"Germs"

[The Atheist]

I recently decided to look up some information on hand sanitisers, which have been extensively advertised here in the past couple of years.

The advertising consists mostly of statements to the effect that the solution "kills 99.99% of germs" (or harmful germs).

This sounded like an extraordinary claim to me, and the first thing I found is that the alcohol-based disinfectants available are practically useless against a wide range of viruses, notably norovirus, which is the second top cause of sick leave. The solutions on the market at the moment are all alcohol-based, although I understand a different type might be available in USA.

One company does advertise its product as "killing 99.99% of harmful bacteria" which claim might even be true, given that bacteria don't like alcohol much.

Every dictionary meaning of "germs" includes bacteria, viruses and other microscopic organisms which are harmful, so there's no defence in claiming they meant bacteria.

Anyway, I'll leave that for the Advertising Standards Authority to sort out, but it got me thinking in general about personal hygiene and handwashing. I read an account of a paediatric doctor who handled sick kids all day every day but never got any infection. She defended claims of immunity through exposure by the obvious fact that influenza, cold and noro-viruses change frequently and immunity is impossible. She based her health on handwashing, claiming that proper hand hygiene just works. We're very obviously aware that hand hygiene is pretty damned useful - especially in little things like surgery and food handling.

There is an alternative view, which suggests that handwashing may lead to humans losing immunity, thereby becoming more susceptible to infection.

That sounds too much like the anti-vaxers crying about vaccines, but lots of people think it's a valid position. Maybe it is, I'm not an expert, although the evidence tends to make me think hygiene is probably better than filth.

Thoughts?

 

[arthwollipot]

As you say, hygiene is better than filth, but at the same time, wrapping one's children in a bubble to prevent them from getting infections is a really good way to ensure that they'll have to stay in the bubble all their life.

I wash my hands after visiting the toilet, usually before handling food (and always before handling food that other people are going to eat) and cleaning up after the dog when she's been accidentally shut inside all night. I don't use an antibacterial soap or alcohol wash. I'm no less healthy than anyone else I know. I also shower only twice a week because we're not on mains water (rainwater tank only). I don't smell as much as other people. I only rarely brush my teeth, and my breath doesn't stink.

One can stay hygenic without being obsessive about it.

 

[casebro]

My take is that you already have immunity to the germs you are confronted with in your daily life. Your mate can't give you an infection- you've already shared germs with each other. Same holds for your kitchen floor, your dog,...

I'll be going to a medical center today for a routine appointment. There will be squirt bottles mounted alllovertheplace. But I don't recall ever hearing about a study that the disease transmissibility is lowered in those places since they've been installed. Sanitizing hands don't help if the germs are everywhere else too. The world is a filthy place.

This reminds me of a friend, a nurse. She was sterilizing her 18 month old babies cup and spoon, at the kitchen window. When she looks outside to see the baby eating a dog-doo popsicle. That was when she finally decided to drop the sterilizing.

OUCH! (a thought just hit me) Did the rate of hospital infections drop as they cut the length of hospital stays in general? Or is the rate still the same, therefor it isn't the quantity of germs, it is the impaired immune system caused by whatever sent the patient to the hospital in the first place?

 

[Mojo]

You need to check out the British Institute of Osteopathy:

http://www.british-institute-of-osteopathy.org/events/Default.aspx

'So you think diseases are caused by little germy-wermies?'

Thursday March 13th
7pm till 10pm

After the great success of our autumn first conference, exploring the first osteopathic principles of natural immunity and structural integrity, an evening seminar exposing the modern medical mythology of germ theory is required.

It is impossible to learn to both appreciate and practice traditional osteopathic methods if the colleges continue to teach the non-evidence based germ causative disease theories.

Or: http://www.british-institute-of-osteopathy.org/articles/origin_germs.aspx

Now then!

Germs are made by your body in an effort to clear up a messy environment. Once this has been achieved they will automatically disappear again. Proven several times in the last 150 years alone, and still not accepted in our world.

Don't be cynical: it has nothing whatsoever to do with vaccines and germ killing substances, and the financial lucrative businesses of making and selling them; not to mention the high regard in which all these cleaver brains are held and the jobs they are holding on to.

 

[Bikewer]

My mother, from a generation where "germ theory" was only fairly recently accepted by the general public, was terrified of them. She "saw" them everywhere, and lived in fear of tetanus, ("lockjaw") and other unspecified ills.
Likely a real concern in her childhood, as effective antibiotics had yet to be invented.

I was always skeptical, and thought the manic cleanliness and handwashing before dinner were overdone.
I've listened to a couple of Science Friday segments on the prevalence of these germicidal products, and the researchers interviewed thought they were at best unnecessary and at worst promoted immunological problems.
They pointed out that hand-washing alone mechanically removes most organisms, and trying kill off the remaining few is just silly.

I often wonder how much water and paper products we use in our almost-compulsive handwashing after using the toilet. I mean, how dirty are you going to get?

We police are perhaps more susceptible than most; we have huge bottles of these alcohol-based sanitizers around the station; since we deal with "dirty" people. We used to have a "stinky" chair designated for certain persons...They made us get rid of it.

 

[robinson]

Who is "they"? And how did they find out about the chair?

 

[The Atheist]

My take is that you already have immunity to the germs you are confronted with in your daily life. Your mate can't give you an infection- you've already shared germs with each other. Same holds for your kitchen floor, your dog,...

....... Are you serious?

Have a butcher's at the statistics for days off work - that's usually the best way to tell how much cost there is in disease. The top three reasons, pretty much throughout the developed world are: colds, norovirus and influenza, usually in that order.

These are exactly the diseases that you will catch off a wife, child, colleague or someone close to you.

I'll be going to a medical center today for a routine appointment. There will be squirt bottles mounted alllovertheplace. But I don't recall ever hearing about a study that the disease transmissibility is lowered in those places since they've been installed. Sanitizing hands don't help if the germs are everywhere else too. The world is a filthy place.

It certainly is.

As you walked to work, you may have walked through someone's TB-infected snot, hawked out of their lungs (pretty unlikely) or you may have just put your hand in roughly 200,000 viral particles of norovirus (fairly likely) as you opened the door after the chick who just had a bad dose of diarrhea but doesn't wash her hands. Getting 10 in your digestive system is sufficient to confine you to a toilet for 24-48 hours. Or you may sit on a bus next to someone with a heavy cold and just inhale the viruses straight into your nose.

This reminds me of a friend, a nurse. She was sterilizing her 18 month old babies cup and spoon, at the kitchen window. When she looks outside to see the baby eating a dog-doo popsicle. That was when she finally decided to drop the sterilizing.

Eating faeces isn't necessarily a recipe for getting infection, it's just that they are a great vector when disease exists. Check out the number of organisms which inhabit dog faeces and the potential harm it can do - especially when kids play with it then rub their eyes.

The real details of the value of sterilisation are pretty obvious, being clearly seen as one of the reasons for decreased infancy death rates.

OUCH! (a thought just hit me) Did the rate of hospital infections drop as they cut the length of hospital stays in general? Or is the rate still the same, therefor it isn't the quantity of germs, it is the impaired immune system caused by whatever sent the patient to the hospital in the first place?

Find out and get back to it.

Generally, I think the take you have on it is not that far removed from this:

You need to check out the British Institute of Osteopathy:

Wow. Ignorance is strength personified.

Were not the vast majority of people quite ignorant about viruses and bacteria, hardly anyone could read that without falling over in astonishment.

 

[blutoski]

One company does advertise its product as "killing 99.99% of harmful bacteria" which claim might even be true, given that bacteria don't like alcohol much.

You'd have to check the active ingredients. Some have antimicrobials in addition to soap and denaturing detergents and alcohols.

There is an alternative view, which suggests that handwashing may lead to humans losing immunity, thereby becoming more susceptible to infection.

That sounds too much like the anti-vaxers crying about vaccines, but lots of people think it's a valid position. Maybe it is, I'm not an expert, although the evidence tends to make me think hygiene is probably better than filth.

Thoughts?

There's a difference between cleanliness achieved from hygine such as hand-washing with soap versus the concerns regarding the over-the-counter availability of certain antimicrobials.

In the former situation, there's no concern: the more cleanliness, the more safety. Soap, detergent, alcohol... gribblies won't evolve a defense against this. It's just the equivalent of removing or physically damaging them rather than interfering with their metabolisms.

In the latter situation, there is some risk. Over-the-counter availability of hospital-grade antimicrobials will develop resistance. It's not that our immune systems will actually get weaker. Constant trivial exposure will create or foster resistant strains in the home, which is the opposite of what the consumer wants.

I'm actually a very outspoken critic of these products. Soap is all you need.

ETA: Bikewer has pretty much already said as much. Sorry to be repetitive.

 

[blutoski]

OUCH! (a thought just hit me) Did the rate of hospital infections drop as they cut the length of hospital stays in general? Or is the rate still the same, therefor it isn't the quantity of germs, it is the impaired immune system caused by whatever sent the patient to the hospital in the first place?

The situation is more complicated than that. The push to reduce hospital stay time was not because it reduced the incidence of infection. Hospitals are cleaner than homes, so people at home are actually more likely to get infected, all things being equal.

The rationale is the reduced risk of infection with rare and extremely dangerous pathogens, which are more likely to be found in a hospital than at home.

A person recovering at home will get a staph infection just as likely as a person in the hospital, but is much less likely to get an MRSA or VRE infection, which are deadly.



In any case, it is already established that the quantity of germs is proportional to the chance of a succesful infection, and also in many cases the intensity and persistance of the illness as well. That's part of conventional Koch's Postulate approach, and our knowledge of minimum infectious quantity is a side effect of the process used to explore whether a particular infectious agent is responsible for a particular condition.

 

[Madalch]

You need to check out the British Institute of Osteopathy:

Their view on vaccination is terrifying. How, then, do they explain the sudden disappearance of smallpox?

 

[shadron]

Germs are made by your body in an effort to clear up a messy environment.

That is impressive. Not since pre-Pasteur have I heard that sort of lame stupidity; I was not aware that anyone in this day and age believed such. That's the medical equivalent of the Flat Earth Society. Then there's the "No need to be cynical."

Or, Maldach, the impending disappearance of poliomyelitis virus. Hooray for that, too.

 

[casebro]

Yes, but: Has anybody actually proved that hand sanitizers cut down on human infections?

Like Atheist said, I'm still walking to work through gobbets of TB sputum. And killing 99.9% of those 200,000 germs on the doorknob still leaves me with 200, 2000% more than the 10 he said are needed to infect.

I can't benefit from the killing of germs that I have already built up immunity to.

 

[dogjones]

I secure liability insurance for US hospitals.

I have yet to see a hospital whose Hospital Acquired Infection rate did not go down significantly following a sustained handwashing campaign.

 

[casebro]

Does "sustained handwashing campaign" mean alcohol based disinfectant bottles in the hallways? Or does it mean hand washing?

 

[The Atheist]

You'd have to check the active ingredients. Some have antimicrobials in addition to soap and denaturing detergents and alcohols.

As noted, all the ones currently on the NZ market have ethyl alcohol as an active ingredient.

I'm actually a very outspoken critic of these products. Soap is all you need.

I agree completely. The hand sanitisers appear to be quite useless.

Yes, but: Has anybody actually proved that hand sanitizers cut down on human infections?

I'm sure the number of bacterial infections would drop, and no doubt the manufacturers will have some data.

And killing 99.9% of those 200,000 germs on the doorknob still leaves me with 200, 2000% more than the 10 he said are needed to infect.

The bad news is that the 200,000 viral particles are norovirus, so an alcohol-based sanitiser won't kill any of them.

I can't benefit from the killing of germs that I have already built up immunity to.

I really think you've got the wrong end of this immunity business. Some viruses act in a way that immunity is impossible.

I secure liability insurance for US hospitals.

I have yet to see a hospital whose Hospital Acquired Infection rate did not go down significantly following a sustained handwashing campaign.

Cheers. That's what I'd expect.

Does "sustained handwashing campaign" mean alcohol based disinfectant bottles in the hallways? Or does it mean hand washing?

Handwashing, I imagine will be washing properly and ignoring sanitisers. I'd expect most medical professionals to be aware that alcohol is only effective against bacteria.

 

[Mojo]

Their view on vaccination is terrifying. How, then, do they explain the sudden disappearance of smallpox?

I expect it was eradicated by some evil Big Farmer conspiracy.

 

[rwp]

I recently read a short article talking about some research done on the subject. The results of the study indicated that washing hands with normal soap and warm water was just as effective as using antibacterial soap.

I will see if I can find the article or the study but perhaps you will find it first.

 

[Bikewer]

Robinson: The fact that someone had attached a sign saying "stinky chair" might have given someone in the administration a clue...

 

[Eos of the Eons]

http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html

Hospitals are becoming more and more concerned about MRSA. Hand sanitizers do kill the bacteria.

http://www.prlog.org/10037266-schools-seeking-hand-sanitizer-guidance-to-fight-mrsa-outbreak.html

http://www.medicalnewstoday.com/articles/30267.php

Hand sanitizer gel works

The alcohol-based gels, widely available in stores, do not require water and rapidly kill most bacteria and viruses on the skin. They are a convenient alternative for busy parents who are unable to get to a sink while caring for sick children.
...there is evidence that rotavirus, the most common GI infection in the child-care setting, is not removed effectively by soap and water but is reliably killed by alcohol.

I've started using them more myself, since it dries fast and takes less effort at work, where I handle paper and don't want to wander off to the bathroom every time I sneeze or whatever.

 

[Eos of the Eons]

The reason that killing some bugs via sanitizers won't lead to decreased immunity is the same that hand washing won't lead to decreased immunity. We're still exposed to so many microbes, including ones that will live happily on areas not washed or sanitized whatever times per day, that our immune systems will still be kept very very busy.

Killing bugs via alcohol is simplistic... the alcohol dries out the bugs, killing them via a system that won't leave any behind to become resistant to that type of death. If some are left behind because they weren't exposed to the alcohol drying process long enough, then they are still the same bugs they were before, and not stronger than they were before. You are no better or worse off, really, but the benefit is that you are less exposed to harmful bugs that are being spread swiftly from surface or hand to hand, then to eye, nose, or mouth routes from picking them up firstly with your hands.