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By: Dr.Mohamudha Parveen

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Overview Germ History How Germs Spread Common Diseases How, Where to control?

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Germs/Microorganisms Bacteria/ Bacteria / Virus/ Fungi/ Parasites/

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Bacteria/ A single cell Helpful, pathogenic (harmful, causing disease), and spoilage (deteriorates food) Round, rods, or spirals Salmonella, Staphylococcus aureus, Streptococci Some bacteria produce poisons called toxins - Clostridium botulinum bacteria , ( , ), Clostridium

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Viruses/ Viruses are smaller than bacteria Viruses are protein structures, not cells Require a living host to survive Highly infectious

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Fungi/ Found in air, in soil, on plants, and in water Familiar ones - mushrooms, yeast, mold Some live in the human body, without causing illness Some are beneficial - penicillin and yeast for fermentation

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Protozoa Microscopic one-celled animals Can be parasites or predators In humans, protozoa usually cause disease Examples: Malaria,Filaria, Amoebasis, Giardiasis

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Germs: modes of transmission : Direct contact ( ) Air ( - : ) Cuts, abrasions, wounds ( )

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Germs: modes of transmission : Pets dogs & cats (rabies), reptiles (Salmonella) Water ( ) E-coli, Giardia and Salmonella Insects mosquito ( ), Housefly ( ) flea ( )

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Which is the major important route for germs to enter in your body?

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Hands ( )

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Routes Via Hands Hands to food poultry to ready to eat foods Hand to hand Food - hands raw foods

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Routes Via Hands... Hands to infant diaper food Nose - hands- mouth Ears - hands- mouth

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Environmental Surfaces/

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Illness Associated With Contaminated Environmental Surfaces Common cold Flu Norovirus-Transmitted by Hand to mouth MRSA Norovirus-

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MRSA Causes a skin infection Commonly occurs at sites of cuts and/or abrasions How MRSA is Transmitted Usually transmitted Skin to skin contact From contaminated surfaces _

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MRSA Where do You get MRSA? Anywhere Setting that have these factors 5Cs Crowding, frequent skin to Surface Contact, Compromised Skin, Contaminated items and surfaces, and lack of Cleanliness Locations Schools, dormitories, military barracks, households, jails, and daycare centers - - 5Cs- - , , -

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Parvovirus Transmitted by respiratory route sneezing, talking, coughing, touching secretions infectious before rash & usually not infectious when rash appears 50% of people infected by adulthood Pregnant women reports of stillbirths & miscarriages ,, , & 50

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Food borne illness due to fecal/oral transmission Poliomyelitis Norovirus acute gastroenteritis Giardiasis Hepatitis A Hepatitis E Rotavirus Shigellosis (bacillary dysentery) Typhoid fever Enteroviruses Cholera Clostridium difficile Cryptosporidiosis Ascariasis A E ( )

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Reptile Salmonellosis ( ) All reptiles shed Salmonella in their feces Increased popularity of reptiles as pets in households and classrooms Special risk to infants, immunocompromised, kids, pregnant women and the elderly Lack of awareness , , ,

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Why Wash Hands ? Reduces Diarrhoea Hand washing with soap : Reduces risk of diarrhoeal diseases by 42-47% No of diarrhoea deaths that could be averted 1.1 million Hand washing by mothers : Lowers incidence of childhood diarrhoea : 42- 47 1.1 :

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Prevention ( ) How Do We Get Rid Of Germs?

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Flies Fomites Fluids FecesFoodsHost HANDWASHING Fingers Hand Hygiene In Fecal Oral Transmission

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Hand washing is the most important method of disease prevention . Bacteria and virus can be spread via dirty hands and the are too small to see with the human eye. You must wash you hands properly in order to remove them.

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What happens when I do not wash my hands? Bacteria and viruses are picked up and stay on your hands. You can pass them to other people when you touch them with your hands. Bacteria and viruses can get into your body when you touch your eyes, mouth, or nose with your hands. . . .

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History/ 1840- Hungarian doctor Ignaz Semmelweis He was trying to figure out if it made a difference in saving lives. In the United States this came to light during the Civil War in battlefield hospitals.

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Germ History 1860 -French chemist -Louis Pasteur. He calls the bacteria "germs."

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Culture plate showing growth of bacteria 24 hours after a nurse placed her hand on the plate Many personnel dont realize when they have germs on their hands

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Gloves?? ( )

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Gloves DO NOT take the place of hand hygiene ( ) Glove use neither alters nor replaces the performance of hand hygiene Gloves should be removed and hand hygiene performed and put back on

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Who Should Wash Hands? WWE ALL WWE ALL are at Risk CClean appearing hands need not be free of Germs

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Hand Hygiene

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Hand Hygiene includes: : Routine hand washing Surgical hand scrub Use of alcohol rubs/gels. " /

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Hand washing ( ) 6 groups Liquid soap and water Foam Soap Water only Alcohol sanitizer Chlorine sanitizer Hand wipes

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Handwashing Soaps - designed to clean the skin by removing dirt, oils and germs. Antibacterial soaps - contain Triclocarbon and Triclosan, for added germ killing protection Hand sanitizers waterless, include a germ kill ingredient: alcohol, Triclocarbon, Triclosan

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How to perform hand hygiene Proper technique is important when it comes to effective hand hygiene. Without proper hand hygiene technique, we can still spread many microorganisms with our hands. Alcohol-based hand rubSoap and water Without water when hands are soiled

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Soap and Water Soap and water - recommended method when hands are visibly soiled. Plain soap -routine hand hygiene Anti-microbial soap -acute care high risk areas. .

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When you should wash? Wash your hands After you use a restroom Before and after you eat Before you touch your eyes, nose or mouth Before and after you prepare food, and after you handle meat or fish After you change a diaper After you pet a dog, cat or other animal After you touch plants or soil After you visit a hospital or nursing home After you come in contact with any body fluids

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50 Handwashing Steps Wet hands and wrists. Apply soap or alcohol- based hand rub Step 1

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51 Handwashing Steps Right palm over left. Left over right. Step 2

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52 Handwashing Steps Palm to palm with fingers interlaced. Step 3

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53 Handwashing Steps Back of the fingers to the opposing fingers and interlocked. Step 4

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54 Handwashing Steps Rotational rubbing of the right thumb by clasping it in the left palm. And vice versa. Step 5

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55 Handwashing Steps Rotational rubbing backwards and forwards with tops of fingers and thumb of right hand in left And vice versa. Step 6

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56 Drying Your Hands Important because damp hands : collect microorganisms spread potentially infectious microorgansims may become colonised with potentially infectious microorganisms Therefore it is important to pat dry your hands thoroughly. Pat drying also helps to prevent damage to skin.

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Drying Hands After Hand Wash Handkerchief / cloth used to dry hands ( / ) Can be a source of re-infection ( ) Air drying with hot air blower ( )

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What if I do not have access to a sink and soap?

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Use an Alcohol-Based Hand Sanitizer

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n Alcohol-based hand rub is the recommended method of hand hygiene in any healthcare setting when hands are not visibly soiled. n In all clinical situations EXCEPT: : When your hands are visibly soiled When a surgical scrub is required n n When can you use an alcohol-based hand gel?

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Are alcohol-based handrubs really effective? alcohol-based handrubs are more effective than either plain soap or antibacterial soaps in reducing the number of live bacteria on the hands

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Promoting alcohol hand rubs improve hand hygiene habits When hospitals/schools/colleges placed alcohol handrub dispensers, students and health care workers clean their hands significantly more often than they did when only sinks were available for handwashing.

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Time Both are effective methods

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Hands are soiled and no water When access to hand washing facilities is limited and running water is unavailable, use a moist towelette to remove visible soiling from hands followed by alcohol-based hand rub. Moist towelette Followed by hand-rub

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Alcohol handrubs have the following advantages over soap and water: take less time to use more accessible than sinks less skin irritation and dryness effective in reducing the number of bacteria on hands handrubs readily available to personnel improved hand hygiene practices Advantages of cleaning hands with alcohol-based handrubs

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Wont frequent use of alcohol dry out my skin? ! NO

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Efficacy of Hand Hygiene Preparations in Killing Bacteria in Health Care Settings

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Obstacles to Hand Hygiene Too busy It is essential that you make time Skin irritation Use lotions & hand rub appropriately Glove use is not a substitute for hand hygiene Not top of mind needs to become as spontaneous as using aseptic technique and all other safety strategies.

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Frequent handwashing with soap and water often causes skin irritation and dryness. In the winter months, some personnel may even develop cracks in their skin that cause bleeding, as seen in the adjacent figure. Another reason why personnel dont wash their hands often

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What Does Clean Mean?

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Teach Children How To Protect Themselves Twinkle, twinkle little star, Look how clean my two hands are, Soap and water, wash and scrub Get those germs off rub-a-dub. Twinkle, twinkle little star, Look how clean my two hands are!

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clean and sanitize toys clean bedding clean soft toys clean soft surfaces on furniture clean carpets and hard surface floors clean tables, door, and cabinet handles At home

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15 th October GLOBAL HANDWASHING DAY! OCT 14

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Hadees about washing hands before meals This hadith can be found in Sunan Abu Dawud, under the chapter "Washing the hands before eating (12)": Narrated Salman al-Farsi: I read in the Torah that the blessing of food consists in ablution before it. So I mentioned it to the Prophet ( ). He said: The blessing of food consists in ablution before it and ablution after it. Sufyan disapproved of performing ablution before taking food.

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When you wash hands before offering salah Then, Why not wash hands before eating Meals?

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Lets do it!!!