ITCHY BUGS
Indoor session 1 Start scratching now
Bed bugs and head lice will be covered at 2pm
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Itchy “bugs” – Top 14
Scabies Ringworm Clostridium difficileMethicillin-resistant
Staphylococcus aureus (MRSA)
Impetigo (Step/Staph)
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Bacterial conjunctivitis Pertussis Meningococcal meningitis Hand, foot and mouth Chickenpox MeaslesMumps Fifth disease “Flu” Influenza “Stomach flu” Norovirus
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Female burrows into the upper skin layer
Infestation of the skin
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Sarcoptes scabiei var. hominis
Human scabies – human itch mite
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Moderately contagious Adults 1/3 millimeter long Inactive below 20oC (68oF)At 20oC mites can persist for 2 weeks
Intensely pruritic skin infection
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Spread by direct, prolonged, skin-to-skin contact
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Infection occurs due to the direct transfer of a single fertilized female
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Life cycle 10-17 days
Remain viable for 3 days on inanimate objects (>22oC, 72oF)
Transmission via articles is possible, but unlikely
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Burrows and malformed fingernails may or may not be evident
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An affected host harbors only 10-15 adult mites - typical infestation
Skin scrapes are the only way to positively identify mites
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Hypersensitivity reaction to the mites, molts, eggs, or scybala occurs about 30 days after infestation
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Disproportionately affects women and children
Secondary bacterial infection is common Staphylococcus aureusStreptococciPeptostreptococci
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Immunocompromised prone to develop crusted scabies
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Usually below the neck - adults
Fingers, flexor surfaces of the arms, wrists, axillae, and the waistline
Umbilicus, nipples, penis, and scrotum
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Infection eliminated using prescription treatments
Once treatment starts individuals are not infectious
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Treatments
Permethrin (e.g. Elimite) Lotion applied over body from neck down Left on for 8-12 hours, then rinsed offReapplication
1 week laterClothes dryer
will kill mites
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Treatments
Crotamiton (e.g. Eurax; Crotan) frequent treatment failure has been reported
Lindane lotion is NOT recommended
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Relief from itching
• Antihistamine diphenhydramine • Itching becomes worse after mites die
Inappropriate things
• OTC pesticides applied to rooms or buses• Incorrect use of sterilants or disinfectants
applied to roomsurfaces
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Happy kids21
Itchy “bugs” – Top 14
Scabies Ringworm Clostridium difficileMethicillin-resistant
Staphylococcus aureus (MRSA)
Impetigo (Step/Staph)
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Bacterial conjunctivitis Pertussis Meningococcal meningitis Hand, foot and mouth Chickenpox MeaslesMumps Fifth disease “Flu” Influenza “Stomach flu” Norovirus
Antimicrobial products are pesticides23
Slows growth Stops
growth Kills some in time
Kills some quickly
Kills all quickly
Quickly = <10 minutes
Microorganisms “bugs”
Have only 2 jobs: Survive Reproduce
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Ringworm - fungal skin infection
Dermatophytes – live off dead tissues (skin, hair, and nails)
Scaly, crusted rash May itch
Moist areas26
ChildrenWarm, moist
climatesContagious Contracted from an
infected person, animal, object, surfaces, or soil
Tinea capitis
Tinea barbae
Tinea pedis
Tinea faciei
Tinea corporis
Tinea manus
Tinea cruris
Tinea unguium (nails)
Transmitted from animals to humans27
Class pets Exclude feral cats
from classrooms
1. 1. 1.
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Immunocompromised individuals should not be around ringworm
Clean hard surfaces with disinfectant29
Carpeted areas vacuumed Prescription antifungal medications before
returning to contact sports Medications - topical
and/or oral
1. 1. 1.
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Can persist on skin, hard surfaces, and on items such as clothing, towels, furniture and bedding
Spores can survive >year
Students should be referred to a doctor
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Wear sandals or slides in showers and locker rooms Discourage sharing towels and clothing
Students should not participate in contact sports until treated
1. 1. 1.
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Must be spayed/neutered, vaccinated and maintained in good health
Campus animals
More happy kids33
Itchy “bugs” – Top 14
Scabies Ringworm Clostridium difficileMethicillin-resistant
Staphylococcus aureus (MRSA)
Impetigo (Step/Staph)
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Bacterial conjunctivitis Pertussis Meningococcal
meningitis Hand, foot and mouth Chickenpox MeaslesMumps Fifth disease “Flu” Influenza “Stomach flu” Norovirus
1. 1. 1. “Clean”35
Cleaning removes pathogens and dirt Sanitation reduces the number of disease-
causing organisms to non-threatening levels Disinfection destroys microorganisms, does not
kill all pathogens Sterilization kills
all disease-causing pathogens
1. 1. 1.You NEED to know36
1. What are you doing?2. What product?3. What are you killing?4. What are you treating”?5. What concentration?6. What length of time? 7. What next?
5 billion pounds cleaning chemicals annually(25% hazardous substances)
One custodian uses, on average, 194 pounds of chemicals / year
Custodians and teachers experience some of the highest rates of occupational asthma
Custodians37
20% burns to the eyes or skin
12% inhaling vapours
6% of custodians are injured annually38
Disinfectants and sanitizers39
Chlorine / Sodium Hypochlorite
Phenols
‘Quats’
Peroxide– EPA Sanitizer– Superior health & environmental
profileLower
Higher
Environmentally preferable purchasing (EPP)
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EPP = Environment + Price + Performance
Lower toxicity No cancer-causing ingredients or asthmagens Not corrosive to eyes or skin or skin sensitizers Won’t pollute air or deplete ozone layer Won’t kill fish Will biodegrade Low phosphorous Package recyclable Available as concentrate Limits on fragrances used Certain ingredients prohibited e.g, phthalates Performance tested Vendor training available
What are green cleaners? 41
Increase frequency of cleaning frequently touched surfaces
Infection interruption from contaminated environmental surfaces
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Influenza virus survives on surfaces 2 - 8 hours
Norovirus survives on surfaces 2 weeksDestroyed by heat (167-212°F), chemical
germicides: chlorine, hydrogen peroxide, detergents, iodophors, alcohols
Concentration and length of time
Sanitation for norovirus and influenza
1. 1. 1.
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Wash surfaces with general cleaner to remove dirt and organic matter first
Follow label directions
Rinse with water if instructed
EPA approved disinfectants
Sanitation steps
1. 1. 1.
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Alcohol wipes and gels
Clean hands constantlyCover coughs
and sneezes -droplets can move through the air 3-6 feet
1. 1. 1.
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1 tablespoon of bleach to 1 quart (4 cups) of water, or ¼ cup of bleach to 1 gallon (16 cups) of waterApply solution to surface with a clothLet it stand for 3 to 5 minutesRinse with clean water
If using chlorine bleach
1. 1. 1.
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Door handles PhonesComputer keyboards
Wipes used on items that are touched often
1. 1. 1.
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Students should not clean surfaces with disinfectant wipes
Surface disinfectant wipes are not hand wipes
Many labels clearly state “KEEP OUT OF REACH OF CHILDREN”
Many disinfectant wipes are registered pesticides
1. 1. 1.
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Persons cleaning classrooms or emptying trash –wear gloves, then wash hands
Tissues thrown in trash or bagged
1. 1. 1.
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Sick staff or those caring for others who are sick should not prepare food
Infected food workers cause 70% of reported norovirus outbreaks
Very contagious
Norovirus is leading cause of food-borne illness
1. 1. 1.
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Found in vomit or stool even before a person is sick, and for 2-3 weeks after symptoms abate
Alcohol-based hand sanitizers used in addition to hand washing
Hand washing is critically important
Impetigo
Highly contagious Caused by Staphylococcus aureus and/or
Streptococcus pyogenes Red sores on the face, around nose, mouth,
hands and feet Sores burst and develop
honey-colored crusts Itchy
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MRSA Methicillin-resistantStaphylococcus aureus
Spread through cuts, abrasions and skin-to-skin contact
Contaminatedsurfaces
Begins as painful/itchy boil
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Managing methicillin-resistantStaphylococcus aureus
Survives 7 days - 7 months on dry surfaces Exclude students with wound drainage
from sports Enforce hand hygiene Cover sores
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Clostridium difficile (C-diff)
After antibiotic therapyDiarrhea Pseudomembranous and toxic colitis FeverAbdominal painCrampingNausea and loss
of appetite
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Managing Clostridium difficile
Spores highly resistant to cleaning agents Survive for 5 months on dry surfaces HandwashingKilled by
chlorine bleach
Isolate infected individuals
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>23,000 Americans die annually from antibiotic resistant infections
Resistance occurs when antibiotics are used:Appropriately Food and water (waste)Our environment Inappropriately (e.g., vial infection)
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Resistant infections58
Antibiotic
PlasmidRibosomes
InactivationAdded phosphate groupreduces ability to bind
Pumping outIncreasing active efflux
Modifiedtarget site
Impermeableprotein
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CDC: washing hands with soap and water is effective
1 (800) 858-7378 http://npic.orst.edu/
Increasing incidence of “super bugs”Avoid triclosan – absorbed through the
skin and bio-accumulates, linked to liver damage and resistant bacteria
Recommended
