October 2014 Edited by: Dennis Scott BVSc MACVSc Inside this issue: Racing welfare under 2 attack Fipronil resistance urban myth or reality? 3 Disinfecting non crit- 4 ical surfaces Deep Cleaning Agents for non critical surfaces 7 Ethical Agents Ltd 54 Hobill Ave Wiri PO Box 97-110 Manukau City Manukau 2241 Ph 09-262-1388 Fax 09-262-1411 Freephone 0800 800-624 email [email protected] website www.ethicalagents.co.nz In House Biosecurity In the modern climate of responsible antibiotic usage hospitals are now even more aware of infection control and hygiene instead of high reliance of antibiotics. Clinic, plus kennel and cattery, biosecurity is also as important as surgical hygiene. The levels of disinfection required are now well established and, while we are all cognizant of the high level disinfection required for critical areas and equipment, the protocols for non critical areas are equally as important. Cost is a major factor but using supermarket disinfectants or cheap bleach can be false economy, as more than one cattery has found to their detriment. Disinfection may not be the most exciting subject but it is vitally important to the modern clinic and so 21st century disinfection principles comprise the major part of this newsletter. However simple principles of cleaning first then disinfecting every day followed by the occasional deep clean with a different chemical can make the process extremely efficient as well as very economical. Canine parvovirus fewer shopping days until Christmas and equinoxial winds abound. start of flea season, especially for puppies and kittens. In the animal world it is full on breeding season for cattle and horses, the great spring racing carnival in Australia is flexing its muscles and it is the Inside we have an article on fipronil resistance, which is rapidly becoming an urban myth due to lack of understanding of how the chemical works. Springtime Spring time is here in all its glory - plants are flowering, the weather is supposed to be getting warmer and the election is over at last. On the converse side traffic cops are appearing on the roads, there are Page 2 EA News Racing Welfare Under Attack Racing is certainly under fire from animal rights activists. A huge 22metre billboard of a dead horse was strategically situated on CityLink, near the Bolte Bridge in Melbourne alongside a billboard promoting the spring racing carnival. According to Fairfax media the group responsible was campaigning for all racehorses to be safely re -homed, "so that they're not shot and killed for dog meat, as is currently the case". This really shows how out of touch with reality they really are – stop horse racing but just retire and pay for all the left over horses! And it is not just in Australia, recently in the UK the Daily Mirror published graphic photos of the putting down of a race horse. The pictures of Wigmore Hall, showing him before and after being shot, were passed to the Mirror by the animal rights group Animal Aid. David Muir, the RSPCA’s equine consultant, suggested there was no case for the sport to answer. Green screens had been erected between the horse and the grandstand as he was put down but the unidentified photographer was on the other side, of the horse with an unimpeded view. “They could have waited for a second lot of screens to arrive so that they could put screens all the way around him,” Muir said, “but all that would have done is make the horse’s suffering worse. And the person who sneaks around the back with a camera could have been an issue itself. He could have distracted the vet.” The British Horseracing Authority said it was “appalled” at the Mirror decision to publish the pictures and said it could see no public interest in them. Racing professionals expressed similar views through social media. The British Horseracing Authority’s chief veterinary officer Jenny Hall said: “The sad incident involving Wigmore Hall was the only fatality at Doncaster’s flat racing course this year from 1,563 runners. The first The Operation An older gentleman was on the table awaiting surgery and he insisted that his son, a renowned surgeon, perform the operation. As he was about to get the anaesthesia, he asked to speak to his son. "Yes, Dad, what is it?" "Don't be nervous, son; do your best, and just remember, if it doesn't go well, if something happens to me, your mother is going to come and live with you and your wife...." priority in British Racing is always the welfare of its competitors, both human and equine. The team of veterinary surgeons were [sic] at Wigmore Hall’s side in moments after the injury. The vets were able to make an immediate assessment of the Wigmore Hall’s condition. In this case the diagnosis was made that the injury was untreatable and so the correct course of action for Wigmore Hall’s welfare was for him to be humanely put down.” Dr Peter Webbon, Ex chief executive of horseracing regulatory authority states “Racing has a horse welfare record to be proud of and is among the best-regulated animal activities. Racehorses are the best looked after 2% of horses in the country.” Despite all the professionalism the racing industry, in NZ as well as overseas, must stay vigilant in its welfare codes to prevent such attacks from ill-informed splinter groups in the future. Ethical Agents Ltd Ph 09-262-1388 Page 3 Fipronil Resistance - Urban Myth or Reality? For several years now, there have been rumors about fleas becoming resistant to fipronil but is this reality or an urban myth? Numerous research projects have examined the susceptibility of fleas to fipronil and there does not appear to be any research to indicate that fleas are becoming resistant to fipronil. The most recent study was published in the February, 2009 issue of the Journal of Economic Entomology (Brunet S et al). This study found no evidence of flea resistance to fipronil. Many veterinarians and researchers believe that the answer lies in compliance. They believe that veterinarians have not done a good job in educating their clients about the flea life cycle and are often guilty of encouraging unrealistic expectations in their clients. An example is this little piece of nonsense published in 2005, “During the past ten years, topical and oral applications of insecticides such as fipronil, imidacloprid, lufenuron and, most recently, selamectin have revolutionized cat-flea control. Recent studies show that these therapies eliminate the need to treat indoor and outdoor environments.” (Rust M K) Understanding the life cycle of the flea is crucial and in cases where flea infestations exist within a household, fipronil flea and tick products will eventually bring the infestation under control, but it may take several months for this happen. Flea eggs and larvae preexisting in the environment must first hatch out and come into contact with the fipronil treated pet in order for the flea life cycle to be interrupted and this takes time (often several months) to occur. In the meantime, often pet owners become frustrated with the presence of adult fleas on their dogs “Thus, a conclusion is incorrectly reached that the original product was ineffective” and cats and come to believe that the product which they have applied is not working properly. So the pet owner quite naturally changes to a different flea control product after a month or two. Once switching over to the new flea product, the flea eggs and flea larvae which had existed in the environment and which have subsequently become adult fleas found on the pet have been reduced or eradicated in number and the pet owner stops seeing live adult fleas on the pet. Thus a conclusion is incorrectly reached that the original product was ineffective and the new flea product worked wonderfully; therefore, the fleas must have been resistant to the original product. Another factor to consider is the actual mode of action; many insecticides block the GABA receptor leading to the chlorine gate being closed, which results in flaccid paralysis then death. Fipronil also binds to the GABA receptor but keeps it open. This results in continuous depolarization, excitation and death, similar- ly to the way permethrin blocks sodium channels in nerves leading to excitation. Just permethrin sprayed flies go into excitation mode, buzzing round the room before dying, so do fipronil treated fleas have the nervous system go into overdrive. The emergence of these overstimulated fleas gives a false impression of vitality, despite the fact that they are actually in the act of expiring. Clearly overuse of any pesticide will eventually result in resistance but it is equally clear that fipronil resistance is not yet a problem. Perceived inefficacy is more likely an education problem rather than a resistance one. References: Brunet S et al, Rdl Gene Polymorphism and Sequence Analysis and Relation to In Vivo Fipronil Susceptibility in Strains of the Cat Flea Journal of Economic Entomology Feb 2009 pg(s) 366-372 Rust M K, Advances in the control of Ctenocephalides felis (cat flea) on cats and dogs Trends in Parasitology Volume 21, Issue 5, May 2005, Pages 232– 236 Elderly Love An elderly couple had just learned how to send text messages on their cell phones. The wife was a romantic type and the husband was more of a no-nonsense guy. One afternoon the wife went out to meet a friend for coffee. She decided to send her husband a romantic text message and she wrote: "If you are sleeping, send me your dreams. If you are laughing, send me your smile. If you are eating, send me a bite. If you are drinking, send me a sip. If you are crying, send me your tears. I love you." The husband texted back to her: "I'm on the toilet. Please advise." Page 4 EA News Disinfecting non critical surfaces It is currently accepted that there are three levels of disinfection: 1. High-level disinfection - kills all organisms, except high levels of bacterial spores, and is effected with a chemical germicide cleared for marketing as a sterilant by FDA. 2. Intermediate-level disinfection kills mycobacterium, most viruses, and bacteria with a chemical germicide. 3. Low-level disinfection - kills some viruses and bacteria with a chemical germicide. The levels of disinfection recommended for any instance are judged by the degree of risk for infection. More than 30 years ago, Earle H. Spaulding devised a rational approach to disinfection and sterilization of patient-care items and equipment. This classification scheme is so clear and logical that it has been retained, refined, and successfully used by infection control professionals and others when planning methods for disinfection or sterilization. Spaulding believed the nature of disinfection could be understood readily if instruments and items for patient care were categorized as critical, semi critical, and noncritical according to the degree of risk for infection involved in use of the items. Critical items confer a high risk for infection if they are contaminated with any microorganism. Thus, objects that enter sterile tissue or the vascular system must be sterile because any microbial contamination could transmit disease. Semi critical items contact mucous membranes or non-intact skin and noncritical items are those that come in contact with intact skin but not mucous membranes. Intact skin acts as an effective barrier to most microorganisms. Thus surfaces would be designated as non-critical items. “effective disinfection of surfaces requires routine cleaning, and a regime for deep cleaning” Noncritical environmental surfaces frequently touched by hand (e.g., bedside tables, bed rails) potentially could contribute to secondary transmission by contaminating hands of health-care workers or by contacting medical equipment that subsequently contacts patients. Mops and reusable cleaning cloths are regularly used to achieve lowlevel disinfection on environmental surfaces. However, they often are not adequately cleaned and disinfected, and if the water-disinfectant mixture is not changed regularly (e.g., after every three to four rooms, at no longer than 60-minute intervals), the mopping procedure actually can spread heavy microbial contamination throughout the health-care facility. (Source: Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008). Therefore it is widely recognised that effective disinfection of surfaces requires routine cleaning, and a regime for deep cleaning; Healthcare facilities are using a multi-pronged approach to deal with hospital acquired infections and recommend different products (Continued on page 5) Ethical Agents Ltd Ph 09-262-1388 Page 5 Disinfecting non critical surfaces gy, human hospitals also embark on a ‘deep clean’ process occasionally, using chlorine dioxide. (Continued from page 4) for routine and deep cleaning of surfaces. UK company Tristel has a range of products specifically produced to meet such varying demands. In a veterinary clinic situation we have various different surfaces to consider. Cages, waiting rooms, consult tables and surgical environments all need regular cleaning and disinfection, some more regularly than others but, conversely, some more rigorously than others. An analogy can be made with the difference between the 20 second minimum hand wash to remove transient organisms and the two minute surgical scrub to get into pores and remove residual bacteria. Waiting rooms and consult tables need continual cleaning for aesthetic reasons as well as for microbial control. Due to the frequency of the cleansing price is a major factor. This is where 4 Kleen, manufactured by Tristel and using TriGene technology, comes to the fore as a highly effective very economical disinfecting cleanser. An analogy is the personal hygiene of a busy person, hand washing several times a day, a quick shower at least once a day then occasionally the old ‘hour in the shower’ with conditioner, body wash and all the bells and whistles. SteriGene is the gold standard for disinfection with its nanotechnology, rapid kill rates, wide spectrum and high safety profile. The use of 4 Kleen and SteriGene would cover nearly all the disinfection and cleaning needs of the normal practice situation. However, despite this high quality technolo- Anistel Swift and Anistel Falcon are positioned as “deep clean” products in Tristel’s Veterinary portfolio. They work alongside SteriGene as a once a week procedure, in isolation or in theatre, especially in busy practices and where there is a lot of dirty surgery. For smaller vet practices they may be used once a month or when they get an outbreak. Due to this sporadic use price is not a real objection and, For high level disinfection however another product manufacture by Tristel, SteriGene (also known as TriGene Advance) is the market leader and not without reason. (Continued on page 6) The Threat A man and woman were married for many years. Whenever there was a confrontation, yelling could be heard deep into the night. The old man would shout, "When I die, I will dig my way up and out of the grave and come back and haunt you for the rest of your life!" Neighbours feared him. The old man liked the fact that he was feared. may indeed be able to dig his way out of the grave and haunt you for the rest of your life?" Then one evening, he died when he was 98. The wife said, " Let him dig. I had him buried upside down...and I know he won't ask for direc- After the burial some of her neighbours, concerned for her safety, asked, "Aren't you afraid that he tions." Page 6 EA News Disinfecting non critical surfaces (Continued from page 5) when it is broken down to price per dose, as seen below, it is not a factor at all. Tristel’s chlorine dioxide based disinfectants comprise a base solution containing citric acid and an activator solution containing sodium NaClO2 Sodium chlorite + dioxide. rapid death. The resulting chemical reaction liberates chlorine dioxide with water and sodium chloride, as byproducts of the reaction The potency of chlorine dioxide is attributable to the simultaneous, oxidative attack on many proteins thereby preventing the cells from The basic chemical reaction for the generation of chlorine dioxide in “Sodium chlorite, mischievously C6H8O7 = ClO2 Citric acid Chlorine dioxide chlorite. Sodium chlorite is an oxidising solution used for the generation of chlorine dioxide. Sodium chlorite, mischievously marketed in some circles as ’stabilised chlorine dioxide’ (there can be no such thing) has some biocidal properties in applications such as mouthwashes, toothpastes, mouth sprays and as a preservative in eye drops. Citric acid is a naturally occurring, weak organic acid found in a large variety of fruits and vegetables, most notably citrus fruits – lemons and limes. The citric acid in Tristel’s products is used for the acidification of sodium chlorite to generate chlorine + NaCl + Sodium chloride H2O Water this way is as follows: Chlorine dioxide exists as a gas in its natural state but is highly soluble in water, having about 10 times the solubility of chlorine. Chlorine dioxide acts as an oxidizing agent and reacts with several cellular constituents, including the cell membrane of microorganisms. By “stealing” electrons from the cell membrane, a process known as oxidation, it breaks the molecular bonds in the cell resulting in the death of the organism. Since chlorine dioxide alters the proteins involved in the structure of microorganisms through oxidation, the enzymatic function of the organism is destroyed causing very marketed in some circles as ’stabilised chlorine dioxide’ (there can be no such thing” mutating to a resistant form. Additionally, because of the lower reactivity of chlorine dioxide compared to that of chlorine, its antimicrobial action is retained longer in the presence of organic matter. InSummary The Spaulding system categorizes equipment for disinfection as critical (enters sterile tissues or blood), semi critical (mucous membranes and non intact skin) and non critical (touches intact skin). For non critical surfaces cleaning (e.g.4 Kleen) followed by disinfection (SteriGene) daily is recommended. Then deep cleaning (Anistel Swift or Anistel Falcon) once a week for larger clinics and surgeries or once a Telecom Contract Telecom needed to hire a team of telephone pole installers for a new highway and the boss had to choose between a local team and a team of Tony and Nagy. Both teams headed right out. At end of the shift the two local guys came back and the boss asked them how many poles they had installed. So the boss met both teams and said "Here's what we'll do. Each team will be installing poles out on the new road for a day. The team that installs the most poles gets the job." They said that it was tough going, but they'd put in twelve. Forty-five minutes later Tony and Nagy came back in and they were totally exhausted. The boss asked, "Well, how many poles did you guys install?" Tony, the team leader, wiped his brow and sighed, "Nagy and me, we got three in.” The boss gasped, "Three? Those two other guys put in twelve!" "Yeah," said Nagy, "but you should see how much they left sticking out of the ground!” Ethical Agents Ltd Ph 09-262-1388 Page 7 Deep Cleaning Agents for non critical surfaces AnistelSwift is a highly effective chlorine dioxide solution that is designed for the rapid disinfection of large hard surfaces within animal healthcare environments. Swift is effective against all organisms of concern at one dilution in one short contact time of 5 minutes. When used as part of a daily or weekly deep clean regime, Swift is an excellent preventative method The cost per litre of disinfectant is well under one dollar and, as each sachet makes up 5 litres of disinfection which can be used within a single clinic day, large surfaces can be sterilized in an extremely economic manner. AnistelFalcon is a highly effective chlorine dioxide spray. It is designed for the rapid disinfection of small hard surfaces within animal healthcare environments. Falcon’s reusable trigger spray head enables chlorine dioxide to be generated at point of use and at one concentration that kills all organisms. “Tristel Falcon is sporicidal in a mind blowing 30 seconds” The cost per shot of disinfectant is under 10 cents so blitz treating small surfaces at less than 10 cents per square metre is a highly economical process. Again it is very easy-to-use, safe and effective; one concentration kills all and again no rinsing is required. Tristel Falcon is sporicidal in a mind blowing 30 seconds. Falcon for surfaces comes in a chemistry pack with a trigger and the Falcon trigger is reusable. for outbreaks. It is sporicidal, mycobactericidal, virucidal and fungicidal in 5 minutes It is easy-to-use with no varying concentration or dilution rates no rinsing requires and one sachet produces five litres working solution. The trigger draws a dose of base and activator from separated sides of the chemistry pack and combines to activate before an aliquot of gel is dispensed. Each pack contains 500 shots of gel and each shot of gel covers a wide 1 square metre and is applied with a dry wipe. The Explanation The mother-in-law arrives home from shopping to find her son-inlaw Percy in a steaming rage and hurriedly packing his suitcase. "What happened Percy ?" she asks anxiously. "What happened!! I'll tell you what happened. I sent an email to my wife - your daughter, telling her I was coming home today from my fishing trip. I get home... and guess what I found? Yes, your daughter, my wife, naked with the next door neighbour in our marital bed! This is unforgivable, the end of our marriage. I'm done. I'm leaving forever!" "Ah now, calm down, calm down Percy!" says his mother-in-law. "There is something very odd going on here. My daughter would never do such a thing! There must be a simple explanation. I'll go speak to her immediately and find out what happened." Moments later, the mother-in-law comes back with a big smile. "Percy. I told you there must be a simple explanation ....She never got your E-mail!" The Wedding Arthur, age 92 and Emily, age 89, are excited about their decision to get married. They go for a stroll to discuss the wedding and on the way they pass a Chemist. Arthur suggests they go in. Arthur addresses the man behind the counter: "Are you the Owner?" The Pharmacist answers: "Yes." Arthur: "We're about to get married. Do you sell Heart Medication?" Pharmacist: "Of course we do." Arthur: "How about Medicine for Circulation?" Pharmacist: "All kinds." Arthur: "Medicine for Rheumatism, Scoliosis?" Pharmacist: "Definitely." Arthur: "Medicine for Memory Problems, Arthritis, Jaundices?" thing I can help you with?" Pharmacist: "Yes, a large variety .....the works!" Arthur says to the Pharmacist: "We'd like to nominate your store as our Bridal Gift Shop." Arthur: "What about Vitamins, Sleeping Pills, Antidotes for Parkinson's Disease?" Pharmacist: "Absolutely." Arthur: "You sell Wheelchairs and Walkers?" Pharmacist: "All speeds and sizes. Why do you ask? Is there some-
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