Actually, I have taken care of quite a few patients who had MRSA in the sputum (respiratory secretions) / respiratory tract and who had been placed in droplet isolation. Sometimes these patient's have had an advanced airway of some sort, but not always. SO that assertion that MRSA is spread only by direct contact is incorrect. Contact is not the only way this is spread, however, it is probably the most common.
CDC: 107 people on TB flights need tests
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Actually, I have taken care of quite a few patients who had MRSA in the sputum (respiratory secretions) / respiratory tract and who had been placed in droplet isolation. Sometimes these patient's have had an advanced airway of some sort, but not always. SO that assertion that MRSA is spread only by direct contact is incorrect. Contact is not the only way this is spread, however, it is probably the most common.
Most hospitals have outlawed any nail extensions / artifical nails. I wouldn't generalize that most peds units use less than optimal handwashing. I know that where I work, we are more than aware that most of our kids are contagious and sometimes wear gloves when it isn't even indicated. Also, as an FYI, sterile gloving is usually only indicated for sterile procedures - it is not something that is done as the norm during routine patient care. Regular gloves are used during routine care unless a procedure / situation that calls for sterile gloving is to do be completed.
When I did rotations through the NICU we had to scrub with special brushes / soaps for quite a few minutes (I can't remember if it was 3 or 5) right when we walked into the unit. All staff and the parents were required to do the same.
It is so sad about the infection with the neonates. I would be very upset if I were the parent.
poco
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It's all a catch 22. We're gonna be in bigger trouble now, IMO, with all these new antibacterial agents that are on the market - antibacterial dishwashing liquid, antibacterial counter cloths, etc etc. The strains of bacteria out there are going to become more and more and more resistant and mutate because of all of the antibacterials on the market now, not to mention antibiotics. It's just a matter of time, IMO.
gaia
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Buzz Mills
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TB Patient to Undergo Surgery
Operation Will Remove Infected Lung Tissue
DENVER (June 14) - An Atlanta attorney will have surgery next month to remove lung tissue infected with extensively drug-resistant tuberculosis , hospital officials said Thursday. Andrew Speaker will have the operation at the University of Colorado Hospital in suburban Aurora, but the exact date has not been set. Speaker is "an excellent candidate for surgery," said Dr. Charles Daley, head of infectious diseases at National Jewish Medical and Research Center, where Speaker is being treated.
"The infected area of his lung is relatively small and well contained. He is also young and otherwise healthy," Daley said.
The infected area is about the size of a tennis ball, hospital officials said. The operation should improve Speaker's chances of recovery by removing most of the tuberculosis organisms in his lungs, leaving fewer that must be killed by the antibiotics he is taking, National Jewish said in a written statement.
Speaker sparked an international scare when health officials tried to find and isolate him because his strain of TB is considered exceptionally dangerous.
http://news.aol.com/topnews/article...e/20070529152509990002?ncid=NWS00010000000001
Operation Will Remove Infected Lung Tissue
DENVER (June 14) - An Atlanta attorney will have surgery next month to remove lung tissue infected with extensively drug-resistant tuberculosis , hospital officials said Thursday. Andrew Speaker will have the operation at the University of Colorado Hospital in suburban Aurora, but the exact date has not been set. Speaker is "an excellent candidate for surgery," said Dr. Charles Daley, head of infectious diseases at National Jewish Medical and Research Center, where Speaker is being treated.
"The infected area of his lung is relatively small and well contained. He is also young and otherwise healthy," Daley said.
The infected area is about the size of a tennis ball, hospital officials said. The operation should improve Speaker's chances of recovery by removing most of the tuberculosis organisms in his lungs, leaving fewer that must be killed by the antibiotics he is taking, National Jewish said in a written statement.
Speaker sparked an international scare when health officials tried to find and isolate him because his strain of TB is considered exceptionally dangerous.
http://news.aol.com/topnews/article...e/20070529152509990002?ncid=NWS00010000000001
Good. I hope his surgery goes well and that he recovers quickly, while getting back to life (as he now knows it) as normal until his overall treatment for the TB is complete.
I know 5 people off the top of my head that have it or have had to battle it. One is a poster here.
One of them did not get it in a hospital. but she has been hospitalized several times for it.
Hers started out looking like a little insect bite.
This bug is nasty.
angelmom
The love stays...forever in our hearts
I found it ironic that Speaker's name was leaked by someone who figured it out - maybe a coworker, neighbor, or "friend" who thought they were doing the right thing by spreading the word about this man. Once his name was out there, the media ran with it, including pictures from his firm's website. Many articles included the web address, email address, and phone number of the law firm. I'm sure those details were particularly helpful to anyone who feared they might have been exposed.
However, this woman - who is DEAD - is not being identified to protect her privacy. Now, you and I both know that the press could easily find someone to give up her name. Her privacy is not that big of an issue any more, and the risk of her having exposed someone is - in my totally non-medical opinion - probably far greater than Speaker's. But the paper goes out of their way not to even hint at who she might be or even name the country from where she arrived.
That is what I meant by irony.
In my setting we are seeing a LOT of community aquired MRSA. It's a nasty little bug and it is really hard one those who get it.
yep yep . My gf said the most important thing she learned was to wash her hands BEFORE and after she uses a public restroom. She said think about it, we typically wash our hands after we touch ourselves, instead of before..doesn;t make sense.
Pedinurse, I think Crypto's point about the sterile gloves is that they fit much better than the nonsterile kind, not that the sterility is necessary for all patient contact. I think he is right that we would all be more likely to wear gloves for all procedures if the nonsterile gloves weren't such a handicap, so to speak
I use both kinds frequently, and there is no question that there is a huge difference in dexterity when wearing the sterile vs. nonsterile gloves. Often I will grab a pair of sterile gloves to do a nonsterile procedure for that reason. I'm sure I'm driving up the cost of healthcare, but I like to think that my patients would rather have me not fumbling around 
Crypto already pointed out to me that some studies have shown airborne MRSA in ICUs (see above). I was not aware of that, since the current isolation recommendations for MRSA are contact precautions. Maybe in the future all MRSA patients and/or carrier healthcare workers will be placed in respiratory isolation, but that is not the current standard from the CDC or in my institution.
The globe-trotting American lawyer who caused an international health scare by traveling while infected with tuberculosis has a less severe form of the disease than previously diagnosed, a Denver hospital official said Tuesday.
http://news.aol.com/story/_a/lawyers-tuberculosis-strain-downgraded/20070703140809990001
http://news.aol.com/story/_a/lawyers-tuberculosis-strain-downgraded/20070703140809990001
GLOW,
Thanx for the update. Now WHY has it taken so long for this news to be reported???
Something about this still fails the smell test.
He's villified for travelling when told he could pass on a deadly disease. The fact he may not actually have had that disease, and whether or not he managed to pass it on doesn't change anything about what his actions are seen as. If you fire a gun into a crowd, and don't hit anyone - does it make it all OK? If you find out that, contrary to what you believed when firing, the gun only had blanks - does that make you any less lousy of a human being?
The tests take time to run. And you can't be sure of any result until you've had a retest or so. It hasn't been that long - we're just impatient.
Marthatex
New Member
Andrew Seeker is being sued by around 8 people for putting them through the "stress" and expense of thinking they were exposed to the serious strain of TB.
It was on O'Reilly tonite; alot of pro and con about whether these people have a case. Now Seeker is on the "other end" of the legal situation.
It was on O'Reilly tonite; alot of pro and con about whether these people have a case. Now Seeker is on the "other end" of the legal situation.
angelmom
The love stays...forever in our hearts
http://www.ajc.com/wednesday/content/news/stories/2008/01/12/tbpublicity_0113_1.html
Months before the Centers for Disease Control and Prevention made Atlanta lawyer Andrew Speaker the unwitting poster boy for drug-resistant tuberculosis, the agency and its advisers discussed a strategy to get more funding by publicizing the deadly strain of the disease, records show.
Frustrated that money for combating TB had dwindled as Congress favored newer threats from bioterrorism and bird flu, advisers suggested taking "drastic actions," according to December 2006 meeting minutes from the federal Advisory Council for the Elimination of Tuberculosis. The council is based at the CDC in Atlanta.
One strategy centered on publicizing the urgency of combating XDR TB a rare, new form of extensively drug-resistant tuberculosis. "The implications of XDR TB for TB control in the United States should be compiled and communicated as a strong advocacy tool to increase the TB investment," the minutes state.
Five months later, CDC's lab diagnosed Speaker as having XDR TB, and the agency issued a federal isolation order its first in more than 40 years and held a national press conference about how he possibly spread the disease aboard international flights.
The actions were in stark contrast to the private way the agency dealt with 100 other TB cases involving airline travelers, both before Speaker and after, including an incident last month when a severely ill drug-resistant TB patient flew from India to Chicago.
"It's unheard of to have that level of public notice," said Dr. Michael Iseman, a national TB expert and professor of medicine at the University of Colorado, where he has been one of Speaker's doctors. "I don't think it was constructive."
The handling of the Speaker case was so unusual that it has raised questions among other TB experts, including whether CDC publicized Speaker's case in a quest for more money.
<snip>
Despite the public perception of Speaker as a modern-day Typhoid Mary, tests at a Denver hospital later showed he didn't have the XDR TB that CDC cited in its press conference, but a more treatable form of drug-resistant TB. Nobody appears to have caught TB from Speaker, tests of more than 250 airline passengers show.
Tuberculosis experts say the Speaker case because of its high profile gave TB its biggest publicity boost in decades and helped secure rare funding increases for combating the disease.
"It was almost as if some prophecy was being fulfilled," Dr. Michael Fleenor, chairman of the federal TB advisory council, which five months earlier had sent a blunt letter to Secretary of Health and Human Services Michael Leavitt warning that "our nation is facing an imminent airborne biological threat" from XDR TB.
<snip>
TB advocates and the CDC agree that Speaker gave funding legislation the traction it previously lacked. The Speaker case was "fortuitous," said Fleenor.
Dr. Alan Bloch, an expert in the airborne transmission of TB and measles, said he's wondered since last summer: "Was there a hidden agenda to use Andrew Speaker's case to get more money for TB control?"
Bloch, who spent 25 years at CDC before he retired in 2005, said the agency's response to Speaker seemed overblown, given that test results known to health officials and Speaker's lack of symptoms made him unlikely to spread the disease.
Bloch conducted the first national survey of drug-resistant TB and designed the expanded TB surveillance system that CDC used to identify the 49 XDR TB cases in the U.S. from 1993-2006.
Watching Gerberding's televised press conference in May, when she announced the CDC had issued the first federal isolation order since a 1963 case of suspected smallpox, Bloch said he assumed "this patient must be extremely contagious.''
"I had visions of a non-compliant patient who was the tuberculosis equivalent of Typhoid Mary, who was highly infectious. When I found out this patient did not meet other criteria for being a very infectious case, I was puzzled."
The CDC has refused for nearly seven months to release documents under the Freedom of Information Act about any role the agency's XDR TB funding strategy played in its handling of the Speaker case.
<snip>
The other patient
While no press conference has been held in the latest case of an airline passenger traveling with MDR TB, CDC officials say that's because they had an easier time getting the list of other passengers on the Chicago-bound plane with the woman than it had in the Speaker case.
<snip>
The woman, who was coughing on the flight, was so ill with TB she went to an emergency room a few days after arriving home in California.
In contrast, Speaker never coughed or had any TB symptoms; the disease was only diagnosed because it showed up on a chest X-ray after he suffered an unrelated injury. Still, all of the passengers on his two trans-Atlantic flights were advised to seek tests.
MUCH MUCH MORE AT LINK
Edited b/c I accidentally posted before I was done snipping the article for length.
Months before the Centers for Disease Control and Prevention made Atlanta lawyer Andrew Speaker the unwitting poster boy for drug-resistant tuberculosis, the agency and its advisers discussed a strategy to get more funding by publicizing the deadly strain of the disease, records show.
Frustrated that money for combating TB had dwindled as Congress favored newer threats from bioterrorism and bird flu, advisers suggested taking "drastic actions," according to December 2006 meeting minutes from the federal Advisory Council for the Elimination of Tuberculosis. The council is based at the CDC in Atlanta.
One strategy centered on publicizing the urgency of combating XDR TB a rare, new form of extensively drug-resistant tuberculosis. "The implications of XDR TB for TB control in the United States should be compiled and communicated as a strong advocacy tool to increase the TB investment," the minutes state.
Five months later, CDC's lab diagnosed Speaker as having XDR TB, and the agency issued a federal isolation order its first in more than 40 years and held a national press conference about how he possibly spread the disease aboard international flights.
The actions were in stark contrast to the private way the agency dealt with 100 other TB cases involving airline travelers, both before Speaker and after, including an incident last month when a severely ill drug-resistant TB patient flew from India to Chicago.
"It's unheard of to have that level of public notice," said Dr. Michael Iseman, a national TB expert and professor of medicine at the University of Colorado, where he has been one of Speaker's doctors. "I don't think it was constructive."
The handling of the Speaker case was so unusual that it has raised questions among other TB experts, including whether CDC publicized Speaker's case in a quest for more money.
<snip>
Despite the public perception of Speaker as a modern-day Typhoid Mary, tests at a Denver hospital later showed he didn't have the XDR TB that CDC cited in its press conference, but a more treatable form of drug-resistant TB. Nobody appears to have caught TB from Speaker, tests of more than 250 airline passengers show.
Tuberculosis experts say the Speaker case because of its high profile gave TB its biggest publicity boost in decades and helped secure rare funding increases for combating the disease.
"It was almost as if some prophecy was being fulfilled," Dr. Michael Fleenor, chairman of the federal TB advisory council, which five months earlier had sent a blunt letter to Secretary of Health and Human Services Michael Leavitt warning that "our nation is facing an imminent airborne biological threat" from XDR TB.
<snip>
TB advocates and the CDC agree that Speaker gave funding legislation the traction it previously lacked. The Speaker case was "fortuitous," said Fleenor.
Dr. Alan Bloch, an expert in the airborne transmission of TB and measles, said he's wondered since last summer: "Was there a hidden agenda to use Andrew Speaker's case to get more money for TB control?"
Bloch, who spent 25 years at CDC before he retired in 2005, said the agency's response to Speaker seemed overblown, given that test results known to health officials and Speaker's lack of symptoms made him unlikely to spread the disease.
Bloch conducted the first national survey of drug-resistant TB and designed the expanded TB surveillance system that CDC used to identify the 49 XDR TB cases in the U.S. from 1993-2006.
Watching Gerberding's televised press conference in May, when she announced the CDC had issued the first federal isolation order since a 1963 case of suspected smallpox, Bloch said he assumed "this patient must be extremely contagious.''
"I had visions of a non-compliant patient who was the tuberculosis equivalent of Typhoid Mary, who was highly infectious. When I found out this patient did not meet other criteria for being a very infectious case, I was puzzled."
The CDC has refused for nearly seven months to release documents under the Freedom of Information Act about any role the agency's XDR TB funding strategy played in its handling of the Speaker case.
<snip>
The other patient
While no press conference has been held in the latest case of an airline passenger traveling with MDR TB, CDC officials say that's because they had an easier time getting the list of other passengers on the Chicago-bound plane with the woman than it had in the Speaker case.
<snip>
The woman, who was coughing on the flight, was so ill with TB she went to an emergency room a few days after arriving home in California.
In contrast, Speaker never coughed or had any TB symptoms; the disease was only diagnosed because it showed up on a chest X-ray after he suffered an unrelated injury. Still, all of the passengers on his two trans-Atlantic flights were advised to seek tests.
MUCH MUCH MORE AT LINK
Edited b/c I accidentally posted before I was done snipping the article for length.
angelmom
The love stays...forever in our hearts
http://www.ajc.com/services/content..._speaker_cdc.html?cxtype=rss&cxsvc=7&cxcat=13
An Atlanta lawyer who was misdiagnosed with a severe strain of tuberculosis, when he had a more treatable form, has sued the Centers for Disease Control and Prevention for invasion of privacy.
They had no right to stand up and talk about my private medical information, Speaker said...
he has filed Freedom of Information Act requests with the CDC to get his test results. But the CDC has not turned the information over, he said.
The only way for me to get that information is through discovery through a lawsuit, Speaker said.
An Atlanta lawyer who was misdiagnosed with a severe strain of tuberculosis, when he had a more treatable form, has sued the Centers for Disease Control and Prevention for invasion of privacy.
They had no right to stand up and talk about my private medical information, Speaker said...
he has filed Freedom of Information Act requests with the CDC to get his test results. But the CDC has not turned the information over, he said.
The only way for me to get that information is through discovery through a lawsuit, Speaker said.
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