Communication is a key element in management of an outbreak / epidemic / pandemic.  The first wave of communication (on the weekend) seemed to me to be pushing the public panic button a bit but it seemed to have stabilized yesterday (at least on TV reports) into more reporting and education.  Today, there is concern raised by the pork producers and the Secretary of Agriculture – that we call the illness by it’s proper viral designation – H1N1.  I maintain that we should refer to it as Influenza A – H1N1 – nicknamed swine flu virus.  But, we need some simple education in virology before the public lets go of the now familiar, swine flu.  Especially, since we already have a 1970’s reference to that name. 

Hardly anyone in the general public knew what the acronym- SARS- meant in 2003 but it became the common reference to the illness - not “civat cat flu” or “Canadian flu” or “North American Flu”.  With Avian flu – we had to reinforce that transmission is not related to eating chicken and poultry.  We have our work cut out for us – communicating the facts and educating the public.  This is an opportune time to teach cough and sneeze etiquette.  (Make it easy and fun with the Nanobugs Training Shirt - in the store on www.nanobugs.com)

Just when we thought the flu season was over for this year, we get the news of clusters of swine flu cases in the USA and deaths in Mexico.  The CDC and WHO are now alerting people of the potential for a pandemic (meaning, worldwide spread of the same disease or infection).  We have been working on global and local planning  for several years now and this is an important part of  the strategy for management of a pandemic.  Communication is a key - we learned that with the SARS Crisis of 2003 when the Chinese kept the initial cases under wraps.  However, the communication we heard today: "we are now "declaring a medical emergency" - can be pretty alarming.  The  media was describing Mexico City as a ghost town and runnning the footage of Mexicans being given surgical masks by policemen if they were outdoors.  But, a surgical mask does not protect you from viruses.  The strategy is to limit people from gathering in groups because they could be exposed to sick people coughing and sneezing on them.  Being outside in parks and fresh air allows dilution of the virus.  What a shame - that all those people in Mexico City were hiding inside their houses today- sharing air and microbes.  It is wise to cancel special events and large gatherings but that doesn't mean confining everyone indoors.  There was alot of reinforcement on the news from public health officals about "good hygiene like hand washing".  I wished they would have emphasized the equally critical behavior - to cover your coughs or sneezes with a tissue or your sleeve. (check out the Nanobugs Training T-Shirt as a tool to teach this technique www.nanobugs.com/shop.php

The purpose of closing schools is essentially to limit the exposure of students and teachers to potentially sick students.  But when people see  footage of dramatic cleaning of the school environment - it leads them to think that influenza A is environementally spread.  Swine flu and Avian flu are influenza A.  They are spread by coughs and sneezes. Course, hand hygiene is always a good strategy to interrupt person to person transmission.  I hope you will keep this situation in perspective.  Be patient and allow the epidemiologists to do the proper investigations and make their decisions based on the information they collect about the microbes and the confirmed cases. 

April has been designated by CDC as “STD Awareness Month” as an annual observance to raise awareness about the impact of sexually-transmitted infections on the health of Americans.  On the CDC website: www.cdc.gov/Features/STDAwareness/ you will find some sobering statistics on the incidence of STI’s especially among young people ages 15-24.  Statistics are not always effective in changing behaviors – especially in young people who are generally convinced that risks apply to others – a common feature of the “teen brain”.  CDC also points out the economic impact of STI’s: $15.9 billion annually in direct medical costs associated with these infections in Americans.  This is certainly why there was a push from the beginning in including STI prevention in the initiatives of the Obama stimulus plan.  There are obvious considerations with the future reforms to health care financing.

Nanobugs, inc has developed an STI Prevention Program for Teens and a powerpoint program to attempt to teach the appropriate microbiology related to the 9 STI pathogens.  We maintain that if individuals (especially teens) are informed about these microbes – call it “profiling” the pathogens – they will be more likely to engage in prevention behaviors (either abstinence or avoidance). 

The STI nanobugs can relieve most of the social pressure surrounding this topic in the classroom.  However, because of the restriction of time in the classroom to cover this section of the health curriculum, it is often covered superficially and combined the topic of pregnancy prevention. So I want to try something different: I am planning to take the STI nanobugs to the social networks this month to subtly inform people as they explore the profiles of these “microbes with attitude”.  My hope is that teens especially will assimilate the information more effectively on the internet than in the conventional classroom setting.

Well, did this discussion take your mind off the topic of this day: taxes? I hope so – STI’s are worse than taxes – no matter what tax bracket you are in – STI’s know no financial boundaries – they infect the rich and the poor and the uninformed.         And next year – I hope they will call this STI Prevention Month – we need move beyond awareness – to prevention.

About every 2 weeks, I spend the day with my 2.5-year-old grandson, Alex.  We almost always have a wonderful day that includes scrambled eggs with spinach, at least one shared apple, a walk around the block (sometimes 2), a long nap after the reading of 3 favorite books, playing restaurant with the play kitchen and fake food, and occassional housework - scouring sinks and vacuuming.  The day of activities would not be complete without the nanobugs.  Today was the best of days spent with Alex and the featured nanobug was Pseudomonas aeruginosa.  We removed the really worn Strep pneumo tattoo from his right forearm that we put on 2 weeks ago as Alex repeated, "he's snotty and naughty, right Nana?"  Then  we went to the website on the "puter" and  looked through the menagerie for the next nanobug to wear on his arm.  It seemed to take forever for him to make his selection - but that is a good thing - to extend the attention span of a toddler!  He clicked on Clostridium botulinum repeatedly along with many old favorites (especially Hep A) before finally making his choice. We applied the Pseudomonas nanobug to his left forearm and Alex learned to say Pseudomonas - it is certainly an appealing image for a 2 year old but saying the name Pseudomonas aeruginosa is a bit of a tongue-twister. Soon he had it down pat and after 22 times - he had memorized the one-liner: "Splish, splash, I'm right here in your bath" and giggled every time he repeated it.  He insisted upon calling Mom at work to share this new microbiology knowledge with her.  To reinforce the lesson, we printed Pseudomonas aeruginosa from the website coloring book.  Alex isn't much into coloring yet so I colored the nanobug while he napped.  He left my house with a tattoo on his arm and a picture to put on the fridge at home.  I was glowing.  What could be more rewarding for an infection preventionist, than being able to teach a 2-year-old elementary microbiology? - I guess, it would have to be effectively teaching health care workers the same!