WHAT IS ALL THIS FUSS ABOUT SWINE FLU?  C. Deficile is 1000 times worse, harder to treat, kills millions, nobody knows about it and it is running wild in America. It is a bacterial infection currently common in hospitals and almost untreatable.  Only the most powerful of antibiotics can be used on it yet often they aren't since they're so hard on the patient.  Low staffing and out-sourced cleaning procedures have let this thing grow  and it is quietley killing people by the thousands, yet all we hear about is Mexican pig flu nonsense. A net chum informed me when I was doing pig flu rant. "My best buddy's two-year old nephew got this shit while visiting his dying granma in hospital......his future is not bright.   They say he will always have the disease."

We all know that diarrhea is an all too common problem in people living with HIV. Many times, the diarrhea is an unfortunate side effect of the very medications used to treat HIV. But there are times when diarrhea is more than just an irritating side effect. Diarrhea can be the result of an infectious organism known as Clostridium difficile, more commonly known as C.diff. What is C.diff and why is it nothing to ignore?

What is C. diff? C. diff is a microorganism that is one of the many bacterial organisms normally found in the gastrointestinal (GI) tract. There are many such bacteria that are normally present in the body; they aid in digestion and absorption of food and nutrients. C. diff is present as normal GI flora in about three percent of all healthy adults and about 10 to 30 percent of hospitalized or chronically ill patients.

If C-diff is a normal GI flora, why does it make people sick?
C-diff usually is not harmful in the patients that have it in their GI tract. However, under certain circumstances, C-diff can grow out of control in the GI tract. This overgrowth of C-diff produces toxins within the GI tract that result in severe infectious diarrhea and inflammation of the large intestine (colitis). It is when these things occur that C. diff goes from normal, harmless GI flora to dangerous infectious organism. In fact, C. diff is the most common cause of hospital-associated diarrhea.

Why Does C-diff Overgrow?
In the GI tract, there can be “good” bacteria and “bad” bacteria. Good bacteria assists in digestion and the absorption of nutrients but also helps control the growth of “bad” bacteria. In other words, good bacteria protects the GI tract from “bad” bacteria. C-diff overgrowth occurs when the good bacteria fails to prevent the overgrowth of C. diff. This can happen for several reasons.

    * Antibiotic Use – We all know that antibiotics are used to kill bacteria that are causing infection somewhere in the body. At the same time, the antibiotic can kill the “good” bacteria in the GI tract, allowing the “bad” bacteria such as C. diff to grow unchecked, producing the toxins that cause severe diarrhea. Some estimates say that about 90 percent of all health care associated C. diff is related to broad spectrum antibiotic use.

    * Anti-ulcer Medications – Anti-ulcer medications decrease the acidity of the stomach which in turn prevents gastric reflux and ulcer formation. However, altering the acidity of the stomach and GI tract can kill off “good” bacteria, allowing C-diff to grow out of control. In addition, altering the acidity of the GI tract can create an environment that is perfect for “bad” bacteria such as C-diff to grow unchecked.

    * Long Hospital Stays – A combination stress from illness, weakness from laying around in a hospital, and the potential for C-diff contamination from patient to patient makes extended hospital stays a risk factor for C. diff infection. In fact, C. diff infections within hospitals is a major problem for all infection control departments. Special isolation procedures are in place to limit the spread of C. diff from patient to patient via health care workers.

    * Underlying Chronic and Acute Illness – As mentioned earlier, acute and chronic illness can weaken a body’s defenses, making it more susceptible to C. diff infection.

    * Age – Like many infectious illnesses, people older than 65 years of age seem to be more at risk for C. diff. In addition, younger children and infants are also at a greater risk. Most likely, the risk is greater in these age groups due to weak or immature immune systems that are unable to fight a C. diff infection.

    * Immune System Suppression – Chronic diseases like HIV and cancer that are characterized by suppressed or weakened immune systems have proven to increase the risk of C. diff.

How Does C. diff Spread?
C. diff is present in the stool of infected people. It forms spores that can be transferred by direct contact to toilets, bed rails, towel racks, etc. People can also spread the spores from hand to mouth when coming in contact with contaminated surfaces. C. diff spores can live and infect up to 5 months on environmental surfaces. Unfortunately, C. diff spores are not killed by traditional disinfectants used by hospitals when cleaning. Chlorine bleach at a concentration of 1:10 is the only agent that effectively kills C. diff spores on environmental surfaces.

What are the Symptoms of C. diff Infection?
There are three primary symptoms of C. diff infection:

    * watery diarrhea that may contain blood or pus
    * fever
    * abdominal pain, cramping or tenderness

How is C. diff Infection Treated? Treated for C. diff infection has to be two-fold; treat the symptoms and treat the cause. Unfortunately, C. diff can prove very difficult to treat. In fact, some people are treated over the course of several months to a year or more. Currently, a big concern surrounds the emergence of a strain of C. diff that is resistant to current therapy. This very severe form of C. diff can be fatal if treatment is not successful. Treatment for C. diff includes:

    * Antibiotics such as Flagyl (the most common treatment) and Vancomycin (stronger and more effective, especially against resistant strains).

    * Oral fluids such as water and electrolyte replacement solutions are necessary because the diarrhea from C. diff can cause profound dehydration very quickly, especially in the elderly and infants and children. If oral fluid can’t keep up with fluid losses, the person is often admitted to the hospital for intravenous replacement of those fluids lost to dehydration.

    * Pain relief can be used but should be used with caution. Masking undiagnosed abdominal pain can be dangerous and delay diagnosis of potentially serious illnesses. In many patients, over-the-counter medications like Tylenol can be used to relieve mild to moderate pain as well as fever. Narcotics should be used with caution because of the effect they have on gastric function, and Motrin should be avoided because of the irritation it would cause to an already-irritated GI tract.

How Can the Spread of C. diff Be Prevented?
Washing your hands is the primary way to prevent the spread of C. diff from person to person.

    * When to Wash Your Hands

          o After any personal hygiene, especially after using the bathroom or blowing your nose.

          o After handling any contaminated or potentially contaminated items.

          o In the health care setting, before and after direct patient care.

          o Before eating.

          o Before preparing sterile items in the health care setting.

          o Whenever a person you have been in contact with is suspected to have a C. diff infection.

    * How to Wash Your Hands

          o Wash every surface of your hands with soap and water with at least 15 seconds of friction before rinsing.
Use liquid soap, turn off faucet with piece of paper towel, use another towel for bathroom doorknob. At home, if anyone has diaharrea, stop using cloth towels and put a paper dispenser in bathrooms. Towels are used only after a bath.

          o Important Fact – While alcohol-based handrub cleansers are effective in killing most bacteria, they are NOT effective in killing C. diff spores and therefore should not be used when caring for or coming in contact with people who have or are suspected of having a C. diff infection.

Hand Sanitizers vs. Soap and Water

By Regina Bailey,

Antibacterial hand sanitizers are marketed to the public as an effective way to "wash one's hands" when traditional soap and water are not available. These "waterless" products are particularly popular with parents of small children. Manufacturers of hand sanitizers claim that the sanitizers kill 99.9 percent of germs. Since you naturally use hand sanitizers to cleanse your hands, the assumption is that 99.9 percent of harmful germs are killed by the sanitizers. Recent research suggests that this is not the case.

How do hand sanitizers work?

Hand sanitizers work by stripping away the outer layer of oil on the skin. This usually prevents bacteria present in the body from coming to the surface of the hand. However, these bacteria that are normally present in the body are generally not the kinds of bacteria that will make us sick. In a review of the research, Barbara Almanza, an associate professor at Purdue University who teaches safe sanitation practices to workers, came to an interesting conclusion. She notes that the research shows that hand sanitizers do not significantly reduce the number of bacteria on the hand and in some cases may potentially increase the amount of bacteria on the hand. So the question arises, how can the manufacturers make the 99.9 percent claim?

The manufacturers of the products test the products on inanimate surfaces hence they are able to derive the claims of 99.9 percent of bacteria killed. If the products were fully tested on hands, there would no doubt be different results. Since there is inherent complexity in the human hand, testing hands would definitely be more difficult. Using surfaces with controlled variables is an easier way to obtain some type of consistency in the results. But as we are all aware, everyday life is not as consistent.

Hand Sanitizers vs. Soap and Water

Interestingly enough, the Food and Drug Administration, in regards to regulations concerning proper procedures for food services, recommends that hand sanitizers not be used in place of soap and water but only as an adjunct.

Likewise, Almanza recommends that to properly sanitize the hands, soap and water should be used. A hand sanitizer can not and should not take the place of proper cleansing procedures with soap and water.

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