By Roger Freeman, DDS
Editors note: We welcome Roger Freeman, DDS, author of thepopular Microbe of the Month column, back to ICTs pages. For those of youscratching your head at the name of this new column, Roger says to think pandemicand comical. Get it now?
A team of researchers from the London School of TropicalMedicine conducted an international study on what really disgusts people.A follow- up study was then done by the BBC, who asked folks to rank disgustingpictures on a scale from one (not very disgusting) to five (major yuck). In bothstudies, people found disgusting things, well ... disgusting! Body fluids, lice, festerati, colorful repugnatia ...they all evoked what may be a very ancient emotion, one that evolved with usto give us an instinct to avoid disease. What a shock! The pound-sterling atwork. Note: The Australians were statistically the most yuck-resistantto gross-out. (Put another what? on the barbie?!)
NNIS (Stands for Not Noticing Infectious Stuff)
The data dump is in, and the new survey says ... depending onthe geography, anywhere from two to 12 unsuspectables per hundred will bite thei-bullet during their high-risk stay. Median hospital stays can increase four to22 days over the uninfected; median costs can increase from $2,700 to $11,000... and this is in the U.S.! If youre thinking about that surgical cruise orthat tropical tuck, you may want to check out the local infectometerfirst. The perspectivo: figures are always startling, especially whenconsidering that promising or effective drugs can be killed by seriouscomplications in just 1 per million. Grossly longer odds, but much better(worse?) press.
If you were to go sub-crevicular no, not attack a postoffice but simply examine the microbes between teeth and gums, youdlikely find entire brigades of potential pathogens. More than 500 organisms havebeen identified to date, and the sulcus sleuths are running out of fingers andtoes. Bite-o-gram from the house DDS: break up the brigands STAT! with floss, pick, barbed wire, missiles ... whatever! Theenemy troops marshal up toute-suite following meals often within 20 minutes so the sooner the shock, the better. Politically correctly (or not),pre-empt or start check under p for periodontists!
Do your fingers parch, dessicate, crack, bleed or otherwisescream as if manicured with a Cuisinart? Heres a tip that might help, whenall other slathers fail: gulp ... diaper ointment! The anecdotals have it thatA&D infa-bottom spread is replete with vitamins A and D in a cod liver(gulp, again) and petroleum base good both as a skin humidifier and amoisturizer. Havent tried it yet, but maybe the secure among you will dosome trials and report back. Just dont confuse the mission.
UH-UH, NOT MINE ...
Your shower curtain is likely teeming with some bacterialopportunists capable of infecting wounds or sickening the immuno-suppressed andelderly. A University of Colorado microbiologist has studied this problem anddiscovered that taking a shower aerosolizes the scumbags, engulfing the unwaryin bacteria. He strongly suggests frequent washing of the shower curtain everyfew weeks. Probably good to know ... maybe thats what got into the footballcoach ...
I USTA BE A CONTENDA
Piercing the upper ear (cartilaginous part) has lead to anumber of infections in kids ages 10 to 19, a group of whom had their ears pokedrecently in a jewelry kiosk in Oregon. Pseudomonas aeroginosa turned outto be the villain, leaving four patients cosmetically deformed. Think cauliflower. Apparently, antibiotics do not work well onthe poorly vascularized cartilage, blocking the get-well juice from its target. Obvious lesson (we guess): pierce something soft. Ouch.
Im primarily a foodborne freeloader, mostly incoqs-sans-vin or in dairy doodles. Depending on my tailor, I can do typhus, or,if in the mood, a simply wretched case of food poisoning. My case load isprobably in the millions, although mostly Im unreported or misunderstood. Imoxidase-negative, whatever that means; but then, who cares when youre archingyour guts out. Oh yeah, I can infect kids via you-know-what from those healthypets with a glowing coat. Better cook me or youll surely be courting theporcelain princess. ID my squiggly-looking self, whose name sounds like a formerrebel without a cause. (Well reveal the answer in the next column.)
Pandemicalswanted. Are you privy to an interesting, educational or even usefulinfecto-byte? Send it to: roger@iAwareables.com, along with a trackable preferably legitimate reference source. If it makes the editors cut, youll receive a minisculecitation and an extraordinarily modest gift.
Roger Freeman, DDS, is a dentist and educator who obviouslyinhaled too much tooth dust in 30 years of practice. He is currently presidentof Infectious Awareables, Inc. (www.iawareables.com), an occasionally for-profitcompany producing science based awareness products.
By Tina Brooks
For those in infection control, it wontbe a surprise as to what motivated Kathy Warye to join the Association forProfessionals in Infection Control and Epidemiology (APIC) as its new executivedirector. It was an opportunity to lead an organization at a verycritical point in its history, Warye says. I think that infectionprevention and control has never been more important to us, and infectioncontrol professionals have never faced greater challenges. If you look ateverything from emerging diseases to the threat of bio-terrorism and even thispast flu season, the healthcare community and infection control inparticular is facing an increasing number of challenges.
The Centers for Disease Control and Prevention (CDC) reportsthere are approximately 2 million hospital-acquired infections per year, many ofwhich can be prevented. As a nation, we need to address this issue, primarilyto improve patient outcomes, but also, when you look at the rising cost ofhealthcare, a business case can be made for this as well, Warye says. But to do this, infection control will needgreater resources and recognition.
Along with these challenges come great opportunities. ForAPIC, they include securing the kinds of resources that infection controlprofessionals need to reduce and prevent infection in their own hospitals, Waryesays. APIC also is faced with addressing mandates that can put a crimp inhospitals operations.
When asked about APICs current activities to overturn OSHAsnew mandate applying the General Industry Respiratory Protection Standard to M.tuberculosis, Warye mentions that the association is working to bring aboutan outcome that is amenable to a variety of healthcare organizations andworkers. The mandate, which becomes effective July 1, 2004, requires the annualfit-testing of respirators in healthcare settings.
APIC has written to John Henshaw, assistant secretary of theOccupational Safety and Health Administration (OSHA), to urge revocation of thismandate, due to the lack of scientific justification for annual fit-testing ofrespirators. APIC has also mobilized its members to write to OSHA to explain howthis mandate will affect their facilities.
APIC continues to enlist members of Congress in dialogue withOSHA and Secretary of Labor Elaine Chao in an effort to overturn the mandate. By press time, APIC will have met with OSHA officials todiscuss its concerns and testified on this issue before the House AppropriationsSubcommittee on Labor, Health and Human Services in late April.
In terms of APICs activities in the coming year, Waryesays, Were about to launch a dynamic new Web site. It is going to becentral to our organization, and our approach to services will be verycutting-edge. For example, members will be able to create their own personalizedhome pages that will enable them to receive information aligned with theirinterests. This new service will be introduced early next year and is only oneof many value-added attributes that we envision through the new Web site.
Warye continues, Education remains critically important tous. Were planning to broaden our educational offerings to better address theneeds of people responsible for infection control and prevention in a variety ofnon-acute care settings and internationally. We are very excited about theintroduction of a new course on bioterrorism preparedness designed for infectioncontrol professionals in state health departments. We also are concerned about the shortage of nurses and whatthis means for the pipeline of professionals needed to advance infectionprevention and control. To ensure adequate numbers of future ICPs, APIC needs toreach out to a younger demographic and encourage pursuit of infection controlcareers.
Warye continues, Our practice guidance activity is alsoincreasingly important, as we are receiving a growing number of requests forexpert guidance and information from a host of organizations. This increasedlevel of activity will go hand-in-hand with our ability to influence publicpolicy and potentially increase the funding that goes into this particular areaof healthcare.
Warye mentions that the associations primary objectives forthe near future include representing an uncompromising standard of excellence inall of its products, programs, and services. Another objective is increasing theassociations expert reputation and visibility among a variety of audiencesfrom Capitol Hill, to healthcare executives, to the general public. Lastly, growing and developing membership consistent with APICsmission and goals will be important as well.
I would like for us to reach beyond the acute-care hospitalbase membership to others who are increasingly in need of infection preventionand control knowledge and skill, Warye says. And by that I mean people inemergency medical services, long-term care, correctional facilities, home care,and behavioral health. I met recently with an individual who is responsible foridentifying infectious disease in people coming from across the border. There istremendous need in the community beyond the hospital setting for the type ofinformation and skill that our members possess. It will be important for us toincrease our strategic affiliations with other non-profits that have a similarmission and also with for-profit organizations that are interested in advancingthe public health to reach out to these professionals.
Working with associations like APIC isnt new for Warye. Shehas more than 20 years of non-profit experience and has held key managerialpositions at high-profile organizations in the Washington, D.C. area. Mostrecently, she oversaw the National Science and Technology Education Partnershipsextensive efforts to expand and improve K-12 education programs.
Previously, Warye served as senior vice president of educationand government programs for the Association for the Advancement of MedicalInstrumentation (AAMI). She was responsible for the associations educationalprogram and services, certification programs, government affairs efforts, andpromotion and marketing activities. Healthcare non-profits in particularappeal to me because I have an affinity for protecting and advancing the publichealth, she says. During my 20-plus years in association management, Ihave spent more than nine years in health-related associations. I find that workto be particularly fulfilling.
Based on her years of experience, Warye notes that there aretwo ingredients that are critical in any strong professional association. Thefirst is having tremendous subject-matter expertise, which APIC has in itsmembers. APIC has more than 110 regional chapters in the United States and morethan 10,000 members worldwide. The other is a staff with strong business experience.
This is the most knowledgeable, dedicated and committedgroup of member volunteers Ive ever worked with, Warye says. Sometimesit can be difficult to get volunteers to really give the time and energy neededto move the organization forward. APIC is unique in that its volunteers are 100percent devoted to the advancement of the association. It is the vision of themembers combined with their commitment and expertise that is going to propelthis organization forward.