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Germs &Public Health

Be Prepared to Avoid Germs in Greece

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 A common reason for not seeking pre-travel health advice is  that the traveler felt that he or she already possessed the relevant information

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To reduce travel-related risks, travellers should seek health-related pretravel consultation. Survey studies performed at departure terminals in Europe, United States and Australia investigating travellers to developing countries have found that between 35% and 66% of travellers sought pretravel health information  
Pre-travel health information was mainly acquired from primary healthcare providers; between 4% and 26% had visited a designated travel medicine clinic. Women were more likely than men to seek pre-travel health information  find source 



In Europe alone, infections caused by multidrug-resistant bacteria are estimated to kill 25,000 people every year. 

Better Avoid Greek Public Hospitals

In at least 3 countries (Italy, Greece and Malta) the resistance to last-line antibiotics has become an “endemic problem”, meaning their hospitals are unable to treat patients infected with resistant bacteria.
Global superbug crisis threatens especially Greece due to migration crisis 

It is feared the crisis could further penetrate Europe as displaced migrants enter from a war-torn Middle East, where countries such as Syria have increasing levels of antibiotic resistance.Dr Brown said undelying that  

“It is almost too late” He said: “In 2016, a number of factors are coming together - including the effects of the migration crisis

Australian hospitals warned over new antibiotic-resistant superbug found in Italy and Greece 

Victorian hospitals are told to strictly enforce infection control measures after being warned about a new antibiotic-resistant superbug called KPC which is believed to be responsible for eighteen deaths since 2012.

“We’re advising now that our system is on heightened alert.”   Dr Romanes , Victorian state chief officer, said hospitals have been urged to introduce new interim screening requirements to pick up the bacteria, which is typically found in Greece and Italy.


Southern Europe, places such as Italy and Greece, and the Middle East are more under threat because of weaker health systems and weaker monitoring systems. India, especially, could be in real trouble.

The migration crisis will probably not be helping anything as a lot of people coming over from Syria could be bringing bugs

Dr David Brown, director at Antibiotic Research UK , December 2015

 

Canada's ‘detect and protect’ strategy to stop drug resistant  infections from being imported from Greece, Italy but also from the US 

Bruce Gamage, manager of B.C.’s Provincial Infection Control Network, said special protocols have been in place for ill patients returning from Greece, Israel, and the Indian subcontinent.

“We are now asking people whether they’ve been in a hospital in the U.S.,” Gamage told The Province. “If so, there are protocols in place.”

Hospitals use extreme caution if a patient became ill and has been treated in a hospital or health-care facility in one of the regions of concern.

“They stay in their own room, and everyone who goes in the room wears gowns and gloves.” said Gamage.”We stress handwashing, to ensure it doesn’t get spread around the hospital.”

Dr. Linda Hoang, a medical microbiologist with the B.C. Centre for Disease Control, said 

some of the CRE carriers contracted the bacteria due to a recent phenomenon known as “medical tourism” – patients needing expensive procedures sometimes opt for cheaper care in the third world, but may contract illnesses even as they’re saving money.

“It can be very serious,” said Hoang, who said travellers treated in hospitals abroad also can bring CRE back to B.C. MARCH 2013


In Greece today 

Basic hygiene at risk in debt-stricken Greek Public hospitals 

Greek hospitals are in such dire straits that staff are failing to keep up basic disease controls such as using gloves and gowns, threatening a rise in multidrug-resistant infections, according to Europe's top health official


Greece already has one of the worst problems in Europe with hospital-acquired infections, and disease experts fear this is being made worse by an economic crisis that has cut health care staffing levels and hurt standards of care, European Center for Disease Control has warned since more than 4 years earlier, but nobody is declaring an Alert   

With fewer doctors and nurses to look after more patients, and hospitals running low on cash for supplies, risks are being taken even with basic hygiene, said Marc Sprenger, director of the European Centre for Disease Prevention and Control (ECDC). after a two-day trip to Athens, where he visited hospitals and other healthcare facilities.


 I'm now really convinced we have reached one minute to midnight in this battle," "I have seen places...where the financial situation did not allow even for basic requirements like gloves, gowns and alcohol wipes," Sprenger said 


"We already knew Greece is in a very bad situation regarding antibiotic resistant infections, he said , underlying that the situation means patients with highly infectious diseases such as tuberculosis (TB) may not get the treatment they need, raising the risk that dangerous drug-resistant forms will tighten their grip on Europe.   Reuters,  Dec 4, 2012 5:14pm EST


Recent findings more than worrying  

MDR bugs not only in hospitals

FEMS Microbiology Ecology Advance Access published February 24, 2016

  As a conclusion, it seems that Greek water bodies could serve as a potential reservoir of resistant P. aeruginosa isolates posing threats to human and animal health

Characterization of Salmonella isolates from municipal sewage, patients, foods, and animals in Greece using antimicrobial susceptibility testing 

Research (Published online: 24-03-2016)


Conclusion:
This study indicates that municipal wastewater would be of interest to further monitor the community’s prevalence of subclinical or non-reported S. Enterica infections

Containment of carbapenem resistance rates of Klebsiella pneumoniae and Acinetobacter baumannii in Greek hospital with a concomitant increase in colistin, gentamicin and tigecycline resistance.July 2015

In 2010 the Hellenic center for disease control and prevention launched the "Prokroustes" nationwide action plan to tackle . Carbapenem resistance rates have been contained for Klebsiella pneumoniae and Acinetobacter baumannii but not for Pseudomonas aeruginosa. More worryingly, in accordance with their overuse against carbapenem-resistant bacteria, resistance rates to colistin and tigecycline have risen significantly. source PUBMED