PANDEMICALS

At the recent Association for Professionals in Infection Control and Epidemiology (APIC) annual conference, renowned public health authority Michael Osterholm, PhD, MPH, delivered the keynote address and drew some serious uh-oh’s. Noting that in his 30 years of service he had never seen a threat as serious as pandemic influenza, he stated, “If there ever was ... a perfect storm, this is it.” Considering the current tsunami of other challenges — infected and migrating birds, chickens, chimps, ducks, tics and ‘skitoes come to mind — this was not good news. It gets worse. Given the very real potential of pandemic, it seems we’re seismically ill-prepared. Echoes of 1918 and the global flu pandemic that caused more fatalities than all world wars combined.

How to prepare? Dr. Osterholm targeted three major areas: prevention, treatment, and collateral damage response. The most immediate concern was the obsolescence of current vaccine and antiviral drug production, and he called for significant investment of resources to develop cell culture systems capable of meeting potential needs. Issues such as inadequate food and equipment supplies and shortage of human resources and inadequate international security rounded out the reality check. Throughout the presentation, Dr. Osterholm emphasized the critical role of the ICP in this worst-case scenario. You probably knew that. But what was also interesting...

... at this same APIC meeting, not long after we stopped hyperventilating from the keynote, we got seriously head-slapped again by the presentation titled, “Nurses’ Beliefs About a Bioterrorism Event: Fear of Abandonment.” Presented by C. O’ Boyle, et. al from the University of Minnesota, it struck us as startling, sobering, maybe even a little sad. The bottom line: From the perspective of those nurses surveyed, all of whom were likely to be on the front lines caring for victims of a bioterrorism event, fear of abandonment was the primary concern. Chaotic settings, no clear chain of command, limited access to protective equipment, defiance of authority, lack of discipline, and other basic survival issues all contributed to the overarching theme of the fear of being isolated and abandoned. This was a tough day.

On a much, much lighter note (except if you’re a toad), the German Institute for Hygiene and the Environment dutifully reported that more than 1,000 toads have recently been observed puffing up and exploding in a Hamburg pond. Pond water and various froggie parts have been tested (messy job, collecting), but to date, none of the chancellor’s men have figured out how to put Kermit back together again. Although likely, no bacterial or viral culprits have yet been identified that might be causing the curious and unseemly combustion. Prospective princes, take note.

Wait long enough, and sure enough, the cost is bound to come down. Thankfully, researchers have found a way to cut the cost of mapping one’s own personal genome, now possible at only $2.2 million, reduced from the pricey, early-adapter tab of $20 million. Whew, we were concerned. The journal Science reports that this newest technology for analyzing DNA uses color-coded beads, a microscope, and a camera. Not sure what the big deal is all about. Sounds suspiciously like some non-research oriented techniques used by some “colleagues” at Berkeley way back in the 1960s.

Vancomycin remains one of the last lines of antibiotic defense against many resistant uberbugs. Just our luck, vancomycin-resistant E. faecium (VRE), has recently joined the list of emergent hospital pathogens. So we weren’t happy to learn that apparently VRE can survive on acrylic fingernails, hospital bed linens, plastic keyboard covers, and who knows what else ... for up to 11 weeks! Somehow the fact that they lose their home-run power after seven weeks does not cheer us up.

Antibiotics were one of public health’s great advancements, but almost from the moment penicillin was introduced in the 1940s, the bugs have been working on outsmarting us, and winning. Contrary to conventional wisdom, in the case of antibiotics, it appears the more you use ‘em, the more likely you are to lose ‘em. Check out www.antibiotic.org for resources on antibiotic resistance.

We know that time is of the essence for stroke victims, and that the sooner a clot-busting drug is administered, the greater the chance of the victim avoiding permanent disability. Current drugs require administration within three hours of onset to ward off permanent disability — not always an easy deadline to meet. (In fact, only 4 percent of stroke victims do). Hope may be just around the bat cave, however. Turns out that bat saliva contains a protein designed by Mother Nature to thin the blood, and afford the little screechers their standard and leisurely 30-minute dining experience. Clinical trials are currently underway on an injectable, genetically-engineered version of the bat protein which shows initial promise for a nine-hour therapeutic window. Now if it were only effective on traffic...

Keep an eye out for author Allison Janse’s new book, “The Germ Freak’s Guide to Outwitting Colds and Flu,” scheduled for release shortly. It’s a clever, entertaining, more-than-a handbook for teaching and implementing healthy hygiene at home, workplace and out there. Ms. Janse uses lethal doses of humor, punctuates with great cartoons, and drives home the messages we all work hard to spread around. Many thumbs up!

Roger P. Freeman, DDS, is a retired dentist and is president of Infectious Awareables, Inc., a private company that creates science-based products designed to promote awareness.

IC CALENDAR
Sponsored in part by SPS Medical

OCTOBER 2005

14-16
Advances in Clinical Practice and RNFA Trends
Boston
www.aorn.org

21-22
Keys to Clinical and Management Success Ambulatory Surgery
Chicago
www.aorn.org

NOVEMBER 2005

6-9
International Association of Health Care Central Service Materials Management (IAHCSMM) Fall Meeting
Norfolk, Va.
www.iahcsmm.org

7-10
APIC’s Infection Control and Epidemiology: Introduction to the Fundamentals (ICE I) course
Indianapolis
www.apic.org

7-10
APIC’s Infection Control and Epidemiology: Clinical Problem Solving in Multiple Practice Settings (ICE II) course
Indianapolis
www.apic.org

10-12
today’s surgicenter conference
The Venetian and Sands Expo
Las Vegas
www.surgicenterconference.com

DECEMBER 2005

6-8
10th Conference on Infectious Disease
Roswell, Ga.
www.aorn.org or www.apic.org

MARCH 2006

19-23
Association of periOperative Registered Nurses (AORN) 53rd Annual Congress
Washington, D.C.
www.aorn.org

Send your event information for publication to Kelly Pyrek at kpyrek@vpico.com.

Poll Reveals Many U.S. Adults are Only Moderately Concerned About the Potential of a Future Influenza Pandemic

ROCHESTER, N.Y. — In the wake of recent reports confirming that avian flu has spread from Siberia into other parts of Russia, a new poll has found that a majority (53 percent) of U.S. adults are either not very or not at all familiar with this virus and that a large number (41 percent) are not very or not at all concerned that the United States might be part of an avian flu pandemic in the near future. Despite this lack of familiarity and concern, majorities of adults believe that particular steps should be taken to prepare for a potential pandemic. These are some of the results of a Harris Interactive online survey of 2,236 U.S. adults conducted Aug. 3-5, 2005 for The Wall Street Journal.

While half (51 percent) of adults say they are very or somewhat concerned that the United States might be part of an avian flu pandemic in the near future (this increases to 60 percent for those who are familiar with avian flu), similar or larger numbers say it will be important to take certain steps in an effort to prepare for a pandemic. Majorities of all adults say it will be absolutely essential or very important to:

• Develop plans to quickly provide critical medical supplies to areas of the globe that experience outbreaks of avian flu (71 percent)
• Develop plans to limit the spread of avian flu via quarantines, travel restrictions, etc. (65 percent)
• Invest government dollars in the development and production of avian flu vaccines (61 percent)
• Stockpile antiviral drugs that might slow an outbreak of avian flu (62 percent)
• Stockpile critical medical supplies (like surgical masks and gloves) that can help slow the spread of avian flu (55 percent)

The public is split on how prepared it thinks the United States is to deal with an avian flu pandemic should it occur. Two in five (40 percent) adults think the United States is very or somewhat prepared to deal with a pandemic of this type while 44 percent think it is not very or at all prepared. A further 16 percent do not know enough to have an opinion.

However, among those who are familiar with avian flu, the percentage that thinks the United States is not very or not at all prepared to deal with a flu pandemic increases to 51 percent.