Take bacteria seriously, MPP says
Health Ministry waiting on advice from experts

Mar 15, 2007
Joan Ransberry, Staff Writer

(York Region) - A York Region politician has joined the call to have hospitals track and report two superbugs, including the potentially fatal Clostridium difficile and a stubborn germ hitting babies in GTA neo-natal units.  

Making C. difficile a mandatory reportable disease is under study by the province, a Health and Long Term Care Ministry spokesperson said.

"The Ministry is waiting on advice from the experts," spokesperson A.G. Kei said.

Charging the Health Ministry with seriously mismanaging C. difficile, Oak Ridges MPP Frank Klees is demanding the common bacteria be flagged as a reportable disease with no further delay.

"I can't understand why the government is treating this so nonchalantly," Mr. Klees said.

'It's time to enact full reporting -- otherwise, we will see a surge in hospital death rates from this organism.'

"This is a disease that kills. The fact that it is not to be reported is beyond my comprehension. If reported, it would give the province a picture of what's happening and let us put in the necessary alerts."

The Ontario Council of Hospital Unions is taking a similar stand, demanding the province register all cases of C. difficile, while suggesting a hotline be set up.

The demand came after the bug hit 39 people in Barrie, killed four in Mississauga recently and claimed 2,000 lives in Quebec over the past two years.

"People have no idea what they're walking into when they go to hospital," said Michael Hurley, president of the provincial hospital union. "York Region residents don't know if their hospital is safe or not."

The province is underestimating the threat of superbugs, Mr. Hurley said.

"The government is downplaying it," the union president said. "The first system failure in the SARS crisis was government overconfidence."

The government's "laissez-fair attitude" leaves the door wide open for C. difficile to gain a foothold, Mr. Hurley added.

"It's time to enact full reporting -- otherwise, we will see a surge in hospital death rates from this organism."

Symptoms of C. difficile are diarrhea, fever, nausea and abdominal pain. In some cases, blood is found in the stool. Proper hand washing is the major prevention tool.

C. difficile cannot be spread through the air. Rather, it is spread when a person touches a contaminated surface and then touches his mouth.

The province's infectious diseases advisory committee has C. difficile on its radar screen.

"They need to get the right kind of training and tools in place to deal with C. difficile," Mr. Kei said, adding the province has put an additional 112 infectious disease practitioners in place since 2004.

Starting next year, hospitals across Canada will risk losing their accreditation if they fail to release information on C. difficile, the Canadian Council on Health Services Accreditation has determined.

York Central Hospital is within the bacteria's national range.

Newmarket's Southlake Regional Health Care Centre is ahead of the game, communications director Tammy LaRue said.

"Southlake already reports cases of C. difficile, while we've stepped up our hand-washing practices," Ms LaRue said.

In 2004, after C. difficile claimed four lives at Southlake, the head of the Newmarket hospital asked the Ministry of Health to make the bacteria reportable.

"That was two years ago," Mr. Klees said. "For the government not to take the advice of a senior hospital official where lives were lost is indefensible."

The bug can, indeed, turn killer, Dr. Danny Chen of Richmond Hill said.

A specialist in infectious diseases at York Central Hospital, Dr. Chen stressed C. difficile is an ongoing problem.

"C. difficile is in every hospital all of the time and it's everywhere," Dr. Chen said. "Cases are happening all of the time. We've seen increases in the past couple of months. But, we often see increases in the wintertime."

Health care officials in nursing homes across York Region are keeping a close watch.

The bacteria has not touched any of the 200 residents at Aurora Resthaven recently. Nor has it turned up at Aurora's Sunrise, an assisted living facility serving 92 residents.

"We are C. difficile-clear at the present time," Resthaven administrator Edith Schultz stressed. "We've dealt with it at other times. It takes takes good hand-washing."

The calculated rate for C. difficile in Canada is five to 10 for every 1,000 patients.

York Central is within the bacteria's national range, while Southlake is below the national rate.

C. difficile first turned up in hospitals in the 1970s. While the stomach bug is not uncommon, infectious disease specialists are concerned because it appears to have mutated into a lethal strain.

Some suggest a combination of broad-spectrum antibiotic use, less attention to hospital cleanliness and the fact hospitals tend to much sicker patients is to blame for the mutation.

The bacteria is directly linked to government cutbacks, Mr. Hurley insists.

The hospital union has been calling for the government to earmark special funding to bolster cleaning in hospital and other long-term care facilities.

"More money needs to be spent on hygiene," Mr. Hurley said.

Pointing out C. difficile is not one of the 75 reportable diseases in Ontario, Ken Brown, York Region's manager of infectious disease, said he's not aware of any recent bacteria outbreaks in the region.

C.difficile has not claimed a life at Markham Stouffville Hospital in more than five years, said Pat Shaw, the hospital's vice president of public relations, stressing that when the bacteria turns up, it's carefully monitored.

Special needs babies born at Markham-Stouffville are not affected by the closure of Women's College Hospital's neo-natal unit from a staph bacteria that has hit 12 of the unit's 28 babies.

No Markham-born babies have needed to be sent to any special-care facilities in the past few days, hospital spokesperson Sandy Brodie said.

If a Markham-born baby requires specialized neonatal care, he or she will be transferred to the Hospital for Sick Children, Ms Brodie added.

Ministry of Health spokespersons were not available at press time.

For more information about C. difficile, call the Health Connection Line at 1-800-361-5653.


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