So long, farewell…

I know its cliché, but where did the year go?  Children are counting the minutes until school is let out for holidays; parents, friends and families are making plans to celebrate the ups and downs of 2017 and I am only 5 months away from being another year older… As I reflect back on the year I am thankful to you, my loyal followers. I was astounded to realize that over the course of the last 12 months almost 31,000 emails have been sent to readers around the world and the I am humbled that in the clutter of our inbox, so many of you have chosen to open and read the blog!

Each year, as I look back on the topics covered, it never ceases to amaze me everything that has happened during the year when it comes to topics related to cleaning and disinfection and infection prevention.  From outbreaks, to new reservoirs being identified as sources of infection transmission, to new science being published to support the importance of cleaning and disinfection or data highlighting that while cleaners and disinfectants are an important part of stopping infections we also need to be wary that some are now proving to be harmful to us and/or our environment.

What is also interesting (and rewarding) is to see that the blogs that made the top of the list in terms of the greatest number of followers reading them, were also varied in the topic covered.  The following are the top Talk Clean To Me blogs for 2017:

1. Ban the bad blowers – further proof that hand dryers are a concern when it comes to infection prevention.
2. Who’s wasted – a discussion on prion diseases (I suspect it was the title that suckered you in!)
3. Is snot our newest superhero? – a discussion of a study looking at the properties mucous have in controlling pathogens
4. Are you part of the 25% group? – a review of a survey conducted looking at presenteeism
5. Volcanic Soil vs Hantavirus – a digression of a blog covering an outbreak of elephantiasis caused from walking barefoot in volcanic soil to the first death in New Mexico of the year associated with Hantavirus
6. The joys of birth and the nightmares of SSIs – one of the tribute blogs during Infection Control Week sharing stories of my colleagues who have firsthand experience with the impact of HAIs.
7. Are we crying wolf over quats – reviewed a study showing that Quats (one of the most commonly used disinfectant chemicals) were found to inhibit mitochondria and estrogenic functions of cells.
8. Triclosan has been banned! – sharing the news that Minnesota was the first state to ban Triclosan in consumer products.
9. Do disinfectants pose health risks? – reviewing the summary of data looking at occupational asthma and occupational risks of using germicides in healthcare facilities.
10. Farewell dear husband, father and friend – one of the tribute blogs during Infection Control Week and probably the story that hit home the most for me.

Thank you again for following the blog!  Until next year, wishing you every happiness this holiday season and throughout the coming year!

Bugging Off!

Nicole

Are men the fairer sex?

Today I just had to tap out and admit I needed a day at home to rest.  I’ve been fighting a cold for over a week.  It started to hit me Sunday, when I had a 2 day committee meeting….with a group of Infection Preventionists (Sorry if I made anyone sick!).  ‘Tis the season for colds and flus – it is what it is and actually I’m pretty happy that I made it almost to Christmas before catching something. 

This morning, while relaxing, I caught up on some reading and low and behold I came across a study that made me chuckle.  The timing of course with being sick couldn’t have been better!  I came across an article “The science behind man-flu” by Dr. Kyle Sue from the University of Alberta that explored whether men are wimps or just immunologically inferior.  OMG!  Who hasn’t mocked their spouse, partner, brother, father, friend or co-worker for being a baby when sick! 

Across the ages, women have often been called the fairer sex.  It’s a stereotype that is hard to escape.  In trying to understand this association, scientists have shown that we automatically link lighter or fairer colours with female names and qualities, and darker shades with more masculine attributes.   How then is it that when it comes to getting sick, women handle it better than men?  According to the Oxford Dictionary, “man-flu” is defined as "a cold or similar minor ailment as experienced by a man who is regarded as exaggerating the severity of the symptoms."  Sue conducted a literature review to determine if men really experience worse symptoms then women and whether this difference has any evolutionary basis.  One study Sue referenced isolated cells from 63 healthy people and infected the cells with a common virus. The researchers found the cells from women had a stronger immune response than those from men.  Some of the other interesting tidbits included the fact that men had a higher risk of hospital admission with the flu, men had higher rates of flu-associated deaths compared to women, women are more responsive to vaccination than men and while perhaps one of the least scientific supported evidence, a survey found that men suffering from a flu reported taking more time off from work than women.

The things that make you go hmmm…..  I guess it’s true that estrogen does have its advantages from time to time! Too bad it let me down this week, but it gives me the opportunity to drink a hot-toddy before bed!

Bugging Off!

Nicole

Street cleaning causes infections?

 

I think I can say with some confidence that it is very rare that cleaning can lead to infections.  I am aware of a study from many moons ago where a facility found that surfaces cleaned by a particular cleaner were dirtier after cleaning took place.  The reason? In order to be more efficient, the housekeeper would set up their cart the night before, and to minimize waste, topped up rather than getting fresh disinfectant solution.

I’ve been fortunate enough to have had the opportunity to travel to some extent, and visit a number of different countries.  Along my travels I have noticed that some areas are dirtier than others.  I have also noted that some areas of the world go so far as to clean their streets each night to keep the dirt at bay – I happen to know that Bourbon Street in New Orleans is frequently cleaned…..but dirt is not really the issue there.  In general, I would say that street cleaning is a good thing.  It keeps dirt at bay, but it also removes food scraps that could become a food source for insects or rodents. For obvious reasons, cleaning gives a pretty good impression to those who may be new to a given city.  It never occurred to me that street cleaning could be an infection hazard.

I now fear that street cleaning trucks may become categorized in the same league as hand dryers for me thanks to a study published in Emerging Infectious Diseases by researchers from Spain.  The study investigated a case of Legionnaires’ disease that had been confirmed at a street cleaning company that reported a similar case 4 years prior.  The long and the short of it is that researchers felt that the infections were caused by contaminated water tanks used by the trucks during street cleaning concluding that Legionella was being aerosolized through the high-pressure hoses used to clean the streets.

This isn’t the first blog on Legionella.  In my Bugs, NOT Robbers Close Police Station and Summer cough due to cold…or Legionnaires’ disease, I reviewed 2 other outbreaks associated with Legionella.  In fact, Legionella is associated with a number of interesting outbreaks including water or liquid associated with windshield washer fluid, dishwashers, hospital hot water systems, cooling towers, asphalt paving machines and even water births…   According to relatively recent statistics, the CDC reports that Legionnaires’ disease has quadrupled in incidents between 2000 and 2014.

Legionella loves water, so it’s not necessarily surprising that it would be found in the street cleaning trucks.  During the investigation the researchers found that the water from the street cleaning trucks was disposed of each night and refilled the next day with either untreated ground water or drinking water. The tanks were disinfected once/year for 2hrs with a chlorine-based solution.  However, the foam linings in the tanks were never replaced and did not dry out overnight creating a perfect reservoir for Legionella to flourish.  As a result of the investigation, street workers are now required to wear masks during tasks that could lead to potential exposure. The internal foam pieces were removed from the trucks and stricter water treatment measures were put in place.

In the end, cleaning and disinfection is important to minimize the chance that Legionella can take hold and cause chaos.  The upside of studies such as this is that it shows you just never know where the next reservoir for Legionella or any pathogen for that matter may be found.  It’s easy to let our guard down during quiet times….but that always seems to be when the next opportunistic infectious agent crops up and wreaks havoc!  Cleaning saves lives and I guess as this study shows, effective cleaning and disinfection protocols are needed everywhere!

Bugging Off!

Nicole 

What’s in your sink, tap or bottles?

Prior to entering the infection prevention world, I worked for almost a decade in a laboratory where we tested water, soil, waste water, air, and food, among other things.  My focus and expertise were in the Environmental Division where we dealt with contaminated sites (water and soil testing), drinking water analysis, etc.  My least favorite project was measuring, weighing, filleting and dissecting >200 fish in order to test for dioxin and other chemicals of concern.  It was stinky and after the first night, the 2 college students who were supposed to help never came back….

Having lived and worked through one of the worst outbreaks associated with drinking water and understanding the need to ensure we have quality water to drink, I am always curious when I come across an article that impacts drinking water, particularly if bottled water is included, as bottled water does not have the same level of testing requirements as tap water (at in Ontario, Canada).  So it was interesting when I read a recent article by researchers out of Thailand looking at Stenotrophomonas maltophilia isolates from environmental samples.

S. maltophilia is an emerging global multidrug-resistant opportunistic bacterial pathogen that is being found both in healthcare facilities and the community. Similar to many emerging pathogens, it is of particular concern for immunocompromised individuals as this pathogen is associated with a significant mortality.  S. maltophilia is an environmental bacterium found in aqueous habitats, including plants, animals, foods, and water sources that has the ability to cause infections in a range of organs and tissues but is most commonly associated with in respiratory tract infections. 

The researchers found that of the 360 samples taken, the majority of the environmental isolates were found in sink drains, drinking water and tap water.  Of particular interest was the frequency of positive samples found from bottled water, which the researchers speculate could have resulted due to poor management of hygiene during the production of the bottle water.  They also found positive samples from the machine filtered water which also highlights the importance of ensuring there is a preventative maintenance and monitoring program in place for on-site filtered water production.

My interest for this was of course the contamination in bottled water.  We’ve become accustomed to grabbing bottles of water and most incorrectly believe that bottled water is safer than tap water.  In some countries, without a doubt this could be true.  However, in other countries, very strict regulations are in place to ensure that municipal water is of the highest quality and safety.  The dirty truth is that bottled water manufacturers do not have to conduct much in the way of testing to ensure their product is as safe as the water coming out of our taps.

As with any study looking at the environment, it is both interesting and scary to learn about new emerging pathogens we need to be on the lookout for and of course the surfaces and areas we need to be particularly vigilant with.

Jae kan mai na,

Nicole

PS – that’s see you later in Thai!  Thanks Nuch (aka Big Sis)!