Blame the kids: 20 sick at Hong Kong kindergarten

The Centre for Health Protection (CHP) of the Department of Health is investigating an outbreak of acute gastroenteritis (AGE) at a kindergarten in Tseung Kwan O, and hence reminded the public and management of institutions to maintain personal and environmental hygiene against AGE.
The outbreak involves 20 students, comprising 13 boys and seven girls aged 2 to 5, as well as two female staff members, who have developed vomiting, diarrhea and fever since November 4. Among them, seven students and one staff member sought medical attention, while one was discharged upon hospitalisation. All affected persons have been in a stable condition.

Officers of the CHP conducted a site visit and provided health advice to the staff of the school concerning proper and thorough disinfection, the disposal of vomit, and personal and environmental hygiene.

Shigellosis outbreak in Flint, Mich. because people afraid to wash hands

Don’t eat poop (and if you do, make sure it’s cooked).

Wash your hands.

handwash_south_park2These are the basics of public health.

Most of us are taught from a very early age that hand-washing is an easy, essential way of keeping ourselves clean and healthy. But residents of Flint, Michigan and surrounding areas have been forgoing this common practice out of fear of the water’s toxicity. Genesee county, of which Flint is a the largest city, and the adjacent county of Saginaw combined have experienced an outbreak of 131 cases of Shigellosis (named after the bacteria that causes it, Shigella). It’s a bloody diarrheal disease transmitted via tiny amounts of contaminated fecal matter. It typically lasts about a week, but can also cause patients to feel like they have to go to the bathroom even when they have no more waste in their systems. Additionally, the US Centers for Disease Control (CDC) also notes that “may be several months before [patients] bowel habits are entirely normal.”

In 2013, there were just under five cases reported per every 100,000 people in America. The outbreak in Michigan far exceeds that number, and it’s likely because residents in the area are afraid to use their tap water, which was found to have toxic levels of lead, a heavy metal that can cause neurological problems when it builds up in the body, in 2015. Even though the water was deemed safe for consumption with a proper filter, people in the area are still scared to wash their hands at all, according to the Washington Post.

Instead, they’re cleaning themselves using baby wipes—aren’t nearly as effective as disinfectant as good old-fashioned scrubbing—which should take about 20 seconds to ensure that any potential pathogens are washed down the drain.

“Some people have mentioned that they’re not going to expose their children to the water again,” Jim Henry, Genesee County’s environmental health supervisor, told CNN.

 

Jersey restaurants’ 4-strike rule: Hamilton considers stiff fines, closure for failed health inspections

In an attempt to make sure restaurant workers are washing their hands and keeping the kitchen clean, Hamilton officials are preparing to bring the hammer down on restaurant owners who frequently violate health codes.

jon.stewart.handwashing.2002The township council on Tuesday is scheduled to introduce an ordinance that would stiffen penalties for restaurants with a history of failing health inspections, imposing fines as much as three times the current amount and imposing mandatory closures.

Under the current model, restaurants that receive a “conditionally satisfactory” rating, which denotes health issues that need to be addressed, are charged a $250 reinspection fee after each of their second, third and fourth consecutive violations.

After four consecutive violations, the restaurant is shut down until the violations are resolved. Kenji Fusion and China Grill were both shut down for brief periods earlier this year after failing three consecutive inspections.

Township health officer Jeff Plunkett said that some businesses do not take the $250 fee seriously: One owner simply tried to hand a health inspector $250 in cash from his wallet.

“We’ve come to the conclusion that people just pay it,” Plunkett said in February.

The new ordinance would impose steps in the reinspection fees: $250 on the second consecutive offense, $500 on the third and and $750 on the fourth. After four consecutive offenses, the township will shut down the restaurant for a minimum of two days — even if the violations are resolved quickly.

“You keep trying to educate the ownership that they have a responsibility to every customer who walks through their door. It cannot be taken lightly.”

You can hold my koala but not wash your hands

Sunday in Brisbane (that’s in Australia) was a perfect chance to discover the local wildlife: kangaroos and koalas at the Lone Pine Koala Sanctuary. Emma and Sorenne were overly excited by the opportunity. When it was their turn to get their photo taken with the koala, however, I noticed the sign on the hand sanitizer station saying, “Out of Order. Sorry for any inconvenience.” As we exited the area into the food court, Emma grabbed some sanitizing wipes that were available (but unmarked and almost not noticeable) on a table and cleaned up Sorenne’s hands the best she could.

After our afternoon “tea” (that’s Australian for “snack”), we headed into the Kangaroo Rescue area. For $2 I bought a rather large bag of kangaroo feed, and we proceeded to shove our hands into the faces of every kangaroo who passed by. Emma was brave and lay down on the ground to pose with one of the big boys. For me the highlight was either seeing a pregnant mommy ‘roo whose joey was wiggling about in her pouch or watching Sorenne’s face light up when the baby kangaroos ate from her hands (right exactly as shown).

Upon exiting the area (which was filled with scrub turkeys, ducks, wombats, emus and feces in addition to the kangaroos), there was a handwashing station with ample running cold water and soap but no paper towel to dry hands. The park prides itself on reusing water, and there was clear signage indicating that all water in use was recycled except for handwashing, food preparation, and drinking water. I didn’t feel confident that they were able to separate distribution so well after realizing that handwashing wasn’t possible in the koala cuddling zone.

Handwashing really isn’t simple, especially when the proper tools are not available.
 

You can hold my koala but not wash your hands

Sunday in Brisbane (that’s in Australia) was a perfect chance to discover the local wildlife: kangaroos and koalas at the Lone Pine Koala Sanctuary. Emma and Sorenne were overly excited by the opportunity. When it was their turn to get their photo taken with the koala, however, I noticed the sign on the hand sanitizer station saying, “Out of Order. Sorry for any inconvenience.” As we exited the area into the food court, Emma grabbed some sanitizing wipes that were available (but unmarked and almost not noticeable) on a table and cleaned up Sorenne’s hands the best she could.

After our afternoon “tea” (that’s Australian for “snack”), we headed into the Kangaroo Rescue area. For $2 I bought a rather large bag of kangaroo feed, and we proceeded to shove our hands into the faces of every kangaroo who passed by. Emma was brave and lay down on the ground to pose with one of the big boys. For me the highlight was either seeing a pregnant mommy ‘roo whose joey was wiggling about in her pouch or watching Sorenne’s face light up when the baby kangaroos ate from her hands (right exactly as shown).

Upon exiting the area (which was filled with scrub turkeys, ducks, wombats, emus and feces in addition to the kangaroos), there was a handwashing station with ample running cold water and soap but no paper towel to dry hands. The park prides itself on reusing water, and there was clear signage indicating that all water in use was recycled except for handwashing, food preparation, and drinking water. I didn’t feel confident that they were able to separate distribution so well after realizing that handwashing wasn’t possible in the koala cuddling zone.

Handwashing really isn’t simple, especially when the proper tools are not available.
 

Promote handwashing at petting zoos and farms or no school visits

In the fall of 1998, I accompanied one of my five daughters on a kindergarten trip to the farm. After petting the animals and touring the crops — I questioned the fresh manure on the strawberries –we were assured that all the food produced was natural. We then returned for unpasteurized apple cider.

The host served the cider in a coffee urn, heated, so my concern about it being unpasteurized was abated. I asked: "Did you serve the cider heated because you heard about other outbreaks and were concerned about liability?" She responded, "No. The stuff starts to smell when it’s a few weeks old and heating removes the smell."??

I’m all for farm visits, local markets, petting zoos, but I want the operators to have a clue about the dangerous bugs that make people – especially little kids – sick.

What I haven’t written about before is that I called the local board of education after the farm visit and insisted the specific farm be removed from future school visits because it was obvious the operators were clueless about the dangerous microorganisms that can sicken kids.

And it happens a lot.

The U.K. Health Protection Agency reported today in Emerging Infectious Disease that it recorded 55 outbreaks of gastrointestinal diseases, such as E.coli and cryptosporidium between 1992 and 2009.

Lead author Dr Fraser Gormley, a HPA epidemiologist, said,

"Handwashing is the single most important prevention step in reducing transmission of gastrointestinal infections after handling animals and it’s crucial that handwashing in young children should be supervised, especially after touching or petting animals or their surroundings on a visit to a farm."

Those ‘Visitors Must Wash Hands’ signs are not enough. Operators need to take this seriously. So do education officials who send kids to substandard farms. If farms and petting zoos want to make money off school visits, they should actively promote handwashing and microbial awareness; if not, no school visits.

The report is available here.

Brit kids avoid school toilets because of dirt and bullies; hard to wash hands

U.K. children are deterred from using school toilets in secondary schools because they are dirty – and occupied by smokers and bullies, a survey warns.

BBC reports that a quarter of the 300 children surveyed by experts from the London School of Hygiene and Tropical Medicine said they avoided toilets if at all possible.

Speaking before Friday’s Global Handwashing Day, the scientists said facilities were "dirty and inadequate."

More than a third (36%) said their toilets were never clean, with 42% saying soap was only available sometimes, and almost a fifth (19%) said there was never any soap.

Nearly 40% of secondary school girls reported ”holding it in” so they didn’t have to go to the toilet.

And 16% of secondary school boys reported "bad things" happening in the toilets, making them wary of going in there.

Around 150 primary school children were also questioned in the survey, but they reported far fewer problems with their toilets.

Dr Val Curtis, director of the London School of Hygiene and Tropical Medicine’s Hygiene Centre, who led the research, said,

"It would be easy to blame laziness on the part of the kids for this state of affairs, but clearly the problem lies with inadequate and dirty facilities, particularly in secondary schools."

Proper handwashing requires access to proper tools.

Dry hands or spread bacteria; paper towel better than blowers

Another meaningless survey relying on self-reporting has found 50 per cent of 1,053 U.S. respondents said they "wash their hands more thoroughly or longer or more frequently" in public restrooms as a result of the H1N1 virus – that’s up from 45 percent in 2009 when the same question was asked.

But even if people think they are vigilant about washing their hands – observational studies say they aren’t – are people washing and drying hands in a way to lower bacterial loads? Not drying hands thoroughly after washing them could increase the spread of bacteria, and rubbing hands whilst using a conventional electric hand dryer could be a contributing factor. Frequently people give up drying their hands and wipe them on their clothes instead.

That’s what I observed anecdotally when I first visited Kansas State University in 2005 and saw these groovy all-in-one hand units that are terrible for hand sanitation; paper towels were subsequently installed so people could at least dry their hands properly.

A study by researchers at the University of Bradford and published in the current Journal of Applied Microbiology evaluated three kinds of hand drying and their effect on transfer of bacteria from the hands to other surfaces: paper towels, traditional hand dryers, which rely on evaporation, and a new model of hand dryer, which rapidly strips water off the hands using high velocity air jets.??

In this study the researchers quantified the effects of hand drying by measuring the number of bacteria on different parts of the hands before and after different drying methods. Volunteers were asked to wash their hands and place them onto contact plates that were then incubated to measure bacterial growth. The volunteers were then asked to dry their hands using either hand towels or one of three hand dryers, with or without rubbing their hands together, and levels of bacteria were re-measured.

??Dr Snelling and her team found that rubbing the hands together whilst using traditional hand dryers could counteract the reduction in bacterial numbers following handwashing. Furthermore, they found that the relative reduction in the number of bacteria was the same, regardless of the hand dryer used, when hands were kept still. When hands are rubbed together during drying, bacteria that live within the skin can be brought to the surface and transferred to other surfaces, along with surface bacteria that were not removed by handwashing.

The researchers found the most effective way of keeping bacterial counts low, when drying hands, was using paper towels. Amongst the electric dryers, the model that rapidly stripped the moisture off the hands was best for reducing transfer of bacteria to other surfaces.
 

Tweeting for toilet paper, handwashing in urinals

As I’ve said before, when Chapman got his first Blackberry he was so proud he sent me an e-mail from the crapper.

“Dude, I’m on the toilet, and I’m e-mailing you,” or something like that.

Last week, the apparently popular Tokyo DJ, Naika_tei, who also apparently doesn’t know to check for toilet paper before laying logs in a public bathroom, discovered the TP shortage after completing his business. The tei played it cool in the electronics store and sent out this tweet:

"[Urgently needed] toilet paper in the 3rd floor toilet of Akiba Yodobashi."

Five minutes later, he sent another desperate tweet.

After 18 minutes, he tweeted again:

"The toilet paper arrived safely! Thank you very much!"

No amount of tweeting would help the fellow in the video, below. According to one of my language correspondents, the folks in this clip are speaking Dutch, and the dude tried to wash his hands in the Pissoir — the portajohns were apparently there for the women. When she asks: For the record: is that the pissoir? The guy in the red shirt says: yes, a pissoir.

The blond with the microphone says she is speechless.

At least when I was a kid and went to Maple Leaf Gardens when Toronto had a winning hockey team (yes, I am that old) the communal urinal trough was level with the floor, not at handwashing height.

30 sick with Shigella in Daviess Co., Kentucky

News25 reports the Green River District Health Department is confirming 30 cases of the bacteria illness called Shigella in Daviess County. Now, the Kentucky Department of Public Health is getting involved.

"We haven’t seen anything like this in a while," said GRDHD Regional Epidemiologist Janie Cambron.

NEWS 25 was the first to report health officials were investigating cases of Shigella in Daviess County. Since last Thursday, the number of confirmed cases jumped from 15 to 30. Health officials say none however stem from this past weekend’s Bar-B-Q fest where extra hand sanitizer were distributed.

Two other counties in the state are also reporting high numbers of Shigella. Prompting the state to become part of the investigation.

Of the 30 confirmed cases in Daviess County, 27 are with kids ages 13 and younger. Cambron says she’s talked with many concerned parents asking if their kids should stay home. If they attend a childcare center, they must be symptom free for 24 hours before returning.

Wash hands.