Monday, July 30, 2012

Quality Control in the Microbiology Lab


Hello everyone,

This week in lecture we discussed quality in the clinical microbiology laboratory. This related directly to laboratory tour our class to of VA Medical Center. Here’s what I learned:

Laboratory quality control is designed to detect, reduce, and correct deficiencies in a laboratory's internal analytical process prior to the release of patient results, in order to improve the quality of the results reported by the laboratory. QC is associated with the internal activities that insure diagnostic accuracy as well as those external activities that ensure positive patient outcome. Positive patient outcomes are:
• Reduced length of stay
• Reduced cost of stay
• Reduced turn-around time for diagnosis of infection
• Change to appropriate antimicrobial therapy
• Customer ( physician or patients )satisfaction

The items list above are the responsibility of all laboratory personnel .

The Standard operating procedures manual (SOPM)  is considered part of QC program. The SOPM defines test performance, tolerance limits, reagent preparation, required quality control ,result reporting and references. The SPOM is available in the work area and is the definitive laboratory reference that is used often for questions relating to individual test .

Continuing education program are also apart of quality control to ensure that sufficient qualified personnel are employed for the volume and complexity of the work performed.

Also apart of quality control, the laboratories are required to participate in an external proficiency testing (PT). The laboratory must maintain an average score of 80%to maintain licensure in any subspecialty area. The laboratory's procedures, reagents, equipment and personnel are all checked in the process. PT provides an insight into the laboratories performance.

And last, the media, is also a part of quality. Sterility checks are performed of all media used in the laboratory. This done by taking a representative sample of the lot and testing it for sterility. 5% of any lot is tested when a batch of 100 or fewer unit is received   and maximum of 10 units are tested in large batches. Sterility is checked by incubating the medium for 48 hours at the temperature at which it will be used.

Of course these are just a few areas of quality control in the microbiology lab. There are many, many more but these are some that not only did we learn about in class but I also heard the microbiology supervisor mentioned that she participated in in her lab.

I have included a link to a video that I thought was interesting called, Meet the Pathologists Behind the CAP's Surveys.  This video is of members of the College of American Pathologists that attended the 2011 AACC Annual Meeting in Atlanta and explained how Board-certified pathologists shape CAP's world-renown Proficiency Testing Program. If you’re interest check it out!!!
http://www.youtube.com/watch?v=tKEJ8mgmqME

Thanks for reading!

Graduate Project - Treatment and Prognosis

Hello everyone,
So as the semester comes to a close and we look back, we have discussed and learned a lot about Systemic Lupus Erythrematosus. We’ve learned about the different types, the many and varying symptoms, the diagnosis,, we’ve even learned the many people that we know that are sufferers of the disease. Now it’s time we chat a little about treatment and prognosis.
Treatment
As we know there is no cure for SLE so the goal of treatment is to control symptoms. Treatment decisions are based on symptoms and the severity of those symptoms.
Mild disease may be treated with:
    • Nonsteroidal anti-inflammatory medications (NSAIDs) treat arthritis and pleurisy

    • Corticosteroid creams to treat skin rashes

    • An antimalaria drug (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms

    • You should wear protective clothing, sunglasses, and sunscreen when in the sun.
Treatment for more severe lupus may include:
    • High-dose corticosteroids or medications to decrease the immune system response

    • Cytotoxic drugs (drugs that block cell growth)
Also, it is important to have preventive heart care, up-to-date immunizations, tests to screen for thinning of the bones (osteoporosis), and therapy and support groups which may help relieve depression and mood changes that may occur in patients with this disease.

Prognosis
SLE is one of the most serious rheumatic diseases and it can affect so many organs that a cause of death in some people with SLE may not be directly attributed to the condition. In fact, a primary cause of death among patients with lupus is atherosclerosis which is a disease of the coronary blood vessels resulting from accelerated buildup of plaque. Never the less because of more effective and aggressive treatment, the prognosis for SLE has improved markedly over the past two decades. Only three drugs were FDA-approved for the treatment of lupus (Prednisone, Aspirin, Hydroxychloroquine) until the 2011 FDA approval of belimumab so advances are being made. It has been seen that treatment early in the course of the illness improves long-term progress. About 85 - 95% of people with lupus survive 10 years and most people with lupus can live normal lives as longs as the disorder is carefully monitored and treatment adjusted as necessary to prevent serious complications.

So, there has been a lot of information shared and now it’s time to put it all to the test. This blog post is what I like to call "SLE Review"!!! Below you will find a crossword puzzle that all about Lupus. If you dare try it out. Test your knowledge and see how much you’ve learned so far.

I hope that you have found this information that I shared on Lupus not only informative but interesting.

Thanks for reading and good luck!



Monday, July 23, 2012

Graduate Project - Antinuclear Antibodies (ANAs) – Diagnosing Lupus

Hello again,

After my post on diagnosing Lupus I recieved a lot of questions on using Antinuclear Antibodies (ANAs) to diagnose Lupus so that’s what we will cover in this post.

The primary test for SLE is Antinuclear Antibodies (ANAs) which checks for antinuclear antibodies that attack the cell nucleus. High levels of ANA are found in more than 98% of patients with SLE. However there are other conditions that may cause high levels of ANA, so a positive test is not a definite diagnosis for SLE. Other diseases are scleroderma, Sjögren syndrome, or rheumatoid arthritis. ANAs may also be weakly present in about 20 - 40% of healthy women. Drugs such as hydralazine, procainamide, isoniazid, and chlorpromazine can also produce positive antibody tests. A negative ANA test makes a diagnosis of SLE unlikely but not impossible. High or low concentrations of ANA also do not necessarily indicate the severity of the disease, since antibodies tend to come and go in patients with SLE.

In general, the ANA test is considered a screening test. If SLE-like symptoms are present and the ANA test is positive, other tests for SLE will be administered. If SLE-like symptoms are not present and the test is positive, the doctor will look for other causes, or the results will be ignored if the patient is feeling healthy.

Antinuclear Antibodies (ANAs) Pattern seen in SLE:
Homogeneous (Diffuse)
  • Uniform fluorescence of entire nucleus with or without masking of nucleoli

  • Chromosome region of metaphase mitotic cells positive with smooth or peripheral staining intensity greater than or equal to interphase nuclei


    Also, additional, more specific tests, such as the anti-double strand DNA (dsDNA) and anti-smith antibodies (Sm), are used to confirm the diagnosis of lupus.
    Tests used to diagnose SLE may include:
    • Antibody tests, including antinuclear antibody (ANA) panel

    • CBC

    • Chest x-ray

    • Kidney biopsy

    • Urinalysis
    Remember, no one test can diagnose or rule out the disease and one would have to present with at least 4 of the 11 typical.
  • Malar rash – a rash over the cheeks and nose, often in the shape of a butterfly

  • Discoid rash – a rash that appears as red, raised, disk-shaped patches

  • Photosensitivity – a reaction to sun or light that causes a skin rash to appear or get worse

  • Oral ulcers – sores appearing in the mouth

  • Arthritis – joint pain and swelling of two or more joints in which the bones around the joints do not become destroyed

  • Serositis – inflammation of the lining around the lungs (pleuritis) or inflammation of the lining around the heart that causes chest pain which is worse with deep breathing (pericarditis)

  • Kidney disorder – persistent protein or cellular casts in the urine

  • Neurological disorder – seizures or psychosis

  • Blood disorder – anemia (low red blood cell count), leukopenia (low white blood cell count), lymphopenia (low level of specific white blood cells), or thrombocytopenia (low platelet count)

  • Immunologic disorder – abnormal anti-double-stranded DNA or anti-Sm, positive antiphospholipid antibodies

  • Abnormal antinuclear antibody (ANA)
  • Hopefully this post added to your wealth of knowledge on SLE.

    Thanks for reading comment and post!!!




      Mycobacterium tuberculosis

      Hello everyone,

      This week in lecture we discussed Mycobacterium tuberculosis. Just so happen this very same week I had to renew my annual TB skin test. This made me wonder, what was the big deal that we had to get tested for TB each year. So I did some research and I found that transmission of tuberculosis, including multidrug-resistant tuberculosis, is a recognized risk for laboratory workers. Health care workers in general are considered to be apart of the high-risk infection groups for Tuberculosis. UAB state that, "Given the nature of their work, students engaged in health professional training programs could have a higher risk of contracting Rubeola, Rubella, Mumps, Tetanus, Diphtheria, Varicella, Tuberculosis, Pertussis, and Hepatitis B. All UAB students in the Joint Health Sciences programs and in the Schools of Medicine, Dentistry, Optometry, Public Health, Nursing, and Health Professions are required to be immunized."

      So what does UAB require for Tuberculosis Screening?
      • All international students and scholars must show proof of a non-reactive Tuberculin skin test or negative blood test (Quantiferon), or appropriate treatment if positive, within three months prior to enrollment or visiting

      • PPD (skin test) screening requires a 2-step process, with PPD (skin test) placements at 1-3 weeks apart.

      • Non-reactive (negative) Tuberculin skin test or chest x-ray reports done outside the United States will not be accepted.

      • Individuals with a history of a reactive Tuberculin skin test or blood test must provide a current chest x-ray (taken since their last positive TB test but within three months prior to enrollment or visiting), indicating that the person is free of active tuberculosis. Individuals with a positive TB screening test should complete the TB Questionnaire, submit it to Student Health Services, and consult the UAB Student Health Services TB Testing Policy to view the required follow-up.
      So what is the TB skin test:
      The Mantoux tuberculin skin test (TST) is the standard method of determining whether a person is infected with Mycobacterium tuberculosis. The TST is performed by injecting 0.1 ml of tuberculin purified protein derivative (PPD) into the inner surface of the forearm. The TST is an intradermal injection and when placed correctly, the injection should produce a pale elevation of the skin 6 to 10 mm in diameter. The skin test reaction should be read between 48 and 72 hours after administration. The reaction should be measured in millimeters of the induration (palpable, raised, hardened area or swelling), making sure not to measure the erythema (redness). The diameter of the indurated area should be measured across the forearm.

      How Are TST Reactions Interpreted?
      Classification of the Tuberculin Skin Test Reaction:
      An induration of 5 or more millimeters is considered positive in
      -HIV-infected persons
      -A recent contact of a person with TB disease
      -Persons with fibrotic changes on chest radiograph consistent with prior TB
      -Patients with organ transplants
      -Persons who are immunosuppressed for other reasons (e.g., taking the equivalent of >15 mg/day of prednisone for 1 month or longer, taking TNF-a antagonists)
      An induration of 10 or more millimeters is considered positive in
      -Recent immigrants (< 5 years) from high-prevalence countries
      -Injection drug users
      -Residents and employees of high-risk congregate settings
      -Mycobacteriology laboratory personnel
      -Persons with clinical conditions that place them at high risk
      -Children < 4 years of age
      - Infants, children, and adolescents exposed to adults in high-risk categories
      An induration of 15 or more millimeters is considered positive in any person, including persons with no known risk factors for TB. However, targeted skin testing programs should only be conducted among high-risk groups.

















      So as you can see from the chart, laboratory personnel and other adults in high-risk categories induration measurement is greater other categories to be consider positive.
      So as students, we should understand our risk and take the TB screening process seriously. I know we are all busy, but we shouldn’t put it off. Make sure to get your TB screening annually and take the necessary precaution to remain TB negative.

      Also, I have included a few links: two on Mycobacterium tuberculosis to provide more information on the bacteria and disease and one on the TB skin test Mantoux Method that I mention above. Also I have included a link from a journal insert on Tuberculosis in laboratory workers. If you are interested please check them out.

      As always, read, comment, and post!

      Thanks for reading!!!




      Mantoux Method Http://www.youtube.com/watch?V=br86g-itrtq

      Monday, July 16, 2012

      Antimicrobial Resistance and Susceptibility Testing


      Hello Again!!!

      This week’s lecture we discussed antimicrobial susceptibility testing.
      Antibiotic use has been beneficial and, when prescribed and taken correctly, their value in patient care is enormous. However, these drugs have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective. People infected with antimicrobial-resistant organisms are more likely to have longer, more expensive hospital stays, and may be more likely to die as a result of the infection.

      What cause antimicrobial resistance?
      Inappropriate and irrational use of medicines provides favourable conditions for resistant microorganisms to emerge and spread. For example, when patients do not take the full course of a prescribed antimicrobial or when poor quality antimicrobials are used, resistant microorganisms can emerge and spread.

      Selecting an Antimicrobial Drug
      Before antimicrobial therapy can begin three factors must be known:
      • Overall medical conditions of patient
      • Nature of microorganism causing infection
      • Degree of microorganism susceptibility (sensitivity to various drugs

      Antimicrobial Susceptibility Testing
      The purpose of performing antimicrobial susceptibility testing is to assist clinicians with the selection of appropriate targeted antibiotic therapy in order to optimize clinical outcomes. Infection-related and overall mortality is reduced when patients are treated expeditiously with an antibiotic to which the organism is susceptible.

      Methods
      The methods of antimicrobial susceptibility testing we learned about are qualitative and quantitative. The disk diffusion method, also known as the Kirby-Bauer method, is a qualitative method of susceptibility testing . Broth microdilution and agar dilution methodologies are considered quantitative because they can measure the minimum inhibitory concentration (MIC). The MIC is defined as the lowest concentration of an antibiotic that inhibits visible growth of a microorganism. Both quantitative methods are considered the reference methods for susceptibility testing because of their high levels of reproducibility.

      How do we prevent antimicrobial resistance?
      • Limit drug use - less selective pressure
      • Proper drug use - viruses are not affected, use full dose to ensure elimination of pathogens
      • Narrow range antibiotics - kill only the targeted microbes; less likely complications
      • Multiple drug treatments - drugs can work synergistically; much less likely to get drug resistances

      Also, for more prevention methods and to learn what initiatives the Center for Disease Control and Prevent are taking to combat this problem, I have included a link to their "Get Smart for Healthcare" page so check it out.

      Also, for those of you who are interested, I’ve included links to journal articles on "Antimicrobial‐Resistant Pathogens Associated With Healthcare‐Associated Infections" as well as "Frequent Acquisition of Multiple Strains of Methicillin-Resistant Staphylococcus aureus by Healthcare Workers in an Endemic Hospital Environment." I found them very interesting so check them out.




      Until next time, read, comment, and post!
      Thanks for reading!!! 

      Joke of the day:

      Sunday, July 15, 2012

      Diagnosing Lupus - Graduate Project

      Hello Everyone,

      In weeks prior I’ve discussed different aspects of Lupus. Now I want to discuss in detail how Lupus is diagnosed.

      As we’ve learned Lupus is chronic and complex, as well as unpredictable and varies greatly from one individual to the next making it often difficult to diagnose. Because of this, there is no single laboratory test that can determine if a person has lupus. To complicate matters even more, many symptoms of lupus are similar to those of other diseases, and symptoms can develop gradually as well as come and go over weeks and months. It can often take years for a diagnosis to be made. To diagnose lupus, a doctor should be able to find physical or laboratory evidence of the condition, such as swelling of joints, protein in the urine, fluid around the lungs or heart, or a skin biopsy that shows evidence of the disease. The doctor also will look at a person’s medical history and special tests to rule out other diseases.

      Doctors use the American College of Rheumatology's “Eleven Criteria of Lupus” to help make—or exclude—a diagnosis of lupus.
      Typically, four or more of the following criteria must be present to make a diagnosis of systemic lupus.

      So what happens after you diagnosed with Lupus?
      Though there is no cure for lupus, in the past several years, treatment has improved considerably and currently there are medications that are proving effective. Only three drugs were FDA-approved for the treatment of lupus (Prednisone, Aspirin, Hydroxychloroquine) until the 2011 FDA approval of Belimumab so advances are being made. Suprising to some, most people with lupus can live normal lives as longs as the disorder is carefully monitored and treatment adjusted as necessary to prevent serious complications. Also, it is recommended that those that have been recently diagnosed with Lupus educate themselve as much as possible about the disease as well as seek support as apart of treatment. I've included a link below that I found very informative titled, "Living with Lupus".

      Also, I've included and interactive link, "Could I have Lupus", which is a checklist/quiz that anyone can take if they suspect they may be suffering from Lupus.
      http://www.lupus.org/newsite/pages/lupusChecklist.aspx

      Until next time, check out the criteria chart above, the links above and below, comment, and post!
      Thanks for reading!!!

      Living With Lupus:
      http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnliving.aspx?articleid=2252&zoneid=527

      Diagnosing Lupus:
      http://www.lupus.org/webmodules/webarticlesnet/templates/new_learndiagnosing.aspx?articleid=2239&zoneid=524


      Monday, July 9, 2012

      Lupus in Dogs


      Hello again,

      After reviewing some of the comments made on my previous post, "Celebrities with Lupus", I received a good bit of feed back concerning former President George Bush Sr. and wife Barbar’s famous pet springer spaniel, Millie, having lupus. Because it sparked so many questions, I wanted to take a moment and provided some information on canine lupus.

      Lupus in dogs, just as in humans, is a general term for an autoimmune disease characterized by the formation of antibodies against the body’s own tissues. There are two distinct forms of lupus in dogs. They are discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE). DLE, sometimes referred to as "collie nose" or "nasal solar dermatitis," is one of the most common immune-mediated skin diseases in dogs.

      Symptoms
      The symptoms of lupus vary widely and often are missed until the disease has reached an advanced stage.
      DLE is a relatively benign variant of SLE wherein a dog becomes allergic to its own tissues. DLE primarily affects facial skin. The most common site is the hairless surface of the bridge of the nose. Other sites are the lips, mouth, and the area around the eyes, the ear flaps and, rarely, the genitalia or feet. Dogs with DLE usually are otherwise healthy.
      SLE is a much more serious condition than its cutaneous counterpart. SLE is a multi-system, immune-mediated disease characterized by the formation of antibodies against normal body cells and tissues. Basically, the dog’s body attacks itself, from the inside out. While a large number of autoimmune symptoms can be caused by SLE, the most common sign of this disease is shifting leg lameness.

      Treatment
      DLE cannot be cured but is more manageable than the systemic form of the disease. The goals of treating DLE are to control and resolve the facial skin lesions, particularly on the hairless areas of the top of the muzzle. Treatment may include oral or topical antibiotics, topical lotions or ointments, oral vitamin E, oral fatty acid supplements and oral or topical corticosteroids. Affected dogs should be kept out of the sun as much as possible, because the symptoms of DLE worsen with exposure to ultraviolet light.
      SLE is also incurable. The goals of treating SLE are to manage the symptoms of the disease, relieve the dog from pain and lameness and prevent progressive renal or other organ failure if possible. Because the effects of SLE often vary, not all cases need to be treated aggressively at all times. Dogs suffering from severe, acute-onset SLE may need to be hospitalized for initial management, until their condition is stabilized. There are a number of drugs that can be used to help manage SLE, including corticosteroids to suppress the abnormal immune reaction and non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammatory response. Secondary bacterial skin infections should be treated aggressively with appropriate antibiotics.

      Hopefully this has answered your questions and for you pet owners made you just a little more knowledgeable about pet health.

      Until next time, check out the image below, comment, and post!
      Thanks for reading!!!




      Conjunctivitis (Pink Eye)



      Hello again,

      Last week in lecture we discussed infections of the eye. Naturally my first thought was of the infamous Conjunctivitis, better known as "pink eye". The more I thought about it, the more I realized I didn’t really know the cause or transmission of pink eye. As crazy as it sounds, I though you got pink eye by looking at the infected eye of a person with it. Not very wise I know, but hey, I was a kid!

      So here’s what I have learned:
      Conjunctivitis is a common eye condition that causes inflammation of the conjunctiva. The conjunctiva is the thin layer that lines the inside of the eyelid and covers the white part of the eye. The reason Conjunctivitis is referred to as "pink eye" is because it can cause the white of the eye to take on a pink or red color. The most common causes of conjunctivitis are viruses and bacteria.

      Viral conjunctivitis can be caused by a number of different viruses which are usually associated with an upper respiratory tract infection, cold, or sore throat. It usually begins in one eye and may progress to the second eye within days. Viral conjunctivitis spreads easily and rapidly between people and can result in epidemics.

      Bacterial conjunctivitis is caused by infection of the eye with certain bacteria, commonly Streptococcous pneumonia and Haemophilus influenzae. Bacterial conjunctivitis also usually begins in one eye and may sometimes progress to the second eye.

      Both the bacterial and viral forms of the condition are contagious. The germs that cause conjunctivitis may be present in nasal secretions and in the discharge from the eyes. People can become infected simply by touching the face of someone with the disease and then rubbing their own eyes without first washing their hands. Sharing contaminated towels or eye makeup also can spread the infection. Infectious conjunctivitis can spread quickly through child-care and school settings and among members of the same family. Because of this bacterial conjunctivitis is a leading cause of children being absent from day care or school. Bacterial conjunctivitis can remain contagious until treatment with antibiotics is started. The viral form is usually contagious before the symptoms appear and for as long as symptoms, including any discharge from the eye, last.

      So how do we prevent pink eye?
      The best way to prevent infectious conjunctivitis is to wash hands frequently, especially after touching the face of someone who has the infection. It is a good idea for people with infectious conjunctivitis to wash their hands often to avoid spreading the infection. It is also wise not to share makeup; disposable items, such as paper towels and cotton balls; or towels. Also, to prevent re-infection once the infection goes away you should throw away and replace any eye or face makeup you used while infected, replace contact lens solutions that you used while your eyes were infected, throw away disposable contact lenses and cases that were used while your eyes were infected and clean extended wear lenses as well as eyeglasses and cases that were used while infected.

      So as you can see, it takes a little more that just looking at someone with pink to catch it!
      Until next time, check out the link and image below, comment, and post!
      Thanks for reading!!!


      http://www.cdc.gov/conjunctivitis/about/index.html
















      Joke of the day:


      Monday, July 2, 2012

      Graduate Project - Celebrities with Lupus

      Hello again,

      One thing for sure about Lupus is it doesn’t discriminate. No matter you socioeconomic status, anyone can get lupus. While researching the disease, I found there are many celebrities that we all are familiar with that have lupus. A total shock to me and one of the most famous sufferers of lupus was Micheal Jackson.  Michael was diagnosed with the disease in 1984, shortly after his hit album Thriller. Reportedly there are numerous pictures of him with what could easily be a lupus rash on his face and the lupus might explain his avoidance of the sun.  Another singer, Seal battled discoid lupus when he was a child. His trademark facial scarring, butterfly rash, is a result of the disease.  Even former President George Bush Sr. and wife Barbar’s famous pet springer spaniel, Millie, suffered from lupus. I was not aware, but it appears animals can get the disease as well. America's Next Top Model star Mercedes Scelba-Shorte, also known as Mercedes Yvette, revealed she had lupus while on the show. I saw that episode and for me, that was my first time ever even hearing of the disease. Symptoms Mercedes had that were displayed on screen was hair loss and spots or around the hairline. Toni Braxton recently admitted to having lupus after her failing health caused her to cancel entire concert tours. The new edition to the “celebrities with lupus” category is comedian and America’s Got Talent host Nick Cannon. Nick open up about his battle with lupus early this year after being hospitalized for kidney failure, common in patients with lupus, in January and then hospitalized again, weeks later, with blood clots in his lungs. The blood clots were found to be directly connected to his kidney infection.  Other celebrities with disease are actress Jasmine Guy, American Idol contestant Leslie Hunt, sister of Sharon Stone Kelly Stone, and even Lady Gaga!

      So why is this important? Celebrities being the face of the disease bring exposure to it that many would never have. Take me for example, I first learned of the disease by watching a reality competition television show. The type of awareness these celebrities can bring to the disease can contribute to more people being aware of the signs and symptoms and seeking help if they feel they may be sufferers of the disease.  Lupus is one of the most serious rheumatic diseases and early diagnosis and control of symptoms are key for a positive prognosis. Though I’m not a celebrity, I am doing my part to spread the word about Lupus and I hope those of you who view and read my blog do the same!

      Until next time, check out the images and link below, comment, and post!

      Thanks for reading!!!
      http://cure4lupus.org/store/index.php?main_page=page&id=148&chapter=2


      Sunday, July 1, 2012

      GI Infections and Handwashing

      Hello everyone,

      This week in lecture we covered gastrointestinal infections.  A few common GI infection we discussed was infections with the bacteria Salmonella spp., Shigella spp. Escherichia coli, and Campylobacter spp.. Most infections occur through what is called the fecal-oral route, in which trace amounts of infected fecal particles are unintentionally consumed. Although this sounds impossible in a society with good sanitation, something as simple as poor hand washing habits after using the restroom can spread diseases to other people through door knobs, shared hand towels, or direct contact. If the recipient happens to touch their mouth or food, they may become infected. Certainly, infected food preparation areas or food preparers in restaurants are also potential sources of illness. Diarrhea, fever, vomiting, and dysentery are some of the most common symptoms. Diarrheal infections are highly contagious. They can spread from person to person via the routes mentioned earlier and most cases are contagious for as long as a person has diarrhea, but some infections can be contagious for even longer. Through excellent hygiene, clean drinking water, and safe food preparation, most gastrointestinal infections can be avoided. The most effective way to prevent contagious diarrheal infections and most gastrointestinal infections is to wash your hands frequently. As simple as that sound, most people do not wash their hands well enough or often enough to prevent the spread of disease. A 2006 American Society of Microbiology study revealed that after using the toile only 75 percent of women and 50 percent of men wash their hands and, of middle and high school student only 33 percent females and 8 percent of males wash their hands. Because of these statistics I have included some links from CDC and Mayo Clinic that will provide information on the importance of hand washing as well as proper hand washing techniques. As future laboratorians we will be in constant contact with infectious agents and this is one way we can keep ourselves as well as our family’s and community safe by preventing the spread of disease. 

      Until next time, check out the links below, comment, and post!
      Thanks for reading!!!

      Hand washing Do’s and Don’tshttp://www.mayoclinic.com/health/hand-washing/HQ00407
      Wash Your Handshttp://www.cdc.gov/features/handwashing/index.html
      Hand Washing in Healthcare Settingshttp://www.cdc.gov/handhygiene/
      Hand Washing Saves Liveshttp://www.cdc.gov/Features/HandHygiene/


















      Joke of the day:

      Wouldn't this be the best thing ever...