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PubMed1989

Haemophilus influenzae type b in respiratory secretions.

Oral and respiratory secretions of 31 children who were healthy or had mild upper respiratory infection, and who had a positive throat culture for Haemophilus influenzae type b, were cultured to determine which secretions contain this organism and how long it can be recovered from fomites. Rhinorrhea was present in 11 of 31 (34%) children and nasal mucus was positive for H. influenzae type b in 10 (91%). In 5 of these children the concentration of H. influenzae type b in nasal mucus was 10(4) to 10(7) colony-forming units/ml3. H. influenzae type b in nasal mucus applied to fomites were recovered for 12 hours. Cultures of saliva and cough secretions compared with nasal mucus were less often positive (3 of 31, P less than 0.001; 3 of 25, P less than 0.001, respectively) and contained fewer H. influenzae type b (5 and 15 colony-forming units, respectively). H. influenzae type b was recovered from the hand of 2 of 27 (7%) children; both children had positive cultures of saliva. These data indicate that H. influenzae type b can be found in oral and respiratory secretions of pharyngeal carriers and can contaminate children's hands. Nasal mucus was the most consistently positive secretion and contained the largest number of bacteria. Careful management of nasal mucus secretions is warranted in settings where transmission could occur to susceptible children.

Child↗

PubMed1995

Chlamydia trachomatis can be transmitted by a nonporous plastic surface in vitro.

Chlamydial conjunctivitis is a disease associated with venereal transmission through direct sexual contact or autoinoculation with genital secretions. Appropriate therapy for patients and their sexual partners involves important questions regarding the source of infection and mode of transmission. This study explored the potential role of a fomite, i.e., an environmental surface, as a possible vector of transmission. We determined the in vitro recovery of Chlamydia trachomatis from a nonporous plastic surface under ambient and humid conditions using the standard shell vial technique and confirmation by direct monoclonal immunofluorescence. Under ambient conditions, the TP50 (time at which 50% of samples were positive for Chlamydia) was 5 min, with complete desiccation occurring at 45 min. Under humid conditions, the TP50 was 52.5 min and complete desiccation did not occur up to 3 h. Beyond 45 min, a significantly greater number of positive chlamydial samples were collected under humid conditions (11 of 30) than under ambient conditions (0 of 30) (p = 0.00016). We conclude that a fomite, such as a nonporous plastic surface, may serve as a potential vector for the transmission of chlamydial infection to the eye, especially under humid conditions. This new information may prove useful in counseling patients and their sexual partners.

Chlamydia trachomatis↗

PubMed2005

Colonization of Yankauer suction catheters with pathogenic organisms.

Oral suction devices may be fomites for nosocomial infections. This study was designed to evaluate the rate of contamination of Yankauer suction catheters. Among the 20 catheters tested, 16 (80%) yielded cultures for pathogens. Seven (35%) were colonized with multiple pathogens. Among the organisms encountered included methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). These devices should be handled and stored with appropriate care.

Bacteria↗

PubMed2006

Blood pressure cuffs: friend or foe?

A study to assess the level of bacterial contamination of blood pressure cuffs in use on hospital wards was performed. Viable organisms were recovered from all the 24 cuffs sampled at a density of between 1000 and >25 000 colony-forming units/100 cm2. Potential pathogens were isolated from 14 cuffs (58%). Eleven cuffs grew a single pathogen and three cuffs grew a mixture, yielding a total of 18 isolates. Meticillin-susceptible Staphylococcus aureus was isolated from eight (33%) cuffs, meticillin-resistant S. aureus was isolated from two (8%) cuffs and Clostridium difficile was isolated from eight (33%) cuffs. This study serves as a reminder that hands are not the only fomite to go from patient to patient on hospital wards, and that measures should be taken to reduce the risks posed by blood pressure cuffs.

Bacterial Infections↗

PubMed2006

Survival of meningococci outside of the host: implications for acquisition.

Meningococci are regarded as being unlikely to survive outside of their human host although this has possibly been more assumed than demonstrated. Seven strains of meningococci were tested for their ability to survive on glass or plastic while retaining expression of their capsule and important outer membrane proteins. A known number of colony-forming units of each strain were dried onto glass and onto plastic and tested for viability over time. Survival on glass was significantly better than on plastic (P<0.0001). Isolates of the New Zealand epidemic strain, B:4:P1.7-2,4 survived better on glass than all other strains tested. Recovered isolates still expressed their capsules and outer membrane proteins. These findings raise the question of whether meningococci can be transferred from person to person via fomites contaminated with oropharyngeal secretions containing meningococci.

Bacterial Capsules↗

PubMed2004

Contamination, disinfection, and cross-colonization: are hospital surfaces reservoirs for nosocomial infection?

Despite documentation that the inanimate hospital environment (e.g., surfaces and medical equipment) becomes contaminated with nosocomial pathogens, the data that suggest that contaminated fomites lead to nosocomial infections do so indirectly. Pathogens for which there is more-compelling evidence of survival in environmental reservoirs include Clostridium difficile, vancomycin-resistant enterococci, and methicillin-resistant Staphylococcus aureus, and pathogens for which there is evidence of probable survival in environmental reservoirs include norovirus, influenza virus, severe acute respiratory syndrome-associated coronavirus, and Candida species. Strategies to reduce the rates of nosocomial infection with these pathogens should conform to established guidelines, with an emphasis on thorough environmental cleaning and use of Environmental Protection Agency-approved detergent-disinfectants.

Bacterial Infections↗

PubMed2005

Dementia-specific risks of scabies: retrospective epidemiologic analysis of an unveiled nosocomial outbreak in Japan from 1989-90.

BACKGROUND: Although senile dementia patients in long-term care facilities are at leading risk of scabies, the epidemiologic characteristics of this disease have yet to be fully clarified. This study documents the findings of a ward-scale nosocomial outbreak in western Japan from 1989-90, for which permission to publish was only recently obtained. METHODS: A retrospective epidemiologic study was performed to identify specific risk factors of scabies among patients with dementia. Analyses were based on a review of medical and nursing records. All inpatients in the affected ward at the time of the outbreak were included in the study. Observational and analytical approaches were employed to assess the findings. RESULTS: Twenty of 65 inpatients in the ward met the case definition of scabies. The outbreak lasted for almost 10 months and as a result, the spatial distribution of infections showed no localized patterns in the latter phase of the outbreak. The duration of illness significantly decreased after initiation of control measures (P = 0.0067). Movement without assistance (Odds Ratio [OR] = 11.3; 95% Confidence Interval [CI]: 2.9, 44.8) and moving beyond the room (but within the ward) (OR = 4.1; 95% CI: 1.4, 12.5) were significantly associated with infection, while types of room (Western or Japanese) and sleeping arrangement (on beds or futons laid directly on the floor) appeared not to be risk factors. CONCLUSION: Univariate analysis demonstrated the importance of patients' behaviours during daily activities in controlling scabies among senile dementia patients. The findings also support previous evidence that catching scabies from fomites is far less common. Moreover, since cognitive disorders make it difficult for individuals to communicate and understand the implications of risky contacts as well as treatment method, and given the non-specific nature of individual contacts that are often unpredictable, real-time observations might help improve control practices.

Aged↗

PubMed2006

Survival of two avian respiratory viruses on porous and nonporous surfaces.

The transmission of pathogens from infected to susceptible hosts may occur through contaminated fomites and inanimate objects. This type of transmission depends on the ability of the pathogens to survive in the environment. In this report, we describe the survivability of two avian respiratory viruses, e.g., avian metapneumovirus and avian influenza virus on 12 different porous and nonporous surfaces. The viruses survived on some of the surfaces for up to 6 days postcontamination but not after 9 days. Both viruses survived longer on nonporous surfaces than on porous ones. One of the reasons for poor survival on porous surfaces could be inefficient elution of virus from these surfaces. These results should be helpful in determining how long the premises should be left vacant after an outbreak of these viruses has occurred in poultry houses.

Animals↗

PubMedDate not supplied

SARS: the new challenge to international health and travel medicine.

Severe acute respiratory syndrome (SARS), the first severe new infectious disease of this millennium, caused widespread public disruption. By July 2003, 8427 probable SARS cases had been reported from 29 countries with a case fatality rate of 9.6%. The new febrile respiratory illness spread around the world along the routes of international air travel, with outbreaks concentrated in transportation hubs or densely populated areas. The etiologic agent was identified as a novel coronavirus, SARS-CoV. The disease is transmissible person-to-person through direct contact, large droplet contact and indirect contact from fomites and unwashed hands. Saudi Arabia successfully prevented the entry of the disease by imposing travel restrictions, special entry requirements, screening procedures at airports, including temperature checks, and quarantine. Ongoing efforts are aimed at developing case investigation, case management and surveillance protocols for SARS.

Aviation↗

PubMed1990

The use of hygiene, cohorting, and antimicrobial therapy to control an outbreak of shigellosis.

Shigellae are easily transmitted in day-care centers to children and adult staff by contamination of diaper-changing surfaces and fomites or directly from person to person. Appropriate antimicrobial therapy may shorten the duration of diarrhea caused by shigellae and eliminate the organism from the feces. Current recommendations of the American Academy of Pediatrics and the American Public Health Association are that infected children be isolated until three and two, respectively, consecutive stool cultures are negative. We utilized a disease control strategy based on use of antibiotics to control diarrheal symptoms and reduce infectiousness, cohorting of asymptomatic infected children in the center, and scrupulous attention to hygiene and environmental cleanliness. This strategy was effective in stopping transmission, was more practical than some of the measures now recommended by the American Academy of Pediatrics and the American Public Health Association, and was well accepted by parents and center staff. The strategy should be evaluated in other day-care settings.

Adult↗

PubMed1996

Patients infected with high-hazard viruses: scientific basis for infection control.

Most of the viral hemorrhagic fevers (VHFs) are caused by viruses that are handled in high containment laboratories in Europe and the United States because of their high pathogenicity and their aerosol infectivity. Special precautions should be taken when caring for patients infected with these viruses, but most hospitals can safely provide high-quality care. The major danger is parenteral inoculation of a staff member. Fomites and droplets must be considered as well. The role of small particle aerosols in inter-human transmission continues to be controversial. We believe that the aerosol infectivity observed for these viruses in the laboratory and the rare clinical situations that suggest aerosol spread dictate caution, but the many instances in which no transmission occurs provide a framework in which a measured approach is possible. The major challenge is in early recognition by an educated medical staff and rapid specific etiological diagnosis.

Aerosols↗

PubMed1988

An outbreak of Trichophyton tonsurans dermatophytosis in a chronic care institution for the elderly.

A nosocomial outbreak of dermatophytosis caused by Trichophyton tonsurans var. sulfureum subvar. perforans is reported in a nursing home for the elderly. The outbreak affected six residents and persisted for nine months despite remedial medical and sanitary measures. In a survey designed to determine the potential role of fomites in disease transmission, 129 environmental sites were sampled. A high proportion (22.3%) of the samples yielded T. tonsurans, including samples from beds, floors, and washroom facilities. Methods for the control of dermatophyte outbreaks in chronic care institutions are discussed.

Adult↗

PubMed1987

Transmission and control of rhinovirus colds.

With the expanding knowledge of rhinovirus transmission and rhinovirus chemistry, the outlook for control of infections with these agents has brightened considerably. Although rhinoviruses are probably the world's leading cause of respiratory illness, they are surprisingly reluctant transmitters, infecting only about 50% of susceptibles in family-like settings. Current research suggests that rhinoviruses are spread chiefly by aerosol, rather than by fomites or personal contact. It has been possible to interrupt rhinovirus transmission completely by careful use of virucidal facial tissues, which, presumably, smothered aerosols generated by coughing, sneezing and nose blowing. Accordingly, it may be feasible to control rhinovirus (and perhaps other virus) dissemination by appropriate air handling and filtration systems in combination with careful nasal sanitation. Anti-rhinovirus drug development is also moving forward. Although there are over 100 rhinovirus serotypes, it has been found that most rhinoviruses attach to a single cell receptor by a single binding site on the virus. Also, the structure of the rhinovirus capsid is now known at the atomic level. These two pieces of knowledge about basic viral architecture appear to open new vistas for reasoned synthesis of antiviral drugs, and some promising compounds are now under investigation. Even interferon has been demonstrated useful in a family setting. On several research fronts, there are good grounds for optimism about control of rhinovirus colds.

Ascorbic Acid↗

PubMed1990

Dermatophytosis of the scalp: incidence, immune response, and epidemiology.

Tinea capitis remains a common infection among the pediatric population of North America. The 'gray patch' Microsporum audouinii infections of the 1950's have been supplanted by the 'black dot' ringworm of Trichophyton tonsurans. The clinical presentation of T. tonsurans infection is quite variable and may be related to specific host T-lymphocyte response. This dermatophytosis is most frequently incurred from contact with an infected child either directly or via a variety of fomites. Current studies indicate that an asymptomatic adult carrier state may also exist which could contribute to the morbidity of this mycosis.

Humans↗

PubMed1988

Mousepox in inbred mice innately resistant or susceptible to lethal infection with ectromelia virus. IV. Studies with the Moscow strain.

The pathogenesis and transmission of infection with the Moscow strain of ectromelia virus were studied in inbred mice. BALB/cAnNcr had high morbidity and mortality and C57BL/6Ncr (B6) mice had high morbidity and low mortality. Virus was detected in B6 mice for 2 weeks after subcutaneous (s.c.) inoculation and infected mice developed lesions compatible with acute mousepox. B6 inoculated by footpad transmitted infection to cagemates for up to five weeks and soiled cages that had housed infected mice were infectious for three weeks. S.c.-inoculated B6 mice also transmitted by contact for 2 weeks. Transmission was attributed to oronasal excretion of virus. Airborne transmission of infection between adjacent cages occurred at a low rate. Ectromelia virus-free progeny were derived from previously infected dams. These studies indicate that the highly virulent and infectious Moscow strain of ectromelia virus caused self-limiting infection in inbred mice and that direct contact is the most efficient means of transmission. These findings support the concept that mousepox can be contained by husbandry practices that minimize or eliminate the spread of infection by direct contact or fomites.

Animals↗

PubMedDate not supplied

An outbreak of molluscum contagiosum in a kibbutz.

Molluscum contagiosum is a viral disease that presents in a primary care setting as single or multiple wart-like lesions. We have seen an outbreak of Molluscum contagiosum in a small rural community, affecting 34 individuals. The most infected were children two-to nine-years-old. The diagnosis was made on clinical grounds. Spread appeared to be as a result of direct contact and by fomites. There was no evidence, in our study, of spread via swimming pool. Cryosurgery was used to treat our patients with Molluscum contagiosum.

Adolescent↗

PubMed1986

[Transmission of Trichomonas vaginalis in swimming pools?].

Trichomonas vaginalis could not be isolated from the water of a highly frequented swimming pool of the City of Zurich. The protozoon T. vaginalis may show a slight degree of motility; even after 20 minutes exposure to the chlorinated water of a swimming pool; but it looses its infectivity within seconds after exposure to water of the swimming pool. It is not yet known how trichomonads are able to survive in the secretions of the vagina and on contaminated objects (fomites) in dressing rooms.

Female↗

PubMed2003

Severe acute respiratory syndrome (SARS).

Several cases of life threatening respiratory disease with no identifiable cause were reported from Guangdong Province, China; these were soon followed by reports from many other countries. The disease was named as severe acute respiratory syndrome (SARS). A novel coronavirus, isolated from the respiratory secretions of patients, has been implicated in the causation of SARS. The modes of transmission include droplet spread, close contact, and Fomites; shedding of virus from respiratory tract is the primary mode of transmission. SARS clinically presents with high-grade fever, chills and rigors, myalgia, headache, cough with or without sputum production, dyspnea, and dizziness. Chest radiographs reveal unilateral or bilateral, predominantly peripheral, areas of consolidation progressing with in a short time of bilateral patchy consolidation. Preliminary reports suggest a milder illness in young children. The case definition of probable SARS cases, laboratory investigations and precautions for prevention of spread are discussed.

Communicable Diseases, Emerging↗