These days, a sneeze is not just a sneeze

If "achoo!" makes you jumpy these days, you're not alone. The swine flu pandemic has made people much more reactive when they hear or see someone sneeze, according to a new study. It found that public sneezing heightens people's fears about germs and even other, totally unrelated, health hazards.

Psychology researchers at the University of Michigan stationed an experimenter in a busy campus building and instructed her to sneeze loudly as students passed by. Researchers then gave a survey to some of the students that asked them to describe their perceptions of an average American contracting a serious disease, having a heart attack before age 50, or dying from a crime or accident. The students who had just witnessed someone sneezing perceived a greater chance of falling ill, suggesting that the sneeze triggered a broad fear of all health threats, not just ones linked to airborne germs.

The study also showed that people within hearing distance of a sneeze had more negative views of the nation's healthcare system.

When the study scenario was repeated at a mall, survey participants exposed to the sneeze were more likely to favor federal spending of $1.3 billion on flu vaccine rather than spending the money on the creation of green jobs.

In times of a flu pandemic, "public sneezing has the power to shift policy," said the lead author of the study, Dr. Norbert Schwarz, in a news release.

Gesundheit!

The study will be published in an upcoming issue of Psychological Science, a journal of the Assn. for Psychological Science.

-- Shari Roan

Photo: British Chief Medical Officer Sir Liam Donaldson demonstrates how to sneeze during a visit to Tyssen Community School, in north London, to help combat the swine flu. Photo credit: Shaun Curry  /  AFP  /  Getty Images

It's Global Handwashing Day! (Do you know where your soap is?)

Today, Global Handwashing Day is being celebrated in 70 countries around the world, with ritual hand-washing clinics, children singing about the disease-preventing benefits of hand-washing and, of course, a heartwarming study to explore what messages work best in promoting the use of soap in hand-washing. (Because -- join in with me here -- water doesn't kill germs; soap does!)

Researchers from the London School of Hygiene and Tropical Medicine spent several months leading up to last year's Global Handwashing Day peering through a camera's lens at men and women using a service station's restroom at a major crossroads in Britain. Their challenge: to gauge not only how many people actually use soap when they wash their hands, but also what messages -- flashed onto LED screens at the entrance to the toilets -- will most effectively induce people to use soap when they wash their hands?

They have gleaned these truths about men, women and hand-washing.

Dude, wash your hands!

Messages to reach college students about the importance of proper hygiene to prevent flu outbreaks probably isn't working, according to a new study. Already this fall, several colleges and universities have been flattened by the H1N1 (swine) flu pandemic. Swine flu has already been reported at 149 of 204 schools. Washington State University has experienced one of the harshest outbreaks, with at last 2,500 students seeking healthcare for flu-like symptoms.

In the new study, published in the September issue of the Journal of Environmental Health, researchers observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak at a university in Ontario, Canada. Only 17.4% students followed proper hand-hygiene protocols -- such as washing with soap and water for at least 20 seconds. But a whopping 83% of the students said they were complying with proper hand hygiene advice.

"Typically, health officials put up posters and signs and rely on self-reporting to determine whether these methods are effective," said a co-author of the report, Ben Chapman, of North Carolina State University, in a news release. "And people say they are washing their hands more. But, as it turns out, that's not true."

Chapman says the information aimed at students has to be compelling in order to get them to change their behavior. He suggests officials use practical ideas, such as posters that point students to the nearest hand sanitizer unit. Posters and brochures should use language that kids use, he adds. Don't say "gastrointestinal illness" when you could say, "this bug will make you puke your guts out."

"If your audience consists of students," he said. "You should use media that students use."
 
-- Shari Roan

Photo credit: PR Newswire

Daycare doesn't protect against asthma later

The "hygiene hypothesis" is a theory that young children who are exposed to a variety of germs will have a lower risk of developing asthma and allergies later in life. Studies on the hypothesis have been inconsistent. The latest study, published today in the American Journal of Respiratory and Critical Care Medicine, concludes that daycare has no effect on later respiratory illnesses.

The researchers, in the Netherlands, followed nearly 4,000 Dutch children over eight years. Parents completed questionnaires at various intervals of the child's life, from pregnancy to age 8. At that age, more than 3,500 of the children were assessed for specific allergies and asthma. Daycare use was also assessed each year.

The study found that children who started daycare early were twice as likely to experience wheezing in the first year of life compared with those who didn't go to daycare. But as the children became older, the illness pattern shifted. There was a trend for less wheezing among early attendees. By age 8 there was no association between daycare attendance and wheezing. The only children who stood out in the study were those who had early daycare attendance and older siblings. Those children had more than a fourfold higher risk of frequent respiratory infections and more than twofold risk of wheezing in the first year compared with children without older siblings and daycare.

"Children exposed to both early daycare and older siblings experienced most infections and symptoms in early childhood, without a protective effect on wheeze, inhaled steroid prescription or asthma symptoms until the age of eight years," the lead author of the study, Dr. Johan C. de Jongste, said in a news release. "Early daycare merely seems to shift the burden of respiratory morbidity to an earlier age where it is more troublesome than at a later age. Early daycare should not be promoted for reasons of preventing asthma and allergy."

-- Shari Roan

Photo credit: Luis Sinco  /  Los Angeles Times

Dogs and dog owners share germs

There are two kinds of people: those who allow dogs to lick their faces and those who are repulsed by that. But if you allow Fido to lick your face or sleep in your bed, you're no more likely to harbor disgusting germs than pet owners who practice stricter human-pet hygiene practices.

Research by Kansas State University veterinarian Kate Stenske looked at dog owners, their dogs and the incidence of E. coli bacteria, a common bug found in the gastrointestinal tracts of dogs and humans. Stenske found that more than half of the owners allowed their dogs to sleep in their bed and lick them on the face.

"There is such a strong bond between dogs and their owners. If you look at one study, 84% of people say their dog is like a child to them," Stenske said in a news release. "We also know diseases can be shared between dogs and people. About 75% of emerging diseases are zoonotic, meaning they are transferable between humans and other animals."

E. coli can cause serious health problems when it acquires genes that make it resistant to antibiotics. Stenske found that 10% of the dog-human pairs shared the same E. coli strains and that the strains had more antibiotic resistance than was expected. The owners had more multiple-drug resistant strains than their pets, which means it's more likely owners spread such strains to their pets than pets spread to their owners. While bed-sharing and face-licking didn't increase the prevalence of E. coli, owners who didn't wash their hands after petting their dogs or before cooking meals did have more antibiotic-resistant E. coli. The study is scheduled to appear in an upcoming issue of the American Journal of Veterinary Research.

Future studies should explore the same relationship between cats and their owners, she suggested. "We have a lot to learn. In the meantime, we should continue to own and love our pets because they provide a source of companionship. We also need to make sure we are washing our hands often."

-- Shari Roan

Photo credit: Kansas State University

Women's hands are friendlier to germs than men's hands

For the gender that considers itself the more fastidious (and has the studies to back up the claim), we women may be chagrined to learn that we harbor more varieties of germs on our hands than men do.

In fact, we all -- male and female -- have whole worlds on our hands, and they’re more diverse than anyone suspected.

In a study published online Monday in the Proceedings of the National Academies of Science, researchers at the University of Colorado at Boulder swabbed 102 human palms and found more than 4,700 species of bacteria.

Species varied from person to person; just five were shared among all 51 of the study’s student volunteers. They even differed from hand to hand. An individual’s right had different species than the left.

It’s well-established that hands are hotbeds for bacteria. That’s why everyone from mothers on up to the national Centers for Disease Control and Prevention admonish us to wash them.

What set this study apart is that it looked not at abundance but at diversity.

It did so by extracting DNA from samples gathered on cotton swabs rather than using the standard method of trying to culture the samples in petri dishes to see what kinds of bacteria would grow. According to Noah Fierer, assistant professor of ecology and evolutionary biology and the paper’s lead author, the older technique tends to greatly underestimate the number of species.

"Bacteria are tough to identify," he said. "Most of them can’t be grown in the lab. The best way we have of identifying them is to look for their DNA."

Fierer doesn’t know why women have a greater variety of bacteria than men do. It could be that men’s more acidic skin discourages some species, or that sweat, hormones or women’s greater use of hand creams play a role.

"The findings don’t necessarily mean that women have more germs than men, just more variety," he said, rather gallantly, in a phone interview.

Not all bacteria found on hands are harmful. Most are probably neutral, Fierer said, and some may protect the skin from pathogenic varieties. But until scientists better understand what’s normal across individuals, it will be difficult to determine which species contribute to or protect from diseases.

Washing hands, by the way, reduces the abundance but not the variety of microbes. A diverse community re-establishes itself within hours, the study found.

This doesn’t mean that applying soap and water is futile.

"We’re not saying at all that washing hands is not a good idea," Fierer said. "We know that it reduces abundance and has a large effect on pathogens."

The study was funded by the National Institutes of Health and the National Science Foundation. (For a video interview with the researchers, click here.)

-- Mary Engel

Photo: Human palms are home to many species of bacteria. Here, hands reach for the ball during an Olympic volleyball game in August.

Credit: Robert Gauthier / Los Angeles Times

Sharpies don't spread germs, people do

Anyone who has had surgery or watched those medical reality shows knows that before patients go under the knife, they’re often written on first with a marker to denote where the surgeon will cut. Bodies end up looking like a cross between a bull's-eye and a topographical map.

Doctors typically use special one-use pens designed for surgery that contain gentian violet, an anti-fungal agent, or Sharpies. Problem is, because of fears of bacterial contamination between patients, the Sharpies, which contain alcohol that can kill bacteria, are also tossed after one use. Even at about a buck a pop, it adds up over time.

That prompted a Canadian surgeon at the University of Alberta to ask a colleague to find out whether both kinds of pens harbor bacteria after one use. That colleague was Dr. Sarah Forgie, associate professor of pediatrics, faculty of medicine and dentistry, who supervised the study also worked on by resident Dr. Catherine Burton. They quickly got to the bottom of things.

Forgie knew the Sharpies contained alcohol, because, she says, "One of my kids used them to color all over my white kitchen cabinets." In determining how to remove the unwanted illustrations (she said Formula 409 worked pretty well) she learned the ingredients.

Pens were tested by contaminating them with four different types of bacteria (in quantities greater than would be found on human skin) commonly found in operating rooms, including two superbugs. They were then left out for varying time periods, from five minutes to a week. None of the Sharpies showed traces of bacteria, but the surgical pens did. Forgie notes that although the Sharpie marker nib itself doesn’t transmit bacteria, the outside of the marker still needs to be sterilized before using it again, like any other surgical instrument. To quell any lingering doubts, parent company Newell Rubbermaid did not fund the study.

Burton is presenting the work at the Infectious Diseases Society of America annual meeting in Washington, D.C., that begins Saturday.

The findings could save hospitals and patients some bucks — maybe thousands a year. And in these days of high healthcare costs, every little bit helps.

Says Forgie, "It’s such a funny, simple little study, but it seems to make a big difference."

-- Jeannine Stein

Photo credit: Bill Waugh / AP

Mouthwashes...they work! (Spread the word.)

Swirling a mouthwash around your mouth may really make your breath smell sweeter, according to a review by the Cochrane Collaboration, a body of scientists that assess medical evidence. In their report, released this week, the scientists reviewed five research trials involving 293 people. Among their findings:

* Antibacterial mouth rinses containing the antibacterial chemicals chlorhexidine and cetylpyridinium were better than placebos at making breath less smelly;

* So were mouth rinses containing chlorine dioxide and zinc, which work by neutralizing the chemicals in breath that make it smelly -- sulfur compounds such as hydrogen sulphide;

* Though the two categories both performed well, a potential drawback to the chlorhexidine ones were that mouths and teeth were temporarily stained and the sense of taste was temporarily altered;

* For all the excited articles they inspire in the press, so-called "electronic noses" are not as good at assessing the offensiveness of breath as the good old human nose, the team concluded -- and thus the human type should remain the "gold standard" for such tests. 

Want to learn more about bad breath? Lean close, and we'll breathily whisper some good links in your ear: halitosis at the Mayo Clinic, how to test your own breath, a halitosis movie (!) from the American Dental Assn. and a veritable cornucopia of halitosis science  including such classic papers as "Therapeutic Approaches to Morning Breath,"  "Assessing the Contribution of the Tongue to Oral Malodor," and other treats besides.

-- Rosie Mestel

When searching for a pet, consider the lowly rock

Having trouble deciding on just the right animal to stop the endless chorus of "Please, can we get a pet? Please, please?" Think a dog or cat is too much trouble? Add the journal Pediatrics to your consult-before-buying reading list.

A report in the October issue acknowledges that being around animals can be good for kids -- providing educational opportunities and all that -- and then details the many, many ways such exposures can go horribly wrong. The authors focus specifically on what it terms nontraditional pets (various rodents, reptiles, nonhuman primates and the like) and those animals found in public settings such as petting zoos and parks.

The potential problems, in short:

Reptiles: salmonella infection.

Rodents: salmonella, plague, anthrax, tularemia, ringworm and assorted parasites. The hedgehog comes in for special criticism -- Beatrix Potter be hanged -- because of those spines. Turns out, they can break skin, allowing microbes to enter more easily.

Nonhuman primates: herpes B infections that can cause fatal meningoencephalitis. Don't get hung up on the "meningoencephalitis." "Fatal" is the operative word.

Then there are the petting zoos and exhibits. The related risks include injuries of various stripes, allergies and sure, rabies.

The authors, who clearly are not fans of nontraditional pets and don't pretend to be, refer to various guidelines and safety measures. They also conclude that pediatricians and veterinarians should weigh in on pet selection. Perhaps carelessly, however, they neglect to recommend the merits of a pet rock -- usually only a danger if large and owned by an older sibling.

-- Tami Dennis

Better get your fish pedicure soon

Fish pedicures -- wherein customers put their feet in pools of carp that feed off the dead skin and leave feet silky smooth -- have just been declared illegal in Washington state, according to an article in the Seattle Times. The one known salon where you can get this done in that state has been informed of the Department of Licensing's decision by hand-carried letter. The Seattle Times quotes licensing department spokeswoman Christine Anthony as saying the live fish can't be sanitized: "You can clean the tank, you can clean the water, but there's no guarantee that the fish aren't carrying something from the previous customer."

Yes, yes, we see their point. But ... check out the video of a fish pedicure in progress.

-- Rosie Mestel