Want to halt the spread of germs? Clean your hands

When Ann Liles is teaching kids the importance of washing their hands, she likes to either dazzle them or gross them out.

"I do glitter with the little kids," said Liles, a registered nurse who works at Molasky Middle School and Tobler Elementary School.

Here's the idea: If they have glitter on their hands and throw a ball or use a pencil, kids can see how germs -- represented by all that sparkly stuff -- spread. Or Liles will put glitter on her own hands and "absentmindedly" touch her face, leaving traces and exclaiming, "Oh, I have germs on my face!"

"The young kids love that visual," Liles said.

For the older, too-cool-for-school (or at least germs) kids, she'll aim right for the deepest desires of every middle schooler and apply the gross-out technique, "CSI"-style. She'll tell the story of a Centers for Disease Control and Prevention investigation of a hospital. Older people and infants are dying, she'll tell them, and investigators are taking swabs from various places, including the doctors' and nurses' lounge. And what do they find there? E. coli.

"Do you know what that is?" comes the question. "It's poop!"

"The more dramatic you are with kids, the better," Liles said.

And, well, maybe those techniques should be used with adults, too, because it's clear that a lot of them haven't gotten the message that hand-washing is very important. Patricia Alpert, a pediatric and family nurse-practitioner and associate professor with the School of Nursing at the University of Nevada, Las Vegas, said her medical background probably makes her more aware of what's going on around her in public restrooms.

"I see them come out of a stall and leave without washing their hands and I'm amazed," Alpert said. "I notice a lot of people don't" wash their hands.

"It's not a complicated process," Brian Labus, senior epidemiologist with the Southern Nevada Health District, said of hand-washing.

Yet, Labus said, "it's the best way to protect yourself from getting sick from a number of different diseases" including food-borne illnesses, the common cold and norovirus.

"Pretty much anything that spreads person-to-person is frequently spread through the hands," he said. "Just touch your nose or mouth."

Although the process is simple and quick, Labus said that in addition to not washing their hands at all, many people don't wash them properly. Using clean running water and soap, you should wash those hands -- all over -- for 20 seconds, which is about as long as it takes to hum "Happy Birthday" twice.

Alpert said the soap and the rubbing action break down the adherence of the bacteria, creating a surfactant type of response.

"It breaks the bacteria away from the skin and the water washes it off your hands," she explained.

The hand sanitizers that seem to be all over the place these days don't take the place of hand-washing, they said. Labus noted that sanitizers initially were developed for use in the medical industry, where people's hands may be soiled, but not visibly dirty.

"They're not effective if your hands are dirty," he said. "They aren't designed to deal with all the stuff on your hands."

He stressed that sanitizers don't sterilize hands, but do reduce the amount of bacteria on them. Some bacteria, he said, respond well to the use of sanitizers, while there are "other things that the sanitizers don't kill, but just move around on your hands," such as norovirus.

Labus said sanitizers should be alcohol-based -- at least 60 percent alcohol -- and you should follow the directions on the package. And most important, don't wipe it off before it's dry.

"You need to have that rubbing action," Alpert said, "need to make sure the sanitizer is spread all over the surface of the hands, and you need to continue rubbing it in until it is completely dry."

And, she said, sanitizers shouldn't be used to the exclusion of soap. Recommendations for medical professionals and others are that once sanitizer has been used 10 times in a row, full hand-washing should follow.

Plastic gloves aren't an effective protection, either. The proper use of gloves, Labus said, is in conjunction with hand-washing. Hands should be washed before the gloves are put on, and hands should be washed and gloves changed when changing tasks. So yes, the person behind the counter who handles your money and your food with the same pair of gloves doesn't have the right idea.

"If a person wears one pair of gloves all day long, all they're doing is keeping the food off their hands; it won't protect you," Labus said. "It can actually increase disease transmission."

Alpert said it's also important to be cognizant of surfaces that can carry germs.

"Even if you wash your hands effectively, you can touch the door handle as you're coming out of the bathroom," she said. "If you don't actually open the door with a paper towel, you're going to have that bacteria back on your hands."

And then there are handbags, she said, which women put on floors in restaurants and restrooms, and in lots of other bacteria-laden places.

"The handbag is one of the worst things in terms of carrying pathogens of anything that I know of," she said.

Oh, and shopping carts. Stand near a store entrance and you'll see people grab a disposable wipe to clean the handle of the cart, but studies have found much more bacteria on the kiddie seat (think dirty diapers, kids' shoes and, yes, those filthy handbags) and in the body of the cart (leaking meat packages, leaking eggs, kids' shoes).

"I guess you could clean it," Alpert said of the body of the cart. "Maybe grocery stores should be responsible for actually doing that once a day."

So, be aware of germy stuff, and especially remember to wash your hands, early and often.

"It's one of those things we talk about at this time of year every year," Labus said, "as a way to prevent colds and flu. It's one of the best ways we have to prevent people getting sick. It gives me less work to do investigating sick people."

Contact reporter Heidi Knapp Rinella at
hrinella@reviewjournal.com or 702-383-0474.