Anniversaries and hand hygiene

April 1, 2013
Anniversaries celebrate an event that occurred in the past, and they are a celebration of the history that brought us to the place we are today.

By Noel Brandon Kelsch, RDHAP

Anniversaries celebrate an event that occurred in the past, and they are a celebration of the history that brought us to the place we are today. A couple of remarkable findings that I love to celebrate are the discovery of the cause of infectious diseases, and learning that the greatest way to prevent them is a simple human behavior -- washing hands. Hands have proven to be one of the greatest sources of microbes that can spread disease. The Centers for Disease Control states that 80% of disease is spread through hand-to-hand contact. The single most effective way of preventing widespread infection is simply washing your hands.


1795--People historically believed that diseases were the result of being exposed to or being possessed by evil spirits. Back in 1795, Dr. Alex Gordon was hanging out in Aberdeen, Scotland, and came up with the outlandish concept that fevers were in fact an infectious process, and that a physician could be the carrier. This man went out a limb to say, "I myself was the means of carrying the infection to a great number of women." He was referring to childbed/puerperal fever, which we now know is caused by Group A or Group B streptococcus, and leads to septicemia, and in many cases death. This is an iatrogenic (doctor-induced) disease.

1847--Ignaz Semmelweis, a simple Hungarian physician who is now referred to as the "savior of mothers," noticed something remarkable. Women who delivered in a hospital setting with a midwife as opposed to a medical student were significantly less likely to get childbed/puerperal fever. The death rate was six times higher if a medical student attended the mother! This perplexed Semmelweis, so he followed the student of greater learning around for a few days. He discovered that the same students who performed autopsies on patients who died of sepsis then assisted in childbirth. Without washing their hands, these physicians performed vaginal examinations on expectant mothers with what Semmelweis called "cadaverous particle." He showed that this act
was chiefly responsible for these women losing their lives.

He enforced a strict policy on hand washing with a chlorinated antiseptic solution, and the mortality rate from childbed/puerperal fever dropped significantly within three months.

Then something very interesting happened. He was not celebrated or loved by his peers for his hypothesis and what he discovered. Instead he was rejected, ignored, publicly humiliated, and openly ridiculed. He lost his job at the hospital and could not find a job as a medical doctor. He did not give up. He could not stand by and let women die for such a preventable occurrence.

He openly pleaded with the community and even wrote letters that called doctors who rejected his pleas "irresponsible murderers." His once comrades and his wife felt he had gone mad, and they had him committed. He died 14 days later and it is believed he was beaten to death by the hospital staff. The miracle that Semmelweis discovered was only accepted after his death.

1879--It wasn't until Louis Pasteur experimented in 1879 and showed the medical community a thing or two about these infinitely tiny microbes that could cause diseases, from tuberculosis to small pox. Pasteur discovered that the streptococcal bacteria could be found in the blood of the women that had puerperal fever. This gave credence to Semmelwe's findings. Semmelweis, who was institutionalized and literally died for his findings, is now considered the pioneer of antiseptic procedures and the father of hand washing. Millions of lives have been saved because of his dedication and sacrifice. His finding greatly impacted the safety and future of you and your patients.

There is another milestone anniversary this year -- 90 years of changing lives, of embracing concepts that others may not, of understanding the impact of health when these concepts are brought forward. Thank you ADHA for 90 years of moving forward and sharing dreams of access to care, and the art and science of dental hygiene. The vision, dedication, and sacrifice of your members have made the world a healthier place. RDH

NOEL BRANDON KELSCH, RDHAP, is a syndicated columnist, writer, speaker, and cartoonist. She serves on the editorial review committee for the Organization for Safety, Asepsis and Prevention newsletter and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all and helps facilitate the Simi Valley Free Dental Clinic. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamines and drug use. She is a past president of the California Dental Hygienist's Association.

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