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Tuesday, October 28, 2014

Healthcare Headlines, Part 2

By Rick Fromme

Welcome back to our second edition of “Healthcare Headlines.” In a popular blog that was posted in late August (“Viruses, Bacteria and Headlines, Oh My!”), I had cited several international Ebola experts on Ebola who claimed that in their estimation, Ebola wouldn’t become a major issue in the U.S.:

“However, the CDC and other leading experts are virtually unanimous in emphasizing the likelihood of Ebola spreading like wildfire across the U.S. is very low. And if a developed country such as the U.S. should experience some isolated cases, our healthcare system has the wherewithal to deal with and contain the infection (in its current state).”

While to date, less than a handful of people in the U.S. have tested positive for Ebola, it remains to be seen if these experts’ prognostications will come to fruition (let’s hope so!) But Ebola is one of the key health issues making headlines right now, so I thought I would post some of the most recent news items concerning the disease.

New Ebola Study Finds it’s Best to Screen Outbound Flights

Photo Credit: marketwatch.com

Given the current rates of infection of the Ebola virus infection found in Liberia, Sierra Leone and Guinea, a team of Canadian infectious disease specialists estimates that as many as three passengers each month are likely to travel on international flights departing from one of the above African countries where the disease continues to proliferate.

As was published in the “The Lancet,” just this past Monday, the research concludes that screening airline travelers in order to block the virus' export would be far more effective if screening tests were conducted at airports inside the three stricken countries, rather than screening done in arrival countries such as the U.S.

The analysis suggests that on average, every 10.5 days, a single person infected with Ebola is likely to carry the virus by air from Liberia, Sierra Leone or Guinea to another country.

For public health officials considering the best protocol to stop passengers who could be exporting the Ebola virus, that pattern of international travel tilts the screening calculation vastly in favor of doing so at airports in those above-mentioned countries.

Photo Credit: wibwnewsnow.com

Every international airline passenger screened at one of those three countries’ airports could be a carrier of the

deadly virus, the authors of the “Lancet” analysis assumed. Airports throughout the U.S. and other countries that aren’t permitting any direct flights from Liberia, Sierra Leone or Guinea. However, thermometer-wielding personnel would have to screen 2,512 passengers in order to find one who may have been exposed to Ebola.

In more disheartening news, the study suggests that countries that are presently the least able to manage the arrival of passengers are also most likely to receive infected passengers. Of those expected to travel internationally from the three West African countries affected by Ebola in 2014, more than 60% are likely to have final destinations in low- or lower-middle-income countries such as Ghana and Senegal.

Moreover, says study coauthor, Dr. Isaac I. Bogoch, screening passengers for Ebola symptoms such as fever will likely miss about 90% of those infected, since the virus' incubation is widely thought to be about 10 days, with the maximum incubation period of 21 days. For as many as nine days (in some cases, longer), an infected person would likely show no signs of fever, limiting the value of thermal screening.

GOP Leaders Say New Ebola Restrictions Don’t Go Far Enough

Photo Credit: redflagnews.com

In a related Ebola-oriented news item, last week, several GOP leaders said the Obama administration’s new Ebola restrictions don’t go far enough and are pressing for a full travel ban. The leaders of three House committees renewed calls for President Obama to suspend U.S. visas for anyone traveling from Liberia, Sierra Leone and Guinea, where more than 4,500 people have died from Ebola.

CDC Tightens Rules on Caring for Ebola Patients

As of today, four people have been officially diagnosed with Ebola in the U.S. (The young boy in NYC who was thought to possibly infected tested negative for Ebola.) As stated on the Center for Disease Control's website, Cases of Ebola Diagnosed in the United States:

"CDC confirmed on September 30, 2014, the first laboratory-confirmed case of Ebola to be diagnosed in the United States in a man who had traveled to Dallas, Texas from Liberia. He did not have symptoms when leaving Liberia, but developed symptoms approximately four days after arriving in the United States.

Photo Credit: premiumgist.com

"The man sought medical care at Texas Presbyterian Hospital of Dallas after developing symptoms consistent with Ebola. The index patient passed away on October 8.

"On October 10, a healthcare worker at Texas Presbyterian Hospital who provided care for the index patient tested positive for Ebola. The patient has since recovered and was discharged on October 24.

"On October 15, a second healthcare worker who provided care for the index patient at Texas Presbyterian Hospital tested positive for Ebola. The second healthcare worker had traveled by air October 13, the day before reporting symptoms. All passengers and crew on the two flights (Dallas to Cleveland on October 10, and Cleveland to Dallas on October 13) have since been contacted by public health professionals and are being monitored.

"On October 23, the New York City Department of Health and Mental Hygiene reported a case of Ebola in a medical aid worker who had returned to New York City from Guinea, where the medical aid worker had served with Doctors Without Borders."

Photo Credit: latimes.com

Given the mishandling of the first patient in Texas, now, full body suits and respirators are being recommended, along with a monitor to observe workers when removing their gear.

Last Monday, U.S. health officials officially tightened guidelines for health workers treating Ebola patients, now requiring full body suits with no skin exposure and use of a full-time respirator.

The U.S. Centers for Disease Control and Prevention (CDC) decided to issue the tougher rules after two Dallas nurses contracted Ebola while caring for the first patient diagnosed in the U.S., a Liberian national who was visiting in Texas. The first patient and procedures were in September. The two nurses were following Ebola guidelines that the CDC first issued in 2008 and had updated during the summer. However they ended up contracting the disease but have since recovered. The CDC now recommends a very specific set of gear to be worn by healthcare workers treating Ebola patients:

Double gloves

Waterproof boot covers that go to at least mid-calf

Single-use waterproof or water-resistant gowns that extend to mid-calf

Disposable, single-use, full-face shields

Surgical hoods to ensure complete coverage of the head and neck

Waterproof apron that covers the torso down to the mid-calf if the patient is vomiting or experiencing diarrhea

Use of a respirator at all times ― either an N95 respirator or a powered air purifying respirator

Healthcare workers must undergo rigorous and repeated training in donning and doffing all this gear, until it becomes "ritualized," the CDC emphasized.

A Breathalyzer to Detect Hospital-Acquired Infections

Photo Credit: gizmag.com

The startup firm Isomark, in Wisconsin has developed a breath-based test that can detect infection within two hours of its onset. The patented concept has wide-reaching applications ― for instance, developing a smart neonatal incubator that’s constantly checking a preemie’s breath for signs of sepsis.

The company received $2.2 million in NIH-backed SBIR grants; the device is in the midst of a 110-patient trial at the University of Wisconsin.

The general idea, however, is that by using the non-invasive measurement of breath-based biomarkers, patients could be diagnosed and treated much quicker than if they wait for a lab results of, say, a blood test. The uses for Isomark’s test include initial disease detection in a clinic and other outpatient medical services, and importantly, post-op monitoring of patients who are at risk of contracting hospital-acquired infections such as sepsis and MRSA. Sepsis is a major problem in ICUs; the NIH estimates that 28-50% of the 750,000 Americans who develop it each year die.

Paralyzed Man Walks Again After Nose Cells Repair His Spinal Cord

Photo Credit: techtimes.com

A 40-year-old paralyzed man from Poland can now walk again (with the aid of a frame) after breakthroughsurgery transplanted cells from his nose into his spinal cord, which had been severed in a knife attack.

The innovative procedure effectively provided a "bridge" over the injury site so nerve cells ― encouraged by the special nose cells ― could regrow across the scar tissue in his spinal cord.

The patient was left paralyzed from the chest down after suffering stab wounds to his back in 2010. After 19 months of treatment at a Polish hospital, his doctors say he’s recovered some voluntary movement patterns and has now regained some sensation in his legs.

The patient is continuing to improve further than predicted; he’s now able to drive and live more independently.

Vaccinations “Not Linked to Increased Risk of MS, CNS Disorders”

Photo Credit: mysuncoast.com

Contracting some findings suggest in previous research studies, a new study published in “JAMA Neurology”

didn’t correlate the association.

In this latest study, researchers set out to assess the link between vaccinations and MS and other Central Nervous System (CNS) disorders in more detail.

The researchers said they found no link between any vaccines ― including HPV vaccines and hepatitis B vaccines ― and an increased risk of MS or any other central nervous system disorder up to three years following vaccination.

However, they did find a link between vaccines and increased risk of CNS disorders among younger patients within the first 30 days after vaccination, but the association disappeared after 30 days. The researchers say this indicates that "at most, vaccines are redundant enhancers of pre-existing autoimmunity."

Health Tip: Dish Up Healthier Halloween Goodies

Young trick-or-treaters typically are overloaded with sugar-loaded candy, but that doesn’t mean you have to contribute to their soaring sugar levels. The Academy of Nutrition and Dietetics suggests these healthier Halloween options:

Photo Credit: lindawagner.net

Vitamin C-packed, 100%-fruit chews

Trans fat-free animal crackers or some sugar-free gum

Small juice boxes with 100% fruit juice

Small cups of low-fat pudding

Halloween stickers, temporary tattoos, pencils or other non-food goodies.

In this second edition of “Healthcare Headlines,” I focused on some of the most current breaking news stories concerning Ebola. The first article cited a recently published study that suggests airport screening should be done in the countries that are experiencing the Ebola epidemic. I mentioned that GOP leaders want to see stronger restrictions set forth by the current administration. The third Ebola-oriented segment focused on the CDC’s new guidelines for healthcare workers treating Ebola patients pertaining to protective clothing. I also featured summaries of other recent medical news articles such as the development of a new breathalyzer that can sense the early onset of various infections, new advances in spinal cord surgery and repair, a new study that found no causal effect of vaccinations and CNS disorders and MS, and lastly, some healthy alternatives to sugar-laden candy for Halloween.

If you found this article useful, please feel free to click “Like” as well as share and repost it. If you have any questions or comments, as always, I’m eager to read them.

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found MedMasters.com. Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding MedMasters.com, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on Facebook, Twitter, Google+, LinkedIn and YouTube.

Friday, August 29, 2014

Viruses and Bacteria and Headlines, Oh My!

By Rick Fromme

Photo Courtesy of flanderstoday.eu

Many of us have heard the expression, “If it bleeds, it leads,” referring to the phenomenon that with many news outlets ― online, TV, radio and print ― the more harrowing a story, the better its chance of becoming headline news.

One of the international medically related stories garnering this axiom is 2014’s epidemic of the Ebola virus disease that has been sweeping across swaths of West Africa and other parts of the continent. Technically, the outbreak originated in Guinea in late 2013, but it wasn’t reported until March 2014, after it had spread to Liberia, Sierra Leone and Nigeria. Augmenting our domestic awareness about the outbreak, as of August 8th, the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) formally designated the outbreak as a “public health emergency of international concern.” And when you consider this legal designation has only been used only twice before, once for the 2009 H1N1 (Swine flu) pandemic and in 2014 for the resurgence of polio, no wonder it’s still contributing to the media’s “bleed::lead” paradigm. Furthering our stateside “fear factor” has been the personal sub-story of the two U.S. residents who’d contracted the virus earlier in this summer while serving in West Africa (both of whom were released from U.S. hospitals, now “Ebola-free”).

It’s true the Ebola virus is a major health concern in West Africa and several other countries of the vast African continent. The facts are disconcerting: Africa is currently facing its worst Ebola outbreak in history, with over 1,600 officially reported cases of infection, a death toll of 880 and rising, and a startling mortality rate of up to 90%. It’s the largest-ever recorded outbreak of Ebola since the virus’ discovery in the Democratic Republic in 1976. Worse, most epidemiologists feel the disease will continue to spread throughout additional regions of the continent before it can be arrested.

Possible Pandemic?

However, the CDC and other leading experts are virtually unanimous in emphasizing the likelihood of Ebola spreading like wildfire across the U.S. is very low. And if a developed country such as the U.S. should experience some isolated cases, our healthcare system has the wherewithal to deal with and contain the infection (in its current state).

Photo Courtesy of www.timesofisrael.com

Dr.Leslie Lobel, an Israeli researcher at Ben Gurion University, and one the world’s few experts and leaders in developing a vaccine against the Ebola virus, feels it’s important to understand the current etiology about this Ebola outbreak and why it’s spreading so quickly in certain parts of Africa. The American-born Lobel feels the poor security regimes of the most affected countries is one of the factors to blame for the extent of the current epidemic. Lobel points out that these countries have very “porous” borders, and their lack of quarantining methods prevents their ability to wean out the disease. Consequently, more people become infected and unknowingly spread the contagion.

Both Dr. Lobel and the World Health Organization (WHO), feel that due to correct medical management and monitoring of the outbreak, chances are remote that even this record Ebola epidemic will morph into a global pandemic.

Photo Courtesy of reunionblackfamily.com

Massachusetts-based risk perception consultant David Ropeik concurs. “It’s called the ‘availability heuristic,’” Ropeik recently explained on NBC News. “It’s a mental shortcut for making sense of partial information. We have lazy brains. We don’t want to think about things in a lot of detail." However, he adds, “Dying from Ebola does suck, it’s not a good way to go. That makes it scarier.”

Thankfully, a U. S.-based pandemic of Ebola is highly unlikely. Instead of fretting disproportionately about it, what we can do is donate funds, our energies, and other altruistic measures towards helping such aid organizations and charities as Doctors Without Borders and the Red Cross towards helping the afflicted in Africa. And, of course, pray for those patients and/or people whose family and friends are sick or endangered.

Wipe, Wash, Wear: New Paradigm for World-Class Healthcare

Another pathogen that continues to make headlines is the ongoing challenge of preventing the spread of methicillin-resistant Staphylococcus aureus (MRSA), an infection caused by a strain of staph bacteria that's become resistant to antibiotics which were regularly used to treat common staph infections. Most MRSA infections occur in people who've been in hospitals or other health care settings, such as nursing homes and dialysis centers. When it occurs in these settings, it's known as healthcare-associated MRSA (HA-MRSA). HA-MRSA infections typically are associated with invasive procedures or devices, such as surgeries, intravenous tubing or artificial joints.

Photo Courtesy of mrsdisease.com

Consider the following:

The CDC reports that about one in 25 hospital patients has at least one health care-associated infection. The agency estimates two million patients suffer from hospital-acquired infections (HAI) every year and nearly 100,000 of them die. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. Furthermore, more than half of all HAIs occurred outside of the intensive care unit.

The CDC’s “Antibiotic Resistance Threats in the United States, 2013” reports: “At least two million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections. Many more people die from other conditions that were complicated by an antibiotic-resistant infection. Antibiotic-resistant infections can happen anywhere. Data show that most happen in the general community; however, most deaths related to antibiotic resistance happen in healthcare settings such as hospitals and nursing homes.”

Photo Courtesy of darrelhicks.com

Of course, if you’re a health care provider, or if you’re looking for a health care job, especially in any of the clinical specialties, you know the prevention of healthcare facility and hospital-borne diseases is of paramount concern.

Diane Raines, Baptist Health’s Senior Vice President and Chief Nursing Officer in Jacksonville, Florida points out that judicious and frequent hand washing remains one of the first tiers of defense against microbial spread. So, too, are the rigorous cleaning of rooms and other surfaces, appropriate use of personal protective equipment, appropriate preparation of patients for surgery, and other measures.

However, studies have found that, outside of the operating arena ― which Raines says is usually the most sterile environment of any hospital ― problematic are soft surfaces, such as uniforms and scrubs, even doctors’ ubiquitous white coats, because they serve as vectors for the spread of organisms in many settings, especially acute care. Last February, the Society for Healthcare Epidemiology of America issued several recommendations to prevent transmission of healthcare-associated infections from healthcare personnel attire.

Furthering its proactive mission as one of the nation’s leading healthcare systems, this past July, Baptist Health in Jacksonville became the first health system in the world to widely adopt specialized staff uniforms to repel fluids and minimize the risk of transmission of organisms. As part of its continued commitment to patient safety, Baptist Health partnered with Orlando’s Vestagen Technical Textiles, a global innovator in the development of advanced textile technologies.

Photo Courtesy of Vestagen Technical Textiles

Vestagen Technical Textiles provides comfortable, easy-to-use, continuous protection to the wearer. Its Vestex® fabric is engineered to repel fluids from the outside, wick away moisture from the inside, and control odor caused by bacteria with an imbedded antimicrobial. The clothing provides a durable fluid barrier, an antimicrobial and a special breathable material for wearer comfort. Each of these benefits lasts the life of the fabric. Vestex technologies can be adapted for a variety of uses and applications, from health care to athletic products. The antibacterial barrier technology has been shown to reduce methicillin-resistant Staphylococcus aureus (MRSA) on the fabric by 99.99%. (Consider that the NFL and other sports associations are also dealing with the challenge of preventing MRSA.)

Are Your Scrubs a Carrier or a Barrier?

The fabric’s fluid barrier binds to individual fibers, resulting in material that’s highly repellent to bodily fluids, water, oil and dirt. This high repellency has been shown to synergize with Vestagen’s embedded antimicrobial technology to prevent organisms from being acquired and retained on the fabric. “It reduces the bio-burden of our hospital staff’s uniforms,” Raines says.

Photo Courtesy of Baptist Health

More than 30,000 pieces of Vestex’s staff uniforms, lab coats and scrub jackets are being distributed in phase one and will feature Vestex textile technology. Over 6,000 Baptist Health inpatient staff, with frequent patient contact employees, including nursing, imaging, respiratory therapy, and environmental service members, have been transitioned into the new uniforms. Staff uniforms are also color-coded by function so patients can more easily recognize who is caring for them per specialty. While wearing the uniforms was voluntary throughout mid-July and August, on September 1, all staff will be required to wear the Vestex clothing, explains Raines.

“The initial rollout includes Baptist Jacksonville, Wolfson Children’s Hospital, Baptist Nassau, Baptist Beaches, Baptist South, Baptist Clay Medical Campus, and Baptist Home Health Agency,” Raines says. Other Baptist-owned facilities, such as its ancillary Baptist Cancer Institute and several neighborhood outpatient clinics and physicians offices have also expressed an interest in the high-tech uniforms.

Vestex Scrub Repelling Water and Fluids. Courtesy of Baptist Health

“In addition to our new staff uniforms, in late September and through October, we’ll be rolling out patient apparel featuring the same technology,” Raines continues. “We’re providing upgraded hospital gowns, with a double-enclosed back, more pockets and access apertures, as well providing our new ‘basketball’ tops and shorts to patients that don’t require a gown.” This will be another landmark move for Baptist Health Jacksonville as it will also be the first to have Vestex patient apparel as well.

Photo Courtesy of Baptist Health

“Patients ages one year and older will receive newly-designed apparel made from Vestex-protected fabric that provides them with dignity as well as protection.” She emphasizes that, “Baptist Health is not making the change because of a problem with infection, but to be proactive in our use of technology to enhance our environment. The technology is part of a broader safety strategy designed to reduce exposure to pathogens.”

The more than $1 million Baptist Health Jacksonville has invested in providing Vestex staff uniforms and patient garments represents its commitment to safety and its brand promise of “Changing Health Care for Good.”

Summary

In this article, I discussed two of the pathogens that have been in the news as of late: the Ebola virus and MRSA. I pointed out that while Ebola remains a challenge for several portions of Africa, the actuality of it becoming widespread in the U.S. remains remote. MRSA on the other hand, continues to be an ongoing concern. This article continues by sharing an innovative step that Baptist Health Jacksonville has taken in partnership with Vestagen Technical Textiles to widely adopt specialized staff uniforms to repel fluids and minimize the risk of transmission of infectious diseases. If you found this article useful, please feel free to share and repost it. If you have any questions or comments, as always, I’m eager to read them.

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found MedMasters.com. Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding MedMasters.com, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on Facebook, Twitter, Google+, LinkedIn and YouTube.