Introduction to HPV OVERVIEW Recent advances in testing with HPV HPV amp related diseases Transmission Tristel amp HPV amp ME WHAT IS HPV Human papillomavirus Small nonenveloped DNA virus ID: 917190
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HPV:
TRANSMISSION & DISINFECTION
Slide2Introduction to HPV
OVERVIEW
Recent advances in testing with HPV
HPV & related diseases
Transmission
Tristel & HPV
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WHAT IS HPV?
Human papillomavirus
Small non-enveloped DNA virus
Physically stable and resistant with long durability
Most sexually transmitted disease worldwide
Over 200 different types identifiedHPV classified into high-risk and low-risk types
Slide4HPV is associated with skin infections:
These result in non-cancerous skin growths (warts).Infections in genital area are associated with genital or anal warts.Mouth papillomas (benign epithelial tumours).
Chronic infections of the cervix with HPV 16 and 18 causes cervical intraepithelial neoplasia (CIN) and leads to cancer.
HPV is found in about 99% of cervical cancers.
More than 70% of these are caused by HPV types 16 and 18.
HPV is also responsible for other anogenital cancers and oropharyngeal (throat) cancers.
HPV type 16 is responsible for up to 60% of all HPV-associated cancers.& MEDISEASES & PREVALENCE
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Source: https://en.wikipedia.org/wiki/Human_papillomavirus_infection
NOTABLE HPV TYPES AND ASSOCIATED DISEASES
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(2002)
Source: Parkin, 2006
HPV & CANCER
Slide7HPV is spread predominantly through sexual intercourse.
Other routes of transmission include:Vertical transmission:From parent to offspring.
From mother to embryo, foetus or baby during pregnancy or childbirth.
At fertilisation via infected oocyte or spermatozoon.
Horizontal transmission:
Via fomites.
Through kissing or hand-genital contact.Through medical procedures such as colposcopy and transvaginal ultrasonography or ENT procedures.This presentation focuses on HPV transmission which can occur in medical facilities (nosocomial).& ME
ROUTES OF TRANSMISSION
Slide8Nosocomial transmission via:
Medical devices which enter cavities such as transvaginal or transrectal probes or laryngoscopes.Medical surfaces - HPV retains 30% of its infectivity even after dehydration for 7 days.Transvaginal probes are routinely protected by a condom, which acts as a physical barrier to contamination.
Studies have shown that 0.9% - 5% of the condoms get punctured during procedures.
It has been shown that low-level disinfection does not remove all HPV DNA from infected probes.
HPV DNA has also been found present on sterilised medical instruments used in patients with HPV genital tract infection.
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RISKS OF TRANSMISSION
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DISINFECTION HAS NOT BEEN WORKING
2012 study found that
7.5%
of transvaginal sonography probes (TVS) were HPV + in A&E.
2011 study found of 198 samples, 7 (3.5%) were HPV + in gynaecology department after endovaginal ultrasound procedure.Same study also found that HPV was found in 6 out of 216 (2.8%) samples before procedure.Using a similar technique another 2012 study found 7.5% of the samples were HPV positive.2014 study found HPV negative mothers had infants with HPV.
HPV & TRISTEL PRODUCTS
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Study showed that HPV was identified on objects (fomites)
commonly used in
gynaecological
care.
Source:
Human papillomavirus (HPV) contamination of gynaecological equipment, Switzerland, 2015HPV & TRISTEL PRODUCTS
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11 commonly used disinfectants -only 0.525% hypochlorite (bleach)
and 1.2% PAA-silver worked!
Source:
Susceptibility of high-risk human papillomavirus type 16 to clinical disinfectants - Department of Microbiology and immunology, Pennsylvania State College of Medicine, USA
HPV & TRISTEL PRODUCTS
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WHY USE TRISTEL?
Commonly used clinical disinfectants, including those used as sterilants in medical and dental healthcare facilities have not been working.
This has been noticed by various health authorities and policy changes concerning disinfectant use has meant that the need for high-level disinfection has become more pronounced.
Tristel offers the level of disinfection needed to get the job done!
HPV & TRISTEL PRODUCTS
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TRISTEL PRODUCT QUALITIES
Chemistry is safe to patient, staff and environment
Unblemished Health and Safety record of over 20 years
Effective against a wide range of microorganisms due to oxidation properties
Microorganisms are unable to build resistance against chlorine dioxide
Decontamination process is fast by industry standards (within minutes)Excellent material compatibilityCompliance with local and international regulationSimple, portable and affordable HPV & TRISTEL PRODUCTS
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HPV & TRISTEL PRODUCTS
Other uses include high-level disinfection of non-invasive medical devices, such as:
Transabdominal probes
Bladder scanners
Blood pressure cuffs
Chemistry: Chlorine dioxide (ClO2)Intended use: high-level disinfection of
endocavity ultrasound probes, such as:Transvaginal ultrasound probesTransrectal ultrasound probesTristel Duo ULT
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Tristel Trio Wipe System
Nasendoscopes
Transoesophageal echocardio probes (TOE/TEE)
Laryngoscope blades
Intubation endoscopes
Manometry cathetersEndocavity ultrasound probesLaryngoscopesOphthalmic instrumentsChemistry: Chlorine dioxide (ClO2)Intended use: high-level disinfection of non-lumened invasive and non-invasive medical devices, such as:
HPV & TRISTEL PRODUCTS
Slide16Chlorine dioxide (ClO2) is a powerful oxidant and eliminates microorganisms through oxidation.
Oxidants are substances which remove electrons from other atoms.Chlorine dioxide ‘steals’ electrons from microorganisms disrupting the cells. This leads to cell death. Chlorine dioxide inactivates viruses by inducing oxidative stress.ClO2 inactivates Poliovirus by reacting with the viral RNA and impairing RNA synthesis.
ClO2 inactivates Influenza virus
through specific oxidative modifications of specific amino acids residues on specific proteins.
Tristel chemistry: Chlorine dioxide
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THE IMPORTANCE OF REMAINING CURRENT
To maintain and potentially expand it’s share of the market Tristel must keep pace.
It is better to survey, anticipate and prepare for changes than tackle them as they arrive.
Changes are anticipated for HPV…
This includes testing new diseases or updating products with changes in regulatory testing method/standard.
ADVANCES IN HPV TESTING
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LATEST DEVELOPMENTS
The ability of HPV to infect host can now be measured.
Two systems have been developed capable of producing high quantities of HPV virus.
ADVANCES IN HPV TESTING
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Testing has been performed with Duo ULT and Trio Wipes System against native HPV 16 and 18.
This testing has demonstrated that both of these disinfectants are effective.
Duo ULT and Trio Wipes System are based on chlorine dioxide chemistry which inactivate viruses by reacting with the viral RNA and impairing RNA synthesis.
We are moving forward to also include simulated use testing on devices to simulate real-life testing.
ADVANCES IN HPV TESTING
Slide20Alvarez and O’Brien (1982)
Mechanisms of inactivation of poliovirus by chlorine dioxide and iodine. Appl Environ Microbiol, 44(5):1064-71.
Casalegno
et al. (2012)
High risk HPV contamination of
endocavity
vaginal ultrasound probes: an underestimated route of nosocomioal infection? PLoS One, 7(10): e48137.Ferenczy et al. (1989) HPV DNA in Fomites on Objects Used for the Management of Patients With Genital HPV Infections. Obstet Gynecol. 74(6): 950-4.Gallay et al. (2016) Human papillomavirus (HPV) contamination of gynaecological equipment. Sex Transm Infect.
92: 19-23. Khan et al., (2005) High level disinfeThe elevated 10-year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type-specific HPV testing in clinical practice. J Natl Cancer Inst. 97(14): 1072-9.Ma et al. (2012) Transvaginal ultrasound probe contamination by the human papillomavirus in the emergency department. Emerg Med J. 30(6): 472-5. Ma et al. (2012) High level disinfection reduces HPV contamination of transvaginal sonography probes in the emergency department. Published as a response to “ Transvaginal ultrasound probe contamination by the human papillomavirus in the emergency department. (Ma et al., 2012)”
Meyers et al. (2014) Susceptibility of high-risk HPV type 16 to clinical disinfectants. J Antimicrob Chemother. 69(6): 1546-50.Miura and Shibata (2010) Antiviral Effect of Chlorine Dioxide against Influenza Virus and Its Application for Infection Control. The Open Antimicrobial Agents Journal. 2: 71-8. National Cervical Cancer Coalition. Cervical Cancer Overview . Available at: http://www.nccc-online.org/hpvcervical-cancer/cervical-cancer-overview/. Accessed: 05/04/2018.
Tota et al. (2011) Epidemiology and burden of HPV infection and related diseases: implications for prevention strategies. Prev Med. 53 Suppl 1: S12-21.Parkin (2006) The global health burden of infection-associated cancers in the year 2002. Int J Cancer. 118(12): 3030-44.Ryndock and Meyers (2014) A risk for non-sexual transmission of human papillomavirus? Expert Rev Anti Infect Ther.
12(10): 1165-70.
Sabeena et al. (2017) Possible non-sexual modes of transmission of human papilloma virus.
J Obstet Gynaecol
Res. 43(3): 429-35.
Syrjanen (2005) Human papillomavirus (HPV) in head and neck cancer
. J Clin Virol
. 32 Suppl 1: S59-66.
REFERENCES
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