Division of Developmental Disabilities Ser vices 
C. diff. is a spore-forming bacteria that can be found in soil, air, human and animal 
feces, and on most surfaces. It does not create infection until it grows in large numbers in the 
intestinal tract; usually of people taking antibiotics. It is not confined to health care facilities. It is 
also a growing problem among otherwise healthy people. Although the infection can usually be 
controlled with treatment, virulent strains are now appearing that resist traditional treatment. The 
use of antibiotic therapy, proton pump inhibitors, GI surgery and or manipulation, advanced age, 
immuno-compromising illness, and long hospital stays have been identified as risk factors for de-
veloping C. diff.-associated disease (CDAD). Some people who are infected with C. diff. never be-
come sick, though they can still spread the infection. Others may experience watery diarrhea, 
blood or pus in their stools, fever, loss of appetite, nausea, and abdominal pain or tenderness. 
C. diff., at times, can be a life-threatening infection; so vigilance is important. 
C. diff is spread through the fecal-oral route; which means from poor toileting hygiene. It 
can live on environmental surfaces for months. Any surface, device, or material that becomes con-
taminated with feces may serve as a reservoir for the C. diff. spores. The spores are usually trans-
ferred via dirty hands that have touched a contaminated surface. In approximately 23% of people, 
CDAD will resolve within 3 days after discontinuing the antibiotic medication that they are receiv-
ing. If that is not successful, a 10 day course of another type of antibiotic may be ordered by the 
healthcare professional. Sometimes, an additional course of medication is needed if the symp-
toms do not disappear with the first course. One of the most important steps in stopping C. diff. 
infections is to use antibiotics judiciously. Every year in the US, antibiotics are prescribed for viral 
infections that are not helped by these medications. Taking a wait and see attitude with simple 
ailments may often be the best course. 
Other important infection prevention and control measures are to use soap and water for 
hand washing. Hands should be washed for at least 15 seconds. While alcohol-based hand rub 
cleansers are effective in killing most bacteria, they are NOT effective in killing C. diff. spores and 
therefore should not be used when coming in contact with people who have or are suspected of 
having CDAD. Wear gloves if working with someone diagnosed with C. diff. and wear a gown to 
protect clothing if soiling is likely. Adequate cleaning and disinfecting of the environment daily with 
a chlorine based product is crucial in stopping the spread of C. diff. An EPA registered hypochlo-
rite-based disinfectant can be used or household chlorine bleach at a 1:10 dilution rate may also 
be used. Remember, C. diff. is a preventable disease but it takes everyone practicing good infec-
tion prevention and control measures to stop its spread. Lisa Graves, R.N. 
Vol. 1, No. 1 
Sept. 2008 
W HAT IS C LOST RIDIUM D IFFICL E (C .D IF F )? 
Vaccine 
Recommendations 
1. Seasonal Influenza 
• Children aged 6 months up to their 
19th birthday 
• Health care workers 
• Pregnant women or those who might 
get pregnant 
• People 50 years of age and older 
• People living in nursing homes and 
long-term care facilities 
• People with chronic health care 
conditions 
• Household contacts & out-of- home 
caregivers for persons at risk for 
influenza complications 
2. Zoster (‘Shingles’) 
Shingles vaccine was recently recommended 
by the Advisory Committee on 
Immunization Practices to reduce the risk 
of shingles and its associated pain in 
people 60 years old or older. 
3. Pneumococcal 
The pneumococcal conjugate vaccine, 
PCV7, licensed in 2000, is the first 
pneumococcal vaccine that can be used in 
children under the age of 2 years. 
Pneumovax® and Pnu-Immune® are 
polysaccharide vaccines (PPV23) that are 
currently recommended for use in all 
adults who are older than 65 years of age 
and for persons who are 2 years and older 
and at high risk for disease (e.g., sickle 
cell disease, HIV infection, or other 
immunocompromising condition.) 
4. Pertussis 
Whooping cough — known medically as 
pertussis — is a highly contagious respiratory 
tract infection. Although it initially 
resembles an ordinary cold, whooping 
cough may eventually turn more serious, 
particularly in infants. Whooping cough is 
most contagious before the coughing 
starts. The best way to prevent it is 
through vaccinations. The childhood 
vaccine is called DTaP. The whooping 
cough booster vaccine for adolescents and 
adults is called Tdap. Both protect against 
whooping cough, tetanus, and diphtheria. 
-From the CDC Webpage 
HEALTH AWARENESS 
A RE YO U P RO M O T I N G Y OUR O RAL H EAL T H ? 
Healthy teeth promote healthy bodies. It's all 
connected. Oral health goes beyond having white 
teeth and no cavities. According to the U.S. Sur-
geon General’s Report on Oral Health, published 
in 2000, “the mouth (including the gums, teeth 
and jawbone) is a mirror for general well-being”. 
A growing body of research now links gum dis-
ease to heart disease as well as stroke, diabetes, 
respiratory problems and low-birth weight babies. 
When your mouth and teeth are disease-free, 
your risks of developing other diseases through-
out your life may be reduced. Because gum dis-
ease is usually painless, many people may not 
even realize they have it until it reaches an ad-
vanced stage. Some of the warning signs are 
persistent bad breath, a bad taste in the mouth 
or gums that bleed. At that time, teeth may be-
come loose and need to be extracted. The main 
cause of gum disease is bacteria, which is found 
in plaque. Plaque is a sticky colorless film that 
constantly forms on your teeth and tongue. 
The basic principles of good oral heath are 
simple and take just a few minutes each day. 
Brush your teeth with a tooth paste containing 
fluoride at least twice a day. Once a day, use 
floss or an inter-dental cleaner to clean between 
teeth to remove food that your toothbrush 
missed. Change your toothbrush at least every 
three months or earlier if the toothbrush looks 
worn. A new toothbrush can remove more 
plaque than one that is old. Eat healthy meals. 
Cut down on tooth decay by brushing after meals 
and not snacking on sugary or starchy foods be-
tween meals. Your dentist may suggest that you 
do different things or prescribe special treat-
ments to keep your mouth healthy. Remember, 
it’s all connected. Make caring for your teeth and 
gums the first thing on your list! Susan Poore, RN