Cruising to Handwashing Woes
11.dec.02, Ben Chapman and Christine Hunsperger, Commentary from the Food Safety Network
11.dec.02, Ben Chapman and Christine Hunsperger, Commentary from the Food Safety Network
Vomit-ridden cruise ships; deserted emergency wards; empty classrooms.
The Norwalk virus is casting a pall across North America, including four different
cruise ships. On the Disney line, Chip and Dale may soon be known as Upchuck and
Diarrhea.
Less noticed but deliciously ironic is that the Norwalk outbreaks are occurring
during America's National Hand Washing Awareness Week.
And the best guess for the current scourge of ships and schools? Poor sanitation,
especially handwashing.
The United States Centers for Disease Control (CDC) has said that the cruise-related
outbreaks of, as one food safety dude described it, Nor-walk/Nor-trots/Nor-runs
virus, originated with passengers boarding the ship rather than food or water.
Last month the CDC issued new hand hygiene recommendations, just in time for the
annual up-with-handwashing calender event, an observance polite and trusting Canadians
don't recognize.
The CDC report states that hand washing is the single-most important means of
preventing the spread of infection and advocates the use of alcohol-based hand
rubs for health care workers. Many food processing plants have workers squirt
the alcohol sanitizers upon entering the line floor and fruit and vegetable growers
are getting in on the practice as well, providing hand sanitizers in the field
and the greenhouse.
Such focus on alcohol-based hand rubs is replacing the previous notion of traditional
soap and water as the only tools in fighting bacteria and contamination. It may
also contribute to an already confused public, which can now choose between three
types of microbial removing agents: anti-bacterial soaps, alcohol-based hand rubs
and the cheaper traditional soap and water, leaving many wondering 'which type
of hand washing product should I use?'
Health Canada advises the public to avoid using anti-bacterial soap and similar
bacteria-fighting household cleaning products, promoting traditional soap and
water, which they deem the most effective way to prevent infection caused by bacteria.
Why is this? The inclusion of friction into the handwashing equation agitates
the dirt that may be stuck to your hands, allowing it to be removed along with
the potential pathogens living in it. Soap has antibacterial action itself, there
isn't a need to pay extra for anti-bacteria labeled soaps.
Alcohol-based gels also take less time to use than soaps, thereby making them
convenient for health-care workers. These products are also useful when no water
is available for traditional hand washing. Although using alcohol-based gels is
an easier way to destroy potentially harmful bacteria in a convenient and quick
method, the public should not completely abandon soaps. Those who rely purely
on alcohol-based rubs are likely leaving dangerous contaminants, viruses and toxins
on their hands that may cause illness.
Alcohol-based gels significantly reduce the number of microorganisms on skin,
are fast acting and cause less skin irritation, if the skin is clean and free
from dirt, blood, grease or other contamination material. The evidence shows that
alcohol based sanitizers reduce surface bacteria but without the friction they
do little to address sneaky microbes. Although the convenience and speed of alcohol-based
hand gels may be appealing to consumers, the most effective method of hand washing
is still plain old soap and water.
Though perhaps not practical for the public, the CDC recommends the use of alcohol-based
gels in day-care centers, hospital and nursing homes, and in food preparation
where close physical contact with people at high risk of infection such as infants,
the sick and the elderly may occur. They are popping up at petting zoos as well,
an activity that has been linked to outbreaks in recent years.
Mickey Mouse is not off the hook on this one either, his gloves do little to stop
the spread of transmission of bugs if they are not cleaned and sanitized between
tasks. As Canadian singer Avril Lavigne asks, "why does it always have to
be so complicated?" Food and water borne illness will always be difficult,
with changing bugs, changing lifestyles, and complacency.
Norwalk virus, named after an outbreak that occurred in Norwalk, Ohio in 1968,
is here for the long-haul. Always wash your hands with warm soapy water after
using the toilet and before preparing foods. Drinking water supplies should be
protected from contamination with raw sewage. Shellfish should be cooked thoroughly.
Vegetables and fruits should be washed before eating.
Handwashing, in the field, at food service, and in the home, can help.
Ben Chapman and Christine Hunsperger are researchers with the Food Safety Network
at the University of Guelph.
519-824-4120 x4280
bchapman@uoguelph.ca
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