Germ Alert: What's Scary, What's Not

It's hard not to get anxious about the superbugs in the news, from drug-resistant staph to the new strain of avian flu  -- especially when young children are so vulnerable to infections. But how can parents keep from getting paranoid? 

Copyright Jessica Snyder Sachs, as first published in Parenting

Experts don't have all the information, they do have some clear and practical advice--some of it surprising. Here are their answers to parents' top questions about germs:

Q:  I've read about children who've died from drug-resistant supergerms. How can I protect my family?

ANSWER: The drug-resistant germs you've heard about are methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (often referred to as C. diff). We do encounter these bacteria on a regular basis, but the good news: Only rarely do they cause major harm.

MRSA generally produces hard-to-treat skin infections. Less often, it can cause severe pneumonia, typically on the heels of a chest cold or the flu, says John Bradley, M.D., director of infectious diseases at the Children's Hospital and Health Center in San Diego. Infection with the other bacterium, C. diff, is usually triggered by antibiotics and generally causes intestinal problems, such as diarrhea. But in rare cases C. diff can cause dangerous intestinal inflammation.

To protect against MRSA: Wash cuts and scratches thoroughly with soap and water, and keep them covered with a bandage until they've healed. Check the bandage every day or so, and don't ignore redness, swelling, or pus, as these can signal an infection. If the wound gets worse after a day, see a doctor and ask her about the possibility of MRSA. The same advice goes for a chest infection that takes a sudden turn for the worse.

For C. diff, the best prevention is to avoid taking antibiotics needlessly. Remember, they work only against bacterial infections, not viruses like colds and flu. When you or your child must take antibiotics, talk with your doctor about choosing the least gut-disruptive drug available and consider taking probiotics (beneficial bacteria that may help protect against drug-resistant germs). Sources of this good bacteria include Saccharomyces yeasts (in supplements), as well as yogurt and supplements containing lactobacillus. You can take probiotics after a course of antibiotics, or you can take probiotics regularly. Ask your doctor what's best for you.}]

Q:  My kids love snacking on fresh fruit and veggies on the way home from the market. Is this safe?

A: It's probably okay  -- and it's great that your kids are eager to snack on produce  -- but in very rare instances contaminated fruits and vegetables can lead to serious, even life-threatening food-borne illness. (Bad spinach, anyone?) The most common culprits include sprouts, lettuce, unpasteurized juice, melons, and tomatoes. But with the exception of sprouts (which can't be cleaned well and should never be served raw to children), a thorough rinsing under tap water decreases the risk for most fruits and vegetables  -- no soap or special sprays needed. So even though your kids may like to munch on grapes or apples on the way home from the grocery store, it's better to rinse off the produce before digging in.

Using public restrooms; the 5-second rule

Q  What can I do to make sure my kids don't pick up disease-causing germs in public rest rooms?

A: Let's start with the toilet: Unless the seat is wet or dirty (yuck), it probably harbors few germs. So you don't need to worry about layering it with tissue paper. What's more important is to turn your face away when you flush, says University of Arizona microbiologist Charles Gerba, Ph.D. (a.k.a. Dr. Germ, for his unprecedented studies of which germs lurk where). This is because the droplets that fly when you flush can be full of bacteria and viruses. ("That's another reason to put the lid down at home," says Gerba, whose research shows that in a typical home bathroom, toilet spray contaminates just about everything.)

Of course, be sure your kids wash their hands with soap and water when they're done. And during cold and flu season, it's a good idea to use a paper towel on the doorknob as they leave, since one-third of public-bathroom visitors don't wash their hands.}]

Q:  What about the "five-second rule"  -- that it's okay to pick up and eat a dropped cookie, say, if you get it off the floor quickly. Is there any harm in it?

A: That depends on where you drop the cookie. "Compared to your kitchen sink, a bare floor is quite safe," says Gerba, who practically shudders at all the germs he's catalogued in drain traps, dishcloths, and sponges. "So long as you clean the floor now and again, I wouldn't worry."

As for food that drops outside, Gerba suggests erring on the side of caution. "Toss it," he says, whether it's been on the ground for five seconds or five minutes. You don't know what got deposited on that spot before you arrived. Beach sand, for instance, is notorious for being contaminated with bird droppings, which can spread intestinal bugs. "Knowing what I know, I never eat off a bare picnic table," says Gerba. "Birds use it as their rest room while they're cleaning up the crumbs the last picnicker left behind."

Eating rare meat; avoiding avian flu

Q:  My husband likes to cook our burgers medium-rare and our eggs "sunny and runny," but what about the bacteria in these raw foods? Am I being a germophobe?

A: No. Much of the meat and eggs on our supermarket shelves is contaminated with disease-causing bacteria, and these bugs are more drug resistant than ever. Most of the time, the infections people get are run-of-the-mill food poisoning, but in a small fraction of cases, gastrointestinal infections can become a life-threatening problem. Infected babies and toddlers are among those at highest risk of death and serious complications.

To kill these germs, public-health experts recommend that you hard-cook eggs and use an instant-read thermometer to make sure burgers and egg dishes reach an internal temperature of at least 160 degrees Fahrenheit. Also, don't let raw meat or eggs contaminate other food in your kitchen; wash any plate, cutting board, counter, or silverware that's come in contact with the raw food before it touches any other food. For people who really want their eggs sunny-side up and runny, a growing number of supermarkets now carry pasteurized-in-the-shell eggs (such as Davidson's Safest Choice).

Q:  I heard that avian flu could arrive any time with migrating birds. Is it safe to let my child feed ducks at the park or seagulls at the beach?

A: Even if the dangerous avian-influenza virus (technically referred to as highly pathogenic H5N1) turns up in North American birds, the chance of transmission from birds to humans is low. In Asia, the people who have gotten this flu were almost exclusively those who regularly handle chickens and ducks. The greater risk, then, is that this virus will mutate, or change, so that it can be transmitted easily from one person to another. Thankfully, that hasn't happened yet.

Still, you and your child shouldn't get too close to wild birds, says Paul Slota, branch chief of the U.S.G.S. National Wildlife Health Center. Feeding wild birds encourages their crowding  -- which is bad for the birds as well as for people (bird droppings can spread germs).

If your child does touch a wild bird or its droppings, be sure to wash her hands with soap and water before letting her touch her face, eat, or drink. If you're not near a sink, a dollop of alcohol hand gel will do the trick.

Antibacterial soaps; puppy kisses

Q:  The supermarket is filled with soaps and household cleaning products labeled "antibacterial." Are they better than regular cleaning products?

A: No. Antibacterial soaps and cleaning products aren't any more effective in preventing the spread of disease-causing germs. (Alcohol-based hand gels, on the other hand, have been shown to cut down on the spread of infections.) What's more, the chemicals in antibacterial products work like antibiotics  -- by interfering with bacterial growth  -- and you've no doubt heard there's concern (not yet proven) that these chemicals may promote the rise of drug-resistant bacteria. "If they don't provide any benefit, why take the risk?" says Tufts University microbiologist Stuart Levy, M.D. When you want to disinfect surfaces, he and other experts recommend cleaning products that contain bleach or alcohol.

Q:  Our new puppy loves to give playful kisses. Is it okay to let him lick our child's face?

A: "The odds are in your favor that the occasional face lick is okay," says Gerba. "Just ask yourself, what was the last thing your dog licked?" Dogs can pick up intestinal parasites from infected canine buddies or if they drink from streams and lakes frequented by wildlife  -- and these infections show up in stool. So if your dog has just licked himself down there, that may not be the best time for a kiss. But if your dog doesn't show signs of illness, you should generally feel safe letting him give your child friendly licks from time to time.

Parenting contributing editor Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World (Hill&Wang/FSG).

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