Infectious Disease Specialist:
Microbes Don’t Need Passports
Darrel Stuart, M.D., infectious disease specialist who sees patients in Bay City, and at McLaren Bay Region, cautions we are more vulnerable now to infectious disease because of the huge growth in urban populations, and because air travel allows disease to spread across the globe in a matter of hours.
"We don’t give much thought to infectious diseases unless we’re the patient, or we know someone who has an opportunistic infection," says Dr. Stuart. "The reality is there are a number of emerging diseases with which we should be very concerned. We’ve discovered more aggressive strains of pneumonia that can be deadly for the very young, the elderly, those with chronic diseases, or compromised immune systems. On college campuses, where people live in close contact, there have been cases of infectious meningitis. Universities have responded well in encouraging students to get the meningitis vaccine.
"Tuberculosis is making a comeback. We attribute this to increasing numbers of people with immune systems weakened by HIV infection, cancer and chemotherapy, drugs taken after an organ transplant, and increasing poverty and drug abuse. West Nile Virus is an increasing concern because its vector is the common mosquito. This disease wasn’t even on a radar screen until a few years ago.
"While many are fortunate to have access to AIDS treatment in the U.S., it’s killing thousands by the day in Africa, because of lack of education about how it’s spread, and access anti-retroviral medications. In many countries, AIDS is this century’s ‘leprosy’ – a disease where the social and political stigma is so great that leaders don’t want to acknowledge there’s even a problem.
"Other emerging potentially deadly infectious diseases include an E. coli infection spread by eating contaminated meat, Ebola hemorrhagic fever, and a new disease – human granulocytic ehrlichiosis spread by ticks that can also carry Lyme disease.
"Changes in the streptococcus bacterium – or invasive strep – are causing diseases where a weakened immune system allows the bacterium to attack muscle tissue, and a second toxin that destroys tissue by breaking down protein. We do have antibiotics that can be effective against invasive strep, particularly when treatment is begun early.
"The truth is we all have challenges with potentially infectious diseases in our own backyards and in our workplaces. Probably 80% of infections are acquired from the environment. I’m just as guilty as anyone, but I’ve yet to see someone disinfect their workspace on a regular basis. A study* at the University of Arizona by environmental virologist Dr. Charles Gerba found desktops had almost 21,000 germs per square inch. Computer keyboards had 3,925 germs per square inch. Phones were the worst – more than 25,000 germs per square inch. The toilet seat averaged just 49 germs per square inch.
"A disinfecting cleaner used to wipe down your workstation could eliminate most of these germs. One of the simplest infection control prevention measures is washing your hands. Soap and hot water for 18-20 seconds, frequently during the day, goes a long way in preventing infections.
"Not infrequently, we encounter infections in everyday life – the common cold, pneumonia, ear infection, bladder infection. With growing populations and individuals crowded together (where you work, shop, play or worship) we may be more vulnerable to contagious diseases than in the past. With global transportation, an emerging infection in one part of the world can be in another in no time. A recent example is Severe Acute Respiratory Syndrome (SARS). We are watching the number of Avian flu cases, and the possibility that this may become a very serious world health concern.
"Companies, organizations and schools would do well to encourage children and adults to stay home if they have a temperature, are coughing and sneezing, or are experiencing diarrhea and vomiting. Going to school or coming to work in those situations increases the likelihood that you’ll pass along your germs to another person. If these symptoms continue for longer than a day or two, schedule an appointment with your doctor."
Click here to review Dr. Stuart’s professional credentials. He holds dual certifications in internal medicine and infectious disease. Dr. Stuart chairs the Infection Control Committee at McLaren Bay Region. At the hospital, he sees patients with infectious disease, either present at admission, or hospital-based infections. In his practice, Dr. Stuart treats the more virulent infectious diseases, like osteomyelitis, invasive strep, neutropenia, hepatitis, bacterial pneumonia, infections from compromised immune systems, and HIV-AIDS.
*Eating at Your Desk? Disinfectant is in Order." Charles Gerba, Ph.D., Occupational Health Management, January 2005.