ITCHY BUGS

Indoor session 1 Start scratching now

Bed bugs and head lice will be covered at 2pm

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Itchy “bugs” – Top 14

Scabies Ringworm Clostridium difficileMethicillin-resistant

Staphylococcus aureus (MRSA)

Impetigo (Step/Staph)

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Bacterial conjunctivitis Pertussis Meningococcal meningitis Hand, foot and mouth Chickenpox MeaslesMumps Fifth disease “Flu” Influenza “Stomach flu” Norovirus

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Female burrows into the upper skin layer

Infestation of the skin

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Sarcoptes scabiei var. hominis

Human scabies – human itch mite

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Moderately contagious Adults 1/3 millimeter long Inactive below 20oC (68oF)At 20oC mites can persist for 2 weeks

Intensely pruritic skin infection

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Spread by direct, prolonged, skin-to-skin contact

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Infection occurs due to the direct transfer of a single fertilized female

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Life cycle 10-17 days

Remain viable for 3 days on inanimate objects (>22oC, 72oF)

Transmission via articles is possible, but unlikely

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Burrows and malformed fingernails may or may not be evident

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An affected host harbors only 10-15 adult mites - typical infestation

Skin scrapes are the only way to positively identify mites

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Hypersensitivity reaction to the mites, molts, eggs, or scybala occurs about 30 days after infestation

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Disproportionately affects women and children

Secondary bacterial infection is common Staphylococcus aureusStreptococciPeptostreptococci

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Immunocompromised prone to develop crusted scabies

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Usually below the neck - adults

Fingers, flexor surfaces of the arms, wrists, axillae, and the waistline

Umbilicus, nipples, penis, and scrotum

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Infection eliminated using prescription treatments

Once treatment starts individuals are not infectious

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Treatments

Permethrin (e.g. Elimite) Lotion applied over body from neck down Left on for 8-12 hours, then rinsed offReapplication

1 week laterClothes dryer

will kill mites

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Treatments

Crotamiton (e.g. Eurax; Crotan) frequent treatment failure has been reported

Lindane lotion is NOT recommended

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Relief from itching

• Antihistamine diphenhydramine • Itching becomes worse after mites die

Inappropriate things

• OTC pesticides applied to rooms or buses• Incorrect use of sterilants or disinfectants

applied to roomsurfaces

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Happy kids21

Itchy “bugs” – Top 14

Scabies Ringworm Clostridium difficileMethicillin-resistant

Staphylococcus aureus (MRSA)

Impetigo (Step/Staph)

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Bacterial conjunctivitis Pertussis Meningococcal meningitis Hand, foot and mouth Chickenpox MeaslesMumps Fifth disease “Flu” Influenza “Stomach flu” Norovirus

Antimicrobial products are pesticides23

Slows growth Stops

growth Kills some in time

Kills some quickly

Kills all quickly

Quickly = <10 minutes

Microorganisms “bugs”

Have only 2 jobs: Survive Reproduce

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Ringworm - fungal skin infection

Dermatophytes – live off dead tissues (skin, hair, and nails)

Scaly, crusted rash May itch

Moist areas26

ChildrenWarm, moist

climatesContagious Contracted from an

infected person, animal, object, surfaces, or soil

Tinea capitis

Tinea barbae

Tinea pedis

Tinea faciei

Tinea corporis

Tinea manus

Tinea cruris

Tinea unguium (nails)

Transmitted from animals to humans27

Class pets Exclude feral cats

from classrooms

1. 1. 1.

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Immunocompromised individuals should not be around ringworm

Clean hard surfaces with disinfectant29

Carpeted areas vacuumed Prescription antifungal medications before

returning to contact sports Medications - topical

and/or oral

1. 1. 1.

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Can persist on skin, hard surfaces, and on items such as clothing, towels, furniture and bedding

Spores can survive >year

Students should be referred to a doctor

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Wear sandals or slides in showers and locker rooms Discourage sharing towels and clothing

Students should not participate in contact sports until treated

1. 1. 1.

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Must be spayed/neutered, vaccinated and maintained in good health

Campus animals

More happy kids33

Itchy “bugs” – Top 14

Scabies Ringworm Clostridium difficileMethicillin-resistant

Staphylococcus aureus (MRSA)

Impetigo (Step/Staph)

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Bacterial conjunctivitis Pertussis Meningococcal

meningitis Hand, foot and mouth Chickenpox MeaslesMumps Fifth disease “Flu” Influenza “Stomach flu” Norovirus

1. 1. 1. “Clean”35

Cleaning removes pathogens and dirt Sanitation reduces the number of disease-

causing organisms to non-threatening levels Disinfection destroys microorganisms, does not

kill all pathogens Sterilization kills

all disease-causing pathogens

1. 1. 1.You NEED to know36

1. What are you doing?2. What product?3. What are you killing?4. What are you treating”?5. What concentration?6. What length of time? 7. What next?

5 billion pounds cleaning chemicals annually(25% hazardous substances)

One custodian uses, on average, 194 pounds of chemicals / year

Custodians and teachers experience some of the highest rates of occupational asthma

Custodians37

20% burns to the eyes or skin

12% inhaling vapours

6% of custodians are injured annually38

Disinfectants and sanitizers39

Chlorine / Sodium Hypochlorite

Phenols

‘Quats’

Peroxide– EPA Sanitizer– Superior health & environmental

profileLower

Higher

Environmentally preferable purchasing (EPP)

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EPP = Environment + Price + Performance

Lower toxicity No cancer-causing ingredients or asthmagens Not corrosive to eyes or skin or skin sensitizers Won’t pollute air or deplete ozone layer Won’t kill fish Will biodegrade Low phosphorous Package recyclable Available as concentrate Limits on fragrances used Certain ingredients prohibited e.g, phthalates Performance tested Vendor training available

What are green cleaners? 41

Increase frequency of cleaning frequently touched surfaces

Infection interruption from contaminated environmental surfaces

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Influenza virus survives on surfaces 2 - 8 hours

Norovirus survives on surfaces 2 weeksDestroyed by heat (167-212°F), chemical

germicides: chlorine, hydrogen peroxide, detergents, iodophors, alcohols

Concentration and length of time

Sanitation for norovirus and influenza

1. 1. 1.

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Wash surfaces with general cleaner to remove dirt and organic matter first

Follow label directions

Rinse with water if instructed

EPA approved disinfectants

Sanitation steps

1. 1. 1.

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Alcohol wipes and gels

Clean hands constantlyCover coughs

and sneezes -droplets can move through the air 3-6 feet

1. 1. 1.

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1 tablespoon of bleach to 1 quart (4 cups) of water, or ¼ cup of bleach to 1 gallon (16 cups) of waterApply solution to surface with a clothLet it stand for 3 to 5 minutesRinse with clean water

If using chlorine bleach

1. 1. 1.

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Door handles PhonesComputer keyboards

Wipes used on items that are touched often

1. 1. 1.

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Students should not clean surfaces with disinfectant wipes

Surface disinfectant wipes are not hand wipes

Many labels clearly state “KEEP OUT OF REACH OF CHILDREN”

Many disinfectant wipes are registered pesticides

1. 1. 1.

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Persons cleaning classrooms or emptying trash –wear gloves, then wash hands

Tissues thrown in trash or bagged

1. 1. 1.

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Sick staff or those caring for others who are sick should not prepare food

Infected food workers cause 70% of reported norovirus outbreaks

Very contagious

Norovirus is leading cause of food-borne illness

1. 1. 1.

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Found in vomit or stool even before a person is sick, and for 2-3 weeks after symptoms abate

Alcohol-based hand sanitizers used in addition to hand washing

Hand washing is critically important

Impetigo

Highly contagious Caused by Staphylococcus aureus and/or

Streptococcus pyogenes Red sores on the face, around nose, mouth,

hands and feet Sores burst and develop

honey-colored crusts Itchy

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MRSA Methicillin-resistantStaphylococcus aureus

Spread through cuts, abrasions and skin-to-skin contact

Contaminatedsurfaces

Begins as painful/itchy boil

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Managing methicillin-resistantStaphylococcus aureus

Survives 7 days - 7 months on dry surfaces Exclude students with wound drainage

from sports Enforce hand hygiene Cover sores

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Clostridium difficile (C-diff)

After antibiotic therapyDiarrhea Pseudomembranous and toxic colitis FeverAbdominal painCrampingNausea and loss

of appetite

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Managing Clostridium difficile

Spores highly resistant to cleaning agents Survive for 5 months on dry surfaces HandwashingKilled by

chlorine bleach

Isolate infected individuals

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>23,000 Americans die annually from antibiotic resistant infections

Resistance occurs when antibiotics are used:Appropriately Food and water (waste)Our environment Inappropriately (e.g., vial infection)

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Resistant infections58

Antibiotic

PlasmidRibosomes

InactivationAdded phosphate groupreduces ability to bind

Pumping outIncreasing active efflux

Modifiedtarget site

Impermeableprotein

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CDC: washing hands with soap and water is effective

1 (800) 858-7378 http://npic.orst.edu/

Increasing incidence of “super bugs”Avoid triclosan – absorbed through the

skin and bio-accumulates, linked to liver damage and resistant bacteria

dhgouge@email.Arizona.edu

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More itching at 2pm