David Gibson discusses the re-emergence of some diseases.
Whenever I envisage the modern dental practice, I picture a busy waiting room, buzzing environment and diligent dental team working hard to deliver a high standard of patient care. A nice image don’t you think? At least until you start thinking of the tens or even hundreds of people that have passed through the practice that day, sneezing, coughing and touching surrounding objects such as door handles and armrests.
Indeed, according to a recent survey, just 75 per cent of Brits say they wash their hands after visiting the bathroom, with one in four at greater risk of becoming infected by the millions of microorganisms our hands come in to contact with everyday. Should an infected individual present to your practice carrying a common modern day communicable disease such as MRSA, influenza or measles, there is an immediate risk that the pathogen could be transmitted to others within the practice. This alone is enough for any dental practice to contend with, but now it seems that there has been a resurgence of a number of (what should be) dated diseases.
Tuberculosis, whooping cough and scarlet fever are just a few of the diseases making a comeback from the Victorian era despite scientific advancements over the last century.
However you choose to look at it – indeed, the death toll of these diseases in 1901 compared to now is relatively low – it can’t be denied that the rate of resurgence is massively disconcerting; especially as many believed such diseases to be gone.
The prevalence of scarlet fever in particular has increased dramatically, with a Public Health England (PHE) report showing that there were a total of 6,157 new cases between September 2015 and March 2016. A more severe infection caused by the same bacterium (group A streptococcus) is also thought to be on the rise, with PHE urging professionals to monitor and report any potential outbreaks.
Tuberculosis (TB) is another example of a bug refusing to give up. Even with a downward trend over the previous four years, there were still a total of 5,758 cases reported in England in 2015, 27 per cent of which, it is important to add, were non-UK born citizens. While treatable, the advent of antibiotic resistance has led to a number of challenges in treating and controlling the disease.
This is the case with many ‘Victorian’ age diseases, including whooping cough, with research showing that the evolution of resistant strains have taken place either as a result of microorganism replication or through the exchange of resistant traits from pathogen to pathogen. It is also widely believed that the emergence of drug-resistant strains could have been accelerated by the misuse and over-prescription of antibiotics, as well as poor infection control practices, inadequate sanitary conditions and inappropriate food handling. As a result of this, Professor Myron Christodoulides, a reader in molecular bacteriology and microbiology at the University of Southampton suggests, “If we don’t tackle the increase in antibiotic and antimicrobial resistance, deaths from these bugs by 2050 might be in the region of 10 million a year worldwide – more than from cancer.” A drop in the amount of people receiving vaccinations is also thought to be a contributing factor, which must be acted upon moving forward if we are to minimise the risk of old diseases coming back to haunt us.
In the meantime, decontamination will play a vital role in eliminating the risk of such pathogens – both archaic and modern – in the dental practice. It has been proven that standard sterilisation and high-level disinfection procedures are adequate in sterilising or disinfecting instruments or devices contaminated with blood or other body fluids from persons infected with pathogens and bioterrorism agents. As such, dental professionals must endeavour to implement best practice at all times, as well as take care to use quality equipment that is well maintained.
To ensure your equipment remains in tip top condition, it is always worth employing the services of a specialist company. There can be no doubt that certain diseases are coming back round. Practices have no choice but to meet the problem head on.
References available on request.