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Copper’s ‘got a handle’ on the Superbugs!
Native Copper Specimen (Cu, 29) - www.en.wikipedia.org Photo: Chris Ralph of Nevada-outback-gems.com “All that glisters is not gold, …” but the pink-blush of copper may well prove to signal a golden triumph over killer superbugs. Copper in our Lives Copper (Cu), 1 Latin: cuprum, the natural chemical element No. 29 of the Periodic Table, as in bronze, predates history and gave its name to the ‘Bronze Age’.2 The mineral was known worldwide to some of the oldest civilizations on record, and its use is at least 10,000 years old. For instance, Sumerian copper artefacts date back to 3000BC and in one Egyptian pyramid a 5000 years old copper plumbing system was found. In the present day location of Michigan and Wisconsin, U.S.A., copper production has been dated back to no less than 6000-3000BC,3 not to mention its use by the ancient Greek and Roman civilizations and the Chinese &c. In Europe, the icebound mummified male (c.3300BC), ‘Öetzi the Iceman’, nick-named Frozen Fritz, was found in 1991 in the Schnalstal glacier in the Ötztal Alps, near Hauslabjoch on the border between Austria and Italy, with a copper-tipped axe.4 Copper has multifarious uses. We may think of copper in everyday terms as money - small loose change coins, or domestically as copper used in pipes for plumbing or copper wires for electrical merchandise. It is also employed in the manufacture of household products such as fittings like door-knobs and finger plates, or may be found in kitchens in cookware equipment and decorative moulds for culinary purposes. The metal also has its place in Art. In sculpture it is used outside in statuary, mainly bronzes, ranging in size from the US Statue of Liberty to a water-spout in back yards and patios, and as a bird-bath or jardinière in private front gardens. It is also found in artistic works indoors, from life-size statues in stately homes and museums to small collectors’ items, such as a dramatic swirly-feminine classic Art Nouveau desk-lamp with coloured glass Tiffany lamp-shade. Copper and its alloys have a huge variety of uses that reflect their versatile physical, mechanical and chemical properties in many areas of our lives. It is found primarily in the bloodstream, as a cofactor in various enzymes, and in copper-based pigments.5 Even though copper is as an essential trace element that all higher plant and animal cells require for healthy growth and function, which must be obtained by animals via their diet, in our modern life-styles it is not most commonly thought of in biological terms. Copper the Ancient & Modern Healer Down the ages, copper has been used in healing, and whatever was missing in scientific validation in the past was not absent from healers’ understanding of its value and therapeutic applications. Copper use for its curative powers goes as far back as the ancient Egyptians, Aztecs, Persians, and the Greeks and Romans. Whether used topically or ingested, many forms of copper and its compounds were found helpful and utilized for medicinal treatments and to maintain hygiene.6 Anciently, copper’s antibacterial and antifungal properties were recognized; its Egyptian medicinal use was recorded in the Smith papyrus, 7 (c.2400BC). They used copper to sterilize water and chest wounds. In the later Egyptian Ebers papyrus (c.1500BC), it mentions the use of copper for headaches, “trembling of the limbs”, burns, and itching.8 The Romans used it variously for diseases. The Aztecs treated sore throats with copper, whilst in Persia and India copper was applied to treat boils, eye infections and venereal ulcers.9 Hippocrates, the ancient Greek ‘Father of Medicine’ also used it to treat leg ulcers. Today, copper is a common constituent in antiseptic and antifungal creams, 9A and of late has also found its way into cosmetic face creams.
Copper (II) sulphate (CuS04) – www.en.wikipedia.org (Suggested and recommended reading: ‘Copper Applications in Health & Environment’ – Copper in My Medicine Chest? by William H. Dresher Ph.D., and A Brief History of The Health Support Uses of Copper, Purest Colloids Inc. http://www.purestcolloids.com/history-copper.htm) Contemporarily, copper sulphate is used to test blood for anaemia10 or as a chemical test for water,11 but perhaps the public are more aware of the use of wearing copper bracelets for arthritis and tenonditis.12 (See Herbsphere: Archived News Articles – ‘Attractive Magnetic Pain Relief’). Effectiveness in such an application to the body’s electro-magnetic fields does not seem so ‘far out’ when one considers that copper is used not only for copper wires to carry electricity, but extensively in products such as electromagnets.13 In the past, Copper’s unique characteristics made it naturally disposed towards the treatment of public health problems and this persists today. As ever, ‘What can heal, can harm’ because, although science has discovered ways to use copper’s antimicrobial properties to contain infections and disease on a large scale, in sufficient amounts copper can be poisonous and even fatal to organisms. The RDA/RDI14 for copper in normal healthy adults is 0.9mg/day.15 Notably, because of its role in facilitating iron uptake, copper deficiency may produce anaemia-type symptoms.16 Copper Fights MRSA Last year it was found that silver pyjamas act contra the superbug MRSA (Methicillin resistant Staphylococcus aureus) and trials for using the material in hospital in other modes, such as for cubicle screens and curtains, are ongoing: (See ‘Herbsphere,’ Archived News Article - ‘MRSA – Silver Pyjamas for Protection?’). Also, in a fairly recent article on Herbsphere, (See ‘Herbsphere’, Archived News Items – ‘Is Your Mobile Phone Bugged?’) it was stated: “… it’s a sobering thought that mobiles harbour more bacteria than a lavatory seat, the sole of a shoe or a door handle.17 The latter is saying something serious, as perhaps the thought has drifted through other minds when reminded to ‘wash our hands’ after using any public convenience – who disinfects the door handles?” – It is a question to which copper and/or its alloys may now have an answer. It has long been known that copper may be employed to plate metals, as a fungicide or herbicide. However, what is exciting the press and media right now is copper’s potential to help eradicate the superbug MRSA. Scientists, administration and hospital staff are well aware that 80% of MRSA transmission comes from contact with surfaces such as door-handles, bathroom taps, toilet flush handles and grab rails. By now a great many of us know that at least 5,000 Britons are likely to die annually from MRSA infection, but more riveting is the fact that 300,00018 patients every year pick up an infection in UK hospitals. This fact alone makes the current 18-month trail taking place at Birmingham’s Selly Oak Hospital, where stainless steel metal fittings such as door-handles and taps commonly used in health centres will be replaced with copper fittings in an effort to reduce the presence of MRSA. Selly Oak has been chosen for the official ‘Copper Clinical Trial’ because it is a specialist trauma centre with an advanced microbiology centre.19 It is also where wounded soldiers with complex injuries come for treatment from the Iraq war-zone.19A It is a ‘landmark’ experiment.19B If the trial proves successful, it is likely that hospitals across Europe will switch to excellent curative copper. In order to test the theory, one general medical ward will have the copper installations put in place in preparation for the trial whilst a similar ward will retain its traditional fittings. It is reported that even pens used by staff will be copper alloy.20 Lead researcher, Professor Bill Kevil, director of environmental healthcare at Southampton University, is well aware that the Egyptians were using copper thousands of years ago to treat infections. He has described copper’s modus operandi to kill off germs as having a property which suffocates them: “The metal reacts with the bacteria and inhibits their respiration, which in effect stops them breathing.” and also destroys their DNA.21 A tiny piece of copper one centimetre square can kill 10 million MRSA bacteria in 90 minutes and probably deal with the lower concentrations of germs on hospital fittings in 30 minutes.21A This copper work is not brand-new ‘news’. In fact, the University of Southampton team, led by Dr Jonathan Noyce and colleagues, first presented their findings on copper and its effects on MRSA at a meeting of the American Society for Microbiology in New Orleans in 2004.21B It is to be hoped therefore that nothing will obstruct or delay future practical appliance and promulgation of this researched work. The team indicated in 2004 that the switch to copper surfaces, being expensive to put into practice, might best address critical care areas where patients are at greatest risk if they become infected.21C However, if copper or copper alloy, (copper alone may not stand up to the necessary expected wear and tear), is indeed an answer to the eradication or containment of MRSA, then it is also to be hoped that relevant hospital surfaces will be changed throughout; plus any planned new medical facilities will have copper surfaces incorporated into their design before they come off the drawing-board. The omens look good, it is already proven since 1994 that the use of copper tubing and piping may help to limit the colonization of water systems by Legionella pneumophila which causes Legionnaires’ disease.22 Copper has also seen off the dreaded E. coli, 23 which is able to survive in a range of environments, under various conditions, including the risk from contaminated surfaces, especially due to the low infectious dose required. In 2005, UK researcher found that E. coli can survive for over 28 days at both refrigeration and room temperatures on stainless steel! By contrast, copper’s strong antibacterial properties demonstrated that (no bacteria could be recovered after 90 minutes exposure at 20oC, increasing to 270 minutes at 4oC) – [but] “its poor corrosion resistance and durability make it unsuitable for use as a surface material.”24 However, it was stated that: “other copper-containing alloys, such as copper nickels and copper silvers, have improved durability and anticorrosion properties and greatly reduce bacterial survival times at these two temperatures (after 120 minutes at 20oC, and 360 minutes at 4oC, no E. coli could be detected on a copper nickel with a 73% copper content.)25 The researchers concluded that use of a surface material with antibacterial properties could aid in preventing cross-contamination events in food processing and domestic environments, if standard hygiene measures fail.26 Last year, further investigations by part of the same team of UK researchers into use of copper cast alloys to control E. coli cross-contamination during food processing found that their results clearly demonstrated the antimicrobial properties of cast copper alloys with potential to aid in food safety.27 Another bacterium, Listeria monocytogenes is an important re-emerging pathogen, commonly found in the environment, and from which a variety of serious and nasty illnesses can proceed, 28 with outbreaks associated with the contamination of food produce, often linked to cross-contamination from surfaces or equipment to prepared foodstuffs. The use of copperized surfaces and alloys in utensils, especially in venues such as hospitals, could assist to reduce such cross-contamination and outbreaks of sickness and worse. Listeriosis has been associated with such foods as raw milk, pasteurized fluid milk, cheeses, ice cream, raw vegetables, fermented raw-meat sausages, raw and cooked poultry, raw meats (of all types) and raw and smoked fish. Its ability to grow at temperatures as low as 0oC permits multiplication in refrigerated foods.29 In a study September 2006, some members of the same UK team tested a number of copper-base metal alloys to assess the survival times of L. monctytogenes on different materials, in comparison with stainless steel.30 Whereas viable cells could be detected on stainless steel after 24-hour incubation at room temperature, on copper, brass, aluminium bronze and silicon bronze, no viable bacteria could be detected after 60 minutes incubation.31 No cells could be detected from copper nickel and copper nickel zinc alloys after 90 minutes incubation.32 Again the results suggested that careful choice of surface material could reduce the risk of cross-contamination in industrial, commercial and domestic environments.33 Copper would seem to be clocking up an encouraging success rate against various pathogens. We already know silver is antimicrobial and has barrier effects against MRSA in wound care34 and that historically copper has also been used for this function. Although it is speculative to suggest that copper-silver will produce a highly effective alloy against MRSA, it will be interesting to see what evolves and develops from this current scientific investigation into copper. So far, last summer, some of the UK, Southampton University team carried out a study to evaluate the effectiveness of copper and brass to reduce the viability of three MRSA strains (MRSA, and EpidemicMRSA -1 and -16) in contrast to stainless steel.35 They found at 4oC, complete kill was achieved on copper for all three strains within 6 hours! The researchers consequently concluded that the contemporary application of stainless steel in hospital environments for work surfaces and door furniture is not to be recommended.36 Additionally, the Southampton team’s latest investigations in January this year show that after 24 hours on stainless steel, 500,000 ‘Influenza A’ virus particles were still infectious, but on copper after 6 hours only 500 particles were active.37 This is also an important finding, as every year influenzas are a cause of death to vulnerable sections of the community such as the very young, those weak from illness, and the elderly. These are all good results, but the crux of what can turn the tide on the superbugs is still rigorous hygiene. COMMENT: Hygiene, hygiene, and hygiene, against the superbugs should be the ‘mantra’ of all who are concerned with hospitals, inside and out, resident, working or visiting. Recently, on discussing the subject of superbugs and hygiene with a Chinese dentist domiciled and practising in the UK, it was made clear that the SARs (Severe Acute Respiratory Syndrome) 38 epidemic was not brought under control by any magic formula, but by exacting and rigorous professional and public hygiene. Modernity did play its part in securing control to contain the disease by use of the mass media and the use of modern equipment e.g. thermal screening for fever to facilitate rapid disease detection prior to the old-fashioned isolation and quarantine of contacts, and travel restrictions - the latter helping to restrict imported cases into other countries to contain and prevent any further transmission of the disease. Case detection was further improved by the opening of hundreds of fever clinics and e.g. constant TV broadcasts to the public to check for fever several times a day. The public also wore face-masks in public places to help restrict the spread of the disease by sneezing or coughing and were told what to do. No such media campaign exists at this time in the UK that could help healthcare professionals and heighten public awareness and understanding regarding superbugs and the application of good ‘old fashioned’ hygiene to eradicate, contain or control them. It is also necessary to assist and instruct members of the public broadly and widely on ‘what to do’ when visiting patients in any hospital, clinic or location where there is superbug activity or outbreak and/or to avoid that situation happening. It is good to learn that the current trial on copper surfaces at Birmingham’s Selly Oak Hospital also includes staff using copper alloy pens, but this is a specific testing of one ward. To ‘up the anti’ of the everyday problem of hygiene in hospitals might require some SARS-type old-fashioned methods with modern materials to attain more rigorous and successful hygiene. For example, inter-ward use of lifts means ‘not touching’ the lift-buttons with fingers (having been cleaned with a sanitized wipe?), or it requires constant bactericidal ‘re-wiping’, but to use the copper pen to press the lift-buttons. A bactericidal surface still needs to be cleaned and the more it is handled, like a door-knob, the more it is bacteria-loaded; again in clinical locations readily available bactericidal wipes could be used to clean any surface after touching it. If an infectious disease such as SARS can be contained at least for now with stringent methods of hygiene, then it is explicit that contagious superbugs could similarly be controlled if not entirely overcome. For the public ‘to get a handle’ on hygiene is largely relevant to the bacterium Clostridium difficile (C. difficile), 39 which is now fast gaining ground - or graves! For the Southampton researchers hope copper will kill more than MRSA, as increasingly problematic C. difficile has made some showing of being killed in preliminary tests.40 Scientists are also hoping copper has potential as a possible defence against bird flu.41 C. difficile caused more than 44,000 infections in the UK in 2004, mostly among the elderly.42 What is particularly disturbing about dealing with C. difficile, and exercises the minds of researchers, is its ability to chop and change its genetic structure very easily, maximising its ability to neutralize attack by antibiotics.43 It causes a range of diseases from antibiotic-associated diarrhoea to a life-threatening colon disease called pseudomembranous colitis.43A In 2006, a large Wellcome Sanger Institute team and associates at Cambridge, determined/unravelled the complete genome sequence of C. difficile 630, a virulent multi-drug resistant strain, and observed the changes which allow it to interact with and thrive in the human gut.44 Furthermore, C. difficile thrives in the absence of oxygen and can ‘hibernate’ in adverse conditions by forming ‘spores’.45 It is thought these spores are responsible for most human infections and, because they are highly resistant to most disinfection methods, they are extremely difficult to eradicate and they spread easily. Perhaps it would be more cost effective and life-saving if, instead of shed-loads of Government money presently being spent on TV advertising to stop the public smoking cigarettes when legal bans are already in place, the tele-viewing public were given more information about and instruction on how to deal with private and public hygiene. Not everything is about money, it is also about will, political and personal. People are attempting to take care of their health, partly through fear of developing and dying from cancers. How many deaths from superbugs it will take before the powers that be and the public take hygiene seriously enough and to its ‘nth degree to avoid such unnecessary deaths remains to be seen. The writing is on the wall! References: 0. Quote: “All that glisters is not gold, …” from William Shakespeare’s play The Merchant of Venice (II, vii), though more often misquoted as “All that glitters is not gold,” is a saying which means that simply because something may appear priceless, pleasing or pretty, it's no sign that without a doubt it will be worth having once its true nature has been discovered. In other words don't rely on the superficial. The expression has been said to be around in various forms dating back to at least the 12th –century (French theologian Alain de Lille wrote: “Do not hold everything gold that shines like gold”. . .) Some experts think it was Aesop and his fables written c.600BCE probably inspired this idea with his two moral takes, The Hen and the Golden Eggs and The Miser. http://www.answers.com/topic/all-that-glitters-is-not-gold-1 Aesop: known only for the genre of fables ascribed to him, was by tradition a slave who was a contemporary of Croesus and Peisistratus I the mix-sixth century BC in ancient Greece. According to tradition he was at one point freed from slavery and eventually died at the hands of the Delphians, but nothing is known about Aesop from credible records. In fact, the obscurity shrouding his life has led some scholars to doubt his existence altogether, notably because there is no fixed body of his work. http://en.wikipedia.org/wiki/Aesop 1. Copper: is a ductile malleable reddish-brown corrosion-resistant diamagnetic element in the periodic table that has the symbol Cu (Latin: cuprum) and atomic number 29. It occurs in various minerals but is the only metal that occurs abundantly in large masses. It is a metal with excellent electrical conductivity, and finds extensive use as an electrical conductor, thermal conductor, as a building material, and as a component of various alloys. - http://en.wikipedia.org/wiki/Periodic_table 2. Bronze Age: In Great Britain, the Bronze Age is considered to have been the period from c.2100-700BC. 3. The Old Copper Complex of the Western Great Lakes by Thomas C Pleger, Ph.D., UW-Fox Valley Anthropology. http://www.uwfox.uwc.edu/academics/depts/tpleger/oldcopper.html 4. Öetzi the Iceman - http://en.wikipedia.org/wiki/Oetzti_the_Iceman 5. Copper - http://en.wikipedia.org/wiki/Periodic_table 6. ‘Copper Applications in Health & Environment’ – Copper in My Medicine Chest? By William H. Dresher, Ph.D. A Brief History of The Health Support Uses of Copper’ June 2000 - http://www.coopper.org/innovatioins/2000/06/medicine-chest.html “Historic uses of copper compounds in medicine”. Dollwet, HHA & JRJ Sorenson. Trace Elements in Medicine 2, No. 2, (1985). 7. The Edwin Smith Papyrus: is the world’s earliest known medical document, written around the 17th century BCE, but thought to be based on material from as early as 3000BC. 8. ‘Copper Healing’ – http://en.wikipedia.org/wiki/Copper_healing 9. ‘A Brief History of The Health Support Uses of Copper’ - http://www.purestcolloids.com/history-copper.htm “Historic uses of copper compounds in medicine”. Dollwet, HHA & JRJ Sorenson. Trace Elements in Medicine 2, No. 2, (1985) pp. 80-87. 9A. ‘Could a copper door handle help to heat MRSA? By Fiona MacRae Daily Mail, 14th March, 2007. 10. Copper Applications in Health & Environment’ – Copper in My Medicine Chest? By William H. Dresher, Ph.D. A Brief History of The Health Support Uses of Copper’ June 2000 - http://www.coopper.org/innovatioins/2000/06/medicine-chest.html 11. Copper II Sulphate - http://en.wikipedia.org/wiki/Copper_sulphate#Uses 12. Tendonitis: Tendons connect muscles to bones, and tendonitis is the result of the inflammation of tendons or the tendon covering at a body part. The inflammation is a healing response to injury, and is usually accompanied by swelling, heat, redness and pain. What usually causes tendonitis is not a single injury but a series of small stresses that repeatedly aggravate the tendon; e.g. professional tennis players &c. are susceptible to tendonitis in their shoulders and arms. 13. Electromagnet: An electromagnet is a type of magnet in which the magnetic field is produced by a flow of electric current. The magnetic field disappears when the current ceases. 14. RDA/RDI: RDI was formerly called Recommended Dietary Allowance (RDA) - RDI is based on the Dietary Reference Intake. The Reference Daily Intake (RDI) is the daily dietary intake level of a nutrient considered sufficient to meet the requirements of nearly all (97%-98%) healthy individuals in each life-stage and gender group. The RDI is used to determine the Recommended Daily Value (RDV) which is printed on food labels in the US and Canada, which are intended to serve as nutrition guidance to the general public and health professionals. http://en.wikipedia.org/wiki/Recommended_Dietary_Allowance 15. Copper - http://en.wikipedia.org/wiki/Copper#Biological_role 16. ibid. 17. “Wash your hands, caller: Your mobile’s dirtier than you think” by Fiona MacRae, Science Reporter, Daily Mail 2nd August 2006. 18. ‘Copper tested in MRSA fightback’ – BBC News Online, 13th March 2007. (300,000 statistic acc. to the National Audit Office UK.) ‘Could a copper door handle help to heat MRSA? By Fiona MacRae Daily Mail, 14th March, 2007. 19. ‘Hospital in soldiers' furore uses copper to beat MRSA bug.’ Daily Mail, 13th March, 2007 19A. Ibid. 19B. ‘Copper tested in MRSA fightback’ – BBC News Online, 13th March 2007. ‘Could a copper door handle help to heat MRSA? By Fiona MacRae, Daily Mail, 14th March, 2007. 20. Ibid. 21. Ibid. 21A. ‘Could a copper door handle help to heat MRSA? By Fiona MacRae, Daily Mail, 14th March, 2007. 21B. ‘Copper surfaces can kill off MRSA’, BBC News Online – 5th July, 2004. ‘Fresh handle on superbug’ BBC News Online – 15th July, 2004. 21C. Ibid. 22. ‘Influence of Temperature and plumbing material selection on biofilm formation and growth of Legioinella pneumophila in a model potable water system containing complex microbial flora.’ Rogers J, Dowsett AB, Dennis PJ, Lee JV, Keevil CW. Pathology Division, PHLS CAMR, Porton Down, Salisbury, Wiltshire, UK. Appl Environ Microbiol. 1994 May; 60(5):1585-92. 23. Escherichia coli: is one of the main species of a bacterium normally present in the intestinal tract of mammals, humans and other animals, known as gut flora. A human may excrete in one day averages of between 100 billion and 10 trillion. However, the bacteria are not confined to this environment, and specimens have also been located, e.g. on the edge of hot springs. Sometimes pathogenic; can be a treat to food safety, E. coli (0157:H7) is one of hundreds of strains of the bacterium that causes human illness. 24. ‘The survival of Escherichia coli 0157 on a range of metal surfaces.’ Wilks SA, Michels H, Keevil CW. Environmental Healthcare Unit, School of Biological Sciences, Uv. of Southampton, Bassett Crescent Eat, Southampton, UK Int J Food Mircrobiol. 2005 Dec 15; 105(3):445-54. Epub 2005 Oct 25. 25. Ibid. 26. Ibid. 27. ‘Use of copper cast alloys to control Escherichia coli 0157 cross-contamination during food processing.’ Noyce JO, Michels H, Keevil CW. Environmental Healthcare Unit, School of Biological Sciences, Uv. of Southampton, Bassett Crescent Eat, Southampton, UK. Appl Environ Microbiol. 2006 Jun: 72(6):4239-44. 28. Listeria monocytogenes (Listeria): The type of species of the genus Listeria can cause Listeriosis, which manifestations include, meningitis, encephalitis, corneal ulcer, pneumonia , septicaemia, cervical infections in pregnant women that may result in spontaneous abortion, endocarditis, and abscesses etc. Studies suggest that up to 10% of human gastrointestinal tracts may be colonized by L. monocytogenes. http://www.wordwebonline.com/search.pl?w=Listeria+monocytogenes+ 29. Ibid. 30. ‘Survival of Listeria monocytogenes Scott A on metal surfaces: implications for cross-contamination.’ Wilks SA, Michels HT, Keevil CW. Environmental Healthcare Unit, School of Biological Sciences, Uv. of Southampton, Southampton, UK. Int J Food Mircrobiol. 2006 Sep 1: 111(2):93-8. Epub 2006 Jul 28. 31. Ibid. 32. Ibid. 33. Ibid. 34. ‘Antimicrobial and barrier effects of silver against methicillin-resistant Staphylococcus aureus.’ Edwards-Jones V. Research Development Unit, St. Augustine’s, Manchester Metropolitan Uv., Manchester, UK. J wound Care. 2006 Jul; 15(7):285-90. Comment in: J wound Care 2006 Oct; 15(9):417-8; author reply 418. . J wound Care. 2006 Oct; 15(9):419-20; author reply 420. 35. ‘Potential use of copper surfaces to reduce survival of epidemic methicillin-resistant Staphylococcus aureus in the healthcare environment.’ Noyce JO, Michels H, Keevil CW. Environmental Healthcare Unit, Uv. of Southampton, Southampton, UK J Hosp Infect. 2006 Jul; 63(3):289-97. Epub 2006 May 2. 36. Ibid. 37. ‘Inactivation of Influenza A Virus on Copper versus Stainless Steel Surfaces.’ Noyce JO, Michels H, Keevil CW. Environmental Healthcare Unit, Uv. of Southampton, Biomedical Sciences Building, Southampton, UK; Copper Development Association Inc., New York, NY, USA. Appl Environ Microbiol. 2007 Jan 26; [Epub ahead of print] 38. SARS (Severe Acute Respiratory Syndrome): is an atypical form of pneumonia, a respiratory disease that first appeared in November 2002 in Guandong Province, China. It is a clinical syndrome characterized by fever, lower respiratory symptoms, coughing or difficulty in breathing or hypoxia (a shortage of oxygen in the body), and radiographic evidence of pneumonia. SARS is now known to be caused by the SARS coronavirus (SARS-CoV), a novel coronavirus. It can be fatal and has a mortality rate of around 10%. 39. ‘Copper tested in MRSA fightback’ – BBC News Online, 13th March 2007. ‘Could a copper door handle help to heat MRSA? By Fiona MacRae Daily Mail 14th March, 2007. 40. Clostridium difficile: A bacterium that is one of the most common causes of infection of the large bowel (colon). In technical terms, C. difficile is an obligate anaerobic or microaerophilic, gram-positive, spore-forming, rod-shaped bacillus. 41. ‘Copper tested in MRSA fightback’ – BBC News Online, 13th March 2007. ‘Could a copper door handle help to heat MRSA? By Fiona MacRae Daily Mail 14th March, 2007. 42. Ibid. 43. ‘How hospital bug can evade attack’ BBC News Online, 25th June 2006. ‘The multidrug-resistant human pathogen Clostridium difficile has a highly mobile, mosaic Genome.’ Sebaihia M, Wren BW, et al. Welcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK. Nat Genet. 2006 Jul; 38(7):779-86. Epub 2006 Jun 25. 43A. ‘How hospital bug can evade attack’ BBC News Online, 25th June 2006. 44. ‘How hospital bug can evade attack’ BBC News Online, 25th June 2006. ‘The multidrug-resistant human pathogen Clostridium difficile has a highly mobile, mosaic Genome.’ Sebaihia M, Wren BW, et al. Welcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK. Nat Genet. 2006 Jul; 38(7):779-86. Epub 2006 Jun 25. 45. Ibid. |
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