Random Quotes on Infectious
Diseases/Infection Control
"Hand washing is the single most important means of preventing the spread of infection."
� � � Centers for Disease Control
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"Human beings need to remember that we are also part of the food chain, and we are losing the war."
� � � Head of Infectious Diseases, VA Medical Center, Boston, Massachusetts.
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"Foodborne illness kills over 10,000 people each year. Over 70% of all outbreaks originate in foodservice operations and, as many as 40% are the result of poor handwashing and cross-contamination. Each year over 80 million estimated cases of food poisoning occur in the United States alone. �The US spends between $7.6 and $23 billion annually on health care and lost productivity resulting from foodborne illness. The average incident costs the foodservice company over $75,000 and results in significant future sales losses."
� � � Food and Drug Administration
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"2400 medical gloves were evaluated for leakage. Types of gloves examined (number of brands)included: sterile latex (7). sterile vinyl (4), nonsterile latex (6), and non-sterile vinyl (7). Sampling was done from one box of each brand. Fifty gloves from each box were filled with 300 ml water (the standard test used by the American Society for Testing and Materials). An additional 25 cm pressure was applied to water filled gloves. Another 50 gloves of each box were donned and dipped into a basin that contained heparinized human blood. Only 4 brands of sterile latex surgeon's gloves proved non-permeable to water or blood. Other brands showed leakage that ranged from 1% to 52%. Analysis of proportions of pairs of gloves permeable to water or blood indicated a strong statistical associated of non-sterile packaging or packaging in suction kits with increased leakage rates. These findings affirm that gloves can be regarded only as a means of reducing the gross soil from blood or body fluids. Quality control standards are needed to ensure more uniform glove quality."
� � � Permeability of latex and vinyl gloves to water and blood. DeGroot-Kosolcharien, J., and Jones,J.M. 1989. Am. J. Infect. Control 17(4): 196-201.
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"Studies indicate that personnel in both the health care and food service industries have poor hand washing habits. (60% of food service personnel in one study were reported to not wash their hands after using the toilet.) Need for training and education of food service personnel."
� � � Changing poor hand washing habits - A continuing challenge for Sanitarians. Emery, H. C. 1990. Dairy Food Environ. Sanitation 10(1): 8-9.
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Drug-Resistant Infectious Diseases
"The long-term use and misuse of antibiotics has caused many microorganisms to adapt to these drugs. Even antibiotics used to treat common bacterial infections are becoming ineffective; as a result, hospital stays are longer, health care costs are rising, and death rates are increasing. In recent years, new or increasing drug resistance has been discovered in organisms that cause malaria, TB, gonorrhea, meningitis, pneumonia, and ear infections. In addition, fewer new drugs are being developed, and our arsenal of effective drugs is diminishing."
� � � Centers for Disease Control
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"Hamburgers contaminated with E. coli O157:H7 and served at a fast-food restaurant chain caused a multistate outbreak of bloody diarrhea and serious kidney disease in 1993. More than 600 persons got sick, 56 had kidney failure, and 4 children died."
" Also in 1993, a municipal water supply contaminated with the intestinal parasite Cryptosporidium caused the largest recognized outbreak of waterborne illness in the history of the United States. Over400,000 people in Milwaukee, Wisconsin, had prolonged diarrhea, and approximately 4,400 were hospitalized. The number of deaths is still under investigation."
� � � Centers for Disease Control
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"In the United States and abroad, infectious diseases increasingly threaten our health and raise health care costs. As society and the environment change, infectious diseases also change. Microorganisms adapt to the changing enviromnment and are carried to every corner of the globe by travelers, whose numbers are growing. Advancing technology and changes in the way we live, eat, and interact with others have made us more vulnerable to infectious diseases. New infections are emerging, diseases thought to be under control are returning, and many dangerous microorganisms survive drugs that used to kill them."
� � � Centers for Disease Control
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"Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States. CDC staff estimate that during the 1980s, an average of 230,000 new infections occurred each year (CDC, unpublished data). Although since 1989 the annual number of new infections has declined by ?% to 36,000 by 1996[1,2], data from the Third National Health and Nutrition Examination Survey (NHANES III), conducted during 1988-1994, have indicated that an estimated 3.9 million (1.8%) Americans have been infected with HCV[3]. Most of these persons are chronically infected and might not be aware of their infection because they are not clinically ill. Infected persons serve as a source of transmission to others and are at risk for chronic liver disease or other HCV-related chronic diseases during the first two or more decades following initial infection."
� � � Centers for Disease Control
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The Recent TB Epidemic
"The registered number of new cases of TB worldwide roughly correlates with economic conditions: the highest incidences are seen in those countries of Africa, Asia, and Latin America with the lowest gross national products. WHO estimates that eight million people get TB every year, of whom 95% live in developing countries. An estimated 3 million people die from TB every year.
In industrialized countries, the steady drop in TB incidence began to level off in the mid-1980s and then stagnated or even began to increase. Much of this rise can be at least partially attributed to a high rate of immigration from countries with a high incidence of TB. It is also difficult to perform epidemiological surveillance and treatment in immigrant communities due to various cultural differences.
A great influence in the rising TB trend is HIV infection. Chances are that only one out of ten immunocompetent people infected with M. tuberculosis will fall sick in their lifetimes, but among those with HIV, one in ten per year will develop active TB, while one in two or three tuberculin test positive AIDS patients will develop active TB. In many industrialized countries this is a tragedy for the patients involved, but it these cases make up only a small minority of TB cases. In developing countries, the impact of HIV infection on the TB situation, especially in the 20-35 age group, is worthy of concern.
A final factor contributing to the resurgence of TB is the emergence of multi-drug resistance. Drug resistance in TB occurs as a result of tubercle bacillus mutations. These mutations are not dependent upon the presence of the drug. Exposed to a single effective anti-TB medication, the predominant bacilli, sensitive to that drug, are killed; the few drug resistant mutants, likely to be present if the bacterial population is large, will, multiply freely. Since it is very unlikely that a single bacillus will spontaneously mutate to resistance to more than one drug, giving multiple effective drugs simultaneously will inhibit the multiplication of these resistant mutants. This is why it is asolutely essential to treat TB patients with the recommended four drug regimen of isoniazid, rifampin, pyrazinamide and ethambutol or streptomycin.
While wealthy industrialized countries with good public health care systems can be expected to keep TB under control, in much of the developing world a catastrophe awaits. It is crucially important that support be given to research efforts devoted to developing an effective TB vaccine, shortening the amount of time required to ascertain drug sensitivities, improving the diagnosis of TB, and creating new, highly effective anti-TB medications. Without support for such efforts, we run the risk of losing the battle against TB."
� � � NJMS National Tuberculosis Center
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"IF IT'S WET,
AND IT'S WARM,
AND IT'S NOT YOURS,
WEAR YOUR GLOVES, AND WASH YOUR HANDS!!!"
M. Crowley, RN, MSN, CIC, PhD.
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"It's not going to be IF we have vaccine, and it's not going to be who's going to GET the vaccine. It's who's going to be alive to GIVE the vaccine."
� � � A physician from CDC and a state public health nurse, speaking about the next influenza pandemic.