October 1, 2005


By Roger P. Freeman, DDS

APIC Keynote: Scary, and Not a Movie!

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-ohs.
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 were 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...

A Powerful Poster Presentation

... 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.

Exploading Toads

On a much, much lighter note (except if youre 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 chancellors 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.

For the Cost-Unconscious Only

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 ones
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.

VRE and Thee

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 werent
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 healths 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 for resources on antibiotic

Holy Bat-Buster!

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...

Who You Callin a Germ Freak?

Keep an eye out for author Allison Janses new book, The
Germ Freaks Guide to Outwitting Colds and Flu, scheduled for release
shortly. Its a clever, entertaining, more-than-a handbook for teaching and
implementing healthy hygiene at home, workplace and out
. 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


Sponsored in part by SPS Medical


Advances in Clinical Practice and RNFA Trends

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International Association of Health Care Central Service
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Infection Control and Epidemiology: Introduction to the Fundamentals (ICE I) course


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Washington, D.C.

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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
  • 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.