May 192012

The elderly are at higher risk for infections due to several factors including decline in the function of their immune system, poor nutrition, lack of activity, as well as medications and other illnesses that inhibit their ability to fight off infections. The best defense is a good offense and that starts with realizing what you are up against.

Drug resistant bacteria, swine flu, avian flu, e-coli, flesh-eating bacteria, West Nile Virus, it seems like we have a new bug to fear every month. And so-called “super bugs” that were once the purview of hospitals are now being acquired in the community setting. These are bad enough in a healthy adult but they are often deadly for our elderly parents.

As hospital stays are shortened, more procedures and surgeries being done on an outpatient basis, the need for good infection control guidelines in the home and community is becoming increasingly more important. To complicate matters even more, home care has gone high-tech with tracheotomies, ventilators, dialysis, intravenous medications and other invasive procedures. Our population is living longer and with chronic illnesses that require the skilled care of nurses, therapists and aides in the home to educate and assist with care.

With the lack of 24 hour professional monitoring, it is up to the family and/or caregivers to be the first line of defense in the prevention of infection as well as the recognition of the early signs and symptoms. Something as simple as a cold can be deadly to someone with chronic breathing problems such as COPD. A small scratch in the elderly can rapidly become septic requiring emergency treatment. (Sepsis is a bacterial infection spread throughout the body and is more commonly called blood poisoning). Good infection control cannot be over-emphasized.

The Chain of Infection

Infection requires a chain of six steps to occur and a break in the chain lessens the likelihood of infection occurring. Those six steps are an infectious agent, a reservoir, a portal of exit, a mode of transmission, a portal of entry, and a susceptible host.

1. Infectious agent: a microorganism, usually bacteria, virus or fungus, or the more common term, germ. The virulence or strength of the germ is determined by its ability to invade and multiply in normal, healthy individuals. While an organism may not be virulent for a healthy individual, in a compromised person such as the elderly it becomes pathogenic (causes illness).

2. Reservoir: There must be a favorable environment for growth and replication. This is the source of the infection such as a sick person, a contaminated object or a carrier species (insect, rodent, animal).

3. Portal of Exit: This is the route the infectious agent takes out of the reservoir such as through the nose, mouth, sexual organs, feces and through blood.

4. Mode of Transmission: This is how it moves from reservoir to host. Contact or touching an infected person such as kissing, sexual intercourse, and shaking hands, or an infected object such as shopping cart handles, phones, computer mouse and door handles. Droplet transmission through sneezing, coughing, and being spit on. Things routinely taken into the body such as air, food and liquids. Insects, rodents and animals don’t actually cause disease, they merely transfer it to us via biting, blood and feces.

5. Portal of Entry: This is how the infection enters the body such as through the mucous membranes of the nose or mouth and through a cut or injury to the skin.

6. Susceptible Host: Someone who is at risk. This includes those who are lowered immunity, fatigued, stressed, anemic, not immunized, poor nutritional status and those with underlying disease.

Tomorrow, we’ll look at breaking the chain, the first step in prevention.


  12 Responses to “Infection Control Part 1 – The Chain of Infection”

  1. Looking forward to the next article in the series!

    Mark Hogan

  2. prevention, prevention, prevention – through diet, nutrition and even the slightest amount of activity is valuable

  3. I have never heard of the chain of infection before.

    How do you feel about the use of hand sanitizers? I, personally, am not a fan unless there’s no other option for hand washing.

    Sabrina Peterson, NASM CPT, CES
    Fat Loss and Fitness 101

    • I’m with you on hand sanitzer. It’s not that effective unless people rub it in until it dries and not many do that. Even then, it doesn’t kill MRSA. Soap and water are the best.

  4. I agree with Sabrina, I am a big fan of soap and water to wash my hands. I’m still not sold on the idea of “hand sanitizers”.

    Yours In Health!

    G.E. Moon II
    Reclaim Your Health!

  5. I always believe that you are only as healthy as your inner terrain and that comes from eating a plant based diet and grass fed protein. I would expect infection control to be tough with someone who is on several medications and has a poor diet. I am looking forward to what your recommendations are.

    Wendy Schauer: Author, Speaker, Chiropractor, Kettlebell Trainer

  6. Infection Control is very important. I work in an environment where I’m in contact with thousands of people from every corner of the globe. We’re always reminding each other to wash our hands with warm water and soap several times during the work day.

    The Three Stooges

  7. Hi Nurse Suzanne,
    Critical Information about Infection!
    Thank you so much for explaining it so well.
    Looking forward to tomorrow!
    Would you like to understand about caregiving depression?

  8. Isnt it amazing that something so simple as washing your hands frequently with soap and water can be so effective against such a bad thing….
    Sunny Carlson

  9. Great points! people are often to sloppy with hygeine, and you can’t be around the eldery.

    Sales Expert

  10. Suzanne,
    Simply washing hands with soap and water is enough. Hand sanitizer works well after washing the hands. The prevention is in the mind – if you think you’ll catch a disease, you will. This is beautifully explained in “Man’s Search for Meaning” by Viktor E. Frankl.

    Covert Hypnosis: How To Read People

  11. It seems that we have accidentally helped the progression of the so called “super bugs”. Sequence? Person gets sick->gets medicine->is told to follow the medicine regimen TO THE END->takes medicine, feels better->STOPS taking the medicine [ “I’m better, I don’t need to bother with the rest”->bug develops resistance when the partial dose doesn’t kill it->hello super bug->no longer responds to original medicine.
    Be Well.

 Leave a Reply



You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>