‘Spread the Word, Not the Germs’ – Infection Control During Religious Gatherings

By Shawn Kennedy, MA, RN, AJN editor-in-chief

Last week there was a disconcerting report from the Associated Press about a Catholic clergyman in North Dakota who may have inadvertently exposed many members of his church to hepatitis A. According to the report, the ill bishop had probably contracted the illness from contaminated food while attending a conference in Italy and, because he didn’t immediately feel ill (incubation period usually ranges from two to four weeks, though can be as long as eight weeks), continued to dispense communion at several area churches.

According to the Centers for Disease Control and Prevention (CDC) Web page for hepatitis A, infection “is primarily transmitted by the fecal–oral route, by either person-to-person contact or consumption of contaminated food or water.” A person is infectious from two weeks before to one week after the onset of symptoms. The FAQ page on the site does say, in regards to infected food handlers (which would seem to fit this case, in that the bishop handled communion hosts), that “transmission to patrons is unlikely”—and also offers some guidance for postexposure prophylaxis (PEP). In this case, too much time had elapsed: PEP needs to be given within two weeks of exposure.

SpreadTheWordNottheGermsOpeningSpreadScreenshotThis situation made me wonder, though, as we’re about to enter peak flu season, if there are any infection control guidelines appropriate for religious services. […]

How Bad Is the Flu Right Now, and Should Nurses Get Vaccinated?

Shawn Kennedy, MA, RN, AJN editor-in-chief

The news has been full of reports about the influenza outbreak, deaths from complications, and shortages of vaccine and antivirals. Is the flu season as bad as purported, or are we experiencing media hype? Nurses are frequently asked for information by family, friends, and neighbors (and strangers—I was in a restaurant once and a diner at a nearby table, having overheard my conversation with a colleague, leaned over and asked if he could ask me a health question!), so here’s the latest information.

WeekEndingJanuary5FluView Week ending 1/5/2013; brown indicates states w/ widespread flu activity. CDC

According to the latest Centers for Disease Control and Prevention (CDC) report for the week ending January 5, epidemiologists from all states except three reported (see map) widespread “influenza-like illness” (ILI, meaning fever and cough or sore throat). California and Mississippi reported regional activity and Hawaii reported sporadic activity. The District of Columbia reported local spread. And while officials in some cities and states declared public health emergencies, the CDC notes that “influenza activity remained elevated in the U.S., but may be decreasing in some areas.”

One of the indicators is the proportion of people seeking treatment for ILI. Thus far, that number has risen as high as 6.0%, but has since fallen to 4.3%, as of January 5. In prior years deemed as moderately severe flu seasons, that indicator rose as high as 7.6%.

So in terms of history, we’re […]

A Primary Source Reminder from the Early Days of HIV/AIDS

By Maureen Shawn Kennedy, AJN editor-in-chief

Last week, I received a press release from the National Institutes of Health noting the publication 30 years ago of the first ‘official’ report that many consider to have heralded the beginning of the AIDS epidemic—a report in the MMWR (Morbidity and Mortality Weekly Report), a publication of the Centers for Disease Control and Prevention (CDC), about cases of Pneumocystis carinii pneumonia and Kaposi’s sarcoma in otherwise healthy young men who all happened to be gay.

This report (which included various causative theories, including speculation that the weakened immune system among these gay men might somehow have resulted from the use of lifestyle drugs such as amyl nitrate!), seemed late in coming for those of us who’d been seeing unusual infections among gay men since the mid-1970s.

In 1975, I became aware of these young men when they started coming for diagnostic consultation with the physicians I worked with in a private hematology–oncology practice in New York City. No one could figure out why they had developed opportunistic infections that were normally seen only in patients who’d been on chemotherapy or who had other immune disorders. We talked about the fact that similar cases were being seen at the (now defunct) St. Vincent’s Medical Center in Greenwich Village. […]

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