Soap vs Sanitizers

You squirt it on your hands as you enter the grocery store, and then again on your way out. You have bottles in your car, on your desk and in your home too – and you use them often.

And no, you’re not a germophobe, it’s just that your hand-sanitizer habit is helping to protect you from colds and flu and other nasty’s, that are wet, sticky and not yours!

And even if it doesn’t, it’s harmless. Right?

Not so fast! Word on the street has it that despite how clean your hands feel after using a hand sanitizer, they’re actually still dirty.  Worse still, they’re potentially toxic and might actually lower your resistance to disease.

So are these rumors true?!  Let’s take a look at the evidence.

When it comes to safety and effectiveness, the main concern with hand sanitizers is triclosan, – the main antibacterial ingredient used in non-alcoholic hand sanitizers.

“There’s no good evidence that triclosan-containing products have a benefit,” says Allison Aiello PhD, associate professor of epidemiology at the University of Michigan. In fact, hospitals in Europe and the United States, won’t even use them because it’s thought that they don’t reduce infections or illness.

Dr. Anna Bowen, an epidemiologist at The Centers for Disease Control and Prevention, says, “Triclosan-containing products don’t provide any disease protection beyond what you get from washing with soap and water.”

Research has shown that triclosan can disrupt the endocrine system, amplifying testosterone. In animal studies, it reduced muscle strength. It may also harm the immune system. Whether these findings add up to human toxicity isn’t established yet, but the FDA is currently reviewing the issue.

A more established concern: “When you expose bacteria to triclosan, it can elicit antibiotic resistance,” says Aiello. “Once the resistance is transferred, pathogenic bacteria can become resistant to many types of antibiotics.”   She also points out that quaternary ammonium, another antibacterial found in nonalcoholic hand sanitizers, has been shown to elicit antibiotic resistance.

The main concern with triclosan, that it’s an anti-bacterial, meaning it doesn’t protect against viruses or fungi.  Which means, colds and flu are not destroyed because they are caused by viruses, not bacteria.

Alcohol-based sanitizers, on the other hand, are fairly effective and safe. Those that contain  60% alcohol are good at killing bacterial pathogens and can also kill some viruses though not all of them.  Norovirus, for example, the bug responsible for the recent cruise-ship outbreaks is not affected.

“If you can’t get to a sink quickly, an alcohol-based sanitizer is a good alternative to washing with soap and water,” says Aiello.

One caveat: They don’t work on visibly dirty hands.  The alcohol can’t get past the dirt.

So how does soap and water match up?   First, they are both safe and effective. That’s right. Good old-fashioned hand washing before you prepare food or after you go to the toilet has been shown to drastically reduce the risk of diarrhea.

“Hand-washing campaigns reduce absenteeism in schools,” says Bowen, “and that means parents miss fewer days of work, too.”

But, and it’s a big but – you have to wash your hands correctly.

According to the CDC you need to wash for about 24 seconds to remove bacteria and viruses from your hands. You need to cover all parts of your hands, front and back and under your nails and then dry your hands well.

How long is 24 seconds? Apparently it’s about as long as it takes to sing two verses of Happy Birthday.  However, as I always tell my infection control students, if you’re in public, sing it with your inner voice …or you could have more than germs to worry about!

Bottom line –  soap and water beats sanitizers hands-down.  Suds up and stay safe this cold and flu season.

Top Travel Tips To Ensure You Don’t Come Back With More Than You Left With

Passport. Check.

Tickets. Check.

Health. Huh?

That’s Right! For those of you planning to get away this summer, SRxA’s Word on Health reminds you get your health planning in before leaving for the airport.  While an overseas trip may appear to be “just what the doctor ordered” , it can also pose various health hazards, depending on the type of travel, length of stay and destination.

Significant changes in altitude, humidity and temperature can lead to illness, and in many parts of the world – especially developing countries and tropical locations – the risk of infectious disease is high.

“Not all countries are high-risk for travelers,” said Christopher Ohl MD, an infectious disease specialist at Wake Forest Baptist Medical Center in Winston-Salem, N.C. “Europe is generally safe, and so are Canada, Japan, Australia. But anybody planning to go to Mexico or Central America, the Caribbean, South America, Africa, most anywhere in Asia, or the Pacific islands should definitely look into what health risks they’ll encounter and what they’ll need to do to minimize their chances of getting ill.”

So where should you look for this information?  The Internet, of course, has a multitude of resources, some better than others, but you still need to be aware that even reputable sites such as those of the U.S. State Department, federal Centers for Disease Control and Prevention and World Health Organization offer only general information about the world’s countries and often do not include specifics about particular locations or activities within those countries.

For someone going to South Africa, there’s a big difference between staying in a modern hotel in Cape Town for a week and going on a two-week budget trip to Kruger National Park!

Because the details of an individual’s health, destination, activities, accommodations and mode of travel are important elements in determining health risk, a travel medicine specialist is probably the best person to consult

Travel clinics also stock the sort of vaccines and anti-malarial medications you’ll need and can advise on up-to-the-minute requirements.

In addition to administering shots and writing prescriptions, travel clinics also provide information on how to avoid insect-borne diseases, how to self-treat diarrhea and other common ailments, what to eat and drink and what to avoid eating and drinking and so on, all based on the person’s health status, where they’re going, what they’re going to be doing and how long they’re going to be there.

And because accidents, not diseases, are the most common cause of injury and death among travelers the clinic can also provide safety tips based on information from the State Department and authoritative foreign sources, such as whether there may be civil disturbances in a particular location, whether it’s advisable to travel at night or even “if it’s safe to rent a scooter.”

But don’t leave it until the last minute. Travelers, regardless of their age or the type of trip they’re planning should visit a travel clinic at least four to six weeks before departure, to allow sufficient time to get prescriptions filled and for vaccines to take effect. Even if the destination doesn’t call for any special shots, he said, a trip abroad presents a good opportunity to see that “routine” vaccinations such as measles-mumps-rubella, diphtheria-pertussis-tetanus, chickenpox and flu, are up to date.

And in the unfortunate event that you return home with something other than a suntan and souvenirs, travel clinics can also provide post-travel medical care. A number of diseases common overseas don’t present symptoms right away, some can even take months to develop, and they might not be recognized by a general practitioner.

Stay safe this summer!

 

Fighting flu in just two hours

As we approach midsummer, while most of us are enjoying days at the pool or beach and long evenings of grilling out, a few people have already begun the countdown to winter frosts and flu season.

For those in the latter group, SRxA’s Word on Health brings you good news!

Researchers from San Diego State University and Nebraska Medical Center have developed a synthetic protein known as EP67 that can fight off flu, in just two hours.

Until recently, EP67 had been used as an adjuvant for vaccines. When added to a vaccine, adjuvants help to activate the immune system. Which led scientists to wonder what effect the synthetic protein might have on its own?

Dr. Joy Phillips, lead author, said: “The flu virus is very sneaky and actively keeps the immune system from detecting it for a few days until you are getting symptoms. Our research showed that  introducing EP67 into the body within 24 hours of exposure to the flu virus caused the immune system to react almost immediately to the threat, well before your body normally would.”

EP67 is useful as a weapon against flu because it works on the immune system rather than the virus.  So it doesn’t matter which flu strain a patient becomes infected with.  If a new strain of flu or some other infectious disease appears, such as occurred with SARA and H1N1, EP67 could be useful as a tool even before the pathogen itself has been identified.

And even though this study concentrated on the benefits of EP67 for flu, researchers are hopeful that it might also be useful for combating other respiratory diseases and fungal infections.

Current tests are being done on laboratory animals, mainly mice, by infecting them with an influenza virus and then administering EP67 within 24 hours. They found that the treated mice did not get sick, while the untreated ones did.  Most mice infected with flu will lose approximately 20% of their body weight – this was the case with the untreated mice. The mice given EP67 lost just an average of 6%. Some mice were even given a lethal dose of flu virus, and then administered EP67 – none of them died.

All of this sounds so promising future studies are already planned to look at EP67’s effect on other pathogens and its functions within different types of body cells.

With this type of good news on the way, maybe we can all stop worrying about the winter and get back to enjoying summer before it’s gone!

Not so Rotten Eggs!

As someone who stood in line for 3 hours to receive my H1N1 vaccine last year, only to be turned away by an officious clipboard wielding nurse, this Word on Health blogger just had an “I told you so” moment!

According to new recommendations by the American Academy of Allergy, Asthma & Immunology (AAAAI), anyone with a history of suspected egg allergy should first be evaluated by an allergist or immunologist for appropriate testing and diagnosis but can probably receive the vaccination.

Matthew J. Greenhawt, M.D., and James T. Li, M.D., Ph.D., from the Department of Internal Medicine at Mayo Clinic, have co-authored the guidelines based on recent studies that show that even the most egg-allergic individuals can receive the flu vaccine safely under the care of their allergist/immunologist.

As I know only too well, in the past, people with egg allergy were told they could not have the flu vaccine because it contained egg protein which could potentially trigger an allergic reaction. However new research shows that not only do flu vaccines contain only tiny amounts of egg protein, the vast majority people with egg allergies don’t react.  Indeed it seems that many people with diagnosed or suspected egg allergy can receive the influenza vaccination successfully, if simple precautions are followed.

These include:

• Anyone with a history of suspected egg allergy should first be evaluated by an allergist or immunologist for appropriate testing and diagnosis
• Patients with a confirmed egg allergy can then receive the vaccine safely using one of two protocols: a two-step graded challenge or a single, age-appropriate dose

“It is not necessary to withhold influenza vaccination from egg-allergic patients,” says Greenhawt. “Our recommendations provide two flexible approaches to vaccination. Each approach is backed with recent evidence that it is safe. Most allergists should be able to identify with one of our recommended approaches and, as such, be able to vaccinate their egg-allergic patients with confidence.”

So, Nah! Nah! Na! Nah! Nah! to you officious nurse.  Who has egg on their face now?

Do you have vaccine stories to share?  Word on Health would like to hear them.