AUGUST 2017 INFECTION PREVENTION · INDIA Severity LOCAL OUTBREAK Transmission CONTACT + VECTOR...

sealedair.com/diversey-care/outbreak-prevention© 2017 Sealed Air

INFECTION PREVENTIONNEWS & UPDATES

AUGUST 2017

FAST FACTS

LocationYEMEN, DR OF CONGO

SeverityREGIONAL OUTBREAK

TransmissionCONTACT + VECTOR

Yemen’s outbreak of cholera, which we reported previously, has been steadily increasing. In total, 408.583 cases have been reported with 1,885 deaths (0.5%). More than 5,000 people are becoming sick each day and the civil war in Yemen is responsible for the break down in the water delivery and waste treatment services and is also causing widespread food shortages. This outbreak is now considered the worst cholera outbreak ever recorded and will likely lead to significant additional deaths if not brought under control. The shortage of food is likely to be declared a famine within the next few weeks as well.

The Democratic Republic of the Congo (DRC) has also reported an outbreak of 15,456 suspected cases and 441 deaths. While smaller than the outbreak in Yemen, the DRC outbreak is also a significant public health issue, especially because the DRC has indicated that local governments lack the funds to properly control the outbreak.

Cholera is an infection caused by a bacterium, Vibrio cholera. Cholera outbreaks usually occur due to contaminated water supplies especially where sewage contaminates the water supply. Cholera infections are an indication of the fragility of the water supply and waste treatment systems.

WHAT YOUSHOULD KNOW

Cholera infections can be prevented by vaccination, access to clean water and proper sanitation for wastes. In countries without access to clean drinking water and proper sewage treatment, risks of a Cholera outbreak are usually significantly increased.

CHOLERA

https://sealedair.com/diversey-care/outbreak-prevention


FAST FACTS

LocationTHAILAND

SeverityLOCAL OUTBREAK

TransmissionCONTACT + DROPLET

Similar to other countries in Southeast Asia, Thailand has been reporting cases of Hand, Foot, and Mouth (HF&M) disease, which is endemic for the region. Thailand has recorded 24,000+ cases of HF&M disease in the first six months of 2017, with most of the cases reported in the Bangkok area.

Hand, Foot, and Mouth (HF&M) disease is caused by several different enteroviruses, including Enterovirus 71 (EV-A71) and Coxsackievirus A16. HF&M causes painful sore/blisters in the mouth, on the palms of the hands, on the buttocks, and on the feet. In rare cases, severe side effects can be life threatening and cause death. The fluid from the blisters can be contagious and control measures should be used to prevent the spread of the virus. Outbreaks of HF&M are common globally, with cases being routinely reported in many countries. Summer months in Southeast Asia historically show the most activity.

WHAT YOUSHOULD KNOW

Preventing Hand, Foot, and Mouth disease involves hand hygiene, environmental disinfection, and respiratory hygiene practices. The virus causing this illness is hard to kill and AHP disinfectants are the best option to kill it as low level disinfectants have minimal effect on enteroviruses. Because the virus can be present in feces, changing the diaper of a baby with HF&M should be followed by thorough hand washing.

HAND, FOOT AND MOUTH DISEASE



HEPATITIS AFAST FACTS

LocationUSA


TransmissionCONTACT

An outbreak in Detroit in the state of Michigan has caused 190 cases and 10 deaths in the last year. This represents a ten-fold increase in the number of cases of Hepatitis A in the state of Michigan. The transmission appears to be through drug use, sexual activity, and close contact with infected family members. 20% of those infected are co-infected with Hepatitis C.

An outbreak in San Diego County in California in the US has affected 275 people with 194 hospitalizations and 7 deaths. No common source of the infection has been identified thus far. Close contacts with affected people are being vaccinated as a precautionary measure because Hepatitis A can be spread from person to person, but the source of the outbreak has not been identified so case totals are likely to continue to increase.

An outbreak in Colorado in the US has affected 49 people. No common source of the infection has been identified thus far, but the number of cases is significantly higher than in 2016..

Hepatitis A is an infection that causes an inflammation of the liver. There are a number of viruses that can cause Hepatitis including Hepatitis A, Hepatitis B, and Hepatitis C, with vaccinations available for Hepatitis A and Hepatitis B. Hepatitis A is passed to other people through contact with infected feces, or if an infected person touches objects after using the toilet and not washing their hands, including contaminating food or drink from contact with contaminated hands, so handwashing and surface disinfection are important interventions to prevent the spread of the virus. It can also be spread by sexual contact. The virus can also be spread through contact with diapers or the stool of an infected child/person. It can take from 15-50 days to develop symptoms once infected.

WHAT YOUSHOULD KNOW

Preventing Hepatitis A infections involves hand hygiene and environmental disinfection. The virus causing this illness is hard to kill and AHP hydrogen peroxide disinfectants are the best option to kill it as low level disinfectants have minimal effect on Hepatitis A virus. In countries where disinfectants are often not used when cleaning, this is especially concerning because the virus can survive for periods of time in the environment in feces (most likely days to weeks) which allows for time for them to be transmitted from person to person.



FAST FACTS

LocationNEW ZEALAND



The previously reported mumps outbreak in New Zealand is showing no signs of stopping. More than 130 cases have been reported in Auckland alone, which is three times the rate for all of 2016. In 805 of the cases, the patient has not been fully vaccinated.

Mumps is an infection of the salivary glands that causes significant swelling of the glands in the neck and while side effects are rare, can cause side effects such as hearing loss and meningitis. The virus causing mumps is spread via coughing, sneezing, or contact with saliva.

WHAT YOUSHOULD KNOW

Outbreaks of mumps are usually related to a lack of vaccination. It is important that all people receive both doses of the MMR vaccine and any required boosters to maintain immunity. The best protection for a facility is to ensure all staff are properly immunized. The virus can be spread by sharing common items, such as cups, dishes, and tableware and via droplets from respiratory secretions so hand hygiene and surface cleaning and disinfection are also important interventions to prevent transmission, especially for non-immunized people.

MUMPS VIRUS



FAST FACTS

LocationINDIA



India reports an outbreak of Japanese Encephalitis (JE) that has sickened 1400+ and killed 131. Of the deaths, 44 are attributed to JE and 87 to AES. This has prompted a more aggressive vaccination program for JE including providing a second dose to people previously vaccinated to increase the effectiveness of the vaccine.

Japanese Encephalitis is an illness spread by mosquitoes and is common in SE Asia, especially in rural areas during the monsoon and post-monsoon season from June to August when mosquito populations are at their peak. AES is an illness with similar symptoms, which can be caused by the Japanese Encephalitis virus and other causes, including enteroviruses.

WHAT YOUSHOULD KNOW

JE is spread primarily by mosquitoes, so mosquito suppression is an important intervention, but AES is spread both by mosquitoes and other routes, so it is not clear at this point what the right preventative measures are to recommend in India. JE is spread primarily by mosquito bites, so mosquito suppression programs and taking precautions to prevent mosquito bites are key to preventing JE, which includes wearing long clothing when outdoors, having screens on doors and windows in buildings that are not air conditioned, and the use of mosquito repellant when outdoors. Vaccination is available to prevent JE infections, but in developing countries few people receive the vaccination.

JAPANESE ENCEPHALITIS (JE) AND ACUTE ENCEPHALITIS SYNDROME (AES)



FAST FACTS

LocationUSA, EUROPE

SeverityMULTI COUNTRY OUTBREAK

TransmissionCONTACT + DROPLET + AEROSOL

The measles outbreak in Europe is continuing to spread with more than 14,000 cases and 35 deaths reported since Jan 2016. Romania and Italy account for the majority of the cases with 7,647 cases and 31 deaths in Romania and 3,346 cases with 2 deaths in Italy. Italy just passed a law requiring people to be immunized or be fined and other countries in Europe are taking preemptive action. France has announced plans to require vaccination of all children among other actions.

In the US, several states have reported increased case counts as well. Minnesota has 73 confirmed cases so far this year versus 70 for all of 2016.

Measles is considered one of the most contagious infectious diseases and is a respiratory infection spread by coughing and sneezing with an incubation period of about 10 days (range of 7-18 days). People infected with measles can suffer from side effects including encephalitis, pneumonia, and the infection can be fatal, especially for children. Measles is the leading cause of vaccine preventable death with an estimated 134,200 deaths globally in 2015. Prior to widespread vaccination in 1980, there were ~2.6 million deaths globally each year.

WHAT YOUSHOULD KNOW

Outbreaks of measles are usually related to a lack of vaccination. It is important that all people receive both doses of the MMR vaccine to ensure a high degree of immunity and any recommended boosters. The best defense is for all staff to be immunized. Facilities should have immunization requirements to protect staff and customers.

MEASLES VIRUS



FAST FACTS

LocationCHINA



China reported 13 deaths from Avian Influenza strain H7N9 in June, taking the death total to 281 since October 2016. As the coming influenza season approaches (the start of the season is typically in October when the weather turns cooler), China is ramping up efforts to control influenza, including closing some poultry markets and starting a nationwide program to vaccinate chickens against H7N9. The increasing prevalence of Avian Influenza, especially the H7N9 strain is continuing to increase concerns that a major outbreak is on the horizon for China, which is very concerning to the Chinese CDC.

All strains of influenza are carried by birds. Some strains are rarely passed to people and these strains are designated as Avian Influenza when transmission to people does occur. If these strains carry a high mortality rate, they are classified as HPAI (High pathogenic avian influenza) while strains with a lower mortality rate are referred to as LPAI (Low pathogenic avian influenza).

WHAT YOUSHOULD KNOW

Containing avian influenza involves the same control measures to prevent person to person transmission of influenza plus control measures on poultry farms and other places where close contact with birds occurs (such as markets) to prevent bird to human transmission. This transmission can occur when birds are dead as well, so slaughter and handling of dead birds during food preparation also carry risks of influenza transmission if the bird is infected.

AVIAN INFLUENZA



FAST FACTS

LocationAUSTRALIA



An outbreak in Australia has affected 50+ people that work in the Geelong Saleyards who have all tested positive for Q Fever, with some of the workers showing symptoms of the disease, prompting the workers union to question why the workers are not vaccinated.

The bacterium that causes Q fever. Coxiella burnetii, is typically passed to people through close contact with animals. As there is a highly effective vaccination to protect against Q Fever, it is considered best practice to be vaccinated if in a job with frequent contact with animals likely to carry the bacteria causing Q Fever. The bacterium causing Q Fever is mainly carried by goats, sheep, and cattle. It can also be carried by kangaroos, wallabies, camels, rodents, cats, dogs, and birds. The bacterium is highly stable in the environment for long periods of time, even in dry environments, and can be airborne, being easily carried by dust in air currents. Q Fever causes high fever, headaches, chills, and muscle pain. Only half of the people infected develop symptoms. Serious side effects include lung inflammation, heart and liver problems.

WHAT YOUSHOULD KNOW

The best protection against Q Fever is vaccination and practicing good hygiene including frequent hand hygiene, the use of gloves and protective clothing to protect against animal secretions and waste. People being vaccinated that have previously been exposed to the bacteria can have adverse reactions, so prior to vaccination, serological screening is generally recommended.

Q FEVER/COXIELLA BURNETII INFECTION



FAST FACTS

LocationSE ASIA, SRI LANKA

SeverityREGIONAL OUTBREAK


Dengue Fever continues to hit Southeast Asia hard. Sri Lanka in particular is experiencing a rate of cases that is 3.5 times the average rate of cases of the last 6 years with 93,000+ cases and 250 deaths to date in 2017. Sri Lanka has been experiencing flooding, which is increasing the mosquito population, which is the primary vector for the virus.

Dengue Fever is a viral infection caused by the Dengue virus and transmitted primarily by the Aedes mosquito. Annually, up to 400 million people are believed to become infected with Dengue virus each year with only 100 million (25%) showing symptoms. This makes Dengue infections routine, especially in Southeast Asia.

WHAT YOUSHOULD KNOW

As Dengue is transmitted via the same mosquito as Zika, control of mosquitoes is an important part of combatting Dengue infections. Countries should have and aggressively enforce mosquito suppression programs to reduce the risk of Dengue infections. Testing for Dengue can help rule out other infections which may present with similar symptoms, but not all countries can afford routine testing.

DENGUE FEVER VIRUS



3-5

MILLIO

N

INFLUENZA

people infected globally each year

250,000 – 500,000 deaths

NOR

OVIRUS21 million people infected in the US alone each year with

600-800 deaths.

PERTUSSIS16 million people infected globally each year, 200,000 deaths.

WHOOPING COUGH

MEA

SLES

infected globally each year, 146,000 deaths

20million

DENGUE

people infected globally each year, 12,500 deaths

400million

Across our customers facilities, our comprehensive cleaning, disinfection, and hand hygiene programs provide the solutions and expertise needed to reduce the risk of infection while increasing operational efficiency.

Diversey Care provides resources to help our customers manage outbreaks including providing education and training for our customers regarding best practices for cleaning, disinfection, and hand hygiene in healthcare and public environments.

AHP® Hydrogen Peroxide Disinfectants• Realistic contact times that kill

pathogens before surfaces dry• Excellent staff safety profile - can

be used without personal protective equipment

• Strong cleaning ability to reduce environmental bioburden

• Excellent sustainability profile to reduce environmental impact

• Available in a range of formats including prewetted disposable wipers

IntelliCare Hand Hygiene Program• Innovative dispenser including

patented hybrid manual/touchless• Full product range and formats from

a single dispenser• Electronic compliance monitoring

program to increase efficiency• Trusted brands, such as Lux, for a

more home-like experience

At Diversey Care, we reduce the risk of infection to make your facility safer

Our best in class solutions include the following:

Our experts frequently consult with our customers on environmental hygiene practices for facilities in a wide range of industries including healthcare, hospitality, education, offices, and public buildings such as retail stores, shopping malls, and airports. Not all outbreaks are environmentally transmitted, but even for those with minimal environmental routes of transmission, we still help customers with other aspects of prevention to create safer facilities.

IntelliCare Hand Hygiene Program

www.sealedair.com© 2016 Sealed Air Corporation. All Rights Reserved. 54702 en 12/16


AUGUST 2017 INFECTION PREVENTION · INDIA Severity LOCAL OUTBREAK Transmission CONTACT + VECTOR...

Documents

Transcript of AUGUST 2017 INFECTION PREVENTION · INDIA Severity LOCAL OUTBREAK Transmission CONTACT + VECTOR...