Tag Archives: bacteria

The Top 5 Places to Catch the Flu

Here we are just into the opening weeks of a new year, and influenza is well into its annual assault on America. Germs aren’t hard to find this season, but where they hide might surprise you.

At the Office
We spend more than a third of our lives at the workplace. This tops our list for flu exposure. Depending on the layout of where you work, you may find yourself uncomfortably close to a sneezing, sputtering coworker. Perhaps you share a telephone with several others. Breath is heavy with moisture and creates a nice warm place for bacteria and viruses to multiply in the telephone mouthpiece. So you may be sharing more that simply a telephone.

Keyboards also get pretty germy. Our fingers are moist and a bit oily, and leave a film on the keyboard surface. This is a perfect place to grow germs. Keyboard use is a good way to both leave and pick up germs. One study found more germs on a keyboard than a toilet handle. Where is that can of Lysol?

How about that break area at the workplace. Which refrigerator gets cleaned more often, the one at home, or the one at work? Washing coffee mugs at work usually takes a quarter of the time and half the amount of soap that the same mug would get at home. Not surprisingly, they don’t get too clean and can be a source of influenza germs. Has that sponge in the break room been replaced since the company opened? Old sponges smell bad for a reason. Old magazines in the break room have been read by generations of people, few of which wash their hands. Put those same magazines in a doctor’s waiting room, and they get to heroic levels of germs rather quickly. Magazines don’t do too well in the washing machine.

DSC_3958photo © 2005 Michael | more info (via: Wylio)

At Home
We all try pretty hard to not leave used tissues lying around the house – these are the hand grenades of the germ world. Germs are sneaky and inventive in their hiding places. The remote control gets handled by many greasy hands – chips and TV anyone? The kitchen at home is cleaner than the one at work but still contains more germs than the bathroom. When is the last time you cleaned the cabinet door to the kitchen waste basket? How about the refrigerator handle? Care to guess how many germs get tracked in on your shoes from the outside?

On the Go
Start with your own car. Rarely do we risk an accident by sanitizing the steering wheel after a good sneeze. Anyone else drive your car? Public transportation in its many forms also serves as a germ reservoir. From elevators and escalators to city buses, large numbers of often sick people pass though, leaving more than a footprint. Who last pushed that elevator button? Who last used the hand rails? I need to take a break and wash my hands.

Airplanes are particularly worrisome as far as influenza virus is concerned. The air in a commercial jet is re-circulated, perhaps better put, recycled. A couple hundred people are shoulder-to-shoulder and breathing the same recycled air. The air is filtered but lots of interesting germs can be cultured right off the filter. There is not enough space to separate you from the germ factory sitting next to you, and it’s always next to you, isn’t it? The aircraft bathroom holds the record for the “germiest” of public bathrooms – all of the usual sources of germs in one-tenth the space. The interesting roaring sound the aircraft toilet makes actually can put colonic bacteria (ecoli) into the air for all to breathe.

Your Retail Life
At least they have figured out shopping cart handles and placed disinfectant wipes close by. You might wipe more than just the handle, as the last user could have had a sick child in the cart seat.

Credit Cardsphoto © 2008 Andres Rueda | more info (via: Wylio)

Everybody knows money is dirty, but credit cards get handled a lot more and are never cleaned. How about the keypad in the grocery line with the credit card swiper? None are cleaned on any kind of regular schedule.

The gas pump handle also sees a lot of hand traffic but no cleaning.

Finally, your cell phone is not always your best friend. Pass it to friends to make a call, show a picture or share a Facebook comment – lots of hands, no cleaning.

Although it seems tempting, I don’t recommend you actually live your life in a bunny suit. Your immune system is designed to help you survive the various insults. You can give it a big help with a yearly flu shot.

Be well,

Dr. B

Combating Household Germs

Do you know your kitchen sink may be as dirty as your toilet bowel?

The kitchen sinkphoto © 2009 Alan Cleaver | more info (via: Wylio)

Given the amount of use, high traffic of organic material and moisture with relatively warm temperatures, the kitchen sink is a perfect breeding ground for many germs. Most people forget to sanitize their kitchen sink and don’t appreciate the potential bacterial source it is for contaminating food, utensils and hands. Many household areas where there is high traffic and surfaces that are touched frequently by family members can be potential sources of germs and contaminants. Most of these high traffic areas are taken for granted or cleaned only occasionally, but rarely sanitized.

The kitchen is not the only source but remains the single biggest reservoir of germs in the house. This is the area that gets a lot of traffic from adults, children, animals, and dirty and decaying food. As an area that is so intimate to our daily lives, it is easy to see how we can contaminate ourselves with germs in this room.

Kitchen towels and sponges are also very contaminated objects that easily transmit contaminants to hands and other surfaces. A dirty or musty sponge is used on most surfaces without a thought to how it is likely transporting and spreading germs. The towel that is used on your hands or counters to mop up spills also harbors germs. Also, don’t let dirty dishes stay in the sink overnight breeding germs. If your kitchen is as busy as most, the sink and countertops should be sanitized once a week or more often.

Commercially available products can be convenient for this purpose. Economical solutions of ¾ of a cup of bleach to one gallon water can be used on a cloth or in an inexpensive spray bottle on most counters or sinks.

• It is important to remove any food particles or organic material before this is done. Then let air dry.
• Cleaning cutting boards as well with a sanitizing solution is also important – just wash, rinse and allow to air dry.
• Towels should be cleaned and rotated frequently. They could be replaced entirely with a paper towel.
• A sponge can be sanitized in the microwave for 30 to 60 seconds. A well used sponge should also be replaced every 2 weeks.
• Hand washing is still an important part of good hygiene during food preparation.
• Plastic garbage can liners can help control spills and leakage from the trash collection.
• One last spot in the kitchen/dining area that is often overlooked is the salt and pepper shaker. Handled frequently by many people and never cleaned, they can harbor illness producing bacteria and viruses, so don’t forget to sanitize these as well.

The bathroom is another culprit when it comes to germs; however, the locations of the germs are again often overlooked. Toothbrushes easily harbor germs because of the moisture and usage. They should be located where they are not close to the toilet and where they air dry after each use. A single toilet flush can send a fine spray of mist several feet contaminating other areas of the bathroom.

bathroom paintedphoto © 2006 cara fealy choate | more info (via: Wylio)

• Since most bathrooms are quite compact, closing the lid before flushing will help.
• Storing personal hygiene products, towels and toothbrushes away from the toilet is prudent.
• A new toothbrush should be used every 2-3 months.
• If you have recently been sick, you may want to switch to a new toothbrush sooner.
• Toothbrushes can only be rinsed thoroughly with water and allowed to air dry completely.
• Areas of caulking between sinks, counters or tubs, and enclosures commonly accumulate high bacterial and mold counts due to their intrinsic traffic, chronic moisture and difficulty cleaning. Applying the same techniques of cleaning as in the kitchen with focus on the problem areas is necessary.

Other areas in the house that can be a problem are door knobs, computer keyboards and remote controls. They all get a lot of traffic from contaminated hands. Actually the amount of germs here are less than some of the previously mentioned areas. Nonetheless, a periodic wipe with a disinfectant like alcohol, bleach solution or one of the commercially available products for disinfectant cleaning is very smart. Also, change bed linens and rotate towels weekly.

Still, the most important and basic technique is covering a cough or sneeze and regular hand washing. Hand washing after using the bathroom or cleaning these areas, before food preparation or eating, is still the gold standard for prevention. Hand sanitizers can be useful in areas of the house where water is not available; however, 15-20 seconds of simply rubbing your hands thoroughly with soap and water is something that germs can’t beat.

– Dr. Bruce Kaler

Rusty Nails, Dirty Wounds and Tetanus

This morning I heard a newscaster lament, “I was cut with rusty metal, and there is a national shortage of tetanus vaccine.”

Despite his concerns, this is not exactly certain death. Growing up in Southern California, I spent most of my youth barefoot, tangled with more than a few rusty nails and was on the tetanus-shot-a-year plan. This experience prompted an interest in the whole rusty nail tetanus connection.

What about rusty nails and tetanus? Tetanus is actually caused by a germ, not by rust. This germ is in spore form and lives in the dirt. The technical name is clostridia tetani. Clostridia is a bad family of bugs; its relatives cause botulism and gas gangrene. Pretty unpleasant stuff.

Nailedphoto © 2005 Scott Robinson | more info (via: Wylio)
Rust is the oxidation product of iron. Oxidation is a form of chemical burning. You are familiar with this – this is what chlorine does to your swimming pool. It oxidizes germs, meaning it kills them. Rust is not infectious for anything, including tetanus. Yes, I said rust does not cause tetanus, and reading in the dark won’t ruin your eyes. So much for medical myths.

The concern is getting dirt in the wound, which may contain clostridia tetani spores. If these spores find a friendly environment in your wound, you can get tetanus. These spores don’t like a lot of oxygen, so wounds that have a lot of dead tissue, like road rash, are perfect for growing clostridia tetani. These spores also like wounds in the foot because the foot is a long way from the heart, so it doesn’t have the best blood flow.

There is the rusty nail connection. The nail was lying in the dirt, thus the rust. When you stepped on it, some dirt may have been pushed into the hole in your foot. Dirt in a foot wound is a good set up for tetanus. You could get tetanus from a plastic nail as long as dirt got into the wound.

If you get a few clostridia tetani spores in your wound and the conditions are just right, they will try to grow. If they succeed in growing, they will release a toxin that paralyzes your muscles. The lock-jaw will be the least of your problems; the lock-diaphragm stops your breathing. If you have had a tetanus shot recently, you have high levels of immunity that can kill these germs before they cause trouble. If you haven’t had a tetanus shot in 5 or 10 years, we give you a tetanus shot (usually TDap) and remind your immune system to get going. Once you have had a couple of tetanus shots, you can mount an immune response in a hurry when given a tetanus booster. Your body can actually make this protection faster than the clostridia spores can grow, so you’re safe.

syringephoto © 2006 connyx / crucify | more info (via: Wylio)

A tetanus shot (TDap) gives you great immunity for 5 years. Even in the presence of a dirty wound containing clostridia tetani, you are safe from tetanus.

For five to 10 years after a tetanus shot, you have partial immunity to tetanus, but it would be a race between the clostridia growing and your immune system fighting it. If the wound is clean, you don’t need a tetanus shot, as there is little or no risk of tetanus. If it is dirty (literally containing dirt), we will give you a tetanus shot, just to be safe.

The most common wound that is the source of tetanus in the U.S. is rose thorn wounds. You are gardening, so you have dirty hands, a rose thorn pokes you, and what self-respecting gardener worries about a rose thorn prick? You don’t even wash your hands. You just keep gardening. Perhaps not too surprising this can be the source of tetanus.

So get a tetanus shot (TDap) every decade or sooner for dirty wounds. Remember to promptly use soap and water to get any visible dirt out of a wound, even minor wounds. Gardeners especially – stay up on your tetanus immunizations.

Stay well,

Dr. B

Can Your iPhone, Droid or Touchscreen Device Transmit the Flu?

According to British researchers, mobile phones harbor 18 times more bacteria than a flush handle in a typical men’s restroom.

And Stanford University research suggests that the risks of transmitting pathogens from glass surfaces to a person’s skin are relatively high. Especially considering that 30 percent of the virus or germ will get on your fingertip when you touch the infected screen.

Since we were little, our mothers admonished us to wash our hands and cover our mouths when we sneezed – pretty good advice in this germy world; however, we received that guidance before anyone had ever heard of a touchscreen device.

But just how are infectious diseases passed from person to person?

People with upper respiratory infections sneeze and cough, blow and snort – spreading germs all over the place. These germs can live on surfaces, sometimes for hours or even days, just waiting for someone to touch them and rub their nose. The fancy word for this is autoinoculation, meaning you gave yourself the disease.

Washing your hands before eating is a good start, but I would take it a step further and wash your hands before you touch your face – always.

What about that smartphone on your hip – the one with the touchscreen?

If you are like me, you pick it up whenever it rings and put it to your mouth. I can almost hear my mom saying, “You don’t know where that cell phone has been!” You also pass it around freely to share the latest music, video or photo.

But when is the last time you disinfected your phone? Do you even think of it as an object capable of transmitting respiratory germs? How would we even go about doing germ warfare with your smartphone?

Clearly, boiling your phone is a really bad idea. I have personally tried the immersion technique – in a lake and in a toilet (two different phones … I’m not stupid), with identical results. In the medical world, we autoclave instruments to make them sterile, a kind of a steam pressure cooking. I haven’t yet tested that method, but I expect it would be a variation on the drowned phone phenomena.

Operating rooms use ethylene chloride gas sterilization to kill germs on sensitive electronic equipment. This would probably work well on the average smartphone, but it is a rather expensive and cumbersome technology for personal cell phone cleaning. Maybe this is a business opportunity for someone: set up ethylene chloride sterilizing equipment in a truck and sterilize cell phones for five bucks a piece. Franchise anyone?

But let’s be practical.

We can be a little bit low tech here and still get most of the bad germs off the touchscreen. There are a number of germicidal wipes available at drug or grocery stores. You can even grab one when you get your grocery cart. Take one that is moist, not dripping wet, and wipe off the screen of your touchscreen device periodically. It’s as easy as that.

Most wintertime respiratory infections are the result of us touching germy surfaces and then touching our face. The germy surface can be the counter, the grocery store cart or even your cell phone. Get in the habit of washing your hands before you touch your face, and give your cell phone the occasional swipe.

Stay well,

Dr B.

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Carbuncles, Furuncles and Boils – Oh My! Fighting Infections of the Skin

Red, swollen, itchy and painful skin.

It irks us and causes us to worry about our health, our appearance and our environment. We question: Did I hit myself? Am I allergic to something? Did something bite me?

We hear on the news that there are flesh-eating bacteria and killer boils. Our neighbor is in the hospital for an infection – should we worry?

Relax. Our skin is the largest organ in our body and is well-suited to the task of keeping bacteria where it belongs – outside of our body.

We’re constantly in contact with bacteria. Some bacteria even live on our skin full time. Strep and staph species are the most common organisms. Also common are a variety of fungi that enjoy the warm, moist folds of our body. When there is balance, these hitchhikers cause no problems.

But when we have high bacterial counts on the skin, get cut, get stressed, are sick for another reason, scratch at a bug bite, pick at a pimple, stay in a wet bathing suit too long or use a lot of sticky lotions on our skin, the balance can shift and infection may result.

Most of the infections that occur as a result of these imbalances are caused by the usual culprits – yes, those hitchhikers – strep and staph. They burrow into cuts, scratches, bites, burns, hair roots and other places that you cannot even see, and they multiply like crazy! The skin inflames trying to get rid of the bacteria – it swells and gets red and hot, trying to stop the infection. Most of the time in a few days, it goes away. Sometimes you need to see a physician for antibiotics, and occasionally hospitalization is necessary to completely get rid of the infection.

With all of this scary stuff out there, how can we help the skin do a better job protecting us?

Unfortunately, there is no medication or injection that we can take to get rid of the bacteria on our body. Even if we are exposed to someone with a skin disease, there is no scientific evidence that taking a pill will prevent us from getting the same disease.

Prevention of skin infections requires a more conscious and active approach on our parts. Remember, you are exposed to bacteria everywhere in your life from the cup you are drinking from to your keyboard. Healthcare professionals and public servants should also be aware of weapons, badges, belts, uniforms, notepads and stethoscopes.

What can you do to help?

1. Stay healthy. Eat right, rest, exercise, avoid tobacco, use alcohol in moderation. Keep chronic illnesses like diabetes under control.
2. Use hand sanitizer liberally.
3. Wash your hands with soap often.
4. Wipe down phones, desktops, keyboards, stethoscopes, pens and other accessories regularly with sanitizer wipes.
5. Change clothes at work or as soon as you get home to avoid contamination of the household.
6. Bacteria can get trapped on the skin by oils and clothing. Avoid soaps and body washes that have moisturizers.
7. Change loofah-type sponges often to avoid trapped bacteria. If your skin gets dry, use a moisturizer after you shower only on the areas that need it.

Do all that you can, and if you have a red, angry skin lesion that worries you, do not hesitate to let a physician evaluate you. We are happy to help.

— Debra Cooper, DO, Managing Physician for U.S. HealthWorks

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The Incredible, In-Edible Egg?

Eggs are back in the headlines this week. For a change, we’re not discussing their health benefits (the Atkins folks like them) or their heart risks (too much cholesterol). This week, we’re not really talking eggs at all. We’re discussing a small bacterium that is hitchhiking on some eggs – salmonella.

Salmonella is the unwanted guest of some Midwest industrial egg producer, and the FDA is pretty upset about this. You might be too.

Salmonella is a bug, or more properly a bacterium. It is one of many microscopic organisms that can cause illness in humans.

Salmonella is not always a problem. There are people walking around right now with salmonella bacteria in their colons, perhaps as many as 25% of us. These people are not sick, and do not have diarrhea. It all depends on the dose. A few salmonella living peacefully in your colon is fine, but let them be the majority organism and diarrhea will soon follow.

Salmonella enters the body by eating food contaminated with live salmonella bacteria. Like everything we eat, it is chewed and dropped into an acid vat (your stomach). This acid bath kills most bacteria, including salmonella, by the time the partially digested food leaves the stomach. Like I said, it is all a matter of dose. Eat something with heavy salmonella contamination, and enough will survive your stomach to make it into your colon. There, they will rapidly multiply and a rather nasty case of diarrhea will occur. Since this is from an active infection in the colon, the diarrhea often contains blood and puss.

In adults this is a very uncomfortable disease but not a deadly one. Most adults beat salmonella with a brief course of oral antibiotics and fluid replacement, like your favorite sports drink. Adults usually recover rapidly.

Like so many other illnesses, salmonella hits young children and the immuno-compromised much harder. They sometimes need hospitalization for hydration and treatment.

Avoiding salmonella sounds like advice from a food handler’s course. It is commonly present on raw chicken as well as eggs. Never eat chicken raw, or use a utensil used on raw chicken without first washing it. All those restaurants’ menus with warnings against eating undercooked meat or fish are not just conversational. They are meant to help you avoid salmonella. Meat has to get to 140 degrees for 30 minutes to kill salmonella. Cool, red centers in steaks do not do the job.

In the meantime, I’m not putting raw eggs in my smoothies for awhile.

Take care,
Dr. B

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