A Fishy Tale of Lumps and Bumps

boa constrictorWhen you think about potentially dangerous pets,  which animals spring to mind? Alligators? Boa Constrictors? Any of the “big cats”? Pit Bulls? Goldfish?

Goldfish? Really?!?  Well, according to a new study from Henry Ford hospital, fish may not be quite as benign as they seem. To be fair, it’s not the fish killer goldfishthemselves, but the water they swim in that may be harmful to health.

Researchers have shown that contaminated water in home aquariums can lead to a skin infection known as Mycobacterium marinum. The condition is characterized by reddish skin lesions or bumps on the hands or arms.

It’s difficult to diagnose and treat because skin lesions don’t appear for two to four weeks after contact with the bacteria, leading to delayed treatment and unnecessary and ineffective use of antifungal and antibacterial agents.

Complicating matters further is that patients fail to remember or mention the source of the exposure, which is often traced to them cleaning their aquarium. Infection results when bacteria in the non-chlorinated water attacks an open skin wound on the arm or hand.

mycobacterium marinumPeople just don’t know or think about their fish tank harboring this bacterial organism,” says George Alangaden, M.D., a Henry Ford Infectious Diseases physician and the study’s lead author.

And unless they’re directly questioned about it by their physician, who may or may not have adequate knowledge of Mycobacterium marinum and its prolonged incubation period, appropriate treatment often gets delayed.”

During the study, conducted between January 2003 and March 2013, researchers identified five patients ages 43 to 72 treated at Henry Ford for Mycobacterium marinum. Skin biopsies performed on all five patients confirmed the infection.

The incubation period before skin lesions appeared ranged from 11 to 56 days. While all five patients responded effectively to antibiotic treatment, it took on average a staggering 161 days from the time of initial presentation to time of treatment.

“Mycobacterium marinum is not a life-threatening illness, but it remains an unrecognized cause of skin infection,” says Dr. Alangaden. “To accelerate diagnosis and treatment, physicians are encouraged to ask detailed questions about the patient’s history, especially questions about potential exposure to aquariums.”

cleaning aquarium Or better still, may we suggest you wear gloves when cleaning out the tank!

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Wishing You a Safe and Healthy Thanksgiving

On the eve of Thanksgiving, we are thankful for many things not least you – our readers. So we’d like to help keep you and your family safe and healthy this holiday with a few seasonal safety tips.

While we all know the dangers of Thanksgiving over-indulgence, did you know that cooking, rather than eating is the number one cause of accidents and illness over the holiday!  So whether you plan on deep frying the turkey or stuffing it, here’s some basic advice to help keep you safe.

Food Poisoning 

  • Wash hands thoroughly when handling uncooked meat
  • Keep cooked and uncooked meats separate from each other…and other food
  • The turkey should be completely thawed before cooking
  • When oven cooking a turkey, the oven temperature should be no lower than 325°
  • Ideally, cook stuffing outside the turkey, but if you choose to stuff, make sure the stuffing reaches a minimum temperature of 165°

Burns 

  • Turkey fryers should always be used outdoors, on a solid level surface a safe distance from buildings and flammable materials.
  • Never use a fryer on a wooden deck, under a patio cover, in a garage or enclosed space.
  • Don’t overfill the fryer.
  • Never leave the fryer unattended because, without thermostat controls, the oil will continue to heat until it catches fire.
  • Never let children or pets near the fryer when in use or after use as the oil can remain hot for hours.
  • Use well-insulated potholders or oven mitts and safety goggles to protect from splatter.
  • Keep all-purpose fire extinguishers nearby.
  • If a turkey fryer fire occurs, call 911 immediately.
  • Avoid wearing lose clothes. A dangling sleeve can easily catch fire.
  • Make ovens and fryers a “Kid Free Zone”.
  • Keep pot handles toward the back burners to reduce risk of knocking pots over.

Cuts

  • Stay focused when slicing food.
  • Give the carving duty to the most experienced carver. No first timers allowed!

Heartburn – many people eat too much, too fast on Thanksgiving which can quickly cause heartburn, indigestion and create chest pain. This can feel like a heart attack which leads people to seek medical attention.

  • Eat slowly
  • Take breaks in between courses
  • Keep antacids on hand

A happy and healthy Thanksgiving to all!

Whoa, whoa, whoa, whoa – Washing at the Handwash!

A few years ago the Centers for Disease Control and Prevention (CDC) estimated that about 1.7 million patients get a hospital acquired infection each year. Of these, 99,000 die. More recently they estimated that infections develop in about 1 to 3 out of every 100 patients who have surgery.

Separately, a new study just presented at the annual meeting of the Association for Professionals in Infection Control and Epidemiology (APIC) found that preventing further complications in patients who develop infections after hip or knee replacement surgery could save the U.S. health-care system as much as $65 million a year.

Hardly surprising then, that the pressure is mounting to reduce hospital-acquired infections. Some of this is being driven by Medicare who has started reducing  payments for hospital readmissions.

Infection-prevention specialists are now focusing on new practices and products to minimize patient exposure from the environment as well as from medical procedures and surgical instruments.

For example, Baycrest Geriatric Healthcare System in Ontario, were able to reduce the rate of transmission for the staph infection MRSA by 82% over a 33-month period by bathing patients daily with germ-killing cloths.   The cloths are presoaked with a powerful antimicrobial agent – chlorhexidine gluconate, which reduces organisms on a patient’s skin and leaves a residue that lasts up to six hours.  Baycrest, also screens all patients on admission to determine if they are colonized with MRSA on the skin, indicating the organism is present on the body but not yet causing an infection.

Many other innovative  infection-prevention ideas were suggested at the APIC “film festival”, which featured short videos including music, drama, dance, humor and animation to promote adherence to best practices.

SRxA’s Word on Health particularly liked the winning video “Scrub-A-Dub Dub”, which features Jerry Herman a former patient from the All Children’s Hospital in St. Petersburg, FL, along with his twin brother, Josie.

The 10-year-old, who spent several months in the ICU, almost totally paralyzed by Guillain-Barré Syndrome, reinforces proper hand-washing technique among staff, patients and families.

Can a hip-hop song improve health?  We think maybe it can.

Now Wash Your Hands Please

Word on Health was horrified to learn that when you meet someone and shake their hand, there’s a one in five chance that they didn’t wash their hands after going to the toilet.

A recent study of 2,000 adults found that more than half did not clean up before eating and even more worryingly, 3:1 men and almost 1:5 women said they also often failed to wash their hands after going to the toilet.

Of those, almost a quarter said they were not worried about hygiene after using their toilet at home because they would only be picking up germs from other members of their family, while one in five said their hands already looked clean without the need to wash them under a tap.

Although 88% of those questioned could correctly name at least one food bacterium such as salmonella, E. coli or campylobacter, many did not realize how easy they were to pick up.

According to the Centers for Disease Control and Prevention (CDC) and leading public health officials, hand washing is the single most important method of preventing the spread of infection.

Perhaps it’s because hand washing is so basic that it’s often taken for granted. Yet the quantity and variety of germs that we carry on our hands everyday is astounding. Each square inch of our skin contains about 5,000 different bacteria.  When we forget to wash our hands, or don’t wash our hands correctly, we can spread these germs to other people.

The importance of hand washing cannot be overstressed. It is so simple and yet forgetting to do it can have such serious consequences.” says Sir John Krebs, chairman of the UK’s Food Standards Agency.

And it’s not just children or the general public that forget to wash their hands, seems health workers are just as guilty.  In the US it is estimated that hand washing alone could prevent 20,000 patient deaths per year. Despite this, studies have shown that hand washing compliance among health-care workers is poor.

Things, it seems, are so bad that  Loyola University Health System has just hosted a forum led by hand-hygiene authority Professor Didier Pittet, MD, MS, and President of The Joint Commission Mark R. Chassin, MD, FACP MPP, MPH.

This forum was designed to educate healthcare leaders about proper hand washing techniques as well as provide strategies to overcome challenges to achieving a highly effective hand-hygiene program.

For those of you who missed the forum, SRxA’s word on Health is pleased to bring you some simple hand hygiene tips:

Always wash your hands before:

  • Preparing food
  • Eating
  • Treating wounds or giving medicine
  • Touching a sick or injured person
  • Inserting or removing contact lenses

Always wash your hands after:

  • Preparing food, especially raw meat or poultry
  • Using the toilet
  • Changing a diaper
  • Touching an animal or animal toys, leashes or waste
  • Blowing your nose, coughing or sneezing into your hands
  • Treating wounds
  • Touching a sick or injured person
  • Handling garbage or something that could be contaminated, such as a cleaning cloth or soiled shoes

Of course, it’s also important to wash your hands whenever they look dirty…or before you come to shake one of ours!

For more on hand hygiene we suggest you check out the CDC’s Clean hands save lives site.