As hospitals begin to "think green" ["Medicine Gears Up for a Code Green," July 22, 2008], it is critically important for healthcare professionals to assure that patients and residents are protected from microbes in the environment. The movement of healthcare organizations to design and implement "green" environments is a well-supported and laudable goal; however, decisions to implement new processes and products must always consider the patient's welfare.

Health Care Without Harm's Anna Gilmore Hall was quoted as stating that "Infection control is just as effective with green cleaners as it is when you use Clorox". Unfortunately, the evidence does not support this comment. While cleaning products are appropriate for many routine jobs, and "green" cleaners will effectively remove microbial contaminants, some "green cleaners" are not as effective as proven disinfectants, such as chlorine-based or other agents, for killing selected harmful microorganisms. Only EPA-registered disinfectants, used correctly, can be relied on to consistently kill certain disease-causing microorganisms such as Clostridium difficile spores and norovirus that can exist for long periods on contaminated surfaces. For high-touch and critical care areas in a healthcare facility, the use of a proven disinfectant can help reduce the risk of organism transmission and thus the risk of healthcare-associated infections.

The Centers for Disease Control and Prevention estimates that nearly two million people acquire an infection while being treated in U.S. hospitals every year, resulting in over 90,000 patient deaths. Many of these infections are preventable. Using appropriate disinfectants effectively is one important line of defense.

Barbara M. Soule, RN, MPA, CIC
Practice Leader, Infection Prevention and Control
Joint Commission Resources
Oak Brook, Illinois

To read the article that prompted the above response, please go to:
The Washington Post

Rising infections from the chlorine-resistant parasite Cryptosporidium are forcing pools and water parks across the country to take new measures -- from ultraviolet-light water treatments to tighter swimming restrictions -- to keep their water clean. The parasite -- commonly called crypto -- is found in human and animal feces and is easily transmitted through water. When ingested, crypto can cause an illness of up to two weeks, with symptoms that include long bouts of diarrhea, abdominal cramps, nausea, vomiting, headaches and low-grade fevers.

Crypto outbreaks have been increasing over the past two decades, according to the National Center for Zoonotic, Vector-Borne and Enteric Diseases. City officials in Phoenix were forced to close and disinfect the city's 29 pools earlier this summer after more than 100 people complained of illness and a pool was found to have the parasite. A series of outbreaks last summer in Utah sickened nearly 2,000 people. And an outbreak at a spray park in Seneca Lake State Park in New York in 2005 caused more than 4,000 people to seek medical help.

The CDC is working with industry representatives and public health officials to put together the Model Aquatic Health Code -- a set of CDC-endorsed water-safety guidelines that state and local agencies will enforce.

The read the full article, please go to:
The Wall Street Journal

The Food and Drug Administration (FDA) has linked a Salmonella outbreak in the United States and Canada to irrigation water and serrano peppers at a Mexican farm in Nuevo Leon, Mexico. The FDA now advises consumers to avoid raw jalapeño peppers grown in Mexico and any foods containing raw jalapeño peppers grown in Mexico.

People in 43 states, the District of Columbia and Canada were made sick by Salmonella Saintpaul. At least 242 have been hospitalized, although federal health officials say only the elderly, infants and people with weakened immune system need to avoid raw peppers from Mexico.

According to the Center for Disease Control (CDC), this particular Salmonella Saintpaul fingerprint is normally seen in only 25 cases a year.

To read the FDA's latest updates on the outbreak, please go to:
The FDA's website

Since the mid-1990s, when nationwide E. coli and Salmonella scares prompted the U.S. Department of Agriculture (USDA) to establish strict microbiological regulations for the meat and poultry industry, chlorine has become a popular agent for disinfecting chickens.

After birds are killed, defeathered, and eviscerated, the carcasses are chilled in massive bathtubs to prevent bacterial buildup. Chemical disinfectants-in about 80 percent of cases, that's chlorine-are added to the water to reduce cross-contamination and stem further bacterial growth.

The USDA has a strict cap on the amount of chlorine that can be used in these chiller baths: no more than 50 parts per million, or 50 ounces for every 7,800 gallons of water. In the disinfection process, the chlorine added to the chiller bath reacts with the meat in such a way that no free chlorine remains. If the chlorine is used correctly, most people won't be able to detect any traces of it. A 1999 University of Georgia taste comparison study found that distinguishing between chlorinated and unchlorinated cooked chicken was possible only after four days of refrigeration of chicken samples.

Chlorine is used in the treatment of other food products besides chicken, such as seafood and produce. There are other poultry disinfection options but, for now, chlorine and other chemical agents remain the most cost-effective.

To read the full article, please go to:
Slate.com

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