The West Lincoln Memorial Hospital annual general board meeting wasn't all just praise and accolades.

Rather, it brought attention to a very real and serious problem in Canada - Clostridium difficile.

A woman whose mother died of C. diff in March at the hospital rose to address the board during the question and answer period of the meeting June 18.

The woman, who declined to give her name, said she believed the hospital did not take sufficient steps to prevent a recent outbreak of C. diff.

David Bird, WLMH chief executive officer, confirmed in a phone interview with The News, that eight people died at WLMH between January 2006 and March 2008 as a result of a C. diff infection.

The woman whose mother died said she believes the hospital staff's care and procedures didn't do enough to prevent the spread of the deadly bacterium through containment and cleanliness.

Mr. Bird said the hospital has been following the Best Practices Manual developed by the Ontario Ministry of Health in 2004 and revised in 2007.

"Essentially we've been following that. And as revisions are made, which might happen every few years, we change our practices as well," he said.

Despite following these standards, which include cleaning procedures and staff education, people still can get the infection, he added.

Of the eight victims at WLMH, five acquired C. diff at the hospital, while one acquired it at another hospital, one at a long-term care facility, and one victim exhibited symptoms but didn't have C. diff when tested, he said.

C. diff is a bacterium which grows in the large bowel. It produces two toxins which cause diarrhea and damage the cells lining the colon, leading to serious health complications or death.

After witnessing what C. diff did to her mother, the woman at the meeting said hospital officials and local media need to do more to warn people in the community about the infection, adding that they too may be at risk.

At the end of the meeting, she declined to give her name or provide any additional information to The News, saying she would like to give the hospital a chance to respond to her concerns.

With 264 deaths confirmed to date in Ontario, 62 of which were at Joseph Brant Hospital in Burlington, Ontario's Chief Medical Officer, Dr. David Williams was spurred in May 2008 to review C. diff outbreaks at Ontario hospitals.

Dr. Williams agreed to review two years' worth of reports from hospitals which had reported diarrhea-like outbreaks.

Under Ontario guidelines, hospitals must report abnormally high levels of gastrointestinal cases.

After a discussion at its May 28 meeting, the WLMH board started its own review, using January 2006 to March 2008 as a time period to track C. diff.

The hospital has determined two victims, who acquired C. diff outside of the hospital, died as a direct result of it, said Bird.

C. diff strongly contributed to the death of one patient, who also had other health problems. It somewhat contributed to the death of four other patients who also had health problems and one patient exhibited symptoms, but did not test positive for the infection, he said.

The hospital was unable to provide any further information about the deaths due to confidentiality guidelines.

Mr. Bird said the hospital is part of the Ontario Provincial Infectious Diseases Advisory Committee's network and a local network for monitoring infections.

"We still are having cases of C. diff in the hospital," Mr. Bird said. "We need to keep on top of this all the time. We take it very seriously."

A committee is looking into further improvements and WLMH officials hope to have a ranking system assessing the risk of C. diff infections on its website soon.

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ABOUT C. DIFFICILE

What IS IT? C. diff is a commensal bacterium in the digestive system, meaning humans benefit from it. It doesn't become harmful until the good bacteria, flora, is depleted through the use of antibiotics, leaving the C. diff to thrive.

How it spreads: The bacterium produces spores that can, for example, be on toilet seats, bed sheets, hospital gowns or doorknobs used by an infected person. The spores can survive on these surfaces for weeks, withstanding the effects of drying and direct sunlight.

C. diff is transmittable through making contact with an infected person's feces or coming into contact with something an infected person has touched.

If individuals come in contact with spores and touch their mouth, for instance, the spores can enter and travel to the gastro-intestinal tract.

PREVENTION: Disinfect washrooms regularly, wash hands and, in hospitals, make sure patients are gowned.