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Continue LogoutWith cold and flu season ramping up, how do infectious disease specialists prevent from getting sick? Writing for TIME, Angela Haupt asked six infectious disease experts about the practical habits they've built into their daily lives to reduce their risk of getting sick without making life less enjoyable.
Jill Roberts, a molecular epidemiologist and professor at the University of South Florida College of Public Health, noted that "one of the major causes of foodborne illness is cross-contamination. It's when you have something that's raw and you get microbes from the raw thing into the ready-to-eat thing."
Her solution is to color-code her cutting boards. Meat always goes on the red cutting board while vegetables never do. "If your meat is always on the red cutting board, you're never going to have your salad stuff on your red cutting board," she said.
Order matters too. Roberts said she makes the salad first, puts it in the refrigerator, and then brings out the red boards and the raw meat. Once she starts handling the meat, she's mindful about sanitizing any surfaces she might have contaminated, from the counters to the sink to the faucet handles and refrigerator door.
Some people wash their produce by filling a bowl with water and letting everything soak, but experts say that's not the best approach.
"What you actually need is that little bit of friction to break the surface," said Heidi Torres, an infectious disease physician and assistant professor of clinical medicine at Weill Cornell Medicine. Roughly 30 seconds under running water, while gently rubbing the produce with your hands, does a lot more than a soak.
The issue with using a bowl is you're washing everything in the same water. "If you have one piece that's contaminated, that water could contaminate the other vegetables," Torres said. Running water washes germs away instead of moving them from one piece of produce to another. It won't get rid of everything, but it will reduce bacteria, viruses, and even some pesticide residue.
Sponges are virtually perfect habitats for germs. They're damp, warm, loaded with food particles, and sit next to the counter where you might be placing your raw meat.
"Sponges and wet dishcloths are really good at growing bacteria," said Kelley Steury, a clinical associate professor in the school of public health at the University of Nevada, Reno.
Steury's routine is to rinse her sponge until no food particles come out, then microwave it for 20 seconds. Just make sure the sponge is wet. "If you did it when it was pretty dry, you could start a fire," Steury said.
Most people brush their teeth to prevent cavities, but Torres said she brushes her teeth to prevent infections.
"At least 25% of infections that I see are related to dental disease," she said. This is because small amounts of bacteria slip into your bloodstream every day, and a healthy immune system clears them out without you noticing. Cavities and gum disease can change this, however, as they allow more bacteria, including more aggressive bacteria, to leak into your blood, which Torres said is a "highway to all your organs."
In some cases, Torres said doctors can trace an infection back to the mouth because the bacteria involved doesn't live anywhere else.
"Rinsing alone wouldn't replace [brushing your teeth], because you really need that mechanical brushing to break down that film of bacteria," Torres said. Hospitals have even started treating basic oral care as a form of infection prevention, she added.
A bathmat outside your tub or shower should be washable, hung up to dry between uses, and tossed into the laundry around once a week. "We don't leave the wet stuff on the floor because that's gross," Roberts said. A damp bathmat can also spread athlete's foot from one person to another.
As for a rug at the base of the toilet, Roberts said she'd recommend getting rid of it entirely. Rubber backings don't typically hold up well in the wash, which means it probably doesn't get cleaned as well as it should.
"Especially if you have kids, they don't aim well," she said. "You have splash-overs."
Shoes don't just pick up dirt — every sidewalk has been shared with other people, their pets, and whatever else passed through. Cesar Figueroa, an infectious diseases specialist at Memorial Sloan Kettering Cancer Center, said he'd rather not track any of that across the floors where his family walks, so shoes should come off at the door.
Hospitals are meticulously cleaned, but Figueroa noted there's always "the risk of bringing pathogens with you on your shoes."
Often before company arrives, people wipe down counters. However, Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, said people should be paying more attention to the air.
"I respect air more than surfaces," he said. "You're probably going to have a bigger bang for your buck when you think about ventilation."
Chin-Hong recommends opening a window, and if your air conditioning is running, make sure it's bringing in fresh outdoor air instead of recirculating the same indoor air all night.
Daniel Griffin, chief of the division of infectious diseases at Island Infectious Disease Medical and president of Parasites Without Borders, said he's seen his colleagues race out of a public restroom because they were about to miss a lecture at a conference.
"They're so anxious to get back out because they're missing whatever the lecture is, and they're not really doing proper hand hygiene," he said. "Even the people that should know better are rushing out."
And even when they do wash their hands, they're often rushing through that. "Nobody's singing 'Twinkle, Twinkle, Little Star' to time themselves," he said.
Griffin also said it's important to know when soap and water beat hand sanitizer, which is essentially always. Alcohol-based sanitizer doesn't kill everything, but soap and water will keep you safe.
Steury said she doesn't mind looking strange to prevent getting germs. "Someone might look at me and think I'm crazy, but I'll use the bottom of a shirt, like my shirt tails" around her hand whenever she has to touch certain surfaces, she said.
Specifically, she worries about high-touch surfaces that are indoors and out of the sun, like elevator buttons, soda fountain dispensers, and the door handle to a medical clinic, for example. And if she does touch one of those surfaces directly, she waits until she can wash her hands before touching her eyes, nose, or mouth.
Before you accept a sample at the grocery store, think about the cart you're pushing. "I always think about what happened to the grocery cart before you got there," Roberts said. "Somebody picked up raw chicken. Somebody picked up raw seafood. And all of that is on the cart. It's on the handle."
Then someone offers you a sample on a toothpick. "I'm supposed to take my hand off this dirty cart and then take that food and put it in my mouth?" Roberts said. "There's no way."
Torres said she's worried less about a person coughing on the treadmill at the gym than she is the surfaces her bare skin touches. Benches, mats, and other shared equipment can be home to MRSA and ringworm, even at nice gyms.
Torres said she wipes equipment down before using it, not just after, and if disinfecting wipes aren't available, she places a towel between herself and the bench.
As for the locker room shower, she recommends sandals. "It's this wet, damp floor, walking around the locker room, walking around the joint showers," she said. " I always recommend bringing a pair of sandals."
Most people instinctively reach for the antiseptic after cutting their finger, but Chin-Hong recommends going to the sink instead. "The more important thing is to rinse it well with running water and soap, which is more important than the aggressive disinfectant," he said. Disinfectants don't kill everything, but running water can flush away germs before they cause a problem.
"Running things are better than stagnant things," he said. "We get infections when things are in stasis rather than in movement."
Torres said she never leaves for a weekend in tick country without having a pair of tweezers packed. "This is a little unusual — maybe my colleagues don't do this — but whenever I go away for a weekend, I always pack a pair of tweezers," she said.
Being vigilant for ticks matters more than you might expect. "Most people that develop Lyme disease or tickborne illness have no recollection of ever being bitten by a tick or ever seeing a tick," Torres said.
Chin-Hong said bug spray is a permanent fixture in his travel bag. "I respect mosquitoes," he said. "They actually kill more people than any other animal."
The biggest mistake people make is treating bug spray as if it's a one-and-done product, Chin-Hong said. "It's like sunscreen. You don't get away with just applying it once," he said.
If you're outside all day, you should reapply bug screen every six hours. Chin-Hong also recommends choosing a repellant with around 20% to 50% DEET, or 20% picaridin if you want to avoid DEET.
Most travelers remember to avoid tap water in areas with questionable water supplies, but Griffin worries more about the toothbrush. "We tell people to be careful of ice cubes and tap water and all the rest," he said. "But then people brush their teeth with the tap water."
What often follows is what Griffin refers to as "third-day sickness." By that point, your toothbrush has been repeatedly washed in tap water and left to sit in a warm, humid bathroom, which gives any microbes plenty of time to multiply before the brush goes back int your mouth. He recommends taking a few seconds to rinse your mouth and toothbrush with bottled water.
(Haupt, TIME, 7/27)
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