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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.
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