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 The
IFH has developed an information resource for
health
professionals in the community entitled "UNDERSTANDING
SARS AND OTHER RESPIRATORY INFECTIONS".
The resource gives background information on respiratory
viruses and a code of good hygiene practice aimed
at preventing spread.
This information, included in a SARS
INFORMATION AREA recently added on the IFH
website, can be used to directly advise the public
or alternatively to develop information leaflets
for distribution to the public. |
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| SYMPOSIUM:
NOROVIRUS, A MODERN CHALLENGE |
| Norovirus
(previously known as SRSV or Norwalk-like virus)
is the most common cause of outbreaks of acute
gastroenteritis. Outbreaks due to the Norovirus
are causing major disruptions in hospitals, nursing
homes, hotels and cruise ships worldwide. There
has been a lot of media interest in the outbreaks
(usually referred to as ‘winter vomiting
disease’), particularly those occurring
in hospitals and in healthcare settings. Based
on data from general outbreaks in England and
Wales, it is estimated that there were 6 million
cases of norovirus infection from 1992 to 2002.
Despite the emphasis placed on outbreaks this
is still an underestimate as more unreported cases
occur in the general community and in the home.
It has been estimated that for every case of norovirus
reported to surveillance, there are another 1562
unreported cases in the community. In the US there
are 23 million cases of norovirus each year!
In
light of this huge problem, the UK Royal Institute
of Public Health recently held a 2-day symposium
bringing together international experts to discuss
the virus, its epidemiology and most importantly,
methods for controlling outbreaks. There were
approximately 150 delegates, most of whom were
infection control nurses and environmental health
officers, but also others from the tourist industry,
public health and law firms! Some of the more
important points made at the symposium were
that:
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85% of acute gastroenteritis outbreaks in
UK are caused by norovirus
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The virus spreads very quickly and widely
via the aerosol particles produced by vomiting.
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In up to 30% of cases, people may not be showing
any symptoms so may spread the
virus unknowingly
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The virus is also spread via hands and surfaces
- Hygiene is a very important way to prevent
this disease spreading:
- Thorough hand-washing is key in preventing
its spread
- Hypochlorite remains the disinfectant
of choice for hard surfaces
- Steam cleaning is recommended for soft
furnishings such as carpets and curtains
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It is recommended to refrain from work for
48-72 hrs after symptoms have passed, but
shedding may occur for up to 3 weeks later
(though it is not confirmed if the virus
is still infective).
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| HOME
HYGIENE TRAINING RESOURCE AVAILABLE
MAY 2003 |
 The
ICNA/ IFH teaching pack
is a teaching/self-learning
resource on home hygiene
practice based on the
IFH “Guidelines
for home hygiene”.
This jointly developed
teaching pack combines
the practical expertise
of the ICNA and the IFH’s
scientific understanding
of how infections are
spread in the home
This
training resource is
written primarily to
help all those (professional
home carers and family
members) who actively
care for others at home.
It includes guidance
on the day-to-day hygiene
activities which apply
in all households and
to all family members,
as well as caring for
babies, children, the
elderly or disabled
and the sick. Thus it
can also be used for
the training of any
group that requires
an understanding of
home hygiene, such as
doctors, pharmacists,
public health and social
care workers, health
promotion organisations,
food standards authorities,
consumer groups and
commercial organisations.
This
training resource gives
guidance on what, when,
and how to prevent infection
and cross infection
in the home, using a
‘targeted
hygiene’
approach. |
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DEATHS
FROM FOODBORNE
DISEASES ARE UNDERESTIMATED |
The
importance of preventing gut infections
is sometimes played down by health
authorities that argue that although
a bout of food poisoning is unpleasant,
most infections are self-limiting
and the sufferer usually recovers
within a few days. Although statistics
show that gut infections can cause
severe complications and death in
some people, mortality rates are
generally seen as “insignificant” relative
to those associated with many other
diseases. A study carried out in
Denmark now claims that in reality,
deaths from gut infections are significantly
underestimated, a key reason being
that death may occur some weeks or
months later and thus is often not
linked to the gut infection as an
underlying cause. In this study researchers
identified 48,857 people with bacterial
gastrointestinal infections due to
Salmonella, Campylobacter, Yersinia
or Shigella. The mortality of these
patients was compared with the mortality
of the general population using 487,138
controls without known bacterial
gut infections. 2.2% of people with
gastrointestinal infections died
within one year after infection compared
with 0.7% of controls. Risk of death
was three times higher among those
who had suffered a bout of food poisoning.
Infections with all four bacteria
were associated with an increased
short-term risk of death, even after
pre-existing illnesses were taken
into account. Salmonella, Campylobacter,
Yersinia infections were also associated
with increased long-term mortality.
Source:
Short and long-term mortality associated
with foodborne bacterial gastrointestinal
infections: registry-based study. |
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| SOME
NEW PAPERS IN THE READING ROOMS |
| Reduction of cholera
in Bangladeshi villages by simple filtration |
| Colwell, R. et al. Proceedings of
the National Academy of Science 2003;100:1051-1055 |
| Using old saris to
filter drinking water from rivers
and ponds has halved
cholera cases in remote Bangladeshi
villages. The 3-year study by US National
Science Foundation found the best filtering
is obtained with a folded sari so that
the water passes through four layers
of cloth. In laboratory tests, this
removed >99% of the cholera-causing
bacteria. The bacteria cling to plankton
that are too big to pass through the
fabric. In practice, this filtering
reduced infections with results showing
that the rate of new cholera cases
in the villages was half of that before
the trial. When the villagers were
shown bacteria in untreated water,
they realised the importance of filtering. |
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| Diarrhoea
and effects of different water sources,
sanitation and hygiene behaviour in
East Africa |
| Tumwine,
J.K. et al. Tropical Medicine and
International Health 2002;7:750-756 |
| This
work analysed domestic water use
and environmental health in East
Africa and charted any major changes
or trends since the last study in
1972. They also investigated the
links between the prevalence of diarrhoea
and the nature of water supplies,
sanitation facilities and hygiene
behaviour. Surveys were performed
of more than 1000 households in 33
sites in Uganda, Tanzania and Kenya
in 1997. The type of water source,
the amount of water used for cleaning
and bathing, ownership of a latrine
or other sanitation facility and
hygiene practices are important determinants
of the incidence of diarrhoea. |
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| Hygiene
measures and micro-organisms in
Japanese households |
| Ojima,
M. et al. Journal of Applied Microbiology
2002;93:800–809 |
| This
study recorded counts of bacteria
and fungi from more than 100 places
in the home directly touched by people.
The kitchen and dining room had the
greatest level of microbial contamination,
with bathrooms the next highest level.
The largest bacterial counts were
for wet/moist items, such as dishwashing
sponges, sinks and bathroom sponges.
Fungi were found throughout the homes.
The authors concluded that it was
necessary to identify items that
can spread bacteria (e.g. cloths/sponges)
and the places such as kitchen counter
tops that subsequently become contaminated,
and use timely and effective disinfection
or sanitising measures after activities
such as handling raw meat. They reiterate
the fact that attention should be
paid when the home contains vulnerable
groups of people. |
| CONFERENCES |
| 12th
Annual European Food Law
Conference |
| Food
Safety and Consumer Protection,
Brussels, Belgium (25–26
June 2003) This
is the leading forum
for food industry executives
from Europe and countries
trading with the EU.
It will bring together
key representatives
from the European Commission,
the European Parliament,
the food industry and
national food agencies
to debate major food
safety issues. The conference
will cover diverse topics,
including health claims
and fortification of
foods, consumer health
protection and labelling
of GM foods among a
few of the highlights.
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| Centre
for Research on Environmental
Microbiology (CREM) Symposium |
The
Changing Profile of
Food and Waterborne
Pathogens: Environmental
and Hygiene Connections,
Ottawa, Canada (2 June
2003)
The
CREM and the Stanier
Institute will jointly
present a one-day symposium
with the aim of examining
recent trends influencing
microbiological safety
of food and water and
their importance, as
well as approaches to
disease prevention.
There will be seven
presentations made to
150 delegates from academia,
government and industry,
health inspectors and
members of the general
public.
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| Kitchen
hygiene in daily life |
| Beumer,
R.R. and Kusumaningrum H. (in press),
hygiene in daily life, International
Biodeterioration &Biodegradation
2003 |
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| This
paper, written by IFH board member
Dr Rijkelt Beumer and by Dr Kusumaningrum,
highlights the reasons for the increasing
incidence of gastrointestinal infections
associated with the domestic environment.
In Europe and North America more
than half of the registered food
infections appear to be contracted
in the home. The main sources of
infection in the domestic environment
are also discussed. To highlight
the importance of hygiene measures
required in the home, the paper summaries
the findings from three studies:
presence of foodborne pathogens in
domestic kitchens, microbiological
quality of leftover food stored in
the refrigerator and the efficacy
of antibacterial dishwashing liquid
on sponges against foodborne pathogens. |
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