Nursing homes had problems controlling infections before all this

Jackson Manor, one of Signature HealthCare's 42 facilities in the state, had a major outbreak.

"Many Kentucky nursing homes failed at infection prevention and control even before the novel coronavirus blazed through them over the last two months, infecting more than 1,000 of their residents and staff as of Friday and killing more than 120," John Cheves reports for the Lexington Herald-Leader, after checking the homes' inspection records from April 2016 to December 2019.

"Among the places cited for errors as routine as a lack of hand-washing are seven of the 10 long-term care facilities now hardest hit by covid-19, such as Rivers Edge Nursing and Rehabilitation Center in Jefferson County, Signature HealthCare at Summit Manor in Adair County and Signature HealthCare at Jackson Manor in Jackson County."

But people who were looking for a nursing home for themselves or a loved one in the last year would have to dig deep, like Cheves did: "State regulators almost never issued a serious penalty for infection control violations, so they seldom resulted in fines or affected the federal government’s five-star rating system that the public uses to compare the quality of nursing homes."

Cheves examined the 333 infection-control citations issued to Kentucky nursing homes from April 2016 to December 2019. He summarizes with examples: "Nursing home employees failed to wash their hands, change gloves and disinfect equipment and supplies while walking from room to room among elderly and ailing residents, even when they handled urine and feces and cared for infectious patients in isolation, according to its own citations. . . . Aides passed out food, drinks and pills to residents with their unwashed bare hands while also touching their own faces, hair and communal objects such as light switches and refrigerator door handles, according to inspection reports. Feces-stained bed sheets were put on residents’ bed tables where personal items were kept. Residents’ surgical wounds were not properly cleaned and dressed."

Yet, the state Cabinet for Health and Services "nearly always determined there was 'minimal harm'," a key to keeping the violations from being considered serious and resulting in fines. Infection-control citations are among the most commonly issued to nursing homes, as well as among the least penalized, Cheves was told by Toby Edelman, senior policy attorney for the Center for Medicare Advocacy, which lobbies for better care for the elderly and disabled.

“We have a lot of nursing homes that get cited for infection control deficiencies year after year, and for really basic stuff like nursing aides not washing their hands between rooms. But our regulatory system is pretty toothless, so we haven’t been solving the problem,” Edelman said. “Unfortunately, at a time like this, during a pandemic, we’re all seeing the results.”

The health cabinet "declined to say whether the state did enough in the past to enforce infection control at nursing homes or whether it would take more aggressive steps in the future," Cheves writes. A cabinet official told him that it follows U.S. Centers for Disease Control and Prevention-recommended protocols for infection control.

“Awareness of confirmed cases of COVID-19 in our commonwealth and in long-term care settings has resulted in the escalation of safety and infection control protocols and expanded emergency-scenario planning,” spokeswoman Susan Dunlap wrote. “Long-term care facilities are anticipating changes to CDC guidelines with respect to safety and infection prevention based on new learnings from combating the novel coronavirus. When these are issued, CHFS will follow them.”

Cheves reports, The U.S. Centers for Medicare & Medicaid Services sent a team of inspectors to the country’s hardest-hit nursing homes. They found that in 36 percent of the facilities, staff were not following proper hand-washing guidelines, and in 25 percent, staff failed to properly use personal protective equipment, such as masks, gloves and gowns, even when they had it."

More action needed to protect patients from antibiotic-resistant infections, which kill an American every 15 minutes, CDC says

Cover of CDC report; to download it, click here.

More action is needed to protect Americans from antibiotic-resistant infections, 2.8 million of which occur in the U.S. each year, killing more than 35,000 people, one about every 15 minutes, says the federal Centers for Disease Control and Prevention.

On top of that, 12,800 people died from an infection that is not drug-resistant but is "caused by the same factors that drive antibiotic resistance—antibiotic use and the spread of germs," the CDC said in its report, Antibiotic Resistance Threats in the United States, 2019. "The number of people facing antibiotic resistance is still too high. More action is needed to fully protect people."

Hospitals are a main battleground in the fight. The word "hospital" appears 188 times in the 148-page report, which was issued days after the Leapfrog Group's latest rankings of patient safety at hospitals nationwide, including 50 in Kentucky. The most common grade, on an A-to-F scale, was a C, and the report showed that many hospitals had difficulty dealing with resistant infections.

The University of Louisville Hospital got a D overall in the Leapfrog Group's patient-safety ratings and was rated poorly in dealing with one of the major antibiotic-resistant infections, Methicillin-resistant staphlycoccus areus (MRSA), and C. diff, an infection related to the use of antibiotics. Click to enlarge.

The report's foreword, by CDC Director Robert Redfield, sums up the history of antibiotics in personal terms: "In March 1942, Mrs. Anne Miller of New Haven, Connecticut, was near death. Infectious germs had made their way into her bloodstream. Desperate to save her, doctors administered an experimental drug: penicillin, which Alexander Fleming discovered 14 years earlier. In just hours, she recovered, becoming the first person in the world to be saved by an antibiotic. Rather than dying in her thirties, Mrs. Miller lived to be 90 years old.

"Today, decades later, germs like the one that infected Mrs. Miller are becoming resistant to antibiotics. You could have one in or on your body right now—a resistant germ that, in the right circumstances, could also infect you. But—unlike the bacteria that threatened Mrs. Miller—the bacteria may be able to avoid the effects of the antibiotics designed to kill them. Unfortunately, like nearly 3 million people across the United States, you or a loved one may face an antibiotic-resistant infection."

The use of antibiotics has a self-defeating element: the growth of genetically different bacteria and fungi that have mutated into forms that are resistant to the antibiotics or picked up resistance traits from other germs through mobile genetic elements. Also, antibiotic use encourages development of Clostridioides difficile, or C. diff., a bacterium "that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon," says the Mayo Clinic. The CDC report says 223,900 cases of C. diff. occurred in 2017, killing at least 12,800 Americans.

"Dedicated prevention and infection control efforts in the U.S. are working to reduce the number of infections and deaths caused by antibiotic-resistant germs, but . . . CDC is concerned about rising resistant infections in the community, which can put more people at risk, make spread more difficult to identify and contain, and threaten the progress made to protect patients," the CDC said in announcing the report. "The emergence and spread of new forms of resistance remains a concern."

What is to be done? "Public-health prevention programs targeting resistant germs can and have worked to slow spread and save lives, but more needs to be done," the report says. "The U.S. and global community must scale up these effective strategies and develop new strategies to prevent infections and save lives. In the United States, infection prevention activities have proven effective in slowing the spread of resistant germs. This includes:

• Strategies to decrease spread within healthcare settings (e.g., implementing hand hygiene)
• Vaccinations
• Implementing biosecurity measures on farms
• Responding rapidly to unusual genes and germs when they first appear, keeping new threats from spreading

Ky. has half the cases in odd, 5-state outbreak of E. coli infection

Video from The Washington Post

Kentucky has about half of the cases in an outbreak of infections from a strain of E. coli bacteria that has also sickened people in Ohio, Virginia, Tennessee and Georgia. The federal Centers for Disease Control and Prevention said Friday that the source of the 72 infections has not been identified.

The CDC said Kentucky had 36 cases, but the day before, the state Department for Public Health said 46 people in the state had been sickened by the O103 strain of E. coli, which is among those that produce Shiga toxin.  Spokeswoman Barbara Fox said six had been hospitalized. The toxin usually sickens people two to five days after they swallow the germ, the health department says.

"Most people get diarrhea (often bloody), severe stomach cramps and vomiting," The CDC says. "Most people recover within a week, but some illnesses can last longer and be more severe. Talk to your doctor if you have symptoms of an E. coli infection. . . . Antibiotics are not recommended for patients with suspected E. coli infections until diagnostic testing can be performed and E. coli infection is ruled out."

The Mercer County Health Department said in a Facebook post, "These cases have been found in children and teenagers with an extensive exposure to fast food," but added, "The outbreak is not limited to young people."

That report, and the median age of those infected, 17, indicate that “It’s probably some convenience, fast food consumed by kids,” Bill Marler, a Seattle food-safety lawyer, told The Washington Post. "One silver lining, he added, is that people in this age range are typically healthy and not prone to further complications from E. coli," reports the Post's Michael Brice-Saddler.

Still, Marler said it is “concerning” that health officials haven't been able to trace the pathogen to a food source. “Given the size and the number of states that are involved, what you’re seeing is very unusual,” he told the Post. “If it was five people or 10 people, that’s a little harder to figure out. But when there’s 72 people and they’re being interviewed by epidemiologists, it’s pretty unusual you don’t have a culprit. The real question is, what do 72 people have in common over five states? It has to be something.”

"That something, Marler said, is likely a food or water product that people can’t remember they ate," the Post reports. "State and local health officials are required to interview ill patients and determine what they consumed in the week leading up to their symptoms, but recalling one’s dietary choices is often easier said than done, he said. Condiments, garnish, toppings, and spices can all contain traces of E. coli."

Marler said, “That’s probably why it’s taking longer to figure out, because people can’t remember what was in their meal.”

"Citing a CDC data set that dates to 1998, Marler noted outbreaks of E. coli O103 are relatively uncommon. Eighteen such outbreaks have been reported in the United States since 2000, with the highest number of reported illnesses being 29 during a 2010 outbreak in Minnesota. That makes this O103 outbreak by far the largest in recent memory, he said."

The state Department for Public Health says E. coli infections can be prevented by:

• Washing hands frequently for at least 20 seconds with soap and warm water, especially before eating, after going to the bathroom, handling raw meat and eggs, and after handling or petting animals;

• Thoroughly washing produce before eating;

• Thoroughly cooking meat;

• Cleaning and sanitizing food preparation areas;

• Avoiding swallowing lake or pool water;

• Drinking only pasteurized milk;

• Frequently cleaning and sanitizing restrooms, including door knobs and faucets; and

• Reporting diarrheal illnesses to your physician.

More information can be found here: https://www.cdc.gov/ecoli/ecoli-prevention.html.

Salmonella outbreak in 35 states linked to live poultry; 21 cases reported in Kentucky; here are some tips to avoid infection

U.S. Centers for Disease Control and Prevention photo

Poultry specialists from the University of Kentucky are urging Kentuckians who raise chickens or ducks to take extra precautions against salmonella infection, since 21 cases have been reported in the state.

“Any contact with live poultry puts you at risk for salmonella infection,” Jacqueline Jacob, UK poultry extension project manager for the College of Agriculture, Food and Environment, said in a news release. “Salmonella germs can be in the birds’ droppings and on their bodies and also on their cages, coops, hay, plants and the soil where they live and roam.”

Salmonella is a bacteria that makes people sick. Symptoms usually develop 12 to 72 hours after exposure and include diarrhea, fever and abdominal cramps. The illness usually lasts four to seven days. Children under 5, adults older than 65 and those with weakened immune systems are at the greatest risk of being severely affected.

These infections are part of a seven-state salmonella outbreak that have all been linked to contact with life poultry from multiple hatcheries. Jacob cautioned that any chicken can carry salmonella, even if it looks clean and healthy.

So far, more than 300 people have been infected, with more than one-fourth of those children aged 5 or younger, according to the federal Centers for Disease Control and Prevention.

“Many of the cases in the current outbreak are linked to backyard flocks, so we want to remind folks of simple things they can do to protect themselves," Jacob said.

Tips to avoid infection:

• Wash hands thoroughly with soap and water immediately after touching live poultry or anything in the area where they live.
• Do not let live poultry inside the house, or around areas where food or drink is located.
• Do not let children younger than 5 handle or touch live poultry without supervision.
• Adults should supervise the handwashing of young children.
• Keep poultry away from your nose, mouth and eyes.
• Wash your hands with sanitizer that has a 99 percent or higher bacteria kill rate after handling poultry at shows and fairs.

“It’s also a good practice to be careful when you wash equipment or eggs in the kitchen sink,” Jacob said. “You don’t want to cross contaminate food. Always use a good disinfectant to clean up in the kitchen when you’re finished.”

Click here for more advice from the CDC for backyard flock owners.

72 in Estill County have stomach sickness; 35 salmonella cases confirmed; eight people hospitalized; restaurant closes voluntarily

The Estill County Health Department reported Feb. 11 that 72 people in the county have reported "gastrointestinal illness," 35 of them have tested positive for salmonella and eight have been hospitalized with "symptoms and suspected Salmonella poisoning," Lexington's WKYT-TV reports.

County and state health officials are still working to determine the cause of the outbreak.

The health department said most of the victims had eaten at the Eagles Roost Sports Bar in Irvine before getting sick, but not all, so "Officials are still searching for a source of the outbreak," WLEX-TV reports.

Health officials told WKYT Feb. 10 that an inspector from the state Food Safety Branch had inspected the restaurant in question and found no infractions, but did take two food samples back to the state lab for further testing. The restaurant received a score of 99 on its most recent health inspection and is cleared to be open.

However, the owner of the Eagles Roost, Don Wiseman, has voluntarily closed its doors for now and told WLEX that he is just being cautious: "I mean, in my heart I felt like I was okay, but I didn't know for sure. I didn't want to take a chance that, that I was the cause of any illness."

Symptoms of salmonella include diarrhea, fever and abdominal cramps; they usually appear 12 to 72 hours after becoming infected and last up to a week, according to the Centers for Disease Control and Prevention. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness from an infection.

People with these symptoms are asked to consult with their doctor and to report them to their local or state health department.

Salmonella infection is a type of food poisoning caused by one of several strains of Salmonella bacteria. Most often it is caused by eating foods contaminated with the bacteria, but it can also be caused by handling pets, especially if they have diarrhea, reptiles, baby chicks and ducklings and small pet rodents and then not washing your hands, according to WebMD.

Myths about colds abound; here's good advice: wash your hands to prevent infection, and if you get a cold, chicken soup can help

Cold and flu season is here, and the lack of a cure for the common cold has helped sustain much misinformation about it. Neda Frayha, an assistant dean at the University of Maryland School of Medicine, did a column for The Washington Post outlining five myths about the common cold:

1. Colds can be spread only if someone sneezes or coughs. Actually, direct contact with a cold sufferer "is even more likely to make you sick, whether or not they cough near you," Frayha writes. "Several major studies have shown that hand-to-hand touch is the most common way to spread rhinovirus, the family of viruses that causes most colds. One of these studies . . . also demonstrated the importance of hand hygiene — it recommended applying a liquid iodine solution to the fingers, though soap works well, too — in reducing the spread of the virus."

You can get a cold from someone else's sneeze even if you aren't around. "Viruses can live on furniture, toys, phones and other common household or office surfaces for several hours," Fyarha writes. "A study in the American Journal of Epidemiology in 1982 showed that when young, healthy adults touched either coffee-cup handles or plastic tiles that had been contaminated with rhinovirus, and then touched their faces, half of them came down with a cold. Fewer of them became sick if they touched a plastic tile that had been sprayed with a disinfectant."

2. Hand-sanitizing gels are as effective as hand-washing to prevent the spread of the cold. "If given a choice between washing with soap and water or coating your hands in a dollop of sanitizer," Frayha writes, "the old-fashioned soap-and-water combination is the safer bet. Sanitizing gels don’t work well if your hands are visibly dirty. And they must contain at least 60 percent alcohol to reduce the spread of diseases such as the cold, but some varieties at your local pharmacy contain significantly less."

3. Air travel increases your risk of catching a cold. "There is no evidence that air travel makes us any sicker than our normal working environments on the ground," Frayha writes. "A large study published in the Journal of the American Medical Association in 2002 showed that traveling in a commercial aircraft with recirculated air did not increase the risk of catching a cold compared with flying in a plane that pumped in fresh air."

4. Colds cause fevers. Usually not in adults. "Fever is listed as a symptom of the common cold in television commercials for over-the-counter remedies . . . and in young children, fever is common in most upper respiratory infections," Frayha writes, but in adults, "fever — defined as a temperature of 100.4 degrees Fahrenheit or higher — is actually very rare in rhinovirus infections. It is much more common for a cold to cause a sore throat, a stuffy and/or runny nose, sneezing and cough, but with a normal body temperature. If you have these symptoms plus a fever, then you and your health-care provider should think about other possibilities, including strep throat, sinusitis, pneumonia or the flu. A true fever often means something else is going on in your body."

5. Home remedies such as chicken soup don’t work. "In 2000, researchers at the University of Nebraska studied homemade chicken soup and found that it had anti-inflammatory benefits, which can ease cold symptoms," Frayha writes. "Chicken soup exerted an anti-inflammatory effect — which could help a person feel better faster." She cautions, "There are dozens of home remedies that are said to help speed up recovery: ginseng, zinc, vitamin C, neti pots. There is little evidence to support them; some can even be harmful (for example, some zinc formulations can lead to permanent loss of smell)."

Anyone returning from an Ebola-stricken country will be monitored by health authorities for three weeks

All travelers who arrive in the U.S. from the Ebola-stricken countries -- Sierra Leone, Guinea and Liberia -- will be closely monitored for 21 days by public health officials, Dr. Tom Frieden, director of the federal Centers for Disease Control and Prevention, announced Wednesday, Oct. 22.

These measures took effect immediately in the six states that receive approximately 70 percent of travelers from Est Africa: New York, Pennsylvania, Maryland, Virginia, New Jersey and Georgia. All other states that receive travelers from the region, including Kentucky, will implement these policies "over the following days," a CDC release said..

Kit for travelers entering U.S. from West Africa

Travelers who have been in these countries will get a kit at the airport with an explanation of what Ebola symptoms are, a thermometer and instructions on how to use it, and specific contact information to report symptoms. These people will also be required to maintain daily contact with state and local officials for the entire 21 days following the last possible date of exposure to the Ebola virus.

"These new measures I'm announcing today will give additional levels of safety so that people who develop symptoms of Ebola are isolated quickly," Frieden told reporters.

These measures are in place only for travelers without symptoms. Those showing symptoms will be isolated and, if need be, transported by trained medical personnel. If a traveler is considered "high risk," but not yet showing symptoms, Frieden said he or she would be quarantined and not permitted to travel via public transportation.

New York and New Jersey have taken this new policy a step further and now require all medical workers returning from West Africa who had contact with Ebola patients to be quarantined for 21 days. Illinois will require people who have traveled to West Africa and have come into direct contact with someone infected with the Ebola virus to "undergo a mandatory 21-day home quarantine," Ray Sanchez and Elizabeth Cohen report for CNN.

New York Mayor Bill de Blasio said the policy could backfire. "These individuals who are going there to serve are the people who will end this crisis," de Blasio said. "We can't have the illusion that we can turn away from it and some day it may end. If we took that attitude, this would be a truly devastating global crisis."

Rural Ky. hospitals make sure they are ready for Ebola

Rural hospitals in Kentucky are making sure they are prepared in the event they get a patient with the Ebola virus, Bill Estep reports for the Lexington Herald-Leader.

The risk of Ebola coming to rural Kentucky is low and there have been no cases in the state, according to officials of the state Department of Public Health, but rural hospitals are getting ready just in case, Estep reports.

It's not known where a patient might enter the health care system, so every hospital must be prepared, State Health Commissioner Stephanie Mayfield, told Estep.

Hospital officials all over the state have told Estep that they are making sure they are prepared in case they get an Ebola patient, saying they are reporting up-to-date daily information on dealing with Ebola to their employees; staying apprised of what the state health department and the federal Centers for Disease Control recommend; updating patient-screening processes to help determine the risk of Ebola, reviewing isolation procedures; taking stock of protective gear; and providing staff education.

"The protocol for rural hospitals would be to put an Ebola patient in isolation, then contact the local or state health department for guidance on whether to transfer the patient," Joe Murrell, chief executive officer at the 25-bed Wayne County Hospital in Monticello, told Estep, because "most rural hospitals don't have the resources to treat an Ebola patient for a long period."

But is this level of preparation enough?

Health care workers continue to be concerned because the two nurses in Dallas who were caring for the infected man from Liberia who has since died, and now have Ebola, "reportedly got the virus despite wearing protective gear," Estep writes.

Initially Dr. Tom Frieden, director of the CDC, said any hospital could safely take care of Ebola, Kimberly Leonard reports for U.S. News & World Report. “You need a private room with a private bathroom, and rigorous, meticulous training and materials to make sure that care is done safely so caregivers aren’t at risk,” he said, Leonard writes.

But Linda Greene, an infection prevention manager at Highland Hospital in Rochester, N.Y., and a member of the Professionals in Infection Control and Epidemiology Regulatory Review Panel, told Leonard, "Despite the best efforts, we do know in many hospitals that infection-prevention control measures are under-resourced,” and "There may be need for even more specialization than we initially thought."

But Greene goes on to say that despite these challenges,"Every hospital, however, should be able to screen and identify a patient at risk and immediately put them into isolation as necessary and do the initial triage, Leonard reports.

This is what Kentucky hospitals seem to be doing, despite concerns of some that it might not be enough.

Kevin Kavanagh, a Somerset physician and board member of Health Watch USA, told Estep that there are still "unanswered questions" about care for patients with Ebola, citing "his understanding that the CDC still doesn't know how the Dallas nurses got infected despite wearing protective gear" and "what plans hospitals have to dispose of the medical waste" and the "extent of the knowledge about how the disease spreads."

News media blamed for most of Ebola scare; experts continue to say that risk of infection is low

The reaction of many Americas regarding the Ebola virus has gone beyond what is medically necessary, but is a natural reaction to fear, Maggie Fox reports for NBC News.

Medical experts told Fox that while the federal Centers for Disease Control and state health departments are taking appropriate measures to keep an eye on people who were in direct contact with Ebola patients, some actions "may be excessive," such as Cleveland-area schools closing after a middle-school worker "traveled home from Dallas on Frontier Airlines Tuesday on a different flight, but perhaps the same aircraft" as the Ebola-infected nurse, Fox reports.

“They are taking drastic steps for a risk that is rather remote,” said George Kapalka, professor of psychological counseling at Monmouth University in New Jersey.

Blame for this fear is placed on the news media and politicians, Fox reports. Media are “undoubtedly complicit in stoking this fear, not by covering the story — that’s fine,” risk perception expert David Ropeik told Fox. “They are complicit by burying all the qualifiers about how minimal the risk is.”

So how risky is Ebola?

“The only individuals potentially at risk for Ebola in the United States right now are those who have traveled to affected areas of West Africa or who have been directly involved in treating cases of Ebola or close contacts to a symptomatic patient with Ebola," Stephanie Mayfield, Kentucky's public health commissioner, said in a press release.

Mafudia Suaray, a family physician at Rutgers Robert Wood Johnson Medical School, says the risk of getting Ebola in the U.S. is "very low." She explains that "Ebola is a virus that is spread from person to person through contact with bodily fluids, including saliva, tears, sweat, urine, blood, stool and semen. It is not spread through the air. ... The virus cannot be spread through contact with intact skin and a person must have symptoms of the disease to spread it to others."

Adam Cole of NPR created a visual to show how unlikely an Ebola infection is, based on the reproduction number of the virus, which indicates how many people one person might infect. It says that for every person who has Ebola will infect two others, but direct contact with a bodily fluid is required.

And the reason that officials, including the CDC Director Thomas Frieden, think Ebola will be contained in the U.S. is because our public health system is good and Ebola isn't contagious until symptoms are present, allowing time to isolate those who have come in contact with anyone who has been infected, and thus stopping the spread of the disease, Michaeleen Doucleff reports for NPR.

Suaray reminds us in the release that "common sense prevention measures should always be the priority, whether for Ebola or for more common illnesses such as the cold and flu." Wash your hands, stay home if you have fever, see a health care provider if your fever is high, cover your face with your arm or a tissue when you cough or sneeze and talk to your doctor if you plan on traveling to an infected region.

Respiratory virus that is sweeping Midwest has found its way to Kentucky; frequent handwashing remains best defense

The respiratory virus that has been hospitalizing children in the Midwest has come to Kentucky, reports Chris Kenning of The Courier-Journal: "Kraig Humbaugh, deputy commissioner of the Kentucky Department of Public Health, said the Centers for Disease Control and Prevention recently confirmed that five of 10 cases it tested from Kentucky were enterovirus D68."

Enteroviruses are common and tend to peak at this time of year, and enterovirus D68, a less common strain of this common virus, causes mostly respiratory illness. The CDC says symptoms for enterovirus D68 can range from mild to severe respiratory illness and that mild symptoms look very much like a cold: fever, runny nose, sneezing, cough, and body and muscle aches.

But it is the severe respiratory symptoms that are causing hospitalizations, particularly among children with asthma or underlying medical conditions, Kenning notes.

"In Kentucky, the spike in respiratory illnesses was first noticed in the central part of the state several weeks ago. But it is now being reported elsewhere, including in Louisville, although D68 has not been confirmed in Louisville," he reports. No deaths have been reported in Kentucky or in other states, officials told him.

"Hospitals in Colorado, Missouri and potentially eight other states are admitting hundreds of children for treatment of an uncommon but severe respiratory virus," probably enterovirus D68, The Washington Post reports.

From mid-August to Sept. 12, 97 people in Colorado, Illinois, Iowa, Kansas, Kentucky and Missouri were confirmed to have respiratory illness caused by enterovirus D68, according to the CDC.

The virus is spread when the infected person coughs, sneezes or touches a contaminated surface. There is no treatment or vaccine for the virus.

The best ways to reduce your risk are: frequent hand washing; keeping unwashed hands off of your eyes, nose and mouth; avoiding contact with people who are sick; and disinfecting communal surfaces frequently.

Humbaugh told Kenning that he is encouraging families who have children with cold-like symptoms that cause difficulty breathing to consult with their doctor. If you're sick, he said, stay home.

West Nile outbreak light in Ky. but 'one of the largest' in nation

U.S. health officials reported Wednesday three times the usual number of West Nile cases for this time of year and one expert told the Associated Press it was “one of the largest” outbreaks since the virus appeared in this country in 1999.

So far, 1,118 illnesses have been reported, about half of them in Texas, according to the Centers for Disease Control and Prevention. Kentucky has reported few cases.

In an average year, fewer than 300 cases are reported by mid-August. There have also been 41 deaths this year. Most infections are usually reported in August and September, so it’s too early to say how bad this year will end up, CDC officials said. AP reports that West Nile virus peaked in 2002 and 2003, when severe illnesses reached nearly 3,000 and deaths surpassed 260.

 The best way to prevent West Nile disease, say experts, is to avoid mosquito bites. Insect repellents, screens on doors and windows and wearing long sleeves and pants are some of the recommended strategies. Also, empty standing water from buckets, kiddie pools and other places to discourage breeding. (Read more)

More hospital-acquired infections are reported in patients cared for nurses who are overworked, study finds

Getty Images stock photo.

Overworked nurses dealing with heavy patient loads are associated with increases in hospital-acquired infections, say researchers with the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

"For each 10 percent jump in the proportion of nurses who logged high levels of burnout, there was roughly one additional catheter-associated urinary tract infection per 1,000 patients and almost two extra surgical site infections per 1,000," reports JoNel Aleccia for NBC News.

Researchers conducted a survey with 7,000 registered nurses at 161 Pennsylvania hospitals and matched that data with hospital infection rates and characteristics of hospitals nationwide. The study found more than a third of nurses said they feel high levels of burnout. They cared for an average of 5.7 patients each, and "when even one patient was added to that load, the result was an additional 1,351 infections within the hospital population studied," Aleccia reports.

The study, published in the American Journal of Infection Control, also found cutting down on burnout not only reduces infections but saves money. Cutting it by 30 percent decreased urinary tract infections by 4,000 and surgical site infections by more than 2,200, resulting in a savings of between $28 million and $69 million each year, researchers found.

When it comes to nurse-to-patient ratios, no one seems to be tracking the averages, Aleccia reports. They can range from one nurse for every one or two patients in intensive care units or a one-to-five ratio, as mandated in surgical units in California. (Read more)

Lyme disease in Ky. probably more common than reported

Nearly anyone who has spent considerable time in the woods this summer has later discovered they carried a visitor back with them — one the size of a freckle who latches on for dear life. Ticks are not uncommon in Kentucky, though Lyme disease, which is spread through the bite of a black-legged deer tick, is not commonly seen in the state.

But those numbers are likely under-reported, Keiara Carr reports for The Courier-Journal, in part because "Current medical guidelines say the disease is so rare in Kentucky that doctors should look for alternative causes for symptoms that might suggest Lyme disease."

Only five cases were reported in Kentucky in each of the past two years and there was just one case in 2009. But it's likely cases went under-reported because doctors don't give the blood test that diagnoses Lyme. They just don't feel it's necessary given the rarity of the disease in the area, Carr reports.

But Mike Gatton of Louisville knows all too well that it's possible. He got bitten by a tick while mowing his lawn two years ago. He developed a rash on his leg but when he went to the doctor he was tested for a variety of diseases, including West Nile, multiple sclerosis and Lou Gehrig disease, but not Lyme. "I was feeling more and more fatigued. I was having severe headaches. I was really concerned," he said.

When he got another tick bite a year ago and had the same reaction he had to the first bite, he put the tick in a vial and brought it to his doctor, who still dismissed the possibility of Lyme. He is now being treated with antibiotics he takes intravenously.

Symptoms of Lyme disease include fever, headache and fatigue. Sometimes, a rash that looks like a bull's eye around the tick bite can develop. Usually, people get better with large doses of antibiotics. If left untreated, "the infection can be painful and debilitating, causing arthritis or spreading to the heart and nervous system," Carr reports.

Guidelines by the Infectious Disease Society of America "to help doctors decide if a patient is eligible for treatment say the patient should have received the tick bite in an 'endemic area," Carr reports, which makes sense according to Paul Mead, a consulting physician for the Centers for Disease Control and Prevention. "For example, a physician in Africa evaluating a child for fever should have malaria at the top of his list; a physician in Kentucky should not," he said. (Read more)

Swine flu killed nearly 300,000 worldwide, study finds

The swine flu of 2009, often referred to as H1NI, killed an estimated 284,500 people, making it 15 times more deadly than it was thought at the time of the pandemic, a new study has found. The report, published Tuesday in the journal Lancet Infectious Diseases, said the numbers might be eventually be  as high as 579,000 people. The original count, tabulated by the World Health Organization, was a mere 18,500.

Those nearly 300,000 deaths were confirmed by lab testing, which the WHO warned vastly underestimated the situation "because the deaths of people without access to the health system go uncounted, and because the virus is not always detectable after a victim dies," reports Sharon Begley for Reuters. In Kentucky, the Department for Public Health reported there were 41 confirmed H1N1-related deaths, said spokeswoman Beth Fisher.

More than 50 percent of swine flu deaths were in Africa and southeast Asia, though they only account for 38 percent of the world's population. Because vital statistics data are either non-existent or incomplete in poorer countries, researchers had to rely on estimates and assumptions but did start with hard data, including the number of health workers who went door-to-door to ask about flu-like symptoms in rural areas and obtained nasal and throat swab samples. They used these numbers to get an estimate on the proportion of a country's population infected with H1N1. Results show the flu killed two to three times more people in Africa than elsewhere. It infected children most, adults moderately and the elderly hardly at all. (Read more)

Measles is still around; rate in 2011 was highest in 15 years

Measles virus (Photo by Scott Camazine/CDC/Getty Images)

In 2000, the Centers for Disease Control and Prevention declared measles had been eliminated in the United States. But last year, the nation had the most cases of the infectious disease since 1997.

A report released last week shows there were 222 cases of measles and 17 measles outbreaks in 2011. In a typical year, there are usually just 50 to 60 cases. This year, there have already been 25 cases.

"Of the 222 reported cases, 50 percent were associated with the 17 outbreaks and 90 percent were associated with importations from foreign countries — 26 percent from U.S. residents traveling abroad and 10 percent from foreign visitors," reports Alexandra Sifferlin for Time magazine.

Each case is treated with intense investigation because of the highly contagious nature of the virus. "You can catch measles just by being in a room where someone with measles has been, even if they left," said Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diesease. "It's serious; one out of three people who got it last year had to be hospitalized." No one died, however.

Of the 196 U.S. residents who contracted the virus last year, 166 had not been or did not know if they had been vaccinated. More than 80 percent of them were eligible for vaccine.

"Many people think diseases like measles are gone and that they do not need to vaccinate themselves or their children," Sifferlin reports. "But the CDC warns measles is still prevalent worldwide. Globally, about 20 million people get measles each year." (Read more)

Kentucky second highest in antibiotic consumption in U.S.

The next time you ask your doctor for an antibiotic, or if he or she offers to give you one, think again. It might do your health no good, but could be bad for public health.

"Every time an antibiotic is used ... future effectiveness of that drug is diminished," but Kentuckians take antibiotics at the second highest rate in the country, with 1,205 prescriptions per 1,000 people, says a study by the Centers for Disease Dynamics, Economics and Policy. Only West Virginia had a higher rate, 1,214 per 1,000. 

Studies show 1 million antibiotics are prescribed unnecessarily every year. "Though antibiotics offer no benefits for colds and other viral infections, many people, including doctors, continue to view these drugs as a quick fix," said a press release by the Robert Wood Johnson Foundation, which helped fund the study.

The problem with the overuse of antibiotics is that bacterial infections become resistant to them. To illustrate the issue, CDDEP says, "High-level penicillin resistance in Streptococcus pneumonia in the United States has experienced a thousand-fold increase in the last 20 years," rising from 0.02 percent in 1987 to more than 20 percent in 2004. The prevalence of methicillin-resistant Staphylococcus aureus — known more commonly as staph — increased from about 2 percent in 1974 to 50 percent in many U.S. hospitals in 2004.

"The problem of resistance is an evolutionary game played between humans and microbes: we try to stay ahead by creating new antibiotics, and microbes develop resistance to our drugs," CDDEP reports. "Unfortunately for us, microbes evolve resistance to antibiotics faster than we can create new drugs, meaning that, in recent years, bacteria have been winning this 'arms race.'"

Though there is no cure to resistance, managing the levels at which people become resistant is possible through judicious prescribing, vaccination, hospital infection control, treatment strategies and new antibiotics. (Read more)