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Reassessing Practices Is Critical During an Infectious Disease Outbreak

As global public health officials focus on the growing pneumonic plague outbreak in Madagascar,1 the ongoing hepatitis A virus (HAV) outbreak in San Diego, California, is a glaring reminder that infectious disease outbreaks can occur even in the United States. As of October 19, 2017, more than 600 individuals have been infected with HAV and 19 have died. California Governor Jerry Brown underscored the severity of the outbreak when he declared a state of emergency on October 13, 2017, to free up funding to respond to the outbreak and stop it from spreading. The outbreak has become so critical that it warranted a late-breaker presentation by experts from the Centers for Disease Control and Prevention and the California Department of Health at this year’s ID Week conference. Vaccinations are essential to the prevention effort as is the reassessment of practices that may not be working, such as infection control and sanitation measures, which have since been reworked to be more effective. A summary of the findings and efforts that are underway to combat the epidemic can be found on page 31 of the print publication, or here online.

As an entrepreneur, the constant reassessment of business practices is necessary to ensure that practitioners are not wasting valuable time, resources, and effort on activities that are not producing the desired results. Such can be seen in the health care field, too, and our feature article on page 18 focuses on a reassessment of the empiric use of broad spectrum antibiotics in patients with bacteremia and sepsis to decrease the risk of Clostridium difficile (C. difficile) infection. The increased use of broad-spectrum antibiotics has resulted in higher rates of hospital-onset C. difficile infections. These infections and the growing incidence of infections in the community setting have contributed to more severe infections and the emergence of hypervirulent strains of the bacterium with fatal complications. These reasons led Alyssa B. Christensen, PharmD, and Viktorija O. Barr, PharmD, BCPS-AQ ID, to urge practitioners to focus on the use of broad-spectrum antibiotics in these patient populations.

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  1. Rosa K. The black death spreads through Madagascar claiming 57 lives thus far. Contagion website. Published October 17, 2017. Accessed October 19, 2017.

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