Monthly Archives: May 2014

The coming MERS pandemic?

The following release from WHO, the world health organization, was published today, May 22. It details the growing problem with a new emerging threat from Saudi Arabia, Middle Eastern respiratory syndrome.

A troubling aspect of this story is that both Ramadan, and the Hajj pilgrimage (Oct 3-6) will bring 4-5 million Muslims to Mecca where they run the risk of exposure. These pilgrims will then return to their home countries, possibly exposing everyone they come into contact with to the virus. The death rate for this disease in the Middle East is over 30%. Several cases have already been reported in the U.S. and more will certainly follow. It will pay to stay informed about this issue.

Globally, 632 laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) have officially been reported to the World Health Organization (WHO), including 193 deaths. The global total includes all of the case reported in this update, plus 17 laboratory confirmed cases officially reported to WHO from Saudi Arabia between May 16 and 18, 2014. WHO is working with Saudi Arabia for additional information on these cases and will provide further updates as soon as possible.

Based on the current situation and available information, WHO encourages all of its member states to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in healthcare facilities. Healthcare facilities that provide for patients suspected or confirmed to be infected with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus from an infected patient to other patients, healthcare workers and visitors. Healthcare workers should be educated, trained and refreshed with skills on infection prevention and control.

It is not always possible to identify patients with MERS-CoV early because some have mild or unusual symptoms. For this reason, it is important that healthcare workers apply standard precautions consistently with all patients – regardless of their diagnosis – in all work practices all the time.

Droplet precautions should be added to the standard precautions when providing care to all patients with symptoms of acute respiratory infection. Contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection. Airborne precautions should be applied when performing aerosol generating procedures.

Patients should be managed as potentially infected when the clinical and epidemiological clues strongly suggest MERS-CoV, even if an initial test on a nasopharyngeal swab is negative. Repeat testing should be done when the initial testing is negative, preferably on specimens from the lower respiratory tract.

Healthcare providers are advised to maintain vigilance. Recent travelers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations. All WHO member states are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.

People at high risk of severe disease due to MERS-CoV should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. For the general public, when visiting a farm or a barn, general hygiene measures, such as regular handwashing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

Source: WHO

First State bans triclosan antibacterial


According to CNN — Minnesota is clamping down on triclosan, an ingredient used in some toothpastes, cosmetics, antibacterial soaps and body washes.

Gov. Mark Dayton recently signed a bill legalizing a measure banning triclosan-containing products in the state. The law will go into effect January 1, 2017.

“In order to prevent the spread of infectious disease and avoidable infections and to promote best practices in sanitation, no person shall offer for retail sale in Minnesota any cleaning product that contains triclosan and is used by consumers for sanitizing or hand and body cleansing,” the law says.

The exceptions to this rule are individual products that have received approval from the U.S. Food and Drug Administration for consumer use.

Triclosan has been incorporated in consumer products for more than 30 years, according to the U.S. Centers for Disease Control and Prevention. A CDC study found triclosan present in the urine of 75% of the people tested.

The health effects of triclosan for humans are still unclear. Some studies suggest that the chemical could be linked to antibiotic resistance, but evidence is mixed, and the Environmental Protection Agency says more research is needed to evaluate risk.

There is some evidence that long-term exposure to some ingredients in antibacterial products, including triclosan, “could pose health risks, such as bacterial resistance or hormonal effects,” according to the FDA.

Studies in rats have shown a decrease in thyroid hormones with long-term exposure to triclosan, Dr. Sandra Kweder, deputy director of the Office of New Drugs in FDA’s Center for Drug Evaluation and Research, told CNN in December. But collecting data from humans is “very difficult” because the studies have to look at a long time period.

The FDA announced a proposed rule in December that would require manufacturers of antibacterial hand soap and body wash to prove their products are more effective than plain soap and water in preventing illness and the spread of infection.

If the rule goes into effect, those manufacturers also will be required to prove their products are safe for long-term use.

“Millions of Americans use antibacterial hand soap and body wash products,” the agency said in a statement. “Although consumers generally view these products as effective tools to help prevent the spread of germs, there is currently no evidence that they are any more effective at preventing illness than washing with plain soap and water.”

About 2,000 individual products contain such chemicals, health officials said.

The FDA first proposed removing triclosan from certain products in 1978, according to the Natural Resources Defense Council, “but because the agency took no final action, triclosan has been found in more and more soaps.”

As I have written about here before triclosan has been banned by the European Union for years. It has a place in limited settings, such as hospital surgical suites but is far too dangerous for use by the general public for the reasons stated above.

Nano-Shield antimicrobial on the other hand does not leach into nature or pose any threat or hazard to people once it has been applied.



Infection control doesn’t cost, it pays.

I recently came across this article in Healthcare Business News. It was written by Denise Murphy and looks at infection prevention from the financial, or business side of the hospital industry. It points out that due to new riembursement protocols put into effect under the Affordable Care Act HAI’s  (hospital aquired infections), 70% of which are preventable, will no longer be paid for by insurers or the federal healthcare system. This poses a significantthreat to the bottom line profitability of these institutions.

For an investment of a few pennies a foot hospitals can keep their patients, staff, visitors, and bottom line safe from the dangers of cross contamination. One application of Nano-Shield will inhibit the growth of all microbes for 90 days.

The ROI of infection prevention

Patients who go to the hospital do not plan to get sicker while they are there. But it still happens all the time. The Centers for Disease Control and Prevention says that 1 out of every 25 patients who enter a hospital contracts a healthcare-associated infection. Tragically, most of these infections are preventable.

In addition to their toll on human lives, these infections represent a heavy financial burden for hospitals as well. As insurers and federal healthcare programs will no longer reimburse for the additional costs of a preventable infection, hospitals must foot the bill for tens of thousands of dollars of care related to each HAI.

There also are intangibles that might not show up immediately on an income statement, but nonetheless have long-term financial consequences. These include negative publicity, which can hurt referrals and result in a loss of community trust. The facility’s accreditation status can take a hit. And the hospital could lose market share to facilities that report fewer infections.

Hospitals have made great strides in reducing infections, but their incidence is still far too high, and their costs must remain a top priority for CEOs and chief financial officers. More than half of HAIs—as many as 70%—are preventable with appropriate infection prevention and control measures.



Infection prevention pays from every possible angle, and success starts at the top. C-level executives set the tone for communications to the entire staff. They must devote the necessary resources and commit to a culture of safety and continuous improvement by setting clear expectations; providing the education, tools and training needed to meet those expectations; and then building and sustaining accountability.

It’s an investment with a powerful return, because it affects the most important bottom line—the number of preventable deaths at your hospital.