Everyone does it – that smart phone goes everywhere, even the loo!
But what are the risks?
If you take your phone to the toilet then you risk getting it covered in germs (or dropping it down the loo)! However, for many people this may be the one time they can have a sneaky look at their messages when at work, and I doubt people will take much notice about not taking it to the loo.
Colds and flu – stay healthy without too much effort
As the cold and flu season approaches, it makes sense to think about how to avoid these illnesses. Every year adults get between 2-4 colds on average and children many more. Apart from the time taken off work and school due to illness, influenza is a major cause of death world-wide and the old and young and other vulnerable groups are more at risk.
Last week I attended the World Organization of Family Doctors (South Asia Region) in Bangladesh to present a paper about hand-washing and how the RSPH were involved in accrediting the Lifebuoy campaign “Help a Child Reach Five.”
Have you ever wondered what might be lurking on your supermarket trolley? We think of food shops as nice clean places, but in fact a study in the US(1) showed that there may be unwelcome micro-organisms on the handle of the trolley.
Indeed, studies suggested that there may be an association between children sitting in supermarket trolleys when raw meat is being purchased and being ill with Campylobacter or Salmonella. (2) (3)
How could that happen, you may ask? Well, next time you go to a supermarket, have a look what fellow shoppers are doing whilst they are shopping – and maybe even look at your habits. If you are picking up bacteria such as Campylobacter and E. coli on your hands when shopping, do you really want to transfer those germs to your mouth or your child’s mouth?
That is effectively what you are doing if you eat whilst shopping, or feed your children when they are sitting in the front of the trolley (and their hands will be on the handle as well). Given that bugs like Campylobacter are infectious in very small numbers, then simply transferring them from the handles of the trolley to your mouth (maybe via a packet of crisps) would be enough to cause illness. Add to the mix respiratory diseases such as flu and colds, and norovirus, and there are quite a few reasons to take care with hygiene.
Think about some of the routes of transmission:
Hands to trolley
Trolley to hands
Hands to face, mouth, eyes
Hands to ready-to-eat food to mouth
Hands to ready-to-eat food in trolley to mouth
Hands to child
Hands to other surfaces (car, home, work surfaces, ready to eat food)
So what’s it like in reality?
You touch a trolley handle with clean hands, you pick up flu virus, rub your eyes and infect yourself
You pick up bacteria such as Campylobacter from the packaging of raw foods, or E. coli from raw veg (eg putting potatoes in a bag) and then you touch grapes with dirty hands, transfer the pathogens and then feed them to your child.
You pick up bacteria from raw meat or vegetables on your hands and transfer them to the trolley handle which is touched by others or your child sitting in the trolley (who then feeds herself crisps)
You put raw meat and vegetables in a bag for life, transferring bacteria to the bag, which may be used subsequently for ready-to-eat food
Your raw meat and vegetables may contaminate ready-to-eat foods in the bag or trolley
So what are top tips for Supermarket hygiene?
It would be great if, as in some parts of the USA supermarkets provide wipes for trolleys
If they don’t then it may be worth using your own anti-bacterial wipes
Try not to eat when shopping, and don’t feed your children if at all possible, as you could be exposing them to infection
Think that your hands could be carriers of disease, and before you rub your eyes, or eat, make sure you wash them!
Keep a separate “raw meat and veg” bag or use a disposable bag, and don’t put ready-to-eat foods next to these dirtier foods
When you get home, wash your hands and those of your child.
Supermarkets, like any public place, will be contaminated with bacteria and viruses from other people. However, there are also raw foods available in the supermarket which may cause additional contamination. Make sure that these organisms don’t get in your body by following some fairly simple rules.
2. Fulterton, K. E., L. A. Ingram, T. F. Jones, B. J. Anderson, P. V. McCarthy, S. Hurd, B. Shiferaw, D. Vugia, N. Haubert, S. Wedel, and F. J. Angulo. 2007. Sporadic Campylo-bacter infection in infants: a pop¬ulation-based surveillance case-control study. Pediatr. Infect. Dis. J. 26:19–24.
3. Jones, T. F., L. A. Ingram, K. E. Fulterton, R. Marcus, B. J. Anderson, P. V. McCarth, D. Vugia, B. Shiferaw, N. Haubert, S. Wedel, and F. J. Angulo. 2006. A case control study of the epidemiology of sporadic Salmo¬nella infection in infants. Pediatrics 118:2380–2387.
We all know how stressful cooking the Christmas lunch is, and you definitely don’t want to add the worry of a houseful of poorly tummies to the mix.
So rather than leave it to chance, stop worrying about whether your food is cooked enough and at the same time have a lovely tasty Christmas turkey that is cooked to temperature not to colour
With a simple probe thermometer you can take the reading in the thickest part of the meat. Easy. And cheap – a great little thermometer costs only £19.00 from Hygiene Audit Systems.
And then after handling the raw turkey, do wash your hands and use an antibacterial cleanser for disinfecting and cleaning the surfaces which may have been contaminated with dangerous bacteria.
Ten Top Tips for Turkey Day!
Make sure your fridge is cold enough – use a cheap fridge thermometer – available from supermarkets for around £5. Turn down the temperature you are aiming for 5 °C
Storing the raw turkey – use a tray to catch the drip, put at the bottom of the fridge away from anything that is ready-to-eat
After handling raw meat or poultry, wash your hands thoroughly using soap and warm water, dry with a paper towel rather than a tea towel.
Clean and disinfect anything that may have contamination from raw turkey – use the dishwasher on a high temperature, use an anti-bacterial cleanser and paper towel for surfaces, and don’t use the kitchen cloth or it will simply spread the bacteria all round the kitchen
Cook to 75 °C in the thickest part of the meat – use a clean probe thermometer
Turkey left overs? With clean hands, strip off the carcass and put on a clean plate, cover and put in the fridge above any raw meat or veg
Eat left overs within 3 days of cooking
Re-heat left overs quickly and to above 75 °C
No room in the fridge? Ditch some of the less important items such as chutneys, jams, sauces etc. and put them in a cold part of the house or in a box in the garage for a few days to make room for cooked meats and foods that could become dangerous if left out of refrigeration.
Lots of people using your wc? Keep the soap stocked up and make sure you change the hand towel daily at least to keep the shared bugs down. Use an antibacterial wipe on the flush handle and door handle if you want to be particularly hygienic!
Today, as is so often the case, I looked at a customer making an allegation of food poisoning, and they were convinced that the last thing they ate caused them to be ill. But this is often not the case at all.
For example, Campylobacter, the bacteria that causes more gastro-intestinal illness than any other in this country, has an incubation period of 1-5 days, and even as long as 11 days. This means that something you ate many days ago brews up in your intestines until it reaches a critical mass, and then you get the symptoms of diarrhoea – and wow what a nasty bug this one is.
In the past, patients have had their appendix removed because the intense pain convinced doctors that they had appendicitis. The diarrhoea can go on for days.
When we are trying to find out the cause of illness, if we know what the organism was that made someone ill, then we can make better investigations into the cause of illness as we can trace back to what was eaten within the incubation period.
The other red herring is norovirus, which may not have been carried by food at all. This virus is infectious in very low doses, and can be picked up from hand-contact sites, where these have been infected by someone who may be recovering from the illness. Protecting yourself from norovirus is simple – make sure you wash your hands before eating. Imagine if you eat a bag of crisps when travelling on the tube – think where your fingers may have touched just before, and think again about whether you may want to wash your hands – especially when you lick your fingers (UGH).
Campylobacter(Camp-I-Low-Back-Ter) are particularly nasty bacteria that can cause diarrhoea and acute abdominal pain, as well as potential long term side effects from reactive arthritis to Guillain Barré syndrome, where sufferers experience varying degrees of paralysis.
Campylobacter can also kill – there are up to 85 deaths per year from this organism, and in 2012 there were 72,000 reported cases in the UK. Of course many cases are not reported as people don’t always go to the doctor, and a recent report suggested that for every case of food poisoning that the GP sees, there are 147 extra cases in the community.
Campylobacter doesn’t grow in food; it grows in the body and is highly infectious. Only 500 bacteria are needed to cause symptoms – this was found out by a scientist swallowing 500 organisms that he had put into a glass of milk!
The most common carriers of Campylobacter are chickens. In a survey carried out by the Food Standards Agency (FSA), 65% of retail chickens were found to be carrying the organism and the FSA estimates that 60-80% of cases can be blamed on chicken. Recent outbreaks have been traced back to chicken liver parfait served in restaurants.
Where is Campylobacter contracted?
With an incubation period of 3-5 days it is difficult to identify what has caused one off cases, but we certainly can’t always blame our local restaurant. In fact we should more often blame ourselves!
Andrew Wadge, Chief Scientist at the FSA points out that there is a bit of a taboo in thinking that we might be at fault. “People don’t like to admit that the germs might have come from their own home but it’s a common myth to think that food poisoning only comes from a dodgy takeaway.”
Keeping Campylobacter under control
The main causes of illness are cross-contamination, where the bugs are moved from one place to another, and not cooking to the right temperature. Both of these are very easy to avoid with some simple hygiene in the kitchen.
But with some sources telling you to use anti-bacterial products and others telling you that hot soapy water will do the trick, who are you to believe?
Well, common sense will tell you that if water is hot enough to kill bacteria, it’s too hot for you to put your hand into, so hot soapy water just won’t do the trick. Then it won’t just be on your surfaces, but on your cloth, in your sink and all over the washing up that you think is actually clean!
So make sure that you always use an anti-bacterial spray on any surface that might have come into contact with raw poultry and meat. Plastic chopping boards and knives can be put into the dishwasher as long as the cycle reaches temperatures of 65° C for at least 30 minutes. You don’t need to go crazy with products, just spray the surface, leave for a few moments then wipe with a paper towel or rinse under the tap. I wouldn’t put my family at risk by failing to do this – and I can assure you, I don’t get through bucket loads of product!
The other very simple control is cooking. Advice such as “cook till piping hot”, “till the juices run clear”, “till there is no pinkness” is all over the place. However, it is well known that colour is not an indication of “doneness”. The only real test is actual temperature in the thickest part of the meat. That’s what we tell caterers to do – so why not advise people cooking in the home to do the same? The simple message, is don’t guess, cook to 75 °C in the centre and you will have killed Campylobacter. A simple probe thermometer can help with this for as little as £15. Obviously the probe needs disinfecting – boiling water or anti-bacterial spray can be used.
Finally it is essential that after handling raw chicken everyone washes their hands thoroughly using soap, warm water and dries their hands on a paper towel, preferably.
Some top tips to prevent Campylobacter laying you up for 2 weeks:
• Cook chicken to 75 °C in the core use a probe thermometer
• Minimise the mess – get all the utensils and ingredients out before you start to prepare chicken – it reduces the spread from your hands to handles etc
• Clean up immediately after handling chicken and blitz any areas that may have Campylobacter on them using a good quality anti-bacterial spray – leave on for a few minutes and wipe away with paper towels. Anti-bacterial wipes are good as well. Spray the sink and taps to make sure they are not contaminated.
• Wash your hands thoroughly using soap and warm water, get in between the fingers and thumbs and soap up round your nails. Dry with a paper towel
• If you enjoy a glass of wine when you are cooking, don’t get Campylobacter all over the rim – wait till you have finished preparing the raw chicken and have cleaned up!
• If you use a cloth, then you need to wash it at over 60 °C or boil it up in a saucepan just like my granny used to do – it’s fun to see the colour of the water!
Making School Science Exciting – and encouraging good hygiene practices!
I was asked to run a science class at a local school for 40 Year 5 children (aged 9-10). Using an ultra-violet light torch and glow-in-the-dark powder, we carried out 3 experiments to bring microbiology to life and show how invisible organisms can spread. Some of the children had seen me doing something very similar on GMTV in the summer.
Bacteria are Invisible, but they are Everywhere
First I explained that you can’t see bacteria and viruses with the naked eye, and that whilst most micro-organisms are harmless, some can cause illness, and these are called pathogens. Our experiments were to demonstrate how bacteria and viruses could spread. Because the powder is invisible in bright light, it is very useful to show how invisible micro-organisms can transfer from hand to hand or surface to surface around the home.
Hand to Hand Transfer of Bacteria
Group one was asked to form a line and the first girl shook my hand, then turned round and shook the hand of the girl behind and so on to the end. Then we dimmed the lights and using the torch we could see the spread of the powder from one girl to the next. This demonstrated how germs could spread via hands. The powder was still visible on the 7th hand! Obviously the importance of hand-washing was becoming evident….
Tea Towels – How they can Transfer Bacteria
Group 2 used a tea towel to wipe dry some wet drinking beakers. What they didn’t know is that I had put some of the powder on the tea towel! When we shone the torch on the cups, the powder could be seen on the inside of the cups. This showed how important it is to wash the tea towel regularly so that you are not putting bacteria onto your clean crockery and cutlery when drying up.
Cleaning – can make things Dirtier!
Group 3 were asked to go and “clean” some surfaces in the classroom with a cloth – and guess what? There was some glow in the dark powder on the cloth too. So when we shone the torch on the surfaces, we saw how the powder had transferred to surfaces. This demonstrated how dangerous a dirty cloth could be. I told them about all the dirty cloths we found in the UK survey, many of them with E.coli on.
Group 4 used the “green is clean” swab to see if there were any dirty areas in the toilets and classroom – but well done school cleaners – all was sparkling!!
Finally, as the powder was now on nearly everyone’s hands, I played a little trick, and asked everyone to go and wash their hands. Then I used the torch to see who had done it properly – oh dear! We then had a discussion on how to make sure that the backs of hands are washed, between the fingers and nails. The time it takes to sing “happy birthday to you” all the way through twice is how long you should take. So I guess it will be quite noisy at the sinks now – sorry teachers!!
We then gave out homework sheets and one task was to invent a bug, draw a picture of it and give it a name.
The Hygiene Doctor takes on the risky subject of poo!
Recently I was watching the Oscar-winning film The Help and was laughing at the scene where Minny cooks the fateful poo pie. Like most people I was horrified at the thought of eating poo, but it got me thinking that in many circumstances, people may be unconsciously doing just that!
Many of the home hygiene studies we do have identified faecal contamination in some fairly surprising places around the home, garden and even on items in handbags!
Faecal contamination is the posh word for “poo”. So how is poo getting around the house?
Wash your hands after using the toilet
It’s so basic you might think I’m wasting my time talking about it, but you would be amazed at the high number of Britons who don’t actually wash their hands after going to the toilet. A recent study showed that as many as 26% of UK hands have faecal matter on them at any one time. That’s around 16.5million pairs of hands!
If you don’t wash your hands, faeces can easily transfer to food, or to crockery and cutlery which means the chances of ingestion are high and if someone is carrying a nasty bug such as norovirus then it can quickly do the rounds. Even if you haven’t done a “number 2” then the person using the facilities before you may have, leaving bacteria on the toilet flush and door handle!
It is especially important to teach children the importance of hand washing as that way they will carry the good habits on into adulthood. I recently went into a school to do a hand washing science session, with some surprising results. You can read more about that visit on my school blog.
Many schools have a policy that children may not return to school until 48 hours after the child has had no symptoms of food poisoning. However, it is known that norovirus and other dangerous food poisoning organisms can be carried for many days, if not weeks after the symptoms were showing. Even more worrying, it is estimated that around 16% of the population carry norovirus without having any symptoms.
So the important message is (sorry) HAND WASHING, HAND WASHING, HAND WASHING!
How to Wash your Hands
Hand washing doesn’t mean a quick swill under the tap:
Wet the hands
Put on soap
Rub your hands together
Rub in between the fingers
In your palms, interlock your fingers to rub soap into your nails
Lather round your thumbs and fingertips
Dry on a clean towel or better still a paper towel.
Watch this video to see how you should wash your hands:
If someone is ill
Hand washing is even more important if you or anyone in your family is ill with any infectious disease from colds and flu to food poisoning.
Is it worth it you may ask? Well think about how much money illness can cost, let alone the pain and suffering!
Here are some of the financial costs:
Time off work
Time off work looking after children
Prescriptions and over-the counter medication
Travel to hospital, doctor, chemist
Parking at the hospital, doctors or chemists
Additional cleaning and laundry
Missing clubs, activities and special events you have paid for
Missing nursery or childcare you have paid for
So spending a little time washing your hands is worth it!
“A peck of dirt before you die” – I will give it a miss, thanks
Dr Lisa Ackerley looks at the reasons why you should wash raw vegetables thoroughly.
The Health Protection Agency revealed that unwashed leeks and potatoes may have been the cause of 250 scattered cases of E.coli O157 during 2010- 2011 which hospitalised 74 people and killed one already sick person.
So how do you make sure you don’t fall ill from E. coli? Should you stop buying leeks and potatoes? Of course not! Just follow some simple rules:
Cooking kills E. coli, so all leeks and potatoes will be safe when cooked.
Use anti-bacterial products to remove dirt and kill E. coli on potentially contaminated surfaces such as chopping boards and sinks.
Make sure you wash your hands properly after handling raw vegetables – not a quick swill under the tap, but with soap, warm water and dry them properly afterwards preferably on a paper towel or hand towel – not a tea towel! This is a video from the Food Standards Agency on hand-washing which is for caterers, but there are some useful tips for the home.
It raises the issue again of how to clean produce which is to be eaten raw – produce wash for domestic and commercial use is available from the Hygiene Audit Systems shop.
So would I want to eat a peck of dirt? Not if it has E. coli on it – and how can you tell? It seems as though nearly every month another source of this potentially deadly organism is uncovered. So to keep things simple, assume that raw vegetables, meat and poultry may be contaminated, clean up carefully after preparation, and wash your hands!