Antimicrobial resistance (AMR) is one of the top global public health threats, according to the World Health Organization (WHO). Scientists estimated that bacterial AMR was responsible for 1.27 million global deaths in 2019 and will cause 10 million deaths by 2050. The superbugs cleaning professionals combat in healthcare settings are a result of AMR, which occurs when germs, including bacteria, fungi, and viruses, develop the ability to defeat the antibiotics/drugs designed to kill them. All organisms, including people, have survival instincts and biological mechanisms to fight back, explained Joanna Mills, a registered nurse and system director of infection prevention at John Muir Health, Walnut Creek, California. She added that AMR is not a new occurrence. Alexander Fleming, who discovered penicillin in 1928, warned that “microbes are educated to resist penicillin.” Infection control progress Since the rise of superbugs, infection control practices have become more evidence-based, standardized, and proactive. “We’ve seen stronger emphasis on hand hygiene, environmental cleaning, and antimicrobial stewardship programs, along with enhanced surveillance and rapid diagnostic testing,” said Rodney E. Rohde, a Regents’ professor and associate director of the Translation Health Research Center at Texas State University System, San Marcos. “Education and cross-disciplinary collaboration—especially between infection prevention, laboratory science, and environmental services—have also improved. Together, these efforts create a more resilient infection prevention culture that helps contain resistant pathogens and protect patients and staff alike.” Improvements in disinfection and sterilization of high-risk environments, such as surgical suites and intensive care units, in addition to isolation standards, also continue to evolve. “I believe that pursuing the research needed to establish a validated and effective cleaning and disinfection methodology will open the door to discover and develop strategies to make significant improvements in prevention and patient outcomes,” Mills said. As the industry studies how to clean surfaces effectively, it has established best practices for cleaning and disinfection in healthcare and learned that personal protective equipment (PPE) can keep staff safe and prevent them from transmitting organisms to other patients, explained Sarah Wilkerson, system executive director of infection prevention at Providence St. Joseph Health, Everette, Washington. The industry also uses broader surveillance techniques to look for these organisms. “We’re trying to identify them early, so that we can put in place targeted interventions that can help prevent the spread that could potentially turn into an outbreak,” Wilkerson said. Healthcare setting improvements Healthcare professionals face significant challenges when dealing with superbugs, including limited treatment options, diagnostic delays, staff shortages, and the constant pressure to maintain strict infection control amid heavy workloads, Rohde said. Misinformation and inconsistent compliance can also undermine prevention efforts. Fortunately, new tools to address these challenges include rapid diagnostic technologies, antimicrobial stewardship programs, and multidisciplinary teams. “By integrating science, communication, and collaboration, we’re steadily improving our ability to detect, manage, and prevent resistant infections in healthcare environments,” Rohde said. “In the medical laboratory setting, we all need to work together to raise awareness surrounding current antimicrobial susceptibility testing breakpoints. These are challenges for clinical and medical laboratories to update their testing methods to keep up with new drug resistance patterns, and face hurdles like regulatory clearance and manufacturer delays.” Mills believes the biggest challenges in superbug prevention stem from three factors patients are exposed to before they arrive at acute care hospitals: the environment they came from, including skilled nursing facilities; the treatment they received, including antibiotics; and the healthcare practices of their care team, such as isolation and disinfection. Unfortunately, standards and requirements are not consistent. “The pandemic illustrated these issues and exacerbated the resistance patterns and emerging urgent and serious organism threats,” Mills said. Superbugs also can spread easily on surfaces, such as equipment. “While we know that it can be challenging to clean and disinfect some of the healthcare surfaces, we now know we need to be looking at the different types of surfaces and what is recommended to clean those effectively,” Wilkerson said. Collaboration between environmental services (EVS), nursing, engineering, supply chain, and infection prevention also is necessary to consider the environment, identify which surfaces need cleaning, and determine how teams can clean most effectively without using multiple products. Managers also must delineate each team’s role. “It can be really confusing to teams, because it can be a shared responsibility to clean the healthcare environment,” Wilkerson explained. As hospitals acquire pieces of equipment, furniture, buildings, etc., teams need to select surfaces that can be cleaned and disinfected easily. “We know that some of the older buildings have a real challenge with being able to keep those clean just because the surfaces degrade over time,” Wilkerson said. “It’s a great opportunity as we’re bringing in new products to be thinking about how to ease our way in the future.” Best practices adaptation Professional organizations have developed and published cleaning and disinfection standards specific to patient populations and specialty services. Still, the specific practices related to the general medical surgical areas are lacking, complicated by the recommendations of manufacturers of medical devices, hospital furniture, and construction materials, Mills explained. “Often, the instructions for use (IFU) related to cleaning and disinfection are insufficient and/or not defined, and the cleaning practices are deferred to hospital standards,” she said. The best cleaning practices for reducing superbugs start with consistency and adherence to evidence-based protocols. This includes routine, thorough cleaning of frequently touched and shared surfaces, proper use of Environmental Protection Agency (EPA) registered disinfectants effective against resistant organisms, and proper contact times. Staff training, hand hygiene, and clear communication between a multidisciplinary team is essential. Regular audits, monitoring, and feedback also ensure compliance. “Ultimately, a culture of shared responsibility—where everyone understands their role in infection prevention—is key to minimizing the spread of superbugs in healthcare settings,” Rohde said. Wilkerson also believes it is important to have rigorous environmental cleaning practices for patients with known AMR organisms. For example, place them on transmission-based precautions or in isolation, meaning that staff entering that room might need to wear a gown and gloves. Hand hygiene protocols also help ensure staff properly disinfect their
Traditionally, cleanliness in facilities, whether it’s a workplace, school, hospital, or senior living facility, has been associated with visible standards—gleaming floors, clear windows, and surfaces free from visible dirt. However, the understanding of what constitutes a healthy indoor environment has expanded significantly. Today’s definition of health and safety includes the quality of the air occupants breathe, calling for a comprehensive strategy that integrates cleaning practices, air quality management, and regulatory compliance to support occupant health, well-being, and productivity. Understanding the indoor environment Buildings operate like complex ecosystems, with multiple interconnected factors influencing indoor air quality (IAQ). Building materials, ventilation systems, cleaning products and practices, occupant behaviors, and even furnishings all play a role in the indoor environment. Each of these elements can introduce or mitigate exposure to invisible pollutants, including allergens (e.g., pollen, dust mites, and mold), volatile organic compounds (VOCs), particulate matter, and airborne pathogens. The National Institutes of Health reports that 50% of illnesses are either caused or worsened by poor IAQ. Individuals with respiratory conditions such as asthma, or vulnerable sectors of society like children, are especially susceptible. Over 50% of U.S. homes contain at least one elevated indoor allergen, and buildings designed for energy efficiency without proper ventilation can trap hundreds of chemicals indoors, contributing to sick building syndrome (SBS). A term coined in the 1970s, SBS described the health problems caused by inadequate ventilation and pollutant buildup in tightly sealed office buildings. Though the term is less commonly used today, the underlying issues remain, manifesting in symptoms such as eye irritation, dizziness, and respiratory symptoms, which often resolve once a person leaves the affected building. The consequences of poor IAQ go beyond physical health. Occupants in buildings with high levels of VOCs often have lower performance scores on cognitive tests, up to 61% lower compared to occupants in low-VOC environments, according to a study in the journal Building and Environment. In contrast, occupants in green-certified buildings, which typically feature superior ventilation and material choices, have shown a 26.4% improvement in cognitive test performance, another study in the same journal reported. Emerging regulations, such as the American Society of Heating, Refrigerating and Air-Conditioning Engineers’ (ASHRAE) Standard 241, emphasize the importance of managing infectious aerosols and enhancing ventilation strategies, guiding facility managers toward healthier indoor environments. Standards such as this encourage facility managers to adopt evidence-based approaches to improve IAQ proactively. Interestingly, ASHRAE 241 is the first consensus-based, code-enforceable standard to address building preparedness and airborne infection risk reduction directly. Cleaning for air quality Traditional cleaning routines often fall short of addressing the root causes of poor IAQ, or worse, may contribute to poor IAQ. Many products and practices redistribute allergens into the breathing zone and release VOCs, negatively affecting air quality. Effective cleaning requires the selection of products that minimize chemical emissions and actively remove allergens. Low-VOC cleaning products, scientifically tested and independently verified through credible third-party programs like the Asthma and Allergy Foundation of America’s Asthma & Allergy Friendly® Certification Program, offer reliable solutions while supporting better IAQ. Effective ventilation, filtration, and humidity control are also essential considerations. Simple steps, such as regular maintenance of HVAC systems and timely replacement of HVAC filters, can greatly influence indoor environments. Choosing certified HVAC filters and air purification systems also can play a key role in reducing indoor pollutants. The use of verified systems ensures products have undergone rigorous, independent testing proving that they effectively remove allergens and particles without introducing harmful by-products, ensuring real-world performance and subsequent health benefits. Differentiating between certifications and selfie seals In today’s crowded marketplace, health claims, certifications, and seals are everywhere, but not all are created equal. Amid a sea of marketing claims and loosely defined standards, it’s essential to recognize the programs that go beyond surface-level messaging to deliver real, evidence-based assurance. Genuine third-party certifications provide transparency, accountability, and confidence. Programs like the Asthma & Allergy Friendly® Certification Program, the U.S. Green Building Council’s Leadership in Energy and Environmental Design (LEED) rating system, and the International Well Building Institute’s WELL Building Standard® (WELL) set high standards, supporting informed decision-making for facility managers who seek products that are proven to contribute positively to occupant health. Backed by accredited laboratories like Airmid Healthgroup, these programs help facility managers make informed choices that align with both health goals and regulatory expectations. Certified products must pass scientifically validated protocols that assess performance in real-world conditions, not just ideal scenarios. This level of scrutiny stands in contrast to what are often referred to as “selfie seals”—unverified labels that appear to suggest third-party verification, but lack substantiated evidence, leading to consumer confusion and potential regulatory pushback. Regulatory bodies, including the Federal Trade Commission (FTC) and the European Commission, increasingly target these misleading claims, resulting in significant fines and consequential reputational damage for companies. Educating for action Despite growing awareness around IAQ, there remains a significant knowledge gap among cleaning and maintenance professionals, perhaps due to limited access to specific training. Tailored education programs are a fundamental tool in bridging this gap. One notable initiative is the Healthier Buildings Awareness training course, developed by the iAIR Academy in partnership with ISSA’s Global Biorisk Advisory Council (GBAC). Specifically designed for facility management professionals, the course addresses a broad array of factors relating to IAQ, including the impact of pollutants on respiratory health, the science behind pathogen control, and the opportunity for becoming an indoor air specialist. This educational support means professionals are equipped with practical knowledge, empowering them to implement efficient cleaning routines and select appropriate products that support a healthier indoor environment. For organizations that adhere to environmental, social, and governance (ESG) guidelines, the use of certified products contributes positively to their objectives, highlighting a commitment to occupant well-being and sustainability. Rethinking clean A genuinely effective approach to healthy buildings requires integrating building science, medical insights, and operational best practices. Implementing a holistic IAQ strategy involves careful selection of certified cleaning products and green building materials, rigorous adherence to improved cleaning protocols, and comprehensive staff training. Regular IAQ
What has the cleaning industry learned as it transitioned from the first pandemic year to the second? In this episode of BioTalk, a GBACtv production, learn the details about what went well and what didn't in 2021, and what we as an industry need to know right now. Infection prevention experts Patty Olinger, the executive director of the Global Biorisk Advisory Council (GBAC), a division of ISSA, and Dr. Paul Meechan, the former head of safety with the U.S. Centers for Disease Control and Prevention (CDC) and who now serves on the GBAC scientific advisory board, discuss these topics with ISSA Media Director Jeff Cross. This webcast also digs into the science and the layered support when it comes to cleaning, disinfection, and air purification, and how the omicron variant shouldn’t be considered just another type of “cold”. Olinger and Meechan also discuss the possibility of the end of the pandemic. This webcast is brought to you by our sponsor Breezy.
On Tuesday, the South Carolina Department of Public Health (SCDPH) reported the state has experienced 789 cases of measles since its outbreak began on Oct. 2, 2025. CNN reported the South Carolina outbreak is now the largest in the United States since the disease was declared eliminated in this country more than two decades ago. South Carolina has reported more than 600 measles cases this year alone. SCDPH reported that at least 18 adults and children have been hospitalized for complications of measles. Additional cases have required medical care for measles but were not hospitalized. No deaths have been reported. Last year’s largest outbreak in Texas reached 762 cases, and resulted in the death of two children, before it ended in August. The South Carolina outbreak is centered around Spartanburg County, with most cases attributed to close contacts of known cases, SCDPH reported. The vast majority of cases are in unvaccinated patients and minors under the age of 18. Currently 557 people are in quarantine and 20 in isolation, including numerous students. The latest end of quarantine for these is Feb. 19. However, the number of public exposure sites indicates that measles is circulating in the community, increasing the risk of exposure and the risk of infection for those who are not immune due to vaccination or natural infection. A person is contagious four days before and after a rash begins, meaning someone can spread measles before they know they are infected. The virus can linger in the air for up to two hours after an infected person leaves. In another large, ongoing outbreak along the Arizona-Utah border, state health departments report that as of Jan. 27, 237cases have been confirmed in Utah while 244 cases have been confirmed in Arizona. As of Jan. 22, the Centers for Disease Control and Prevention confirmed 416 measles cases in the U.S. this year. (The CDC is aware of probable measles cases still being reported by jurisdictions and this number is likely to grow higher.) Cases were reported by 14 states: Arizona, California, Florida, Georgia, Idaho, Kentucky, Minnesota, North Carolina, Ohio, Oregon, South Carolina, Utah, Virginia, and Washington. A total of three measles cases were reported among international visitors. No new outbreaks have been reported in 2026, and 94% of confirmed cases (393 of 416) are outbreak-associated (none from outbreaks in 2026 and 393 from outbreaks that started in 2025).
Cases of influenza have been steadily climbing this winter season, with the Centers for Disease Control and Prevention reporting more than 15 million flu illnesses, 180,000 hospitalizations, and 7,400 deaths as of early January. The flu isn’t the only infectious disease making its rounds this winter, with norovirus, COVID-19, the common cold, and other illnesses spreading as well. Custodians, environmental services specialists, and facility managers must be prepared with efficient disinfection practices to protect inhabitants of the buildings they service. A free webinar presented by Cleaning & Maintenance Management (CMM) on Feb.18—Virus Busters: Protecting Building Residents From Flu, Norovirus, and Other Infectious Diseases—will offer practical tips on how front-end workers can help stop the spread of disease-causing germs. During this fast-paced, one-hour interactive session, you will learn strategies to: Predict which illnesses will be prevalent during specific seasons and set up methods to keep track of infection rates. Ensure pathogen removal on surfaces through cleaning protocols and the use of effective cleaning and disinfecting products. Reduce the airborne transmission of germs through ventilation practices to improve indoor air quality. Choose technology and other tools to strengthen cleaning routines. Promote effective handwashing and personal protective equipment use among staff and facility occupants. The webinar will conclude with a Q&A session, allowing you to ask the panelists your most pressing questions. The expert panel for this webinar includes: Kathleen Misovic (moderator), CMM Managing Editor Sophia McCrae, Vice President of Operational Strategy, Crothall Healthcare Rodney E. Rohde, Chair & Regents’ Professor, Texas State University Barbara Strain, Member, ISSA Healthcare Advisory Council Don’t miss this opportunity to gather best practices from industry experts that will help you protect facility inhabitants from infectious pathogens. Register for CMM’s free infection prevention webinar today.
On Monday, the American Academy of Pediatrics (AAP) published the “Recommended Childhood and Adolescent Immunization Schedule: United States, 2026,” that continues to recommend routine immunization for protection against 18 diseases, including respiratory syncytial virus (RSV), hepatitis A, hepatitis B, rotavirus, influenza, and meningococcal disease. A policy statement describes the schedule in AAP Red Book Online, the academy’s clinical guidebook for infectious diseases prevention and treatment. A parent-friendly immunization schedule is published, here. “The AAP will continue to provide recommendations for immunizations that are rooted in science and are in the best interest of the health of infants, children, and adolescents of this country,” AAP President Andrew Racine, MD, PhD, FAAP said. “Routine childhood immunizations are an important early step in the path to lifelong health. Every step you take alongside your child on that path is because you want them to grow up healthy and as a trusted partner on that journey, your pediatrician welcomes conversations about all your child’s healthcare, including immunizations.” The 2026 AAP immunization schedule has been formally endorsed by 12 medical and healthcare organizations, including: American Academy of Family Physicians (AAFP) American College of Nurse Midwives (ACNM) American College of Obstetricians and Gynecologists (ACOG) American Medical Association (AMA) American Pharmacists Association (APhA) Council of Medical Specialty Societies (CMSS) Infectious Diseases Society of America (IDSA) National Association of Pediatric Nurse Practitioners (NAPNAP) National Medical Association (NMA) Pediatric Infectious Diseases Society (PIDS) Pediatric Pharmacy Association (PPA) Society for Adolescent Health and Medicine (SAHM) The 2026 AAP recommendations remain largely unchanged from prior AAP guidance released in August 2025, but they differ from a schedule recently issued by the Centers for Disease Control and Prevention (CDC ). The AAP formerly partnered with the CDC to create a unified set of vaccine recommendations, but recent changes to the CDC immunization schedule depart from longstanding medical evidence and no longer offer the optimal way to prevent illnesses in children. By contrast, the AAP childhood and adolescent immunization schedules continue to recommend immunizations based on the specific disease risks and health care delivery in the United States. “AAP recommends immunizations that have been designed to teach the immune system to recognize and resist serious diseases,” said Sean O’Leary, MD, MPH, FAAP, chair of the AAP Committee on Infectious Diseases. “They are carefully tested and monitored over time. The pacing and combination of vaccines are based on what we know about when your child’s immune system is ready to learn and respond best.” The AAP recommendations are based on a well-established framework for evidence evaluation, review of vaccine safety data, the epidemiology of the diseases in the U.S., the impact of the diseases, and how the vaccines could prevent the diseases and their complications. The AAP recommendations protect against several diseases, including: RSV (Respiratory Syncytial Virus), which is the leading cause of hospitalization for babies before their first birthday. It is a common virus that affects the lungs and airways. Immunizations for pregnant mothers and newborns provide antibodies that offer necessary protection. Influenza, or the flu vaccine, which is recommended for all children starting at 6 months old. This vaccine helps protect not only the child but also the community—especially during seasons when other viruses like RSV and COVID-19 are also circulating. Historically, over 80% of influenza-associated pediatric deaths have occurred in unvaccinated or incompletely vaccinated children. Children younger than 5 years, especially those less than 2 years, are especially vulnerable to severe illness, hospitalizations, and death due to influenza. Hepatitis B, a viral infection that attacks the liver and can cause both acute and chronic disease. Chronic infection over the course of a lifetime can lead to liver damage, liver failure, liver cancer, or even death. The hepatitis B vaccine has been tested extensively for safety and efficacy, and when administered within 24 hours of birth it is highly effective in preventing newborn infection. Measles, an extremely contagious disease whose complications can lead to pneumonia, encephalitis (swelling of the brain), deafness, intellectual disability, and even death. More than 2,200 cases, including three deaths, have been reported in outbreaks during the past year, with young children most likely to be affected. Rotavirus, diphtheria, tetanus, whooping cough (pertussis), polio, pneumococcal disease, COVID-19, mumps, rubella, chickenpox (varicella), meningitis, and hepatitis A are other diseases that can be prevented by following the AAP recommendations for vaccines. “Infectious diseases physicians see the devastating consequences of vaccine-preventable diseases every day, and we are proud to endorse AAP’s childhood immunization schedule,” said Infectious Diseases Society of America President Dr. Ronald G. Nahass, MHCM, FIDSA. “Now more than ever, families and clinicians need accurate information and evidence-based recommendations they can trust to keep our children healthy, and our nation’s physicians are united in answering the call.” Additionally on Monday, the California Department of Public Health (CDPH), in coordination with its partners in the West Coast Health Alliance (WCHA), endorsed the 2026 AAP Recommended Child and Adolescent Immunization Schedule. “The United States achieved elimination status for measles in 2000 with high vaccination rates. Now, we're seeing the highest numbers of measles cases, outbreaks, hospitalizations and deaths than we’ve seen in more than 30 years, driven by populations with low-vaccination rates,” said Dr. Erica Pan, CDPH director and State Public Health officer. “We are at risk of losing our measles elimination status, and we all need to work together to share the medical evidence, benefits, and safety of vaccines to provide families the information they need to protect children and our communities." CDPH has also issued separate mpox vaccine recommendations to increase access for that vaccine to adolescents at increased risk of infection. Because the 2026 AAP recommendations are essentially unchanged from prior CDPH recommendations, health insurance coverage in California will continue to cover these recommended vaccines. If parents have questions about the effectiveness and safety of vaccines, they should discuss any concerns with their healthcare provider.
The January/February issue of ISSA Today is now available in digital format. The cleaning industry is stepping into a new era—where performance, technology, and people intersect. This special issue of ISSA Today explores how artificial intelligence (AI) is reshaping work without replacing human judgment, why sustainability is becoming a core business driver, and how design, training, and science-based cleaning decisions impact real-world outcomes. By highlighting insights on measurable culture, safer choices, and smarter facilities, the January/February issue delivers practical thinking for leaders navigating what’s next in cleaning and facility solutions. Here’s a quick look at what you’ll find in this issue: Straight Talk!: Culture You Can Measure President’s Message: ISSA’s Refreshed Tagline ISSA In Action!: An inside look at what ISSA is doing for its members today. Cleaning for Performance: Making safer choices will help everyone win. Sustainability Takes Center Stage: A celebration of progress, purpose, and momentum. The Inevitable Advantage: Why embracing new technology isn’t optional. It’s survival. AI Skepticism: Generational differences in AI perception. Proposals: From AI Draft to Human Win: The strategies behind winning the bidding game. Human vs. Machine: How curiosity closes the gap between human understanding and machine intelligence. Inside ISSA Show North America 2025: Innovation, inclusion, and leadership converged to shape the next era of cleaning and facility solutions. The ROI Playbook for Sensitive Populations: Replace fragrance with science, align wages with skills, and track outcomes that matter. Designing for Cleanability: Why architects and cleaning professionals need each other long before opening day. Member Spotlight on Hospeco Brands Group: A company that wrote the playbook on distribution. View the Table of Contents to see everything available in this issue. Keep up to date with industry topics in video format. Subscribe today for free. Advertise and promote your company, products, and services in the next issue of ISSA Today magazine!