Becker's Clinical Quality & Infection Control

8 INFECTION CONTROL & PATIENT SAFETY 4 flu preparedness lessons from the 1918 pandemic By Mackenzie Bean T he 1918 flu pandemic offers several lessons on infection control and outbreak response efforts for health officials today, according to a study published Oct. 8 in Frontiers in Cellular and Infection Microbiology. For the study, researchers analyzed numerous flu studies to identify the human, viral and societal factors that fueled the flu pandemic of 1918, in which 50 million people died. "Like the 1918 pandemic, the severity of any future outbreak will result from a complex interplay between viral, host and societal factors," study author Carolien van de Sandt, PhD, a researcher at the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia, told Science Daily. "Understanding these factors is vital for influenza pandemic preparedness." Here are four lessons from the 1918 flu pandemic, as outlined by the researchers: 1. Conduct regular viral surveillance. e viral strain respon- sible for the 1918 pandemic was capable of infecting tissues outside of the respiratory tract and contained mutations that allowed it to spread more easily between humans. Today, scientists can analyze new viral strains for pandemic potential, a practice that proves more important than ever amid climate change, according to the researchers. "Climate changes affect animal reservoirs of influenza viruses and bird migration patterns. is could spread viruses to new locations and across a wider range of bird species," Dr. van de Sandt told Science Daily. 2. Address public health issues. A century ago, malnourished individuals or those with underlying health issues were more likely to die from the flu. Current public health issues, such as obesity, could pose an issue for future pandemics and cause a higher death toll. 3. Consider population demographics. e 1918 pandemic had an outsized effect on young adults, not the elderly. Researchers suggest the older population had a greater immunity to the 1918 flu strain due to past virus exposure. "Providing emergency vaccines during future pandemics should take [into] account different age groups, viral and host factors," Kather- ine Kedzierska, PhD, a study author and researcher at the Doherty Institute, told Science Daily. 4. Be proactive with infection control methods. Infection control measures such as prohibiting public gatherings and promot- ing hand-washing helped lower infection levels and death during the 1918 pandemic. However, the measures were only successful if the interventions were implemented early and used throughout the entire pandemic. "Until a broadly-protective vaccine is available, governments must in- form the public on what to expect and how to act during a pandem- ic," Dr. van de Sandt told Science Daily. "An important lesson from the 1918 influenza pandemic is that a well-prepared public response can save many lives." n Sunlight can kill infection-causing bacteria indoors, study finds By Megan Knowles R ooms exposed to daylight contain fewer germs than those with less light, a study published in Microbiome found. The researchers set up a study of dusty, miniature model rooms to see what happened in rooms exposed to daylight through regular glass, rooms exposed to only ultraviolet light and rooms kept dark. They used a mix of dust collected from real homes and let the miniature rooms sit outdoors while keeping the insides at a normal room temperature. The researchers then sampled the dust and looked at the types of bacte- ria present after 90 days. In addition to finding that rooms exposed to daylight have fewer germs, the researchers found rooms exposed only to UV light had slightly less viable bacteria than ones exposed to daylight. The researchers evaluated both visible light and UV light because UV is known to be a good disinfectant. However, typical window glass filters out most UV light. The study authors were surprised by the amount of mi- crobes that were able to grow in dust since earlier studies did not suggest it would be as much, co-author Kevin Van Den Wymelenberg, PhD, co-director of the University of Oregon's Biology and the Built Environment Center in Eugene, told NPR. The study found 12 percent of bacteria in dark rooms were viable compared to 6.8 percent in rooms with day- light and 6.1 percent in rooms exposed to UV light only. Although it sounds like a small number, "Six percent of millions of cells is still a lot of microbes," Dr. Van Den Wymelenberg said. "Until now, daylighting [illuminating a building with natural light] has been about visual comfort or broad health. But now we can say daylighting influenc- es air quality." The researchers aim to develop further studies that deter- mine how much light is needed to kill microbes so archi- tects can design buildings with these facts in mind. n

• Cover