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Emerging Infectious 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. 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.

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Emerging Infectious Diseases:  The Hype and the Reality

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  1. Emerging Infectious Diseases:  The Hype and the Reality Bruce Gamage, RN BSN CIC BC Centre for Disease Control

  2. Outline • 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

  3. SARS Brief History of SARS • November 16: First case of atypical pneumonia in Guangdong Province • February 11: WHO receives notification of outbreak in China • February 20: Hong Kong notifies WHO of 2 cases of “bird flu” • February 21: Doctor from Guangdong visits Metropol Hotel in Hong Kong • February 28: Dr Carlo Urbani informs WHO of cluster of “SARS” in Hanoi • March 5: Elderly Toronto women who had been at Metropol Hotel dies in Toronto. Five Family members infected • March 14: Women’s son admitted to Toronto Hospital (no isolation for first 18hours 3 more cases in same family and family physician • March 14: Singapore reports three cases of atypical pneumonia, one of whom had stayed at hotel (100 cases linked to her) • 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. • February 23-May 14: 92 (65%) of cases in Canada involved health care workers

  4. Canadian SARS Epi Curve

  5. SARS Infection Control • 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

  6. What happened at KPL?

  7. KPL consequences • 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”

  8. West Nile Virus • (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.

  9. West Nile Virus • 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)

  10. What are the chances of getting sick from WNV? • Very small! • <1% of mosquitoes where WNV is active are infected • <1% of persons infected become seriously ill • Protect yourself from bites-use DEET.

  11. Avian influenza • 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

  12. Avian Influenza • 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.

  13. Antibiotic Resistant Organisms • Antibiotics are the most significant discovery of modern medicine • Resistance is limiting their usefulness • Are we entering a post antibiotic era?

  14. Facts about Antibiotics • 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!

  15. Key messages • 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

  16. A Reality Check

  17. Back to Basics • Handwashing! • Alcohol hand rubs • Routine Practices (Universal Precautions) • Transmission based precautions • We don’t need a new protocol for each new disease! • Teach All Health Care Students How to Use Barriers Appropriately!

  18. Summary • Don’t Panic! • Wash your hands • Keep Infectious Diseases in Perspective

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