Monday, August 08, 2011

Fomite to Fingers To Face: A Triple Play Combination




 Photo Credit – CDC 

# 5741


Fomites are any surface or object that can become contaminated with viral or bacterial pathogens and that can act as a vehicle of transmission. 


Surfaces like the touch screen on your bank’s ATM, the door knob to a public restroom, or the the handle of a shopping cart are touched by scores of people every day.  


And some of those people, undoubtedly, are leaving behind bacteria and viruses you really don’t want to get.


Last June (see Firefighters & MRSA Revisited) I wrote of a study by researchers from the University of Washington that looked for – and found – MRSA (Methicillin-resistant Staphylococcus aureus) contaminated surfaces at fire houses in Snohomish county.


MRSA was detected in 4% of samples taken from places such as kitchens, bathrooms, and rescue vehicles – and researchers also found 30% of firefighters who volunteered to be tested were colonized with either MRSA or S. aureus in their noses.


While fomites have long been suspected of playing a significant role in the transmission of diseases, it has only been in recent years that we’ve learned how remarkably resilient many of these pathogens are once they are deposited on an inanimate surface.


The 2007 study Significance of Fomites in the Spread of Respiratory and Enteric Viral Disease by Stephanie A. Boone,& Charles P. Gerba found that most viruses survived longer on nonporous surfaces (metal or plastic), and that respiratory viruses (RSV, HPIV, influenza virus, coronavirus, and rhinovirus) could remain viable for hours or even days.


Under the right conditions, enteric viruses - like Rotavirus, Norovirus, and Hepatitis A - have been known to survive on fomites from weeks to months


It’s a germy world out there, and most people touch their face 10 to 20 times each hour, providing ample opportunities for pathogens to move from fomite to fingers to face.


All of which serves as prelude to a study that appears in the August issue of the American Journal of Infection Control that surveyed the hand hygiene knowledge and beliefs of 71 nurses, infection preventionists and hospital environmental services managers.


Individual differences in judgments of hand hygiene risk by health care workers

Anne Collins McLaughlin, PhD Fran Walsh, PhD


Participants were asked to assess their perceived risk of contracting or spreading an infection in 16 real-life situations. 


The authors found that across all levels, healthcare workers perceived surfaces as safer to touch than a patient’s skin, despite studies that have implicated fomites in the chain of disease transmission. 


The authors comment:

"Despite the dangers that fomites present, this knowledge may not be common enough among HCWs for them to understand the level of risk when touching surfaces and then touching patients."


Studies have shown that although compliance rates are improving, 50% of health care workers in the United States fail to consistently wash their hands between patients (cite).


Hospital acquired infections (HAIs) remain a huge problem, and exact a terrible toll on patients and their families.


This from the HHS.


HHS Action Plan to Prevent Healthcare-Associated Infections: Introduction

Healthcare-associated infections exact a significant toll on human life. They are among the top ten leading causes of death in the United States, accounting for an estimated 1.7 million infections and 99,000 associated deaths in 2002.


Of course, this isn’t just a problem in the United States, but also around the world. 


So this year the World Health Organization designated May 5th as global  CLEAN YOUR HANDS DAY - to encourage HCWs (Healthcare workers) to improve and sustain hand hygiene practices around the world (see A Movement With Five Moments).





For some earlier blogs on the importance of fomites in the transmission of disease, and the value of hand hygiene you may wish to revisit:


CMAJ: Infectious Risks In Family Doctor’s Offices
Hand Hygiene Among Doctors Exposed
MDs Behaving Badly
Suitable For Framing


And lastly . . . to start your week off with a smile, a return engagement by that consummate entertainer, one that Maryn McKenna  introduced me to a couple of years ago . . .  the one you all know and  love . . give it up for GERMY, in the award winning all singing, all dancing production of Soapacabana!

Stick around for the outtakes!

1 comment:

Lisa said...

I enjoyed reading your blog. Thanks for posting!