As reported by heraldsun.au.com, all but one patient treated at Australia’s Bundaberg Hospital dental health clinic has returned a negative result for blood-borne viruses.  The treatment stemmed from a problem which occurred in the cleaning process of dental instruments.  Some of the instruments used were thought to be unsterile, and thus, tests were carried out to see if an infectious viral disease was passed on to any of the patients.  This makes you wonder whether or not the dentists were using high quality disinfectant sprays or wipes.  Before going any further, I will simply say that it’s always important to use a medical grade disinfectant.

Original Source: Herald & Weekly Times

The results for the final patient are expected tomorrow.  Thirty-three patients were treated at Bundaberg Hospital’s dental health clinic on November 6, the day a problem occurred in the cleaning process for dental instruments.   Two were not treated with instruments, but Queensland Health tested the remaining 31 patients for Hepatitis A, B and C and HIV.

The tests were done to determine whether any of them might have passed on an infectious viral disease to anyone of 235 patients treated the following week.   Queensland Health initially said the 31 patients visited the clinic “prior” to the bungle occurring.   However, yesterday, they admitted some of the 31 patients may have also been operated on with unclean instruments, as it is believed the cleaning mishap occurred at about 10am (AEST) on November 6.

Queensland Health director-general Mick Reid said the issue had been complex, but admitted his department should have been more clear in communication.   “While we are confident there is a very minimal risk to patients, we know this is a difficult time for them,” Mr. Reid said.  He said he would be placing the highest importance on getting to the bottom of what occurred.  “What occurred was not good enough and I apologize for any confusion and distress caused by this episode,” he said. “Yesterday I directed that Queensland’s chief dental officer assume operational control of the oral health services for the northern cluster of the Sunshine Coast-Wide Bay Health Service District, while the issues that have arisen are examined.  I hope that this action will go some way to restoring the community’s confidence in the services provided by the Bundaberg oral health service.”

This article reminds us that it’s always important to be sterile.  Keeping clean can usually be as simple as using a high grade disinfectant spray or even disinfectant wipes.  It is important to use a medical grade disinfectant – one that is certified to kill H1N1, MRSA, Hepatitis, HIV, and other bacteria and viruses.  Most over the counter disinfectants are not strong enough to kill these germs.  Remember, a good disinfectant cleaner can mean the difference between passing and not passing a deadly disease.  Stay sterile and use high grade spays and wipes.

The second case of an H1N1 infected cat surfaced in Utah last week.  The cat’s owner tested positive for H1N1 swine flu, also.  This is believed to be the second case of an H1N1 infected cat in the area.  There is now cause for concern, as it is feared that infected cats can transmit swine flu to not only other cats, but to human beings as well.  Preventing the spread of this virus might prove more difficult that we first thought if house pets such as cats (and perhaps dogs) can carry and pass the strain.

Like the first cat reportedly diagnosed with H1N1 (in Iowa), this most recent situation involved an older female cat – a spayed female, much like the one from the first case.  Dr. Carl Prior, owner of the Park City Animal Hospital, was one of the people who initially treated the cat.  He stated that the cat presented heavy breathing issues and that its apparent illness seemed quite serious; “I was thinking pneumonia or cancer of the lungs,” he said.  “It (the cat) looked so sick.”

Upon arrival, blood work was performed on the cat.  It was then placed in an oxygen chamber set to about 50%.  Over the next four to five hours, the oxygen percentage was decreased.  The veterinarian later took X-rays of the cat’s blood samples – which showed low white blood cell counts.  An influenza A/B type test (typically used on humans) also came back positive, according to Prior.  Prior didn’t immediately assume H1N1, but began thinking about the first Iowa cat that had been infected; at least one of the cat’s owners was suffering from influenza and another occupant of the house had contracted the H1N1 virus.

A test conducted at Iowa State University came back seropositive, so more samples were sent in for screening (including a PCR test – which came back negative).  Iowa State veterinarians were surprised at the negative result, but, indicated that the first cat had tested the same way.  More testing will be needed before any definite conclusion can be released.

Dr. Carl Prior suggested that the virus is probably not shed for very long, adding that a second blood test confirmed an H1N1 infection in the cat.  The cat’s health improved after several hours of antibiotics and oxygen care, and it did not have to be hospitalized overnight.  Park City Animal Hospital vets will continue to monitor the cat, and test another cat from the same household to see if there is a link.  “It hasn’t shown any signs on illness,” Prior explained, though he does plan to monitor the animal and stay alert to the possibility of a cat-to-cat and cat-to-human H1N1 transmission.

Safeguard yourself.  Try DCA Disinfectant Spray – this commercial grade disinfectant kills H1N1, HIV, MRSA and many other viruses and bacteria.

The Department of Health has conducted an interesting study on the risks of Creutzfeldt Jakob Disease (CJD) transmission; through the use of dental and orthodontic instruments.  Based on a pre-existing model for surgical instruments, the analysis shows a number of uncertainties in the realm of dentistry.

If a patient is recognized as high risk for CJD disease (has CJD symptoms), instruments used on the individual must be selected with special care.  These instruments should always be sterilized, quarantined, and if absolutely necessary, destroyed.  The issue with instruments stems from the idea that they might unknowingly be used on someone carrying the disease, or a CJD variant.  If this were to happen, two potential infection routes exist.

1.  The possibility on transmitting the Jakob Creutzfeldt Disease infection through abrasions, typically of the patient’s lingual tonsils.   This route has been studied and applied in humans.  CDJ infectivity can also occur in other tissues (dental pulp, for example).  This type of transmission, though not yet studied in humans, has proven efficient in animal studies.

2.  Some instruments used in oral surgeries, such as reamers and files, can sometimes carry significant material residues – even after washing.  Transmission risks would most certainly be present if any remaining residue carries CJD disease.

While there are definite risks to patient, the chance of Creutzfeldt Jakob Disease transmission through tonsil invasion is fairly minimal.  However, if tissues such as dental pulp were to be infected, the risk of transmitting the disease would increase significantly.  The risk to the public in general, of course, would depend critically on the initial prevalence of CJD disease and the number of invasive dental procedures carried out in a given period.  The ratios at this point are not yet clear, but, we can conclude that transmission through dental tools is much less likely than infection through surgical instruments.

Reducing the risk of vCJD spread starts with dental and orthodontic instrument decontamination.  Though most current methods cannot remove the threat completely, they will greatly decrease the amount of risk posed.  Other simple ways to reduce risk of infection include the utilization of single-use instruments and medical grade disinfectants.

The qualifications of this study are based on a couple of factors.  For one, the decontamination and disinfectant procedures of standard dental offices isn’t much less effective than the researchers assumed (the assumptions are provided as fairly conservative estimates for CDJ infectivity).  Second, is the area of uncertainty, since we are still not completely certain which types of tissues carry the disease, and what tools and instruments carry the highest risk of infection.  Therefore, it remains extremely important to monitor decontamination practices, and, to use a medical grade disinfectant spray whenever possible to decrease the risk of infection.  As a side not, the information contained in this study was tabulated by the UK Department of Health.

Swine flu can affect the dental office just as easily as anywhere else. With information obtained from the CDA website (below), we have come up with some suggestions and best practices for preventing the spread of H1N1 in the dental office.  Respiratory cough etiquette, along with disinfectant precautions, are currently recommended for preventing the transmission of swine flu in a dental health care setting. CDC is working very closely with officials in states where human cases of H1N1 have been identified, as well as with health officials in Mexico and Canada. Using medical grade disinfectant sprays, such as DCA disinfectant spray, will kill H1N1 Swine Flu, MRSA, TB, HPV, HIV-1 (AIDS Virus) and more.  The spray is also safe for all areas of your practice – the exam room, all hard surfaces, tools and instruments, and all patient care rooms.  Below, is more information on suppressing H1N1 Swine Flu in the dental and orthodontic setting.

What should I do if a patient is present for a routine checkup, and has respiratory symptoms?

If the dentist suspects the illness could be due to swine flu (fever, body aches, runny nose, sore throat, nausea, or vomiting are all symptoms), elective dental treatment should be stalled and the patient should be instructed to contact their health care provider. The health care provider will determine whether influenza testing or treatment is necessary. Be sure to sterilize and disinfect any instrument or surface touched by the patient with a proper grade disinfectant spray.

How would you handle a situation where the patient has symptoms, but requires urgent dental care?

If necessary dental care is required and the swine flu virus has either been confirmed or suspected, the care should be provided in a facility (hospital with dental care capabilities) that provides airborne infection isolation (airborne infection isolation rooms with negative pressure air handling).

For aerosol-generating procedures, use a procedure room with negative pressure air handling. Personnel providing direct patient care for suspected or confirmed swine influenza A (H1N1) cases should wear a fit-tested disposable 3M N95 mask (respirator masks) when entering the patient room and when performing dental procedures. Respirator use should be in the context of a complete respiratory protection program, in accordance with Occupational Safety and Health Administration (OSHA) regulations.

What if someone of your staff reports to work with acute respiratory symptoms?

Staff experiencing influenza-like-illness (fever with cough or sore throat) should not report to work.   Staff who experience these symptoms and wish to seek medical care should contact their healthcare provider to report the illness before seeking care at a clinic, physician’s office, or hospital. Workers who were not using appropriate personal protective equipment during close contact with a confirmed, probable, or suspect case of swine flu (H1N1) virus infection during the case’s infectious period should receive chemoprophylaxis according to CDC guidance.  Finally, employees who have difficulty breathing or shortness of breath, or are believed to be severely ill, should seek immediate medical attention.

With the proper preventative measures, issues surrounding swine flu and H1N1 infection can be controlled.  Using proper cough etiquette, n95 masks (one of the best swine flu masks), and high grade disinfectant sprays, can go a long way in preventing the spread of H1N1 swine flu in the dental setting.  If you are a dentist or work in a dental office, it might even make sense to get a swine flu vaccine for further prevention.  Read more about our high grade DCA Disinfectant Spray, and sterilizing Disinfectant Wipes.  At this point, a high grade disinfectant cleaner or hospital disinfectant might be your best bet for protection against H1N1.  You might also want to look into the DCA Disinfectant Ear Loop Mask.

In an article taken from the Daily Pilot, we learn that the H1N1 virus is starting to effect schools across the United States.  The swine flu virus can be protected against with the help of 3M N95 Maks.  However, if you’d rather not use a surgical mask, you should look into DCA’s Disinfectant Spray.  Our line of Disinfectant Sprays can be used to kill the H1N1 flu and a number of other viruses.  Use the disinfectant on dental instruments, medical supplies, surgical tools, and on any hard surface.  For more on H1N1 and its effect on US schools, read on…

As the H1N1 influenza virus, or swine flu, begins to affect area schools, administrators and teachers are trying to get the word out on how to stop the flu from spreading.

Twenty UC Irvine students have contracted swine flu since Sept. 1.

As of Tuesday, two schools in the Newport-Mesa Unified School District — College Park Elementary in Costa Mesa and Lincoln Elementary in Corona del Mar — have seen more than 10% of their students call in absent since late last week. However, school and district officials Tuesday couldn’t say for sure whether an H1N1 outbreak was the cause of the high number of absences.

At College Park, 13 out of 18 students in one second-grade class either called in sick or were sent home sick. Forty-eight students school-wide were out sick Friday.

For College Park Principal Julie McCormick, fears of such an outbreak have hit her personally; her daughter, a Corona del Mar High School student, was diagnosed with swine flu Tuesday.

“She’s doing fine,” McCormick said. “And the second-grade class is recovering. We’re very, very cautious about sending them back before they’re completely well. There’s no reason to risk relapse. People’s health is what matters most.”

McCormick said teachers and staff are emphasizing clean habits like washing hands frequently, and no touching above the neck.

School representatives called every parent to calm them down and talk about the situation in their native language, McCormick said; 65% of College Park parents speak Spanish. Letters went home in English and Spanish; the latter version was crafted Monday by the district’s translator.

PTA President Michelle Pommier “cleaned out the shelves at Target” to buy large bottles of hand sanitizer for every classroom, she said.

And the district sent three maintenance and operations workers to College Park Friday to sterilize every door handle, counter top, faucet and desktop, McCormick said.

Both students and staff have contracted swine flu this school year, but exact numbers are unavailable, district spokeswoman Laura Boss said. There have been no reports in the district of fatalities or severe illnesses, she said.

“This is an issue that affects us all, so we feel strongly about keeping our schools and public informed,” Boss said. “Every appropriate precaution advised by the OC Health Care Agency is being followed.”

At this time, the district is not planning to shut down schools, Boss said. The Centers for Disease Control and Prevention in Atlanta does not recommend that schools close during outbreaks, except as a last resort.

In the case of either a 10% overall absence rate or a 20% within-class absence rate, a school nurse is required to contact the County of Orange Health Care Agency to discuss how to proceed, the district said. The district also is notified; it has a team in place that represents health services, communications, human resources, emergency planning and administration, Boss said.

The school also sends a letter home to parents that details symptoms to watch for, high-risk groups, and tips to prevent the flu’s spread. College Park parents whose children were in the affected second-grade class received letters Friday; all other students were sent home Monday with letters. Lincoln Elementary students took letters home Tuesday.

Students or staff who appear to have a fever or other flu symptoms will be sent home and asked not to return until they’ve been fever-free for 24 hours without the aid of fever-reducing medicines like acetaminophen, Boss said.

The district also recommends that students and staff who develop flu symptoms, such as fever with a cough or a sore throat, stay home and follow the same procedure.

The district has its own swine flu information center at nmusd.ca.schoolloop.com/swineflu.

Sick anteaters

UC Irvine has developed similar protocols for its own sick students.

“As of Sept. 1, the UCI Student Health Center has confirmed 20 students as having H1N1 this quarter. From April to September, there have been 76 cases on campus,” said Tom Vasich, UCI’s assistant director of health services. More than 25,000 students attend the school.

The university is unable to confirm how many students have the virus; all information to date is anecdotal, Vasich said, but the university’s human resources department is collecting data.

Student Health Center representatives say that the H1N1 flu symptoms reported to date have been mild.

UCI dorm residents use a door hanger to indicate that they’re sick, Vasich said. Students on campus are encouraged to stay isolated in their rooms while they recover. Those with roommates are either transferred to an empty room, or the roommate is relocated while the sick student recovers. The sick students are monitored and given instructions for self-care, Vasich said.

The first week of school was Flu Prevention Week, and students and staff are sent campuswide e-mails alerting any news.

“We are telling people, ‘If you feel like you’re getting the flu, go home.’ And practice good hygiene — cover that cough, wash those hands,” Vasich said.

A large-scale vaccination program is in the works at UCI for those on the CDC’s priority list. The vaccine is expected later this month.

Just the facts

Swine flu, like other influenza viruses, is spread person-to-person through coughing and sneezing. Symptoms can include fever, cough, a sore throat, body aches, headaches, chills and fatigue, the district said. Vomiting or diarrhea also may occur. The majority of people who contract swine flu — as in any type of influenza — only develop a mild to moderate form of the disease, and feel better within three to five days.

High-risk groups include pregnant women; those with chronic health conditions like asthma, heart or metabolic diseases or a suppressed immune system; those younger than 5, particularly infants; and those 65 and older. If high-risk individuals develop flu symptoms, experts recommend that they call their doctor and consider antiviral medications.

Many pediatricians and doctors aren’t offering tests to diagnose swine flu, due to its ubiquity.

The virus survives only two to eight hours outside the human body, county health officials said, and is not difficult to kill. Specialty cleaning products and vigorous scrubbing are not required.

The H1N1 flu vaccine is expected to be available later to this month. To see if flu vaccines are available, call your doctor or the Orange County Health Care Agency Health Referral Line at (800) 564-8448, or visit ochealthinfo.com.

How To Prevent Spreading Germs

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. If no tissue is available, cough into your elbow.

• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.

• If you get sick, stay home from work or school and limit contact with others to keep from infecting them.

• Try to avoid close contact with sick people.

• Avoid touching your eyes, nose or mouth. Germs spread this way.

• Do not share personal items such as towels or utensils.

• Routinely clean items or surfaces that are frequently touched (use your normal cleaning products).

Source: Newport-Mesa Unified

Get the DCA Disinfectant Ear Loop Mask.

As a dentist or orthodontist, it is important to be aware of the H1N1 virus and the dangers it can carry.  Using the proper type of mask can help to stop the spread of swine flu and also keep you and your patient’s healthier long term.  The following article will explain N95 masks and their role in slowing the swine flu epidemic.

How serious is the risk of the H1N1 swine flu? The H1N1 Virus, also known as “Swine Flu,” has already claimed the lives of some United States citizens.  Many in Mexico have been killed by the swine flu virus, as well, and the infection rates continue rise up each and every day.  How can you protect yourself from the H1N1 virus this cold season?  Many believe that an N95 mask can offer a viable shield.

There are many types of masks available that do not protect against the H1N1 flu.  Some surgical, isolation, and dental masks offer no protection from the swine flu pandemic.  In August of 2009, the CDC in collaboration with the WHO released a statement that suggested the N95 mask could be used as valid protection against the H1N1 Swine Flu Virus.

A 3M N95 mask is technically an n95 particulate respirator mask.  The N95 respirator mask is designed to provide protection from body fluid and blood penetration.  The National Institute for Occupational Safety and Health agrees with the above statement, as they also believe that the N95 masks works effectively against Swine Flu.  The N95 mask, when properly used, can filter germs from the breath and put a halt to the spread of the H1N1 virus.

According to information released by UCLA, N95 is made by various manufacturers under different names (the 3M N95 being one of many).  The “N95″ is a simple government efficiency rating indicating that the mask blocks just about 95% of all particles that are at least .3 microns in size.

When using a 3M N95 Respirator Mask, or any N95 masks, certain guidelines should be followed.  First off, the mask should be removed and discarded immediately if it becomes physically damaged.  Second, masks should be disposed of as “bio hazard” waste and the user should always wash their hands immediately upon disposal.  Masks are only effective if they fit properly and are worn according to instructions.  While wearing an N95 respirator mask, be sure to avoid touching the eyes and nose, also, as these can be quick routes to infection.

The N95 disposable mask comes in five different models and several designs.  The earloop facemask design offers a standard tie on surgical mask.  The N95 surgical dust mask helps to protect from not only germs and birdflu, but also airborne dust particles.  The N95 disposable filter mask is has an activated carbon filter, and can also protect against airborne allergens.  Finally, the 3M N95 Surgical Mask, perhaps the best of the bunch, has a flat fold three panel design which offers a most comfortable fit.  This mask can be used during surgery to help protect against airborne particulates.

Whichever N95 mask you decide on, it is important to follow instructions and insure that the fit is proper.  Even with a swine flu vaccine, the swine flu virus must be avoided proactively, and the n95 particulate mask might just be the best option.  It should be noted that Sklar Disinfectant Spray is another viable option for killing H1N1.  Also, try the DCA Disinfectant Ear Loop Mask on for size.

Sklar Lube™ is an easy-to-use, water soluble, non-silicone lubricant and rust inhibitor.  Unlike some rust removing products, this lubricant is actually a rust proofing product.  Regular lubrication is essential no matter which cleaning method is employed, but Sklar Lube™ offers rust protection and prevention at its best.  While most products simply offer a water based lubricant, oil lubricant or silicone spray, Sklar Lube™ is a true full service lubricant and rust inhibitor. 

As stated by the Federal Center for Disease Control, a thorough cleaning of sinks, toilets, doorknobs, and many other hard surfaces that people frequently touch is the first and most important step in preventing the spread of disease.

Though a good cleaning removes many of the germs living on these surfaces, the ones left behind soon begin to grow and re-accumulate. Therefore, to be safe most janitors also use a disinfectant or antiseptic product to kill the bacteria and viruses that are present. It usually isn’t possible to kill everything, including spores. Doing so would require the use of a sterilizer.

Most disinfectant spray products work by oxidizing the germs, breaking down their cell walls, or otherwise deactivating them. Different ingredients or combinations of ingredients kill different germs. Therefore you either need to select a disinfectant spray that works on the specific germs you are trying to get rid of, or, select a broad-spectrum product that works on all of the germs as an antiseptic.

How can you tell what germs a disinfectant product will kill? Check the container label or product fact sheets for an EPA Number. All commercially available disinfectants register their effectiveness claims with the Environmental Protection Agency.

In order to kill germs your disinfectant must stay wet on the surface for about 10 minutes. Because this time is longer than what most janitorial situations allow, a thorough pre-cleaning of the surface is very important before using products such as Lysol Disinfectant sprays or even a skin disinfectant.

For simple disinfection, clean the area thoroughly. Use a mild but effective spray disinfectant product, and use as little of it as possible. Always wear gloves and goggles to protect yourself from the antiseptic chemicals.

It is usually enough to use an institutional grade disinfectant product for daily hard surface maintenance. In addition, milder sanitization grade products may be used on carpets or in toilet tanks where the goal is to reduce germs.

In some cases you may need to deeply disinfect a part of your building or home.  In that situation, or if you are working in a health care setting, it is important to use a hospital grade disinfectant product. Such products accomplish a more thorough job and kill a broader range of pathogens.  These are typically used on medical supplies and surgical instruments.

Some products can be used as medical or dental spray disinfectants.  These are designed to disinfect appliances and surfaces in dental, medical, and orthodontic offices.  Most of these are non-toxic broad spectrum antiseptics that can be used on almost any surface.  These disinfectants are especially useful in labs and other areas where infection control is of the up most importance.  With dental and medical disinfectants, it is safe to clean the most delicate of items (use as a skin disinfectant), in addition to medical supplies and surgical instruments.

By: Paul Guenther

Sklar Disinfectant™

DCA offers a true broad spectrum disinfectant.  For use on the surfaces of inanimate objects.  Great for cleaning lights, tables, dental equipment, and other items.

Starting at $8.50/bottle