Thursday, January 30, 2014

Natural History of Influenza

Here is a link to a recent article comparing influenza in immunocompromised vs non-immunocompromised patients.

Immunocompromised patients with influenza had more severe disease/complications, longer viral shedding, and more antiviral resistance while demonstrating less clinical symptoms and signs on clinical assessment. 

The sickest patients may have the least pronounced symptoms on presentation. 

The physician must be alert and beware of the pitfalls of influenza diagnosis and management in immunocompromised patients. 

Tuesday, January 28, 2014

Goodbye to the Doctor's White Coat?


Here is an NY Times article on our recently published SHEA Expert Guidance on Healthcare Personnel Attire in Non-Operating Room Settings.

Many of the comments are interesting.

I particularly like this one:  
Well, Dr. Oz wears scrubs in the television studio! How's that for setting an example?

Right on!

Monday, January 27, 2014

Contamination of Hands with C.difficile after Patient Care

Here is a recent study on the contamination of healthcare worker hands with viable C.difficile spores after caring for patients with C.difficile associated diarrhea.

C. difficile spores were detected on 24% of HCWs' hands in the exposed group and on 0% in the unexposed group. Logistic regression, which adjusted for high-risk contact (ie, exposure to fecal soiling), contact with the environment, and contact with or without use of gloves, revealed that high-risk contact (adjusted odds ratio [aOR] per 1 contact increment, 2.78; 95% confidence interval [CI], 1.42-5.45; and at least 1 contact without use of gloves (aOR, 6.26; 95% CI, 1.27-30.78; were independently associated with HCW hand contamination by C. difficile spores.

The take home message: not wearing gloves (as recommended) when taking care of patients with C.difficile associated diarrhea results in a high rate of healthcare worker hand colonization with viable C.difficile spores.

Wear your gloves (and gown) when caring for patients with  C.difficile associated diarrhea and wash your hands with soap and water afterwards to physically remove the spores from your hands. 

Thursday, January 23, 2014

SHEA Expert Guidance Paper on Healthcare Worker Apparel in Acute Care Settings- Press Coverage

This week has been busy with respect to the SHEA Expert Guidance Paper on Healthcare Worker Apparel.

Here is some additional press coverage:

Germy white coats prompt dress code for doctors in USA Today

New guidance on healthcare apparel aims to limit infections in McKnight's Longterm Care News

ID Experts Issue Recommendations on Healthcare Attire in NEJM Journal Watch 

SHEA: Obsessed, and Proudly So in HAI Controversies Blog

Live radio interview, on January 21, the Simi Sara Show, News/Talk Radio, CKNW AM 980, Vancouver BC. (Click on the January 21 episode, hour 1) 


Tuesday, January 21, 2014

SHEA Expert Guidance Paper on Healthcare Worker Apparel in Acute Care Settings.

Hang it Up at VCU Medical Center


I am back in the USA and back to blogging about local matters.

Here is a link to our latest SHEA Expert Guidance paper on healthcare worker apparel in acute care settings.

Here is a brief NBC News article about the above guidance paper.

Monday, January 20, 2014

Honduras January 2014- Summary

Olanchito, Honduras, January 2014: with Dr. Mike Stevens, Jean Rabb, RN, Dr. Renderos, Padre Pedro O'Hagan
The June 2014 VCU GH2DP Honduras Medical Relief Trip is taking shape:


  • Ongoing clinical care to 18 mountainous villages in collaboration with the Olanchito Ministry of Health
  • Collaboration with Pico Bonito Foundation to install permanent water chlorination systems for communities with cisterns
  • Collaboration with VCU Engineers Without Borders to assess new water catchment systems in remote villages
  • Ongoing maintenance and distribution of water filtration systems for communities without chlorinated cisterns
  • Ongoing provision of medications, vaginal speculums and antihelminthics (deworming) for the La Hicaca Centro de Salud (Health Centre) to maintain a supply for one year
  • Ongoing collaboration with the Ministry of Health for education projects on nutrition and hygiene
  • Ongoing research projects on soil transmitted helminths and women's health issues. We will coordinate with Dr. Ana Sanchez of Brock University of Ontario, Canada.

Wednesday, January 15, 2014

Honduras Day 4 - Leaving Olanchito















Our planning mission has come to an end. Today we left Olanchito and headed back to San Pedro Sula.

Back to the USA tomorrow.

Tuesday, January 14, 2014

Honduras 2013 Day 3 Part 3























More photos from our day in the mountains of Honduras.

After today's meeting and on site visit, the strategy for the 2014 medical trip has begun to take form. This will include the clinic, research and public health works.

Highlights include:

  • Collaboration with Pico Bonito Foundation to install permanent water chlorination systems for communities with cisterns
  • Ongoing maintenance and distribution of water filtration systems for communities without chlorinated cisterns
  • Ongoing provision of medications, vaginal speculums and antihelminthics (deworming) for the La Hicaca Centro de Salud (Health Centre) to maintain a supply for one year
  • Ongoing collaboration with the Ministry of Health for education projects on nutrition and hygiene
  • Ongoing research projects on soil transmitted helminths and women's health issues. We will coordinate with Dr. Ana Sanchez of Brock University of Ontario, Canada.

Honduras January 2014 Day 3 Part 2






















We spent the day in the rugged Honduran mountains visiting our friends and colleagues.

The June 2014 trip will be a collaborative project with the Ministry of Health, the Catholic Church. We will tend to patients in the clinic and attempt to establish a more permanent water sanitation system in collaboration with Pico Bonito Foundation.

More to come.