Entries in Infectious Diseases (3)


Many Schools Unprepared for Next Pandemic

Purestock/Thinkstock(ST. LOUIS) -- During the school day, you leave your children’s health in the hands of the school nurse -- but it’s hard to know if they are prepared for everything. Some forms of preparedness training, like fire drills and tornado drills, are mandated in schools. Yet, readiness for infectious outbreaks is surprisingly low. Fewer than half of U.S. schools are prepared for the next pandemic, according to new research.

Biosecurity researchers surveyed approximately 2,000 school nurses at elementary, middle and high schools about their preparations for pandemics, like swine flu or SARS, and published their results on Thursday in the American Journal of Infection Control.

The results showed that since the swine flu pandemic in 2009, less than half of schools had updated their crisis plans or had developed a plan to address biological events. Only a third of schools had instructed children on how to protect themselves from infection, only a third had stockpiled personal protective equipment, and only half of schools coordinated their relief plans with local and regional agencies.

Almost no schools ever ran school disaster exercises that included infectious disease scenarios. And nearly one in four schools had no staff members who were trained in the disaster plan.

Study author Terri Rebmann, associate director for curricular affairs at the Institute of Biosecurity at Saint Louis University, said she believes more emphasis should be placed on planning for the next pandemic.

“Disaster preparedness -- including planning for bioterrorism, pandemics, and outbreaks of emerging infectious diseases -- is essential for all academic institutions,” Rebmann wrote in the study. “It is vital that schools become more actively involved in disaster preparedness and coordinate these efforts with regional response agencies, to increase their ability to respond effectively to a future event.”

Rebmann points out that although the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics have both released recommendations for disaster management for schools, there is limited data regarding their execution. In fact, until now, no study has examined whether these guidelines have been implemented in schools or included in school disaster plans, even though schools are important places for disaster preparedness.

“Schools are an important place for preparedness for pandemics,” said Dr. Kristi Koenig, director of public health preparedness at the University of California at Irvine. “Not only do we need to protect our children, but those same children can learn how to prepare for disasters and bring this knowledge home to their families. This can be for all types of disasters whether it is a pandemic, hurricane, earthquake or terrorist attack.”

Although many people think that schools should emphasize the basic tenets of disaster and pandemic preparedness, the reason for such common omissions may be that official recommendations are often impractical to implement. For example, the CDC recommends that schools consider participation in a community surveillance program. These school-based surveillance programs report numbers of students with flu-like symptoms, upset stomach, or absence rates to regional centers. Some experts in public health argue that these measures may be overkill.

“School-based syndromic surveillance, although highly popularized in recent years due to primarily bioterrorism related surveillance, has not been proven either very cost-effective, e.g., too many false alarms,” said C. Ed Hsu, associate professor of public health informatics at University of Texas School of Public Health at Houston. “The return on investment of these syndromic surveillance systems is largely unknown.”

Hsu argues that while the intent of the study is timely and relevant and the information is much needed, it may be difficult to draw specific policy recommendations from the study.

Nevertheless, author Rebmann does have a simple strategy suggestion for improving school disaster preparedness: get the school nurses involved.

“School nurses are the health professionals responsible for implementing policies and programs to prevent infection transmission in schools, and thus are those best able to inform school disaster planning committees on aspects of plan development that will affect infection transmission,” she writes. “In addition, the National Association of School Nurses recommends that school nurses be involved in school disaster preparedness activities.”

Copyright 2012 ABC News Radio


Is Chagas the New AIDS? Experts Disagree

Comstock/Thinkstock(NEW YORK) -- Chagas disease, a parasitic infection spread to humans by insects, is not the new HIV/AIDS of the Americas, according to infectious disease experts who called the comparison “unrealistic” and “unfortunate.”

Responding to an editorial posted Monday in PLoS Neglected Tropical Diseases and the media attention that followed, Rick Tarleton, president of the Chagas Disease Foundation, said the diseases have little in common beyond disproportionately affecting poor people.

“I think it’s an unfortunate comparison,” said Tarleton, a distinguished research professor at the University of Georgia studying Chagas disease. “There are stigmas attached to HIV/AIDS that themselves are inappropriate, but it would be even more inappropriate to apply them to something like Chagas disease.”

About 300,000 people in the U.S. have Chagas disease, an infection transmitted to humans by blood-sucking insects. But almost all of them became infected before coming to the U.S. from Mexico, Central America and South America, according to the U.S. Centers for Disease Control and Prevention.

“It’s difficult to say whether the type of attention this is generating is going to be good or bad for people with the disease,” said Tarleton, describing how many people with Chagas disease face obstacles in getting care. “I don’t think the comparison to HIV/AIDS is a realistic one, and I don’t expect it to serve the situation terribly well.”

But Dr. Peter Hotez, dean of Baylor College of Medicine’s National School of Tropical Medicine, said he penned the provocative editorial to rally resources for people with Chagas disease.

“I wanted to call attention to the disease; make people aware of it,” said Hotez, adding he had no intention to diminish the impact of HIV/AIDS. “I believe that Chagas disease is every bit as important as the AIDS problem, but no one’s ever heard of the disease.”

When asked whether drawing a connection to HIV would stigmatize people with Chagas disease, Hotez replied “I don’t think it can get any worse for them.”

“They already lack access to medical care and many governments are ignoring the problem,” he said. “They’re already treated as outcasts.”

The insects that transmit Chagas disease, nicknamed “kissing bugs” for their tendency to bite people’s lips, infest low-income housing in countries where the disease is endemic. They bite at night, allowing parasites from their feces to infect the itchy wound. Insecticide can kill them, but few can afford it.

“For most of the people affected, it’s not an avoidable infection,” said Tarleton. “It is totally preventable, but largely unavoidable in certain regions.”

But unlike HIV, Chagas disease is largely asymptomatic. Only 30 percent of those who get it develop serious health problems such as heart failure.

“An HIV infection without treatment is essentially a death sentence, but most people with Chagas disease live with the infection for many decades and some people live a perfectly long life without any treatment,” said Tarleton.

And unlike HIV, Chagas disease can be treated in three months.

“In Chagas disease, there are treatments that cure the infection,” said Tarleton.  Current HIV treatments are life-long. “The downside is there is toxicity associated with those drugs in a substantial number of people, and it’s difficult to determine how effective the drugs are. They can cure the infection, but they don’t always cure the infection.”

Those drugs also come at a cost upward of $11,000, according to the editorial, making them out of reach for most.

Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn., and president of the National Foundation for Infectious Diseases, agreed there’s much to be done to improve care for people with Chagas disease.

“This might be called a forgotten disease of forgotten people -- impoverished people in the developing world. And there have not been major efforts to find better drugs to combat this illness,” he said.

And while the comparison between Chagas and HIV may be alarmist, Schaffner said he hopes it will help rally resources.

“I was surprised, frankly, at the whole tone of the editorial,” he said. “But I hope it shifts the view from forgotten problems of forgotten people to newly recognized and appreciated problems of people who need help.”

Copyright 2012 ABC News Radio


Hospital Privacy Curtains Covered with Germs, Researchers Say

Hemera Technologies/Thinkstock(IOWA CITY, Iowa) -- A new study shows that hospital privacy curtains are full of germs and may give patients more than privacy.

For this study, researchers swabbed more than 40 privacy curtains, twice a week over a three-week period at the University of Iowa Hospital. Their results, presented at an infectious disease conference, showed that virtually all of the curtains were contaminated with bacteria, including the potentially deadly antibiotic-resistant strain know as MRSA.
Some curtains were contaminated with the same germs over and over. Even new curtains became contaminated within a week.
In addition to being difficult to disinfect, most privacy curtains hang for a long time,
The study's authors stress the need to reduce the risk of infecting patients with this bacteria. The first, most practical and inexpensive defense is by making sure health care workers wash their hands between pulling the curtain and interacting with the patient. Second, patients should take an active role in protecting themselves. They should not be afraid to speak up if they notice the doctor or nurse did not wash their hands after touching the privacy curtain.
Copyright 2011 ABC News Radio

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