Infection Control Today: pandemicals

By Roger P. Freeman, DDS

Napoleon Got a Lousy Break!

How could the little guy have suspected, when he invaded Russia in 1812 witha half of a million men strong, he would lose nearly onethird of his troops tosomething even smaller, the common, er... louse. Lice are ectoparasites thattend to lease long-term on the outside of their hosts. They were knownto have found Napoleons troops particularly tasty. Recent findings by a French research team, as reported in the online editionof the Journal of Infectious Diseases, conclusively identified severalforms of the wingless insects among troop clothing remnants found duringconstruction at a former army barracks in Vilnius. Additional evidence of theevent was also found in the dental pulp of unerupted teeth of 35 soldiers. Lice can transmit both trench fever and typhus, plagues historically wellknown to thin out and devastate armies. Had the pointy-hatted one visited thelocal nursery school, he might have anticipated the problem, dont you think?

Splatter Matters

Ever wonder about that tsunami launching from your mouth while on the workingend of your dentists drill or hygienists ultrasonic scaler? Fortunately, most dentists wonder a lot about it, and take precautions totame that mushroom cloud of water, saliva, blood, tooth particles, bacteria, andpotential viruses. For the record, aerosols are particles less than 50micrometers in diameter, and are able to remain airborne for extended periods,potentially lodging in nooks and crannies of the lung. TB and measles areclassic examples of tiny culprits that can waft about for hours, ending up inmost unwelcome locales. Splatter, on the other hand, describes airborne particles bigger than 50micrometers that behave in a ballistic manner, scudding in droplets, ejectingforcibly from an operating site and arcing similar to a bullet. You get thepicture.

With this appetizing background, imagine for a moment, the war zone aroundyour personal la vida boca. While its impossible to control all airbornematerial during dental procedures, dentists reduce the collateral damage bythree primary means: First, by the use of standard precautions (i.e., barrierprotection) for hands, eyes, and nose. (This, of course, helps the dentist; it doesnt always do as much for you).Second, by the use of a preoperative rinse with antiseptic mouthwash. (This will reduce bacterial count, but it wont have much effect on biofilmorganisms found in plaque, below the gums, or migrating from the nasopharynx). Third, by the use of a high-volume evacuator, that oral Oreck used by anassistant, which often gobbles up everything not tied down. (But what if workingalone?) Aerosol and splatter, a messy dilemma ... and now you know. (With thanksto Drs. Harrel and Molinari, Journal of the American Dental Association,April 2004.)

Butt Out

Hypodermic needles do not make for fun times, at least for most of us. Addinginsult to sharp-o-phobia, now were being told needles probably should belonger, or else their therapeutic load may fall short of the target. According to a study conducted in Dublin, Ireland, standard one-and-a-quarterinch needles failed to reach the bullseye buttock muscle in 23 of 25 women,making for a lot of medicine frittered away in fat. This means that two-thirdsof test patients ended up with less than optimal dosages of the meds typicallyadministered rearly (e.g., painkillers, anti-nausea drugs, and others.Theres also the question of what the shortfall does, exactly, while bubbled up infat tissue. Guys, maybe its just a girl thing!

AIDS Takes its Toll

The stats, according to a UNAIDS AIDS Epidemic Update:

• People currently living with HIV and AIDS: 40.3 million

• New HIV cases in 2005: 4.9 million

• AIDSdeaths in 2005: 3.1 million

How is this possible?

In Memoriam

Jack Snow was a split-end for the Los Angeles Rams for 11 years during the1960s and 1970s. At 6-foot-2 and 210 pounds, he caught 340 passes for 6,012 yards and had 45touchdowns. He was fearless, his signature route taking him into the jaws of thedefensive secondary and an open invitation to annihilation from all sides. Many more times than not, he held on to the football, challenging the defenseto shake his courage and skill. It never happened. Snow died on Jan. 9, 2006, atthe age of 62, from a resistant staph infection he had been battling for twomonths post-operative. Staph ... Its such a tiny little thing...

Roger P. Freeman, DDS, (roger@iAwareables.com) is a member of APIC, and ispresident of Infectious Awareables, Inc. (www.iAwareables.com), a privatecompany that creates science-based awareness products.