Coronavirus Clean Up

According to the WHO, 82,539 cases and 2,812 deaths due to COVID-19 have been recorded.  While around the world, these cases have been linked back to the original source of Wuhan, China, this week, the CDC confirmed the first U.S. COVID-19 case of unknown origin.  The patient appears to have contracted the virus without visiting a foreign country recently or coming into contact with an infected patient meaning this is an instance of community spread of COVID-19 in the United States.  That said, it is possible that the patient was exposed to a returned traveler who was infected without realizing it.

The outbreak is not going to stop any time soon and with the ever-increasing number of cases around the world, we need to be taking every measure possible to limit the spread.  Certainly, hand hygiene and quarantining of suspected and confirmed cases is a way to help slow the spread especially within the community, but focusing cleaning and disinfection are key aspects that cannot be forgotten – just ask those responsible for the Diamond Princess.             

Princess Cruises has put out a global search for a service provider with advanced, scientifically proven cleaning and disinfection capabilities to perform work onboard the Diamond Princess. They are looking to hire a vendor that has experience in significant cleaning and disinfection projects and experience in the use of the disinfectant agent manufactured by Virox®, which is well-known to be an effective disinfectant.  According to the RFP, companies who wish to submit a proposal should be prepared to comply with detailed standards set forth by experts in health protocols and administration such as the Japanese Ministry of Health, the U.S. Center for Disease Control and the World Health Organization, in addition to the operational standards established by Princess Cruises.

This is not the first time that Virox’s patented Accelerated Hydrogen Peroxide® (AHP®) has been used against Coronavirus.  In 2003, during the SARS outbreak, AHP® became the recommended disinfectant of choice, resulting in the distribution of a Training Bulletin disseminated by the Ontario Ministry of Health and Long-Term Care mandating the use of AHP® by all EMAs and Paramedics.  While the original Training Bulletin referenced the use of AHP® for emergency vehicles, AHP® became the only disinfectant used by healthcare providers across Canada.

Coronaviruses are known to be able to persist on environmental surfaces for up to nine days.  In a recently published study, AHP® was included among the disinfectants that have been shown to have proven efficacy against various strains of Coronavirus.  When it comes to managing the transmission of Coronavirus, thoroughly cleaning environmental surfaces with a safe and effective disinfectant that carries a short contact time, like AHP®, will support in ensuring healthcare facilities, offices, schools, cruise ships and transportation vehicles (planes, trains and automobiles) have a cleaning and disinfection program that will support their infection prevention needs.

Infection prevention requires a daily focus.  In this time of heightened concerned and continued expansion of COVID-19, I hope you’ll add cleaning and disinfection to your daily routine!

Bugging Off!

Nicole

Sharing towels is not caring

Have you ever looked at a towel and thought “OMG! I’m going to get sick from using it!”?  If you’re old enough to remember the cotton roller towels in public washrooms you’ve likely had that reaction.  Have you ever looked at a towel of a family member and wondered if it would make you sick?

I would hazard a guess that most people would think about the potential to pick up germs from high touch surfaces such as refrigerator door handles and the TV remote and most would not consider sharing toothbrushes, but towels?  According to a recent study published in The Lancet Infectious Diseases, sharing personal hygiene items including towels could increase the risk for colonization of antibiotic resistant organisms like MRSA. 

Over a course of a year, researchers made several visits to the homes of 150 children treated for MRSA infections. A total of 692 family members, as well as 154 cats and dogs, took part in the study.  The researchers swabbed sinks, refrigerator door handles, bathroom countertops, bath towels, bedsheets, light switches, telephones, TVs, video game controllers and computer keyboards and mice. The humans had their nostrils, armpits and groins swabbed, while the animals their noses and backs as this is where they are most often petted.  By the end of the study, 3,819 samples were collected and analyzed.

For the children, the bedsheets of the child with the initial infection were found to be most often contaminated with MRSA. The refrigerator door handle was the most contaminated kitchen site; the sink was the most contaminated place in the bathroom and as most would expect, the TV remote was the dirtiest electronic device.  From a transmission perspective, the dirtier the house was, if the home was rented and the larger the family size also contributed to the likelihood of additional members of the family becoming infected with MRSA.  Surprisingly to the researchers, pets were more likely to catch MRSA from people than visa versa.

Researchers and healthcare providers agree that hand hygiene is the greatest method to stop the spread of disease, however, if a loved one comes home with an infection like MRSA, sharing of personal hygiene items should be avoided as once MRSA is in the home as this study shows it can be easily spread around, picked up by other family members and difficult to get rid of.

The next time you’re at a family members or friends house and use the washroom, will you look at the hand towel in the bathroom in a different light?  If it’s wet, will you be wondering how many people have used it before you and what may be on it?  I know I will!

Bugging Off!

Nicole

Spread Love, Not Germs

The history of Valentine’s Day is shrouded in mystery. Saint Valentine's Day, or the Feast of Saint Valentine, is believed to have originated as a Western Christian feast day honoring one or two early saints named Valentinus.  Today, it’s a special commemoration of our love for others. We celebrate it in many ways with gifts, date nights or maybe a night in which you do not have to cook or do the dishes. No one is thinking about how to prevent germs from spreading from person to person. 

Unfortunately, Valentine's Day falls in the heart of cold and flu season.  For many star-crossed lovers who plan to hold hands and kiss their sweetheart, there are two ways this could go: good or bad.  It can be difficult to tell if your sweetheart is sick with the flu, a cold or if you’re a teenager, mono (aka the kissing disease).   If you didn’t already know, you start shedding viruses before you experience the full effect of any illness.

Many of the viruses can be spread through respiratory secretions from talking and laughing, touching surfaces and of course, through saliva.  Since kissing is a big way to show affection, you may be getting more than just a little romance.  But all is not lost, you can protect yourself from the cold and flu:

• Wash your hands often (especially after holding hands and definitely before eating)
• Avoid close contact when you or someone you know is sick (and maybe even when you’re not sure)
• Clean and disinfect commonly touched surfaces
• Get your flu vaccine

In the words of Helen Keller, “The best and most beautiful things in the world cannot be seen or even touched. They must be felt with the heart.”   I’m not sure anyone would think a cold or flu virus is beautiful, but they most definitely cannot be seen!   If the strategies given above do not work and you happen to get sick, I find when I have a cold, if I can share it with one person I feel immediately better!   My parents always taught me that sharing is caring, so my heart is in the right place, isn’t it?

Wishing everyone a happy Valentine’s Day!

Bugging Off!

Nicole

The Flu and You!

While the world is mesmerized with the burgeoning 2019 n-CoV outbreak and the novelty of a new virus infecting tens of thousands of people, in a single state of the US, tens of thousands of children are being impacted by influenza.  In Tennessee, more than a dozen school districts were closed on Monday due to widespread illness.  While the outbreak in China has topped 24,000 confirmed ill patients, almost 72,000 children stayed at home to allow the school boards time to clean and disinfect the schools to try and stop the spread of illness.

According to the CDC, estimates for this flu season indicate that between 19 and 26 million cases of influenza have occurred across the country, and at least 10,000 people have died as a result.  In one Tennessee county, 10% of the entire student and teacher population had been off sick with the flu and other illnesses.  The cost of illness is nothing to sneeze at.  Schools are reimbursed based on bums in the seats.  The numbers can vary by district, but on average, $25 - $30 per student per day is provided.  If we assume 10% of the 12 affected counties have been impacted, that is $216,000 in lost funding for just one day!  

The flu season is not expected to wain until at least the end of February.  In Tennessee, 10 children have died from the flu so far this season with more than more than 41,000 cases of the flu reported across the state.   People with flu can spread it by coughing, sneezing or TALKING to others up to about six feet away!  The droplets "excreted" by someone carrying the flu can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.  People can also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose.

The good news is that keep yourself and your family members healthy is relatively easy.  The first step is getting vaccinated.  The second step is to wash your hands frequency and especially before you eat and after you blow your nose or cough into your hands.  Lastly, keep your area clean using disinfectants.  Influenza is an enveloped virus, meaning while it is highly infectious, it is actually very easy to kill with a disinfectant.  Wiping down high-touch surfaces frequently is an easy way to stop the spread of influenza.  Whether your wiping down areas in your house or your office at work, having disinfectant wipes handy is a simple and easy way to keep healthy!

Bugging Off!

Nicole

Coronavirus Deemed an International Health Threat

Yesterday, the WHO announced that the Coronavirus outbreak in China is now a considered a public health emergency of international concern.  This means that an extraordinary event is in process which constitutes a public health risk through the international spread of disease, and that a coordinated international response may be required.   When the PHEIC is announced, this means that Infection Prevention experts believe that the situation is serious, unusual or unexpected; carries implications for public health beyond the affected state or country’s national border; and may require immediate international action.  

From the WHO Committee meeting held yesterday (Jan 30, 2020), the following are key points:

1. The Committee acknowledged that there are still many unknowns: cases have now been reported in five WHO regions in one month, and human-to-human transmission has occurred outside Wuhan and outside China.
2. The Committee believes that it is still possible to interrupt virus spread, if countries put strong measures in place to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the infection.
3. The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the frontlines of this outbreak, with transparency, and hopefully, with success. In line with the need for global solidarity, the Committee felt that a global coordinated effort is needed to enhance preparedness in other regions of the world that may need additional support.
4. It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, as well as to share full data with the WHO.

What does that mean to in terms of disinfection and infection prevention?

1. In North America both Health Canada and the CDC have enacted guidance measures for emerging viral pathogens.   This guidance is based on a hierarchy of susceptibility of viruses to disinfectants, recognizing that a product with efficacy against non-enveloped viruses will also be effective against enveloped viruses, which are much more readily inactivated.
2. Health Canada’s Broad Spectrum Virucide claim requirement may be used to determine expected efficacy of a disinfectant against the virus.  In accordance with the Guidance Document – Safety and Efficacy Requirements for Hard Surface Disinfectant Drugs, Health Canada considers that a registered disinfectant with submitted efficacy data against any of Poliovirus type 1, Chat strain, Human adenovirus type 5, Bovine parvovirus or Canine parvovirus is a broad-spectrum virucide, and is therefore expected to inactivate other enveloped and non-enveloped viruses. Coronaviruses are enveloped viruses, and would be expected to be readily inactivated by any Health Canada-registered broad-spectrum virucide.
3. The EPA’s Emerging Viral Pathogen Guidance states that a registered hospital or broad-spectrum disinfectant product with claims against two small non-enveloped viruses, each from a different family, is expected to inactivate other enveloped and non-enveloped viruses.

What does this mean for you?

1. The greatest risk of infection is for people in China or people who have traveled to China.
2. It’s unclear how easily or sustainably this virus is spreading between people.  There is proof of limited person-to-person spread among close contacts has been detected, however experts are not seeing the virus spreading within communities.  This means the likelihood of someone getting sick with this virus is very low.
3. Patients with 2019-nCoV have reportedly had mild to severe respiratory illness with symptoms of fever, cough and/or shortness of breath.
4. Like the cold or flu virus, there are simple actions to help prevent the spread of respiratory viruses, including:

• Avoiding close contact with people who are sick.
• Avoiding touching your eyes, nose, and mouth with unwashed hands.
• Washing your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
• Cleaning and disinfecting frequently touched objects and surfaces.

The key is not to panic.  Yes, a new virus is scary, but it’s also kind of exciting. I do not mean that the lives lost are not meaningful, but that this is history in the making.  This is a time that we need to reflect upon how the lives we live impact the environment and animals that we cohabitate this world with.  It’s time to accept that we are the likely cause for the increased number of zoonotic diseases we are coming up against.

Bugging Off!

Nicole

Pigs have outbreaks too!

This week I was in Des Moines, Iowa attending the Iowa Pork Congress.  As you’ve likely guessed, the congress draws people interested in the swine industry from producers and contract feeders to consultants and students.  I am now certified in Transport Quality Assurance meaning I am now among many in the industry that understand the best practices for handling, moving and transporting pigs and the impacts that can occur on pig well-being, the quality of meat and what biosecurity considerations need to contemplated to avoid outbreaks.

As mentioned in the last several weeks, we have a potential for a global outbreak in the works with the 2019-nCoV outbreak in China and cases now found in the US.  At this point, all imported cases can be traced back to Wuhan, China.   While the world may be focused on this outbreak and becoming increasingly concerned for what it may mean to our health you may not be aware that for the swine industry and outbreak of African Swine Fever Virus (ASF).  In 2007 an outbreak occurred in Georgia and the virus has been spreading through the Caucasus region, the Russian Federation and Eastern Europe with cases being confirmed the wild boar population in Belgium.   In 2018, ASF hit China and has rapidly spread across the country which has the global community on high alert as containing the virus has been serious challenge in a country that owns almost half of the world’s domestic pigs.

From a Canadian perspective, because of China’s endemic status of Foot and Mouth Disease live pigs and even pork products are not allowed to be imported into Canada.  When in comes to ASF, on a global basis, the highest risk factor from China is the importation of feed, travellers coming into contact with the virus and bringing it back on their clothes and footwear, and people smuggling in infected pork and pork products.

The virus itself is an enveloped virus belonging to the Asfivirus family and includes at least 22 strains which has helped in tracing outbreaks to their source. It is extremely resistant to putrefaction and sunlight and can persist in refrigerated meat and carcasses for up to 6 months and for much longer when frozen.  This highlights the reason why smuggling pork into countries that do not yet have the virus is such a concern.  The virus is spread from pig to pig by aerosol from infected discharges and faeces by the bites of soft ticks, the bites of lice and flies and by direct inoculation from contaminated syringes. Infection can also be spread on contaminated implements and during transport.

The world is small.   You never know when a pathogen is going to board a passenger or cargo flight or arrive by sea on a ship in hold of feed destined for not just us, but the animals we eventually eat.

Bugging Off!

Nicole

One World, One Health

Last week, I referred to an outbreak of a new coronavirus in China.  Being an epi geek, I love following and reading about disease causation, transmission and outbreak investigation.  As I mentioned to some of my colleagues, this is the stuff that I get excited about and love sharing.   I also know not everyone shares my love of a good outbreak, so I gave my colleagues an “opt out” option for my “Outbreak Geek Alert” emails.  So far no one has opted out so maybe I’ve converted them to be as geeky as me!

The appearance of novel pathogens with epidemic potential and potentially high mortality rates have threatened global health security for centuries. The unfortunate truth is that over the past few decades, new zoonotic infectious diseases of humans caused by pathogens arising from animal reservoirs such as Ebola virus, Nipah virus, Lassa Fever virus, Hantavirus,  severe acute respiratory syndrome coronavirus, highly pathogenic avian influenza viruses, Middle East Respiratory Syndrome Coronavirus, and Zika virus. 

The latest outbreak is yet another example.  The rapid identification and containment of the 2019-nCoV is reassuring, however, there are many unanswered questions, such as what animals or other reservoirs the virus originated from, what is the route of transmission, incubation period,  or risk factors for infection, and survival rates.   When it comes to coronaviruses in particular, SARS-CoV has seemingly disappeared, while MERS-CoV continues with sporadic cases and continued questions, such as the source, how it’s transmitted, and what the epidemic potential is.  This latest coronavirus outbreak is a stark reminder of the continuing threat of zoonotic diseases to global health security and the need to support a collaborative global "one-health" approach in the battle against zoonotic diseases. 

One Health is a growing movement with the intention to create interdisciplinary collaborations, research and education in all aspects of health care for humans, animals and the environment recognizing that the health of humans is CONNECTED to the health of animals and the environment and vice versa.  I think we can all agree that human populations are growing and expanding into areas that were previously inhabited by animals.  The result being that as we increase the number of people that live in close contact with wild and even domestic animals, this closeness provides more opportunities for disease to pass between animals and people.  Further, our growth and development has caused changes to climate and land use (e.g. deforestation to build homes and intensive farming practices). The result? Disruptions in environmental conditions and habitats provide new opportunities for diseases to pass to animals.  Lastly, the world has become a very small place with our ability to travel internationally in very short periods of time means diseases can spread quickly across the globe.  

The next time you see a coyote on a walk in a park or skunk or possum in your back yard remember that where you are living may have been forest and their home before you took over the area.  One Health is important, so much so that January has been designated as One Health Awareness Month.  If you’re interested in learning more, follow along via social media using #onehealth.

Bugging Off!

Nicole