CDC: C. diff Caused Half a Million Infections in a Single Year

The CDC has released a new study that reveals Clostridium difficile (or C. diff) caused almost half a million infections in U.S. patients in a single year.

Of those infected, 29,000 died within 30 days of their initial diagnosis. Fifteen thousand of those deaths are estimated to be directly attributable to C. diff infection. Of particular concern for long-term care, more than 80 percent of the deaths associated directly with C. diff occurred in adults 65 years or older and more than 100,000 cases develop in nursing homes each year.

C. diff causes colon inflammation and deadly diarrhea. Infection can occur through touching surfaces or items that are contaminated with feces. C. diff is shed through feces.

The new CDC study revealed that one out of every five patients with healthcare-associated C. diff experienced a recurrence of the infection and one out of every nine patients aged 65 or older died within 30 days of diagnosis.

The CDC noted that these infections can be prevented by improving infection control and antibiotic prescribing.

To read the press release, click here.

Need Help Finding a Flu Vaccine?

If you haven't yet received your flu vaccine, the CDC has a tool to help. Simply enter your ZIP code in the Flu Vaccine Finder above to be shown locations near your home offering the vaccine. Even though this year's flu vaccine has been shown to not completely align with current flu strains (because of so-called "drift variants"), the CDC still recommends that everyone six months and older get vaccinated because vaccines have been shown to offer some protection against drift variants in the past. The vaccine could also provide protection against other flu strains that might become more common as the season progresses. To learn more, visit flu.gov.

CDC Issues Ebola FAQs

In the wake of the first confirmed case of Ebola in the United States, the CDC has issued a new document titled "What You Need to Know about Ebola."

Facts about the disease that are listed in this document include:

• A person infected with Ebola can't spread the disease until symptoms appear, which is typically 8 to 10 days after exposure. Symptoms include fever, severe headache, muscle pain, vomiting, diarrhea, stomach pain and unexplained bleeding or bruising. 
• Ebola is spread through direct contact with blood and other body fluids, including urine, feces, saliva, vomit, sweat and semen as well as through objects that have been contaminated with these body fluids. It is not spread through the air, water or food. 
• While there is no FDA-approved vaccine for Ebola, the CDC recommends individuals protect themselves through regular hand hygiene, by avoiding the body fluids of people who are sick, refraining from handling items that may have come into contact with a sick person's blood or body fluids and not touching the body of someone who has died of Ebola. 
• If you have traveled to an area where Ebola outbreaks are happening, you might be at risk of developing the disease if you had direct contact with blood or body fluids of someone who has the disease, touched bats or nonhuman primates (or their blood, fluids or raw meat), went into hospitals where Ebola was being treated or touched the body of a person who died of Ebola. 
• If you traveled to an area where Ebola outbreaks are occurring, you should check for signs and symptoms for 21 days. You should also call your doctor to have your risk level evaluated. 
• If you get sick after coming back from an area with an Ebola outbreak, get medical care right away. The CDC recommends calling ahead to the hospital so that they can adequately prepare for treating you. 

To view and download the FAQs, which are presented in a convenient PDF, click here.

Enterovirus D68 Update: CDC Recommends Additional Precautions

As Enterovirus D68, or EV-D68, continues to spread across the United States, the CDC has released an official health advisory that provides guidelines for preventing the spread of the respiratory illness in healthcare settings.

Although early cases of EV-D68 were confined to children and young adults, nine cases of the illness have now been confirmed at a nursing home in Kentucky. The strain is being described as rare and easily spread. It produces symptoms similar to a severe cold and can also cause difficulty breathing.

Because the routes of transmission for EV-D68 are not fully understood, the CDC is now recommending that infection control guidelines in affected facilities include droplet precautions in addition to standard and contact precautions.

Droplet precautions include:

• Placing the ill person in a private room with a closed door if possible 
• Donning a facemask before entering the resident’s room and keeping it on during close contact with the resident 
• Wearing gloves, a gown and either goggles or a face shield if substantial spraying of respiratory fluids is anticipated
• Performing hand hygiene before and after touching the resident and after contact with respiratory secretions 
• Instructing the resident to wear a facemask when leaving their room or coming into contact with other people
• Following respiratory hygiene and cough etiquette guidelines 

To learn more, click here.

Professional Medical stocks a full range of infection control products, including personal protective equipment needed to adhere to droplet precautions. To learn more about our respirators, masks, gloves, gowns and more, contact your ProMed territory manager, give us a call at (800) 648-5190 or visit us online at promedsupply.com.

CDC Announces Core Actions for Addressing Drug-Resistant Bacteria

The CDC has announced four core actions designed to combat antibiotic resistance. The actions are described in detail in the agency's new report Antibiotic Resistance Threats in the United States, 2013.

According to the report, more than two million people yearly in the U.S. get infections that are resistant to antibiotics and at least 23,000 die from them. Additionally, C. difficile, a serious diarrheal infection usually associated with antibiotic use, causes at least 250,000 hospitalizations and 14,000 deaths yearly.

The following are the four core actions that the CDC is undertaking to combat these figures:

1. Preventing Infections, Preventing the Spread of Resistance. Preventing infections from the get-go reduces the amount of antibiotics that have to be used and reduces the likelihood that resistance will develop during their use. 
2. Tracking. The CDC collects information on antibiotic-resistant infections, causes of infections and whether specific risk factors caused some people to develop a resistant infection. 
3. Improving Antibiotic Use/Stewardship. This involves changing the way antibiotics are used, such as looking at prescription frequency and prescribing them only when needed. 
4. Development of Drugs and Diagnostic Tests. New drugs will need to be developed because antibiotic resistance is part of a natural process as bacteria evolve. New tests will also be needed to track the development of resistance. 

To learn more, click here. 

CDC: What You Can Do to Avoid MERS-CoV

On May 2, the first confirmed case of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the U.S. was reported in Indiana. The individual in question traveled through Chicago to reach his final destination. The CDC is working diligently to minimize the spread of the virus.

MERS-CoV was first reported 2012 in Saudi Arabia and likely developed from an animal source, possibly camels. All reported cases have been linked to the Arabian Peninsula (the case in the U.S. involves an American traveling from Saudi Arabia).

People who have MERS-CoV are likely to develop severe respiratory illness with fever, cough and shortness of breath; however, some infected people had mild symptoms or no symptoms at all. Thirty percent of the people who have developed the virus have died. Most of these people had an underlying medical condition.

MERS-CoV has been shown to spread between people who are in close contact. The illness has also been transmitted from patients to healthcare personnel.

The CDC is not recommending that Americans change their travel plans to avoid MERS-CoV. However, the agency is recommending that people take the following steps to help prevent potentially contracting the virus:

• Wash your hands with soap and water for 20 seconds, or use an alcohol-based hand sanitizer if soap and water are not available.
• Cover your nose and mouth with a tissue when you cough or sneeze and then throw the tissue away.
• Avoid touching your eyes, nose and mouth with unwashed hands. 
• Avoid close contact (kissing, sharing eating utensils, etc.) with ill people. 
• Clean and disinfect frequently touched surfaces, such as countertops and doorknobs. 

To learn more, click here.

Are You Fully Stocked for Flu Season?

The CDC predicts that the current flu season will continue on for some time and worsen in many locations before coming to an end. If an outbreak occurred in your building today, would you have everything you need to fight back?

We encourage you to examine the chart below, which was created based on CDC recommendations, to ensure you’re not caught empty-handed when illness strikes. 

CDC Recommendation	ProMed Product Solutions
“Wear a facemask (e.g., surgical or procedure mask) upon entering the resident’s room. Remove the facemask when leaving the resident’s room and dispose of the facemask in a waste container. If resident movement or transport is necessary, have the resident wear a facemask if possible.”	Our N95 particulate respirators meet CDC guidelines for fluid resistance and TB exposure control and provide respiratory protection for your entire staff.            We also offer basic procedure masks to protect your residents, staff and visitors.
“Perform hand hygiene before and after touching the resident, after touching the resident’s environment or after touching the resident’s respiratory secretions, whether or not gloves are worn. Gloves do not replace the need for performing hand hygiene.”	GelRite Instant Hand Sanitizer contains 65 percent ethyl alcohol and kills 99.9 percent of harmful bacteria, making it the perfect choice for healthcare use.           DermaKleen is a soft antimicrobial hand cleanser. It kills bacteria on contact while softening, conditioning and moisturizing skin.
“Wear gloves if hand contact with respiratory secretions or potentially contaminated surfaces is anticipated. … [Change] gloves and gowns after each resident encounter and performing hand hygiene.”	We offer gloves in nitrile, stretch synthetic, synthetic, latex and powder-free poly formulations.                        Super Sani-Cloth Germicidal Disposable Wipes meet CDC, OSHA and CMS Tag F441 guidelines for disinfection of contaminated surfaces. They are effective against Influenza A, the most prominent strain this year, among numerous other microorganisms. The wipes are also available in bleach and alcohol-free formulas.
“Wear a gown if soiling of clothes with a resident’s respiratory secretions is anticipated.”	Our isolation gowns feature elastic cuffs for a more secure fit under gloves. They’re made from high-quality spunbonded polypropylene.
“Administer the current season’s influenza vaccine to unvaccinated residents and healthcare personnel as per current vaccination recommendations.”	ProMed’s safety syringes are ideal for flu vaccines and medication delivery.

To read the CDC’s complete guidance, click here.

ProMed also stocks products to help ill residents manage their flu symptoms, including facial tissue, electrolyte drinks and disposable bedside bags.

Professional Medical has everything you need to develop a comprehensive flu prevention and management strategy. To learn more, contact your territory manager, give us a call at (800) 648-5190 or visit us online at promedsupply.com.

Reference

1 Centers for Disease Control and Prevention. Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities. Available at: http://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm. Accessed January 22, 2013. 

CDC Launches New LTC Infection Control Website

The CDC has launched a new website to help long-term care facilities meet their infection control goals. The site offers information for clinicians, infection control coordinators and residents.

Topics on the site include, among others:

• Antibiotic stewardship
• Dialysis safety
• Hand hygiene 

Users will also find links to to the CDC's National Healthcare Safety Network and other resources that the CDC developed in partnership with the Advancing Excellence in America's Nursing Homes Campaign. 

Click here to access the site.

Flu Season Update

According to the CDC, 40 states are currently reporting widespread flu activity. To be considered widespread, flu activity needs to be reported in more than 50 percent of a state's geographic regions.

In the past week, the proportion of deaths attributed pneumonia and influenza increased and moved above the epidemic threshold for the first time this season.

There have been 3,745 laboratory-confirmed influenza-related hospitalizations since October 1, 2013. The highest hospitalization rates are among those 65 older and children younger than five years old. This is typical of most flu seasons.

The most common strain of flu this year is Influenza A, or H1N1. After causing a pandemic in 2009, H1N1 has established itself in the human population and is no longer referred to as swine flu. In fact, it's become so common that it was included in this year's vaccine. This is the first season that H1N1 has circulated at high levels since the pandemic in 2009.

Typically, the flu continues to spread in January and peaks either in January or February before tapering off. The CDC expects that the flu season will continue for some time, especially in parts of the country that are seeing recent increases in flu and those that have yet to experience significant activity

The CDC emphasizes that anyone aged six months or older who has not received a flu shot should get one now.

To learn more, click here. 

CDC: Nursing Home Occupancy Holding Steady

A new report from the CDC shows that the nursing home occupancy rate was steady at 82 percent between 2000 and 2011. However, while occupation remained consistent, the number of Medicare- or Medicaid-certified nursing homes fell from 16,389 in 2000 to 15,702 in 2011.

Other information included in the report:

• The number of Medicare-certified SNFs increased from about 14,800 in 2000 to nearly 15,100 in 2010 
• CCRCs and nursing homes accounted for roughly 6 percent of total 2011 healthcare expenditures, down from 22 percent in 2010 

To learn more, click here.

House Leaders Call for Hearing on CRE

On the heels of the CDC's release of new information regarding carbapenem-resistant Enterobacteriaceae, lawmakers are calling for the House of Representatives' Energy and Commerce Committee to hold hearings on the deadly bacteria. (We first wrote about the CRE threat here last week.)

The lawmakers are asking the committee to meet with healthcare providers, researchers and health agency representatives as quickly as possible to determine the appropriate federal response to the threat.

CRE is lethal in about 50 percent of cases, is resistant to even last-resort antibiotics and can spread its resistance to other germs. It has been reported in hospitals and long-term care centers in 42 states.

CDC: Antibiotic-Resistant CRE Bacteria On the Rise, Becoming More Lethal

According to a new report from the CDC, a lethal, drug-resistant bacteria is spreading throughout U.S. healthcare facilities. The bacteria, carbapenem-resistant Enterobacteriaceae, or CRE, has been on the rise and has become more resistant to last-resort antibiotics over the past decade.

The CDC describes CRE as a "triple threat" because of the following:

• Resistance: The bacteria are resistant to nearly all antibiotics, including the most powerful, last-resort drugs. 
• Death: CRE germs kill 50% of the patients who contact bloodstream infections from them. 
• Spread of disease: CRE bacteria can easily transfer their antibiotic resistance to other bacteria. For example, carbapenem-resistant klebsiella can spread its drug-resistant properties to E. coli, making that bacteria resistant to antibiotics too. 

CRE is typically spread person-to-person, often by the hands of healthcare workers.

According to Tom Friedman, Director of the CDC, "CRE are nightmare bacteria. Our strongest antibiotics don't work and patients are left with potentially untreatable infections. Doctors, nurses, hospital leaders and public health must work together now to implement CDC's 'detect and protect' strategy and stop these infections from spreading."

The CDC has released a CRE Toolkit that includes guidance on halting the spread of the bacteria. According to the toolkit, all long-term care facilities should observe the following eight core measures:

1. Hand hygiene 
2. Contact precautions
3. Healthcare personnel education
4. Minimizing device use 
5. Patient and staff cohorting
6. Laboratory notification
7. Antimicrobial stewardship
8. CRE screening

To learn more, click here.

Great News: Flu Has Peaked In Chicago

The Director of the Chicago Department of Public Health has said that the city's flu season is "winding down" after getting off to an early and active start. This is certainly welcome news for a city that, like most of the nation, has been suffering the effects of a particularly nasty strain of flu and has even had to reroute patients when emergency rooms hit their capacity.

In addition to Chicago, data shows that the flu is decreasing across most parts of the country.

Despite this good news, the CDC is still anticipating the flu season will get worse for the elderly population before it shows signs of improvement. Seniors account for more than half of all flu-related hospitalizations.

To learn more, click here.

Flu-Related Fatality Rate Hits Record High for Seniors

The CDC is reporting that this is the worst flu season for seniors since they started tracking the 65-and-older flu-related death rate in 2005.

Last week, the fatality rate for laboratory-confirmed influenza cases among seniors reached 116 per 100,000. The previous record was 90 deaths per 100,000. Seniors also account for more than half of all flu-related hospitalizations.

While the national flu-related hospitalization rate is leveling off, the CDC anticipates that the worst is still to come for the elderly population.

To learn more, click here.

Flu Hospitalizations In Elderly Up, Immunization in LTC Workers Low

Only about half of long-term care workers have received the flu vaccine, according to new information from the CDC. This is especially worrisome considering that the flu has hit the elderly hard this year.

Hospitalizations related to laboratory-confirmed flu cases among those 65 and older have reached a rate of 82 per 100,000 people. By comparison, the rate for all age groups is 19 per 100,000 people. The CDC notes that these figures are undoubtedly low because influenza-rated hospitalizations can be missed because of lack of testing or because cases may be attributed to other illnesses.

The CDC's vaccination data notes that only about 50 percent of long-term care workers have received the flu vaccine, compared to 85 percent of pharmacists, doctors and nurses. They point out that vaccination routinely reaches 90 percent or higher at facilities that provide the flu vaccine during work hours.

To learn more, click here.

Flu Season Off To an Early Start

The CDC has reported that flu season is off to an early start in the U.S. Typically, flu season peaks around January or February, but the agency began to see significant increases in flu activity beginning in late November. 

According to the CDC's most recent FluView influenza surveillance report, dated December 22, 31 states have reported widespread flu activity. There was also an increase in outpatient visits for influenza-like illness (ILI). 

The CDC recommends that anyone six months or older get the flu vaccine to lessen their chances of contracting the illness. The agency also recommends taking the following steps to help prevent flu and other respiratory infections from spreading throughout your facility: 

1. Post signs around the facility to instruct residents and visitors to alert staff members if they have any symptoms of a respiratory infection.
2. Ensure that hand hygiene and other necessary items are within easy reach.
   • Place alcohol-based hand-rub dispensers in convenient locations throughout your building.
   • Provide tissues and no-touch receptacles for disposing of used tissues.
   • Make sure that supplies for handwashing (i.e., soap and disposable towels) are readily available at all sinks.
3. Encourage residents, staff and visitors to perform proper respiratory hygiene and cough etiquette. This entails:
   • Covering your mouth and nose with a tissue when coughing or sneezing (to download a handy "Cover Your Cough" poster from the CDC, click here).
   • Placing used tissues in the closest waste receptacle after use.
   • Performing hand hygiene (with alcohol-based hand rub, antiseptic handwash or non-antimicrobial soap and water) after having contact with respiratory secretions or contaminated objects or surfaces.
4. Offer masks to residents who are coughing to contain respiratory secretions.
5. Advise your staff to observe Droplet Precautions (i.e., wearing a mask during close contact) in addition to Standard Precautions when they are with residents who have symptoms of a respiratory infection, particularly if a fever is present.

CDC Launches Online Healthcare-Acquired Infection Tracking Tool

The CDC's National Healthcare Safety Network (NHSN) has launched a new online tracking tool designed to help nursing homes monitor healthcare-acquired infections, or HAIs. HAIs are a serious problem in the long-term care setting with staggering statistics¹:

• 1 to 3 million serious infections occur every year in long-term care
• As many as 380,000 residents die every year from the HAIs they contract
• Infections are one of the most common reasons that residents are admitted to hospitals 

By using the tracking tool, the CDC expects that nursing homes will be better able to identify problems, implement preventive measures and monitor their progress in halting infections. Right now, the tracking tool is available to record data on C. difficile, MRSA and other drug-resistant infections as well as urinary tract infections. In addition to capturing data, the online tool also offers access to forms, protocols, training information and additional resources for preventing HAIs. Facilities can begin using the program by enrolling here. 

The NHSN's website notes that submitted data will be used to help gauge progress toward meeting national HAI reduction goals. To learn more, click here.

Professional Medical offers a complete line of infection prevention products, including the new CaviWipes1^™, which are effective in killing 99.9% of bacteria, viruses and fungi in one minute. To learn more, contact your ProMed territory manager, visit us at online at www.promedsupply.com or give us a call at (800) 648-5190.
Reference
1 Centers for Disease Control and Prevention National Healthcare Safety Network. Tracking Infections in Long-term Care Facilities. Available at: http://www.cdc.gov/nhsn/LTC/index.html. Accessed September 26, 2012.

CDC: Cancer Patients, Survivors Need the Flu Vaccine

October is National Breast Cancer Awareness Month - and it's also the beginning of fall, when flu starts to crop up.

While cancer patients and survivor are not more likely to get the flu, they are at an increased risk of complications if they do, including pneumonia, hospitalization and even death. The CDC recommends that cancer patients and survivors get the flu vaccine (they should receive the shot, not the nasal spray).

Cancer patients and survivors are also advised to contact their healthcare providers immediately if they experience flu-like symptoms.

To learn more, click here.

CDC: Flu Season Underwhelms

According to the CDC, this year's flu season was milder and peaked later than previous years.

Typically, flu season starts around the end of the year, but in 2012 it remained low through February and only rose about the baseline for one week in March. This is the shortest and lowest peak recorded since the CDC started keeping track in 1997.

The researchers cited the mild winter, effectiveness of the flu vaccine and similarity of the influenza viruses to previous seasons as mitigating factors.

To learn more, click here.

CDC: Use New Latent TB Treatment

The CDC is recommending a new treatment for latent tuberculosis that is as effective as existing treatment procedures and much easier to carry out. It is estimated that roughly 11.2 Americans have latent tuberculosis infections.

The current standard treatment for latent tuberculosis, an asymptomatic version of the respiratory infection, involves nine months of daily doses of isoniazid, an antibiotic. Only 60 percent of patients complete the regimen. The new treatment would include 12 weekly doses of isoniazid paired with rifapentine, another antibiotic. This treatment has been shown to be equally effective under the supervision of a healthcare worker.

The CDC is targeting their TB prevention efforts toward high-risk populations, including the elderly, healthcare workers and people with diabetes.