition to the novovirus, the Portsmouth Hospitals NHS Trust also claims to have significantly reduced cases of other gastrointestinal viruses.
The initiative meant that norovirus outbreaks at the trust dropped by 91 per cent between 2009-10 and 2010-14.
And this reduction in the virus was much pronounced than those reported by other hospitals across England.
This can be considered particularly significant as these debilitating bugs create particularly unpleasant symptoms in patients, and can be extremely disruptive to the overall functioning and capacity of hospitals and other healthcare institutions.
The paper in BMJ Quality and Safety concluded: “A multi-year quality improvement programme, including use of real-time electronic identification of patients with norovirus-like symptoms, and an early robust response to suspected infection, resulted in virtual elimination of outbreaks.”
Central to the success of the Portsmouth Hospitals NHS Trust was its collaboration with The Learning Clinic.
This helped produce computer software referred to as ‘VitalPAC Infection Prevention Manager’.
The VitalPAC Infection Prevention Manager is able to utilise the Apple iPod MP3 player to record important patient observations related to the novovirus, and create a sophisticated yet simple series of alerts that enable healthcare staff to respond quickly.
Commenting on the success of the approach adopted by this southernmost NHS trust, Dr Caroline Mitchell, associate director for infection and patient safety at Portsmouth Hospitals NHS Trust, and one of the study’s authors, commented that other trusts could achieve similar results by adopting the Portsmouth methodology.
“By application of simple measures we have significantly reduced the number of cases of Norovirus and other gastrointestinal viruses which can cause serious and unpleasant symptoms in patients and massively disrupt the operational capacity of the hospital. The combination of new technology and better training and organisation of our staff has contributed hugely to our successful results in this field.”
Dr Peter Greengross, medical director of The Learning Clinic, which developed the VitalPAC system, added: “We believe Norovirus outbreaks cost the NHS £41.5m a year. If every hospital achieved the same result as Portsmouth the savings could be £38m a year. That would have a massive impact.”
Research published by Public Health England claims that novovirus outbreaks affect as many as 30,000 patients worldwide, and that the virus is ultimately responsible for the equivalent of 8,900 days of ward closure and 15,500 bed-days.
Potential savings from a nationwide implementation of the strategy adopted by the Portsmouth NHS trust could result in savings equal to £38 million per year.
While this may be a relatively paltry figure converted to the massive deficits that some NHS trusts are experiencing, it would nonetheless make a small contribution toward balancing the books, while delivering superior treatment to patients.
According to a report released by Public Health England, the flu jab released last winter was effective in 34 per cent of cases.
This represented a significant improvement on the early trend in the season, but can overall be considered a sub-par result.
At one stage, it was observed that the vaccine was protecting around three out of every 100 immunised people developing symptoms.
However, according to the report, a shift in the dominant circulating strains of flu saw the efficacy of the vaccination improve significantly.
Nonetheless, considering that the flu jab was still ineffective in two out of three cases, there will still be question marks regarding the efficacy of this treatment.
Many campaigners have called into question the need for vaccination against influenza, considering that it is a relatively benign virus in healthy people.
And these latest figures certainly won’t dampen down any such criticism.
Commenting on the figures, Professor Paul Cosford, from Public Health England, conceded that its effectiveness had been “slightly lower” than usual.
In defence of the flu jab, it should be noted that the virus mutates very rapidly, ensuring that manufacturing and distributing an effective vaccine is extremely challenging.
This also explains the reasoning behind a new jab being released every year.
Considering the fact that vaccinations can have side-effects, the relatively disappointing figures could have a negative impact on uptake of the virus in 2015.
Officials are apparently concerned that public opinion could be swayed against the flu jab by the somewhat poor performance of the vaccination in 2014.
Nonetheless, Professor Cosford underlined his particular belief that vaccination remained an effective measure against the flu.
“Whilst it’s not possible to fully predict the strains that will circulate in any given season, flu vaccination remains the best protection we have against an unpredictable virus which can cause severe illness and deaths each year among at-risk groups. These include older people, pregnant women and those with a health condition, even one that is well-managed,” Cosford asserted.
According to the World Health Organisation, flu vaccines can typically be expected to work in roughly 50 per cent of cases.
But the winter past featured one particular strain of flu that mutated so dramatically that the vaccine proffered presented much lower levels of protection than would usually be expected.
An EU report in 2014 suggested that pensioners in Britain are more likely to die of flu or pneumonia than anywhere else in Europe, and that 80 Britons die from the diseases every day.