Pigs’ Ears – a Tasty Treat and Health Hazard

If you’re a pet lover you may be among those who like to spoil their pets.  My cats get the occasional treat, but being cats they’re finicky and the organic, meat-only healthy treats that cost an arm and a leg don’t pass muster.  They prefer the easy-to-find on sale Temptations Cat Treats.  I have also spent a fair chunk of change on fluffy, plush cat beds.  It was a waste of money.

Dog lovers have a never-ending supply of treats they can pick up for their beloved canine friends, from rawhide and animal bones to pigs’ ears and raw food.  If you think you dog may like it, you can probably find it.  Unfortunately, pet treats and raw food does have some pitfalls and can adversely impact not just your pet’s health, but yours as well.   Case in point, pig ears sold as dog treats in 33 states are being recalled due to an outbreak of Salmonella. At least 127 people have now been stricken with the bacteria, with 26 of them hospitalized.   Thankfully no one has died.

Salmonella can affect animals eating contaminated products as well as the humans who handle the sickened animals or the infected product. Affected pets may become lethargic and have diarrhea, fever and vomiting.  Dog owners who have come in contact with the pig ear treats should see if a doctor if they experience high fever (temperature over 102˚F), blood in stool, diarrhea, or frequent vomiting that prevents keeping liquid down, and are concerned about the symptoms. People infected with Salmonella are usually ill for 4-7 days and recover without treatment.

Some key recommendations from the CDC include:

1.  Do not feed any pig ear treats to your dog. Throw them away in a secure container so that your pets and other animals can’t eat them.

·     Even if some of the pig ears were fed to your dog and no one got sick, do not continue to feed them to your dog.

·     Wash containers, shelves, and areas that held any pig ear dog treats with hot, soapy water. Be sure to wash your hands after handling any of these items.

2.  Shop safely

·      Always wash your hands thoroughly with soap and water after touching unpackaged dog food or treats, including products in bulk bins or on store shelves.

3. Take extra care around young children

·     Children younger than 5 should not touch or eat dog food or treats.

·     Young children are at risk for illness because their immune systems are still developing and because they are more likely than others to put their fingers or other items into their mouths.

Thankfully, as a vegetative bacteria, Salmonella spp. are among the easier-to-kill pathogens.  Until recently, Salmonella was one of the 3 main bacteria that had to be tested in order to receive a Hospital-Level disinfectant designation by the EPA.  While it is no longer required to be tested, virtually every consumer and professional product carries the claim due to its importance and association with foodborne illnesses.

If you have any pig ears at home, please take care and make sure your home is Salmonella-free!

Bugging Off!

Nicole

Cleaning, a Good Investment that Saves Lives

Do you ever feel like you’re bashing your head against a wall or like a salmon swimming upstream? Having been in the infection control arena, focusing on cleaning and disinfection, I often wonder why we have to repeat the same things over and over. Why do we keep having to prove the things we know to be true and know that work over and over and over again?

A recent article published in ICHE titled “Sustained improvement in hospital cleaning associated with a novel education and culture change program for environmental service workers” concluded that the program the researchers introduced was able to address environmental service worker’s knowledge gaps, challenges and barriers resulting in behaviour change and sustained improvements in cleaning. I don’t mean to sound callous or disrespectful of the researchers, but this is not rocket science.

In June 2011, in my “To Clean or Not to Clean”, I referenced a collection of articles published by APIC, where the take home message was cleaning is important. Cleaning needs to be done right the first time, and that cleaning saves lives. Looking back through history, Florence Nightingale, during the Crimean War (1853 – 1856), identified the link between overcrowding, hygiene and poor patient outcome and by instituting a cleaning program and increasing the space between patients, saw a marked decrease in infection transmission. 

In June 2012, a guest blogger, Rick Wray’s blog “Complexities of cleaning a paediatric hospital environment” talked to the fact that achieving optimal cleaning requires an understanding of the complex interplay of chemistry, human factors and behavioural science involved in cleaning processes. He further discussed a program they had at their facility where assorted hospital staff were partnered with a member of our cleaning staff to learn from and to work with them to clean patient rooms. One senior leader became aware of the pride and diligence of the staff member with whom he was partnered. She was reluctant to let him do the cleaning; not because it was a job beneath his usual position but because he wouldn't do it well enough and she would have to clean up behind him.  

In December 2014, in my blog “Hey! Hey! Ho! Ho! Apathy has to go!” when it comes to cleaning and disinfection there are just as many people who believe they cannot affect change so they do nothing, and just as many people again that plainly think cleaning and disinfection is someone else's responsibility.  However, based on another review of published literature by Donskey to determine if we had sufficient evidence to prove that improved cleaning and disinfection could reduce HAIs, the conclusion was that, "Although the quality of much of the evidence remains suboptimal, a number of high-quality investigations now support environmental disinfection as a control strategy. Based on these data, current guidelines for pathogens such as C. difficile, MRSA, VRE, and norovirus emphasize the importance of environmental disinfection as a control measure." 

These are but a few examples of the work the infection prevention community has completed to link the importance of cleaning and disinfection to the reduction in HAIs. The work has investigated best practices to ensure the cleaning processes used will meet the needs of our healthcare facilities and there are several studies that highlight the importance of providing training to our EVS staff and elevate them to a higher level to support the fact that they are a crucial part of our infection prevention program.

In reviewing this study, we have proven yet again that cleaning when completed effectively by skilled and trained staff, can directly impact the lives of patients.  If we know it, and if we have proven it time and time again, why can’t we get the C-suite or the wallet holders to understand the importance of cleaning and disinfection and the importance of having a skilled environmental services team? How do we get them to understand that this investment will save money and more importantly save lives?

Bugging Off!

Nicole

State Fair Nightmares

August is a bitter sweet month.  We have jokingly been telling my son he only has 30 days until school starts.  It’s fun to bug him, but then you realize that August has arrived and summer vacation is quite literally a month away from being over!  While summer may be drawing to a close, August marks another change in season – City or State Fair season! 

I’ve always loved a good summer or fall fair.   As a country kid, I could be found showing horses and cows and not to brag or anything, I may have won a ribbon or two for my beloved Belgium belted rabbit, Mr. Boots or my white and ginger guinea pig Sparky.  For those that may be looking for an event that can pair education with cotton candy, funnel cakes and fried food, there are a few things to consider to ensure you keep yourself, your family and your animals safe.

Case in point, 1 child has died and 3 others were sickened by E. coli after coming into contact with animals at the San Diego County Fair.  The source of E. coil has not been confirmed but the children all visited the animal areas or the petting zoo.  As a result of the infections, public access to animal areas was closed including the petting zoo.  While this is just one example, between 1996 to 2012 about 200 outbreaks involving animals in public settings were reported to the CDC.  The National Association of State Public Health Veterinarians (NASPHV) has put together a number of recommendations as a way to minimize outbreaks, infections and deaths:

1.       Contact with animals should only occur in settings where measures are in place to reduce potential for spread of disease (e.g. access to hand washing stations).

2.       Disseminate educational and training materials to venue operators (e.g. infection control training and guidelines).

3.       Sample collection to ensure that animals do not carry pathogens that can transmit to humans.

4.       Information on facility design to reduce potential for contact with manure.

5.       Avoid contact with pre-weaned calves, reptiles, amphibians and live poultry for children under the age of 5.

6.       Signage to clearly communicate the importance of hand hygiene.

7.       Do not provide animal feed in containers that can be eaten by children (e.g. ice cream cones).

8.       Disinfect the area, at least once per day.

Being a farm girl, I am a proponent of people-animal interactions and not just the cute baby animals, but all animals, as learning where our food comes from and how farmers raise animals is important.  Farm fairs are also a time where farmers get to show off their prized animals.  To some, it may seem strange or boring to watch a ring full of cows or pigs, but let me tell you, winning can increase the worth of the animal and their future offspring.  If you don’t believe me google “Missy, the million dollar Holstein” or “Deveronvale Perfection”, a sheep that sold for $376, 691.

I hope you’ll search your area for a State or City Fair.  It’s a great day of entertainment and education, but just remember to wash your hands after touching the animals!

Bugging Off!

Nicole

Are you a Judging Judy?

Many people in the healthcare field know that they make horrible patients.  They know too much.  They question everything and worse yet, they think they know better.  I don’t pretend to be a doctor or nurse.  I will admit to using Google and my background in epidemiology, pharmacology and growing up on a farm where you learn to assess your animals before the vet shows up has without a doubt turned me into a patient who asks lot of questions.  Working in the field of cleaning and disinfection, I think worse than asking questions about treatment options or diagnosis, I have become a person who judges.  I judge hand hygiene practices.  I judge over the level of cleanliness.  I judge the process of cleaning and disinfection (if I get to observe them in action) and I judge based on the type of disinfectant used.

What’s worse is that I also take pictures to share with others…

I’m getting old.  I recently started physiotherapy.  As with any healthcare appointment, you often have some time waiting in your exam room.  I should never be left alone.  It gives me the time to investigate and take pictures.  I’m happy to say my Physiotherapist uses good hand hygiene techniques.  They use a popular Quat-Alcohol product and liberally apply to achieve the longer than 1 minute contact time as the table was still damp when I was shown to my room.   Then, I was left alone and as the saying goes, a picture is worth a thousand words…

As the picture indicates they seemed to have missed a spot on the ultrasound machine and the glove box had some “gunk” on it.  I may have moved the box to see what was below it.  I also noticed that their disinfectant spray bottle, while it had the name of the product written in black sharpie, did not have any further information such as precautionary information or expiry date.  The product is a RTU so I doubt it had expired, but it certainly makes me wonder if they are topping up the bottles rather than using until empty and cleaning before reusing.

Physiotherapy offices, like doctor’s clinics and hospitals, are prone to having infectious agents like influenza, norovirus or MRSA, walk through the door.  Cleaning and disinfection of the environment and shared patient devices is vital to ensure infections are not transmitted.  While most of the treatments are non-invasive and performed on intact skin, some procedures can be more invasive and associated with mucous membranes such as the mouth, for physiotherapy on your jaw. 

While the media may not be promoting sensational outbreaks associated with a physiotherapy office, infection control practices should not be based on the fact that the number of outbreaks is low.  Everything is based on risk.  Some procedures are riskier than others.  The key is to be vigilant, ask questions and at the minimum remind your healthcare provider to wash their hands!

Bugging Off!

Nicole

PS – for my second visit I was in another room.  It was spotless, but I’ll continue to watch and you can be assured I’ll give them any advice on cleaning and disinfection that I think is prudent!

Be Careful what you Step (or Fall) in!

When it comes to pets, you either love them or hate them. If you love them, many of us can be separated into two camps: cat lovers or dog lovers. I happen to like both, but tend to lean towards cats. I have two. My older male cat may be a grumpy gus, but he loves his belly rubs and he loves to groom me. Not all cats groom “their” people, and frankly with his sandpaper like tongue and penchant for nibbling while he’s grooming, I sometimes wish he didn't love me as much as he does… 

  

The problem with pets is there is the chance for transmission of zoonotic diseases. Case in point is a study that was presented at ASM Microbe at the end of June that investigated 79 cases of pet associated Pasteurella multocida infections with reports of novel modes of non-bite transmission.  Pasteurella multocida is a common cause of infection following bites or scratches caused by dogs, and (especially) cats. If infection occurs, cellulitis at the site of injury is often the first thing that is present, but it can develop into a chronic infection of deep tissues. Of interest (at least to me) is that infectious complications occur in more than 50% of the cat-related bites and that cats of the female persuasion are most often to blame. Dog bites account for 15-20% of the reported infections and are generally associated with younger animals engaging in playful activities, mostly with children. 

In the study, 34 of the 79 cases of infection were not associated with bites or scratches. Of further concern was the fact that these infections were life-threatening. Upon investigation, some of the novel modes of transmission included:

• Stepping on dog drool and contaminating a foot ulcer
• Contamination of a wound by socks covered with cat hairs and dander
• Falling down when drunk and contaminating abrasions with dog saliva
• Epiglottitis after eating peanut butter and crackers that had been half-eaten by a dog

     As a cat lover, I would like to point out the it would appear that dog owners (or friends of dog owners) seem to lead a far more “adventurous” life or at the very least seem to throw caution to the wind expanding the 5-second rule to include eating not just food that has fallen on the floor, but to food that has been partly eaten by dogs… 

As saliva, dander and cat hair can be picked up from the floors, cleaning and disinfection of floors and other surfaces can help stop the chance of infection transmission. Pasturella is a gram-negative bacteria that is not spore forming, meaning that it is relatively easy to kill with the use of most Health Canada or EPA registered disinfectants.  

Infections, particularly potentially deadly ones are not a laughing matter. Pets are a part of our family.  They would not knowingly make us sick, but the next time you are bitten or scratched while playing with your pet, you may want to consider cleaning it thoroughly and keep an eye on wound to make sure it does not get infected. If like me, you have a cat who loves to groom you, try to keep the grooming to areas of your skin that do not have cuts!

Bugging Off!

Nicole