Download The Disarming of America - National Air Filtration Association

Bill Palmer
AeroMed, Inc.
NAFA Tech Session
Louisville, KY April 2013
Gun Control
controversy
CRE
Nightmare Bacteria
 "These are nightmare bacteria that
present a triple threat," CDC director
Thomas Frieden told USA Today.
"They're resistant to nearly all
antibiotics. They have high mortality
rates, killing half of people with serious
infections. And they can spread their
resistance to other bacteria."
Human Biome
 Body – made up from 10
trillion human cells
 Total cells in human body =
100 trillion
 Bacteria
 Viruses
 Other micro organisms
 Natural Flora
 10,00 species of microbes
 Representing 8 million genes
Hospital Infections
 Klebsiella pneumoniae
 Methicillin-resistant Staphylococcus aureus
(MRSA)
 Norovirus
 Clostridium difficile
 Influenza
 Mycobacterium tuberculosis
Klebsiella bacteria
 Does not normally affect healthy people
 Causes healthcare-associated infections including
pneumonia, bloodstream infections, wound or surgical
site infections, and meningitis.
 Spread through contact (person to person), not spread
through the air
 Infection common in those using ventilators, IV
catheters and those on long course of antibiotics
 Growing resistance to antibiotics (CRE)
Methicillin-resistant Staphylococcus
aureus (MRSA)
 Staphylococcus aureus or staph
infection, is a bacteria that is part of
our normal flora
 Normally presents as an easily
controlled skin infection such as
boils or pustules
 Has become resistant to antibiotics
 Can turn deadly if the bacteria
invade deeper into your body,
entering your bloodstream, joints,
bones, lungs or heart
Methicillin-resistant Staphylococcus
aureus (MRSA)
 How transmitted
 Contact with infected skin
 Contact with fomites
 Airborne



Droplet nuclei from sneezes
Infected dust from cleaning
Skin squames
 Co infection with a virus (such as
rhinovirus) increases airborne
transmission of MRSA as does
allergy related sneezing.
Norovirus
 group of viruses that cause
gastroenteritis
 inflammation of the lining
of the stomach and
intestines, causing an
acute onset of severe
vomiting and diarrhea.
 not affected by treatment
with antibiotics
 most people get better
within 1 or 2 days
Norovirus
 Transmission
 Food
 Water
 Contact with surfaces
 Person to person
 Airborne


Vomit aerosols
Toilet plume
 Can persist in the
environment for 3-4 weeks
 Where?
 30-50% in Hospitals,
retirement centers and
nursing homes
 28% in restaurants
 16% on cruise ships
 8% in day care centers
 Infection Control
 Very difficult to kill by
cleaning
 Very expensive to control
Clostridium Difficile
 Spore forming bacteria
that causes inflammation
of the colon, known as
colitis
 More common in elderly
and in patients on
prolonged antibiotic use
 Found in 3% of healthy
individuals and 30% of
hospitalized patients
 Shed / transmitted by fecal
matter
 Contact with
contaminated surfaces
 Contact with
contaminated hands
 Airborne – fecal cloud
 336,000 infections in US
hospitals in 2009 (<100,000
in 1993), 9% fatal!
Influenza
 Symptoms
 Fever* or feeling
feverish/chills
 Cough
 Sore throat
 Runny or stuffy nose
 Muscle or body aches
 Headaches
 Fatigue (very tired)
 Viral respiratory
infection
 Seasonal
 Constantly changing
 Resistance to Tamiflu is
developing
 Transmission
 Droplet transmission
 Airborne transmission*
 New avian flu in China
 H7N9
Avian Influenza
 Infectious disease has
an impact across
borders
Mycobacterium tuberculosis
 Bacteria
 Transmission
 Obligate – airborne
 Growing anti-microbial
resistance
 MDR-TB
 XDR-TB
 TDR-TB
 Diminishing # of cases in
US, huge problem
globally
 Majority of US cases are
foreign born
TB in China
TB in China
MRSA
CRE
C Diff
TB
Norovirus
Influenza
Klebsiella pneumoniae
 Filtration response
 NONE
 Not airborne
Methicillin-resistant
Staphylococcus aureus (MRSA)
 Most likely contribution of filtration is to prevent
environmental contamination from airborne skin
squames
 Source capture with MERV 15 – HEPA with about 20
ACH to reduce likelihood of transmission
 MERV 15 filters on return air to prevent spread to other
areas of the facility
 Secondary contribution is to provide source capture
filtration in rooms housing MRSA patients with viral
co infection or active allergy symptoms
Norovirus
 Most likely contribution from air filtration is the
reduction of droplets and droplet nuclei from patient
vomit aerosols and toilet plume
 Use of portable air filtration with MERV 15 – HEPA and
20 ACH
 Possible use of source capture filtration of toilet seats
 MERV 15 filters on return air to prevent spread to other
areas of the facility
Clostridium Difficile
 Most likely contribution from air filtration is the
reduction of patient fecal cloud and possibly toilet
plume
 Use of portable air filtration with MERV 15 – HEPA and
20 ACH
 Possible use of source capture filtration of toilet seats
 MERV 15 filters on return air to prevent spread to other
areas of the facility
Mycobacterium tuberculosis
 Many filtration applications
 Use of HEPA recirculation in waiting areas serving at
risk population
 Use of HEPA on exhaust from isolation rooms and
special treatment rooms
 MERV 15 filters on return air to prevent spread to other
areas of the facility
 Use of portable HEPA recirculation in rooms where
negative pressure containment is not available
 Use of HEPA filters in sputum induction booths
Defenseless?