New Developments in the Infection Control War
Small world networks and
battles on the homefront
by Jeannie Akridge

Welcome to the HPN 2005 Annual Infection Control Guide. More products are being developed that address the complexity of infection control and safety for patients and healthcare staff. This year we’ve compiled more companies and more product choices then ever. We’ve also included an update on the importance of handwashing on page 46. As we all anticipate the spread of infection on a global basis - we hope this guide helps you in your preparation defense. Our comprehensive directory begins on page 48.

A message delivered a year ago in June, by the Centers for Disease Control and Prevention’s director Julie L. Gerberding, MD, MPH, foretold a year teeming with challenges, losses and victories in the never-ending battle of infection control. Presenting the keynote address at the annual meeting of the Association of Professionals in Infection Control (APIC) in Phoenix, AZ, Gerberding spoke of the need to recognize "small world networks" in which weak ties (people moving between communities) become a link to connect highly clustered communities. As examples, she cited the Hong Kong traveler who spread SARS throughout the world, and the American Midwest pet shop where the spread of monkeypox began. She then urged infection control professionals to be a strong link for learning…to promote health, prevent disease and improve preparedness to meet health challenges; to serve as knowledge managers, early warning leaders, expert spokespersons, global health ambassadors and patient advocates. She introduced new health priorities for the CDC with a focus on prevention and preparedness.

Over the next year, those in the healthcare profession would have their strength and resolve tested against numerous and unforeseen threats to global health. The WHO issued warnings that the avian flu could mutate and cause an unprecedented worldwide pandemic; and the U.S. faced a shortage of flu vaccine after a major manufacturer found contaminated doses and was forced to stop production.

On the sterile processing front, several incidents of improperly cleaned instruments put patients at risk of disease. Also in 2004, New Jersey became the first state to pass a mandatory CS certification law; and the FDA ruled that several single use devices were no longer safe to be reprocessed.

In December 2004, Health and Human Services Secretary Tommy Thomspon resigned, but not before issuing stern warnings about the threat of a global flu pandemic and the risk of a terrorist attack on the nation’s food supply. Days later, the FDA announced new, stricter food-tracking rules. Also in December, the Institute for Healthcare Improvement (IHI) announced its groundbreaking "100,000 Lives Campaign". The campaign aimed to enlist thousands of hospitals across the country, at no charge, in a commitment to implement changes in care that have been proven to prevent avoidable deaths. The response was overwhelmingly positive.

Then, just before the new year rolled over – in an eerie omen to the absolute need to be ever-vigilant – a killer tsunami washed ashore in southeast Asia, causing fear of typhoid, hepatitis, and other disease epidemics among shaken survivors and the world.

The first half of 2005 brought continued challenges with MRSA, which shut down a Vancouver hospital and was reported as reaching out into the community in record numbers. A rare and aggressive HIV was reported in New York; an epidemic of Marburg hemorrhagic fever ravaged Angola; and a killer virus was accidentally sent in lab samples throughout the world.

In February 2005, a report showed that U.S. hospital infections claimed more lives than AIDS, breast cancer and traffic accidents combined and warned that before the end of the year, such infections would claim over 100,000 lives and become the fourth largest killer of Americans. The Committee to Reduce Infection Deaths urged public pressure on hospitals to "clean up" by following basic hygiene procedures and to "come clean" by publicly disclosing infection rates. That same month, Maryland weighed a bill forcing data collection on hospital-acquired infections, joining several other states in a move toward mandatory infection reporting. The CDC stepped in in March, issuing guidelines to hospitals for reporting on infections.

Seeming to make good on Gerberding’s promise for heightened prevention and preparedness measures, in April 2005, the CDC announced a major reorganization that created four new coordinating centers designed to defend against a new breed of 21st century health threats.