Bugs, Germs, Diseases and Other “Nasties”

1. Bugs, Germs, Diseases and Other “Nasties” Pacific EMPRINTS Presentation August 1, 2006

2. PRESENTED BY: John Casken, RN, MPH., PhD., Fellow, Royal Society of Health (U.K.) Director, Office of International Affairs School of Nursing and Dental Hygiene University of Hawai`i at Manoa Honolulu, HI casken@hawaii.edu

3. Outcomes • What you’ll learn from this presentation: • Differences between bugs, germs, bacteria, and viruses • Why these guys can cause trouble • What we can do to protect ourselves

4. What are we really talking about? • Germs? • Bugs? • Bacteria? • Viruses?

5. Germs and Bugs • In every day use, we might say: “I picked up a bug” What is a “bug”? 1) Something small that is making us sick. 2) Something we catch from someone else or from something like food that has gone “bad.”

6. Germs and Bugs (2) • Germs and bugs are not accurate words to use professionally – in the health field • But after giving you a formal definition of bacteria and viruses, which are the more correct names for germs, we will go back to using bugs and germs

7. Bacteria • Technical Definition: • “Any of a variety of one-celled micro-organisms of the plant kingdom, existing as free living organisms or parasites, multiplying by subdivision and having a large range or biochemical (including pathogenic) properties.” • Melloni: Medical Dictionary

8. More about Bacteria • Can exist almost anywhere • More bacteria as separate individuals than any other organism • More useful types than harmful ones • Used in many human tasks – making alcohol, cheese, sewage disposal

9. Viruses • Technical Definition: • “An intracellular, infectious parasite, capable of living and reproducing only in living cells”. • Melloni: Medical Dictionary

10. More about Viruses • They are very tiny and require an electron microscope to be seen • Are composed of mainly nucleic acid within a protein coat • At this time, viruses are not known to be of value to man, but as we have been able to work with them for only about 80 years, we still have a lot to learn about them.

11. Germs and Bugs – Problems (1) • Germs cause infectious diseases. • Infectious diseases are a major problem in many parts of the world, especially poorer countries. • TB, malaria, diarrhea, measles and HIV/AIDS are some of the major infectious diseases that are caused by germs.

12. Germs and Bugs – Problems (2) • Being sick with an infectious disease is a problem not just for the individual but for the person’s family, the person’s village and the whole community. • If you’re sick, you can’t work; you can’t harvest the crops. • If you’re sick, you can infect other people and so on and so on.

13. The Major Infection That We’re Worried About • We lived with Malaria and TB and we know that they take a long time to kill us! • Avian ‘Flu or Pandemic ‘Flu can kill many people, very fast. • These flu’s are spread by germs

14. Protection Against Bugs and Germs • The first thing to do is to ask how bugs and germs grow and then how they spread among people and also among animals as they can also be affected by bugs and germs

15. How Bugs and Germs Grow • Think of what we need to live and increase in numbers: • A good safe place • A good food source • No enemies

16. Good Places for Bugs to Grow • Each type of bug can be different but for most them warmth and moisture are important. • Food should be readily available. • If no enemies they can multiple very fast. The inside of bodies is often an excellent place with everything that a bug needs!

17. How Bugs and Germs Spread 1. They often can move a little bit where they are living but can’t make big moves. 2. They need a carrier: people pets animals insects plants

18. Using People • What did we do at the beginning of the class? • Did anyone share my food and drink? • Did anyone cough or sneeze?

19. Using Pets • My dog likes me to scratch his ears and is always hanging around the kitchen and the table….. • When I take my dog for a walk…yes! If I don’t pick it up there are a lot of germs in that mess waiting for a ride • Dogs and cats can drool on furniture and lick our hands….

20. Using Animals • Just like my dog, many animals live near people and their poop has germs. • People who work with the skins (or feathers) of wild or domestic animals can pick up germs from the skins (or feathers). • Animals can get sick from their own diseases and die. Their carcasses can be full of germs waiting to be picked up.

21. Using Insects • Flies are everywhere. Just think: where was that fly walking before it walked on your food? • Mosquitoes spread many germs that cause major diseases. • Ticks and other insects feed on our blood and spread germs in the process.

22. Using Plants • If you eat a vegetable or a fruit ask yourself how it got water? • Who picked the plant? • Who prepared it for the table?

23. Protecting Ourselves • Basic Principle: • Cut the spread of germs. • If they can’t spread and multiple, they will die off.

24. Protecting Ourselves from Bugs and Germs 1. Avoid problem areas and sick people 2. Long lasting protection, such as vaccinations and immunizations – “shots” 3. Short lasting protection, such as bug spray

25. More Protection • The basics: Soap and Water! • Washing hands – Happy Birthday x 2 • Washing our bodies • Washing our fresh fruits and vegetables • Washing clothes • Washing places in our homes

26. More Protection • For airborne spread: • Cover mouth when coughing or sneezing • Wearing a mask • when dealing with items that have bugs and germs • when other people are coughing and sneezing

27. More Protection • To reduce germs around our houses • pick up poop • get rid of things that can hold still water • get rid of rotten old food

28. Avian Flu – How It’s Spread Among Birds • Normal spread is from a wild bird to domestic bird. • Ducks, geese and swans are usual carriers. • Can be spread among domestic birds by contaminated food and clothing, feed and cages. • The current highly lethal virus HPAI H5N1 can survive for 35 days in contaminated poop at 4C and for 6 days at 37C.

29. Spread from Birds to Humans • Still unclear how it’s spread but mainly through contact with dead or sick birds – especially when slaughtering birds. • Bird droppings can be a source of infection – in areas where kids might play. • It does NOT appear to spread by eating thoroughly cooked meat.

30. Why Avoid an Avian Flu Death? • H5N1 at the moment is highly lethal. • Death is relatively rapid. • Acute respiratory distress within around 6 days of infection – you need to be intubated in order to breathe. • Multi-organ failure and breakdown • All the health staff will be wearing protective clothing – no human contact.

31. Can We Prevent Avian Flu Spread • Only way to successfully stop the spread is by slaughtering and carefully disposing the bodies of all the birds • Rigorous disinfecting of the farms and areas where the birds were • How could this be done in the Islands?

32. Are There Any Drugs to Prevent or Cure? • A number of firms are working on a vaccine against the H5N1 strain • Tamiflu CAN be useful if given to the patient within 48-60hrs after symptoms begin

33. Current Situation • 231 deaths since the beginning of the latest outbreak beginning December 2004 • Most deaths have occurred in S.E.Asia but there have been deaths in Turkey. • The disease has been detected in birds all over Europe and Asia • WHO is paying very close attention to the problem as are most countries in the whole world because the costs of a pandemic would be very high

34. If There is an Outbreak of Pandemic Flu – What happens? To date the most talked about solution is social isolation for two weeks. However: 1. We’d still need to clean up the virus 2. How would your community cope with no one working for 2 weeks?????

35. Best Advice • Keep yourself up-to-date on what is happening • Practice the basic steps!

36. Sign off Enjoy your stay in Honolulu.