Kids, Coughs and Viruses on Healthcare Workers

This week we received an email from my son’s teacher confirming what I already knew – respiratory viruses are in abundance and wreaking havoc in schools, offices and anywhere people congregate. We have a nasty virus floating around my office that keeps taking people down one by one.  The only way to manage cold and flu season is to keep as healthy as you can in order to fight off the germs that plague us, keep our environment clean and wash our hands frequently.

Due to the number of kids sick and differing types of infections – phlegmy coughs to bronchitis and pneumonia, I sent a canister of wipes to school with my son, gave his teacher a few tips on what surfaces she may want to wipe down with more frequency and suggest she engage the kids in helping to “wipe out” the germs.  She did just that and my son said it was fun helping to wipe down his area.

With the number of respiratory viruses floating around it was interesting to come across a recently published study in ICHE that investigate the level of virus contamination on PPE, skin, and clothing of healthcare workers.  The researchers that 31% of glove samples, 21% of gown samples and 12% of face mask samples, 21% of bare hand samples, 11% of scrub samples and 7% of face samples were positive for viruses.  This level of contamination can contribute to transmission of pathogens via contact and increase not only the risk for infection in health care workers but increase the risk of contaminating the environment.

The study highlights the ease and frequency of viral contamination on PPE, clothes, and skin of HCWs which emphasizes the significance of appropriate PPE use, and hand hygiene in preventing transmission via both direct and indirect contact.  Of further interest, there was an association between the number of self-contacts by HCWs with their gloves, gowns, or masks and the concentration of virus their PPE meaning the more self-contacts, the more virus was found.  The strongest correlation identified was between self-contact with the gown (torso) and virus concentrations on a personal stethoscope, which as we know is often draped around the neck.

A study published in BMC Infectious Diseases earlier this year looked at contamination of masks by respiratory viruses and found similar results. In this study, 10% of the masks tested were found positive for respiratory pathogens and the risk is higher with longer duration of mask use (> 6 h).  The researchers concluded that finding respiratory pathogens on the outer surface of the used medical masks may result in self-contamination.

Unfortunately, respiratory viruses cannot be avoided.  Whether you’re a teacher, student, parent, coach or healthcare worker you’re likely to come into contact with someone who is infectious and spreading their virus with each cough, sneeze or touch of their dirty unwashed hands on surfaces you then touch.  What’s as important is that the PPE we wear to protect ourselves can also become contaminated and we can unwittingly contaminate ourselves.  In the end, the best prevention is cleaning and disinfecting high touch surfaces and wash our hands with increased frequency!

Bugging Off!

Nicole

Mold Found in Air Causes Death

You never know where and how a pathogen may enter a healthcare facility and wreak havoc.  For the last several years, we have been focusing on environmental surfaces and shared patient care equipment and their contribution to infections - whether it be direct contact by a patient, or indirect by healthcare workers’ hands that have been contaminated from touching surfaces.  Infections resulting from improperly reprocessed medical devices have also resulted in quite a bit of scrutiny about processes that need to be followed, ease of reprocessing in designing medical devices and the type of training needed by healthcare workers tasked with reprocessing.

There are some pathogens that are easier to determine the route of transmission and pinpoint how they may have managed to be passed to a patient.  MRSA and C. difficile are recognized as two of the more significant pathogens transmitted via environmental surfaces.  As such, a focus on these and other antibiotic-resistant pathogens has been given to ensure cleaning and disinfection methods are up to par, that disinfectant products have the capability of killing the pathogens of concern, and that facilities have a method to validate and monitor cleaning and disinfection practices.

Unfortunately, that does not stop other pathogens from arriving on the door step, or in the ORs of your facility.  Case in point, Seattle Children’s Hospital has had to close most of its ORs after finding Aspergillus following air testing.  This is the second time this year, ORs at the facility have had to close and the facility has attributed at least 6 deaths as a result.  The facility has acknowledged that Aspergillus has been in the air of the ORs since at least 2001.  Aspergillus is not an uncommon pathogen.  In truth, it can before everywhere — indoors and outdoors.  More than 180 different types of Aspergillus have been identified and while most are harmless, some types can cause a variety of diseases ranging from simple allergic reactions to life-threatening invasive disease.  Illness from Aspergillus is referred to as Aspergillosis and rarely develops in healthy individuals - in fact, most people breathe in these spores every day without any issues.  The risk of infection increases in individuals who have an underlying condition such as asthma, cystic fibrosis, etc. and/or in people who have taken corticosteroid drugs for a long period of time or who have weakened immune systems.

In Seattle, the presence of the mold is being blamed on deficiencies in the ventilation and purification systems.  To correct the situation, the ORs will remain closed until the end of January so that in-room HEPA filters can be installed in every operating room.  HEPA filtration is capable of removing more than 99.9% of particles from air that passes through the filters.  It’s unfortunate that this situation has occurred and my heart goes out to the families impacted.  I hope, however, that other facilities will take this as a wakeup call and check out their air, their infrastructure and ensure that something like this does not happen in another facility.

Bugging Off!

Nicole