In the current healthcare system, many things keep on emerging day to day and the most common one is the word “infection”. Recently my mum asked me with frustration that whenever she visits the hospital with her granddaughter after all recommended tests they (attending Healthcare professionals) tell her that her granddaughter has an infection. Desperately speaking she wanted to understand why she is told about infection every now and then.
What is infection?
By definition, an infection is the invasion and growth of germs in the body. The germs may be bacteria, viruses, yeast, fungi, or other microorganisms. Infections can begin anywhere in the body and may spread all through it. Infectious diseases can be viral, bacterial, parasitic or fungal infections. There’s also a rare group of infectious diseases known as Transmissible Spongiform Encephalopathies (TSEs).
How Infections Spread?
Germs are a part of everyday life and are found in our air, soil, water, and in and on our bodies. Some germs are helpful, others are harmful. Many germs live in and on our bodies without causing harm(Normal flora) and some even help us to stay healthy. Only a small portion of germs are known to cause infection especially when our bodies are found weak to fight back(low immunity) or when the normal flora changes location were they stay without harm.
How Do Infections Occur?
An infection occurs when germs enter the body, increase in number, and cause a reaction of the body. Three things are necessary for an infection to occur:
- Source: Places where infectious agents (germs) live (e.g., sinks, surfaces, human skin)
- Susceptible Person with a way for germs to enter the body
- Transmission: a way germs are moved to the susceptible person
Infections Source
A Source is an infectious agent or germ and refers to a virus, bacteria, or other microbe.
For instance, In healthcare settings, germs are found in many places. People are one source of germs including Patients, Healthcare workers, Visitors and household members.
People can be sick with symptoms of an infection or colonized with germs (not have symptoms of an infection but able to pass the germs to others).
Germs are also found in the healthcare environment. Examples of environmental sources of germs include Dry surfaces in patient care areas (e.g., bed rails, medical equipment, countertops, and tables); Wet surfaces, moist environments, and biofilms(e.g., cooling towers, faucets and sinks, and equipment such as ventilators); Indwelling medical devices (e.g., catheters and Cannulars/ IV lines) and Dust or decaying debris (e.g., construction dust or wet materials from water leaks), so you can visit a health unit and get an infection you previously didn’t have(Nosocomial infection).
Other sources also include; Food we eat(leftover /rotten or decomposing food causes food poisoning, infected meat/milk causes Brucellosis), Water/ juice we use/consume can predispose us water borne(e.g Typhoid)/ water wash(e.g Cholera) infections, poor environment and personal hygiene (e.g dirty pants over & over; dirty shower rooms predispose to Urinary Tract infections).
Exchange of body fluids with an infected person/environment (kissing, sex practices [oral, anal, vagina & fingering] predispose to sexually transmitted infection.
Infestations like parasites may be transmissive agents and also indirect immune weakeners for infection to set in e.g Ticks(Typhus fever), Lice, and intestinal worms (Aneamia[reduction of blood levels]).
Susceptible Person
A susceptible person is someone who is not vaccinated or otherwise immune, or a person with a weakened immune system who has a way for the germs to enter the body. For an infection to occur, germs must enter a susceptible person’s body and invade tissues, multiply, and cause a reaction.
Devices like Intra Venous (IV) catheters and surgical incisions can provide an entryway, whereas a healthy immune system helps fight infection.
When patients are sick and receive medical treatment in healthcare facilities, the following factors can increase their susceptibility to infection;
- Patients in healthcare who have underlying medical conditions such as diabetes, cancer, and organ transplantation are at increased risk for infection because often these illnesses decrease the immune system’s ability to fight infection.
- Certain medications used to treat medical conditions, such as antibiotics, steroids, and certain cancer-fighting medications increase the risk of some types of infections.
- Lifesaving medical treatments and procedures used in healthcare such as urinary catheters, tubes, and surgery increase the risk of infection by providing additional ways that germs can enter the body.
Recognizing the factors that increase patients’ susceptibility to infection allows seekers of medical care & providers to recognize risks and perform basic infection prevention measures to prevent infection from occurring.
Transmission
Transmission refers to the way germs are moved to the susceptible person. Germs don’t move themselves, they depend on people, the environment, and/or medical equipment to move in healthcare settings.
There are a few general ways that germs travel in healthcare settings – through contact (i.e., touching), sprays and splashes, inhalation, and sharps injuries (i.e. when someone is accidentally stuck with a used needle or sharp instrument).
- Contact moves germs by touch. For example, healthcare providers’ hands become contaminated by touching germs present on medical equipment or high-touch surfaces and then carry the germs on their hands and spread to a susceptible person when proper hand hygiene is not performed before touching the susceptible person.
- Sprays and splashes occur when an infected person coughs or sneezes, creating droplets which carry germs short distances (within approximately 6 feet). These germs can land on a susceptible person’s eyes, nose, or mouth and can cause infection (for example pertussis, COVID-19 or meningitis).
- Close-range inhalation occurs when a droplet containing germs is small enough to breathe in but not durable over distance.
- Inhalation occurs when germs are aerosolized in tiny particles that survive on air currents over great distances and time and reach a susceptible person. Airborne transmission can occur when infected patients cough, talk, or sneeze germs into the air (example: TB or measles), or when germs are aerosolized by medical equipment or by dust from a construction zone (example: Non-tuberculous mycobacteria or aspergillus).
Sharps injuries can lead to infections (for example: HIV, Hepatitis B Virus, Hepatitis C Virus) when blood-borne pathogens enter a person through a skin puncture by a used needle or sharp instrument.
Avoiding Infection
Most Infections have specific preventive measures but generally Avoid self-medication, good personal & environmental hygiene, improve your health-seeking habits, good sexual practices, feed well (Balance meals), avoid staying with animals in the same house and use your consciousness to avoid infection especially application of protective gears like Masks, goggles, gum boots, aprons, gloves, condoms gowns). Run away from possible infection is you can.
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About Author: Brian Nambale is a Clinical Case Manager at Medicure Trauma Centre-Nabumali, Medical Student (MUK),LCV Councilor Mbale District(Nabumali Town Council), Member of the Health & Education Committee and an Independent Medical Writer.
