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Friday, August 18, 2017

Fall Fair Fun

The end of August is bitter sweet.  On the sweet side, it marks the anniversary my husband and I started dating and got married and it marks the month we moved from a high-risk pregnancy to a “you’re good to go” pregnancy.  On the bitter side, it marks the end of summer, the return of cool nights and for children the return to school.  It also marks the start of Fall Fair season!

Growing up on a farm, Fall Fairs were where you got to show off your prized animal (in my case a purebred Hereford named Patience).  She was aptly named as it took all my patience to teach her to lead on a line, stand quietly to be judged and to stop dragging me through the manure pile.  I was a horse girl, so Fall Fairs were also high season for competition – hunter, equitation and jumping were my events.  My boy Wally, known in the show world as “The Other Man” was a bit fickle.  We had our good days and our bad days.  In hindsight, I should have named him “The Only Man” seeing as he was the reason for much of my teenage drama and losses of boyfriends.  If I had a show, you could be sure that I would cancel a date to go ride and groom my horse.

Fall Fairs are a great time for people to learn where our food comes from and to get to touch and feel different animals, learn their sounds and their smells, and for some unsuspecting child or adult it may also mark the first time you got nipped, bit or kicked it because you wrongly thought that all animals were pets.  Fall Fairs are also a time of food poisoning and catching a zoonotic disease such as Salmonella or influenza.  Because Fall Fairs result in the mixing of humans and animals, it is important that we all take steps to protect ourselves from picking up a zoonotic disease.  Whenever there is a human and animal interface, we need to recognize the risks that come with it.  Promoting simple things like good hand hygiene habits and ensuring there is adequate access to hand washing stations or hand sanitizers can go a long way to protecting people.  But it’s not just about our protection, animals can be susceptible as well, so we need biosecurity measures in place to prevent animals getting sick because we traipsed something in to their area on our shoes.

In fact, a study recently published in Emerging Infectious Disease looked at how novel viruses can evolve in an agricultural fair setting highlighting how quickly influenza and other potential diseases can spread from pigs to humans.  The study looked at samples from 161 pigs from 7 different fairs.  They found that for 6 of the 7 fairs, 77.5% of the pigs were infected with Influenza A. Interestingly only 2 of the fairs showed extensive influenza-like illness among the pigs, meaning subclinical infections with influenza pose a potential public health threat.  Influenza viruses can jump from humans to pigs and back to humans.  Biosecurity measures at Fall Fairs and the need to conduct surveillance within the pig population is an important method for detecting novel influenza A viruses that threaten swine and human health alike.

Don’t let this stop you from attending these fun events.  There is much to see and do, and of course eat!  If you happen to attend any in Southwestern Ontario you may come across my niece!  She’s gone the “western” route meaning she runs barrels, poles and flags, but I still love her even if she picked the wrong events!

Bugging Off!


Friday, August 11, 2017

It was the stethoscope in the ER, my dear Watson.

If you ever read or watched the Sherlock Holmes books, movies or the TV series you will recall the line “Elementary, my dear Watson”.  It was the explanation that Sherlock Holmes gave to his assistant, Dr. Watson, when explaining deductions he had made.  Science, like solving murders, is all about deduction and solving mysteries and puzzles.

The same can certainly be said with infection prevention and trying to find out who or what are transmitting infections and how.  In recent years, there has been a huge push on improving hand hygiene rates.  There has also been a focus on improving cleaning and disinfection processes, particularly when it comes in environmental surfaces.  Studies have looked at different types of disinfectant actives, different cleaning processes, changing frequency of disinfection, increasing staff (or decreasing staff), and implementing verification methods to ensure that cleaning and disinfection has in fact occurred.  Several studies have shown that changing products, processes and including a validation program could in fact improve cleaning and disinfection showing a direct link to reducing HAIs. 

Regardless of the implementation of hand hygiene programs or improving environmental surface disinfection, HAIs were not eliminated.  Improved hand hygiene and enhanced cleaning certainly showed a reduction in HAIs, but HAIs still occurred.  Several years ago after conducting a cleaning audit at a facility that was in the midst of an outbreak one of the observations I made was that I never saw any cleaning and disinfection of patient care equipment by nursing staff.

Don’t jump to conclusions.  I’m not saying that nurses are to blame for outbreaks, but the thought came back in flash after reading a study that hoped to improve both hand hygiene and stethoscope hygiene. The researchers’ intervention sought to educate staff regarding the importance of stethoscope hygiene. Expectations were set that stethoscopes needed to be disinfected between each patient encounter due to the fact that they are repeatedly used throughout the day and can become contaminated after contact with patients.  This repeated use throughout the day and between multiple patients make stethoscopes a key fomite that can transmit pathogens from patient to patient.  Unfortunately for the researchers (and maybe the patients) of the 128 initial observations disinfection of the stethoscopes never occurred.  Post-intervention, an additional 41 observations found that even with an education intervention to discuss the importance of disinfection of the stethoscopes, no stethoscope hygiene was performed.

Do I hear crickets chirping

I wonder just how wide spread the lack of stethoscope hygiene is? I know the next time I’m at my doctor’s I’m going to ask when the last time she disinfected her stethoscope was and may just offer to clean it for her myself!

Bugging Off!


Friday, August 4, 2017

Sharing is Caring

My dad is a prostate cancer survivor.  We were lucky.  He had a doctor who was on top of things and through my contacts, we were able to find him an excellent specialist.   The best news of all was in June when the oncologist said my dad no longer needs to visit him and passed him back to his GP.  It was an awesome day.

Why am I sharing this?  Well each November since my dad was diagnosed with prostate cancer I have supported “Movember”.  Rest assured, I am not growing facial hair.   I do, however, donate to friends or family members who decide to grow a beard, a mustache or a goatee.  I’m giving to a worthy cause – prostate cancer research.  I’m hoping that sometime in the future someone else’s dad won’t have to tell his baby girl that he has cancer.

Without a doubt there is no shortage of worthy causes – cancer research, food banks, clothing and even hair donations – we can become almost numb to the requests for money to support cause after cause.  So I will apologize as this is another cause, but one I hope the infection control community can get behind – infection control education.  In particular, funding for infection control education in Africa.

Why is education in Africa so important?  Because there is a shortage of skills particularly in infection prevention and related topics like engineering and infrastructure maintenance.  Education and understanding of the local conditions is pivotal to good infection control practices in both healthcare facilities and in the communities.  Similar to the National Infection Prevention Associations we see in industrialized countries like Canada, the US, the UK, etc, an association was started by a group of visionaries in Africa.  The Infection Control African Network (ICAN) was established in 2012 and has grown include 500 members from 34 countries across Africa. It has an extensive Education programme – Cape to Cairo.  Since 2005 ICAN in partnership with Stellenbosch University has graduated over 120 students in the Postgraduate diploma program in IPC, 300 in fundamentals in IPC, 1200 in the Basic course in IPC, 94 managers in cost effective IPC practices. These are just a few of the many courses that are offered. There is also an ICAN conference where bursaries and scholarships are given to African scientists to present their research. Further, ICAN has been a member of the WHO committees on IPC and related topics with a view to carry forward the view of low to middle income countries. There is no question that ICAN has had a very positive impact on African lives.

But all of this comes with a cost.  In a country the size of Africa where resources and money is scarce, support is needed to continue and expand the education efforts.  By using teleclass education systems like Webber Training, ICAN can take their infection control education into some of the more rural and remote parts of the African continent.  To ensure that as many people as possible can receive the training, all of the course lectures will be made available on teleclassafrica.org in English, and eventually, in French, Portuguese, Arabic, and Swahili.  This will mean that virtually every healthcare worker on the continent will be taught in at least one language that is understandable to them.

In the spirit of “sharing is caring” I am hoping that some of you may be willing to support this worthy cause.  If you’re not able to support, I am hoping that you would consider sharing the Go Fund Me link.  It’s amazing how far $15,000 can go.  Where else on earth can an infection control education program be brought to healthcare workers from 54 countries?  

Bugging Off!


Friday, July 28, 2017

Diarrhea, the newest occupational risk?

I generally start each blog with a little story. Often times the story may be personal and something that can lead nicely into the main topic of the blog.  This week after reading the article that is serving as the basis for the blog topic and deciding upon the title, I knew if I shared a personal story I would really have tipped the scales of TOO much information.   I’m sure each of you can think of a situation where you’ve been hit by diarrhea.  You may even recall from childhood a certain song dedicated to the topic of diarrhea.  There are a few different renditions and I think in an attempt to be mature I’ll let you google “Diarrhea Song” on your own.

So why the talk of diarrhea?  Well an investigation report was released by the CDC last week about a Salmonella outbreak linked to microbiology laboratories which infected a total of 24 people in 16 states between March and June this year.  Of the 24 confirmed cases, 6 people were hospitalized, but no deaths have been reported.  The infections occurred in clinical, commercial, college and university microbiology laboratories where the investigation revealed that several of the people infected in the outbreak reported risky behaviors, such as not wearing gloves, not washing hands and using writing utensils or notebooks outside the laboratory. 

As a result of this latest outbreak, the CDC has released a new set of guidelines to be used when working in laboratories.  Some of the key recommendations include not bringing home items used in the lab; following proper biosafety training; wearing gloves, a lab coat or other protective garments; actively washing your hands; and avoiding touching your face or body while in the lab.  Having worked in a lab setting and being responsible for the technical service team and sample reception, I would also say a key recommendation should be not to store your lunch, snacks or drinks in the same fridge that samples are stored…..

The Salmonella typhimurium strain identified in this outbreak was also linked to infections in microbiology labs in 2011 where 109 people infected including 2 children of an infected student and 2014 where 41 people infected.   The long and the short, is it seems to take about 3 years for lab staff to forget that outbreaks and diarrhea associated with Salmonella can be an occupational risk.  This goes to show that biosecurity measures cannot be underestimated.  In a lab setting, once the crisis is over we cannot simply fall back into our old habits over time. Biosecurity measures were designed for one very specific reason – to protect us as we work with potentially infectious pathogens.  This is our health we are talking about.  Sure an infection with Salmonella and the associated diarrhea is a nuisance and some may just shrug it off as a fact of life.  Would we’d be so cavalier if we were talking about Ebola?

Check back with me in 2020 and let’s see if we can find another outbreak!

Bugging Off!


Saturday, July 22, 2017

Pedicures, Plantar Warts and Tinea pedis

I was in SoCal this week.  It was lovely.  It had been a while since I’ve been to California and was able to enjoy a drive down the coast from LA to Dana Point.  If you’ve not been there, it’s the home of the Doheny Beach – you know the one mentioned in the Beach Boy’s song “Surfin’ USA”?  If you love sand and surf it’s worth the trip, as is a visit to Salt Creek Beach.  I say “if you like sand” because I #hatesand!  It gets all over you, and I may have had a bit of a tantrum while trying to get sand out of my sandal and then locking the keys to my rental car in the trunk……  The car wasn’t locked and while there was no trunk button in the cabin of the car we did manage to unlock the car by putting down the back seats and crawling into the trunk that way.  If you don’t believe me check out my Twitter or Instagram for hilarious picture evidence @nicolecronkenny. 

As is the case with the picture that inspired this week’s blog, I may also have followed the local way and walked bare foot in public on sidewalks and stairs.  Why would I risk contracting Plantar Warts or Athlete’s foot (Tinea pedis) by walking bare foot in a public place?  I had #Ihatesand on my feet.  I had to walk back to the car without shoes so that I could use a bottle of water to wash the sand off.  Don’t you agree it’s ridiculous they did not have showers readily available as you came off the beach?  I’m sure I’m not the only #Ihatesand person out there!  At the very least, I am sure that most people hate bringing sand home with them!

Aside from enjoying days at the beach accumulating sand in areas it does not belong, summer is also known as high season for pedicures, because who does not want to make sure your feet look good while walking in public?!  Back in 2012, I wrote a blog “Be Spa Safe” where I gave 7 things to look for when going to a spa or nail salon:

1. Is the facility clean and organized?
2. Are the tools and work surfaces in good repair?
3. Did I see the personal service worker wash their hands?
4. Are the tools and supplies stored in a clean area?
5. Are creams, lotions, wax etc used in a way that does not contaminate them?
6. Are clean sheets, towels, etc used for each client and paper liners thrown out after each use?
7. Most importantly, ask yourself if you feel comfortable with getting whatever treatment you are looking forward to done.  If what you see or hear is making you uncomfortable…RUN!!!!!
I hope that you’ll consider these the next time you go for a mani or pedi!  If you’re off to the beach this weekend enjoy, but I hope it’s a beach that has showers and you’ll wear sandals!  You can be sure this weekend I will not be spending time at the beach.  #Ihatesand you know!

Bugging Off!


PS – I’ll let you know if I caught anything infectious walking in public!

Friday, July 14, 2017

#FF Schools out for summer!

As much as I hate to date myself, I’m hoping that when many of you read the title for this week’s blog you started humming, singing or at least thought of the 1972 song by Alice Cooper “Schools out for Summer”!  Let me be clear, I was still a baby when it first debuted, but I dare say many of us probably sang the song on the last day of school as we ran out the school doors whether it was to catch the bus, to jump in your car or simply run all the way home.   While many kids hope to completely avoid anything that may resemble learning in any form this summer, there are some of us who take the opportunity to catch up on reading or learning during the couple months that we anticipate having a bit more time to slow down and relax.

As I do each quarter I wanted to share the Webber Training teleclasses coming up for the next three months.  As noted in past blogs, the Teleclass Education by Webber Training is an international lecture series on topics related to infection prevention and control. The objective is to bring the best possible education to the widest possible audience with the fewest possible barriers when trying to access it.  Here's the list of teleclasses for the third quarter of 2017.

Title of Teleclass
July 13th
The psychology of hand hygiene: How to improve hand hygiene using behaviour change frameworks
Dr. Jocelyn Srigley, Canada
July 26th
The impact of catheter associated urinary tract infection
Prof. Brett Mitchell, Australia
August 10th
Learning infection control via games
Prof. Anne-Gaëlle Venier, France
August 23rd
Biofilms in the hospital environment: Infection control implications
Prof. Karen Vickery, Australia
August 24th
Social Media: Useless or useful in infection prevention
Barley Chironda, Canada
September 14th
Relationship between patient safety climate and adherence to standard precautions
Dr. Amanda Hessels, USA
September 18th
Igniting passion, sparking improvement
Julie Storr, UK
September 20th
How to publish in the journals and why it matters
Prof. Elaine Larson, USA

For more information on Webber Training, including a full list of the upcoming Infection Prevention and Control Teleclasses, please visit www.webbertraining.com.  If you’re a Twitter follower you can also be part of the conversation during the sessions by following #WebberTraining.

I hope many of you will take the opportunity to listen to these teleclasses and share them with your colleagues! 

Bugging Off!


Friday, July 7, 2017

Happy belated Canada Day and Independence Day!

With school finally coming to an end last week, this week we took a long needed family vacation.  I decided I would even take a break from blogging. So unlike me, I know. I hope you don't mind, but with views like the one in the picture, while enjoying a little sunset fishing, what's a girl to do!

Some of you may have already received our Corporate Solutions Newsletter and know that we are fortunate to have friendships with Opinion Leaders from around the world who are willing to write articles for our newsletter.  If you haven't read the newsletter, I hope you will!  I'm currently enjoying reading the book "Preventing Hospital Infections: Real-World Problems, Realistic Solutions" that we mentioned in the newsletter.  I'll tell you all about it next week!

Bugging Off!