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Sirius

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Posted 17 June 2008 - 10:55 PM

In a local residential care facility, a third victim of a gastroenteritis outbreak has died. It is believed by SA Health that the outbreak is due to salmonella from contaminated food. Currently, all those who are stricken with gastroenteritis are in the state hospital (where I work). Given the aged population at ground zero, we expect more victims.

A THIRD person has died from the gastroenteritis outbreak at the Hahndorf Residential Care Services facility in the Adelaide Hills. Gordon Haynes, 88, died this morning at the Royal Adelaide Hospital. The tragedy follows the deaths of another man, 77, and a woman, 71.

SA Health has notified the federal Department of Health and Ageing of the death as it continues to identify the source of the outbreak.

SA Health chief medical officer Professor Paddy Phillips said the man's death had been referred to the Coroner.

"The man was a resident of the Hahndorf Residential Care Service and died while being treated in hospital this morning," he said.

"I would like to express our deepest sympathies to the patient's family.

"SA Health is continuing to investigate the source of the outbreak, which is thought to be linked to salmonella from contaminated food.

"We are also working on the probability that the illness has spread to some residents by person-to-person contact.

"Our team is working with the nursing home to ensure that food handling and hygiene practices are appropriate and to ensure the spread of the illness is contained."

Twenty-two people have been affected by the outbreak, which remains contained to the nursing home.

A woman, 81, continues to receive hospital treatment for gastro symptoms.

Professor Phillips said while the outbreak appeared to be contained to the nursing home, it was timely to remind people of the importance of good hygiene practices to avoid the spread of bacteria, such as salmonella.

"While salmonellosis is a food-borne disease, it can also be spread by person-to-person contact, so common hygiene advice remains important for us all," he said.

Home director of nursing Suzanne Fuller said the staff and residents were ``very saddened'' by Mr Haynes' death.

She said health investigators had looked at ``every possible thing'' in a bid to find the source of the outbreak.

"We're really not coming up with an answer at all, which is unfortunate because we'd like to know how it all began,'' Ms Fuller said.

Mr Haynes had lived at the home for three years with his pet cat and birds.

"Unfortunately, (Gordon) hadn't been well for quite some time,'' Ms Fuller said. ``I've spoken with his family and all the residents and staff are really quite upset and very saddened by his death.''


TIPS TO STOP BACTERIAL SPREAD:

STORE food at the right temperature: Cold food should be kept at 5C or less, hot food at 60C or more

COOK food thoroughly: Minced meats need to be cooked through and poultry should be cooked so that juices run clear

DON'T cross contaminate: Keep raw and cooked foods separate; place raw meats on the lowest shelf in the refrigerator so that juices cannot drip on to other foods

CLEAN up all equipment: Wash knives and boards thoroughly; it is best to have separate meat and vegetable boards so that raw meat does not contaminate food that is to be eaten fresh

USE good hygiene practices: Regularly wash and thoroughly dry your hands whilst preparing food, particularly between handling raw meats and foods that will be eaten fresh.

ALWAYS wash your hands after using the toilet or changing nappies and before eating, drinking and smoking.


Link to news article

Personal gripe but why do journalists think that one sentence is enough for a paragraph?? I'd have had my butt handed to me on a plate by my matriculation English teacher if I ever passed up one sentence paragrahs.


Simon

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Posted 18 June 2008 - 07:34 AM

Thanks for posting this Sirius.

"While salmonellosis is a food-borne disease, it can also be spread by person-to-person contact, so common hygiene advice remains important for us all," he said.

I had no idea that it could be transferred person to person.

"Unfortunately, (Gordon) hadn't been well for quite some time,'' Ms Fuller said. ``I've spoken with his family and all the residents and staff are really quite upset and very saddened by his death.''

Hmmm try telling that to an auditor or the judge. Even more reason to practice good hygiene principles.

Regards,
Simon

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Charles.C

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Posted 18 June 2008 - 09:16 AM

Dear All,

I had no idea that it could be transferred person to person.


I extracted this from another well-documented Salmonella tragedy in a hospital background -

Salmonella species causing gastrointestinal infection in man are often derived from cattle or poultry in which they may be found as commensals in faeces. For infection to occur, the organisms must be ingested, usually through the faecal-oral route. In the main, infection is foodborne and occurs by ingestion of meat or animal products contaminated with these faecal salmonella. In a smaller proportion of outbreaks infection may occur due to person-to-person contact, either directly or indirectly via contamination of equipment or of a surface, which is then handled by a second person and the organism transferred to their mouth.


http://www.scotland..../10/15658/12298

Unfortunately, similar occurrences may also derive from treatment procedures, eg

http://www.anapsid.org/salm5.html

Deep Sympathies to all concerned.

Rgds / Charles.C

Kind Regards,

 

Charles.C


GMO

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Posted 18 June 2008 - 12:51 PM

Blimey. I know this isn't of any comfort to the victims but I'll use this in some training. I think it will bring home the message.

I think the thing is Simon in any food poisoning where the live bacterium is the cause of the illness rather than a toxin, there are so many bacteria in the vomit and faeces, the skin of the patient is probably infested with bacteria. It's even more so with viral gastroenteritis. My husband got a bout of it once and despite me being careful and aware of what could happen, 24 hours later, I was ill. I mean who sanitises door handles in their home? That's how easily it could be spread. (Ok, maybe I would next time!)



cazyncymru

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Posted 18 June 2008 - 01:50 PM

Blimey. I know this isn't of any comfort to the victims but I'll use this in some training. I think it will bring home the message.

I think the thing is Simon in any food poisoning where the live bacterium is the cause of the illness rather than a toxin, there are so many bacteria in the vomit and faeces, the skin of the patient is probably infested with bacteria. It's even more so with viral gastroenteritis. My husband got a bout of it once and despite me being careful and aware of what could happen, 24 hours later, I was ill. I mean who sanitises door handles in their home? That's how easily it could be spread. (Ok, maybe I would next time!)



I tell you what i do for training, especially with those who's english isn't fluent, is to take plates of the toilet door handles.

TBX and E Coli are brilliant (Big Blue Colonies!) or just Coliforms on VRBA

if you have access to ATP swabs, i take a swab of their hands AND their faces for them to see how many bacteria are on them.

C x


Charles.C

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Posted 18 June 2008 - 07:49 PM

Dear All,

I hope Sirius has no objection to my further extending his thread to expand the prevention tips given in his post.

WHO have issued a detailed presentation on this subject. I extracted a small section below but the full article (sec. 5 of link below) should be consulted for proper context.

Advice on personal hygiene
Advice on personal hygiene should be issued to all individuals with gastrointestinal disease and should include the following:
– Avoid preparing food for other people until free from diarrhoea or vomiting.
– Thoroughly wash hands after defecation, urination and before meals. Thorough handwashing with soap in warm running water and drying is the most important factor in preventing the spread of enteric diseases.
– Use your own separate towels to dry hands. Institutions, particularly schools, should use liquid soaps and disposable towels or hand-dryers.
– Clean toilet seats, flush handles, hand-basin taps and toilet door handles with disinfectant after use. If young children are infected, these cleaning procedures must be undertaken on their behalf. Similar arrangements may also be necessary in schools and residential institutions (if temporary exclusion is not possible).
– If employed in food preparation activities, scrub your nails with soap and a brush.
Infection control precautions
Infection control precautions for hospitalized and institutionalized persons with infectious diarrhoea (in particular, easily transmissible infections such as Salmonella typhi, Shigella,
etc.) include:
– isolation of patients (e.g. in a private room with separate toilet if possible);
– barrier-nursing precautions;
– strict control of the disposal or decontamination of contaminated clothing and bedding;
– strict observation of personal hygiene measures (see above).
Protecting risk groups
Certain groups are at particularly high risk of severe illness and poor outcomes after exposure to a foodborne disease. Safe food-handling practices, including strict adherence to thorough hand-washing, should be particularly emphasized to such people. Specific advice for risk groups may be considered in some circumstances. Examples include advice to:
– pregnant women against consumption of unpasteurized milk, unpasteurized cheeses, and other foods potentially contaminated with Listeria;
– immunocompromised persons, such as those with HIV/AIDS, to avoid eating unpasteurized milk products, raw fish, etc;
– persons with underlying liver disease to avoid consumption of raw oysters and other food that may transmit Vibrio bacteria;
– persons with underlying chronic viral hepatitis B or C or other liver disease to be
vaccinated against hepatitis A if appropriate;
– personnel of day-care centres about receiving vaccination or immunoglobulin during a hepatitis A outbreak in the institution (although this is more likely to protect against secondary spread than against foodborne transmission).

http://www.who.int/f...l/en/index.html

The specific risk areas mentioned in previous thread posts seem alarmingly well validated, eg

Attached File  survival_of_salmonella_in_bathrooms_and_toilets.pdf   149.39KB   14 downloads

Nonetheless, one should perhaps maintain a degree of equilibrium, eg see –

http://www.webmd.com...ch-in-restrooms
(quoted in http://www.wikihow.c...estroom#_note-4 )

Rgds / Charles.C


Kind Regards,

 

Charles.C


Jean

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Posted 19 June 2008 - 07:53 AM

Thanks Sirius for the info & Charles for the detailed prevention tip. I will be using it for my training session next week.


Best regards,

J

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Sirius

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Posted 20 June 2008 - 03:46 AM

Glad to help and thanks for the extra info, Charles. :smile:

Just a quick update that the Department of Health has finished all its' testing and could not find the source. We still have three victims of the outbreak in the hospital. Age and pre-existing health conditions are not making it easier for them unfortunatelty.

On a somewhat similar tangent, I was recently surprised to find MRSA showing up in tomatoes in the US/Mexico recently. And you should all be aware of the existence of VRE in various meat products.

I've recently taken our distribution section through VRE training and was amazed at the amount of disinformation out there. Of course, this wasn't helped by the recent beatup story by Dr. Phil which was aired here recently. (There's one bloke I like to beat up!)



Charles.C

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Posted 20 June 2008 - 04:29 AM

Dear Sirius,

Thks for the update. I had just been checking back myself -

http://www.news.com....76-2682,00.html

I think the quoted source detection rate of 20% is no worse, maybe even better than I recall seeing in other statistics but this obviously can't alleviate the personal shock and suffering involved. Very sad.

Rgds / Charles.C


Kind Regards,

 

Charles.C




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