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Staying healthy is in your hands

It's easy for the average Canadian to feel a bit helpless amid the stream of news reports on pandemic flu. As scientists around the world scramble to develop vaccines and predict the course of a possible outbreak, it can seem as though the matter is totally beyond your control. Yet experts say a simple way to reduce your risk is literally in your hands: good, frequent handwashing is the best way to prevent infectious diseases of all kinds.

Hands spread an estimated 80 percent of common infectious diseases like the common cold and flu. For example, when you touch a doorknob that has the flu virus on it and then touch your mouth, you can get sick. But these disease-causing germs slide off easily with good handwashing technique.

Handwashing is easy to learn, cheap and incredibly effective at stopping the spread of disease-causing germs. Dr. David Butler Jones, Canada's Chief Public Health Officer, recommends handwashing as one of the 12 pain-free ways to a healthier life.

It's a fact: handwashing works

Good, frequent handwashing is the single best way to prevent the spread of many common diseases. Research published in July 2005 in the The Lancet confirms that handwashing with regular soap is a good way to control infection. The study measured the health impact of proper handwashing among 900 households in Karachi, Pakistan. Those who were given handwashing education and regular soap reported a 50% decrease in pneumonia and diarrhea, and a 34% decrease in skin infections.

Infectious disease expert Dr. Edith Blondel-Hill, Medical Director of Do Bugs Need Drugs? and Infectious Diseases Specialist at BC Children's Hospital in Vancouver says the study confirms that infection control doesn't have to be fancy or complicated. Washing your hands might be low-tech but it works. Despite what we know about the value of proper handwashing, Dr. Blondel-Hill says more work needs to be done in raising public awareness about the importance of good handwashing practices. "Our society is obsessed with cleanliness - people will vacuum their houses several times a day - but many forget basic hygiene principles like washing their hands before they eat".

Are all germs bad?

"Germs are essential for human life. Bacteria in our mouths and intestines help us to digest the food we eat and bacteria on our skin protect us from invading viruses and bad bacteria," explains Dr. Blondel-Hill.

The word "germs" is a general term for different types of tiny organisms, or living things, commonly known as germs. Bacteria and viruses are examples of two different types of germs. Bacteria are virtually everywhere in our environment and make up 60 per cent of the living matter on earth. Of the billions of types of bacteria only about 50 are known to cause infection.

Viruses cause far more illnesses than bad bacteria because they spread more easily. If more than one person in your family has the same sickness, odds are it is a viral infection. Cold and flu viruses invade our cells and rapidly grow in number causing symptoms like runny nose, cough, aches and sore throats. Bacterial infections are "opportunistic," which means they tend to infect one part of the body e.g. pneumonia, an infection of the lungs that usually comes on following a common cold or flu. Antibiotics don't work against viruses.

Where do germs hide?

If you had to pick the place in your house with the most disease-causing germs, what would you choose? Many of us automatically think of the bathroom toilet seat or bathroom floor. But Dr. Blondel-Hill says the kitchen is the biggest hot-zone for disease-causing germs. Top prize goes to the kitchen sink, followed by the dishrag or sponge.

Germs can live for a surprisingly long time on hard surfaces like desks, doorknobs and tables. Most people get sick when they touch something that is contaminated with germs and then touch their eyes, nose or mouth. The easiest way to reduce your chance of getting sick is to wash your hands often with regular soap and water and avoid touching your face.

Is antibacterial soap better than regular soap?

Antibacterial soaps offer no benefit over regular soaps in preventing common illnesses and their widespread use can cause antibiotic resistance. Antibacterial soaps and cleaners are readily available - there are hundreds of brands on the market. Yet research doesn't support the use of antibacterial soaps and cleaning products over regular soaps and cleaners.

In a March 2004 study published in the Annals of Internal Medicine, researchers studied 238 households in New York City. Each household had at least one child in preschool. Half were given regular hand soap and cleaners and half were given antibacterial soaps and cleaning products. At the end of 48 weeks, there was essentially no difference between the two groups in reported infectious disease symptoms (runny nose, cough, sore throat, vomiting and diarrhea, etc) Antibacterial products don't offer any added protection against viruses because antibiotics don't kill viruses.

Should I worry about antibiotic resistance?

Plain soap has ingredients that help to remove dirt and grease from your skin whereas antibacterial soaps contain antibiotics in amounts that kill some of the germs on your skin. When you use antibacterial soaps the bacteria at the edge of the "soap line" are exposed to only a little bit of antibiotic. These bad germs survive and become resistant (they can't be killed) to that particular antibiotic. They can also transfer their antibiotic resistance to good germs.

This means healthy people who have never taken antibiotics can be exposed to antibiotic resistant bacteria from other people. Dr. Blondel-Hill says the increasing use of antibiotics in products like soap, cleaners, toothbrushes and even chopsticks is a worrisome trend. "By introducing antibiotics in everyday products we risk not having antibiotics when we really need them - to treat pneumonia, help premature babies and provide chemotherapy treatment to cancer patients. Using antibiotics willy-nilly could mean we don't have them when we really need them." The bottom line: regular soaps and good handwashing technique are the best way to remove the dirt and grease that attract bad bacteria.

Are alcohol-based hand cleansers better than regular soap?

Alcohol-based hand sanitizers should only be used if you don't have soap and water. For example, if you're at the mall and you sneeze or when you get off the bus you should use an alcohol sanitizer. Alcohol-based hand sanitizers don't contain antibiotics. But the alcohol kills both good and bad bacteria on your skin so use it sparingly. And keep in mind that they don't work well if you have a lot of dirt and grease on your hands.

When to wash your hands:

• Before meals
• Before feeding children, including breastfeeding
• Before and after preparing food
• After using the toilet
• After changing diapers or helping a child use the toilet
• After blowing your nose, coughing or sneezing
• After playing with shared toys
• Before and after visiting with people who are sick
• After handling animals or their waste

How you wash is also important

The mechanical action of handwashing - rubbing your hands together with soap and water - breaks down the tiny bits of grease, fat and dirt on your hands that bad germs cling to. Soap doesn't actually kill the bad germs. Instead, it's the combination of soap, rubbing, rinsing and drying that helps these bugs slide off your hands.

With a bit of practice everyone can learn how to wash their hands properly and reduce the spread of infection.