Infection Control Today - 09/2004: Pandemicals

Surveillance for the Tortured ICP

ByRoger Freeman, DDS

50,000 Co-workers Per Square Inch So Much for Downsizing

Dr. Charles Gerba is at it again. We gunnited our kitchenafter Dr. Gerbas not-too-bon-appetit study on the galley a few years ago.Now, the University of Arizona guru-de-guk has completed a study of workplacegerms, and the news is not good. Describing the desk as a laptop of luxuryfor bacteria, Dr. Gerba and his team concluded that the office toilet seat (49bacteria per square inch) has 400 times fewer bacteria per square inch than theaverage desktop! The phone receiver is the heaviest employer, at 25,127 bsi,followed by desktop, fountain handle, microwave door handle, computer keyboard,mouse, fax and toilet seat, in that order. Levels dropped sharply if are yousitting down the surfaces were cleaned! Thatbubble is looking better all the time.

Guidelines for Gums

The Centers for Disease Control and Prevention (CDC) hasrecently issued updated guidelines for infection control in dental-caresettings. Historically, dental offices have been among the most highly regulatedhealthcare venues, stemming initially from intense media attention in the early1990s. Today, dentists and dental personnel look much like riveters in effortsto protect both themselves and their patients. Because there is no real scienceto support many of the recommended practices, guidelines are often based on strongtheoretical rationale, suggestive evidence or the opinions of respectedauthorities. What does it mean to you? Look for these telltale signs of anoffice that has its Occupational Safety and Health Administration (OSHA) and ICact together, at least from your prone position:

• Both Doctor and personnel wash hands in front of you.

• Both should also glove in front of you. No fair washing gloved hands.

• Instruments are sterile-wrapped, tray set-ups sealed.

• Personnel minimize fomite transfer, (i.e., keep theirhands tending to business).

• You are offered clean protective glasses (insist on this.)

No Peeking

Fill in the blanks: Contaminated ___________ accounts for themajority of food-borne outbreaks, while ____________ is the source of the mostindividual cases of illness in the U.S. Hint: if you said meat, chicken orfried pork rinds for either of the blanks, youd be dead wrong!Contaminated seafood is the culpritus majoris in the former, whereas produce isthe chief offensive officer for the onesies and twosies. This, according to anew report called Outbreak Alert! by the Center for Science in thePublic Interest.

Check out www.cspinet.org/reports/outbreak_report.pdf for allthe gory details. Anyone for a nice sea urchin soufflé?

Rear-View Mirror?

A U.S. District Court recently awarded a woman in Wyoming$50,000 for hospital negligence in post-exposure and needlestickprotocolflun fortunately, sticks still happen and are always serious andunsettling. But in this case, the modus stickem was a little unusual.Apparently, while visiting a friend, the victim backed into a used needle lodgedin a heat register left, ahem, behind in the patients room poking herselfin the thigh! It proves, once again, that if it can happen, it will!

Play the Odds

Recent studies indicate that administering antibiotics to achild with an ear infection results in only a 12 percent chance of improvement,but a 20 percent chance of an allergic reaction! Not to mention the millions of over-killing antibioticprescriptions falling, so to speak, on deaf ears. Concluding that there is noclear advantage to the treatment, the AAP and AAFP (think pediatrics) recentlyissued guidelines discouraging immediate use of antibiotics, and instead,recommended an observation option of 48 to 72 hours for healthy kidsbetween two months and 12 years. You moms may want to look over Diagnosis andManagement of Acute Otitis Media at www.aap.org. The continuing emergence ofresistant strains is actually scarier than what happens to the kids once theybecome teens!

Mystery Microbe

Much has been made of WMD,
Theres lots of talk about WNV
Timely topics plain to see,
Better hope the future aint all about me!

Im a starlet Phlebovirus, hanging so far in Africa, where Ivectorize among both animals and human. Delivering a higher mortality rate thanmy bird-borne buddy, I have far more mosquito groupies than West Nile morethan 30 types of skeeters air shuttle me to my cattle or sheep mobile homes. Ihavent done any tours outside of Africa, as yet; but the fact I am bothblood-borne as well as stable in aerosol form, brings to mind the term agri-terror,and is starting to worry those-who-know. Oh, and did I mention therescurrently no known course of treatment? Looking for some marquee time down the road, I am ? (Youll find the answer in the next Pandemicals column.)

Answerto the last Mystery Microbe: Salmonella

Pandemicalswanted. Are you privy to an interesting, educational or even usefulinfecto-byte? Send it to: roger@iAwareables.com, along with a trackable preferably legitimate reference source. If it makes the editors cut, youll receive a minisculecitation and an extraordinarily modest gift.

Roger Freeman, DDS, is a dentist and educator who obviouslyinhaled too much tooth dust in 30 years of practice. He is currently presidentof Infectious Awareables, Inc. (www.iawareables.com), an occasionally for-profit company producingscience-based awareness products.