Infection Control Today - 09/2004: Pandemicals

Surveillance for the Tortured ICP

By Roger Freeman, DDS

50,000 Co-workers Per Square Inch … So Much for Downsizing

Dr. Charles Gerba is at it again. We gunnited our kitchen after Dr. Gerba’s not-too-bon-appetit study on the galley a few years ago. Now, the University of Arizona guru-de-guk has completed a study of workplace germs, and the news is not good. Describing the desk as a “laptop of luxury” for bacteria, Dr. Gerba and his team concluded that the office toilet seat (49 bacteria per square inch) has 400 times fewer bacteria per square inch than the average desktop! The phone receiver is the heaviest employer, at 25,127 bsi, followed by desktop, fountain handle, microwave door handle, computer keyboard, mouse, fax and toilet seat, in that order. Levels dropped sharply if … are you sitting down … the surfaces were cleaned! That bubble is looking better all the time.

Guidelines for Gums

The Centers for Disease Control and Prevention (CDC) has recently issued updated guidelines for infection control in dental-care settings. Historically, dental offices have been among the most highly regulated healthcare venues, stemming initially from intense media attention in the early 1990s. Today, dentists and dental personnel look much like riveters in efforts to protect both themselves and their patients. Because there is no real science to support many of the recommended practices, guidelines are often based on “strong theoretical rationale, suggestive evidence or the opinions of respected authorities.” What does it mean to you? Look for these telltale signs of an office that has its Occupational Safety and Health Administration (OSHA) and IC act together, at least from your prone position:

• Both Doctor and personnel wash hands in front of you.
• Both should also glove in front of you. No fair washing gloved hands.
• Instruments are sterile-wrapped, tray set-ups sealed.
• Personnel minimize fomite transfer, (i.e., keep their hands tending to business).
• You are offered clean protective glasses (insist on this.)

No Peeking

Fill in the blanks: Contaminated ___________ accounts for the majority of food-borne outbreaks, while ____________ is the source of the most individual cases of illness in the U.S. Hint: if you said “meat, chicken or fried pork rinds” for either of the blanks, you’d be dead wrong! Contaminated seafood is the culpritus majoris in the former, whereas produce is the chief offensive officer for the onesies and twosies. This, according to a new report called “Outbreak Alert…!” by the Center for Science in the Public Interest.

Check out www.cspinet.org/reports/outbreak_report.pdf for all the gory details. Anyone for a nice sea urchin soufflé?

Rear-View Mirror?

A U.S. District Court recently awarded a woman in Wyoming $50,000 for hospital negligence in post-exposure and needlestick protocolflun fortunately, sticks still happen and are always serious and unsettling. But in this case, the modus stickem was a little unusual. Apparently, while visiting a friend, the victim backed into a used needle lodged in a “heat register” left, ahem, behind in the patient’s room — poking herself in the thigh! It proves, once again, that if it can happen, it will!

Play the Odds

Recent studies indicate that administering antibiotics to a child with an ear infection results in only a 12 percent chance of improvement, but a 20 percent chance of an allergic reaction! Not to mention the millions of over-killing antibiotic prescriptions falling, so to speak, on deaf ears. Concluding that there is no clear advantage to the treatment, the AAP and AAFP (think pediatrics) recently issued guidelines discouraging immediate use of antibiotics, and instead, recommended an “observation option” of 48 to 72 hours for healthy kids between two months and 12 years. You moms may want to look over “Diagnosis and Management of Acute Otitis Media” at www.aap.org. The continuing emergence of resistant strains is actually scarier than what happens to the kids once they become teens!

Mystery Microbe

Much has been made of WMD,
There’s lots of talk about WNV
Timely topics plain to see,
Better hope the future ain’t all about me!

I’m a starlet Phlebovirus, hanging so far in Africa, where I vectorize among both animals and human. Delivering a higher mortality rate than my bird-borne buddy, I have far more mosquito groupies than West Nile – more than 30 types of skeeters air shuttle me to my cattle or sheep mobile homes. I haven’t done any tours outside of Africa, as yet; but the fact I am both blood-borne as well as stable in aerosol form, brings to mind the term “agri-terror,” and is starting to worry those-who-know. Oh, and did I mention there’s currently no known course of treatment? Looking for some marquee time down the road, I am …? (You’ll find the answer in the next Pandemicals column.)

Answer to the last Mystery Microbe: Salmonella

Pandemicals wanted. Are you privy to an interesting, educational or even useful infecto-byte? Send it to: roger@iAwareables.com, along with a trackable — preferably legitimate — reference source. If it makes the editor’s cut, you’ll receive a miniscule citation and an extraordinarily modest gift.