Baby, it’s cold—and contagious—outside

Winter is coming. That means now is the time to brace for cold and flu season's resurgence with useful, universal infection-control reminders.

Cold weather is a harbinger for sneezes, sniffles and sicknesses as individuals' close proximity to one another indoors easily facilitates the spread of pathogens. That is, in part, why January and February mark peak flu season in the U.S., and also why the Centers for Disease Control and Prevention (CDC) is taking the time now to urge the public toward an ounce of prevention.  

This week, Dec. 4-10, marks National Influenza Vaccination Week, the CDC's public awareness observance that reminds people it's never too late to get a flu vaccine. Its timing is key, not only because it typically takes two weeks for a vaccine to reach maximum effectiveness, but also because at this point last year, only 40% of Americans had been vaccinated.  

Although a seasonal flu vaccine is the best way to reduce the chances that the virus will spread, good hygiene is equally critical. Universal infection control precautions help minimize the chances of getting sick from contact with patients, other health care workers and bystanders, writes David Krumholz, O.D., a professor at State University of New York College of Optometry, in AOA's Infection Control in Optometric Practice paper for the AOA Paraoptometric Resource Center.   "Failure to follow infection control guidelines puts everyone at risk." Dr. Krumholz notes.  

Eliminating transmission opportunities  

Just a few years ago, it was the global Ebola scare that renewed attention on universal infection control protocols, underscoring the importance for all health care providers to be educated about disease transmission and mitigation. Although Ebola is an extreme case, lessons gleaned from the contagion's outbreak directly apply to the more routine.  

Dr. Krumholz writes, "a whole series of conditions have to be just right for an infectious disease to be passed from one person to another"—a concept called the chain of transmission.

Breaking the chain, from contagious carrier to susceptible host, involves a three pronged focus:

1. Identifying viral hotspots. Find and eliminate areas where pathogens can live and grow, or "reservoir recognition and control," Dr. Krumholz notes. Think of all the instruments and equipment that may contact contagious hosts, including phoropters, slit lamps, examination chairs, condensing lenses, etc. All these resources must be cleaned, disinfected or sterilized between patients to eliminate cross-contamination. The type of surface material determines whether sterilization—removal of all microbial life forms—is possible, or whether disinfection—removal of pathogenic life with exception of bacterial endospores—is appropriate.
2. Mitigating spread. Commonly, asymptomatic patients spread pathogens without ever showing signs of infection, therefore universal precautions can minimize transmission opportunities. Handwashing is the single most important precaution, but can be wholly ineffective if done improperly. Dr. Krumholz suggests using liquid soaps and to wash hands vigorously for at least 15 seconds, using disposable paper towels to dry hands as opposed to a cloth towel. Alcohol or glycerin gels also are appropriate. If direct contact with infectious material is likely, remember that personal protective equipment (PPE) offers an effective barrier only for as long as the PPE remains safely in place. Immediately wash hands after PPE is removed and safely disposed.
3. Encourage healthy behaviors. It is important to proactively reinforce such infection mitigation techniques with doctors and staff, no matter the size of the office setting. While larger clinics or hospitals have employee health services to offer immunizations and health screenings, smaller offices don't have that luxury. Reinforce with staff the importance of not only following these universal precautions, but also acquiring vaccines when appropriate and ensuring they're truly healthy enough for work.

"Proper infection control practices protect yourself and those around you," Dr. Krumholz writes. "By knowing how pathogens may be transmitted, it is possible to limit your exposure to pathogens and how to interfere with their transmission."

Learn more seasonal infections commonly seen by doctors of optometry and how to help prevent the spreading of infectious diseases.