Some people think of today as an era of infectious diseases, but pathogens have always posed dangers for people. For example, Xiang Han of The University of Texas M.D. Anderson Cancer Center and Francisco Silva of the University of Valencia in Spain reported that “it is most likely that the leprosy bacilli started parasitic evolution in humans or early hominids millions of years ago. This makes leprosy the oldest human-specific infection.”1 Despite the age of infections like leprosy and centuries of medical advances, many of today’s pathogens drive health crises around the world. One of the critical challenges arises in handling pathogens at the point of care.
Being invisible to the human eye adds complexity to keeping pathogens contained. Viruses and bacteria are only about 0.0011 microns across, and “Air Filtration and the Use of HEPA Filters in Biological Safety Cabinets” (produced by NuAire, Plymouth, MA), notes that a “healthy human body can filter out particles as small as the 35 micron size via the respiratory system; however, it is exposure to smaller submicron particulate matter that can present health risks in humans.” Pathogens make up key items on the list of submicron dangers.
Among the top-10 causes of death in 2016, according to the World Health Organization (WHO), three were infectious disease: lower respiratory infections, diarrheal disease, and tuberculosis. On top of those, there is HIV, Ebola, and others.
From Texas Women’s University in Denton, director of environmental health and safety Matt Moustakas, says, “The two bloodborne pathogens we are most concerned about in a normal occupational setting are HIV and Hepatitis B. HIV, of course, because of the seriousness of the disease, and Hep B, due to the relative ease of transmission and high infection rate in the general population.”
So, carefully handling pathogens makes up a critical technique in today’s healthcare.
Process of precaution
To reduce the risk of infection for bloodborne pathogens in healthcare settings, experts must follow so-called “standard precautions.” This “basically just means assuming that all blood or other potentially infectious materials are infectious and handling them appropriately,” Moustakas explains. This means using appropriate protective equipment and following procedures, including cleaning.
For instance, the U.S. Centers for Disease Control and Prevention (CDC) notes that standard precautions are “based on a risk assessment and make use of common-sense practices and personal protective equipment use that protect healthcare providers from infection and prevent the spread of infection from patient to patient.” One element noted by the CDC is hand hygiene, which can impact infections in even unexpected ways.
For instance, Michael Canales of Saint Vincent Charity Medical Center (Cleveland, OH) and his colleagues looked at mobile phones as a source of transmitting infections in a hospital.2 The scientists found pathogenic organisms on about one-third of the phones of hospital personnel tested. Even more dangerous, the researchers discovered that 98% of the phones were used in the hospital and 37% in patients’ rooms. To reduce the danger, Canales and his colleagues encouraged medical personnel to clean phones with disposable wipes that include quaternary ammonium compounds (QACs). The scientists wrote: “QAC could potentially decrease the transmission of microorganisms that cause diseases and reduce the risk of cross-contamination infections from mobile phones.” So, it’s not so surprising that the CDC states: “Hand hygiene is the most important measure to prevent the spread of infections.”
Still, clean hands and cell phones are not enough, especially when it comes to keeping medical tools free of pathogens. As the CDC notes, “Instrument processing requires multiple steps using specialized equipment,” which must sterilize the tools.
In a medical battle over millennia, there is some evidence of success. In 2010, the WHO’s top-10 causes of death included four infectious diseases—the same as in 2016 plus HIV/AIDS. Nonetheless, as healthcare edges forward in the battle with some pathogens, others evolve unique features and new ones emerge. In many situations, pathogen handling makes up a key first line of defense.
References
- Han, X.Y. and Silva, F.J. On the age of leprosy. PLoS Negl. Trop. Dis. 2014, 8(2), e2544.
- Canales, M.B.; Craig, G.C. et al. Dissemination of pathogens by mobile phones in a single hospital. Reconstructive Review 2017, 7(3), 41–7.
Mike May is a freelance writer and editor living in Texas. He can be reached at [email protected]