EMERGING INFECTIOUS DISEASES

 

WHEN THE PRESIDENT IS THE PATIENT

 


Prevention and Control

Today, infectious diseases present new challenges and new potential for epidemics. Globalization, the resurgence of long-standing infectious diseases and the emergence of new diseases have forced us to re-examine strategies to protect health. Timely recognition of emerging infections requires early warning systems to detect such problems so that they may be promptly investigated and controlled before they evolve into public health crises. In addition, professional expertise, laboratory support and research capabilities are required to address the changing threats from emerging infections. The Centers for Disease Control and Prevention are on the front lines of the war on disease. CDC disease detectives battle the world's gravest health threats as they occur throughout the world. Each year, the CDC's laboratories receive thousands of specimens- blood, tissue containing unidentified disease-causing microbes in search of a diagnosis. Some are so deadly that scientists wear contamination-proof spacesuits and enter the maximum containment Level 4 Laboratory in order to investigate these killer microbes.

As with many issues of health, education is a vital part of the battle against the spread of infectious diseases. By learning what threats are posed by emerging infectious diseases and by changing our behavior we can reduce the risk. With all the hi-tech approaches used in combating infectious disease causing microbes, it is important to remember that each individual can play a critical role in preventing and controlling infection. While a healthy immune system is the best defense, basic hygiene, such as proper hand-washing. and keeping the kitchen and bathroom clean, can help defend against harmful microorganisms. Are you doing your part to reduce the spread of infectious diseases'?

Quarantine

Observation Quarantine

Quarantine comes from the Italian word for forty days and refers to the period during which ships capable of carrying contagious disease such as plague were kept isolated on their arrival at a seaport. Since the 14th century quarantine has been the most common organized response of the authorities responsible for protecting the health of the public. It has been more a response to popular demands to create boundaries between the sick urban masses and the healthy segments of mainstream society than it has been an effective means of controlling disease. Efforts to quarantine sick persons in their households were dropped, however when in the light of new knowledge it became apparent that such measures were ineffective.

 

"Diphtheria-Until this notice is legally removed all persons not occupants of these premises are forbidden to enter."

 

Scarlet Fever

Scarlet fever was a dreaded disease prior to the discovery of antibiotics. Dr. Stratton Woodruff describes what happened when he contracted scarlet fever at the age of eight in 1931.

"A man arrived at our home to glue quarantine signs to the front and back doors. Under the direction of the Health Officer our home was turned into an isolation ward. My brother and father had to live elsewhere in order to continue school and work. I saw no one other than my mother, the visiting nurse and the doctor for the next three weeks.

A long sheet hung from a pole placed across the top of the doorway to my bedroom. The bottom of the sheet was immersed in two pans of lysol solution, functioning as a wick to carry those noxious germacidal fumes up to the ceiling as a barrier to the spread of the disease.

When it was all over every book I had read and every toy I had played with during that illness had to be either burned or soaked in lysol solutions. The house was evacuated for a few hours while sulpher candles fumigated it."

 

How Safe Is Your Kitchen?

Foodborne diseases causes approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths a year in the United States, according to the Centers for Disease Control and Prevention. The estimates vary because only a small percentage of cases are reported to public health officials. The 24 hour stomach bug most of us call the flu isn't influenza, which lasts a week or more, but is a mild food poisoning, usually from some common bacterium like salmonella. Bacteria that find their way into your food are responsible for cholera, botulism, and a dozen variations of diarrhea. Disease-causing microbes are appearing in foods long considered safe and healthful such as eggs, lettuce, even alfalfa sprouts. With the nation's growing reliance on food imports, there is continued concern about produce from countries with lax food inspection standards.

These bacteria also appear on household surfaces. From there, they do harm by making their way into unrefrigerated food. Viruses work more directly. One to ten particles off a tabletop can start an infection. A person with a cold sneezes or touches a household surface and you in turn touch that surface before the virus dries out and dies - which can take five weeks in a humid climate. How quickly these microbes travel from one member of the family to another - in food or from touching some household surface, depends on home hygiene.

Kitchens are hot spots for opportunistic microbes. "You'd be better off eating a carrot stick that fell in your toilet than one that fell in your sink," said Charles Gerba, a University of Arizona microbiologist who measured germ levels in 15 well tended homes. While scientists' caution that people shouldn't overreact, there are steps you can take to defend yourself against food-borne illness and the spread of infectious disease in your home. Just how safe is your kitchen?

Keep sinks and food preparation areas in the kitchen clean. Clean sink with disinfecting cleanser daily or fill sink with hot water and bleach. Sponges and neatly folded dishcloths, used to mop up food waste stay eternally moist harboring billions of bacteria that spread germs over counters, plates and hands. Wash sponges, dishcloths and other dish cleaning implements in the dishwasher or washing machine every few days, or clean them in a solution of one teaspoon bleach to one quart of water. Clean counters with bleach or commercial cleaning agent. Hot water and detergent may not kill all the bacteria.

 

Dirty dishes and utensils should be hand washed within two hours. Let them air dry to avoid contamination from dishcloths or hands.

 

Don't leave food sitting out. Keep food out of the danger zone of 40F-140F. As soon as possible (within two hours) put cooked perishables in the refrigerator. Thaw meat in the refrigerator or in the microwave, not on the countertop. Date leftovers so they can be used in three to five days.

 

Cross contamination occurs, for example, when a knife used to cut up a chicken, is also used to slice raw vegetables or fruit for a salad. Or you wipe off the knife used to cut chicken and potatoes with a sponge and then was a dish with the same sponge. One out of three chickens are contaminated with a newly evolved strain of salmonella called Salmonella enteritis. Cooking kills salmonella.

 

As tempting as it may be, don't eat the cookie batter until it comes out of the oven. Uncooked batter and other food made with raw eggs or animal products carry a food safety risk.

 

Keep pets off counters and away from food preparation areas.

 

Keep clean to prevent bacteria from growing.

 

Food safety starts at the grocery store. Pick up frozen and perishable foods last and get them into your refrigerator or freezer as soon as possible.

 

One out of three chickens are contaminated with a newly evolved strain of salmonella called salmonella enteritis. Cooking kills salmonella.

Salmonella loves a warm moist environment. They double their ranks every 20 minutes. Keep food out of the danger zone- 40 -140F span in which bacteria thrive for 5 or 6 hours. Don't leave foods sitting out. Thaw meat in the refrigerator, not on the countertop.

Salsa- hot spices don't kill bacteria. On the contrary, many species love chili pepper. While onions and garlic are antimicrobial, they won't save salsa that has been sitting out on a table all day.

Be especially careful with ground beef. Sometimes, cows used to supply butchers with hamburger will harbor harmful bacteria, including E.coli and salmonella. Burgers should be cooked until no longer pink.

Hand Washing

It is normal to have microorganisms on our skin and in the air we breathe. Many are harmless under normal circumstances. Others are pathogenic, disease causing. Many are passed from person to person by a touch of the hand or from a contaminated surface to a clean one by the things we touch and move around. It is especially important to wash hands thoroughly prior to preparing food in order to reduce the risk of spreading pathogens from hands to food.

Rubbing Is Necessary To Remove Pathogens

It's the rubbing that really does it. Use soap and warm water with a rubbing motion for 20 seconds to clean hands. Don't forget your nails. Some scientists believe it is the rubbing rather than the antibacterial properties of some products that truly clean hands. In fact, some scientists speculate that use of antibacterial soaps in the home may simply cause the bacteria to mutate to a resistant form, and recommend soap and water rubbing rather than the use of antiseptic soaps. Whichever method you prefer, be sure to rub vigorously when you wash.

Pets Are A Source Of Joy In The Home,

but they do not belong on the kitchen counter or near food preparation surfaces, especially if they are outdoor pets. Always wash your hands before preparing food and especially after you've been playing with your pet.

Leave The Dishes In The Sink - Not!

Don't give bacteria or other possible pathogens time to settle and multiply on your dishes after you finish eating. Hand-wash within two hours and let air-dry. Towels can move organisms from one plate to another. Kitchen towels should be changed every few days. Clean your sponges or washing cloths in the dishwasher or by hand in a solution of one teaspoon of Chlorine bleach to one quart of cool water. Clean refrigerator handles and the shelves with this solution. Use it on your telephone, the can opener, on your counter tops, the sink and to clean garbage pails. Then discard the solution down the drain. It will disinfect the sink strainer on the way down.

Spare The Salmonella

Today, one chicken in three contains Salmonella eneritis. It can cause diarrhea or severe disease and death. Disinfect the knife and the sponge used to clean the knife with the bleach solution prior to using them again. Do not use the sponge to wipe up the counter top without first disinfecting it. This spreads the Salmonella around.

It Takes Two

Use one cutting board to prepare meats, poultry, fish or seafood and a second one to prepare vegetables, fruit or other foods that will be served raw. Disinfect both after use. Some scientists believe that there are natural properties in wooden boards that fight the build-up of pathogens and therefore they safer than plastic or glass.

Cool As A Cucumber

The "danger zone" for pathogenic build-up is between 40 and 140 degrees Fahrenheit. Therefore, put perishables in the refrigerator as soon as possible. Also, defrost food in the refrigerator or in a microwave, not on the counter. Uneven defrosting can cause some portion to reach the danger zone while waiting for the remainder to defrost. Make sure that the eggs used for home-made mayonnaise, Caesar dressing, or other raw egg recipes have been heated to an internal temperature of 160F. Refrigerate cooked eggs. Use leftover foods within three to five days. In the refrigerator, make sure that raw meats, poultry, seafood or any of their juices do not come in contact with ready to eat foods.