Transcript Emerging Infection Diseases: The Hype and the Reality

Emerging Infectious Diseases:
The Hype and the Reality
Bruce Gamage, RN BSN
CIC
BC Centre for Disease
Control
Outline
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SARS – a new normal
West Nile Disease – a new vector
Avian Influenza – a new threat
AROs – the post antibiotic era
A Reality Check
Back to the basics
SARS
Brief History of SARS
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November 16: First case of atypical pneumonia in Guangdong Province
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February 11:
WHO receives notification of outbreak in China
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February 20:
Hong Kong notifies WHO of 2 cases of “bird flu”
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February 21:
Doctor from Guangdong visits Metropol Hotel in Hong Kong
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February 28:
Dr Carlo Urbani informs WHO of cluster of “SARS” in Hanoi
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March 5:
Elderly Toronto women who had been at Metropol Hotel
dies in Toronto. Five Family members infected
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March 14:
Women’s son admitted to Toronto Hospital (no isolation for
first 18hours 3 more cases in same family and family
physician
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March 14:
Singapore reports three cases of atypical pneumonia, one
of whom had stayed at hotel (100 cases linked to her)
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March 14:
Traveler from Hong Kong, who had stayed at hotel admitted
to Vancouver General (masked within minutes and isolated
within 8hours). Vancouver had 2 further travelers admitted.
One case in exposed nurse.
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February 23-May 14: 92 (65%) of cases in Canada involved health care
workers
Canadian SARS Epi Curve
SARS Infection Control
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Routine infection control
precautions did not appear
to work
HCW became ill despite full
precautions
Lead to extreme measures
Jury is still out
Many protocols have been
written
What happened at KPL?
KPL consequences
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Facility quarantined
Visitors prohibited for 3 weeks
Many frightened residents, staff and
family members
Turned out to be OK43 (common cold)
In hindsight, MHO would do the same
thing again!
“treat the patient not the lab result”
West Nile Virus
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(CNN) -- Before there was
SARS, there was West Nile
virus. And with the arrival of
summer, the re-emergence
of mosquitoes and the
resurgence of West Nile
cases won't be far behind,
say experts.
West Nile Virus
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WNV is transmitted by
the bite of an infected
mosquito (who get it
from it from
infected birds)
Humans are dead end
hosts (except in instance of blood
transfusion or
organ transplant)
What are the chances of getting
sick from WNV?
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Very small!
<1% of mosquitoes
where WNV is active
are infected
<1% of persons
infected become
seriously ill
Protect yourself from
bites-use DEET.
Avian influenza
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News Story: Avian Influenza - Death Toll: 50 Million and Rising
Villagers to cull about 3,000 chickens in the Balinese village of
Bolangan February 6, 2004. The human death toll from bird flu rose
to 18 on Friday with two more deaths in Vietnam a day after China
said the virus had spread to more provinces and U.N. agencies
chided Asian states for being slow to sound the alarm.
REUTERS/Supri
Avian Influenza
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H5N1(the avian flu in
Asia) was not here in BC
– we had H7N3
There was only two
cases in CFIA workers,
both had mild symptoms
Outbreaks are ongoing
in Asia (>26 deaths have
occurred)– we need to
remain vigilant for a
possible pandemic
strain.
Antibiotic Resistant Organisms
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Antibiotics are the
most significant
discovery of modern
medicine
Resistance is limiting
their usefulness
Are we entering a
post antibiotic era?
Facts about Antibiotics
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80% are used in
the community
75% are used for
respiratory infections
50% of prescriptions
are inappropriate
The majority of RI are cased by viruses
54% of adults believe antibiotics are effective
against viruses!
Key messages
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Wash your hands!
Not all bugs are
created equal
Use antibiotics
wisely
AROs are no longer
just a problem in
hospitals – we all
need to take
responsibility
A Reality Check
Disease
# cases/year
Deaths
West Nile (US)
9862
264
SARS
8437
813
Tuberculosis
8 million
2 million
Malaria
400 million
2 million
AIDS
5 million
3.1 million
West Nile
1388
14
SARS
250
39
Tuberculosis
1700
81
Influenza
500,000
7000 (75%>65)
Canada
Back to Basics
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Handwashing!
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Alcohol hand rubs
Routine Practices (Universal Precautions)
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Transmission based precautions
We don’t need a new protocol for each new disease!
Teach All Health Care Students How to Use
Barriers Appropriately!
Summary
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Don’t Panic!
Wash your hands
Keep Infectious
Diseases in
Perspective