INFECTION PREVENTIONNEWS & UPDATES

OCTOBER 2017

FAST FACTS

LocationYEMEN

SeverityLOCAL OUTBREAK

TransmissionCONTACT + VECTOR

Yemen’s outbreak of cholera continues to grow. In total, 725,488 cases with 2,110 deaths have been reported since April 2017. While the number of new cases slowed for several weeks, the case totals are again increasing. The outbreak is not expected to be contained any time soon due to conditions in the country.

Cholera is an infection caused by a bacterium, Vibrio cholera. Cholera outbreaks usually occur due to contaminated water supplies especially where sewage contaminates the water supply. Cholera infections are an indication of the fragility of the water supply and waste treatment systems.

WHAT YOUSHOULD KNOW

Cholera infections can be prevented by vaccination, access to clean water and proper sanitation for wastes. In countries without access to clean drinking water and proper sewage treatment, risks of a Cholera outbreak are usually significantly increased.

CHOLERA

FAST FACTS

LocationSOUTH AFRICA, WALES

SeverityLOCAL OUTBREAK

TransmissionCONTACT + DROPLET + AEROSOL

A measles outbreak in South Africa was recently reported. There are 21 cases in the initial cluster and the government of South Africa is implementing widespread vaccination for children in an attempt to control the outbreak.

An outbreak in Wales in the UK has affected 17 children. As part of the government’s investigation, it has determined that 7.600 children between 5 and 16 are not current on their measles vaccinations. This lapse in immunization is believed to be at the center of the measles outbreak across Europe that has infected 14,000 people in 2017, resulting in dozens of deaths.

Measles is considered one of the most contagious infectious diseases and is a respiratory infection spread by coughing and sneezing with an incubation period of about 10 days (range of 7-18 days). People infected with measles can suffer from side effects including encephalitis, pneumonia, and the infection can be fatal, especially for children. Measles is the leading cause of vaccine preventable death with an estimated 134,200 deaths globally in 2015. Prior to widespread vaccination in 1980, there were ~2.6 million deaths globally each year.

WHAT YOUSHOULD KNOW

Outbreaks of measles are usually related to a lack of vaccination. It is important that all people receive both doses of the MMR vaccine to ensure a high degree of immunity and any recommended boosters. The best defense is for all staff to be immunized. Facilities should have immunization requirements to protect staff and customers.

MEASLES VIRUS

FAST FACTS

LocationANGOLA

SeverityLOCAL OUTBREAK

TransmissionVECTOR

An outbreak of malaria in Cunene province in Angola has sickened 33,100 people and killed 91 since Feb 2017. Malaria is not considered high risk in this province, so having an outbreak is concerning because it may indicate a migration of the mosquitoes that carry the parasite causing malaria.

Malaria is caused by the Plasmodium parasite that infects Anopheles mosquitoes, which in turn infects people. There are more than 100 species of Plasmodium that can infect animals and people. There are an estimated 214 million cases of malaria each year in people resulting in 438,000 deaths, mostly children in Africa.

WHAT YOUSHOULD KNOW

As Malaria is transmitted via mosquitos, control of mosquitoes is an important part of combatting Malaria infections, including use of mosquito repellants and eliminating breeding grounds for mosquitoes. If traveling to an area with high levels of Malaria, recommended precautions include the use of Malaria pills, insect repellant, long-sleeved clothing, bed nets, and the use of door and window screens or air conditioning (to reduce the potential for mosquitoes to enter buildings).

MALARIA

HEPATITIS AFAST FACTS

LocationEU, AUS, USA, JORDAN

SeverityMULTI-COUNTRY OUTBREAK

TransmissionCONTACT

Europe is experiencing an outbreak of Hepatitis A across 19 EU/EEA countries. There are 1,363 confirmed cases across Austria, Belgium, Denmark, Estonia, Finland, France, Greece, Ireland, Italy, Latvia, Luxembourg, Malta, the Netherlands, Norway, Portugal, Slovenia, Spain, Sweden and the United Kingdom-England and Wales. The cause of the outbreak is not known. In France, a cluster of 66 cases of Hepatitis A center in Gironde, where 16 of the cases ate at a restaurant in Bordeaux. While not confirmed, this is believed to be the source of the outbreak that has now spread to 50 additional people.

Australia has experienced a small outbreak of Hepatitis A with 13 cases in New South Wales. Most of those affected are gay men (9 of 13) and the strain is the same as the strain circulating in Europe, suggesting a travel related case may have caused the outbreak.

An outbreak in San Diego County in California in the US continues to spread with 461 people affected with 315 hospitalizations and 17 deaths. 42,000 people have been vaccinated as a result of the outbreak, but no common source of the infection has been identified thus far. In nearby Santa Cruz, 69 people have been diagnosed, indicating the outbreak is spreading. Los Angeles is now considered part of the outbreak as well as a small number of cases (10) have been reported there also.

Jordan is also experiencing an outbreak of Hepatitis A with 32 students in the same school infected by Hepatitis A. An investigation has failed to identify the source of the infection. Infected students are being allowed to stay home for 7-10 days until they are no longer contagious, but vaccination of other students is not being done.

Hepatitis A is an infection that causes an inflammation of the liver. There are a number of viruses that can cause Hepatitis including Hepatitis A, Hepatitis B, and Hepatitis C, with vaccinations available for Hepatitis A and Hepatitis B. Hepatitis A is passed to other people through contact with infected feces, or if an infected person touches objects after using the toilet and not washing their hands, including contaminating food or drink from contact with contaminated hands, so handwashing and surface disinfection are important interventions to prevent the spread of the virus. It can also be spread by sexual contact. The virus can also be spread through contact with diapers or the stool of an infected child/person. It can take from 15-50 days to develop symptoms once infected.

WHAT YOUSHOULD KNOW

Preventing Hepatitis A infections involves hand hygiene and environmental disinfection. The virus causing this illness is hard to kill and AHP hydrogen peroxide disinfectants are the best option to kill it as low level disinfectants have minimal effect on Hepatitis A virus. In countries where disinfectants are often not used when cleaning, this is especially concerning because the virus can survive for periods of time in the environment in feces (most likely days to weeks) which allows for time for them to be transmitted from person to person.

FAST FACTS

LocationEU, AUS, USA, JORDAN

SeverityMULTI-COUNTRY OUTBREAK

TransmissionCONTACT

ACUTE FLACCID MYELITIS – NON-POLIO ENTEROVIRUS

FAST FACTS

LocationGERMANY

SeverityLOCAL OUTBREAK

TransmissionCONTACT + DROPLET

Germany reports the results of a study of a cluster of children that suffered paralysis after an infection. Acute Flaccid Myelitis (AFM) is a polio-like symptom that causes paralysis of the limbs over a period of time and occurs as a result of certain infections, including non-polio enteroviruses. While not polio, the infections are often called “polio-like” because the enteroviruses causing the infection are similar to polio and have the potential to cause AFM as a result of the infection.

Enteroviruses often cause minor respiratory diseases including Hand, Foot, and Mouth disease. However severe complications are possible including meningitis, encephalitis and acute flaccid paralysis, which is a polio-like disease that can cause temporary or permanent paralysis.

WHAT YOUSHOULD KNOW

Preventing enterovirus infections hand hygiene, environmental disinfection, and respiratory hygiene practices. The virus causing this illness is hard to kill and AHP disinfectants are the best option to kill it as low level disinfectants have minimal effect on enteroviruses. Because the virus can be present in feces, changing the diaper of a baby with an enterovirus infection should be followed by thorough hand washing.

FAST FACTS

LocationAUSTRALIA

SeverityLOCAL OUTBREAK

TransmissionCONTACT + DROPLET

Tasmania is in the peak of an influenza outbreak that is the worst in many years with 2,337 cases and 21 deaths versus 969 cases for all of 2016. These numbers are consistent with a heavy influenza season in Australia and other countries in the region, potentially forewarning a heavy influenza season for North America and Europe, which are just starting into flu season.

Influenza is a large enveloped virus that causes an acute respiratory condition. While for most people having the “flu” is a minor illness, people in high risk groups can suffer complications and in some cases, death as a result of infection.

WHAT YOUSHOULD KNOW

Influenza outbreaks occur in most years and countries need to be vigilant to protect their citizens. Vaccination and practicing good personal hygiene including handwashing, cleaning and disinfection of surfaces, and respiratory hygiene are important practices to prevent the spread of Influenza.

INFLUENZA A

CYCLOSPORIASISFAST FACTS

LocationUSA

SeverityLOCAL OUTBREAK

TransmissionCONTACT

There is an outbreak of cyclospora in the US that has affected 988 people so far across 40 states. 553 (56%) of the people have no international travel, indicating they were sickened the US. The state of Texas is reporting more cases than any other state with 163 people affected so far. Florida is second with 68 cases. Public health investigators have not identified the source of the outbreak, but it is believed to be food related and most likely contaminated fruit or vegetables that were not adequately washed before consumption.

Cyclosporiasis is an illness caused by the parasite Cyclospora cayetanesis which infects people through consuming contaminated food or water or swimming in contaminated water and causes watery diarrhea, loss of appetite, and fatigue that can go in cycles from a few days to more than a month.

WHAT YOUSHOULD KNOW

When traveling on holiday it is helpful to understand the risk of infections specific to the area and take appropriate precautions. For Cyclosporiasis, a common method of contracting this parasite is to consume contaminated food. To prevent this infection, food should be cooked thoroughly. Raw fruit and vegetables should be washed thoroughly or avoided completely if they come from areas known to have certain foodborne illness risks such as Cyclosporiasis. Swimming in fresh water bodies that may be contaminated should be avoided.

3-5

MILLIO

N

INFLUENZA

people infected globally each year

250,000 – 500,000 deaths

NOR

OVIRUS21 million people infected in the US alone each year with

600-800 deaths.

PERTUSSIS16 million people infected globally each year, 200,000 deaths.

WHOOPING COUGH

MEA

SLES

infected globally each year, 146,000 deaths

20million

DENGUE

people infected globally each year, 12,500 deaths

400million

Across our customers facilities, our comprehensive cleaning, disinfection, and hand hygiene programs provide the solutions and expertise needed to reduce the risk of infection while increasing operational efficiency.

Diversey provides resources to help our customers manage outbreaks including providing education and training for our customers regarding best practices for cleaning, disinfection, and hand hygiene in healthcare and public environments.

AHP® Hydrogen Peroxide Disinfectants• Realistic contact times that kill

pathogens before surfaces dry• Excellent staff safety profile - can

be used without personal protective equipment

• Strong cleaning ability to reduce environmental bioburden

• Excellent sustainability profile to reduce environmental impact

• Available in a range of formats including prewetted disposable wipers

IntelliCare Hand Hygiene Program• Innovative dispenser including

patented hybrid manual/touchless• Full product range and formats from

a single dispenser• Electronic compliance monitoring

program to increase efficiency• Trusted brands, such as Lux, for a

more home-like experience

At Diversey, we reduce the risk of infection to make your facility safer

Our best in class solutions include the following:

Our experts frequently consult with our customers on environmental hygiene practices for facilities in a wide range of industries including healthcare, hospitality, education, offices, and public buildings such as retail stores, shopping malls, and airports. Not all outbreaks are environmentally transmitted, but even for those with minimal environmental routes of transmission, we still help customers with other aspects of prevention to create safer facilities.

www.diversey.com© 2017 Diversey