Clostridium difficile (C. difficile) is the most common cause of acute diarrhea in hospitals and long-term care facilities in North America. Over 60% of C. difficile cases are acquired within healthcare facilities. Reducing environmental contamination plays a key role in preventing the spread of infection to immunocompromised patients and healthcare workers.
C. difficile is extremely resilient, and, depending on conditions, can persist in the open environment for months. Spores are resistant to common cleaning agents and hand sanitizers, and have been shown to travel by physical means, making them very difficult to eliminate. Special chemical disinfectants & protocols are required to eradicate C. difficile, but the challenge lies in knowing where the contamination exists in order to take necessary steps to keep our healthcare facilities safe.
A multi-disciplinary team at Vancouver General Hospital has developed a program that trains dogs to detect C. difficile with high accuracy. Since its inception in 2016, our canine detection teams have successfully screened well over a thousand hospital areas for C. difficile. Each contamination alert is acted upon immediately and used as an opportunity for in-the-moment education for healthcare workers, cleaning staff and patients. Alert data is also used to design & implement targeted local and system-level quality improvement initiatives.
Enhance surveillance measures - a cost-effective method to rapidly detect & monitor contamination
Increase staff engagement - provide feedback & education based on real-time alerts
Improve practices - highlight & address gaps in cleaning & infection control practices
Reduce environmental contamination - decrease transmission risk to patients & health care workers
K9 Angus is a field-bred English Springer Spaniel who comes from a long line of recognized hunting dogs. Angus is trained to find environmental reservoirs of C. difficile contamination in the hospital environment, and has screened hospitals across Canada. Angus has become the ambassador for the Canine Detection program, with regular features in the international media, appearances in three books and two documentaries, as well as countless public appearances with his human partner, Teresa Zurberg.
Teresa Zurberg is the co-founder and program lead for VCH’s Canine Detection Program and a nationally recognized Canine Detection Specialist. She is responsible for the training, management and deployment of the Canine Detection Teams in healthcare facilities. As part of her work, she has contributed to several research projects that highlight the effectiveness of medical biological detection canines. Teresa has worked in the field of Canine Detection as a validated Narcotic, Explosives and Patrol Handler since 2010 and has been responsible for explosives screening at large transportation hubs, such as BC Ferries, at concert and sports venues, such as Rogers Arena for the Vancouver Canucks, as well as screening industrial warehouses for contraband. She is currently working with the team to expand the medical biological odor profiles used to train detection dogs. Their award-winning work is being followed internationally and was recently honored by the Peggy Lillis Foundation at the “C.Diff is a Drag” gala in October 2020. The team has also won several awards for innovation.
Dodger is an English Springer Spaniel who completed his C. difficile detection training in 2017. He conducts daily screenings for environmental reservoirs of C. difficile in many hospitals across the greater Vancouver area.
Jaime Knowles spent over 10 years handling and training professional detection dogs in explosives, narcotics and bed bugs before joining VCH’s Canine Detection team in December 2017. Jaime is Dodger's partner.
For more information on C. difficile Canine Scent Detection at VCH, expand the sections below.
We provide C. difficile canine scent detection services to hospitals in British Columbia and across Canada.
Rapid & accurate identification of C. difficile environmental reservoirs.
In-the-moment staff education opportunities upon alert.
Identifying trends in alert data that can be used to improve infection and control practices.
Access to professional canine detection teams with hospital experience and knowledge in infection control theory and practices.
Increased awareness of C. difficile among staff, patients, and visitors.
"[Canine scent detection] is an innovative and exciting way to discover new places where C diff might reside. That way we can immediately target problem areas for cleaning and disinfection."
- R.D., Infection Control Practitioner, VCH
"Having our Infection Control Practitioner attend rounds with Teresa & Angus helps us because we can ask more detailed questions about C diff, how it is spread, antibiotic utilization, etc."
- J. L., Patient Service Manager, VCH
"Having Angus and Teresa as part of our IPAC team has a profound impact on our program and has impacted hospital staff in general in a very positive way. Angus is loved and respected "staff member "of the VGH IPAC team. He captures the attention of the hospital staff, patients, and family, and he is giving Infection Control great PR. Canine scent detection is providing us with a new type of environmental data that has not been readily available before. Nothing can replace the sensitivity of Angus's nose. Quick and swift action following Angus’s alerts is very reassuring to all of us who are striving to provide best patient care."
- A. I. B., Infection Control Practitioner, VCH
"When Teresa & Angus walk through the units, they brighten up everyone's day! The environmental services staff enjoy working closely with them and are always interested to find the results of their searches so they can make sure there are no gaps in cleaning practices."
- R. R., Operations Manager, Crothall Healthcare, a division of Compass Group Canada
Ask us how we can help you achieve the full benefits of C. difficile canine scent detection at your facility
Email: canines4care@vch.ca
For answers to frequently asked questions, expand the sections below.
Our training protocols & validation test were developed based on best practices from the Scientific Working Group on Dog & Orthogonal Detector Guidelines (SWGDOG), and the National Detector Dog Manual, created by the U.S. Department of Agriculture. We have also adapted our training protocols & validation test to reflect the unique challenges canine detection teams will face when detecting C. difficile in hospitals. Our validation process includes, but is not limited to, using a double testing format (as recommended by SWGDOG) along with the addition of an odour recognition test, and search capable test in the validation test. Additionally, our canine detection teams are validated yearly by an independent validator.
We have trained and validated three dogs, and are always in the process of training more dogs.
We only use toxigenic strains in our training scent kits. Thus, we do not know if our dogs can differentiate between non-toxigenic and toxigenic strains.
We look for the right personality traits such as great work ethic, integrity, teamwork skills, willingness to learn, and aptitude for working in the healthcare environment. All of our handlers possess a strong knowledge of how odour works, along with a strong understanding of their dog’s communication.
While all working breeds have proven themselves to be able to do detection, there are some traits in dogs that lend themselves better to this type of detection service:
Floppy eared dogs instead of pointy eared dogs, as they are less intimidating to staff, patients, and visitors.
Small to medium size so they can fit into tight spaces, such as in between medical equipment & patient beds.
Dogs with exceptionally high drive and impeccable temperaments who have been professionally evaluated in a hospital environment.
Good health.
Has not been trained to detect other types of odours.
Similar to humans, dogs are more susceptible to contracting C. difficile from the environment if they are immunocompromised. Our dogs receive regular veterinary check-ups, and are only brought into the healthcare environment upon receiving a clean bill of health.
We have received an overwhelmingly positive response from staff, patients, and visitors. As part of our program, our canine handlers also act as infection control & prevention ambassadors to increase C. difficile infection awareness & promote good practices.
Our canine detection teams do not search surgical suites, food preparation areas, neonatal units, psychiatric units, palliative care units, and offices outside of patient units. We also only search occupied patient rooms if we are accompanied by a staff member, and have permission from the patient. We do not search people, our dogs are not diagnostic tools but rather used to identify environmental contamination.
It depends – the amount of time it takes for the canine detection team to search a patient unit is dependent on the size of the unit, extent of contamination, and the amount of in-the-moment education provided upon identification of contamination.