A Veterinarian's View on the Control of Human Hospital Related Infictions

First we must define the problem. It is that an estimated 2,000,000 patients who enter human hospitals as patients contract an infection not present prior to their admission. Of those patients in one year in our country 90,000 actually die of their infection. The following adresses only those infections that are the result of bacterial infections that are the major problem. I have been informed that that figure may underestimate the problem as many of the smaller human hospitals do not report on this situation.

Next we should consider some of the efforts made so far in the unsuccessful effort. 1. Sick leaves for all hospital employees obviously affected by symptoms. 2.Hand washing. 3. Constant testing of premises including heating and air conditioning ducts. 4. The use of proven more and more effective bactericidal agents used in cleaning and disinfecting. 5.Other efforts such as discouraging the wearing of long neckties in favor of bow or no ties. Hmmmm.

It seems to this veterinarian that the more dangerous killing organisms are the most difficult to control in human hospitals. To locate the source of these dangerous agents should be a major effort in the eventual control of such a serious problem.
In consideration of potential sources the medical profession has decided that human hands are a major source. That effort, having been tried without improvement the other sources should be investigated. What are they? 1. There is a question as to the more obvious source but I shall put down as source in no order of importance,1. The human mouth. 2.The filth walked into hospitals on shoes. 3.Sanitation of the premisis.

Next logically come the attempts to control this problem. First the for the human mouth. An experiment for a hospital-wide examination of every mouth that enters the establishment should be instigated by requiring everyone to spit into a container for bacterial examination. This experiment should be for a 24 hour period. The hunt would be for specific bacterial organisms most frequently associated with the diseases contracted in that specific hospital. Admittedly this requires a massive temporary enlargement of the bacterial effort with both facilities and the expert bacteriologists searching for the culprits. Ideally each specimen would be examined immediately and after incubation.

Another volunteer human hospital could study the other source of filth and that is the shoes of everyone admitted through the doors. Disposable sterile "booties" or shoe coverings should be handed to all to be worn over shoes. Each pair of "booties" would be removed, folded and placed in an envelope marked with name and address for bacteriologists to seek the bacteria involved. The debris from the shoes would indicate information of public health importance if a pattern of infection was to be found on shoes from a specific geographic area or places of employment.

For another experiment, in one small surgical facility a culture of harmless organisms, perhaps yeast could be sprayed over the facility to try to introduce an agent that would overcome the dangerous bacteria. Very few bacterial organisms can survive in the presence of yeast. After 100 or so procedures were performed in such z facility the effectiveness or not of the attempt could be evaluated.

As a veterinarian, I see another area of perhaps even more potential for good than the above and that is the encouragement of the human immune system. There is much statistical evidence that runners have stronger resistance to many infections than non-runners. For perhaps a volunteer hospital could refuse to permit the entry of any patient who did not run at least once a week. That experiment should be done by a hospital in a large metropolitan area or as part of a huge establishment as the Mayo Clinic, or the Columbia Medical Center facilities. The USATF(Track and Field) approximates 30 million runners who run at least once weekly and it would take a facility in a heavily populated area to find enough runner-patients in need of surgery to fill beds to make it worthwhile.

On visiting the Hog Farm at the University of New Hampshire some years ago to purchase a piglet for a pet a sterile white outer clothing was issued with plastic boots for our shoes, masks and hats and that was not to protect us but to protect the pigs from contracting diseases from us. Wouldn't you think the human medical profession would do as much for their patients as the veterinary profession is capable doing for pigs? Or shouldn't the two professions work together as all medical professions should do?

The Dawn of Comercial Animal Food

One reason for our family moving from the city of New Haven to The Town of Orange in 1930 was to provide my father, Leon F. Whitney with the space he needed to keep large numbers of dogs to study the inheritance of characteristics. As an example breeds of dogs that were born to hunt for birds run with their heads held high where as a bloodhound runs with his nose to the ground. If crossed would the puppies grow up to run like a setter or a bloodhound? The answer is that all the puppies run with their heads held high. To breed and raise large numbers of dogs takes a lot of food and in those days there was no balanced ration for any animals other than for rats and mice. With 18 or 20 bloodhounds and many coon hounds and various collies, cocker spaniels and beagles and other breeds there was a need for a good balanced food. So what to do? The answer was simple, compound one ourselves. Dad had anticipated an attempt to solving that problem and when our garage was planned an extra closed in bay of the garage was planned. It would be a "rat" laboratory heated with an oil stove. Dad constructed shelves from floor to ceiling. He made rat cages out of hardware cloth which is the name of quarter inch wire mesh with elevated bottoms and no tops. The shelves above would be the tops of the cages.
I don't recall where he got a few pairs of rats but in a year the shelves were full of occupied rat cages. That was the time when the members of the veterinary profession declared that dogs were carnivores and had to have fresh meat to flourish.
It was my paid job to care for the 200 or so rats. Food and water daily and clean the cages weekly. The salary was $1 a week. Each cage of the two top shelves had 4 adult females and one male. It was my job to separate the pregnant females before they gave birth. The weened youngsters would be divided half as controls and half on a different diet and each young rat was weighed weekly to compare weight gains of the two groups. Soon we had a rat food that would grow rats twice as fast and healthier than the commercial rat food. Food for our White Isle Kennel required purchasing all the ingredients necessary and mixing and storing it. My father studied nutrition and found we required 24 different ingredients. The two car garage was sanitized and the bases of the diet, bread meal was piled on one side of the garage with ingredient such as alfalfa leaf meal, bone, fish, beef and on and on with each carefully weighed down to small quantities. Then began a slow process of shoveling the pile to the other side of the garage to mix it. At first we mixed several hundred pounds and eventually a thousand pounds at a time. To be sure some of the trace elements were well mixed required hours of shoveling back and forth.
In studying the per cent protien and trace elements in each component of the food and minerals as well as the same values in each ingreedient resulted in necessary nutritionsl knowledge. It amounted to a self learned home earned degree in canine nutritian.
At this time, questioning the knowledge of that time that dogs could not tolerate much fat in their diets, dad wondered about that idea when he knew dogs often killed animals such as woodchucks and ate the whole animal including the fat. Inquiring about beef fat he was told he could have all he wanted for the taking as the butcher had to pay to dispose of it. Soon dad found his dogs could tolerate up to 20 per cent of their diets as fat and flourished. The new food with fat added resulted in the healthiest looking and active hunting dogs imaginable.
For a short time we donated food to a few kennel owners and the results were so outstanding a company put the formula on the market and that was really the start of the commercial pet food industry in our country. It started as Baloration in Brooklyn, NY, was purchased by Tioga Mills in Waverly, NY and renamed Tioga Dog food. During WWII the formula became too expensive and rather than cheapening the formula my father insisted on stopping the production.
It was royalties from the sales of that dog food that later paid for a veterinary degree for both my father and for me.

Conn. Experiment Sttion Associates

The Connecticut Agricultural Experiment Station is the oldest station of its kind in our Country and I have had an interest in it since I was about 8 years of age. My father took me along when he had questions the scientists at that station might answer. At one I was introduced to a Donald Jones who gave my father some corn to plant. This was the Jones who led the way for hybridizing plants resulting in important results such as growing twice the amount of corn per acre than with the usual seed available. He gave my father seeds that resulted in corn stalks the size of field corn and huge ears of sweet corn. In my practice of veterinary medicine I asked scientists for help in some difficult cases. For example with a case of sudden death in a coon hound I asked if they could test parts of the dead animal for poisoning. The results came back in a few hours, cadmium poison. The scientist at the station asked if the dog might have been fed out of a hub cap. I phoned the owner of the dog and asked him and got the reply, "I feed all my dogs our of hub caps." I had never heard of cadmium poisoning and did not know cadmium was found in them. That one case is a good example of the unsung hero's who work lives of quiet discovery with little recognition unless their field has a special effect on people such as ticks and Lyme Disease. Scientists are wrapped up in their work with no time to lecture to the public and if they did take the time the public would not be able to understand most of the research. They get their kicks out of publishing findings never reported before as published in scientific journals for other investigators to appreciate. The scientists at the station are asked to make a special effort to educate the public and do so effectively. I had been President in an outreach volunteer group for Yale's Peabody Museum. We supported many activities with food for special functions and with lectures for the public that were good for the Town and Gown effort of the University. Peabody Associates was so successful I wondered why the Ag Station did not have such a support group.The Director of the Ag Station at that time was Dr. John Anderson and one day I asked for an appointment with him and brought up that subject. He was enthusiastic and asked if I would put my thinking on paper and present it to the Board of Control, the director of the station. It was a simple job to copy the constitution and bylaws of Yale's Peabody Associates and present it as a plan. I made no secret where I found the plan. The Station's mailing list was contacted and by return mail we had over 200 members. So many people in Public Health and in agriculture had been helped in so many ways that I think they thought they owed the Station and so formed the nucleus of The Experiment Station Associates. I am prouder of that accomplishment than of any other in my life. I have a plaque stating that I am the Founder of that group. A few years passed and the financial situation of the state of Connecticut resulted in our Governor suggesting the Station no longer be funded. With the members of The Associates spread over the State to write letters to the media and legislators as well as the Governor, he had to back down. The Station thrives today.