Judy Arbique's Blog
Posted by Judy Arbique
Canadian hospitals applying for accreditation will have to provide MRSA and Clostridium difficile infection rates, compelling organizations to track these organisms within their organizations.
Healthcare accreditation is largely voluntary in Canada (except for Quebec). However, 99% of acute care hospitals in Canada participate in accreditatation programs, as do many nursing homes, community health centres and home-care services.
Hospital-associated infection accounts for approximately 220,000 illnesses in Canada each year. MRSA and Clostridium difficile are two of the most problematic organisms involved in hospital-associated infections.
MRSA has been denoted a superbug because of its increased resistance to antibiotics and in some cases higher potential to cause infection, particularly in healthcare facilities where the population is generally more susceptible because of underlying disease conditions. Organisms with a greater potential to cause infection and/or increased resistance to commonly used antibiotics pose serious infection control issues for healthcare organizations.
Clostridium difficile is another superbug that gained notoriety in Quebec hospitals due to the spread of strains with a greater potential to cause infection. However, Clostridium difficile is an infection concern for many acute care hospitals, transitional care and long-term care facilities. Clostridium difficile produces a toxin that causes severe diarrhea and inflammation of the bowel (pseudomembranous colitis) that can be life-threatening. It is difficult to clear from the environment because once out of the human body, it enters a protective state (spore) that is resistant to heat, cold, chemicals and disinfectants. In older facilities, like many of the Quebec hospitals involved in recent outbreaks, C. diff is even more difficult to eliminate.
Read more about superbugs:
C. difficile Associated Disease (CDAD)
Methicillin Resistant Staph: Superbug Infections
Source:
Priest, Lisa. ‘Ottawa Targets Hospital Superbugs: Health agency acts as infection rate soars.’ Globe and Mail, Tuesday February 5, 2008.
Posted by Judy Arbique
Human papillomavirus, a leading cause of cervical cancer in women, gained media attention last year with the introduction of controversial HPV vaccine programs in young girls. Now HPV is in the news for a different reason: HPV is also becoming one of the leading causes of oral cancer in men, rising steadily in men from 1973 to 2004. Mike Stobbe reported in the Globe and Mail that HPV “now causes as many cancers of the upper throat as tobacco and alcohol”. The reasons for the increase in oral cancers caused by HPV may be due to “an increase in oral sex and the decline in smoking”.
A skeptic might wonder whether this latest report is a marketing ploy by Merck & Co. to increase HPV vaccine sales by including men in immunization programs. However, the news report was supported by studies published in the prestigious journal New England Journal Of Medicine and in the Journal of Clinical Oncology.
Read more about human papillomavirus:
Posted by Judy Arbique
A study by Diep and colleagues published in the Annals of Internal Medicine (January 2008) found that infection with multi-drug resistant methicillin-resistant Staphylococcus aureus (MRSA) is common among men who have sex with men. MRSA infection did not seem to be related to HIV infection.
The study involved data from hospitals in San Francisco and Boston and found a higher incidence of infection with a particular multi-drug resistant strain of MRSA (USA300) in the population of men who have sex with men than in the general populations of those areas.
USA300 is a strain of community-associated MRSA, not seen before 2000, that is now widely spread through North American and Europe. USA300 is resistant not only to methicillin, but to a number of other drugs as well. USA300 commonly causes skin infections but can cause serious infection including necrotizing fasciitis (flesh-eating disease), sepsis, endocarditis and pneumonia, although these types of infection are rare. Infections occurs mostly among healthy people living in the community.
In San Francisco, MRSA infection most commonly involved abscesses or cellulitis of areas in the buttocks, genitals or perineum. The higher proportion of infection in these areas suggests that MRSA can be spread through sexual contact, although further study is required to validate the assocation between sexual contact and MRSA transmission.
Read more about MRSA:
Methicillin Resistant Staph: Superbug Infections
Staph and Methicillin Resistance
Measures to Reduce MRSA in Sports
Emergence of Multidrug-Resistant, Community-Associated, Methicillin-Resistant Staphylococcus aureus Clone USA300 in Men Who Have Sex with Men
Posted by Judy Arbique
Surveys conducted between 1999-2006 by the Centers for Disease Control and Prevention National Center for Health Statistics, suggest that approximately 0.47 percent of the U.S. household population (aged 18-49) are infected with HIV. Data was generated from the National Health and Nutrition Examination Survey (NHANES).
The report did not provide information on how many of these infections are newly acquired (incidence of disease). The incidence of disease is the number of new cases of disease among a certain group of people during a certain period of time, generally a year.
Prevalence of disease, on the other hand, indicates the total number of people in a population with a certain disease at a given time. As an example, a person diagnosed with HIV will be reflected in the incidence and prevalence numbers of HIV infection in their first year of diagnosis, but only in prevalence numbers for subsequent years.
Survey findings:
- Men are more likely to be infected than women (0.7% versus 0.2%).
- 2% of black adults were more likely to be infected than white and Mexican-American adults (2% versus 0.23% and 0.3%, respectively).
- Adults infected with herpes simplex type 2 virus (HSV-2) are at least 15 times more likely to be infected with HIV (approximately 2% of HSV-2 positive adults also have HIV).
Read more about sexually transmitted disease:
Chlamydia trachomatis Infection
Human Papillomavirus Infection
Sources:
New Report Provides Information on HIV Prevalence in the U.S. Household Population
Posted by Judy Arbique
Cholera in Birds
A recent outbreak of cholera has been reported in birds of the Great Salt Lake in Utah. Avian cholera, the most common infection in wild waterfowl in North America, is responsible for the deaths of some 15,000 birds over the past month. Bird carcasses (including eared grebes, ruddy ducks, California gulls and northern shovelers) have been found along the shoreline of the Great Salt Lake in Utah.
Avian cholera is not related to human cholera: in birds cholera is caused by a different bacterium than the one that causes cholera in humans. Avian cholera is caused by Pasteurella multocida; human cholera is caused by Vibrio cholerae.
Pasteurella multocida can be spread by bird-to-bird contact, contact with secretions or feces from infected birds, or contaminated food or water. Aerosol spread can also occur especially during colder months when birds are concentrated together.
Death can result in an early as 6-12 hours following infection, although the average time of death is 24-48 hours after infection. Death may be rapid with birds reportedly falling out of the sky or dying while eating.
Symptoms of avian cholera:
- lethargy,
- convulsions,
- swimming in circles,
- throwing the head back between the wings,
- erratic flight (e.g. flying upside down or attempting to land above the water),
- mucousy discharge from the mouth.
Humans can be infected by birds through a scratch or wound when handling infected carcasses. However, it is unlikely to be infected from eating infected birds.
Sources:
Posted by Judy Arbique
Herpes labialis (oral herpes) affects 30% of the population and is often recurrent, reactivated by stress, ultraviolet light (including sunshine),
Recurrent herpes labialis is a frequent disorder. Following primary infection, the herpes virus hides out in the sensory ganglia and results in a life-long predisposition to herpes outbreak infections (recurring infection). The herpes virus lies latent in the Gasser ganglion and awaits conditions that promote reactivation.
Treatment and prevention of recurrent labial herpes are targeted by specific antiviral agents. Whereas, treatment regimens address the virus following infection, prevention strategies reduce the incidence of herpes recurrences.
Read more about herpes infections:
Infections Caused by Herpes Virus
Posted by Judy Arbique
An expectant mother is not only responsible for her own health, she is also responsible for the health of her unborn child. Infection during pregnancy can cause harm to the physical and mental development of her child, sometimes serious enough to cause death.
Infection acquired by the baby during birth can also lead to serious or life-threatening illness.
Athough there are common sense practices that can reduce the risk of getting an infection, expecting mothers need to be especially careful to ensure that their fetus is protected from infectious diseases and their effects.
General practices that reduce the risk of getting an infection include:
- Wash your hands often (e.g. after using the bathroom, touching or preparing raw foods, handling pets or soil, caring for and playing with infants and children, contact with sick people).
- Cook meat thoroughly.
- Ask your doctor about which vaccinations are appropriate to you and keep them up to date.
- Avoid other people who are sick.
- Avoid unpasteurized milk and its products (e.g. raw animal milk or cheese).
- Avoid dirty cat litter.
- Avoid rodents (wild or pet) and their droppings.
- Take precautions against sexually transmitted infections (e.g. HIV, hepatitis B).
Get tested for sexually transmitted infections regularly if you are sexually active.
If you are pregnant ask your doctor about group B strep (Group B Streptococcus).
Read more about sexually transmitted infections:
Sources:
Preventing Infections During Pregnancy (Centers for Disease Control and Prevention)
Posted by Judy Arbique
A ten person team from the Centers for Disease Control and Prevention deployed to Uganda remained there through the holiday season attempting to control the Ebola hemorrhagic fever outbreak. One of their efforts is the establishment of a laboratory in Entebbe so that diagnostic testing can be performed.
Ebola hemorrhagic fever is a severe, often-fatal disease caused by a virus belonging to the same family as the virus that causes Marburg hemorrhagic fever.
The current outbreak in Uganda is responsible for 123 cases, 34 of whom died. An earlier outbreak of Ebola in the Democratic Republic of the Congo in October of 2007, resulted in more than 170 deaths.
Read more about hemorrhagic fever:
Marburg Fever: African Fruit Bats Potential Reservoir
Sources: