Keeping Clean to Help Prevent Spread of Disease

Doctors discuss the importance of handwashing and how to properly wash your hands to prevent the spread of disease and infection. Video by Elaine McMillion/The Washington Post
By Marilyn D'Angelo
Washington Post Staff Writer
Friday, July 24, 2009; 12:05 PM

Mother knew best when she told you to wash your hands before every meal and after you go to the bathroom. These days, following habits like those could be the deciding factor in maintaining your health. With the world still abuzz from the swine flu outbreak and E. coli-infected cookie dough, hand washing is an even more integral part in preventing the spread of many infectious diseases and viruses that can be passed on through a gesture as simple as a handshake.

Washing your hands properly with soap and water can drastically reduce germs that host diseases and viruses. "It's a good idea to sing 'row, row, row your boat' [while doing it] -- it really takes 15-20 seconds," said Marcia Patrick, a nurse and Director of Infection Prevention and Control for MultiCare Health System in Tacoma, Washington. "It's that mechanical removal and that's why you can't do it in 7 seconds."

Some colleges have also taken an initiative in spreading this message. James Welsh, Georgetown University's assistant vice president for student health services and chair of the Department of Family Medicine has done his best to keep the campus "sensitized to hand washing." Though Georgetown has had four students diagnosed with the H1N1 virus, their public health campaign has kept the spread of swine flu to a minimum. There are nearly 100 hand sanitizer dispensers on campus in many common areas, like the student center, cafeteria, and restrooms as well as some not so common places.

"We have some attached to trees and bus stop poles. It's a constant reminder that hand washing is extremely important," said Welsh. "Everyone is concerned in the fall and the early winter we may see possibly higher rates of influenza. I sure hope we get a [swine flu] vaccine, but until then these are the tools we have."

When soap and water are not available, Patrick supports the use of hand sanitizer instead. "Think about what we do every day. We go to the drive-thru and we don't have a sink in our car. I gel my hands before I start eating my lunch."

The FDA recommends an alcohol based sanitizer with a 60 to 95 percent ethanol or isopropanol concentration. Antimicrobial hand sanitizers are not effective in reducing bacterial counts on hands. According to a 2006 report from the Emerging Infectious Diseases Journal, "hand sanitizers were effective in reducing gastrointestinal illnesses in households, in curbing absentee rates in elementary schools and in reducing illnesses in university dormitories."

Domininon Virginia Power, based in Richmond, Va., like many other businesses, is responding to H1N1, by distributing posters and setting up a Web site for their employees to keep them updated on developments and provide tips, such as flu hygiene reminders, said Karl R. Neddenien, a spokesperson for Dominion Virginia Power.

"The tips include a specific suggestion for keeping alcohol-based hand cleanser nearby and using it often," he said. Washing hands often, coughing into the crook of your arm and even avoiding shaking hands. "Things we all know, but it pays to be reminded about."

They also have liquid hand sanitizer in all of their common work areas in each of their offices in Virginia, North Carolina, Connecticut, Pennsylvania and Ohio.

Washing and sanitizing hands may also prevent illnesses obtained from handling raw or uncooked food, or cooking with utensils that have touched contaminated food. Bacteria like E. coli has recently caused outbreaks associated with meat and spinach. The most recent contamination was found in Nestle raw cookie dough. E. coli is known to cause severe stomach cramps, diarrhea, and vomiting. It can be obtained by eating or handling food with the bacteria. Washing your hands is the first step in protecting yourself from contracting E. coli, or spreading it to other people and throughout your kitchen.

"There are several things people can do in their kitchens to protect themselves," said Patrick. "Assume that all chicken has salmonella, all ground beef has E. coli." Make sure you cut all the veggies first and wash all your surfaces after handling raw meats.

Patrick recommends using a plastic cutting board over the wooden ones for easy sanitization. "With steak, I never use a fork, only a spatula," said Patrick. "If there's surface contamination on the steak, poking it with a fork would drive it into the center of the steak that may not be quite as hot." Making sure to change utensils when switching between raw and cooked foods is also important in keeping the spread of disease down in the kitchen.

When cleaning up, Patrick recommends cleaning cutting boards with hot soapy water and using a bleach solution of one part bleach to nine parts water. "You can use that anywhere, but it's not a cleaner, it's a disinfectant. It's cheap, it's readily available, but it needs to be mixed fresh daily," she said.

There have also been efforts by the federal government to create new standards in food safety and awareness. The Food and Drug Administration is developing new industry guidelines to improve protections for leafy greens, melons, and tomatoes. The Department of Health and Human Services has also recently begun working with the Food Safety Working Group to implement these upgrades. These changes may not reach consumers for months, but people can be more diligent about washing their hands today.

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