I'm not one for themes - well unless it comes to planning
birthday parties: CARS, Angry Birds or surprise parties for "big"
milestones. In writing our weekly blogs,
Lee and I have tried to weave a story about the use of disinfectants for
infection prevention. However
unintentional, this month, as I plan out topics for the blog, I'm seeing a
theme develop - viruses.
In part the reason for developing theme is an article I
read that was published in the October edition of AJIC by Tzialla et al titled
"Viral Outbreaks in neonatal intensive care units: What we do not know". Not unexpectedly, infants
admitted to NICUs are at risk for contracting HAIs and certainly over the past
decade, the HAIs rates have steadily increased.
However, the vast majority of outbreaks published in scientific studies
focus on bacterial or fungal infections and certainly they do account for a
significant portion of the outbreaks, the impact of viruses as nosocomial
agents are not well documented.
read that was published in the October edition of AJIC by Tzialla et al titled
"Viral Outbreaks in neonatal intensive care units: What we do not know". Not unexpectedly, infants
admitted to NICUs are at risk for contracting HAIs and certainly over the past
decade, the HAIs rates have steadily increased.
However, the vast majority of outbreaks published in scientific studies
focus on bacterial or fungal infections and certainly they do account for a
significant portion of the outbreaks, the impact of viruses as nosocomial
agents are not well documented.
Tzialla et al queried an outbreak database and found a
total of 75 neonatal outbreaks of which 64 were directly related to neonatal
patients and 44 (>68%) associated with NICUs. The top 5 causative agents were: Rotavirus
(>23%), RSV (>17%), Enterovirus (>15%), Hepatitis A (>10%) and
Adenovirus (>9%) with gastrointestinal system infections accounting for
>54% of outbreaks and respiratory tract infections accounting for
>34% of the infections.
total of 75 neonatal outbreaks of which 64 were directly related to neonatal
patients and 44 (>68%) associated with NICUs. The top 5 causative agents were: Rotavirus
(>23%), RSV (>17%), Enterovirus (>15%), Hepatitis A (>10%) and
Adenovirus (>9%) with gastrointestinal system infections accounting for
>54% of outbreaks and respiratory tract infections accounting for
>34% of the infections.
From an infection prevention perspective, is there a
common theme?
common theme?
• From a microbiological perspective, Rotavirus,
Hepatitis A, Enteroviruses and Adenoviruses are non-enveloped viruses. They tend to be hardier viruses that are more
resistant to traditional disinfectant chemistries such as quaternary ammonium compounds.
Hepatitis A, Enteroviruses and Adenoviruses are non-enveloped viruses. They tend to be hardier viruses that are more
resistant to traditional disinfectant chemistries such as quaternary ammonium compounds.
• From a transmission perspective, Rotavirus,
Enterovirus, Hepatitis A and Adenovirus can be transmitted via fecal-oral route
- meaning the poor little neonate is eating poop!
Enterovirus, Hepatitis A and Adenovirus can be transmitted via fecal-oral route
- meaning the poor little neonate is eating poop!
• From a transmission perspective RSV, Adenovirus and
Enterovirus are transmitted by contact with respiratory droplets.
Enterovirus are transmitted by contact with respiratory droplets.
• Transmission from contact with environmental surfaces
and/or fomites has been documented.
and/or fomites has been documented.
• Many of these viruses increase circulation during the
fall, winter and early spring.
fall, winter and early spring.
We are well into Fall and what we typically call Flu Season, in fact there are only 46 more days until the first day of winter! While we often plan well in advance for
Halloween, the Canadian and US Thanksgiving and Christmas holidays (there are
only 49 more days to shop!), do we consider planning for "Virus
Season"? Are there preventative
measures we can and should consider putting into place? When was the last time you reviewed the
efficacy claims of the daily disinfectant your facility uses? Does your
product carry claims against Influenza, Norovirus, Rotavirus, RSV, Enterovirus,
and Adenovirus? Do you have an infection
prevention plan that considers making a change to a more efficacious product to
help in the prevention of viral outbreaks?
Do you increase the frequency with which high-touch hand contact
surfaces are cleaned and disinfected in order to reduce the risk of
transmission from contact with these surfaces?
Do you have a readily accessible Fact Sheets that can be reviewed with
staff to help them identify when they may be ill to help minimize the risk that
staff are the source of the outbreak?
Halloween, the Canadian and US Thanksgiving and Christmas holidays (there are
only 49 more days to shop!), do we consider planning for "Virus
Season"? Are there preventative
measures we can and should consider putting into place? When was the last time you reviewed the
efficacy claims of the daily disinfectant your facility uses? Does your
product carry claims against Influenza, Norovirus, Rotavirus, RSV, Enterovirus,
and Adenovirus? Do you have an infection
prevention plan that considers making a change to a more efficacious product to
help in the prevention of viral outbreaks?
Do you increase the frequency with which high-touch hand contact
surfaces are cleaned and disinfected in order to reduce the risk of
transmission from contact with these surfaces?
Do you have a readily accessible Fact Sheets that can be reviewed with
staff to help them identify when they may be ill to help minimize the risk that
staff are the source of the outbreak?
A fulsome program that considers (and hopefully
implements) infection PREVENTION measures such as changing of disinfectant
solutions or increased cleaning and disinfection can certainly be implemented
with relative ease and likely contribute to fewer infections. The alternative of course is having to
implement INTERVENTION measures to help combat a viral outbreak!
implements) infection PREVENTION measures such as changing of disinfectant
solutions or increased cleaning and disinfection can certainly be implemented
with relative ease and likely contribute to fewer infections. The alternative of course is having to
implement INTERVENTION measures to help combat a viral outbreak!
Bugging Off!
Nicole
