Saskia v. Popescu, PhD, Discusses How to Prepare for Rare Infectious Diseases

Because the landscape of infectious diseases is constantly evolving, health care workers (HCWs) should be aware of the possibility of rare, yet equally significant, pathogens. HCWs should be aware of the critical importance of robust infection prevention measures, including accurate diagnostics, isolation protocols, and stringent disinfection practices, in mitigating the spread of such infections.

For Rare Disease Awareness Month, Infection Control Today^® (ICT^®) spoke with Saskia v. Popescu, PhD, MPH, MA, FAPIC, assistant professor at the University of Maryland School of Medicine in Baltimore, Maryland, and a member of ICT’s Editorial Advisory Board.

Popescu discussed multidrug-resistant organisms like Candida auris and other emerging infectious diseases not endemic or typically seen in the US, like SARS-CoV-1, Ebola, Nipah virus, Hendra virus, Marburg virus, and others.

She emphasizes that infection prevention health care workers should know about these diseases, including infection preventionists, environmental hygienists, and sterile processing personnel. “The tough part is that if we only stuck to one disease, we'd be doing our staff a disservice. And even if the likelihood of the Nipah virus showing up in your hospital is extremely low, I would rather we talk about it and have plans for response because it's actually a very manageable disease. From an [infection control and prevention] perspective, we can easily put those protocols in place. Even with Ebola, it is much more complicated to handle, but we have protocols and a tiered hospital system within the universe. But we have to make sure people know about it; we have to make sure they have the resources to adequately respond and communicate it.”

Popescu told ICT where she goes to get the latest information on rare diseases and infectious diseases in general. She said she goes to ProMed, “This is a free online information service about outbreaks that are reported globally,” Popescu said. She also reads CIDRAP, ICT, the CDC website, the Morbidity Mortality Weekly Reports, and the social media from those sources.

Popescu said that training teams on recognizing and handling rare diseases should be addressed at the highest level, such as for Ebola, because it requires a high level of infection control processes. “If you can train your teams and make them comfortable with those processes, comfortable with the protocols, the donning and doffing and knowing what to do, or at least where to find the resources. [Ebola] is a nice top to your level of readiness, that anything else will probably not be as burdensome because even when we look at novel respiratory pathogens like COVID-19, [which] is not the same level of PPE because Ebola is so infectious, that you have to be very, very careful, you have to have the designated donning and doffing rooms, and going in and out.”

She continued, “The PPE is very exhausting and hot. It's very time-consuming. So, I use Ebola as a gold standard for if we can do [follow those high-level processes]. And it involves so much in terms of engineering controls, cleaning, disinfection, waste management…PPE, just communication, everything, then everything else will just be either a little bit less or different in a way that [the team] will know what to do, essentially. I like using Ebola as a metric.”

Some individuals believe that just because a disease usually is only found in a foreign country, that doesn’t negate that HCWs should be prepared for any disease that shows up at their facility. “There's a sense of saying this disease isn't something we have seen in the US,” Popescu said. “But that doesn't mean we're not preparing for it is a better strategy because I don't want people to ever live in a state of fear. I also don't want us to ever be so complacent that we're not preparing ourselves.”

(Quotes have been edited for clarity. Watch the entire video for more of Popescu’s advice.)