Download HAI Student Research

Burkholderia cepacia
Gill and Johanna
Introduction: [burk-hōld–er–ee-uh si−pay−shee−uh] is the name for a group or "complex" of bacteria that can
be found in soil and water. Burkholderia cepacia bacteria are often resistant to common antibiotics.
Burkholderia cepacia poses little medical risk to healthy people; however, it is a known cause of infections in
hospitalized patients. People with certain health conditions, like weakened immune systems or chronic lung
diseases (particularly cystic fibrosis), may be more susceptible to infections with Burkholderia cepacia.
[Burkholderia cepacia is also called B. cepacia]http://www.cdc.gov/HAI/organisms/bCepacia.html
Name: Burkholderia cepacia http://www.cdc.gov/HAI/organisms/bCepacia.html
Bacterium or virus: Bacterium http://www.cdc.gov/HAI/organisms/bCepacia.html
Spores: Non-spore forming http://jmm.sgmjournals.org/content/45/6/395.full.pdf (pg. 2, paragraph 2)
Symptoms: The effects of B. cepacia on people vary widely, ranging from no symptoms at all to serious
respiratory infections, especially in patients with cystic fibrosis.
http://www.cdc.gov/HAI/organisms/bCepacia.html
For many people with CF, infection with B. cepacia complex cannot be traced back to exposure to another
infected person. In these cases, infection is believed to have occurred by exposure to Burkholderia in the natural
environment.
Reservoirs: Cont. Meds sand devices, contaminated mouthwash, nasal spray, not viral, etc.
B. cepacia poses little medical risk to healthy people. However, people who have certain health problems like
weakened immune systems or chronic lung diseases, particularly cystic fibrosis , may be more susceptible to
infections with B. cepacia. B cepacia is a known cause of infections in hospitalized patients. (Thus, sick
patients would be most vulnerable to this disease.) http://www.cdc.gov/HAI/organisms/bCepacia.html
Associated diseases:
B. cepacia complex can cause a rapid decline in lung function and health. This leads to more severe lung
disease and maybe death. http://www.cff.org/LivingWithCF/StayingHealthy/Germs/Bcepacia/
Once B. cepacia enters the body, there are three possible effects and it is not possible to predict which will
happen. Sometimes B. cepacia colonizes in the lungs, causes no symptoms, and has no long term effect. Other
times B. cepacia colonizes in the lungs and causes damaging lung infections and inflammation that lead to a
slow deterioration of lung function. In the worst case scenario, B. cepacia can spread throughout the body
causing “cepacia syndrome”, which leads to a rapid deterioration of lung function. Cepacia syndrome is a
serious condition that does not always respond well to treatment. Unfortunately, even with proper treatment,
cepacia syndrome can lead to death within a few weeks.
http://cysticfibrosis.about.com/od/relateddiseases/tp/bcepacia.htm
Transmission:
Portals of entry and exit?
Respiratory tract and intravascular catheters
Routes of transmission outside of a healthcare facility?
-Person to person contact
-Contact with contaminated surfaces
-Exposure to B. cepacia in the environment
How is it transmitted in a healthcare facility?
-Sublingual probes http://www.cdc.gov/HAI/organisms/bCepacia.html
Drew Gardner Sarah Berry HAI Assignment-­‐ West Nile Virus 4-­‐8-­‐2014 West Nile Virus is a mosquito-­‐borne zoonotic arbovirus belonging to the genus Flavivirus in the family Flaviviridae. The West Nile Virus is enveloped single strand DNA No symptoms in most people. Most people (70-­‐80%) who become infected with West Nile virus do not develop any symptoms. Febrile illness in some people. About 1 in 5 people who are infected will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months. Severe symptoms in a few people. Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues). •
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The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis. People with certain medical conditions, such as cancer, diabetes, hypertension and kidney disease are also at greater risk for serious illness. Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent. About 10 percent of people who develop neurologic infection due to West Nile virus will die. West Nile virus is most commonly transmitted to humans by mosquitoes. Additional routes of human infection have also been documented. It is important to note that these methods of transmission represent a very small proportion of cases: •
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Blood transfusions Organ transplants Exposure in a laboratory setting From mother to baby during pregnancy, delivery, or breastfeeding West Nile virus is not transmitted: •
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From person-­‐to-­‐person or from animal-­‐to-­‐person through casual contact. Normal veterinary infection control precautions should be followed when caring for a horse suspected to have this or any viral infection. From handling live or dead infected birds. You should avoid bare-­‐handed contact when handling any dead animal. If you are disposing of a dead bird, use gloves or double plastic bags to place the carcass in a garbage can. Through consuming infected birds or animals. In keeping with overall public health practice, and due to the risk of known food-­‐borne pathogens, always follow procedures for fully cooking meat from either birds or mammals. Birds serve as the natural reservoirs for the West Nile Virus. The vectors of the disease are female mosquito’s who are the only mosquitos who bite you. Portals of entry and exit would be your skin. Usual routes outside of hospital would be female mosquitos. Within a hospital it would be from patient to patient or from health care provider to patient via mosquito. You can cut down transmission of West Nile Virus with DDT and mosquito nets around patient’s bed. Tessa Tedeschi
Simone Hill
HAI
IDENTIFY YOUR PATHOGEN
+ Correctly name your pathogen.
Clostridium Difficile also known as C. difficile.
+ Is it a bacterium or a virus?
It is a bacterium.
+ If it is a bacterium, does it make endospores? If so, why is this important in microbial
control?
Yes, this bacterium does shed spores from the feces. This is important for microbial control
because these spores in the feces may use many devices, surfaces, and material (toilets,
bathing tubs, and electronica renal thermometers) to contaminate and turn into a reservoir for
the Clostridium difficile spores.
Web site: http://www.cdc.gov/hai/organisms/organisms.html#c
+ What diseases does it cause and what are the signs and symptoms?
SYMPTOMS:
Symptoms include:
• Watery diarrhea (at least three bowel movements per day for two or more days)
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Fever
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Loss of appetite
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Nausea
Abdominal pain/tenderness
C. Diff causes: causes inflammation of the colon, known as colitis.
A bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation
of the colon.
Illness from C. difficile most commonly affects older adults in hospitals or in long-term care
facilities and typically occurs after use of antibiotic medications. However, studies show
increasing rates of C. difficile infection among people traditionally not considered high risk,
such as younger and healthy individuals without a history of antibiotic use or exposure to
health care facilities.
Each year, more than a half million people get sick from C. difficile, and in recent years, C.
difficile infections have become more frequent, severe and difficult to treat.
Web Site: http://www.mayoclinic.org/diseases-conditions/c-difficile/basics/definition/con20029664
RESERVOIRS
+ What are potential reservoirs of your pathogen in a healthcare facility?
Other patients, healthcare environment and healthcare workers
Clostridium difficile is shed in feces. Any surface, device, or material (e.g., toilets, bathing
tubs, and electronic rectal thermometers) that becomes contaminated with feces may serve as
a reservoir for the Clostridium difficile spores. Clostridium difficile spores are transferred to
patients mainly via the hands of healthcare personnel who have touched a contaminated
surface or item. Clostridium difficile can live for long periods on surfaces.
Web Site: http://www.cdc.gov/hai/organisms/cdiff/Cdiff-patient.html
TRANSMISSION
+ What are the portals of entry and exit (specific body parts)?
Portals of exit: anus
Portals of entry: mouth
Web Site: http://www.cdc.gov/hai/pdfs/toolkits/CDItoolkit2-29-12.pdf
+ What are the ususal routes of transmission outside of a healthcare facility ? (skin-to
skin, fecal-oral, airborne, sexual, vector)
fecal-oral route, contact transmission from contaminated hands, and through environmental
reservoirs
+ How is it transmitted in a healthcare facility? (indirect (fomites = medical devices),
direct (healthcare workers), airborne)
-->Clostridium difficile is shed in feces. Any surface, device, or material (e.g., toilets,
bathing tubs, and electronic rectal thermometers) that becomes contaminated with feces may
serve as a reservoir for the Clostridium difficile spores. Clostridium difficile spores are
transferred to patients mainly via the hands of healthcare personnel who have touched a
contaminated surface or item. Clostridium difficile can live for long periods on surfaces.
-->Transmitted indirectly through fomites (medical devices) and directly through health care
workers who have not washed their hands, contaminate a surface or touch a patient.
Web Site: http://www.cdc.gov/hai/organisms/cdiff/cdiff_infect.html
C. difficile is an anaerobic, gram-positive bacterium. Normally fastidious in its vegetative
state, it is capable of sporulating when environmental conditions no longer support its
continued growth. The capacity to form spores enables the organism to persist in the
environment (e.g., in soil and on dry surfaces) for extended periods of time. Environmental
contamination by this microorganism is well known, especially in places where fecal
contamination may occur. The environment (especially housekeeping surfaces) rarely serves
as a direct source of infection for patients. However, direct exposure to contaminated patientcare items (e.g., rectal thermometers) and high-touch surfaces in patients’ bathrooms (e.g.,
light switches) have been implicated as sources of infection.
Web Site: http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_excerpt.html
Transfer of the pathogen to the patient via the hands of health-care workers is thought to be
the most likely mechanism of exposure. Standard isolation techniques intended to minimize
enteric contamination of patients, health-care–workers’ hands, patient-care items, and
environmental surfaces have been published. Handwashing remains the most effective means
of reducing hand contamination. Proper use of gloves is an ancillary measure that helps to
further minimize transfer of these pathogens from one surface to another.
Web Site: http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_excerpt.html
Jennifer Bonsu
Yodit Bihonegne
Influenza
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the pathogen is virus the name of the family is orthomyxoviridae and reservoir is human, in health care facility, the reservoir can b e in other patients , the h ealth care environment and health care workers. The signs and s ymptoms are Fever* or feeling feverish/chills
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Cough
Sore throat
Runny or stuffy nose
Muscle or body aches
Headaches
Fatigue (tiredness)
Some people may have vomiting and diarrhea, though this is more common in children
than adults.
The mode of transmission is through direct contact. Is an air borne disease.
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The potential exit is coughing and the entry is inhaling in the virus in the air. www.cdc.gov/flu/about/disease/symptoms.htm Influenza Morgan Bailess, Carla Morfin Influenza is primarily a community-­‐based infection that is transmitted in households and community settings. Each year, 5% to 20% of U.S. residents acquire an influenza virus infection, and many will seek medical care in ambulatory healthcare settings (e.g., pediatricians’ offices, urgent-­‐care clinics). In addition, more than 200,000 persons, on average, are hospitalized each year for influenza-­‐related complications. Healthcare-­‐associated influenza infections can occur in any healthcare setting and are most common when influenza is also circulating in the community. Therefore, influenza prevention measures should be implemented in all healthcare settings. Supplemental measures may need to be implemented during influenza season if outbreaks of healthcare-­‐
associated influenza occur within certain facilities, such as long-­‐term care facilities and hospitals. •
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Influenza Virus Signs and symptoms: Influenza (also known as the flu) is a contagious respiratory illness caused by flu viruses. It can cause mild to severe illness, and at times can lead to death. The flu is different from a cold. The flu usually comes on suddenly. People who have the flu often feel some or all of these symptoms: •
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Fever* or feeling feverish/chills Cough Sore throat Runny or stuffy nose Muscle or body aches Headaches Fatigue (tiredness) Some people may have vomiting and diarrhea, though this is more common in children than adults. o http://www.cdc.gov/flu/about/disease/symptoms.htm How Flu Spreads •
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Person to Person People with flu can spread it to others up to about 6 feet away. Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose. •
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To avoid this, people should stay away from sick people and stay home if sick. It also is important to wash hands often with soap and water. If soap and water are not available, use an alcohol-­‐based hand rub. Linens, eating utensils, and dishes belonging to those who are sick should not be shared without washing thoroughly first. Eating utensils can be washed either in a dishwasher or by hand with water and soap and do not need to be cleaned separately. Further, frequently touched surfaces should be cleaned and disinfected at home, work and school, especially if someone is ill. The Flu Is Contagious Most healthy adults may be able to infect other people beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Children may pass the virus for longer than 7 days. Symptoms start 1 to 4 days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Some people can be infected with the flu virus but have no symptoms. During this time, those persons may still spread the virus to others. o http://www.cdc.gov/flu/about/disease/spread.htm Lamin Ceesay Schuyler Morrison
Pseudomonas aeruginosa-­‐Bacterial Symptoms: Serious Pseudomonas infections usually occur in people in the hospital and/or with
weakened immune systems. Infections of the blood, pneumonia, and infections following
surgery can lead to severe illness and death in these people.
However, healthy people can also develop mild illnesses with Pseudomonas aeruginosa,
especially after exposure to water. Ear infections, especially in children, and more generalized
skin rashes may occur after exposure to inadequately chlorinated hot tubs or swimming
pools. Eye infections have occasionally been reported in persons using extended-wear contact
lenses.
Reservoirs: d irect contact (healthcare worker to patient) and indirect (through fomites and the environment) Patients in hospitals, especially those on breathing machines, those with devices such as
catheters, and patients with wounds from surgery or from burns are potentially at risk for serious,
life-threatening infections.
In hospitals, where the most s erious infections occur, Pseudomonas can b e spread on the hands of healthcare workers or by equipment that gets contaminated and is not properly cleaned. http://www.cdc.gov/HAI/organisms/Pseudomonas.html#a3 David Hamilton Senait tedla Norovirus It’s a naked virus. noroviruses are a group of viruses that cause gastroenteritis [gas-trō-en-ter-ī-tis] in people.
Gastroenteritis is an inflammation of the lining of the stomach and intestines, causing an acute onset of severe vomiting and d iarrhea. Norovirus illness is usually brief in p eople who are otherwise h ealthy. Young children, the elderly, and p eople with other medical illnesses are most at risk for more s evere or prolonged infection. Like a ll viral infections, n oroviruses are n ot affected b y treatment with antibiotics. http://www.cdc.gov/HAI/organisms/organisms.html#n The symptoms of norovirus illness usually include nausea, vomiting, diarrhea, and s ome s tomach cramping. Sometimes p eople a lso have a low-­‐grade fever, chills, h eadache, muscle aches, a nd tiredness. Noroviruses are found in the feces and vomit of infected people. This virus is very contagious
and can spread rapidly throughout healthcare facilities. People can become infected with the
virus in several ways:
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Having direct contact with another person who is infected (a healthcare worker, visitor,
or another patient)
Eating food or drinking liquids that are contaminated with norovirus
Touching surfaces or objects contaminated with norovirus, and then touching your mouth
or other food items
Norovirus Amy Orloff Katie Haug Identification: • Noroviruses are a group of viruses • It is a virus • It is a naked virus • Causes: gastroenteritis (inflammation of the stomach lining) o symptoms: nausea, vomiting, diarrhea, and some stomach cramping. Sometimes causes low-­‐grade fever, chills, headache, muscle aches, and tiredness. o Signs: sudden sickness w/ frequent vomiting (more common in adults) or several episodes of diarrhea (more common in children). Most people recover within 1 or 2 days (no long-­‐term health effects). Reservoirs: • Other patients • Healthcare workers • Healthcare environment: infected food, clothes, linens, and medical devices. Transmission: • Portals of entry and exit (body parts): mouth and anus • Routes of transmission: main route is fecal-­‐oral transmission, including: contact with infected person (direct), eating or drinking contaminated foods or liquids (direct), touching contaminated surfaces or objects and then touching your mouth or food (indirect) • Transmission in healthcare facility: not practicing proper hand-­‐hygiene, not using gowns or gloves when caring for infected patients, failure to remove and wash contaminated clothing or linens (fomites), healthcare worker coming into work when infected. Source: http://www.cdc.gov/HAI/organisms/norovirus.html Human immunodeficiency virus (HIV)
Researching HAIs
Members: Juliana Wangai
Juliana Wanyiri
Sharleen Widjaja
Source: http://www.cdc.gov/HAI/organisms/organisms.html#h1
Human immunodeficiency virus (HIV) is the virus that can lead to acquired immune deficiency
syndrome (AIDS). HIV destroys blood cells called CD4+ T cells, which are crucial to helping the body
fight disease. This results in a weakened immune system, making persons with HIV or AIDS at risk for
many different types of infections. Transmission of HIV to patients while in Healthcare Settings is
rare. Most exposures do not result in infection. [Human immunodeficiency virus is also called HIV]
The pathogen is Human immunodeficiency virus (HIV). HIV is an enveloped virus. It causes AIDS.
Source: http://aids.gov/hiv-aids-basics/hiv-aids-101/signs-and-symptoms/
http://www.cdc.gov/HAI/organisms/hiv/hiv.html#a4
Some of the signs and symptoms may include:
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Fever (this is the most common symptom)
Swollen glands
Sore throat
Rash
Fatigue
Muscle and joint aches and pains
Headache
Researching HAIs-­‐ HIV http://www.cdc.gov/HAI/organisms/hiv/hiv.html HIV is a virus, the virus is enveloped http://www.cdc.gov/HAI/organisms/organisms.html#h1 Human immunodeficiency virus (HIV) is the virus that can lead to acquired immune deficiency
syndrome (AIDS). HIV destroys blood cells called CD4+ T cells, which are crucial to helping the body
fight disease. This results in a weakened immune system, making persons with HIV or AIDS at risk for
many different types of infections. Transmission of HIV to patients while in Healthcare Settings is
rare. Most exposures do not result in infection. [Human immunodeficiency virus is also called HIV]
Symptoms:
The only way to know if you are infected with HIV is to be tested. You cannot rely on symptoms
to know whether you have HIV. Many people who are infected with HIV do not have any
symptoms at all for 10 years or more. Some people who are infected with HIV report having
flu-like symptoms (often described as “the worst flu ever”) 2 to 4 weeks after exposure.
Symptoms can include:
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Enlarged lymph nodes
Sore throat
Rash
Fever
Transmission:
Sharing drug equipment (or works) can also be a risk for spreading HIV. Infected blood can get
into drug solutions by
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Using blood-contaminated syringes to prepare drugs.
Reusing water.
Reusing bottle caps, spoons, or other containers (cookers) to dissolve drugs in water and
to heat drug solutions.
Reusing small pieces of cotton or cigarette filters (cottons) to filter out particles that
could block the needle.
During vaginal sex, HIV is passed from men to women much more easily than from women to men. In women, HIV can be directly absorbed through the mucous membranes that line the vagina and cervix. The lining of the vagina can also sometimes tear and possibly allow HIV to enter the body.
Rahwa Yehdego & Fikadu
04/08/2014
MicroBio
Researching HIV
http://www.cdc.gov/HAI/organisms/organisms.html#h1
Human Immunodeficiency Virus (HIV/AIDS)
Human immunodeficiency virus (HIV) is the virus that can lead to acquired
immune deficiency syndrome (AIDS). HIV destroys blood cells called CD4+
T cells, which are crucial to helping the body fight disease. This results in a
weakened immune system, making persons with HIV or AIDS at risk for
many different types of infections. Transmission of HIV to patients while in
Healthcare Settings is rare. Most exposures do not result in infection.
[Human immunodeficiency virus is also called HIV]
General Information about HIV:
http://www.cdc.gov/HAI/organisms/hiv/hiv.html
Transmission of HIV:
Healthcare personnel are at risk for occupational exposure to bloodborne
pathogens including HIV. Important factors that influence the overall risk for
occupational exposures to bloodborne pathogens include the number of
infected individuals in the patient population and the type and number of
blood contacts. Transmission of HIV to patients while in healthcare settings
is rare; however, proper sterilization and disinfection procedures are
required.
Group name: kayoung cho, Selamawit O haile
Researching HAIs
Stage 01 – Disease Transmission
Human Immunodeficiency Virus (HIV/AIDS)
Human immunodeficiency virus (HIV) is the virus that can lead to acquired
immune deficiency syndrome (AIDS). HIV destroys blood cells called CD4+ T
cells, which are crucial to helping the body fight disease. This results in a
weakened immune system, making persons with HIV or AIDS at risk for many
different types of infections. Transmission of HIV to patients while in Healthcare
Settings is rare. Most exposures do not result in infection. [Human
immunodeficiency virus is also called HIV]
http://www.cdc.gov/hiv/basics/index.html General Information about HIV
Human immunodeficiency virus (HIV) is the virus that can lead to acquired
immune deficiency syndrome (AIDS). HIV destroys blood cells called CD4+ T
cells, which are crucial to helping the body fight disease. This results in a
weakened immune system, making persons with HIV or AIDS at risk for many
different types of infections. Transmission of HIV to patients while in healthcare
settings is rare. However, proper sterilization and disinfection procedures are
required to prevent infection risks. Most exposures do not result in infection.
Top of page
Identify the pathogen
1. Human Immunodeficiency Virus (HIV)
2. It is a virus
3. It is enveloped
4. It causes an acquired immunodeficiency syndrome
The signs and symptoms of HIV/AIDS
HIV disease has a well-documented progression. Untreated, HIV is almost universally fatal
because it eventually overwhelms the immune system—resulting in acquired immunodeficiency
syndrome (AIDS). HIV treatment helps people at all stages of the disease, and treatment can
slow or prevent progression from one stage to the next.
A person can transmit HIV to others during any of these stages:
Acute infection: Within 2 to 4 weeks after infection with HIV, you may feel sick with flu-like
symptoms. This is called acute retroviral syndrome (ARS) or primary HIV infection, and it’s the
body’s natural response to the HIV infection. (Not everyone develops ARS, however—and some
people may have no symptoms.)
During this period of infection, large amounts of HIV are being produced in your body. The
virus uses important immune system cells called CD4 cells to make copies of itself and destroys
these cells in the process. Because of this, the CD4 count can fall quickly.
Your ability to spread HIV is highest during this stage because the amount of virus in the blood
is very high.
Eventually, your immune response will begin to bring the amount of virus in your body back
down to a stable level. At this point, your CD4 count will then begin to increase, but it may not
return to pre-infection levels.
Clinical latency (inactivity or dormancy): This period is sometimes called asymptomatic HIV
infection or chronic HIV infection. During this phase, HIV is still active, but reproduces at very
low levels. You may not have any symptoms or get sick during this time. People who are on
antiretroviral therapy (ART) may live with clinical latency for several decades. For people who
are not on ART, this period can last up to a decade, but some may progress through this phase
faster. It is important to remember that you are still able to transmit HIV to others during this
phase even if you are treated with ART, although ART greatly reduces the risk. Toward the
middle and end of this period, your viral load begins to rise and your CD4 cell count begins to
drop. As this happens, you may begin to have symptoms of HIV infection as your immune
system becomes too weak to protect you .
AIDS (acquired immunodeficiency syndrome): This is the stage of infection that occurs when
your immune system is badly damaged and you become vulnerable to infections and infectionrelated cancers called opportunistic illnesses. When the number of your CD4 cells falls below
200 cells per cubic millimeter of blood (200 cells/mm3), you are considered to have progressed
to AIDS. (Normal CD4 counts are between 500 and 1,600 cells/mm3.) You can also be
diagnosed with AIDS if you develop one or more opportunistic illnesses, regardless of your CD4
count. Without treatment, people who are diagnosed with AIDS typically survive about 3 years.
Once someone has a dangerous opportunistic illness, life expectancy without treatment falls to
about 1 year. People with AIDS need medical treatment to prevent death.
http://www.cdc.gov/hiv/basics/whatishiv.html
Reservoirs and Transmission of HIV
Although HIV transmission is possible in healthcare settings, it is extremely rare.
Medical experts emphasize that the careful practice of infection control procedures,
including universal precautions (i.e., using protective practices and personal
protective equipment to prevent transmission of HIV and other bloodborne
infections), protects patients as well as healthcare providers from possible HIV
transmission in medical and dental settings. Healthcare personnel are at risk for
occupational exposure to bloodborne pathogens including HIV. Important factors
that influence the overall risk for occupational exposures to bloodborne pathogens
include the number of infected individuals in the patient population and the type
and number of blood contacts. Transmission of HIV to patients while in healthcare
settings is rare; however, proper sterilization and disinfection procedures are
required.
CDC has documented rare cases of patients contracting HIV in healthcare settings
from infected donor tissue.
HIV Transmission
Myths persist about how HIV is transmitted. This section provides the facts about
HIV risk from different types of sex, injection drug use, and other activities.
How is HIV passed from one person to another?
Only certain fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal
fluids, vaginal fluids, and breast milk—from an HIV-infected person can transmit
HIV. These fluids must come in contact with a mucous membrane or damaged
tissue or be directly injected into the bloodstream (from a needle or syringe) for
transmission to possibly occur. Mucous membranes can be found inside the
rectum, the vagina, the opening of the penis, and the mouth.
In the United States, HIV is spread mainly by
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Having unprotected sex (sex without a condom) with someone who has
HIV.
o Anal sex is the highest-risk sexual behavior. Receptive anal sex
(bottoming) is riskier than insertive anal sex (topping).
o Vaginal sex is the second highest-risk sexual behavior.
o Having multiple sex partners or having other sexually transmitted
infections can increase the risk of infection through sex.
Sharing needles, syringes, rinse water, or other equipment (works) used to
prepare injection drugs with someone who has HIV.
Less commonly, HIV may be spread by
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Being born to an infected mother. HIV can be passed from mother to child
during pregnancy, birth, or breastfeeding.
Being stuck with an HIV-contaminated needle or other sharp object. This is
a risk mainly for health care workers.
Receiving blood transfusions, blood products, or organ/tissue transplants
that are contaminated with HIV. This risk is extremely small because of
rigorous testing of the US blood supply and donated organs and tissues.
Eating food that has been pre-chewed by an HIV-infected person. The
contamination occurs when infected blood from a caregiver’s mouth mixes
with food while chewing, and is very rare.
Being bitten by a person with HIV. Each of the very small number of
documented cases has involved severe trauma with extensive tissue damage
and the presence of blood. There is no risk of transmission if the skin is not
broken.
Oral sex—using the mouth to stimulate the penis, vagina, or anus (fellatio,
cunnilingus, and rimming). Giving fellatio (mouth to penis oral sex) and
having the person ejaculate (cum) in your mouth is riskier than other types
of oral sex.
Contact between broken skin, wounds, or mucous membranes and HIVinfected blood or blood-contaminated body fluids. These reports have also
been extremely rare.
Deep, open-mouth kissing if the person with HIV has sores or bleeding
gums and blood is exchanged. HIV is not spread through saliva.
Transmission through kissing alone is extremely rare.
http://www.cdc.gov/hiv/basics/transmission.html
Sitom Habte, Roland Ma
Apr 8, 2014
Tuberculosis (TB)
TB is a disease caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack
the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not
treated properly, TB disease can be fatal. TB disease was once the leading cause of death in the
United States. Learn More »
http://www.cdc.gov/tb/ We think TB is a great topic to research into, especially like in those h igh density counties (according to CDC) they have a high population of TB. Tuberculosis (TB)
Tuberculosis [tuh–burk–yoo–lō–sis] is caused by a bacterium called Mycobacterium tuberculosis.
Transmission of Mycobacterium tuberculosis is a recognized risk to patients and healthcare
personnel in healthcare facilities. Transmission is most likely to occur from patients who have
unrecognized pulmonary tuberculosis or tuberculosis related to their larynx, are not on effective
anti-tuberculosis therapy, and have not been placed in tuberculosis isolation. Transmission of
Mycobacteriumtuberculosis in Healthcare Settings has been associated with close contact with
persons who have infectious tuberculosis, particularly during the performance of cough-inducing
procedures such as bronchoscopy and sputum induction. Mycobacterium Tuberculosis is spread
through air and can travel long distances. Cases of multidrug-resistant tuberculosis (MDR-TB,
which includes extensively drug-resistant tuberculosis [XDR-TB]), have been recognized and are
more difficult to treat. [Tuberculosis is also called TB]
http://www.cdc.gov/tb/default.htm
As right now, we are looking into why TB could still spread in a hospital setting with many great
technologies, should American consider taking a shot of the Bacille Calmette-Guérin (BCG)
vaccine? But before we do that, we were looking into the CDC website what cause TB and how
to prevent that. According to CDC, TB is caused by a bacterium called Mycobacterium
tuberculosis, this is absolutely not a virus at all, and not everyone will get sick because of their
immune system (considering without BCG vaccine) can fight back, but if finally developed an
active TB, the symptoms of TB disease include: a bad cough that lasts 3 weeks or longer, pain
in the chest, coughing up blood or sputum, weakness or fatigue, weight loss, no appetite, chills,
fever, sweating at night, etc…
Now, when we take a step back, first why we consider BCG vaccine. If we look into the
statistics provided by CDC, TB usually spread wide and quick in those high population density
countries, such as China, Vietnam, Mexico, etc…
(http://www.cdc.gov/tb/topic/globaltb/china.htm) And the only way how to prevent it spread wide
and quick it is by giving a BCG vaccine for all new born children. Moving forward again, why TB
is spreading too in hospital setting? Is that because of the high population density setting?
Especially we are putting all the sickest people in the world into the hospital, is that why it cause
the problem? By given the facts that TB is associated with the population density, and most of
the hospitals in the world trying to fit their max capacity with the sickest people to give them the
best treatment. We assume that because of that reason (especially TB is transmitted by air to
lungs), this could spread TB wide and quick to other patients and healthcare provider.
Iman Hassan & Elias Gebrezghi Microbiology 04/08/2014 Tuberculosis (TB) Tuberculosis: Tuberculosis [tuh–burk–yoo–lō–sis] is caused by a bacterium called Mycobacterium t uberculosis. What are the Difference b etween Latent TB Infection and TB Disease? People with latent TB infection have TB germs in their bodies, but they are not sick b ecause the germs are not active. These people do not have symptoms of TB disease, and they cannot spread the germs to others. However, they may develop TB disease in the future. They are often prescribed treatment to prevent them from developing TB disease. People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue i n their body. They usually have symptoms of TB disease. P eople with TB disease of the lungs or throat are capable of spreading germs to others. They are prescribed drugs that can treat TB disease. http://www.cdc.gov/tb/publications/factsheets/general/tb.htm How Tuberculosis affects the body? Tuberculosis (TB) is caused by a b acterium called M ycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be f atal. TB i s spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected. http://www.cdc.gov/tb/topic/basics/default.htm Symptoms of TB disease include: •
a bad cough that lasts 3 weeks or longer •
pain i n the chest •
coughing up blood or sputum •
weakness or fatigue •
weight loss •
no appetite •
chills •
fever •
sweating at night http://www.cdc.gov/tb/topic/basics/default.htm What are the potential reservoirs of tuberculosis in healthcare facility; o ther patients, healthcare environment, health care workers and patient microbiota? Transmission of Mycobacterium t uberculosis i s a r ecognized risk to patients and healthcare personnel in healthcare f acilities. Transmission i s most likely to occur from patients who have unrecognized pulmonary tuberculosis or tuberculosis related to their larynx, is not on effective anti-­‐tuberculosis therapy, and has not been placed i n tuberculosis i solation. Transmission of Mycobacterium t uberculosis i n Healthcare Settings has b een associated with close contact with persons who have infectious tuberculosis, particularly during the performance of cough-­‐inducing procedures such as bronchoscopy and sputum i nduction. Mycobacterium Tuberculosis is spread through air and can travel long distances. Cases of m ultidrug-­‐resistant tuberculosis (MDR-­‐TB, which includes extensively drug-­‐resistant tuberculosis [XDR-­‐TB]), have been r ecognized and are more difficult to treat. [Tuberculosis is also called TB] http://www.cdc.gov/HAI/organisms/organisms.html#t Healthcare workers: Tuberculosis (TB) transmission has been documented in health care settings where health care workers and patients come in contact with people who have TB disease. People who work or r eceive care in health care settings are at higher risk for becoming i nfected with TB Patients: For patients that sick and their immune systems are weak will be easily infected by the TB
disease which why it’s dangerous if a person who is infected is at the hospital where there are many
sick patients, especially those with HIV infection, the risk of developing TB disease is much higher
than for people with normal immune systems.
TB disease is higher if the person:
•
Has HIV infection;
•
Has been recently infected with TB bacteria (in the last 2 years);
•
Has other health problems, like diabetes, that make it hard for the body to fight bacteria;
•
Abuses alcohol or uses illegal drugs; or
•
Was not treated correctly for TB infection in the past
http://www.cdc.gov/tb/topic/basics/default.htm Transmission: Airborne transmission airborne transmission occurs by dissemination of either airborne droplet nuclei or small particles in the respirable size range containing i nfectious agents that remain infective over time and distance (e.g., spores of Aspergillus spp, and Mycobacterium tuberculosis). Microorganisms carried in this manner may b e dispersed over long distances b y air currents and may be i nhaled by susceptible individuals who have not had face-­‐to-­‐face contact with (or b een in the same room with) the infectious individual 121-­‐124. Preventing the spread of pathogens that are transmitted by the airborne route r equires the use of special air handling and ventilation systems (e.g., AIIRs) to contain and then safely r emove the infectious agent 11, 12. I nfectious agents to which this applies include Mycobacterium tuberculosis 124-­‐127, rubeola virus (measles) 122, and varicella-­‐
zoster virus (chickenpox) 123. In addition, published data suggest the possibility that variola virus (smallpox) may be transmitted over long distances through the air under unusual circumstances and AIIRs are recommended for this agent as well; however, droplet and contact routes are the more frequent routes of transmission for smallpox 108, 128, 129. I n addition to AIIRs, respiratory protection with NIOSH certified N95 or higher level respirator i s recommended for healthcare personnel entering the AIIR to prevent acquisition of airborne i nfectious agents such as M. tuberculosis 12. http://www.cdc.gov/tb/topic/basics/default.htm TB is N OT s pread by: •
shaking someone’s hand •
sharing f ood or drink •
touching bed linens or toilet seats •
sharing toothbrushes •
kissing http://www.cdc.gov/hicpac/2007ip/2007ip_part1.html How is TB Spread? TB germs are put i nto the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can b ecome infected; this i s called latent TB infection. http://www.cdc.gov/tb/publications/factsheets/general/tb.htm Name: Yirgalem Solomon, Mehari Nugusse, Mussie Abraham Title: Healthcare associated infections (HAIs) HEPATITIS B Introduction: Hepatitis B is a disease caused by the hepatitis B virus (HBV), which is transmitted through percutaneous (i.e., puncture through the skin) or mucosal (i.e., direct contact with mucous membranes) exposure to infectious blood or body fluids. HBV can cause chronic infection, resulting in cirrhosis of the liver, liver cancer, liver failure, and death. Persons with chronic infection also serve as the main reservoir for continued HBV transmission. Although chronic infection is more likely to develop in persons infected as infants or young children, rates of new infection and acute disease are highest among adults. What groups of peoples are at risk of infection? Ad ult s a t Ri sk for H BV I nfe cti o n
In the United States in 2005, the highest incidence of acute hepatitis B was among adults aged 25–45 years (Figure 1). Approximately 79% of newly acquired cases of hepatitis B are associated with high-­‐risk sexual activity or injection-­‐drug use; other known exposures (i.e., occupational, household, travel, and health-­‐care–related) together account for 5% of new cases, and 16% deny a specific risk factor for infection (61; CDC, unpublished data, 2001–2005). Adults at risk for infection by sexual exposure. The most common source of HBV infection among adults in the United States is sexual contact. Heterosexual transmission accounts for approximately 39% of new HBV infections among adults, and transmission among MSM accounts for approximately 24% (CDC, unpublished data, 2001–2005). Serologic evidence of HBV infection (i.e., anti-­‐HBC positive) has ranged from 10% to 40% among adults seeking treatment in STD clinics (6_2_–6_4_) and from 10% to 25% among MSM aged <30 years (6_5_; CDC, unpublished data, 1999–2000). Follow-­‐up studies identified HBV infection in 20%–42% of susceptible heterosexual partners of persons with acute hepatitis B (6_6_–6_8_). Among susceptible heterosexual spouses of persons with chronic HBV infection, the seroprevalence of HBV infection ranged from 25% to 59% (6_9_–7_1_). Injection-­‐drug users. IDUs account for approximately 16% of new HBV infections in the United States (CDC, unpublished data, 2001–2005). Incidence of HBV infection among unvaccinated IDUs is high, ranging from 10 to 31 per 100 person-­‐years (72–74). Risk for HBV transmission increases with the number of years of drug use and is associated with frequency of injection and with sharing of drug-­‐preparation equipment (e.g., cottons, cookers, and rinse water), independent of syringe sharing (73,75). In a study of the seroprevalence of HBV infection among IDUs admitted to drug treatment in six U.S. cities, 64% (range: 50%–81%) had serologic evidence of HBV infection, and seroprevalence increased with age (76). Studies of street-­‐recruited IDUs (77,78) and female IDUs (79) have identified similar prevalence of HBV infection, whereas a lower prevalence (25%) was found in a study of young IDUs (aged 18–30 years) (74). Chronic HBV infection has been identified in 3.1% of IDUs in a detention setting (77) and 7.1% of IDUs with HIV co-­‐infection (80). Persons at risk for occupational exposure to HBV. Before hepatitis B vaccination was widely implemented, HBV infection was recognized as a common occupational hazard among persons who were exposed to blood while caring for patients or working in laboratories (90,91). Since then, routine hepatitis B vaccination of health-­‐
care workers and use of standard precautions to prevent exposure to bloodborne pathogens have made HBV infection a rare event in these populations (92–94). Since the mid-­‐1990s, the incidence of HBV infection among health-­‐care workers has been lower than that among the general population (94). Public safety workers with exposures to blood also might be at risk for HBV infection (95–97); however, the prevalence of HBV infection in occupational groups such as police officers, firefighters, and corrections officers generally does not differ from that in the general population when adjusted for race and age (97), and infection is associated most often with nonoccupational risk factors (97,98). No increased risk for occupationally acquired HBV infection has been documented in workers exposed infrequently to blood or body fluids (e.g., ward clerks, dietary workers, maintenance workers, housekeeping personnel, teachers, and persons employed in day care settings) (91). Hemodialysis patients. Since the initiation of strict infection-­‐control practices and hepatitis B vaccination, the rate of HBV infection among patients undergoing hemodialysis has declined approximately 95% (99,100). Nonetheless, repeated outbreaks of HBV infection among unvaccinated patients underscore the continued risk for infection in this population (101). Persons with chronic liver disease. Persons with chronic liver disease are not at increased risk for HBV infection unless they have percutaneous or mucosal exposure to infectious blood or body fluids. Furthermore, studies of the outcomes of acute hepatitis B among patients with chronic liver disease provide little evidence that acute hepatitis B increases their risk for an acute liver failure. However, concurrent chronic HBV infection might increase the risk for progressive chronic liver disease in HCV-­‐infected patients (102). Travelers to HBV-­‐endemic regions. Short-­‐term travelers to regions in which HBV infection is of high or intermediate endemicity (Box 2) typically are at risk for infection only through exposure to blood in medical, health-­‐care, or disaster-­‐relief activities; receipt of medical care that involves parenteral exposures; or sexual activity or drug use (103). Infection rates of 2%–5% per year among persons working in such regions for >6 months have been reported (104,105). HIV-­‐positive persons. Published data on the overall prevalence of HBV and HIV co-­‐infection in the United States Presentations: 1) Universal vaccination of infants beginning at birth, 2) Prevention of perinatal HBV infection through routine screening of all pregnant women for hepatitis B surface antigen (HBsAg) and post exposure immunoprophylaxis of infants born to HBsAg-­‐positive women or to women with unknown HBsAg status. 3) Vaccination of all children and adolescents who were not vaccinated previously and 4) vaccination of previously unvaccinated adults at risk for HBV infection. Immunization strategy to eliminate transmission of hepatitis B virus (HBV) in the United States •
Universal vaccination of infants beginning at birth •
Prevention of perinatal HBV infection through •
Routine screening of all pregnant women for hepatitis B surface antigen (HBsAg), and •
Immunoprophylaxis of infants born to HBsAgpositive women or to women with unknown HBsAg status •
Routine vaccination of previously unvaccinated children and adolescents •
Vaccination of previously unvaccinated adults at risk for HBV infection Sum m ary
Hepatitis B vaccination is the most effective measure to prevent hepatitis B virus (HBV) infection and its consequences, including cirrhosis of the liver, liver cancer, liver failure, and death. In adults, ongoing HBV transmission occurs primarily among unvaccinated persons with behavioral risks for HBV transmission (e.g., heterosexuals with multiple sex partners, injection-­‐
drug users [IDUs], and men who have sex with men [MSM]) and among household contacts and sex partners of persons with chronic HBV infection. Recourses:_ http://www.cdc.gov/mmwr/PDF/rr/rr5516.pd