6 Common Viruses and How You Can Avoid Spreading Them Plus, find out how long you could be contagious with each one

With cold and flu season fast approaching, there’s no doubt that you’ll be extra thorough in your efforts to protect yourself from germs and viruses this year. Before COVID-19, did you ever think about how long you could be contagious after catching a cold or having bronchitis, strep throat or the flu? If not, the answers just might surprise you.

As you’re being extra cautious to avoid catching or spreading the coronavirus, keep these helpful guidelines from family medicine physician Matthew J. Goldman, MD in mind so you don’t pass the following common illnesses on to others.

Are you contagious or not?

Common Cold

When are you probably the most contagious? Within the first 48-72 hours.

How long could you be contagious with a cold? Up to 2 weeks.

How does a common cold spread? Hand contact or droplets in the air.

How do you avoid infecting others? Cough/sneeze into your elbow and not your hands.
Stay home until symptoms improve and your fever resolves.

Hand hygiene: Clean your hands often with soap and water/alcohol-based hand sanitizers.

Flu

When are you probably the most contagious? Within the first 48 hours.

How long could you be contagious with the flu? Up to 10 days.

How does the flu spread? Coughing/sneezing (sends large amounts of flu virus into air).

How do you avoid infecting others? Stay on top of hand hygiene.
Cough or sneeze into your elbow and not your hands.
Stay home until symptoms improve and fever resolves.

Hand hygiene: Clean your hands often with soap and water/alcohol-based hand sanitizers.

Sore Throat/Strep

When are you probably the most contagious? Within the first 48-72 hours.

How long could you be contagious with a sore throat or strep? Three to four weeks if left untreated. You could be contagious with strep 24 to 48 hours after you start antibiotics.

How does a sore throat or strep spread? Saliva or nasal mucus/discharge (especially strep).

How do you avoid infecting others?
Avoid close contact with others.
Don’t share utensils or drinks.

Extra hand hygiene: Wash your hands with plain soap and water for 20-30 seconds; scrub your nails, wrists and between your fingers. Rinse thoroughly.

Bronchitis

When are you probably the most contagious? Within the first 48-72 hours.

How long could you be contagious with bronchitis? Up to 3 weeks.

How does bronchitis spread? Through droplets in the air and contaminated surfaces.

How can you avoid infecting others?
Be sure to step up your hand hygiene.
Promptly discard used tissue and wash your hands.
Get tested for the flu.

Extra hand hygiene: Wash your hands with plain soap and water for 20 to 30 seconds; scrub your nails, wrists and between your fingers. Rinse your hands thoroughly.

Pneumonia

When are you probably the most contagious? Within the first 48-72 hours.

How long could you be contagious with pneumonia? Up to three weeks.

How does pneumonia spread? Coughing or sneezing (you can infect anyone within 6 feet).

How can you avoid infecting others?
Extra hand hygiene.
Wash your hands before making meals.
Promptly discard used tissue and wash your hands.
Environmental cleaning.

Environmental cleaning: Frequently disinfect surfaces where infected droplets can collect.

Stomach Virus

When are you probably the most contagious? Within the first 24-48 hours.

How long could you be contagious with a stomach virus? It varies. Wait 48-72 hours after your symptoms resolve to return to school or work.

How does a stomach virus spread? Sharing food or utensils, contaminated surfaces or close contact.

How can you avoid infecting others?
Extra hand hygiene.
Environmental cleaning.
Avoid close contact with others.

Environmental cleaning: Frequently disinfect surfaces where infected droplets can collect.

Publihed September 3, 2020
By Clevelandclinic
https://health.clevelandclinic.org

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Study: Regular Handwashing Reduces Personal Risk of Acquiring Seasonal Coronavirus Infection

In a new study looking at 1,633 participants of the England-wide Flu Watch project, a team of researchers found that moderate-frequency handwashing (6-10 times per day) was associated with a reduced overall risk of seasonal coronavirus infection.

The expanding global outbreak of COVID-19 demands an evidence-based public health response.

Seasonal human coronavirus strains (NL63, OC43, 229E, and HKU1) as well as SARS-CoV-2, a novel coronavirus that causes the COVID-19 disease, appear to be transmitted via droplets, direct and indirect contact with infected secretions and, to an unknown extent by aerosol.

Hand hygiene measures are recommended by health authorities and public health experts worldwide to interrupt these transmission mechanisms by preventing viral transfer via contact with infected people and surfaces.

While hand hygiene recommendations are acceptable in a variety of community settings worldwide and are widely recommended by health authorities, evaluation of their effects on the risk of illness in the general population is limited.

“It’s important to highlight that frequency of handwashing is only one aspect of hand hygiene,” said first author Sarah Beale, a researcher in the Public Health Data Science Research Group of the Institute of Health Informatics at University College London (UCL) and the UCL Institute of Epidemiology and Health Care.

“We also know that both longer duration of handwashing and the context of handwashing e.g. upon returning home or before eating — have been associated with lower overall risk of influenza or influenza-like-illness.”

“Good hand hygiene should be practiced at all times regardless of whether you show symptoms or not. This will help protect yourself and prevent unwittingly spreading the virus to others around you.”

For the study, Beale and colleagues used data from three successive winter cohorts (2006 to 2009) of the Flu Watch study, a national household-level prospective cohort study investigating transmission, burden and risk factors associated with influenza and other acute respiratory infections across England.

The majority of participants (almost 80%) were adults over sixteen years of age. They provided baseline estimates of hand hygiene behavior. Coronavirus infections were identified from nasal swabs using RT-PCR.

To assess overall handwashing frequency, participants were asked at baseline of each season to ‘Estimate how many times you washed your hands yesterday.’

Frequency of daily handwashing was subsequently categorized as low (≤5 times daily), moderate (6–10 times daily), or high (>10 times daily) guided by literature around influenza-like illness in Western community settings.

The outcome of interest was whether participants contracted any PCR-confirmed coronavirus infection in a season.

Detected coronavirus strains (NL63, OC43, and 229E) were combined into a binary outcome (yes/no coronavirus) as the effect of hand hygiene is believed to be consistent across these strains.

Moderate-frequency handwashing was associated with significantly reduced overall risk of contracting coronavirus (36% reduction in the risk of infection compared to those who washed their hands 0-5 times per day).

For higher intensity handwashing there was no significant dose-response effect.

“Something as simple as washing our hands regularly can help us to keep the infection rate low and reduce transmissions,” said senior author Ellen Fragaszy, a researcher in the Public Health Data Science Research Group at the UCL Institute of Health Informatics and the Department of Infectious Disease Epidemiology at London School of Hygiene & Tropical Medicine.

“Given that COVID-19 appears to demonstrate similar transmission mechanisms to seasonal coronaviruses, these findings support clear public health messaging around the protective effects of handwashing during the pandemic,” Beale added.

The findings appear in the journal Wellcome Open Research.

Published May 25, 2020 by News Staff
http://www.sci-news.com

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Which Works Best Against Covid-19: Clean Hands Or Face Masks?

To stop the spread of Coronavirus, the public needs to carry out several physical interventions at the same time. And while the media focuses on the culture war over wearing face masks, we must not forget another intervention that science suggests may be even more important than a mask: clean hands.

Hand hygiene is central to stopping Covid-19 from spreading by contact transmission, which occurs via routes such as touching a contaminated surface and then your face. Since around 1850, when microbiologists began developing the modern germ theory of disease and doctors started washing their hands, we’ve know that practicing proper hygiene helps prevent microbes from transmitting infectious diseases from one person to another.

But while there’s plenty of research on how good hygiene blocks the spread of respiratory viruses generally, there’s relatively little knowledge of how well it works against the SARS-CoV-2 coronavirus specifically.

As a consequence, recommendations from authorities like the World Health Organization and Centres for Disease Control are mainly based on extrapolating from other viruses with a similar structure, especially a fatty envelope that surrounds certain viruses. That envelope is studded with the proteins used to break into cells, and the logic goes that if an intervention is effective against another ‘enveloped virus’ — influenza, say — then the same should apply to novel coronaviruses.

There are hundreds of studies on interventions that might interrupt or reduce the spread of respiratory viruses, but their results sometimes contradict each other. And when there’s no agreement, scientists will perform a systematic review and collect all the available research in order to analyse the quality of work then reach a consensus. That’s what was done in the 2010 Cochrane review, led by the Centre for Evidence Based Medicine at Oxford University. Based on 67 studies, the reviewers found that hand hygiene helps stop the spread of viruses, particularly around young children — probably because kids are less hygienic.

The 2010 review wasn’t conclusive, however, as it didn’t identify enough studies that compared the intervention with a control. Such experiments allow reviewers to perform a ‘meta-analysis’ that combines data from multiple trials then offer a conclusion. An as-yet unpublished update to the Cochrane review achieved just that, combining 15 trials involving both adults and children. Those trials weren’t carried out in a lab, but took place in homes, offices and classrooms — real-world settings where infections are commonly transmitted.

According to the new review, hand hygiene led to a 16% drop in the number of participants with an acute respiratory illness (ARI) and 36% relative reduction in an associated outcome: people being absent from work or school. The reviewers concluded that “the modest evidence for reducing the burden of ARIs, and related absenteeism, justifies reinforcing the standard recommendation for hand hygiene measures to reduce the spread of respiratory viruses.”

Although the 2020 review confirms the intervention’s efficacy in limiting viral transmission, it’s not specific to Coronavirus. A direct link to SARS-CoV-2 is supported by one study from a Covid-19 hospital in Wuhan, China, however: from a statistical analysis of several risk factors associated with transmitting the virus, researchers found that poor hand hygiene was a major factor, raising the relative risk of infection by around 3%.

The Chinese study also revealed that the higher Covid-19 risk remained even when healthcare workers wore full personal protective equipment (PPE), which suggests that hand hygiene is more important than wearing a face mask. The 2020 review also didn’t find much added benefit to wearing a mask along with good hygiene.

Anti-maskers might interpret such findings to mean that masks are worthless, but that would be wrong because the variation in results among studies was too large to draw any strong conclusions. Masks probably do help block viral transmission, but we won’t know exactly how effective they are until we have more data.

Employing only a single intervention — such as masks or handwashing — allows an infectious disease to spread because not everyone will follow the recommended guidelines and so infected people slip through the ‘holes’ in that intervention. When multiple interventions are used simultaneously, however, it’s like stacking several slices of Swiss cheese: the more slices you add, the less likely it is that two holes will overlap and let the disease pass every intervention.

While this ‘Swiss cheese model’ has traditionally been used in medical error reduction, it’s relevant to reducing Covid-19 transmission. Regardless of the relative importance of various interventions, we should employ several strategies to stop the spread of Coronavirus.

By JV Chamary
Published


Water & Sanitation This WHO-UNICEF Initiative Is Fighting so Everyone Can Wash Their Hands Against COVID-19

Nearly half of the world population can’t wash their hands at home.

Why Global Citizens Should Care

COVID-19 has been called an equaliser, because it doesn’t discriminate based on race, gender, geography, sexuality or religion. Yet, in the months since the World Health Organisation declared coronavirus a pandemic, it’s become increasingly evident that people from marginalised communities and poor countries bear the brunt of the virus due to lack of access to resources, like water and sanitation. You can join us here to take actions to help mitigate the impact of COVID-19 on the world’s most vulnerable communities.

It’s often been said that changing personal behaviour is vital in containing COVID-19: wearing a mask in public, maintaining social distance, and frequently washing hands with soap and clean water.

Yet for 3 billion people globally, access to hygiene is not as simple as turning on a tap, according to the United Nations Children’s Fund (UNICEF).

That’s 40% of the world population who cannot wash their hands with soap and water in their homes.

The majority are in sub-Saharan Africa, while children and people who live in informal settlements, refugee camps, or conflict areas are most affected by the continent’s lack of clean water and sanitation facilities.

The World Health Organisation (WHO) and UNICEF have recently launched a hand-washing initiative aimed at bringing attention to the plight of people who don’t have access to clean water and are, therefore, unable to protect themselves effectively from COVID-19.

“Hand hygiene has never been more critical, not only to combat COVID-19, but to prevent a range of other infections. Yet, nearly six months since the onset of the pandemic, the most vulnerable communities around the world continue to lack access to basic hand hygiene,” said the executive directors of UNICEF and WHO, Henrietta Fore and Dr. Tedros Adhanom Ghebreyesus, in a joint statement.

The statement added: “According to our [UNICEF and WHO] latest data, the majority of people in the least developed countries are at immediate risk of COVID-19 infection due to a lack of hand hygiene facilities.”

The statement said one billion people are at direct risk of contracting COVID-19 as a result of not having water and soap in their homes, and that almost half of then are children.

However, it’s not only homes that lack access to clean water, the statement added. “All too often, schools, clinics, hospitals and other public spaces also lack hand hygiene facilities, putting children, teachers, patients and health workers at risk. Globally, two in five in health care facilities do not have hand hygiene at points of care,” said the statement.

A report by World Vision revealed that nine out of 10 countries in the world with the worst access to water are African.

These include: Eritrea, where 81% of the population do not have clean drinking water. In Uganda, 61% of the population doesn’t have basic water services. The figures are 61% in Ethiopia, 60% in Somalia, 59% in Angola, 58% in the Democratic Republic of the Congo, 58% in Chad, 54% in Niger, and 53% in Mozambique.

“The COVID-19 pandemic has exposed an uncomfortable truth: too many people around the world simply cannot clean their hands,” said the statement.

UNICEF and WHO said they will be working through the initiative with other international partners, national governments, the public and private sectors, and community organisations to ensure that products and services are available and affordable, and to enable a culture of hygiene. This includes ensuring that handwashing stations are accessible, especially in disadvantaged areas and among marginalised communities.

“We must also ramp up investment in hygiene, water and sanitation, and in infection prevention and control,” said the statement. “We urge countries to scale up, systemise, and institutionalise hand hygiene and commit to strengthening the enabling environment, supply vital products and services, and to actively promote hygiene practices as part of a package of actions that save lives.”

You can join us to help mitigate the impact of COVID-19 on the world’s most vulnerable and marginalised communities by taking action here.

By Lerato Mogoatlhe
Published July 2, 2020
https://www.globalcitizen.org


Controlling COVID-19: hand hygiene must be accessible to all

UNICEF and the World Health Organization have launched the ‘Hand Hygiene for All’ joint initiative to help control the spread of COVID-19.

In a bid to control the spread of the novel COVID-19 infection the United Nations Children’s Fund (UNICEF) and the World Health Organization have launched a new join initiative ‘Hand Hygiene for All’ to help make hand hygiene accessible to all, including the least developed countries that have a lack of hygiene facilities.

Hand Hygiene for All

Henrietta Fore, Executive Director of UNICEF, and Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, made a statement on the launch of the initiative. “As the world struggles to cope with a new disease, one of the most effective tools to prevent its spread is also one of the most basic. Hand hygiene has never been more critical, not only to combat COVID-19, but to prevent a range of other infections. Yet, nearly six months since the onset of the pandemic, the most vulnerable communities around the world continue to lack access to basic hand hygiene.

“According to our latest data, the majority of people in the least developed countries are at immediate risk of COVID-19 infection due to a lack of hand hygiene facilities. In the 60 highest-risk countries, two out of three people – 1 billion people in total – lack basic handwashing facilities with soap and water at home. Around half are children.

“All too often, schools, clinics, hospitals and other public spaces also lack hand hygiene facilities, putting children, teachers, patients and health workers at risk. Globally, two in five healthcare facilities do not have hand hygiene at points of care. We cannot overstate the threat.

“Many of the those who lack access to basic handwashing live in overcrowded, desperately poor conditions. Even before the pandemic, children and families faced barriers to accessing health and hygiene services. Now the grave risk of COVID-19 threatens further suffering and spread of this deadly disease.

“If we are going to control COVID-19, we have to make hand hygiene accessible to all. That is why we are launching a new global initiative to move the world towards the same goal: supporting the most vulnerable communities with the means to protect their health and environment.

“We are joining our efforts with those of other international partners, national governments, public and private sectors, and civil society organisations to ensure affordable products and services are available, especially in disadvantaged areas, and to enable a culture of hygiene.

“Public health response plans and reopening plans should couple physical distancing and other control measures with hand hygiene and access to safe water and sanitation, and must reach the most vulnerable communities.

“Our teams are developing comprehensive country roadmaps and committing human and financial resources to support global and local implementation efforts. Task teams will facilitate learning and knowledge exchange, while multisector stakeholders will strengthen hygiene programming and monitor global progress. Leaders and community mobilisers will advise on strategies and advocate for their implementation. Only together can we achieve universal hand hygiene.

“We must also ramp up investment in hygiene, water and sanitation, and in infection prevention and control. We urge countries to scale up, systemise and institutionalise hand hygiene and commit to strengthening the enabling environment, supply vital products and services, and to actively promote hygiene practices as part of a package of actions that save lives.

“The COVID-19 pandemic has exposed an uncomfortable truth: too many people around the world simply cannot clean their hands. But we can help to reduce the spread, and we can prevent future infectious diseases from following a similar path. It starts by making sure everyone, everywhere has access to basic hand hygiene facilities with soap and clean water or alcohol-based products in homes, schools and healthcare facilities.”

 

Published


Why Americans are tiring of social distancing and hand-washing – 2 behavioral scientists explain

States are beginning to open up their economies after successfully slowing the spread of the coronavirus. Much of the credit for that goes to Americans dutifully following prescribed behavior.

People have been washing their hands frequently, maintaining physical distance from others, wearing face masks, sanitizing door knobs and even disinfecting food and packages brought into the house.

But in order to continue to contain the spread of the virus, we’ll still need to sustain these behaviors for weeks and maybe months to come. Will people be able to maintain their vigilance over time?

As scholars who study health-related behavior change, we’re skeptical. While continuing to wash your hands and stay six feet away from others doesn’t seem so hard for an individual, the problem is that people are unable to “see” the benefits of their actions – and thus often don’t recognize just how important they are.

As a result, adherence to these protective behaviors could wane over time without policies designed to sustain them.

Intangible benefits

It is, in fact, remarkable to us that efforts to promote hygiene measures have been as successful as they have been. That’s because they are almost the embodiment of the types of protective measures that people are especially bad at taking.

The most obvious reasons are that maintaining physical distances and constantly washing hands are inconvenient and require constant vigilance. The costs of these behaviors are immediate, but the benefits are delayed.

A more subtle and equally important reason, however, is that the benefits are intangible: You can’t touch, taste, feel or see the benefits of, for example, wiping off your door knob.

One reason the benefits are intangible is that people tend to be insensitive to even dramatic changes in probabilities – such as from one-in-a-thousand chance to one-in-a-million chance – when it comes to small probability events such as the chance of contracting coronavirus.

This is true unless the change in probability leads to certainty that the event will not occur, which is why people are not eager to engage in preventive behaviors unless they completely eliminate the risk, as research by psychologists has shown.

For example, one study found that people were willing to pay much more to reduce a pesticide risk from 5 in 10,000 to 0 in 10,000 than from 15 in 10,000 to 10 in 10,000, even though the actual reduction in risk was identical. A similar study concluded that people were more attracted to a vaccine said to entirely eliminate a 10% risk for a disease than to one that reduced the risk from 20% to 10%. And a third one found that a vaccine described as 100% effective in preventing 70% of known cases of a disease was more appealing than one that was 70% effective in preventing all cases even though both would have the same net effect.

Even if we follow all recommendations about sheltering in place, washing hands, wearing masks and disinfecting grocery deliveries, we can only reduce and not eliminate the chance of catching COVID-19.

Will people continue to feel that it’s really worth it to sanitize all those plastic bags from the supermarket if the only effect is to reduce the odds from, say, 1 in 2,000 to 1 in 3,000?

Invisible impact

Another reason the benefits of prevention seem intangible is that we don’t get useful feedback about the effects of our actions.

The microbes are invisible, so we have no idea whether we had them before we washed our hands or have gotten rid of them after we have done so.

In addition, we get no feedback about how a particular protective action has changed our probability of getting infected. If all of our actions work, the outcome is that we don’t get sick. But not being sick was the state we were in before we took those actions. Thus, it seems as if the preventive actions caused nothing to happen because we can’t see the negative outcome that might have happened if we hadn’t been so vigilant.

Documenting such a pattern, studies of treatment for depression have found that many patients skip or discontinue taking antidepressants as soon as their symptoms improve, leading to relapse.

The same is likely true at a societal level. If all the sacrifices people are making pay off in the form of lower infection rates, people will point to those low rates as evidence that the sacrifices weren’t actually necessary. Such a pattern has been documented among anti-vaxxers, who claim that low rates of diseases that are vaccinated against are evidence that the vaccine wasn’t needed in the first place.

When one is healthy, it is very difficult to imagine being sick – even when one has been sick in the past. This probably has something to do with low rates of adherence to lifesaving medications.

For example, one year after hospitalization for a heart attack, nearly half of patients prescribed statins stop taking them. And rates of medication adherence for acute diabetics are similarly dismal.

In both cases, people who are healthy – or even those who are sick but not experiencing immediate symptoms – don’t appear to appreciate the risks of failing to protect themselves.

Constant vigilance

So how can we sustain vigilance in the face of pervasive intangibility?

We could remind ourselves that life rarely offers certainty, and behaviors that reduce risk significantly are worth continuing even if they don’t eliminate it altogether. Or we could try to keep in mind those who have been hospitalized or even killed by COVID-19 – a fate that could befall any of us.

Realistically, however, neither of these approaches is likely to have much traction due to the intangibility of the effects of preventive behaviors. And so the best policies are those that eliminate the need for individual decision-making altogether, such as when stores ensure grocery carts and public spaces are kept well sanitized.

As for policymakers, they could compel companies to maintain these measures as a condition of being open. And they could design regulations that require people to continue to wear face masks in public or don gloves when entering public buildings, while lightly punishing those who don’t comply. Small penalties can have a huge impact on behavior.

The longer these behaviors are maintained, the more likely it is that they’ll become habitual, overcoming the problem of their benefits being intangible. And society will be able to get back to some semblance of normal while keeping the lid on the coronavirus.

By Mr. Edwyne Fernandes
Published May 31, 2020

This is an updated version of an article originally published on April 20, 2020.
https://theconversation.com


How better home hygiene could curb antibiotic resistance

Pharmacologists and infectious disease specialists say there is an urgent need to promote good hygiene in the home and in community settings. They believe that this will be essential in reducing antibiotic use and preventing the spread of drug-resistant bacteria in the coming years.

Rates of resistance to commonly used antibiotics have already reached 40–60% in some countries outside the Organisation for Economic Co-operation and Development (OECD) and are set to continue rising fast.

In OECD countries, rates of resistance could reach nearly 1 in 5 (or 18%) by 2030 for eight different bacterium-antibiotic combinations.

By 2050, about 10 million people could die each year as a result of resistance to antimicrobial agents.

While policymakers usually focus on hygiene in healthcare settings, such as hospitals, a group of pharmacology and infectious disease experts believes that improved hygiene in homes and community settings is just as important.

The scientists have published a position paper in the American Journal of Infection Control on behalf of the Global Hygiene Council.

“Although global and national [antimicrobial resistance] action plans are in place,” they write, “infection prevention and control is primarily discussed in the context of healthcare facilities with home and everyday life settings barely addressed.”

They have also launched a manifesto that calls on health policymakers to recognize the importance of this topic.

‘More urgent than ever’

Simple hygiene measures, such as hand washing, can help reduce infections and antibiotic use, the authors argue. In turn, this will minimize the development of resistance.

“In light of the current COVID-19 pandemic and evidence presented in this paper, it is more urgent than ever for policymakers to recognize the role of community hygiene to minimize the spread of infections, which, in turn, will help in reducing the consumption of antibiotics and help the fight against [antimicrobial resistance],” says lead author Prof. Jean-Yves Maillard from the School of Pharmacy and Pharmaceutical Sciences at Cardiff University in the United Kingdom.

The World Health Organization (WHO) estimate that 35% of common infections are already resistant to currently available medicines, with this figure rising to 80–90% in some low and middle income countries.

Overuse of the drugs accelerates the development of resistance. In the United States, for example, the Centers for Disease Control and Prevention (CDC) estimate that of the 80–90% of antibiotic use that occurs outside hospitals, about half is inappropriate or unnecessary.

The authors point out that while the majority of bacteria that are multidrug-resistant (resistant to at least one agent in three or more antimicrobial classes) get picked up in hospitals, some have become prevalent in the community.

Patients leaving the hospital can carry methicillin-resistant Staphylococcus aureus (MRSA) on their skin, for example, or resistant strains of enterobacteria in their gut. Resistant bacteria can then pass to other family members.

The authors write:

“Although the precise impact of hygiene on transmission of infection between community and healthcare settings needs further investigation, it is important to recognize that reducing the need for antibiotic prescribing and the circulation of [antimicrobial-resistant] strains in healthcare settings cannot be achieved without also reducing circulation of infections and [resistant] strains in the community. We cannot allow hygiene in home and everyday life settings to become the weak link in the chain.”

 

Hand washing is a crucial measure

They argue that better hand hygiene would prevent many infections in the home and in community settings, such as schools, nurseries, and workplaces.

Only about 19% of people wash their hands after using the toilet, according to a review of research that the paper cites. The same review found that hand washing reduces the risk of diarrhea by nearly one-quarter (23%) in studies with good methodological design.

Educating people to wash their hands with ordinary soap is one of the best ways to reduce infections, according to experts. Overall, research has shown that improvements in hand hygiene lead to a 21% reduction in respiratory illnesses and a 31% reduction in gastrointestinal illnesses.

In addition, the position paper highlights the problem of foodborne pathogens, including Salmonella, Campylobacter, and Escherichia coli. These affect millions of people globally every year, causing diarrhea and other debilitating symptoms.

A 2014 study in Mexico found Salmonella in almost all cleaning cloths. Soaking these dish clothes in a 2% solution of bleach twice a day reduced the bacteria by 98%.

Key risks and strategies

The authors identify key risk moments for transmitting infections in the home. These are:

• food handling, including contaminated chopping boards and kitchen sponges
• using the toilet
• changing a baby’s diaper
• coughing, sneezing, and nose blowing
• touching surfaces that others frequently touch
• handling and laundering clothing and household linen
caring for domestic animals
• disposing of refuse
• caring for an infected family member

As key strategies to combat infection in the home, they recommend:

• soap or detergent-based cleaning together with adequate rinsing
• alcohol-based hand sanitizer
• inactivation or eradication using a disinfectant on hard surfaces
• mechanical removal using dry wiping
• heating to at least 60°C (140°F)
• UV treatment
• a combination of the above

However, they note that further research is necessary to evaluate the extent to which these practices might contribute to preventing the transmission of antimicrobial-resistant bacteria.

____________________________________

Written by James Kingsland on May 25, 2020 – Fact checked by Hilary Guite, FFPH, MRCGP

Published: https://www.medicalnewstoday.com


Don’t Let Hand Hygiene Standards Dip When COVID-19 Ebbs

As communities move into the next phase of COVID-19, healthcare organizations must keep hand hygiene top of mind in all environments to ensure patient and employee safety, and to ultimately reduce the risk of cross-contamination and HAIs.

Keeping healthcare staff informed of the latest protocols and essential hygiene measures will have a profound impact on the post-pandemic world, but driving behavioural change can be extremely challenging. To achieve hand hygiene compliance, healthcare facilities should focus on three areas:

· Hygiene training

· Hygiene tools and dispenser placement

· Signage

With 40% of surveyed healthcare workers saying they would like better training in hand hygiene, healthcare facilities can combine technology with hand hygiene training to help staff easily adapt to the demands of their environment.

Implementing a technology-first approach to training is an engaging and interactive way to reinforce hand-hygiene and sanitization protocols within a facility. According to educational technology pioneer Edgar Dale, learning by doing (direct, purposeful experience) is essential to keeping learners actively engaged as opposed to being passive observers. In fact, the University of Oklahoma created a similar learning hierarchy that emphasizes the usefulness of virtual reality in the learning process today. Virtual reality apps are a readily available and effective means to reinforce the World Health Organization’s “5 Moments of Hand Hygiene.” These apps can serve as an innovative alternative to hand hygiene training.

It is equally important to consider the critical factors of hygiene access in a facility, such as location of hygiene tools and hand-washing stations. Dispenser placement is key to promoting hand hygiene compliance within a healthcare environment.

It is imperative that dispensers are placed throughout walking routes and corridors to ensure accessibility for nurses and other staff on-the-go. Increasing the accessibility and visibility of hand hygiene stations throughout a facility can have a significant impact on hand hygiene practices without adding an extra burden to your environmental services staff (EVS).

Most healthcare staff understand the importance of hand washing, but visual cues for staff and patients are essential in the ongoing education of hand hygiene best practices and are especially helpful for nurses working long shifts.

Hand hygiene focused signage is an effective way to further hygiene and sanitization communication with staff, on an everyday basis. In addition to improving health standards, hand hygiene posters can also have a positive effect on a facility’s image. In fact, more than 8 in 10 patients indicate that the presence of hand hygiene signage makes them feel more confident about a facility’s cleanliness and its quality of care.

These simple steps can have a far-reaching impact on the success of hygiene compliance within a healthcare facility and takes hand hygiene from an afterthought to a long-lasting habit and routine—as it should be.

Deborah Chung is the regional marketing manager for Essity Professional Hygiene, North America.

 
By Deborah Chung
May 8, 2020

Published at: https://www.infectioncontroltoday.com

Deborah Chung is the regional marketing manager for Essity Professional Hygiene, North America.


Hygiene reduces the need for antibiotics by up to 30%

Everyday hygiene reduces the need for antibiotics by up to 30%, helping to prevent daily deaths from antimicrobial resistance (AMR), new paper reveals.

According to a new Position Paper published in the American Journal of Infection Control (AJIC) online, improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%. Global public health experts responsible for the Position Paper, are now calling for home and community hygiene to become part of strategic plans to reduce hundreds of thousands of deaths from AMR globally each year.

As witnessed during the recent global efforts to delay the spread of COVID-19, hygiene practices, including hand-washing, have become an essential part of everyone’s daily routine and are considered to be the first line of defence in reducing the spread of common infections. However, national and international AMR strategies, while focussing on the important role of hygiene in the healthcare setting, fail to recognise the key role that home and community hygiene plays.

This Position Paper, developed on behalf of the Global Hygiene Council (GHC), and published online in AJIC, explores the role of targeted hygiene in the home and everyday life settings to reduce antibiotic prescribing and its likely impact on antibiotic resistance. It provides evidence that practising hand hygiene in homes and community settings can prevent infections and therefore reduce the need for antibiotics. One intervention study demonstrated a 30% reduction of antibiotic prescriptions for common respiratory infections in a group who used hand sanitisers compared with a control group.

The Position Paper, also demonstrates the increasing prevalence of multidrug-resistant bacteria in the home and community. It is considered that 35% of common infections occurring in healthcare and the community are already resistant to antibiotics, and that in some low-and middle-income countries, resistance to antibiotics is as high as 90%,4 causing 2,000 people to die every day globally.

According to the lead author, Jean-Yves Maillard, Professor of Pharmaceutical Microbiology at the School of Pharmacy and Pharmaceutical Sciences, at Cardiff University; “In light of the current COVID-19 pandemic and evidence presented in this Paper, it is more urgent than ever for policy makers to recognise the role of community hygiene to minimise the spread of infections, which in turn will help in reducing the consumption of antibiotics and help the fight against AMR.

To coincide with the publication of the Paper, the GHC has launched a Manifesto calling upon national and international policy makers, health agencies and healthcare professionals to further recognise the importance of hygiene in the home and everyday life settings and acknowledge the following:

1/ IPC committees, responsible for implementing national AMR plans, should recognise that improved hand and surface hygiene in the home and community are key to minimise the spread of infections and as a consequence the consumption of antibiotics, which will then help in the fight against AMR. To achieve this, recommendations for improved hygiene in the wider community should be included in global AMR action plans by 2022 and in all national plans by 2025.

2/ IPC advice, guidance and education for HCPs on hand and surface hygiene and its relation to AMR should not be limited to healthcare settings, but also include recommendations to influence the wider community with immediate effect.

3/ Relevant medical associations should ensure messaging around home and community hygiene is cascaded to members through amending on-going and existing AMR training and education.

With evidence to show that home and community hygiene urgently needs to be taken more seriously, it is time for the global community to collaborate and recognise that reducing the need for antibiotic prescribing and the circulation of AMR strains in healthcare settings cannot be achieved without also reducing the circulation of infections and AMR strains in the community.

The Position Paper ‘Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings,’ was developed on behalf of the Global Hygiene Council, following a scientific meeting in London 2019 with global hygiene, AMR and public health experts.

Published by: https://www.eurekalert.org/

References:

Curtis V, Cairncross S. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis. May 2003; 3 (5): 275-81

Azor-Martinez E, Yui-Hifume R. Effectiveness of a hand hygiene program at child care centers: a cluster randomized trial. Pediatrics. November 2018;142 (5). Available from:ncbi.nlm.nih.gov/pubmed/30297500 (Accessed 15 April 2020)

amr-review.org/

Interagency Coordination Group on Antimicrobial Resistance. No Time to Wait. Securing the Future from Drug-Resistant Infections. April 2019. Available from: https://www.who.int/antimicrobial-resistance/interagency-coordination-group/IACG_final_report_EN.pdf?ua=1. (Accessed April 15, 2020.)

Review on Antimicrobial Resistance: Tackling Drug-resistant Infections Globally. 2014. Available from: https://amr-review.org/Publications.html. Accessed July 3, 2019.


Hvorfor er det noen som aldri vasker hendene?

Det har blitt innprentet som det aller viktigste smitteverntiltaket i kampen mot coronaviruset. Likevel er det mange som sjeldent eller aldri vasker hendene.

– Jeg tror ikke jeg har vasket hendene på ti år. Jeg vasker aldri hendene, sa Fox News-programleder Pete Hegseth på lufta i februar 2019, til latter fra sine medverter.

– Bakterier er ikke en virkelig greie. Hvis jeg ikke kan se dem, så finnes de ikke. Jeg gjør meg selv immun og blir aldri syk , sa han videre.

Dette førte naturlig nok til en del reaksjoner i amerikanske medier, og ble blant annet omtalt av Forbes. Fox-programlederen måtte senere gå ut og melde at han mente det som en spøk.


Mange slurver

Likevel kan de fleste som har brukt offentlige toaletter si seg enige i at han definitivt ikke er den eneste som slurver med håndvasken. En fransk forskningartikkel fra 2015 kom med de slående resultatene at på global basis, er hendene vaskes med vann og såpe kun 26,2 prosent av alle toalettbesøk, med potensiale for kontakt med avføring.

Noe av grunnen til de lave tallene skyldes at spesielt i utviklingsland, kun 27% av befolkningen har tilgang på tilstrekkelige toalettfasiliteter.

I undersøkelsen ble 64.000 personer fra totalt 64 land spurt om «å vaske hendene med vann og såpe er noe man gjør automatisk etter toalettbesøk».

Hver fjerde slurver i Norden

Best i studien kom Saudi-Arabia der 97 prosent sa de som automatikk vasket hendene, mens det i Kina, Japan og Sør-Korea var under halvparten som sa seg enig i det utsagnet.

Norge var ikke en del av studien, men våre nordiske naboer Sverige, Finland og Island kom alle noenlunde likt i sine resultater, der i overkant av 75 prosent sa seg enig i utsagnet. Det var på nivå med Storbritannia og Tyskland og noe høyere enn land som Frankrike (62 prosent), Italia (57 prosent) og Nederland (50 prosent).

Det pågår nå forskning på hvorvidt det er en korrelasjon på smitten i forskjellige land og holdningene til håndvask. De foreløpige resultatene ser ganske klare sammenhenger mellom utbredelse av smitte og håndhygiene-vaner.
Menn dårligere på håndvask

I slutten av mars gikk to forskere ved SIFO ut i et debattinnlegg i VG og stilte spørsmål ved om det var en sammenheng mellom hvorfor flere menn enn kvinner i Norge ble smittet av viruset og at menn oftere slurver med håndvasken.
De henviste til nasjonal forskning fra henholdsvis 2011 og 2007 som viste at menn vasket hendene sjeldnere enn kvinner og var dårligere til å følge helseråd.

Latskap

«Vi vet ikke om det er noen sammenheng mellom håndvaskevaner og den økte risikoen blant menn for å blir smittet av coronaviruset. Men vi vet at menn vasker hendene mindre. Kanskje det er riktig med en ekstra oppfordring til det sterke kjønn? Dere er ikke bare de som er mest utsatt for å bli smittet, men også de som har mest å «gå på» når det gjelder å forbedre håndvaskevaner», skrev Sifo-forskerne Ingun Grimstad Klepp og Silje Elisabeth Skuland i innlegget.

– Det høres så enkelt ut, men jeg har jobbet med dette i 25 år og det er fortsatt mye å gå på , sier Robert Aunger, ved London School og Hygiene and Tropical Medicine til BBC. Han tror slurvet for mange rett og slett kan skyldes latskap.

– Et problem med håndvask er at, spesielt i utviklingsland, så kan du unngå å vaske hendene ofte, og likevel ikke bli syk, sier Aunger og utdyper at det kan ta flere dager fra man blir smittet til man får symptomer, noe som gjør at man ikke ser sammenhengen med dårlig håndvask.

– Selv med coronaviruset så sier de at forsinkelsen fra man får smitten til man ser symptomer, kan være fem-seks dager, så koblingen er vanskelig å gjøre, sier han til BBC.

Bedre med såpe enn håndsprit

Både håndvask og desinfisering med sprit fungerer bra mot coronaviruset, hvis det gjøres riktig.

– Håndvask er best når du er møkkete eller har organiske ting som mat eller urin på hendene. Du må være synlig ren for å bruke sprit. I helsevesenet passer dette helt supert , forklarte Mette Fagernes, seniorrådgiver i FHI, som leder den nasjonale arbeidsgruppa for håndhygiene, til NRK tidligere i mars.

Se video: Slik vasker du hendene riktig (Video: Folkehelseinstituttet)

I lys av pandemien som tvinger oss til å holde oss hjemme har kjendiser fra hele verden oppfordret folk til å vaske hendene ofte og lenge – minst 20 sekunder.

Til og med pornonettstedet Pornhub har laget en parodi-konto kalt Scrubhub, som inneholder folk som vasker hendene og overholder sosial distansering i det offentlig rom.

 

Magnus Fossen
22. april 2020 09:20 – Oppdatert 23. april 2020 08:26
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