By:
Dr.Mohamudha Parveen
‫‪Overview‬‬
‫تاريخ الجراثيم •‬
‫كيف تنتشر الجراثيم‬
‫األمراض الشائعة‬
‫غسل اليدين –لماذا ومتى ؟‬
‫خطوات غسل اليدين‬
‫‪Germ History‬‬
‫‪How Germs Spread‬‬
‫‪Common Diseases‬‬
‫?‪How, Where to control‬‬
‫•‬
‫•‬
‫•‬
‫•‬
Germs/Microorganisms ‫جراثيم‬/ ‫الكائنات‬
‫الحية الدقيقة‬
Bacteria
Bacteria/‫بكتيريا‬
Fungi/‫الفطريات‬
Virus/‫فيروس‬
Parasites/‫طفيليات‬
Bacteria/‫بكتيريا‬
• A single cell
• Helpful, pathogenic
(harmful, causing disease),
and spoilage (deteriorates
food)
• Round, rods, or spirals
• Salmonella, Staphylococcus
aureus, Streptococci
• Some bacteria produce
poisons called toxins Clostridium botulinum
bacteria
‫وحيدة الخلية‬
‫ مسببة‬, ‫ممرضة (ضارة‬, ‫مفيدة‬
) ‫للمرض‬
‫وتسبب تسمم الغذاء‬,
‫بعض البكتيريا تنتج سموم تسمى‬
‫سموم‬Clostridium
Viruses/‫فيروس‬
• Viruses are smaller than
bacteria
• Viruses are protein
structures, not cells
• Require a living host to
survive
• Highly infectious
• ‫الفيروسات اصغر من البكتيريا‬
• ‫الفيروسات تتركب من البروتين‬
‫والتحتوي على خاليا‬
• ‫تحتاج لكائن حي تعيش عليه‬
‫ألجل البقاء‬
• ‫شديدة العدوى‬
Fungi/‫الفطريات‬
• Found in air, in soil, on
plants, and in water
• Familiar ones - mushrooms,
yeast, mold
• Some live in the human
body, without causing
illness
• Some are beneficial penicillin and yeast for
fermentation
Protozoa
• Microscopic one-celled
animals
• Can be parasites or predators
• In humans, protozoa usually
cause disease
• Examples: Malaria ,Filaria,
Amoebasis, Giardiasis
‫‪Germs: modes of transmission‬‬
‫الجراثيم‪ :‬وسائل انتشار‬
‫)االتصال المباشر( ‪• Direct contact‬‬
‫)هواء‪ :‬السعال‪-‬العطس ( ‪• Air‬‬
‫)تخفيضات والجروح‪ ،‬والجروح( ‪• Cuts, abrasions, wounds‬‬
Germs: modes of transmission
‫ وسائل انتشار‬:‫الجراثيم‬
• Pets – dogs & cats (rabies),
reptiles (Salmonella)
• Water (‫ –) ماء‬E-coli, Giardia
and Salmonella ‫األغذية‬
‫الملوثة والمياه‬
• Insects – mosquito (‫)بعوض‬,
Housefly (‫) الذبابة‬
flea (‫)براغيث‬
Which is the major important
route for germs to enter in your
body?
‫الذي هو الطريق المهم كبيرا؟‬
Hands (‫)أيادي‬
‫‪Routes Via Hands‬‬
‫انتقال الجراثيم من اليد الى‬
‫الطعام من خالل اعداد‬
‫الطعام من غير غسل‬
‫اليدين‬
‫من يد الى يد عبر المصافحة‬
‫انتقال الجراثيم من الطعام‬
‫الى اليد الى طعام آخر مثل‬
‫الدواجن النية او‬
‫الخضروات الغير مغسولة‬
‫‪Hands to food‬‬
‫‪Hand to hand‬‬
‫‪• poultry to ready to eat‬‬
‫‪foods‬‬
‫‪Food - hands –raw‬‬
‫‪foods‬‬
Routes Via Hands...
‫نقل الطعام الملوث الى‬
‫خالل األطفال من‬
Hands to infant diaper –food
‫اطعامهم باليد‬
Nose - handsmouth
Ears - handsmouth
Environmental Surfaces/‫األسطح البيئية‬
Environmental Surfaces/‫األسطح البيئية‬
Illness Associated With Contaminated
Environmental Surfaces
 Common cold
 Flu
 Norovirus-Transmitted
by Hand to mouth
 MRSA
 ‫نزالت البرد‬
 ‫االنفلونزا وغيرها من‬
‫الفيروسات‬
 Norovirus- ‫تنتقل عن‬
‫طريق اليد الى الفم‬
 ‫الجرثومة‬
MRSA
• Causes a skin infection
– Commonly occurs
at sites of cuts
and/or abrasions
• How MRSA is
Transmitted
– Usually transmitted
• Skin to skin
contact
• From
contaminated
surfaces
• ‫تسبب عدوى للجلد‬
• ‫يحدث عادة في‬
‫اماكن الجروح‬
• ‫كيفية انتقال‬
‫الجراثيم‬
‫عادة تنتقل عن‬
_‫طريق‬
‫مالمسة الجلد‬
‫من االسطح الملوثة‬
MRSA
•
Where do You get MRSA?
– Anywhere
– Setting that have these factors
• 5C’s – Crowding,
frequent skin to
Surface Contact,
Compromised Skin,
Contaminated items
and surfaces, and lack
of Cleanliness
– Locations
• Schools, dormitories,
military barracks,
households, jails, and
daycare centers
•
‫أين يمكنك الحصول على هذه‬
‫الجرثومة؟‬
-‫من أي مكان‬
-‫المحيط الذي لديه هذه العوامل‬
5C’s -‫المس المتكرر لسطح‬-‫الزحام‬
‫المواد الملوثة‬,‫الجلد‬
‫انعدام النظافة‬,‫والسطوح‬
-‫المواقع‬
،‫المدارس والمهاجع والمواقع العسكرية‬
‫ ومراكز الرعاية‬،‫والسجون‬
‫النهارية‬
Parvovirus
• Transmitted by
respiratory route
– sneezing, talking,
coughing, touching
secretions
– infectious before rash
& usually not
infectious when rash
appears
• 50% of people
infected by adulthood
• Pregnant women
– reports of stillbirths &
miscarriages
•
•
‫تنتقل عن طريق الجهاز التنفسي‬
‫لمس‬,‫ السعال‬, ‫الكالم‬, ‫العطاس‬
‫االفرازات‬
• ‫العدوى قبل الطفح الجلدي&عادة ما‬
‫تكون غير معدية عندما يظهر الطفح‬
• ‫ من الناس المصابين هم‬٪50
‫البالغين‬
Food borne illness due to fecal/oral transmission
‫الطعام الملوث بالبراز ينتقل عن طريق الفم‬
•
•
•
•
•
•
•
•
•
•
•
•
•
Poliomyelitis
Norovirus acute gastroenteritis
Giardiasis
Hepatitis A
Hepatitis E
Rotavirus
Shigellosis (bacillary dysentery)
Typhoid fever
Enteroviruses
Cholera
Clostridium difficile
Cryptosporidiosis
Ascariasis
‫شلل األطفال‬
‫التهاب المعدة واألمعاء الحاد نوروفيروس‬
‫الجيارديا‬
‫التهاب الكبد‬A
‫التهاب الكبد‬E
‫فيروس الروتا‬
)‫الشيغيالت (الزحار العصوي‬
‫حمى التيفوئيد‬
‫الفيروسات المعوية‬
‫كوليرا‬
‫المطثية العسيرة‬
‫كربتوسبوريديوسس‬
‫داء الصفر‬
Reptile Salmonellosis (‫) الزواحف السالمونيال‬
• All reptiles shed
Salmonella in their feces
• Increased popularity of
reptiles as pets in
households and
classrooms
• Special risk to infants,
immunocompromised,
kids, pregnant women
and the elderly
• Lack of awareness
‫توجد بكتيريا السالمونال في براز‬
‫الزواحف‬
‫تزداد وتتواجد في الحيوانات االليفة في‬
‫المنازل والفصول الدراسي‬
‫ضعفي‬,‫االطفال‬,‫تشكل خطرللرضع‬
‫كبار السن‬,‫المناعه الحوامل‬
‫قله الوعي‬
 Hand


Why Wash Hands ?
Reduces Diarrhoea
washing with soap
 :‫غسل اليدين بالماء والصابون‬
:
‫يقلل من مخاطر اإلصابة‬
Reduces risk of -42 ‫بأمراض اإلسهال بنسبة‬
diarrhoeal
diseases
٪47
by 42-47%
 ‫عدد الوفيات الناجمة عن‬
No of diarrhoea deaths
1.1 ‫اإلسهال التي يمكن تفاديها‬
that could be
‫مليون‬
averted 1.1 million
Hand
washing
by
mothers :
 Lowers incidence of
childhood diarrhoea
 :‫غسل اليدين من قبل األمهات‬
‫يقلل من اإلصابة باإلسهال‬
‫الطفولة‬
Prevention (‫)منع‬
How Do We Get Rid Of Germs?
‫كيف نتخلص من الجراثيم؟‬
Hand Hygiene In Fecal Oral Transmission
Fingers
HANDWASHING
Flies
Feces
Foods
Fomites
Fluids
Host
Hand washing is the most
important method of disease
prevention
Bacteria and virus can
be spread via dirty
hands and the are too
small to see with the
human eye.
You must wash you
hands properly in
order to remove them.
 ‫يمكن أن تنتشر الجراثيم‬
‫والبكتيريا عن طريق‬
‫األيدي القذرة‬
‫وهي صغيرة جدا لرؤية‬
‫ يجب‬.‫بالعين البشرية‬
‫عليك غسل يديك بشكل‬
‫صحيح من أجل إزالتها‬
What happens when I do not
wash my hands?
 Bacteria and viruses
are picked up and stay
on your hands.
 You can pass them to
other people when you
touch them with your
hands.
 Bacteria and viruses
can get into your body
when you touch your
eyes, mouth, or nose
with your hands.
‫البكتيريا والفيروسات تتعلق و‬
‫تبقى على يديك‬.
 ‫يمكنك تمريرها إلى أشخاص‬
‫آخرين عند لمس ايديهم‬.
 ‫البكتيريا والفيروسات يمكن ان‬
‫تنتقل إلى الجسم عند لمس‬
‫عينيك أو فمك أو أنفك بيديك‬.
History/‫تاريخ‬
• 1840- Hungarian
doctor Ignaz
Semmelweis
• He was trying to
figure out if it made
a difference in
saving lives.
• In the United States
this came to light
during the Civil War
in battlefield
hospitals.
Germ History
• 1860 -French chemist -Louis Pasteur. He calls
the bacteria "germs."
‫هل تعرف؟‬
Many personnel don’t realize when
they have germs on their hands
Culture plate showing growth of bacteria 24 hours after
a nurse placed her hand on the plate
Gloves?? (‫)قفازات‬
Gloves DO NOT take the place of hand
hygiene (‫)قفازات ال تأخذ مكان نظافة اليدين‬
• Glove use neither
alters nor replaces the
performance of hand
hygiene
• Gloves should be
removed and hand
hygiene performed
and put back on
‫ستخدام القفازات ال يغير وال‬
‫يستبدل أداء نظافة اليدين‬
‫يجب إزالة القفازات ونظافة‬
‫اليدين تنفيذ ووضع مرة‬
‫أخرى على‬
Who Should Wash Hands?

WE ALL

WE ALL are at Risk
Clean appearing hands
need not be
free of Germs

• ‫نحن جميعا‬
• ‫ونحن جميعا في خطر‬
‫االيدي النظيفة من الخارج‬
‫ليس بالضروره تكون خالية‬
‫من الجراثيم‬
Hand Hygiene
Hand Hygiene
Hand Hygiene includes: ‫ومن ناحية النظافة‬
‫وتشمل‬:
 Routine hand
washing
‫غسل اليدين الروتيني‬
 Surgical hand
‘scrub’
/ ‫استخدام الكحول التدليك‬
‫الجل‬
 Use of alcohol
rubs/gels.
‫“اليد الجراحية "فرك‬
Hand washing (‫) غسل اليد‬
6 groups
–
–
–
–
–
–
Liquid soap and
water
Foam Soap
Water only
Alcohol sanitizer
Chlorine sanitizer
Hand wipes
–
–
–
–
–
–
‫الصابون السائل والماء‬
‫رغوة الصابون‬
‫الماء فقط‬
‫الكحول المطهر‬
‫الكلور المطهر‬
‫مناديل اليد‬
Handwashing
‫نظافة اليدين‬
‫الصابون‬
‫الصابون المضاد للبكتيريا‬
‫مطهرات اليد‬
Soaps - designed to clean the skin by
removing dirt, oils and germs.
Antibacterial soaps - contain
Triclocarbon and Triclosan, for
added germ killing protection
Hand sanitizers – waterless, include
a germ kill ingredient: alcohol,
Triclocarbon, Triclosan
How to perform hand hygiene
‫كيفية إجراء نظافة اليدين‬
Proper technique is important when it comes to effective hand
hygiene. Without proper hand hygiene technique, we can still spread many
microorganisms with our hands.
Alcohol-based hand rub
Soap and water
Without water when
hands are soiled
Soap and Water ‫صابون والماء‬
• Soap and water - recommended method
when hands are visibly soiled.
• Plain soap -routine hand hygiene
• Anti-microbial soap -acute care high risk
areas.
‫يستخدم الصابون العادي لنظافة اليدين الروتينية في حين يتم استخدام الصابون‬
‫المضاد للجراثيم في المناطق المعرضة للخطر الرعاية الحادة‬.
When you should
wash?
• Wash your hands
After you use a restroom
Before and after you eat
Before you touch your eyes, nose or mouth
Before and after you prepare food, and after
you handle meat or fish
After you change a diaper
After you pet a dog, cat or other animal
After you touch plants or soil
After you visit a hospital or nursing home
After you come in contact with any body fluids
Handwashing Steps
‫خطوات غسل اليدين‬
Step 1
Wet hands and wrists.
Apply soap or alcoholbased hand rub
50
Handwashing Steps
Step 2
Right palm over left.
Left over right.
51
Handwashing Steps
Step 3
Palm to palm
with
fingers interlaced.
52
Handwashing Steps
Step 4
Back of the
fingers to the
opposing fingers
and
interlocked.
53
Handwashing Steps
Step 5
Rotational rubbing of
the right thumb by
clasping it in the left
palm.
And vice versa.
54
Handwashing Steps
Step 6
Rotational rubbing
backwards and forwards
with tops of fingers and
thumb of right hand in
left
And vice versa.
55
Drying Your Hands
‫تجفيف اليدين‬
Important because damp hands :

collect microorganisms
 spread potentially infectious microorgansims
 may become colonised with potentially infectious
microorganisms
Therefore it is important to “pat dry” your hands thoroughly.
“Pat” drying also helps to prevent damage to skin.
56
‫‪Drying Hands After Hand Wash‬‬
‫تجفيف اليدين بعد غسل اليد‬
‫‪• Handkerchief / cloth used to dry hands‬‬
‫) منديل ‪ /‬القماش تستخدم لتجفيف اليدين(‬
‫)يمكن أن تكون مصدرا من اإلصابة مرة أخرى( ‪– Can be a source of re-infection‬‬
‫)تجفيف الهواء مع منفاخ الهواء الساخن( ‪• Air drying with hot air blower‬‬
‫‪What if I do not have access‬‬
‫ماذا لو لم ?‪to a sink and soap‬‬
‫نتمكن من الوصول إلى حوض الماء‬
‫والصابون؟‬
Use an Alcohol-Based
Hand Sanitizer
‫استخدام الكحول‬
When can you use an
alcohol-based hand gel? ‫متى‬
‫يمكنك استخدام الكحول جل اليد؟‬
n
n
Alcohol-based hand rub is the
recommended method of hand hygiene in
any healthcare setting when hands are not
visibly soiled.
In all clinical situations EXCEPT: ‫في جميع الحاالت‬
‫السريرية باستثناء‬:


n
n
When your hands are visibly soiled
When a surgical scrub is required
‫عندما يكون اتساخ يديك واضح‬
‫عندما يطلب فرك للجراحة‬
Are alcohol-based
handrubs really effective?
‫فوائد غسل اليدين بالكحول‬
 alcohol-based
handrubs are more
effective than either
plain soap or
antibacterial soaps
in reducing the
number of live
bacteria on the
hands
Promoting alcohol hand rubs
improve hand hygiene habits
When hospitals/schools/colleges placed
alcohol handrub dispensers, students and
health care workers clean their hands
significantly more often than they did when
only sinks were available for handwashing.
Time
• Both are effective methods
Hands are soiled and no water
‫اذا كانت اليد متسخة بالدم وال يوجد ماء‬
When access to hand washing facilities is limited and running
water is unavailable, use a moist towelette to remove visible
soiling from hands followed by alcohol-based hand rub.
Moist towelette
Followed by hand-rub
Advantages of cleaning hands with
alcohol-based handrubs
‫مزايا تنظيف اليد مع التدليك اليد على الكحول‬
Alcohol handrubs have the following advantages over soap
and water: ‫غسل اليدين بالكحول اكثر منافع من غسل اليدين بالماء والصابون‬
• take less time to use ‫يستغرق وقتا أقل الستخدام‬
•more accessible than sinks ‫ويمكن استخدامه في اي مكان‬
•less skin irritation and dryness ‫يسبب تهيج الجلد أقل وجفاف‬
•effective in reducing the number of
‫هي أكثر فعالية في تقليل عدد البكتيريا على األيدي‬
bacteria on hands
•handrubs readily available to personnel ‫تدليك اليدين بالكحول متاح‬
‫لدى العاملين‬
•improved hand hygiene practices
‫أدى إلى تحسين الممارسات الصحية‬
 Won’t frequent use of
alcohol dry out my skin?
‫كثرة استخدام الكحول تجف بشرتي؟‬
 ‫ !ال‬NO
Efficacy of Hand Hygiene Preparations in
Killing Bacteria in Health Care Settings
Obstacles to Hand Hygiene
‫سبب نسيان غسل اليدين‬
• Too busy –
– It is essential that you make
time
• Skin irritation –
– Use lotions & hand rub
appropriately
• Glove use –
– is not a substitute for hand
hygiene
• Not top of mind –
– needs to become as
spontaneous as using aseptic
technique and all other safety
strategies.
Another reason why personnel
don’t wash their hands often
Frequent
handwashing with
soap and water often
causes skin irritation
and dryness.
In the winter months,
some personnel may
even develop cracks
in their skin that
cause bleeding, as
seen in the adjacent
figure.
What Does “Clean” Mean?
Teach Children How To
Protect Themselves ‫تعليم األطفال‬
‫كيفية حماية أنفسهم‬
“Twinkle, twinkle little star,
Look how clean my two hands are,
Soap and water, wash and scrub
Get those germs off rub-a-dub.
Twinkle, twinkle little star,
Look how clean my two hands are!”
At home …
•
•
•
•
‫تنظيف وتطهير اللعب‬
clean and sanitize toys
‫الفراش نظيفة‬
clean bedding
‫لعب لينة نظيفة‬
clean soft toys
clean soft surfaces on ‫األسطح الناعمة النظيفة على األثاث‬
furniture
‫السجاد نظيفة واألرضيات الصلبة‬
‫السطح‬
• clean carpets and hard
surface floors
‫ ومقابض‬،‫ والباب‬،‫الجداول نظيفة‬
• clean tables, door, and
cabinet handles
GLOBAL
HANDWASHING
DAY!
OCT 14
th
15
October
Hadees about washing hands before meals
• This hadith can be found in Sunan Abu
Dawud, under the chapter "Washing
the hands before eating (12)":
• Narrated Salman al-Farsi: I read in the
Torah that the blessing of food consists
in ablution before it. So I mentioned it
to the Prophet ( .)‫ﷺ‬He said: The
blessing of food consists in ablution
before it and ablution after it. Sufyan
disapproved of performing ablution
before taking food.
• When you wash hands before offering salah
• ‫عند غسل اليدين قبل تقديم الصلوات‬
• Then, Why not wash hands before eating Meals?
‫ لماذا ال يغسل يديه قبل األكل وجبات الطعام؟‬،‫ثم‬
Let’s do it!!!