Handwashing
November - 2007

BRITAIN: Handwashing more useful than drugs in virus control
28.nov.07
Reuters
Tan Ee Lyn
http://www.reuters.com/article/healthNews/idUSSHA25252620071128
Hong Kong -- Physical barriers, such as regular handwashing and wearing masks, gloves and gowns, may be more effective than drugs to prevent the spread of respiratory viruses such as influenza and SARS, a study has found.
The findings, published in the British Medical Journal, came as Britain announced it was doubling its stockpile of antiviral medicines in preparation for any future flu pandemic.
Trawling through 51 studies, the researchers found that simple, low-cost physical measures should be given higher priority in national pandemic contingency plans.

CANADA: Hand washing stimuli
26.nov.07
Globe and Mail
http://www.theglobeandmail.com/servlet/Page/document/v5/content/subscribe?user_URL=
http://www.theglobeandmail.com%2Fservlet%2Fstory%2FLAC.20071126.COLETTS26-3%2FTPStory%2FComment&ord=16221967&brand=theglobeandmail&force_login=true
Toronto -- Michael Gardman and Leah Gitterman writes that all of us should be shocked that a cause of deadly bacteria spreading throughout our hospitals is health-care workers' not washing their hands (Timbits Given As Reward For Handwashing - Nov. 20).
But changing and guiding human behaviour is never easy. We have to make it easy for our staff to wash their hands by installing handwashing stations in the hospital; we need to educate staff and audit their performance so that poor performance can be improved; and we need to advertise the program to staff, patients and visitors.
A program only based on negative feedback is not going to succeed; positive performance needs to be recognized, hence the coupons. Don't underestimate the power of a pat on the back.
As for concerns about unhealthy eating habits, coupon holders can buy whatever they want at Tim Hortons, not just Timbits.

Double Handwashing with a fingernail brush (HACCP SOP)
20.nov.07
http://www.hi-tm.com/Documents/Handflow.html
This document shows the standard operating procedure for hand washing with a fingernail brush to achieve appropriate pathogen reduction.  It will be shown in full on the hand washing techniques page once that section of the site is up and running.

CANADA: Timbits given as reward for handwashing
20.nov.07
Globe and Mail
Lisa Priest
http://www.theglobeandmail.com/servlet/story/RTGAM.20071120.wwash20/BNStory/specialScienceandHealth/home
Barfblog Post
In an effort to persuade hospital workers to properly clean their hands, a roaming posse of infection control staff at University Health Network, Canada's largest research hospital, will give a $2 Tim Hortons gift certificate to some of those caught cleaning their hands at its Princess Margaret, Toronto General and Toronto Western hospitals.Michael Gardam, the director of infection prevention and control for the University Health Network, was cited as saying the gesture, to begin later this month, is aimed at reducing the number of hospital-acquired methicillen-resistant Staphylococcus aureus (MRSA) infections to zero, adding, "We're looking for a definite decrease in nosocomial [hospital-acquired] MRSA as that is primarily affected by hand hygiene. If all of our systems work appropriately, we theoretically should be able to get our hospital-acquired rate to zero."The story says that hand hygiene is a crucial and obvious step to reducing infections, yet prodding those who provide care to scrub up has been maddeningly difficult: Only 40 per cent of Canadian health-care workers wash their hands properly. Over the years, hospitals, keen to increase that figure, have installed alcohol hand rubs in hospital corridors and next to patient beds. Button and poster campaigns encouraging people to scrub up are dreamed up by those working in infection control.Still, an estimated 220,000 patients suffer from hospital-acquired infections each year, according to the Canadian Nosocomial Infection Surveillance Program. Another study by that same group found one of 10 patients admitted to hospital leaves with an infection.University Health Network's Dr. Gardam was cited as saying he got the idea after hearing how Cedars-Sinai Medical Center in Los Angeles offered $10 (U.S.) Starbucks gift certificates to doctors in a bid to increase hand hygiene compliance.

CALIFORNIA: Resort restaurant reopens after outbreak of illness: Health officials suspect gastrointestinal illness spread when someone failed to wash their hands
18.nov.07
Contra Costa Times
Jennifer Squires
http://www.contracostatimes.com/health/ci_7498728?nclick_check=1
Aptos -- Sanderlings, the Seascape Resort restaurant closed Wednesday by a foodborne illness that sickened at least 80 people, reopened Saturday and, according to this story, even catered a wedding.
County health officials suspect norovirus, a highly contagious gastrointestinal illness, spread through the hotel restaurant when someone failed to wash their hands, but have been unable to pinpoint the source of the contamination.
Bob Kennedy, the county's director of environmental health, was quoted as saying, "We don't have any exact knowledge of where it originated from."
The story explains that Sanderlings' management contacted the county Health Services Agency on Monday night after people who had attended a weekend medical conference at the beachfront resort called from the hospital.
Jim Maggio, Sanderlings' manager, was quoted as saying, "Some conference attendees were the first to report an illness, followed by some of our employees."
More than 1,000 people could have been exposed to the gastrointestinal virus last weekend, Kennedy said, and almost 60 hotel guests and 23 employees were sickened.
Staff from the county Public Health Department inspected Sanderlings on Tuesday after Maggio notified them of the possible infection, and the restaurant was cited for a minor violation of inadequate hand-washing procedures.
Sanderlings closed Wednesday for a three-day cleaning and disinfecting frenzy that also included safe food handling education for employees. Hotel guests were informed of the closure by a posting near the restaurant entrance, according to Maggio, and hotel staff directed them to other local eateries during the closure.
About 30 county Public Health Department employees investigated the outbreak.
County health officials gave the restaurant the OK to reopen around 8:45 p.m. Friday with the following conditions:
Facility and equipment cleaning and disinfection supervised and approved by Public Heath Department staff was completed.
Sanderlings' 71 staff members had been interviewed by the county.
The employees received food handling education.
Sanderlings management will screen employees returning to work for illness and they will not be allowed to work if they feel sick at all. The management will also keep a log on this screening, which the Public Health Department can inspect on an unannounced basis.
Sanderlings will start an hourly alert program that requires all staff to properly wash their hands as instructed by the county every hour in addition to normal hand-washing.
County Public Health inspectors will conduct unannounced -- possibly daily -- checks to confirm the restaurant is following the new policies.

Disinfecting Rediwipes launch targets E. coli and Salmonella
14.nov.07
U.S. Nonwovens Corporation
http://usstock.jrj.com.cn/news/2007-11-13/000002919253.html
BRENTWOOD, N.Y. -- Although soap and water work well for simple cleaning, they won''t do the job when it comes to killing the bacteria that causes illness. Something stronger must be used.
U.S. Nonwovens Corp.''s Disinfecting Rediwipes(TM) are a safe and economical solution to this pressing problem. Rediwipes are proven to kill 99.9 percent of common household bacteria, including Salmonella and E. coli.
"The first cardinal rule of safe food preparation in the home is simple: Keep everything clean," says Christopher Klapak, technical director of U.S. Nonwovens.
An estimated 36 percent of food-borne illnesses in the home result from cross contamination. That means contaminated cutting boards, counters, or utensils are not properly disinfected or sanitized before being used in the preparation of foods. Using Disinfecting Rediwipes can quickly and easily eliminate these bacteria and remove this threat.
The United States Center for Disease Control and Prevention (CDC) estimates 76 million of the roughly 300 million people who live in the United States get sick each year from food-borne illnesses. More than 300,000 of those are hospitalized, and about 5,000 people die from food-borne illnesses each year.
Salmonella causes between 60-80 million cases of illness every year, and E. coli is responsible for recent food recalls.
Cargill Beef Solutions recalled over one million pounds of ground beef, while Annex Foods recalled over 4,300 pounds of contaminated beef and chicken. General Mills has recalled over five million contaminated frozen pizzas. The concern is that many of these products have already found their way into homes and kitchens.
"Rediwipes can be a valuable weapon to prevent harmful bacteria that may have landed on countertops and other surfaces from spreading," says Shervin Zade, CEO. Disinfecting Rediwipes Dispenser Canisters are available in various sizes and scents at retailers nationwide, including Wal-Mart.
They come in an easy to use, reach-in dispenser canister and work well as an all-purpose cleaner to sanitize, deodorize, and disinfect. They are free of bleach and alcohol, and all product claims are supported and approved by the Environmental Protection Agency. The product is made in the U.S

AUSTRALIAN men and young adults rate badly in food safety report
12.nov.07
Food Standards Australia New Zealand (FSANZ)
www.foodsafety.asn.au
Australian men and young adults rate the worst in their knowledge and practice of food safety according to a report card released today by the Food Safety Information Council at the beginning of its 10th anniversary Food Safety Week.
Dr Michael Eyles, Chair of the Food Safety Information Council, said the Council’s tracking research shows that most Australians have greatly improved their food safety knowledge in the 10 years since the founding of the Food Safety Information Council.
‘For example, 97% of Australians now recognise that you should wash your hands using soap and dry thoroughly before handling food. This compares with 54% who weren’t aware they should wash their hands in 1997 – a 43 percentage point improvement,’ Dr Eyles said.
‘Today, 89% of Australians know they have to wash a chopping board in soapy water and dry thoroughly between chopping up meat or chicken and before using it to chop salad. This compares with 70% in 1997 – a 16 percentage point improvement. There has also been a 12 percentage point improvement on knowledge to cook sausages and hamburgers all the way through and a 52 percentage point improvement on knowing to refrigerate leftovers as soon as they have stopped steaming.
‘But with an estimated 5.4 million cases of food poisoning each year in Australia, and with one fifth of these cases linked to practices in the home, we can still do a lot better simply by getting back to basics – clean, chill, cook and separate.
‘I am particularly concerned that men’s overall knowledge of food safety continues to be lower than women’s. This may not have been an issue in the past but today men play an active role in the kitchen and they could be putting their family and friends at risk.
‘Also young adults have less food safety knowledge, although that changes when they reach their thirties and may become parents. Many young people work in the food service industry, even if it is only for a period while they are studying, so it is important they have a sound knowledge of food safety.
‘I am shocked that a Food Safety Information Council survey found that 7% of women and 29% of men didn’t wash their hands at all after using the bathroom in the food hall in a shopping centre. There is no excuse for this as we know that nearly all Australians understand how to wash their hands correctly. Correct hand washing is a good way to reduce your risk of food poisoning and you may also find that you also get fewer bouts of colds and flu as well.
‘To celebrate our 10th anniversary we have prepared a Back to the Basicspackage of material to help consumers understand the key food safety messages of cook, clean chill and separate. The package includes 4 instructional videos on how to wash hands correctly, how to stack a fridge, how to use a cooler safely and how to separate raw and ready to eat food. There is also a poster and a brochure available free of charge and a web based seminar. I urge you to look at all this information on the website and to order copies of the printed material,’ Dr Eyles concluded.
The web seminar can be accessed at http://www.webpresent.com.au/present/FSANZ/fsanz_02112007_
foodsafety/player.html
The videos can be accessed here
Audio clips here
The brochure at http://www.foodsafety.asn.au/_srcfiles/NewcrookBrochure.pdf
The poster at http://www.foodsafety.asn.au/_srcfiles/NewcrookPoster_A2.pdf
The Food Safety Information Council is Australia’s leading disseminator of consumer targeted food safety information. It is a non-profit entity supported by the Australian Department of Health and Ageing, state and territory health and food safety agencies, local government, and leading professional, industry and community organisations. The Council’s major activity is National Food Safety Week ,held each year in the second week of November.
There is more information on the Food Safety Information Council’s website www.foodsafety.asn.au

AUSTRALIA: Spreading more than good will
10.nov.07
The Daily Telegraph / Kate Sikora
http://www.news.com.au/dailytelegraph/story/0,22049,22731353-5005
941,00.html
Kevin Rudd and John Howard are, according to this story, spreading more than just election messages among Australian voters - they are passing on millions of germs.
Shaking the hand of a politician is more dangerous than you think, with dozens of gastro and respiratory viruses transferred in just one grip.
As Mr Rudd clocked up almost 1000 handshakes in one day in Brisbane last week, the germs on his hands - which are cut from the incessant contact - are multiplying.
The story says that up to 80 per cent of all infectious disease are passed on by human contact - just one square centimetre of skin contains more than 1500 germs.
Mr Rudd or Mr Howard's hands could be carrying gastro viruses such as salmonella, rotovirus and resistant strains such as pneumonia.
As Mr Rudd shook hands with voters in Adelaide yesterday he may have unknowningly been passing on his cold.
Epidemiologist Professor Mary Louise McLaws from the University of NSW was cited as saying that a political handshake spread more than just goodwill, adding, "If you are a politician and have been shaking with numerous people and your hand gets sweaty, those bacteria have increased in numbers. Shaking hands with a politician is bringing you in contact with many more germs than shaking hands with your neighbour or an individual in the street."
Politicians' favourite hangout, shopping malls, are also a haven for infectious diseases.
Bacteria is swapped through handling money, food, visiting the bathroom and through people not washing their hands afterwards.

NEW ZEALAND: PHA: Some school handwashing facilities appalling
09.nov.07
Scoop.co.nz
Public Health Association
http://www.scoop.co.nz/stories/GE0711/S00057.htm
New Zealand--Public Health Association (PHA) Director Dr Gay Keating is urging all people – but especially school boards of trustees – to take action in response to new research that has found New Zealanders are lax when it comes to washing their hands.
The research, published in the New Zealand Medical Journal, found almost 20 percent of men, and 8 percent of women didn't wash their hands after going to the toilet.
"Hand washing is a first defence against the spread of coughs, colds, the flu, tummy bugs and food poisoning. When the influenza pandemic hits, hand washing is going to be one of the most important ways of keeping you and your family alive."
She says some schools have appalling washroom facilities, and it is often not possible for students to wash and dry their hands properly – even if they want to.
"Sometimes there is no soap, let alone hot water, and children are expected to wash their hands in freezing water, even in the middle of winter. There may be no paper towels, or hand dryers.
"This is a great disincentive to proper hand washing, and pupils who do not wash their hands properly are at greater risk of contracting illnesses themselves, or passing on bugs. They then have to have days off school, which recent educational research has shown often leads to them falling behind in school work."
She says hand hygiene requires soap, water and drying, and shouldn't be hurried.
"You should wash for at least 20 seconds. Then hands need to be dried for at least 20 seconds because wet hands can transfer bugs."
All schools should provide pupils with soap, warm water and hand-drying facilities, Dr Keating says.
“Hand-hygiene is basic to maintaining good health.”

SERBIA: Serb officials want hands washed before dinner
08.nov.07
Reuters
http://www.reuters.com/article/latestCrisis/idUSL08723621
Serbian health officials on Thursday were cited as appealing to the public to wash their hands and step up personal hygiene to stop jaundice spreading in the impoverished south of the country.
Some 400 people are infected so far by this form of Hepatitis A -- commonly known as "the poor people's disease" -- mostly in or around south Serbia's biggest city of Nis.
Djurdja Kisin, chief of health education at the institute, was quoted as saying, "Please wash your hands before dinner and after going to the bathroom. It's better to prevent the disease than to have to treat it."

FLORIDA: Hand sanitizer vs. washing
06.nov.07
WTXL 27
http://www.wtxl.com/Global/story.asp?S=7315358
With all the threats of staph or MERSA making the headlines, we've  
heard over and over from medical professionals about the importance  
of washing your hands.
Wash your hands or use hand sanitizer, do they both work? Well, that  
depends.
Wallace Kelly works as an Infection Control R.N. at TMH and certainly  
has insight on this issue.
"They're both effective in cleaning staph aureus, and the bacteria  
that are causing these staph infections," he said.
But alcohol based hand sanitizers are not effective in killing other  
types of bacteria like the type of bacteria from the gastro-
intestinal tract, or hazards such as e-coli and salmonella.
"Alcohol doesn't destroy spores, but washing your hands washes the  
spores down the sink."
Kelley says what really counts: is which method you use most, because  
they're both effective in protecting you. But if you can't get to a  
sink you're better off using the gel than nothing at all.
"Anytime you open a door that's been touched by thousands of people,  
pick up a gasoline pump you want to use a hand sanitizer, but before  
you eat you'll want to wash your hands because that's protecting you  
from types of bacteria that forms spores."
Kelley says people sanitize their hands more with the hand gel  
because it's more convenient.
As for hand sanitizers being banned from some schools, it's not due  
to alcohol content, but more a flammability concern.
The fire department allows Tallahassee Memorial Hospital to have a  
certain about of hand sanitizer per smoke compartment, and they  
supply up to that limit.
But Kelley says he personally would like to see hand sanitizers in  
all schools.
"I think the accrediting agencies and the fire department need to  
take up with the school and readdress the issue, because I really  
advocate having hand sanitizers in the schools where kids can use them."
Kelley suggests two things you should look for when buying hand  
sanitizers.
You want to make sure there is at least 60% alcohol content, and you  
should also look for moisturizers in the gel, especially during  
winter so your hands don't become dry and cracked from over washing  
in dry weather.

Yes, washing hands works
05.nov.07
USA Today
Kim Painter
http://www.usatoday.com/news/health/painter/2007-11-04-yourhealth_N.htm
Remember the recent study that showed men were less likely to wash their hands in public restrooms than women were?
The story says that some guys firmly believe that there is no good reason to do it — at least after urinating. They told me so in e-mails and online comments after I wrote about the hand-washing gap (Your Health, Oct. 8).
The gist of their comments: We don't urinate on our hands or touch any especially germy body parts.
Jim Elliott of San Marcos, Calif. Wrote that the invention of no-touch, motion-detecting faucets and soap dispensers is proof that "conventional washing is a source of germs."
Still others protested that any hand-washing seems almost pointless in a world teeming with sneezing, coughing, nose-wiping fellow humans touching grocery carts, doorknobs, handrails and keyboards.
"You cannot get away from germs," wrote Robert Smith of Natchitoches, La.
Painter took these objections to three experts: Stephen Luby, a researcher with the federal Centers for Disease Control and Prevention; Judy Daly, a Salt Lake City microbiologist and spokeswoman for the American Society for Microbiology; and Susie Craig, a food-safety and hand-washing educator with the Washington State University Extension Service.
Here's what they said on the key issues:
Why should men wash their hands after every restroom use?
"I've heard men say that it's nothing but Victorian prudery" to ask them to wash after urinating, Luby says. "And we cannot show them studies" that prove doing so will protect them or others from illness.
But the experts still recommend washing, for two reasons.
Reason one: You may pick up more germs than you think, from doors, flush handles and other surfaces, and from your own body. "Your gastrointestinal tract is close by," Daly says. "It all fits together, and you can't see where the microorganisms are."
Reason two: The restroom, stocked with sinks, soap and water, is a convenient place to wash off bacteria and viruses your hands accumulate elsewhere during the day. Studies do show groups of people who wash their hands regularly get fewer gastrointestinal and respiratory illnesses.
But won't you pick up germs in the process?
There is something to the idea that you may contaminate just-washed hands on germy faucet handles and doors. That's why hospital workers are instructed to use paper towels to turn off faucets and open doors — and why waste baskets for those towels should be near restroom doors.
Anyone can adopt those practices. But the lack of hand towels or a well-positioned waste basket is no excuse for skipping the hand wash. In one study in Pakistan, Luby found that regular hand-washing by whole neighborhoods reduced diarrhea cases in children by half, even though people washed with unsanitary water and dried their hands on their clothing.
Hand-washing works, even in an imperfect world.

Developing benchmarks for handwashing in retail foodservice operations: A pilot study in delicatessens
03.nov.07
International Association of Food Protection
Paola Paez, Catherine H. Strotrohbehn, and Jeannie Sneed
http://www.foodprotection.org/publications/Abstracts/2007Abstracts/November2007.htm#Southeast
The purpose of this study was to develop a process for establishing benchmarks for handwashing in retail foodservice establishments. One type of restaurant, the delicatessen (deli), was used for the pilot study. A handwashing observation form to be used in determining actual and desired handwashing frequencies and methods used by employees was developed and pilot tested.
Two in-depth field observations were conducted in each of five delis. Employees (n = 18) were observed during production and service. Each operation had one handwashing sink located in the sandwich assembly and service area, and each met the Food Code requirements of providing soap and a supply of disposable towels. Hot water was available in three of the five operations.
Results indicated that during production and service, employees in delis did not wash their hands properly or at appropriate times. Most employees used only one or two steps of the 3-step handwashing process described in the 2005 Food Code. Handwashing in compliance with the Food Code was observed for two situations during the service phase: “before employees engaged in food preparation” and “before returning to the preparation area.” Proposed benchmarks specify that employees should wash their hands a minimum of 6 times per hour during production and 11 times per hour during service.