MEASLES VIRUSAn outbreak of measles in California in the Los Angeles area has spread to another county with a case total of ~15 cases, only one of whom was vaccinated. Los Angeles is in Southern California and many people in this part of the US chose not to vaccinate their children, making it more likely for there to be outbreaks in these areas.
WHAT YOUSHOULD KNOW
Measles is a highly contagious respiratory infection spread by coughing and sneezing. People infected with measles can suffer from side effects including encephalitis, pneumonia, and even death. 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. The best defense is for all staff to be immunized. Facilities should have immunization requirements to protect staff and customers.
INFECTION PREVENTIONNEWS & UPDATES
FEBRUARY 2017
FAST FACTS
LocationUSA
SeverityLOCAL OUTBREAK
TransmissionCONTACT + DROPLET + AEROSOL
The outbreak of Lassa Fever in Nigeria from late summer 2016 has re-emerged in Nigeria. There are a further 16 cases with 4 deaths. Dozens of people who had contact with those infected are being monitored to see if they also develop the infection.
The Lassa virus is transmitted primarily via rats which are believed to be the primary host for the virus. Infected rats secrete the virus in urine and feces, so cleaning areas where rats are prevalent can spread the virus as can eating infected rats.
WHAT YOUSHOULD KNOW
Lassa Fever is a viral hemorrhagic fever with a high mortality rate and outbreaks of Lassa Fever in Africa are not unusual, but are always of a concern because of the ease with which the virus can be carried to other countries by infected people.
Malaria is caused by the Plasmodium parasite that infects Anopheles mosquitoes, which in turn infects people. There are more than 100 species of Plasmodium that can infect animals and people. There are an estimated 214 million cases of malaria each year in people resulting in 438,000 deaths, mostly children in Africa.
A recent outbreak in Cuba has infected at least 10 people, but it is difficult to know for certain how many people are infected because the Cuban health ministry does not wish to acknowledge the issue.
WHAT YOUSHOULD KNOW
As Malaria is transmitted via mosquitos, control of mosquitoes is an important part of combatting Malaria infections, including use of mosquito repellants and eliminating breeding grounds for mosquitoes. If traveling to an area with high levels of Malaria, recommended precautions include the use of Malaria pills, insect repellant, long-sleeved clothing, bed nets, and the use of door and window screens or air conditioning (to reduce the potential for mosquitoes to enter buildings).
MALARIAFAST FACTS
LocationCUBA
SeverityLOCAL OUTBREAK
TransmissionVECTOR
Norovirus cases in Germany have spiked sharply in the last few months. In November, there were 14,900 cases in Germany versus 7,800 as the average for November over the last 5 years. This sharp increase is related to a new strain that has not circulated in Germany previously, but has been seen occasionally in a few other countries.
Norovirus is caused by a small non-enveloped virus that is hard to kill by traditional disinfectants and hand hygiene products. It is generally spread through a fecal-oral route, indicating that hand hygiene and surface hygiene play key roles in the spread of the virus. Close contact with infected persons increases the risk of transmission.
WHAT YOUSHOULD KNOW
As norovirus may not be killed by certain alcohol based hand sanitizers or low level disinfectants, it is important to ensure the alcohol based hand rub and the surface disinfectant are capable of killing novovirus and that proper procedures are in place to control an outbreak once it occurs.
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. 40 countries have reported cases of Avian Influenza since Nov 2016, including China, Canada, Hong Kong, Malaysia, Taiwan, France, Israel, Russia, Germany, Serbia, Romania, Egypt, Ukraine, Netherlands, Sweden, and Finland. China recently reported that 17 people have been infected with Avian Influenza thus far this winter resulting in several deaths and to prevent the spread, they have killed 170,000 birds since October 2016. The H7N9 strain of avian influenza has caused more than 100 deaths in China over the last 4 years and appears to be active again. The CDC in the US recently issued a travel advisory for people traveling to China to avoid chicken and poultry markets because of the risk of exposure. As several recent outbreaks of Avian Influenza have originated in China, there is a heightened sensitivity to potential outbreaks that may originate in China.
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.
As summer starts in Brazil, an outbreak of Yellow Fever infecting at least 550 people has been reported in Brazil with 105 deaths and has led to the declaration of a 180 day state of emergency in Minas Gerais State in southeastern Brazil, which is adjacent to the state of Sao Paulo and reportedly has low vaccination rates for Yellow Fever. While the total number of cases has yet to be verified as the affected persons are undergoing testing, the rapid increase in numbers is concerning to the Brazilian government. This is the first Yellow Fever outbreak in Brazil since 2009. As a result, Brazil’s government had initially ordered 450,000 doses of the vaccine but has increased the order to 11.5 million doses to be provided to residents in the affected areas with approximately 5 million doses already provided to local governments for distribution. This outbreak is believed to be a result of the Sylvan forest cases reported previously, but the outbreak has grown in scope since it has become clearer that more people are affected.
The virus that causes Yellow Fever is spread by Aedes mosquitoes, and as with Dengue and Zika, efforts to control Yellow Fever center on mosquito control. The symptoms of Yellow Fever are similar to other mosquito-borne diseases, including fever, chills, headache, back pain, body aches, nausea, and fatigue, but can include jaundice (yellowing of skin color), which is how the infection was named. While most people that get Yellow Fever show no symptoms, about 15% of those that show symptoms develop the more severe form of the disease, which includes the jaundice, high fever, bleeding, and eventually shock and organ failure. For those that develop symptoms, the mortality rate for Yellow Fever is 20-50%.
WHAT YOUSHOULD KNOW
If traveling to the Brazil, you may wish to discuss with your doctor whether you should have the Yellow Fever vaccination. Because of the recent outbreak in Angola, global stocks of the vaccine are low, which may make it difficult to get the vaccination in a timely manner.
Cholera is an infection caused by a bacteria, Vibrio cholera. Cholera outbreaks usually occur due to contaminated water supplies especially where sewage contaminates the water supply.
In the aftermath of Hurricane Matthew, the devastation in Haiti has laid the ground for a number of infectious disease concerns, including Cholera as we reported in October Since then we have started to get better reporting from Haiti as to the scope of the outbreak. 39,000 people are believed to have Cholera infections resulting in 420 deaths. While small in scope compared to the more than 300,000 people that died from the hurricane and its aftermath, 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 impacted by natural disasters, such as a hurricane, the fresh water supply and sewage system mix, contaminating the water supply and exposing people to raw sewage, which creates opportunities for infection. In countries without access to clean drinking water and proper sewage treatment, risks of a Cholera outbreak are usually significantly increased.
A recent outbreak in a cancer hospital in the UK has sickened 14 people and caused one death. While the hospital believes no further people will be infected, the fact that people in the hospital became sick calls into question the precautions the hospital has in place to prevent this sort of transmission.
Respiratory Syncytial Virus (RSV) is a respiratory virus that causes influenza-like symptoms. Healthy people usually experience minor symptoms, but RSV infections can be serious for infants, older adults, and people with weakened immune systems, where it can cause pneumonia. RSV can be spread by contaminated droplets from a cough or a sneeze or through direct and indirect contact with environmental surfaces and peoples hands that have been contaminated with respiratory secretions.
WHAT YOUSHOULD KNOW
RSV outbreaks occur routinely and facilities need to be vigilant to protect their customers. Practicing good personal hygiene including handwashing, cleaning and disinfection of surfaces, and respiratory hygiene, such as covering coughs and sneezes are important practices to prevent the spread of RSV.
New cases of Dengue continue to be reported in Southeast Asia, but a new outbreak in Sri Lanka has been reported with 3,500 cases+ in the last 3 months and 1,000+ cases in the last 2 weeks. As a result of ongoing inspections 13,000 sites have been sued by the government for violating the Dengue prevention guidelines for the country and another 97,000 sites have been put on notice that they need to improve practices.
A number of Southeast Asia countries have reported their final Dengue case counts for 2016. India finished 2016 with 112,000 confirmed cases of dengue, making it the highest case count in 7 years for India. Pakistan reported 19,300 confirmed cases of dengue for 2016. Vietnam reported 110,900 confirmed cases of dengue for 2016.
Dengue 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.
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.
