Hospitals world-wide battle nosocomial infections on a daily basis. One of the most difficult bacteria to combat is Clostridium difficile (C.difficile) which can cause diarrhea, ranging from a mild disturbance to colitis and, at worst, perforation of the intestine leading to peritonitis. In a recent study funded by the Canadian Institutes of Health Research, researchers found that the most effective way to eliminate C.difficile bacteria from the hands of health care workers is with soap and warm water.

For the study, researchers tested five separate hand washing protocols that duplicated hospital conditions as closely as possible. The hands of the ten volunteers were contaminated with C.difficile, which were then washed with: regular soap and warm or cold water, antiseptic soap and warm water, an alcohol-based solution, and a disinfectant towel.

The results of the study showed that the protocols involving hand washing with water eliminated more than 98% of the bacteria, while washing with an alcohol-based solution eliminated almost none. The protocol involving a disinfectant towel eliminated around 95% of the bacteria. The researchers believe that alcohol eliminates the 'living' bacteria but not the spores, whereas the mechanical action of washing combined with the chemical action of soap eliminates both. While the alcohol "hand rubs" remain very effective and convenient for routine hand hygiene and eliminating non-spore producing bacteria, the study authors recommend using soap and water whenever contamination with C.difficile is suspected.

For more information on the study, please visit:
Chlorination Hand Washing Best for C.difficile

Last week the U.S. Environmental and Protection Agency (EPA) issued a new national water regulation that aims to reduce human exposure to lead in drinking water and to reassure the public that its drinking water does not contain dangerous levels of the toxic metal. The rule will make changes in the areas of monitoring, treatment processes, public education, customer awareness and lead service line replacement.

Several factors contributed to the revised rule including revelations in January 2004 that thousands of residences in the Washington, D.C. area had dangerously high, record-setting levels of lead in their water. This finding spurred the EPA to conduct a comprehensive nationwide review, which found that high lead levels in drinking water were not widespread. The EPA also concluded that some of the rule’s language was vague, which made it hard for many utility operators to understand and implement the rule.

According to the EPA, lead enters drinking water primarily through distribution pipes and other plumbing materials. The EPA concluded that changes to the Washington, D.C. utility’s treatment methods made the systems water more corrosive, causing lead to leach from the pipes. Even at low levels, lead can cause impaired intelligence, behavioral problems and learning disabilities.

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EPA Moves to Make Drinking Water Safer

Thousands of residents across the Rocky Mountain West have been sickened by Cryptosporidium this year, including more than 1,600 cases reported in Utah. The outbreak has reached record numbers and has federal officials in the affected states looking at the role water parks and splash parks play in spreading the diarrhea-causing parasite.

Splash parks, a popular feature with younger children because they require no swimming skills, have features where water sprays up from spouts in the ground. The risk of spreading cryptosporidium occurs in parks where this water is recirculated, the spray can rinse any contamination - whether from diarrhea, vomit or dirt - down into a water holding area and back up through the water spouts, according to the Centers for Disease Control and Prevention (CDC).

In general, water poses a high risk for transmitting cryptosporidium, which can live in human and animal fecal matter. Young children, especially those in diapers, can easily contaminate splash parks and pools. While there is no national pool code to regulate how splash parks are designed, the CDC is working with a consortium of scientists to come up with a model splash pool code. In addition to existing chlorine disinfection, recommendations call for inclusion of new supplementary disinfection measures that kill the parasite.

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Cryptosporidium Outbreak Hits the West

In mid-August, three northern provinces in Iraq experienced a cholera outbreak. Until last week, the outbreak had been limited to these three provinces. However, this month a case of cholera was confirmed in Basra, Iraq's second-largest and southernmost city. In addition, the World Health Organization (WHO) confirmed the same week the first case of cholera in Baghdad.

According to the WHO, Iraq has registered 29,000 cases of acute watery diarrhea, with 1,500 of those confirmed as cholera in cities in northern Iraq. The current outbreak has sharply increased Iraq's needs for chlorine to disinfect drinking water. Officials are concerned over a shortage of chlorine in the country, which is needed to prevent the disease from spreading.

The head of Baghdad's Water Department noted the capital had only a week's supply of chlorine remaining. Officials in Baghdad doubled the amount of chlorine in the drinking water since the outbreak occurred. A shipment of 100,000 tons of the water purifier has been held up at the Jordanian border over fears the chemical might fall into the hands of insurgents and be used in bombs.

For more information on the report, please visit:
Cholera Spreads to Iraq's South

In The News-is a bi-weekly, online service from the Water Quality & Health Council.  The publication is updated every other Friday and can be viewed by logging onto www.waterandhealth.org.  To receive the publication via e-mail, please click here and enter your e-mail address to join our mailing list.