HealthTuesday, May 29, 2007 10:32 AM CDT

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War against germs

Are we going over the top
in our quest for cleanliness?

By Tim Engle
McClatchy Newspapers

KANSAS CITY, Mo. -- Courtney Bash is "obsessed" with antibacterial gel, which she carries in her purse, her computer bag, "every bag I have."

At pizza places, she'll touch the Parmesan and pepper shakers only with a napkin, because "All those kids touch that, and they probably lick the top of it." Shaking hands? "I think it should be outlawed."

Friends and family consider her a little extreme when it comes to germ-fighting, "but that's just because they're filthy," says Bash, 32, of Kansas City, Mo. "Just kidding."

For Kati Vanderhagen, it was a stay in a grimy hotel 20 years ago that made her realize "just how filthy places are." These days she refuses to drink from a water fountain, even if she's extremely thirsty. She tries to avoid public restrooms. At the gym, "If I don't like the way somebody sprayed (a piece of equipment) down, I can do it again."

And then there are restaurants.

"Have you seen what they clean tables with? The nastiest, dirtiest rags you've ever seen in your life." She concedes that's not true of every eatery. Still, "If my food touches the table, I don't eat it, and if my silverware touches the table, I ask for clean silverware," says Vanderhagen, 49, of Merriam.

Not everyone takes it as far as these women, but chances are, you're more germ-conscious than you used to be. Do you use your foot to flush public toilets? Do salad bars gross you out because of all those hands on the tongs? Do you keep a list in your head of co-workers who don't wash up after going to the restroom? Do you Lysol your keyboard if someone with a cold as much as looks at it?

Well, good news. Maybe.

Granted, the people familiar with your germus operandi may be muttering "OCD" under their breath, but an expert at the Centers for Disease Control and Prevention understands our collective germ phobia -- or, as he puts it, our "interest in infections."

We're often jammed together in airplanes and elevators. Some of us, such as babies and elderly people, are susceptible to infections. And there are the scary headlines about bird flu and E. coli tacos. Given all that, worries about germs are "a rational reaction to some of what we see," says Michael Bell. He's associate director for infection control at the CDC in Atlanta.

Infectious diseases have always been with us, Bell says. There's always been a risk of getting sick from tainted food or water, always the possibility of catching something from other people or animals.

But a lot has changed for the better. In the Civil War, a soldier with an infected wound was likely to lose a limb or die. Now, we expect that antibiotics will defeat any infection. We expect clean drinking water. And there've been many improvements in "our hygiene infrastructure" the last couple of centuries, Bell says.

Yet we fret about germs.

This is fine with Bell, who says that as a society, we'd perhaps become a little too blase, "a little distanced from the realities of infectious diseases."

So those of us engaged in daily germ warfare -- we who use tissues to touch door handles or make guests remove their shoes -- might represent "a fairly reasonable return to normal thinking," Bell says.

But keep in mind that not all germs (a catch-all term for bacteria, viruses, fungi) are bad, and in any case you can't escape them, no matter how much Purell you slather on.

"Germs are everywhere," says Alan Salkind, a professor of medicine in the infectious diseases section at the University of Missouri-Kansas City School of Medicine. "They're in the air we breathe. They're in the water we drink. They're on the surfaces we touch. We share an environment with germs."

Your mouth, for example, is swarming with bacteria, hundreds and hundreds of microscopic living organisms. And to think you kiss your mother with that mouth.

But that's the way it's supposed to be.

"There's that balance between the (body's) healthy state and the germs," Salkind says. "They kind of coexist together."

Overall, our bodies are well-equipped to fight bad germs. As we're exposed to them, we build up immunities to them. Even Kati Vanderhagen recognizes that. "If you become too germ-phobic, you're going to end up having no antibodies and you will get sick," she says.

Someone who's overly concerned about not touching certain things might have OCD, obsessive-compulsive disorder. Generally, the "determining mark" of whether there's a problem is when someone's germ phobia starts interfering with their day-to-day life, says Michael Blair, a psychologist at Crittenton Children's Center in Kansas City.

Salkind urges common sense: "If you touch something dirty, wash your hands."

And yes, children are terrific conduits of germs. Still, Salkind says, "Are you going to tell your kid he can't go over to Johnny's to play because Johnny doesn't have antimicrobial toys?"

Touching indeed

Your fingers don't suffer when you touch something germy, of course.

But unless you wash your hands, you're likely to introduce the germs on your fingers to your eyes, nose or mouth. The next thing you know, you could have a cold or worse.

You can try not touching your face (the average person does it one to three times every five minutes), but it's probably a losing battle.

Battling germs

Germs can live several hours or up to two or three days, depending on the environment.

There's no magic number of how many times a day you should wash your hands. But let's say you go to the bathroom three or four times. You eat at least three times. You touch something dirty -- a sticky handrail, maybe -- at least three or four times over a day.

That means you should probably be washing your hands at least 10 times daily.

"And yet if you ask most folks how many times a day they wash their hands, very few will say 10 times," says Michael Bell of the CDC.

Scrubbing is key when washing your hands. As for how long, a rule of thumb is to wash for as long as it takes to sing "Happy Birthday." That's about 20 seconds.

Another piece of advice from the CDC: When you're sick, stay home. If you must be out in public, cover your face when you cough or sneeze. (Then wash your hands.)

You might be a germophobe if ...

Do you do any of these things to avoid germs? Should you? We ask two infectious-diseases experts Alan Salkind at the UMKC School of Medicine and Michael Bell at the Centers for Disease COntrol and Prevention.

Reasonable or over the top?

Use paper towels to turn off the faucet in a public restroom. -- Seems reasonable, Salkind says.

Use your elbow to press elevator buttons. -- Over the top.

Use disinfectant wipes on handles of grocery carts. -- Over the top. You touch a lot of things at the grocery store, Bell says. Wash up when you get home.

Refuse to join a gym because of all the germs. -- Over the top. Gyms provide disinfectant for wiping off equipment.

Wash hands only with antibacterial soap. -- Not necessary. "Plain old soap and water is great," Bell says.

Wash up after petting a cat or dog. -- Reasonable.

Refuse to let anyone drink from your glass. -- Not a bad idea.

Won't share makeup. -- Smart. There've been outbreaks of infection from makeup sharing , Salkind says.

Refuse to let kids play in one of those indoor playgrounds. -- "A big room full of plastic balls that dozens of children with runny noses go diving into is a very effective way to spread around cold germs and the like," Bell says. But "little kids do a lot of things that are tough to control."

The bottom line: Even if you avoid touching, say, a germy restroom door, "you're sort of acting as though you're not going to touch anything else thereafter," Bell says. But you will. Just remember, the problem is not the germs on your hands; it's touching your eyes, nose or mouth. Best advice: Wash your hands regularly and vigorously.

Celebrity germophobes

"Deal or No Deal" host Howie Mandel. He does "fist bumps" instead of shaking hands. Also built a guest house he stays in when his kids are sick.

Oakland Raiders player Randy Moss. Won't touch doorknobs with his bare hands, won't let people open his refrigerator without washing their hands.

Actress Drew Barrymore. When her star on the Hollywood Walk of Fame was unveiled in 2004, she kissed it immediately because she wasn't going to once people's feet had been on it. Denies she is a "Howard Hughes germophobe or anything like that."

Rosie-hater and bazillionaire Donald Trump. Detests handshakes. "It's a terrible custom," he says.

SOURCE: The Germ Freak's Guide to Outwitting Colds and Flu by Allison Janse with Charles Gerba

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Are we becoming more germ phobic? (Kansas City Star photo illustration/Shane Keyser)

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