Personal Hygiene in a Biowarfare World, by TruthFirst

Thursday, Sep 7, 2006

It’s a new world: West Nile virus, Cryptosporidium, Anthrax, Norwalk virus, Cholera (in the Gulf States, from shellfish!), Avian Flu, Ebola, Malaria (yes, in the US!), Hepatitis C, HIV / AIDS, genetically-engineered bacteria, and the ominous and very real threat of biological warfare. Thanks to the speed of international travel, persons who would have never made it very far from the point they were infected can now circle the globe in the time it takes to develop symptoms.
Someone you bump into at the mall could have contracted an exotic disease in Africa last week. The person who used the restroom before you could have just come from South America and is only now coming down with cholera. The person you shake hands with could have just shook hands with someone carrying Hepatitis A.
The odds of your becoming infected with a truly dangerous disease are small, but real. (No one even wants to catch a Type A flu!) You could go around in a biohazard suit all day, but of course you’d be treated like some kind of freak. There is good news, though: effective personal hygiene practices don’t have to be "weird" or attention-getting!
There are simple steps that with practice can become second-nature habits, and simple things you can buy, which will significantly reduce your potential for catching any contagious disease. These steps will help with everything from colds and flu to bio-weapon attacks or genetic-engineering accidents.

Do the basics:
Eat right, exercise, get a good night’s sleep. A healthy body is far more resistant to bacteria and viruses.
If there’s an outbreak of the flu, cold, or worse going on in your community, minimize going out in public as much as possible until things get better. If it’s something truly nasty, stay home and eat from your pantry a week until things improve. (Stored food and water are recommended by the Red Cross and Department of Homeland Security.)
Keep in mind that staying well isn’t so much a matter of avoiding germs entirely, as it is minimizing your exposure. It generally takes a certain number of bacteria or viruses to overcome your body’s natural defenses and make you ill. So you get exposed to some germs – it’s not a big deal as long as the number is relatively small because your body will be able to protect you.

Buy the basics:
1. Waterless hand sanitizer lotions are available in the grocery store (Purell is probably best). Buy a little bottle for your pocket or purse. You an refill it from a larger size bottle. Lotions can get into the tiny cracks and crevices in your hand better than towelettes. (Use a generous amount and wash your hands with hot water and antimicrobial soap at your first opportunity.)
2. Buy a couple boxes of pop-up antiseptic / antimicrobial towelettes that contain bleach to keep at home and at work. They make cleanup quicker and less smelly than sprays (and you won’t accidentally get the chemicals on things you don’t want sprayed, like your clothes).
3. Get a box of nonsterile vinyl gloves from your pharmacy or store. They’re inexpensive and also good for painting, cleaning up dog or cat accidents, scrubbing the kitchen or bathroom with harsh chemicals, etc. For your purposes they don’t have to fit snugly like surgical gloves, and vinyl doesn’t have the allergen complications of latex (rubber) gloves. Nitrile gloves are more expensive, but are harder to puncture. Carry a pair of gloves with you, if possible, for those times when you’re giving first aid or you have to handle something that may have been contaminated with germs, chemicals, or even just dirt and grease. They do get old and crack eventually, so you might want to change them every 6 months or so.
4. Buy a box of folding protective masks, 3M model #9211 (about $10). They’re not as efficient as “N100” dust/filter masks, but because they’re foldable you can keep one with you most times. Keep one for each member of your family in your purse, glove box, or briefcase. (NOTE: If you’re wondering, dry masks filter particles better than wet masks.) Your mask should be rated "N95" or better - most “surgical masks” are actually very poor filters and don’t form a good seal to your face. Know how and when to use your mask.
5. A little bottle of nasal saline spray, or Xlear spray (even better), can be used any time you’ve been in close quarters with someone who’s sick. The xylitol in Xlear greatly reduces the number of bacteria or viruses that attach to the inside of your nose and sinus cavities.
6. Get facial tissue pocket-packs to carry in your pocket, purse, or briefcase. They’re better than handkerchiefs, which can continue to re-expose you to the very same bacteria or viruses you just got rid of.

Hand hygiene:
1. Keep your hands away from your eyes, nose, and mouth unless (1) you’ve just washed or sanitized them, or (2) you’re using a facial tissue. Since people often rub their eyes or touch their face unconsciously. Not doing so is probably the hardest new habit to learn. Fewer organisms are floating in the air than have settled out on surfaces (or other person’s hands) that you’ve touched. Not touching your face is the #1 best way of reducing the number of bacteria and viruses that get access to your body. Work on it!
2. Make a habit of washing your hands frequently (for those times when you do accidentally touch your face). Wash every time you use the restroom, before every time you snack, before every meal, and at bedtime.
3. When you wash your hands, remember this: it’s at least as important to dry your hands thoroughly as to wash them thoroughly. Washing rarely kills every germ on your hands, but if your hands are damp, it’s far easier for the few germs on your hands to be transferred to another surface or person than if your hands were completely dry.
4. Glove up any time you’re around bodily fluids, such as at an accident scene, or helping someone who’s become sick. If there’s not time, wash up and sanitize your hands immediately afterwards. The likelihood of infection in this manner is small, but it has happened. Any object or clothing that comes into contact with bodily fluids is contaminated too and needs to be disposed of or disinfected (clothing or bedding can be washed - use a little bleach).
5. On a somewhat related note, encourage children to blow their noses, rather than sniffing when they have a runny nose. Better to expel the stuff rather than inhaling bacteria and viruses still deeper into the nasal passages.
At school, work, or shopping:
1. It may not be practical at work, but try to wash your face at least a couple of times during the day. A washcloth makes this much easier to do – you can wash, and rinse with the same cloth. Put it in a Ziploc for the trip home each day.
2. Don’t hold pencils, pens, or tools in your mouth. Buy a belt holder / holster for frequently-used items if your shirt or uniform doesn’t have a pocket.
3. If you share a keyboard or area at work with someone who’s been sick, wipe your computer keyboard, phone, and entire area down with an antiseptic towelette each day.
4. If a house- or office-guest or customer was coughing or sick, after they leave, wipe down all of the hard surfaces they may have come in contact with: doorknobs (inside & outside), tables & counters, etc. Using one of the commercially available pop-up towelettes that contain bleach will make this more convenient!
5. Spray your nose a couple of times during the day during cold and flu season to wash away germs that may have floated in.

Restrooms:
We don’t like to talk about them, but potty functions are one of the greatest opportunities to accidentally transfer germs to surfaces and from there to your eyes, nose, and mouth. Ignorance is not bliss! These steps below will take you only another 30 seconds. A little attention and some simple new habits will go a long way toward protecting you from getting sick:
1. Before doing anything in a public restroom examine the toilet seat that you are contemplating having intimate contact with. If its wet or flecked with stuff, switch stalls.
2. Then, look at the floor around the toilet and run your foot over the tiling. Also look at the back of the toilet seat where it attaches to the wall or tank. If the floor or toilet seat are wet they may have just been cleaned, or the toilet’s recently overflowed, or someone’s got bad aim. In any case, you don’t want cleaning chemicals or toilet overflow on your clothes (and from there to your body and eventually your hands!) – just switch stalls!
3. Flush once before sitting down (if you flush after sitting down you just misted your south end with microscopic bits of stuff left in the water). If there are skid marks or other remnants from previous users, flush and keep flushing until the bowl appears clean, or switch stalls. Even if there is any invisible residue from the previous user still in the water, “pre-flushing” will help remove or dilute it further. (This will also show you if the toilet has been plugged up by the last user and is going to overflow after you use it, in which case, switch stalls!)
4. Take a wad of toilet paper off the roll (check to be sure its not wet – some places leave spare toilet paper (TP) rolls on the floor…), and wipe the toilet seat off. This is also a good check that there is TP in the stall and that you won’t end up being stranded. Buttock skin in its intact state is generally impervious to germs (but not cleaning chemicals). But even if your skin is pristine, the previous user’s may not have been, hence the need for cleaning and a barrier (below).
5. Then put the TP wipe into the water and even add a little more so that you create a “splash-down damper” to minimize splash-back during your use, which at least in theory could infect you through your rectal mucosa. Just think about it for a moment.
6. Toilet seat covers are your extra bit of insurance from coming into contact with something unpleasant on the seat. You can buy seat covers at the grocery store in little plastic carriers for your purse or briefcase (“Charmin To Go” is one example), or take one or two the next time you’re in a public restroom, fold them up, and put them in a little Ziploc Snack-size bag. If the stall doesn’t have seat covers, you can drape TP around on the seat (seat covers are probably faster, but TP is softer…) Some people even carry their own toilet paper (again, you can buy it in little plastic carriers) in case every stall in the restroom they pick is out. (And in case you didn’t know, the toilet seat cover should be flushed.)
7. You’ve checked the seat and floor, wiped the seat, improvised your splash-down damper, and deployed your seat cover in 30 seconds or less. Now, as you sit down, keep one final thing in mind: do not allow any portion of your tender regions to touch the toilet seat, or toilet rim, or its all for naught. This can be an extra challenge for men for reasons that should be apparent. Neither the seat nor rim is sterile, and it may be very unpleasant or impossible to adequately clean yourself once you make accidental contact. ‘Nuff said…
8. Step away from the toilet and dress yourself again when you’re through, check to make sure none of your pocket stuff – guys in particular – has fallen into the toilet (I say this from experience…), and only then flush the toilet. The splashing action and force of many modern toilets creates a fine mist that can contain bits of toilet content and drift around in the air. Exit the stall as the toilet is flushing. No loitering…
9. After you’ve washed your hands with hot water and soap, you should also try to turn the faucet off without touching it with your hands, since the knob(s) could be contaminated. Some faucet designs make this easy with paddle-shaped handles. Newer public faucets are electronic and have no knobs at all. (Imagine your hands with paint on them. If you touched the faucet handles to wash the paint off, how will you turn the faucet off without getting the “paint” back on you again?)
10. After using a public restroom be aware that others have probably left the room without washing their hands, and the doorknob to exit is probably contaminated with their germs. After you’ve washed your hands and thoroughly dried them, keep the paper towels you used and use them to open the door (if it pulls toward you). If there are no towels use a facial tissue, piece of toilet paper, or the sleeve of your coat to grasp the handle, or use the knob but give yourself a generous dab of hand sanitizer (Purell is great) after you exit to sanitize your hands. Throw the paper towel away after you exit the restroom.
11. And while we’re on the subject: clean your home bathroom before guests arrive (so it looks nice!), but also remember to clean your bathroom after they leave (so your guests haven’t inadvertently left you a bio-present).

Eating:
Minimize eating out. Teenagers and convicts are frequently the food preparers, and neither have very much concern for the basics of food safety. We have often been shocked to see just who was cooking our meals. Not to mention your food and its packaging goes through many more hands than meals prepared at home. Sit-down restaurants are probably better than fast food places, and they may actually serve food fit to eat (less fat, in particular). Observe the employees in restaurants you routinely visit. If they appear unhealthy, find a different place to eat.
Public salad bars, cold food counters, buffets, cold salads, peeled fruit and cream dishes are easily contaminated (by accident or on purpose). Try to avoid these wherever possible. Your food should be steaming hot when it is served to you, to guarantee its at least been heated recently. Undercooked seafood in particular can harbor an amazing variety of diseases (ironically, frying adequately sterilizes most everything). Avoid condiments that are served from dishes that could be coughed on or otherwise contaminated. Avoid dishes which are dipped into with crackers or chips or bread by several different people.
Drink pure water. If possible, don’t drink water from the city water supply (chlorinated water still has dead bacteria in it, may still have active viruses and parasites, and the chlorine really isn’t good for you). If you’re not on your own well, use distilled or reverse osmosis water to drink and cook with. Home water purifiers vary greatly in cost and effectiveness - get the best filter or system you can afford. City water supplies are vulnerable to terrorist attack as well as accidental contamination. Try to avoid drinking out of drinking fountains, if possible (my own son caught Hand, Foot, and Mouth Disease in this way, so I know it can happen). Keeping yourself hydrated helps your body be healthy and fight infections.
Flying (also applies to riding the bus or riding the train or subway):
NOTE: People who have flown within the past week get colds at four times the average rate, so a little extra attention to hygiene is worth avoiding a week or more of misery!
1. Leave rested and well fed.
2. Bring your own (little) pillow if it’s going to be a long flight or trip.
3. Spray your nose frequently during and after your trip.
4. Keep your hands away from your face.
5. Keep your hands washed or sanitized.
6. Drink plenty of (bottled) water.
7. Avoid alcohol on your trip - it dries out your body quicker.
8. If you’re seated near someone who’s obviously ill, ask a flight attendant for a different seat if possible. If you’re on a bus or train, move somewhere else. If you can’t move, and the person sounds sick enough, break out your folding dust mask.

Using a Dust Mask:
You usually only want to wear a mask under three conditions. One, if there is a particularly bad flu or cold going around, and your immune system is already run down from another illness, medication, or surgery. Or if you’re “trapped” sitting near someone who’s obviously very sick, but you can’t get away because you’re in an airplane, bus, train, or subway. Or finally, if you suspect there has been some kind of biowarfare release in your area, or refugees are arriving in town from a city that’s been attacked.
Things to remember when using a protective mask:
1. Getting a good seal around the mask against your face is critical. If air is able to leak around the mask and into your mouth and nose it is not being filtered. Follow the directions that come with the mask closely.
2. Once you arrive at a safe destination – an evacuation point or your own home – keep your mask on while you change clothes outside. Bag up your contaminated clothes until you can find out if it was a real biological or chemical attack. If no one else is at home to help, just do your best to contaminate as few areas as possible while doing this.
3. Treat the outside of your mask as contaminated. If there really were harmful biological organisms in the air that it filtered out, they’re now stuck to the outside of the mask. Take it off carefully, outdoors, so as not to disturb the germs on its surface, then dispose of it in a sealed bag.
4. Then thoroughly wash and disinfect your hands and face (use Purell, but don’t get it in your eyes; even just soap and water is good), then take a shower. If you have some zinc-base eye drops use them to try to flush and disinfect your eyes (bacteria and viruses getting into your lungs are a much greater threat than eyes).

Miscellaneous
When using a locker room, pool, or public shower try to keep your wet feet from touching clothing that will eventually touch your body. This can be pretty tricky (bathing suits, underwear, pants, etc.), but you really don’t want to apply what’s on the floor to your body. And don’t put your clothes on the floor for the same reason. Every time I’ve gotten “athlete’s foot” its been from showering at the gym or pool, so you know there are germs there!
It should go without saying that you shouldn’t share makeup, chap-stick, lipstick, powder brushes, etc. that have been used by others because of the possibility that they may contaminate you. The risk is low, but there is some risk. Use a little common sense.

In an actual biological warfare attack:
If there is a known biowarfare release in your area and you use your car to drive home, your car may become contaminated inside (from you) and outside, and you may be taking deadly biological agents with you to contaminate your home. Also, studies have shown that nearby buildings are a much better shelter from biological or chemical weapons than cars are.
If the government is pretty sure there has been a biological attack, go to the decontamination areas specified by the government over the radio or television. If you’ve gotten a good dose of germs you’re going to need professional medical help to decontaminate yourself and to survive the exposure. Quick use of your protective mask will reduce your exposure. The key phrase is “minimize your exposure.”
If you’re concerned about biological warfare, get more information from the Department of Homeland Security, the Centers for Disease Control, the RAND Corporation, or the American Red Cross. Paranoia doesn’t help, but reasonable preparation makes a lot of sense.


Print out, laminate, and refer to the following summary. Some habits are hard to break and will need constant work:

PERSONAL HYGIENE

Hand hygiene:
Keep your hands away from your face
Wash and thoroughly dry your hands frequently
Wear gloves if you know something is contaminated

At school, work, or shopping:
Wash your face a couple of times during the day [washcloth]
Don’t put stuff in your mouth.
After a potentially sick persons leaves, wipe down all of the hard surfaces
Spray your nose often

Restrooms:
Check the toilet seat
Check around and behind the toilet
Pre-flush
Wipe the seat
Make your splash-down damper
Use a toilet seat cover
Don’t touch the toilet seat or toilet rim
Step away from the toilet and dress. Exit the stall as the toilet is flushing.
Wash with soap and hot water – don’t touch the faucet handles afterwards
Don’t touch the restroom door handle – use a paper towel or something

Eating:
Minimize eating out.
Avoid salad bars, cold food counters, and buffets
Drink lots of pure water.

Public Transit: (in addition to the above)
Leave rested and well fed.
Bring your own pillow
Avoid alcohol on your trip - it dries out your body quicker.
If you’re seated near someone who’s obviously ill, just move


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