Keeping Winter Germs at Bay
How Health Experts Skirt Sniffles, Coughs, Colds and Flu

By Yvonne J. Medley
Special to The Washington Post
Thursday, January 18, 2007

'Tis the season of colds and flu -- if you aren't sniffling or coughing, you probably are working near someone who is.

But what's the reason for the season? Cold weather and stale air, said one Southern Maryland public health official. During the winter, said Ashley Conway, director of disease surveillance for the Calvert County Health Department, "people are inside and their windows are closed. They're closer together and [viruses and germs are] so easily transmitted. That's when people get it."

But there are strategies to fight the microbes.

"People who haven't gotten their flu shot yet really should still consider it," Conway said. "It looks like our flu season this year is a little on the late side. . . . The CDC [Centers for Disease Control and Prevention] estimates that 36,000 Americans a year die from flu and flu-related complications."

State Health and Mental Hygiene Secretary S. Anthony McCann said recently that getting vaccinated as late as the end of February can be helpful in fending off the illness.

"This year, we had almost 45 percent of schoolchildren receive their [flu] vaccine here in St. Mary's County," said Leslie Payne, spokeswoman for the St. Mary's County Health Department. "It was a wonderful partnership between the school district and health department. Hopefully, that's going to pay off in reduced absenteeism and healthier staff."

Along with a flu shot, the most effective weapon in the arsenal against germs and viruses is "a clean pair of hands," said Cathy Delligatti, vice president for patient care services at Civista Medical Center in La Plata.

The CDC and other public health agencies have a host of pointers for staying well during cold and flu season. Along with washing hands, it is recommended that people avoid close contact with those who are sick, stay home when they are ill, cover their nose and mouth when coughing or sneezing, and avoid touching their eyes, nose or mouth.

Shopping for Germs

Armed with a list of recommendations and facts published by the CDC, I recently ventured to several Waldorf locations to gauge the level of epidemic danger.

On a trip to the grocery store, one of those facts weighed heavy as I worked to free a shopping cart from the middle of a long, caterpillar-like line. The CDC notes that viruses and bacteria can survive on an open surface for up to two hours, and the cart I set my sights on looked as if no one had touched it in two years.

But I was stopped short by the kindness of a stranger. Witnessing my quest for the cart in the middle of the pack, a gentleman pushed his warm cart in my direction. I lulled myself into a false sense of security and thanked him, wondering whether I was now pushing the remnants of his or someone else's sneeze or cough.

In her book "The Germ Freak's Guide to Outwitting Colds and Flu," Allison Janse writes, "When you sneeze, air particles leave your mouth and nose at 93 miles per hour."

Payne, with the St. Mary's County Health Department, offered the standard advice for blocking the speeding microbes: Cover your mouth with a tissue and throw it away. If you don't have a tissue or handkerchief, cough or sneeze into the elbow of your sleeve. Wash your hands regularly and thoroughly with soap and water.

"That's still the best," said Calvert County's Conway. But when you can't wash hands, "definitely use the alcohol-based hand sanitizers. If you're in your car eating your McDonald's french fries and you can't wash your hands and you've been all over creation shopping, pull out your hand sanitizer and give yourself a squirt."

And how long does it take to do a thorough job? Long enough to sing a song -- the CDC suggests putting hand washing to song. Sing the Happy Birthday song or the ABC song, twice, under your breath while you scrub.

Inside the grocery store, a baby sat in the child seat section of a shopping cart, slobbering on its handle.

The public health folks also cautioned against this. They advised wiping down the shopping cart's handlebar and other areas a child might touch or bite (let the onlookers scoff). Many baby stores now carry disposable liners specifically designed to line shopping carts and restaurant highchairs.

If you can avoid it, Conway said, "don't take your baby places where they're going to come into contact with a bunch of people who are coughing and sneezing. Just use some common sense to keep them healthy. In the spring, they can come out."

Not on the Menu

Sitting in a restaurant, a friend and I passed the hand cleaner back and forth. Perhaps we should have also brought a sanitized wipe (I know I had one) to swab down the table.

I watched the busboy wipe down the three tables and seats adjacent to ours with one universal damp, dingy rag, then toss it in his plastic basin filled with dirty dishes. To his credit, he was pleasant, quick and efficient. It's impossible to efficiently monitor the food droppings of toddlers. Janse suggests, along with a good wipe, whip out the place mats. They can be purchased for well under a dollar. Tuck a few in the diaper bag or even in your carry-on for the airplane.

In the Five Guys Famous Burgers and Fries restaurant in Waldorf, I watched the cook to see whether he would discard his plastic gloves after touching raw meat and don a fresh pair to handle the cooked hamburgers. He did.

"Gloves are changed every time you interact with raw meat, or you touch your hat or you touch your apron or you pick something up off the floor," said owner Robin Kurst, as she ripped off the old and pulled on the new. Kurst added, "I'm pretty sure that effective in 2007 in Charles County, gloves are going to be mandatory for every restaurant."

Don't be afraid to dine out. Charles Gerba, an environmental microbiologist and co-author of "The Germ Freak's Guide," said, "Fifty percent to 80 percent of all food-borne illnesses originate in the home."

If not cleaned properly, some of the most germ-ridden places in the home are the kitchen sink, dishcloth, garbage can, refrigerator and cutting board. "Ninety percent of kitchen sinks carry salmonella," Gerba said. "If an alien came from space and studied bacterial counts in the typical home, he would probably conclude he should wash his hands in your toilet and pee in your sink," Gerba said, quoting from the book.

Dirtiest Little Secrets

Speaking of the bathroom, Janse said the most troubling place there is not the toilet seat. Rather, in public restrooms, it's the floor. At home, it's the toothbrush. So be careful where you set your purse or briefcase in a public bathroom. The sinks and door handles are also likely to be havens for germs. At home, the toothbrush can be a landing place for droplets that fly from the toilet when it is flushed without closing the lid.

Contagious Co-Workers

Just going to work can be a hazard during cold and flu season.

Public health experts suggest reconsidering eating at your desk because it can be one of the most germ-ridden places in the office. Others include the microwave oven door handle and keypad, telephone receivers, and the computer keyboard and mouse. Beware of communal foods that others have picked over, maybe even dropped on the floor and put back.

"Presenteeism" can be another source of exposure at work. This is the opposite of absenteeism, Janse said. The phenomenon refers to workers who insist that the job can't get done without them -- in sickness and in health. Their sense of duty, even when sick, costs employers an estimated $180 billion annually, according to the American Productivity Audit, in lower productivity and lost time from co-workers to whom they pass their illnesses.

Watch out for the co-worker who seems to have his own workplace dispensary. This cheerful colleague keeps a supply of tissues, Band-Aids, headache and pain medication, candy and general munchies at his desk. Often there is a colored rubber stress ball atop the desk, and folks stop by to knead and squeeze in a deadline crunch.

Such helpfulness quickly becomes known throughout the workplace. And that is the problem: Nearly everyone who comes by for a tissue or aspirin is sick and may leave germs behind. It is better, health officials said, to keep your own tissues, wound care, drugs and jelly beans secured in your own space.

Conquering Phobias

Public health officials say some precautions also are in line at the doctor's office, where many of the people in the waiting room are sick.

Janse offers some specific suggestions in her book.

Don't drink from the water fountains at medical offices. Try to prevent children from crawling, playing and rolling on the floor. After you've failed, change their clothes when you get home.

Whenever possible, make morning appointments or try to be the first one there when the office reopens after lunch. During the break in many offices, the rooms are freshly cleaned and sanitized.

Recently in the waiting room at the office where my daughter was to get an X-ray, I whispered a mandate to her not to touch the toys mounted on the wall. Boldly, she whispered back that she was not afraid of potential contamination. After all, it was gymnastics, not germs, that had broken her ankle.

Further injury was averted when I spied the huge container of sanitized wipes mounted on the wall beside the toys. She selected a toy. I wiped it down and handed it to her. There was peace and goodwill in the land.

What's the moral of this story? Do we have to be freaky about avoiding colds and flu?

"Certainly there are germs everywhere," said Civista hospital's Delligatti. "I guess you're going to have to figure out how crazy, alert or sensitized you want to be because, really, you could develop a phobia about it and never leave your house. I think you need to do what's reasonable."