Hand washing – still the cornerstone of infection prevention

Infections are scary to think about sometimes, especially when you see how they are portrayed in the news.  When one person gets an infection, others who come into contact with them get worried that they may get it too, and they certainly can.  However the risk can be greatly reduced by the simple act of washing or sanitizing hands.

1.  I got onto a crowded subway train In NYC one day.  The first thing that struck me was a man eating chicken with his bare hands.  The train was full so he was standing and intermittently had to hold onto the bar so he wouldn’t fall when the train made sudden moves.  But the thing was, he would pick up the chicken to eat, lick the chicken juices off his fingers, then hold onto the same bar with the soiled hand; that process was repeated over and over until he finished his meal.  Imagine, that bar would not have been cleaned for hours if at all.  In addition to him possibly infecting himself from germs originally on the bar, new germs brewing in remnants of  that chicken meal, potentially E. coli, Salmonella, etc, or germs from the  man’s mouth such as herpes or influenza, could potentially multiply on that bar during off-peak travel times when the train isn’t full enough for hands to repeatedly ‘wipe it clean.’ Then when peak travel time comes around again a few hours later, there is a nice load of bacteria or viruses to contaminate the hand of an unsuspecting person.  If that person has the habit of traveling with hand sanitizer and using it on stepping off the train, then he or she would probably be fine.  If that person is not cognizant of the need to sanitize and puts their hand in their mouth of rubs their eye with a contaminated finger, they can potentially come down with gastroenteritis, or maybe the flu, for example.

2.  I was waiting to use a public restroom in a bookstore one day and an elderly woman came out of one of the stalls.  She was a bit unsteady on her feet and I could tell she was just focusing on making it back to her family outside.  She bypassed the sinks, turned the knob for the door and let herself outside.  Most of us wash our hands when we are finished with the rest room but not all of us use a piece tissue to open the door when we leave, or, sanitize our hands after exiting the restroom.  If that lady’s hands got contaminated with something like stool, then she would have contaminated the door knob and someone’s hand would then get secondarily contaminated and they could go on to get an infection if they put their hand in their mouth, rubbed their eye, or infect someone else such as their baby.

 3.  I was working in a clinic in Jamaica several years ago when there was a bad outbreak of conjunctivitis (red eye/pink eye).  Just about all the clinic staff came down with this highly contagious viral infection of the eye and there were numerous patients coming in daily to be treated for the same thing.  The staff kept telling me, “doc, you are next!” but I made a bet with them that I would not get the infection.  I kept a big bottle of hand sanitizer in my office and used it liberally.  Every time I went from room to room, I used tissue to hold and open the door knobs.  I made a conscious effort not to touch anywhere on my face, particularly my eyes and mouth.  The outbreak passed and I remained infection free.

4.  Last year we had a pretty bad flu season, particularly because the Influenza vaccine was not a very good match.  That is, it was not very effective so quite a few vaccinated people came down with the infection and were sick enough to be admitted to hospital.  I have had the flu a couple times in the past and it definitely is not something I wish to get again. I am even more careful about sanitizing my hands around flu season (even though I get the vaccine also).  I remember walking into a bank last season and the teller was coughing quite a bit, but the thing was, she was coughing into her hands! (I guess she didn’t learn cough etiquette, i.e., cough into your armpit).  After a bout of coughing she looked at me and asked for my card.  I kindly asked her to sanitize her hands first (she had a big bottle of sanitizer next to her) because I didn’t want to chance getting sick.  She was a little perturbed, saying “Im not sick, I don’t have the flu” but I just had to get the message across to her.  Hopefully she will think to use the sanitizer more in the future and protect others as well as herself.

I use these examples to illustrate just how easy it is to pick up disease carrying germs.  The simple habit of sanitizing can prevent much illness, loss of time from work, and general inconvenience.  I encourage everyone  to carry sanitizer around, in your bag, in your car, in your office.  When you leave the supermarket and get into your car, sanitize your hands.  When you leave the movie theater, sanitize.  When you leave the hospital after visiting a loved one, sanitize.   It is still the first line against infection prevention.