In the UK, some hospitals are experiencing ‘superbugs’ – which may come from careless health workers. Here in Malta we have a new hospital, but have new ways been adopted? At least as far as I can see, there doesn’t seem to be the residue of years of pigeon droppings on the sills of windows that are never opened.

Yet, when relatives of a patient complain that, for example after an operation, blood is still seeping out and no real attention is being given and the hapless relatives just turn the mattress over and replace the sheets, what might the consequences be for the next user of the bed? Anyway, allow me to quote from a study carried out in France involving a very minor oversight that had grave results.

Using a mathematical model to simulate infections in a hospital ICU, a group of French researchers has found that one careless health-care worker who has fleeting contact with many patients can undermine everyone else’s conscientious hand-washing.

A ‘superspreader’ can be a radiologist, a physical therapist, or a specialist who consults on many wards. The key is that superspreaders are “peripatetic”, i.e. they roam a wide territory. Other hospital workers who are more limited to a particular unit do not do as much damage when they forget to wash their hands between patients.

One superspreader is the equivalent of careless hand-washing among 23 per cent of the rest of the hospital staff, the French researchers calculate. Their study appears in the Proceedings of the National Academy of Sciences.

The research helps explain a number of documented disease outbreaks that were traced to a single health worker, such as a cluster of drug-resistant staph infections in a nursery.

The implication is that it is not enough to issue general exhortations about hand-washing to hospital workers. Infection-control specialists should pay close attention to the workers who roam most widely and have even the briefest contact with the most patients.

Also, the authors write: “Evaluation of compliance to hygiene measures in hospitals should be done individually rather than globally.” Maybe they should try one of the bathroom signs we wrote about the other day: “Is the person next to you washing with soap?” And “Has the previous shift workers seen to it that everything has been left clean, and soiled mattresses or whatever marked?”

Public health detectives abroad have long known about superspreaders. In the early 1900s, “Typhoid Mary”, an Irish immigrant to the USA who worked as a cook, was quarantined against her will after being linked to a string of typhoid cases. No measure is to be discounted to stop the spread of disease, least of all disciplinary action for dereliction of duty.

Guz Bonett

MARSALFORN