THE INFECTION POTENTIAL IN THE DOMESTIC SETTING AND THE ROLE OF HYGIENE PRACTICE IN REDUCING INFECTION
A new evidence-based IFH publication, reviewed by Prof Syed Sattar from the University of Ottawa, has just been posted on the website. The object of the ‘Infection Potential’ paper is to review the infection potential in the home. The first part of the paper reviews “audit” surveys of the home environment which indicate where and under what circumstances, microbial contamination which could represent a hazard is most likely to be found. Studies specifically related to the home setting which show how pathogenic bacteria and viruses can persist and be disseminated have been reviewed, as well as the importance of infectious dose as a determining factor in cross infection. The last part of the paper documents the evidence that shows a positive impact of hygiene practice in reducing infection.

IFH CONFERENCE STATEMENT
The 2nd IFH conference held in New Delhi, India was an important meeting that brought together leading researchers, experts, groups and associations that are responsible for generating policy advice on hygiene issues in the developing countries. During the conference, the delegates and speakers agreed to the development of a consensus statement that summarised the key conference conclusions as well as priority actions and areas requiring further research. It is intended that this conference statement will form a basis for concerted action by the involved parties – governmental and non-governmental organisations, academic researchers, corporate groups and the consumer - in addressing the key issues of hygiene in the domestic setting in developing countries. Click here to read the statement.

FOOD MICRO 2002
Reported by Lars Axelsson, MATFORSK Norwegian Food Research Institute; and Viggo Hasseltvedt, Nasjonalt folkehelseinstitutt (Norwegian Institute of Public Health), Norway, on behalf of the Food Micro 2002 Scientific Committee.

'Friends and Foes' was the subject of Food Micro 2002, the 18th symposium of the International Committee on Food Microbiology and Hygiene (ICFMH), held in Lillehammer, Norway, from 18 to 23 August 2002. The conference highlighted the message that food associated micro-organisms can be our friends, as in fermented foods; or our enemies, as in spoilage or causing foodborne infections. MATFORSK, the Norwegian Food Research Institute (http://www.matforsk.no/), hosted the event in which over 300 scientists from the medical, veterinary, surveillance, epidemiological, and quality assurance of the food chain fields took part. Review articles for the symposium have been published in a special issue of International Journal of Food Microbiology (1). Read full report.

HYGIENE SYMPOSIUM IN SOUTH AFRICA
Lever Ponds South Africa hosted its annual Hygiene Symposium in Johannesburg on September 17th. The title this year was “Home hygiene and infectious disease prevention in South Africa. IFH was represented by two Associate Members: Dr Ros Stanwell Smith from London who talked about the hygiene hypothesis and its implications for hygiene and Dr John Barker from Aston University who talked about viruses and the home environment. Dr Adrian Duse from Wits University, Johannesburg, presented the results of his work on the problems of handling contaminated poultry in the home. Ethne Whitley, Lever Ponds SA, reports that the calibre of the speakers and the papers they presented was excellent and the flow of the day worked very well. Ethne said “the presentations, although academic, were delivered in a way which made it accessible to a predominantly non-professional audience. The turn out this year and the constituencies which our delegates represented, were extremely broad, including Departments of Health and Education, Training Colleges and Technicians, Hotel Schools, Franchise Food Outlets, Consumer organisations, Hospice, Frailcare, After Care providers, etc.- a total of about 420 people”.

RIPH SYMPOSIUM: ARE WE TOO CLEAN?
A symposium entitled ‘Are we too clean? A question of immunity balance’ was held on September 9th 2002 in London at the Royal Institute of Public Health. The keynote speaker, Professor David Strachan from St George’s Hospital Medical School, London, UK, gave a frank talk about the conflicting evidence that still surrounds his ideas on the Hygiene Hypothesis, which he first proposed 10 years ago. While not abandoning his notions he recognised that the hypothesis was still far from proven. He outlined how the link between hygiene and asthma was very weak and that the hypothesis now seemed to be more aligned to hay fever and atopic eczema. [Read full report.]

IFH REVIEW OF THE HYGIENE HYPOTHESIS
IFH are in the process of finalising a review of the hygiene hypothesis and its implications for hygiene practice in the community. The work has been carried out by Dr Ros Stanwell Smith, who is a Public Health and Epidemiology Consultant and an “expert advisor to IFH on hygiene and immunity”. The report will be published within the next 2 months. If you wish to receive further information and notice of publication, plase email IFH secretariat through the “contact us” facility on this website

UPCOMING EVENT
The World Health Organization European Center for Environment and Health (Bonn Office) is organizing an international symposium on housing and health in Forli, Italy, on November 21-23.
IFH board member Dr Scott will present,on behalf of the IFH board, the paper 'Food safety and foodborne disease in homes of the 21st century'. The IFH Secretariat will also be there with an information stand. Come visit us!
Registration information and the preliminary programme can be found on the Comune di Forlì site. The symposium is open to participants with or without contributions. For further information and registration forms, you may contact the WHO ECEH Bonn Office, Scientific Secretariat, ph (+49)-228-2094-415, email: forlisymp@ecehbonn.euro.who.int

SAMPLE OF NEW PAPERS IN READING ROOMS
The role of the home environment in the transmission of infectious diseases
Similar to the new IFH ‘Infection Potential’ paper, Dr Elaine Larson and colleagues have just published a paper examining the literature published 1980-2000 regarding the microbiology of the home, and summarise the evidence of transmission within the home, and assess the effectiveness of cleaning practices and products. They found that the home serves as a reservoir of large numbers of micro-organisms and infectious disease transmission has been demonstrated to occur in 6-60% of households in which one member is ill. They conclude that food preparation and cleaning practices provide multiple opportunities for spread among the household. Routine cleaning is often sufficient, but in cases of household infection, may not adequately reduce environmental contamination. The behavioural aspects of infection prevention in the home warrant increased public attention and education. Elaine Larson is at the University of Columbia and is a well-respected global expert on home hygiene.
Ref: Kagan LJ, Aiello AE and Larson E. Journal of Community Health 2002;27:247-267

Prevalence of community acquired MRSA in Finland
Methicillin-resistant Staphylococcus aureus (MRSA) is no longer only hospital acquired. A recent paper reports that one fifth of all Finnish MRSA isolates came from people with no connections to health-care facilities, suggesting that these isolates may be community acquired. Children were more likely to have a community- than a hospital-acquired MRSA. One third of all community-acquired strains were isolated because of screening of persons exposed to a known MRSA carrier, most of whom were family members. This highlights that good hygiene is needed in the home to prevent transmission of infections in the home to other family members.
Ref: Emerging Infectious Diseases 2002, (8): http://www.cdc.gov/ncidod/eid/vol8no6/pdf/01-0313.pdf

Pseudomonas outbreak associated with contaminated surface cleaning equipment
Following an outbreak of hospital-acquired Pseudomonas aeruginosa (PA) infections, samples from the patients’ environment were tested and 4.5% of samples from sanitary equipment and 20% of samples from surface cleaning equipment were contaminated with PA. It was found that cleaning staff had used cleaning solution instead of disinfectants for decontamination of the patients’ environment. The outbreak stopped after re-adoption of surface disinfection, application of sterile filters on taps and shower heads and chemical disinfection of the washbasin drains.
Ref: Engelhart S, Krizek L, Glasmacher A, Fischnaller E, Marlein G and Exner M. J Hosp Infect 2002;52:93-98.

Mould triggers severe asthma
Researchers from the National Institute of Health and Medical Research in Paris have found a strong link between people who are sensitive to moulds that grow on surfaces in the home and those who have severe asthma attacks. They examined over 1100 adults with asthma (part of the European Community Respiratory Health Survey) to see if their symptoms worsened on exposure to various allergens. Three out of four people were sensitive to at least one allergen; 2 out of 3 were sensitive to 2 or more allergens. Almost 1 in 5 was allergic to a plant fungus or mould. People sensitive to mould were more likely to have a severe form of asthma. The authors suggest this may be because mould spores can reach the lower airways. In addition, these spores were present in the home where people generally spent most of their time.
Ref: BMJ 2002;325:411-417