19: Contagious Conversations: The Bold New Series Tackling the Toughest Topics in Infection Prevention

23: Hantavirus: A Podcast with Matthew Pullen, MD, an Infectious Disease Doctor

A rare hantavirus outbreak linked to an expedition cruise ship near South America has drawn international attention and renewed concerns about emerging infectious diseases. While experts emphasize that the risk of a widespread outbreak remains extremely low, the appearance of Andes virus-associated hantavirus pulmonary syndrome on a cruise ship has raised questions about global preparedness, travel-related transmission, and public understanding of infectious disease threats. A rare hantavirus outbreak linked to an expedition cruise ship near South America has drawn international attention and renewed concerns about emerging infectious diseases. While experts emphasize that the risk of a widespread outbreak remains extremely low, the appearance of Andes virus-associated hantavirus pulmonary syndrome on a cruise ship has raised questions about global preparedness, travel-related transmission, and public understanding of infectious disease threats. Matthew Pullen, MD, an infectious disease physician and member of the Infection Control Today® Editorial Advisory Board, said much of the concern stems from confusion about the virus itself. “Hantavirus is actually a very large family of viruses,” Pullen explained. “The ones we’re hearing about most right now are the Sin Nombre virus and Andes virus.” According to Pullen, Sin Nombre virus is the hantavirus most commonly found in the United States and is transmitted through infected deer mice. Andes virus, first identified in Argentina and Chile, has generated greater concern because of limited evidence suggesting possible human-to-human transmission. “There are a few cases where they’re pretty confident there was human-to-human transmission,” Pullen said. “But there’s still academic debate about whether some of those outbreaks represented true transmission or simply shared exposure.” Both viruses can cause hantavirus pulmonary syndrome, a severe disease with a case fatality rate approaching 40%. “It starts like a flu-like illness,” Pullen said. “Body aches, headaches, fever, nausea, vomiting. Then the severe cardiopulmonary phase develops, and that’s what kills people.” Despite the seriousness of the illness, Pullen stressed that fears of a COVID-19-like pandemic are unsupported by current evidence. “I would say the likelihood is very, very, very low,” he said. One reason is the virus's limited transmissibility. “It doesn’t spread like COVID[-19] does. It doesn’t spread like the flu does,” Pullen said. “The last estimate I saw had an R-naught of about 1.2, meaning not every case even propagates to another case.” Pullen also questioned whether current monitoring measures surrounding the cruise ship outbreak are sufficient. “While balancing public health with patient autonomy is important, there are still seemingly unanswered questions about the transmission and exposure events in this outbreak,” Pullen told Infection Control Today®. “This raises concerns about the current monitoring strategy, especially as compared to other nations that have repatriated citizens from the ship and are following tighter monitoring plans.” More than the virus itself, however, Pullen worries about the social environment surrounding emerging disease events. “What worries me most actually isn’t the virus itself,” Pullen said. “It’s the social conditions around the virus.” He pointed to rapidly changing narratives on social media. “One morning, people on social media were saying this was going to be the next pandemic that would kill us all,” he said. “By that afternoon, those same people were posting that hantavirus was nothing to worry about and that the government was lying.” Pullen also warned about individuals attempting to profit from public fear. “There was even a physician online promoting ivermectin as a cure for hantavirus,” Pullen said. “Then conveniently mentioning they also sell ivermectin.” For clinicians, awareness remains important despite the rarity of the disease. “If someone comes in with severe pulmonary syndrome after traveling through Argentina or Chile, that should absolutely bubble up in your mind,” he said. Pullen believes most US hospitals already have the infection prevention infrastructure necessary to manage suspected cases. “Every hospital should be equipped to do respiratory isolation and airborne precautions,” he said. “The key is recognizing the syndrome early and escalating appropriately.” Still, he expressed concern about broader public health capacity. “The people working at CDC are phenomenal,” he said. “But they’re being hamstrung by funding limitations and policy decisions.” Ultimately, Pullen said the outbreak serves as another reminder that emerging zoonotic diseases will remain a global challenge. “Viruses don’t respect borders,” he said. “And the more interconnected the world becomes, the more important preparedness, communication, and public trust become.”

22: Contagious Conversations: How SPD Voices Are Shaping Patient Safety

At the SoCal Sterile Processing Association (SPA) Chapter meeting [https://www.socalspd.com/] on March 21, 2026, in Newport Beach, California, one message came through clearly: Leadership in sterile processing does not begin with a title. It begins with a voice. In this special edition of Contagious Conversations, hosts Jill Holdsworth, MS, CIC, FAPIC, NREMT, CRCST, CHL, AL-CIP; and Brenna Doran, PhD, MA, ACC, CIC, AL-CIP, turned the microphone toward Tori Whitacre Martonicz, MA, lead editor of Infection Control Today®, following her presentation, “Leadership Beyond the Sterile Processing Department: Expanding Professional Influence and Patient Safety Impact.” The conversation reflected broader themes echoed throughout the event, where leaders across sterile processing, infection prevention, and industry highlighted mentorship, communication, and systems thinking as essential to advancing patient safety. The event featured a diverse lineup of speakers, including Shahbaz Salehi, MD, MPH, MSHIA; Randalyn Harreld, CRCST, CIS, CER, CHL, CSPDT, CASSPT, CLS, AAS, FHSPA; Sharon Lashley, MS, MBA; Brian North; and Sarah B. Cruz, AS, CSPDT, CRCST, CHL, CIS, each addressing critical gaps in education, workflow, and system integration across sterile processing. “The March conference was highly successful, with over 100 attendees from Greater Los Angeles to San Diego coming together for a full day of impactful learning, collaboration, and advancement of the sterile processing profession,” said Jaime Amaya, CRCST, president of the SoCal SPA Chapter, and the sterile processing manager, Hoag Memorial Hospital Presbyterian, Newport Beach & Irvine. To highlight their excellence, the chapter also recently won the Healthcare Sterile Processing Association (HSPA) Large Chapter of the Year award for 2026.   Leadership Starts Before the Title For Whitacre Martonicz, the foundation of her presentation came from personal experience and observation. “Leadership is not a title,” she said. “It is a choice about whether you'll use your voice to make a difference.”  She described how her understanding of infection prevention and sterile processing did not come from job titles or hierarchy, but from individuals willing to share their knowledge publicly. “The people that I was learning from were not necessarily the people with all the titles,” she explained. “It was always the person who had gone out beyond their comfort zone and given that information out.”  That insight shaped the core message of her talk: that writing, speaking, and sharing experiences are powerful tools for influence across health care systems. Why Speaking Up Matters in SPD Throughout the discussion, both hosts reinforced the need for leadership development within sterile processing. Holdsworth emphasized the growing demand for these skills within the field. “They are probably one of the professions most hungry for leadership knowledge, and leadership training, and leadership discussions,” she said.  Whitacre Martonicz agreed, noting that many professionals hesitate not because they lack expertise, but because they lack confidence. “I've gotten messages… ‘I'd love to write an article… but I don't know how,’ or ‘I'd love to give a speech… but I don't know how to speak,’” she said. “All you have to do is try.”  Her advice was practical and accessible. Start small, build confidence locally, and expand outward. “Start in your own facility,” she said. “Even if it's just standing in front of your colleagues… or write a post… anything to get that conversation started.”  The Power of Everyday Expertise A recurring theme throughout the panel was the value of everyday problem-solving in sterile processing. Whitacre Martonicz highlighted how even simple observations can lead to broader improvements. “If you have that problem, I guarantee you that there's somebody else… [who's] having the same problem,” she said.  This perspective aligns closely with broader discussions at the event. Harreld’s session on fatigue and interruptions, Lashley’s focus on navigating IFUs, and North’s emphasis on technology and audits all reinforced the idea that small, consistent improvements drive system-level change. Cruz, the president-elect of the national HSPA, echoed similar principles in her focus on quality systems, while Salehi’s presentation on mentorship underscored the importance of guidance and professional growth across career stages. Overcoming Fear and Finding Your Voice One of the most candid moments in the discussion centered on fear, particularly around writing and public speaking. “I was surprised how many people were so terrified of writing,” Whitacre Martonicz said.  She encouraged attendees to reframe the process and lower the barrier to entry. “If you can't think of what to write… write that,” she said. “‘I don't know what to write, but I still have to write, so I will just write that I can’t think of what to write’ and so on… and then suddenly it's coming. It's kind of like the cork out of a bottle.”  Doran added another perspective on building confidence through intentional reflection. “What do I want them to walk away with? If I know the ending… I can back design it,” she said.  Together, these insights offered a practical roadmap for professionals looking to move from silent expertise to active leadership. Writing as a Patient Safety Tool Beyond professional development, Whitacre Martonicz framed communication as a direct pathway to improving patient outcomes. “If you don't have any words down… then I can't help you… and therefore [it cannot be] read by other people… and you saved the life of someone you never met,” she said.  That statement resonated as one of the most powerful takeaways of her session. Writing, presenting, and sharing knowledge are not just career-building activities. They are mechanisms for spreading best practices across facilities and improving care at scale. Building a Culture of Contribution The discussion closed with a call to action for sterile processing professionals to engage more actively in the broader infection prevention community. “I want to know what's going on in your facility,” Whitacre Martonicz said. “What works? What doesn't work?”  She encouraged submissions across a wide range of topics, emphasizing that every question, observation, or improvement has value. “Send it in… we'll get that information,” she added.  Looking Ahead The SoCal SPA will continue this momentum with two additional events in 2026: the Summer Symposium and Vendor Show on August 15 at Long Beach Memorial Medical Center, and the Late Summer Seminar and Vendor Show on September 26 in Riverside, California. If the March conference is any indication, those events will continue to elevate the voices of sterile processing professionals who are ready to lead, not by title, but by action. These are the speakers and topics for this conference: Shahbaz Salehi, MD, MPH, MSHIA, the director of infection prevention and control at Foothill Regional Medical Center, Instructor at UCLA Extension. Topic: “The Power of a Mentor: My Journey From SPD to Medicine.” Tori Whitacre Martonicz, MA, lead editor of Infection Control Today®. Topic: “Leadership beyond the Sterile Processing Department: Expanding Professional Influence and Patient Safety Impact.” Randalyn Harreld: Clinical Education Manager (US), SteelcoBelmed. Topic: “Common Breakdowns caused by Fatigue, Interruptions, and Assumptions” Sharon Lashley, Clinical Education for STERIS. Topic: “Lost in the IFU wilderness? Find your way today!” Brian North, platform specialist—Ascendco Health. Topic: “Modernizing SPD: How Technology, Staffing, and Audits Must Evolve Together” Sarah B. Cruz, Sterile Processing Program Instructor. Topic: “Clean, Sterile, and Streamlined: Quality Systems for Sterile Processing.”

21: What Is Surgical Smoke, and Why Is it So Dangerous? An Expert Explains

Surgical smoke has been part of operating room culture for decades, generated routinely by lasers, electrosurgical devices, and ultrasonic tools. Yet despite its constant presence, it remains one of the least understood and least consistently addressed risks in perioperative care. In a recent interview with Infection Control Today® (ICT®), Vangie Dennis, MSN, RN, CNOR, CMLSO, FAORN, FAAN, a former president of AORN and current member of the ICT’s Editorial Advisory Board, made it clear that this normalization has contributed to a dangerous blind spot in health care. “It is a hazard that sometimes we’ve been doing it for so many years… it is just part of the culture,” Dennis, who is also a health care consultant with Perioperative Consulting, LLC, said, describing how familiarity has dulled concern across the field.  A Risk That Extends Beyond the Surgical Field Dennis, who is also a perioperative nurse executive and speaker [https://www.vangiedennis.com/], stressed that one of the biggest misconceptions about surgical smoke is who it affects. While many clinicians associate exposure primarily with surgeons, the reality is far broader. She pointed to overlooked patient risks, particularly in vulnerable scenarios such as cesarean deliveries or procedures under monitored anesthesia. “The patients are affected by the surgical smoke,” she said. “What about the baby’s first breath on a C-section… the nurse who’s pregnant… that unborn baby is exposed to surgical smoke.”  This framing expands the conversation from occupational safety alone to a shared exposure risk across the entire perioperative team and patient population. “It really affects everybody in that perioperative platform when we generate smoke,” Dennis added, emphasizing that no one in the room is truly isolated from exposure.  Understanding the Science Behind the Smoke Dennis explained that the source of the smoke matters less than many clinicians believe. Whether generated by lasers, electrosurgery, or other heat-producing devices, the resulting plume contains harmful components. “Any heat-generating device will create a surgical plume or smoke… it’s all bad for you,” she said, underscoring that differentiation between technologies does not equate to differences in safety.  She reinforced this point with a lesson from early in her career, recalling a physician who distilled the issue bluntly. “He said, there’s no such thing as safe smoke,” Dennis noted.  To make the risk more tangible, she cited common comparisons used in education and research. “One gram of tissue vaporized by a laser is equivalent to 3 unfiltered cigarettes… by an electrosurgical device, 6 unfiltered cigarettes,” she said.  However, Dennis emphasized that even this comparison may underestimate the danger, given the biological and chemical complexity of surgical smoke, which includes human tissue, blood particles, and toxic gases such as benzene and formaldehyde. Health Effects That Accumulate Over Time Dennis described both the immediate and long-term health consequences associated with repeated exposure. Early in her career, she experienced symptoms that many perioperative staff still report today. “You had headaches… your eyes are burning… nausea, fatigue,” she said, recalling the physical effects of prolonged exposure during smoke-heavy procedures.  While these symptoms may seem transient, Dennis emphasized that chronic exposure could lead to more serious outcomes. “I know several of my friends… one has adult-onset asthma, and the other has stage 2 [chronic obstructive pulmonary disease],” she said, highlighting the potential progression from irritation to long-term respiratory disease.  She also pointed to the presence of mutagenic and carcinogenic compounds in surgical smoke. “We’re being exposed to toxic gases and volatile organic compounds… these are all mutagenic and carcinogenic chemicals,” she explained, reinforcing that the risks are not hypothetical.  In addition to respiratory concerns, Dennis discussed infection risks, noting that viable viral particles have been identified in surgical smoke. “There has been documented, proven risk,” she said, referencing studies involving pathogens such as [human papillomavirus (HPV)].  The Persistent Awareness Gap Despite decades of research and guidance, Dennis believes the greatest barrier to progress remains a lack of awareness. “It is the unknown,” she said. “If you don’t see it, smell it, touch it, it’s not real, but it is real.”  This gap extends beyond clinicians. Dennis highlighted that many ancillary staff, including environmental services personnel, are rarely educated about surgical smoke exposure. “If I walked up to anybody with [environmental services], I bet they would have no idea,” she said, pointing to missed opportunities for broader organizational engagement.  For infection prevention professionals, this underscores the need to expand education beyond traditional clinical roles and create a more unified approach to risk communication. Why PPE Alone Is Not Enough Dennis also addressed a common misconception regarding personal protective equipment (PPE), particularly surgical masks. “The surgical mask is designed to protect the patient from you… not you from the patient,” she said, clarifying its intended purpose.  She explained that standard masks are not capable of filtering the fine particulate matter found in surgical smoke. “They will not protect you,” she added, emphasizing that reliance on masks alone is insufficient.  Engineering Controls and Practical Solutions Instead, Dennis pointed to engineering controls as the most effective intervention. “The first line of defense… is local exhaust ventilation, smoke evacuation systems,” she said.  However, she stressed that proper use is just as important as availability. Smoke must be captured close to its source to be effective. “Within inches of the source… about 2 inches,” she explained, noting that even small deviations can allow contaminants to disperse widely in the room.  Moving Toward System-Level Change Dennis has been actively involved in legislative efforts to mandate smoke evacuation practices. While some states have adopted regulations, others continue to lag behind. “We have to go state by state by state,” she said, describing the slow and uneven pace of change.  At the organizational level, she emphasized the importance of aligning safety initiatives with measurable outcomes and leadership priorities. “You can’t manage what you can’t make measurable,” she said, highlighting the need to connect exposure risks with operational and financial data.  She also pointed to workforce implications, noting that safety investments can influence recruitment and retention. “They want to know you care,” Dennis said, reinforcing that culture and leadership play a critical role in sustaining change.  The Bottom Line for Infection Prevention Ultimately, Dennis believes the path forward requires a coordinated effort across education, policy, and practice. “Compliance and culture change is the biggest barrier,” she said, acknowledging that awareness alone is not enough.  She urged health care organizations to act proactively rather than reactively. “Let’s not wait till we have hurt ourselves… before we make this compliance and culture change,” Dennis concluded.  For infection prevention and control personnel, the message is clear. Surgical smoke is not a minor nuisance. It is a persistent and preventable exposure risk that demands attention, advocacy, and action across the entire health care system.

20: The Invisible Heroes: Why Dental Assistant Recognition Week Matters

Every time you sit in a dental chair, you witness a carefully choreographed performance. The dentist guides the instrument. The hygienist checks your bite. Behind the scenes stands the dental assistant, orchestrating the invisible work that keeps you safe. "Dental assistants do more than just assist the doctor," says Sherrie Busby, EDDA, CDSO, CDIPC, dental assistant speaker and trainer, with 42 years of experience, and a member of the Infection Control Today® (ICT®) editorial advisory board. "We're responsible for setting up rooms, breaking down rooms, following the entire chain of infection control from start to finish." Most states require dental hygienists to earn degrees and complete specialized schooling. Dental assistants? In most states, you can work in infection control without any formal training. Many learn on the job, sometimes absorbing bad habits along with good ones. Yet dental assistants manage staggering responsibilities: sterilizing instruments, documenting visits, managing lab cases, maintaining infection control protocols, and providing patient education. In hospitals, these tasks are divided among specialized roles. In dental offices, one person does it all. The compensation doesn't match the responsibility. The median wage hovers around $20 per hour, with some states paying just $16 to 17. "It's sad that the person with the most duties in the practice is the lowest paid," Busby notes. The infection control stakes are particularly high. Dental settings involve constant exposure to aerosols and instruments. Proper PPE use, meticulous cleaning, and sterilization are non-negotiable. C. difficile bacteria can survive on surfaces for up to 5 months. Failure in any step compromises patient safety. The COVID-19 pandemic exposed this vulnerability. Dental professionals faced harm's way, yet compensation didn't reflect that risk or the essential work they perform. The Dental Assistant National Board is pushing for standardized credentialing and education requirements across states, a long-overdue shift ensuring consistency in infection control practices and knowledge. This Dental Assistant Appreciation Week, it's time to acknowledge what's been invisible too long. Dental assistants aren't just assistants. They're infection control specialists, patient educators, and safety guardians. They deserve recognition, fair wages, and professional standards reflecting the critical work they do every day. The magic you see in the dental chair? Behind every moment is a dental assistant making it happen.

19: Contagious Conversations: The Bold New Series Tackling the Toughest Topics in Infection Prevention

Contagious Conversations is a new video series by Infection Control Today® (ICT®) created to make space for the conversations infection preventionists (IPs) often avoid, not because they are unimportant, but because they are personal, complicated, and sometimes uncomfortable.  In the premiere episode, the hosts, Isis Lamphier, MPH, MHA, CIC, AL-CIP; Heather Stoltzfus, MPH, RN, CIC; Brenna Doran, PhD, MA, ACC, CIC, AL-CIP; and Jill Holdsworth, MS, CIC, FAPIC, NREMT, CRCST, CHL, AL-CIP, introduce the series' purpose and set the tone for what is to come: honest dialogue about the profession, the people doing the work, and the pressure points shaping the future of infection prevention. The opening frames the problem clearly. “Infection preventionists are great about talking about pathogens, but we’re not so great at talking about ourselves,” said Stoltzfus. Doran added that the work can consume even the most resilient professionals, noting, “We spend so much time trying to manage the tasks of our job, but sometimes the most important work starts with a conversation.” Lamphier describes Contagious Conversations as an intentional space for those discussions that rarely happen in staff meetings and rarely make it into policy documents. “This series is our space to have those real human conversations,” she said, emphasizing that the goal is to “break down barriers, challenge assumptions, and remind us that we’re all still figuring it out.” The hosts reinforce that the series is not built around being right; it is built around being real. Stoltzfus underscores that approach by explaining, “These conversations aren’t about being right. They’re about being real.” A brief but memorable line from another panelist lands as the guiding theme. “Courage is contagious, and so are good conversations,” the hosts said. The first episode tackles a topic many infection preventionists say they are hearing everywhere but rarely address directly: what backgrounds belong in infection prevention, and how the profession is navigating tension around clinical and nonclinical career paths. Stoltzfus frames it as an issue that shows up across the workplace, from informal chats to formal processes. She calls it “a conversation that I keep hearing, that everybody’s having in hallways, in their direct messages and their meetings and human resources.” She also sets guardrails for the discussion, emphasizing that the series is not about taking sides but about creating space for curiosity, transparency, and psychological safety. Lamphier introduces her own path through public health, long-term care, and acute care leadership. She describes entering the field during the pandemic as both chaotic and catalytic, saying, “I graduated… during the pandemic,” and that the urgency of the moment accelerated opportunities and shifted hiring patterns in ways newer applicants may not experience today.  Holdsworth, an IP with more than 16 years of experience, shares a different path, beginning with a master’s degree in exercise physiology and progressing into infection prevention. She recounts how discrimination can become more visible when you move from being the sole infection preventionist to being part of a larger team. “Once I became a member of a larger team… I really started seeing some of those discrimination-type things happening,” she said. Doran describes her pathway from clinical microbiology and teaching into public health epidemiology and infection prevention, along with the barriers she encountered in hiring systems that defaulted to nursing requirements. She remembers the repeated dead ends clearly. “I was not an eligible candidate because I wasn’t a nurse,” she said, describing how difficult it was to even apply to some positions. Together, the group begins mapping where the problem may actually sit, not just in individual bias, but in organizational structures and leadership assumptions that shape job postings, pay bands, and access to experience. By the end of the episode, the purpose of Contagious Conversations is clear. It is not a one-off discussion; it is a series designed to bring more voices into the room, including people from human resources, professional organizations, and training programs. The hosts also signal that future episodes will invite audience participation through surveys and feedback, with the goal of turning shared experience into shared solutions.