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Thursday, April 18, 2019

Best Before, Not Bad After


I’m sure I’m not the only one who has seen an expiry date on a product and wondered if it’s still good. Without a doubt, I have thrown caution to the wind and eaten something that had expired. I’m here to tell the tale of it, so obviously I have been lucky so far. Food is probably the most common source of the “best before, not bad after” scenario. In fact if you google it, you can find several sources willing to tell you how long you can continue to consume something past the labels expiry date.


The same goes for drugs and disinfectants. When registering products, a regulatory agency requires a manufacturer to conduct testing and provide data to prove that the drug or disinfectant being registered will remain effective for the products shelf life. I’ll be truthful, in most cases the drug or disinfectant is still effective after the expiry date. The question is for how long after? That question is harder to answer. The shelf life a manufacturer provides is intended to ensure there is a reasonable amount of time from when a product is manufactured to when it is used. A fail safe may be built in, as let’s be honest, we know people are going to use the product beyond the expiry date found on the label, and of course, we do not want a product to become less efficacious as it approaches its expiry date. The last thing we want is for a drug to not treat the infection, or cease the migraine, and of course, when it comes to disinfectants, we do not want to run the risk that the disinfectant to be the cause of an outbreak, not killing what the facility needs it to kill.


This is why it is SO important to ensure you know the shelf life and expiry date of the disinfectants you are using. The truth is, I have worked with hospitals that upon investigation, we realized the reason an outbreak was not brought under control was because the disinfectant they were using had expired and had no “killing juice” left. If you don’t believe me, take a look at the picture that is the inspiration for this week’s blog. It was sent to me by an acquaintance. This was a disinfectant wipe product that was in an exam room at a hospital and was being used to disinfect the shared patient care equipment. Would you want that equipment used on you? I’m comfortable with a 6 month window to use drugs and disinfectants past their expiry date, but four (4) years?! Well, I would be refusing to allow any of that equipment to be used on me until after it was cleaned with a product that had not yet expired, and I would seriously be questioning the infection prevention and control program of the facility.  


HAIs kill almost 100,000 people per year. Please don’t let the reason for catching an HAI be the result of an expired disinfectant.


Bugging Off!


Nicole


PS – Yes, this is one of the products my company manufacturers. I’m not happy the product is 4 years old, but this is a teaching moment I cannot in good conscious pass by.

Friday, April 12, 2019

Dead Bunnies Don’t Bode Well for Easter!


Have you noticed how as we get closer to Easter more commercials on TV have bunnies? I’ll admit, bunnies are cute. They’re soft, they can be social and as I was lucky enough to experience as a child they can be snugglers. If you enjoy gardening you may have a different opinion of rabbits. They can be destructive and as my husband can attest to, rather than eating an entire pepper they take bites out of every single one so that we get none!

Rabbits, like any other animal are prone to diseases and there are some that can be very deadly. Case in point, for the second year in a row, residents of Vancouver Island are being warned to keep an eye on their pet rabbits as officials have confirmed the presence of rabbit hemorrhagic disease, with the virus showing up in four dead feral rabbits. While deadly for rabbits, the disease is not zoonotic, so rabbit owners do not have to be concerned for their health. There is also no concern for any other pets you have (cats or dogs) in getting infected. In 2018, outbreaks for RHD also occurred in Pennsylvania and Ohio.

Rabbit hemorrhagic disease (RHD), also known as rabbit calicivirus disease or viral hemorrhagic disease, is a highly infectious and often fatal disease that affects wild and domestic rabbits. It has not been known to affect any North American native rabbits or hares, such as cottontails, snowshoe hares and jackrabbits. RHD, is often a very swift and sudden killer where rabbits often die without showing any symptoms at all, while others may show some bleeding from the nose, mouth and rectum.

There are a number of ways RHD can spread, including a rabbit coming in contact with contaminated inanimate objects (i.e. via fomites) such as clothing, shoes, as well as car and truck tires. RHD can also be spread via direct contact of a rabbit with an infected rabbit or the feces of an infected rabbit. Humans can also spread the virus to their rabbits if they have been in contact with infected rabbits or in contact with objects contaminated by the virus, including feces from an infected rabbit. Maintaining a clean environment is critical because contact transmission is a key driver for infection transmission. Therefore, ensuring you are using an effective disinfectant that is safe for use around animals is important.

If you’re thinking of getting or giving a pet rabbit for Easter, please keep these things in mind! You never know what you may be dragging in the door on the soles of your shoes. Be sure they’re left at the door and if you’ve been somewhere playing with someone else’s bunnies, think about changing your clothes before playing with your cute little ball of fluff!

Bugging Off!

Nicole

PS – the bunny in the picture is Flossie. She’s up for adoption in Burnaby, BC Canada, if anyone falls in love with her!

PPS – Fingers crossed the Easter Bunny is of North American Native Rabbit decent. I would be sad to wake up on Easter with no egg hunt!

Friday, April 5, 2019

False Sense of Security?


How many of you have walked in a hospital, hotel or any other building and notice how clean and shiny the floors are? Did you consciously or subconsciously feel that the building itself must be clean? When you see something clean do you feel safe and free from harm’s way? If you’ve never given it much thought, think about it the next time you enter a building. When you go out for lunch, go to a spa, the dentist or the doctor’s office, and you see them putting on a pair of gloves, what do you think? I bet it’s similar to the above… there is a sense of security in seeing someone putting on clean gloves. Does your stomach turn if you see that the gloves being worn seem to be covering sweaty hands? Have you ever been brave enough to ask the person to remove the gloves, wash their hands and put on a fresh pair?  

I have. It caused a scene. The phlebotomist was not impressed. I was slowing down her ability to get people in and out of the chair to take blood samples. Frankly, I did not care. I quite literally wiped down the chair myself with a disinfectant wipe and sat there until she had removed her gloves, sanitized her hands and put on clean gloves. Only then was she able to touch me. She was not happy. I ended up with a nice bruise as her pay back was to puncture my vein. No big deal. Bruises heal quickly, but infections may not.

Why all the talk about getting a false sense of security and making people change their gloves? Well, a study published in ICHE concluded that improper removal of PPE contaminated Healthcare Workers (HCWs) lead to self-contamination. In fact more than 1/3 of the HCWs were contaminated with multi-drug resistant organisms after caring for patients who were colonized or infected with the bacteria. HCWs are highly trained, yet almost 40% of the workers in the study made errors in removing their PPE which lead to self-contamination. As one would expect, the dirtier the environment the greater the chance of contamination.

The study highlights the fact that we need to not only re-evaluate methods for removing PPE, but to contemplate how frequently training needs to occur. Which leads me to ask you about gloves on hands of non-healthcare workers. HCWs are trained in techniques of donning and doffing PPE. In healthcare we know that self-contamination can lead to serious consequences, just take SARS as an example where many of the infected HCWs became ill from self-contamination during removal of their PPE. Do non-HCWs get the same training? The next time you see a teenager at Subway putting on gloves before they make your sub you may want to consider how clean their hands are… Don’t even get me started about the security staff at airports. The next time you fly, check out how sweaty their gloved hands are. They have been touching all sorts of stuff before they touch your things!

Bugging Off!

Nicole