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Good afternoon all:

Well, the media storm over the nursing home outbreak has intensified over the past few days, with Toronto being mentioned on CNN. In fact, I just got back from the Minister's press conference on progress in healthcare reform, and essentially all the questions related to the outbreak.

I am sure that this story has brought back some uncomfortable memories for those of you who were here during SARS. It certainly has for me, and I am getting more and more frustrated with the sensationalistic coverage.

Some key facts:

1) Well over 100 nursing home outbreaks occur every year in Toronto

2) While the number of deaths in this outbreak is unusual, it certainly is not unprecedented. The GTA has had worse outbreaks that did not attract this kind of media attention.

3) We frequently cannot find the cause of an outbreak. There are literally hundreds of viruses that can cause this type of disease.

4) The new deaths resulting from this outbreak are not new cases, but rather people who we have known about all along who unfortunately have died as a result of their infection. It is a sad truth that once elderly and infirm people become infected with something like this, we are often too late to prevent them from becoming really ill.

5) The oubreak has not spread anywhere else.

6) When the media first broke the story on October 1st, the outbreak was already winding down. I've attached the actual epidemiologic curve below to show that when Dr. David McKeown of Toronto Public Health says the outbreak is essentially over, he means it.

Description: Image: chart

All of those involved in this outbreak are confident that it will be over very soon. For public health to officially declare an outbreak over, they normally wait two viral incubation periods without any new cases just to be sure, so it may be a few more days before they make an announcement. I am hoping that once the media realises that there are no longer new cases, they will move on to other issues.

So what should we be doing about this? The same things we have always been doing. If patients are transferred to us from an outbreak area (specifically 7 Oaks, not other Scarborough facilities), they would go in to the appropriate isolation. Otherwise, it is business as usual. If you have any questions, please call your local infection control practitioner.

Finally, please participate in the Infection Control week activities and flu shot campaign. As we have seen with this outbreak, preventing outbreaks is so much better than having to control them.

Michael

Michael Gardam MSc, MD, CM, MSc, FRCPC 
Director, Infection Prevention and Control 
Medical Director, Tuberculosis Clinic 
University Health Network

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