Keeping the bugs out

Yet more infection control issues at the VA

This HND piece covers one more infection control problem at a VA hospital, only this time, it involves dental work. What makes this one so bad is that there is absolutely no mystery as to what went wrong.

You see, the unnamed dental offender didn't use the disposable drill bits provided to him by the agency. Oh, no. This genius preferred to use his own personal bits, only he...forgot to sterilize them. Now, they'll be testing nearly 600 of his patients for HIV, hep B, and hep C.

More details in the piece. Read the complete article.

Stopping a bloodthirsty killer

This HND piece focuses on the world's most dangerous animal (to humans). And that, of course, is the lowly mosquito, responsible for the deaths of more than 1 million people every year.

We go on to explain that this little fly is really a vector for the actual pathogens, and then go on to discuss the history of orgnaize3d efforts in mosquito abasement. As one of my friends—who lives in a mosquito-infested area of metro NYC—noted, "All but the most lunatic Greenies are on board with killing these miserable creatures."

Since we have already covered the tragedy of banning DDT, and what it did to Africa, that sordid aspect of this story wasn't included.

Read the complete article.

Education and wellness: protecting people from a public health crisis

This is a guest post from Micah Ali, of the Compton Creek (California) Mosquito Abatement District

One of the chief responsibilities of government is to educate people about the risks of exposure to—and ways to prevent the spread of—a public health crisis. I refer, specifically, to mosquito-borne illnesses such as West Nile virus and the Zika virus, potentially lethal conditions that demand a combination of civic outreach, community-based preparedness, action by individual men and women, and couples and families, as well as the engagement of schools and other institutions.

I write these words from experience because, as President of the Compton Creek Mosquito Abatement District, I know that an epidemic like the one described above—a threat that continues to spread with unprecedented speed and ferocity—requires leadership, on the one hand, and the dissemination of relevant information, on the other. I understand that, for the good of my constituents and the betterment of all citizens throughout the United States, we must make this matter a top priority.

That process begins like any other campaign to improve personal health and wellness: It operates from a foundation of intelligence and wisdom, where you must make the former intelligible so you can ensure respect for the latter; it involves patience and conversation, inviting questions about issues big and small; it includes practical steps to isolate this or that challenge; it revolves around attentiveness, from public officials, and answers, for concerned members of the public; it requires constant vigilance on behalf of achieving a consequential victory.

These rules extend to so many facets of life, because they show how they can influence the outcome of one situation and inspire positive results for a multitude of other scenarios. The emphasis, then, is where it should; where it must be—on education and in-class programs for students and teachers, which mobilize people of all ages and interests, guaranteeing that no one is unaware of—that no one is without recourse to—the solutions to avoid a crisis or stop an epidemic.

Think of these guidelines as a primer for individual safety and collective protection.

If we adopt this advice, and if we abide by these suggestions, then we will be stronger—and healthier—for many years to come.

Yet more endoscope related infections

This HND piece is a reminder that there are still way too many of these infections.  The latest outbreaks occurred in an unnamed hospital, causing two deaths.  Maybe the best thing would have been for the hospital in question to 'fess up.  We explore that aspect, and take a dimmer view of the situaiton than even Sen. Patty Murray's recent report.

Also covered are several recent articles strongly indicating that ethylene oxide sterilization is the answer to this problem.  Read the complete article.


Will the Patty Murray superbug/tainted scope report shake things up?

This HND piece covers the devastating report released a few days ago by Senator Patty Murray (D-WA). Murray was dragged into the world of endoscope reprocessing and infection control when famous Virginia Mason Medical Center of Seattle became one of the first hospitals to report deaths related to tainted endoscopes. Who knows how many went unreported?

Making matters worse is that the entire situation reveals epic failure at all levels, not the least of which is the good old FDA. Bear in mind that the processing (cleaning and sterilizing) of these scopes is left up to hospital employees who are among the lowest paid.

Murray's report proffers a number of recommendations, and we comment on these.

Read the complete article.

Over the river and through the wood: Healthcare observations for Thanksgiving week

This HND piece invokes the first line from Lydia Maria Child's "The New-England Boy's Song About Thanksgiving Day" (1844). Child was always on the side of the oppressed, and I suspect that she would have a few things to say about our present day healthcare system.

The article examines the continuing saga over infection control issues relating to certain types of endoscopes. We're talking about a double recall involving 2800 units of a commonly used "reprocessor" for these scopes. That the FDA was asleep at the switch on this one is quite an understatement.

We also open the huge topic of conflicts of interest in healthcare (such as Big Pharma buying influence), even though this matter seems to downplayed by the New England Journal of Medicine. I'm sure that NEJM's position has nothing at all to due with the fact that absent Big Pharma advertising, it would cease to exist.

Read the complete article.

More on the endoscope-related CRE outbreaks

This HND article is a follow-up to last week's entry.

Yet another prestigious hospital joins the ranks of those reporting Carbapenem resistant enterobacteriaceae (CRE) infections, linked to endoscopic retrograde cholangiopancreatography (ERCP) endoscopes. On March 4th, Cedars-Sinai Medical Center in Los Angeles discovered that four patients were infected with CRE, and 67 others may have been exposed. On the same day, Hartford (CT) Hospital announced that as many as 281 patients may have come into contact with a "tough strain" of E. coli over the past year, but denied that it was CRE.

Two matters keep coming up: The non-use of proven ethylene oxide sterilization, and the detached attitude of the GI-docs. Then there's the dumb idea of blaming the scopes and going back to older models, as if the earlier design did not also have contamination problems. More than that, just about everyone thinks that many more similar cases will emerge—and not just with ERCP scopes.

One wonders when the rest of the medical community will put pressure on the GI-docs to show some leadership. Read the complete article.

Prey of a foul command part 1: ERCP patients and superbug infections

The title of this HND piece is taken from a mordant lyric in Richard Fariña's 1966 folkie love song "Children of Darkness." In this case, our "foul command" is officialdom, and its pathetic reaction to serious outbreaks of the dreaded superbug Carbapenem resistant enterobacteriaceae (CRE), related to endoscopic retrograde cholangiopancreatography (ERCP).

High profile cases include Seattle's Virginia Mason Medical Center, and UCLA"s Ronald Reagan Medical Center.

The FDA has been asleep at the switch—to be kind about it, while the rest of the players are blaming each other. Cover-ups have surely occurred. Associated deaths have attracted plaintiff's attorneys, but the burden of proof will be on the plaintiffs, to show that the CRE was indeed caught during the hospital stay. Fortunately, this can now be done with DNA analysis.

Lax procedures in disinfecting the endoscopes are likely at fault, but the hospitals insist that they have always followed the manufacturer's instructions. This is subject to some debate, of course. It is expected that many more such cases will emerge in the coming months.

Read the complete article.

Teixobactin to the rescue

This HND piece describes something that is all too rare these days: A shining example of great science.

With the media chock full of junk science on matters ranging from climate change to this week's new food or chemical scare, the brilliant research of Kim Lewis and associates, in isolating an antibiotic that does not seem to induce resistance, is quite exciting. His group calls this potential miracle drug Teixobactin.

The key to Lewis' discovery is a device they call an ichip, which lets them culture bacteria that previously could not be grown in vitro. It is likely that other wonderful discoveries will emerge via this same method.

Read the complete article.

High tech--and common sense--to the rescue...against infection

This HND piece discusses infection control, and how high tech, common sense, and a bit of high touch can make a dent in the spread of pathogens.  We bring in some cool innovaitons from NASA, and mention a few products that incoproate this wizardry.

Read the complete article.