​“In the winter of 1906 I was called on to investigate a household epidemic of typhoid fever which had broken out in the latter part of August at Oyster Bay, New York”
 
Wow! They don’t write journal articles like that anymore. It sounds like an opening from a Sherlock Holmes story, or some other detective or investigator dreamed up by H.P. Lovecraft. Instead, it’s the opening sentence of a scientific article entitled “The work of a chronic typhoid germ distributor” from the Journal of the American Medical Association (JAMA) way back in 1907, by a chap called George Soper (the hero of our story), and it deals with one of the most famous/infamous outbreaks of typhoid of modern times.
 
Cue dramatic music…!

Back in 1986 a certain ex-film star, and former President of the United States, set in motion an annual event known as International Infection Prevention Week (IIPW). I had no idea Ronald Reagan was the person who started this, but apparently, he was! Okay, so along with trying to save lives he was also keen on reducing the amount of money being spent dealing with healthcare associated infections, but let’s give him the benefit of the doubt and say it was mainly about saving lives.
 
Since its inception IIPW has spread around the globe and now is an annual event in such diverse places as Australia, the United Kingdom, the Middle East, and Southeast Asia.
 
Each year IIPW has a theme. Recent themes include Vaccines are Everybody’s Business in 2019, Protecting Patients Everywhere in 2018, Antibiotic Resistance in 2017 and Break the Chain of Infection in 2016.
 
This year’s theme is “Make Your Intention Infection Prevention” …catchy huh? Our Infection Control Team has been running around the hospital sporting fancy T-shirts looking like “professional footballers”!
 
They told me that the idea behind this year’s theme is to encourage everyone, the general population as well as healthcare workers, to put infection control practices at the heart of what they do; make them an instinctive and everyday part of how we go about our lives.
 
Now this may seem obvious, surely everyone does this already …but do they? How many people wash their hands regularly? How many people self-isolate when they are unwell? How many people carry tissues around in case they sneeze? My suspicion is …not many!
 
Let’s look at the elephant in the room …Covid-19 (clearly my favourite topic!).
 
Below is a graph from the Department of Health (UK) website showing the cumulative number of cases of Covid-19 in the UK since the pandemic began. 

Earlier this year we all went into lockdown… remember? Not like the current lockdown where most people seem to be carrying on regardless, I mean when the streets were eerily quiet, and our capital cities looked like a set from a post-apocalyptic movie.
 
During this time, I remember seeing news stories about the positive impact of the Covid-19 pandemic on the environment as everyone moved indoors, cars stayed off the roads and heavy industry shut down. There were striking pictures of Nitric Oxide levels over China showing a massive reduction in the production of greenhouse gases. It seemed that something good may come out of the pandemic, almost as if the Earth was pressing the reset button and taking back control.

We’re all waiting for a vaccine against SARS Cov2, right? Once we have a vaccine, we can all get back to normal and 2020 will be a period of time that we look back on as a bad time in our lives. Well this is what I hear a lot of people saying… SPOILER ALERT! I think we need a reality check; the new normal is NOT going to look like the old normal.

More and more of us are being affected by imposed quarantine measures (sometimes at very short notice!). Holiday plans are all over the place (we are not going to the Drakensberg’s, our flight is cancelled, UK residents are banned and there is 14 days of quarantine even if we could get in! Boom, our holiday’s gone BUST!). There is mass quarantining on a global scale. But added to this is the fact that in the UK you must also quarantine yourself if you are exposed to a person with Covid-19. No ifs, no buts, do not pass “Go”, do not “collect £200”. But where does the term quarantine come from, what does it mean and are we “actually” using it correctly?

Everyone I see around the hospital asks me how the Microbiology department and the Microbiologists are coping. They are concerned that WE are flooded with work… and yes we are busy… BUT we are not frontline staff dealing with acutely sick patients or GPs in primary care struggling to deal with Covid-19 whilst juggling all of their other patients!
 
I am especially in awe of how my primary care colleagues are dealing with Covid-19.
 
Primary care must be unbelievably hard right now. Not only are GPs still having to manage their normal case loads of chronic illnesses but they are also the first line of contact for many people who have been infected with SARS Coronavirus 2 (SARS Cov2). AND they are doing this remotely using telephone and videoconferencing!!! The Editor Chief in Charge (aka my wife) will tell you just how useless I would be at that… I don’t even own a smartphone; in fact I can barely use the TV remote control!

“We have a lady with puerperal fever. She’s 2 days post-delivery and pretty unwell. Critical Care are reviewing her now and we’d like some advice about the best antibiotics to give her” said the Obstetrics Registrar.
 
Excellent thought the Microbiologist; they’re being proactive about a serious problem.
 
“If she’s not allergic to anything then IV Benzylpeniciilin and Clindamycin. Have you looked for retained products and done a DNC?” asked the Microbiologist.
 
“She’s really unwell, we don’t really want to take her to theatre. We might damage the uterus” replied the Registrar.
 
“She’s unlikely to improve if you don’t,” said the Microbiologist sympathetically. “You need to remove as much infected material as you can. I know it sounds brutal but it’s really important”.
 
“Okay,” said the Registrar sounding doubtful, “my Consultant is with the patient at the moment so I’ll go and tell them what you have advised. Thanks for your help.”
 
The Microbiologist put down the phone and put down his pen. Time to visit the obstetric ward and see what is going on…

Happy Valentine's Day! The Love Virus is in the air...
“Chinese media are showing hardworking hero stories, it's Jeong Jae Pung’s wedding anniversary … ‘come home soon’ his sign says [according to the BBC reporter] … his wife is a nurse looking after virus patients and contact with the outside world is forbidden…” (BBC News at 10, 13/02/2020)

So what’s wrong with this picture?
The nurse is on a mobile phone wearing her PPE outside of the hospital, according to the UK’s guidelines it should be removed inside the patient’s room and why is she using her mobile phone?!

This breaches Infection Control policy in so many ways; leading to contamination of the hospital and the wider environment and also exposes this person and their family to the virus. She might as well not bother wearing the PPE at all.

This picture is so crazy it deserves a caption competition, no prizes, just the kudos for being the wittiest reader of the bug blog!
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Add your caption below or on Facebook :-)

It’s all over the news; a new deadly plague is spreading across the World in an unstoppable wave of death and disease! Cities are falling, governments are collapsing, mass panic and chaos are ensuing… or at least that’s what the media would have us believe about the novel coronavirus from Wuhan in China. Gosh, it’s reminding me of the game of Pandemic!