Microbes and celebrities have at least one thing in common: Only the ones that behave badly seem to make headlines.
The vast majority of bacteria, viruses, and other microscopic bugs either show little interest in us humans or actually work to our advantage. Take, for instance, the 400 or so species of bacteria that reside in your gut, writes microbiologist Anne Maczulak, PhD, in her book The Five-Second Rule. Without them, you couldn’t digest food, synthesize vitamins, or manufacture proteins.
“Germs have been around us forever. There are a few precautions, but to live in constant fear is silly,” Dr. Maczulak says. “The good microorganisms far outnumber the dangerous ones. That’s something people don’t always realize. They think all germs are bad.”
Rather than trying to eliminate all microbes—which, besides being impossible, would backfire in the long run—it’s best to marshal your resources against the harmful germs that tend to inhabit particular environments. In this chapter, we’ll take a look around 12 common microbial hot spots (including your home) and offer some sensible strategies for outsmarting the not-so-friendly bugs that may be lurking there.
1. Public restrooms
For most of us, public restrooms rank highest on the ick scale. They aren’t always the cleanest places—and that’s judging by what we can see. As far as what we can’t see … well, we’d probably rather not know the details.
Interestingly, men’s rooms tend to be slightly tidier than women’s. Both, though, harbor bacteria on virtually every surface—including faucets and door handles, according to Dr. Maczulak. And by bacteria, she means the kind found in feces. (Presumably, viruses are widespread, too, but they’re harder to measure.)
The Strategy
Move along. Overflowing trash cans and offensive smells suggest that the restroom hasn’t been cleaned in a while. If your need isn’t urgent, consider seeking another restroom, recommends Ruth Carrico, PhD, an assistant professor at the University of Louisville in Kentucky who specializes in disease prevention.
Don’t fret about the toilet seat. Go ahead and line the toilet seat with toilet paper, or use one of those sanitary seat covers. It might protect you somewhat, Dr. Maczulak says. But studies suggest that toilet seats are relatively germ-free compared to other surfaces that a stream of people touch with their soiled hands.
Keep your purse aloft. Hang your purse from the hook on the stall door, Dr. Maczulak advises. If you put it on the floor, it’s going to collect germs—and then you set your purse on the kitchen table or countertop when you get home.
Use your shoe. If the toilet doesn’t flush automatically, and you’re agile enough to reach the handle with your foot, flush that way, Dr. Carrico recommends. The fewer objects you touch with your hand, the better.
Wash your hands. In a study conducted on a university campus, 61 percent of women washed their hands with soap, compared to 37 percent of men. When the researchers put up a sign reminding of the importance of hand washing, nearly all the women scrubbed up. The men weren’t so convinced; the percentage of male hand washers stayed about the same.
You should wash your hands after every expedition into a restroom. If you need pointers on how to wash well, see page 28.
Take a towel or two. If paper towels are available, use one to dry your hands, then turn off the faucet with it. Also use toweling to pull open the restroom door. Cover your hand with the paper towel to open the door, then prop the door with your foot and toss the towel into the trash can. For a door that pushes outward, nudge it open with your hip rather than grabbing the handle.
Changing a diaper? Clean up before and after. If you need to change a baby’s diaper on a fold-down table in the restroom, clean it off first, Dr. Carrico suggests. You don’t have to use a bleach wipe; baby wipes will do the trick, or use a paper towel that’s dampened with water and a little soap. When you’re done, clean the table one more time.
2. Restaurant buffets
With its endless array of food choices—entrées and sides, soups and salad fixings, breads and desserts, and assorted other offerings—a restaurant buffet has something for everyone. And microbes are waiting in line with the rest of us to dig in.
Buffet preparation is labor-intensive, which means that workers may not always wear gloves when handling food. And it may sit for hours on the buffet, where keeping hot and cold foods at their proper temperatures can be difficult.
But what makes buffets especially prime real estate for bacteria and viruses is the stream of coughing, scratching restaurant patrons who are putting their possibly dirty hands near or on the food, says Angela Fraser, PhD, an associate professor at Clemson University in South Carolina who trains restaurant employees in food safety.
The Strategy
Check for cleanliness. If the dining area looks unappetizing, can you imagine what the kitchen looks like? “If the owners really care about safety, they’ll keep the dining area and buffet area clean,” Dr. Fraser says.
Watch for quick turnaround. Food shouldn’t sit on a buffet for more than 4 hours at a stretch, cautions Dr. Fraser, who teaches restaurant workers to use smaller serving dishes and replenish them more often. If you’re in a restaurant with few other patrons and you see mounds of food on the buffet, that’s a sign that it may have been out for too long.
While you’re waiting to order, take notice of how often the staff replenishes the buffet. If the answer is not very often, then you might want to choose something from the menu.
Wait for replacements. Avoid spooning out the last remnants from a serving dish. Wait until a server returns with the fresh stuff.
Look for heat. Food that’s served hot needs to be at least 135°F to resist microbial growth. At this temperature, food may produce steam, and though it won’t burn your mouth, you might need to blow on it before taking a bite. If your soup or other normally hot item doesn’t pass this test, consider helping yourself to something else.
Look for a sign. Patrons should use a fresh plate for each trip to the buffet, and the restaurant should post a sign that says so, Dr. Fraser says. “I really don’t eat at places that don’t have signs saying that children under 12 need to be accompanied by adults,” Dr. Fraser adds. “I’ve seen children exhibit many bad behaviors at the buffet.”
Tell the manager. Dr. Fraser has also spotted ill-mannered adults nibbling a cherry tomato and then putting the rest back in the serving dish, or dipping a finger into the salad dressing. If you spot such behavior, alert a manager. A good restaurant will replace items that have been handled inappropriately, she says.
Wash your hands before you eat. Think about all the people who’ve handled the ladles, forks, and tongs before you. They may have blown their noses or visited the restroom, then headed for the buffet without bothering to wash their hands. You can’t do much about their habits, but you can protect yourself. After you load up your plate, set it on your table and go wash your hands, Dr. Fraser advises. You’ll scrub away any germs that others may have left on the buffet utensils.
3. Supermarkets
Singles aren’t the only ones patrolling the produce aisle for hookups. Germs like to hang out in the supermarket, too.
Just think of the hundreds of shoppers that pass through each day, touching shopping cart handles, handling raw meat and produce, pulling items off shelves, and then putting them back. They’re leaving behind a trail of microbes just waiting to hitch a ride on you.
The Strategy
Clean the shopping-cart handle. For a 2005 study, researchers sampled surfaces in more than 1,000 stores, gyms, theaters, and other public venues. Shopping-cart handles fared worse on several measures of yuckiness than elevator buttons, public telephones, and ink pens left out for public use.
Many stores now offer sanitizing wipes near the cart corral. It’s probably a good idea to swipe one of these across your cart handle before you begin shopping, Dr. Fraser says. “I don’t know how much it reduces the number of organisms, but it can’t hurt,” she adds.
Bag and bag again. Most supermarkets have plastic-bag dispensers all over the produce aisle, and maybe at the meat counter, too. Use them for your produce and meat purchases. Bagging keeps the produce from picking up germs from the cart, and the meat from dripping microbes onto other items in your cart. In fact, double-bagging these items might be wise, Dr. Fraser says.
Hand Washing How-Tos
You’ve been washing your hands since you were a little kid. Do you really need a tutorial? Probably. Keeping your hands clean is one of the most important steps you can take to avoid getting sick and spreading germs to other people.
No soap and water around? Use an alcohol-based hand sanitizer instead. They are fast acting and can significantly reduce the number of germs on your skin.
When you use soap and water:
Wet your hands with clean running water—warm, if possible. Apply soap.
Rub your hands together to make a lather. Scrub all surfaces and under your fingernails.
Continue rubbing your hands for 20 seconds. To keep track of the time, imagine singing “Happy Birthday” twice through.
Rinse your hands thoroughly under running water.
Dry your hands using a paper towel—yes, even at home. If you prefer to use hand towels from your bath, be sure to launder them regularly. (In a public restroom, you can use the air dryer if paper towels aren’t available.)
When you use an alcohol-based hand sanitizer:
Apply the product to the palm of one hand.
Rub the palms of both hands together.
Rub the product over all of the surfaces of your hands and fingers until your hands are dry.
Mind your supermarket manners. Although everyone likes to get the most unblemished fruits and vegetables, try to limit the number of times you handle produce. It’s just another opportunity to pick up germs—or pass them to someone else.
Skip the samples. Those bite-size morsels may be tempting, but you’re better off taking a pass, Dr. Maczulak says. That goes doubly if you don’t know how the food was prepared or how long it’s been setting out.
Wash up. Once you’re home, wash your hands before you start putting away your groceries, Dr. Fraser suggests. You’ll get rid of any uninvited guests of the microbial kind before they have a chance to settle in for an extended stay.
Clean your produce. The US Food and Drug Administration recommends thoroughly washing fruits and vegetables before eating them, even if you’re going to peel them first. After washing your hands, rinse any fruits and veggies under cold running water. If they’re small like berries or grapes, put them in a colander and gently tumble them under the water. If they’re firm enough to take a little more handling, like cucumbers or apples, scrub them with a vegetable brush, too.
Drying your fruits and veggies with a paper towel may remove even more germs. But don’t bother using soap or store-bought produce-cleaning products, the FDA advises.
Does Your Child’s Daycare Pass the Test?
Day care centers can’t totally stop germs from coming through their doors, but they can take steps to reduce the spread, says Laura Jana, MD, a pediatrician in Omaha, Nebraska, and a member of the executive committee for early education and childcare for the American Academy of Pediatrics. Consider whether your child’s daycare has implemented these germ-proofing practices; if not, you can be proactive in encouraging such practices—or at least take extra precautions to protect your child from infection.[all source 12 from chapter 7]
Are parents given a “sick policy” explaining when kids should be kept at home?
Are children sent home when they have a fever or diarrhea or they’re vomiting?
Are children encouraged to wash their hands, especially before and after eating and after using the bathroom?
Do staff members wash their hands regularly, especially before and after feeding children and after changing diapers and wiping noses?
Do staff members wear gloves when changing diapers?
If hand sanitizer is available, is it safely stored away from small children who might ingest it?
Does the day care center use its own utensils and cups? (It’s more sanitary if parents don’t bring them from home, Dr. Jana says.)
Is there a cleaning policy in place—for example, for sanitizing changing pads, toys, and desks?
Does an outside cleaning service do deep cleaning? (They tend to do a better job, Dr. Jana says.)
Are staff members required to get seasonal flu and H1N1 vaccines every year?
4. Hotels
You’ve heard the expression “You get what you pay for.” It might be right on the money, so to speak, when it’s referring to the relative germiness of hotel rooms.
Charles P. Gerba, PhD, professor of soil, water, and environmental science at the University of Arizona in Tucson, says that in general, pricier rooms tend to be cleaner. “One of our studies found that if you paid more than $50 a night, there was a much greater chance that the room was regularly disinfected. Rooms under $50 weren’t.”
Other, nonscientific research has found that germs abound no matter what the room rate. One media investigation found traces of urine or semen on bedspreads, chairs, walls, and floors. In another, hotel housekeepers rinsed drinking glasses with water or industrial cleaner, then used towels from the previous guests to dry them. Some staffers wore the same pair of latex gloves to clean the toilet and the glasses.
Although it’s true that these investigations might not stand up to scientific scrutiny or represent widespread industry practices, they still beg the question: Just how clean is your hotel room?
The Strategy
Use disinfectant wipes. Clean the often-touched surfaces of your room, like door handles, light switches, faucets, telephones, and television remotes. If your room has a kitchenette, clean that, too.
Slip on flip-flops. Athlete’s foot fungus can linger in bathrooms. Protect your feet by keeping them in disinfectable flip-flops whenever you use the bathroom—and if you visit the hotel pool, too.
Look for triple sheeting. Along with the usual bottom sheet, some hotels use two top sheets to sandwich the heavier bedding, like blankets and comforters. Wouldn’t you rather sleep between easily laundered sheets than under a blanket that’s harder to wash? (You could ask the housekeeping staff for an extra set of sheets, if you’re up for triple-sheeting the bed yourself.)
And while we’re on the subject …
Remove the bedspread. It probably isn’t laundered between guests’ visits.
BYO glasses. As we’ve seen, the drinking glasses provided by a hotel may be less than sanitary, so pack your own plastic cups. And don’t forget to use them!
5. Airplanes
Any mode of public transportation can be a breeding ground for microbes. In the case of air travel, though, the cramped quarters provide an especially welcoming environment for germs to multiply and spread, says Syed A. Sattar, PhD, professor emeritus of microbiology and director of the Centre for Research on Environmental Microbiology at the University of Ottawa in Ontario.
“It’s not unusual for air travelers to cough, sneeze, or worse, vomit. Then other passengers inhale those germs or touch them on shared surfaces,” Dr. Sattar explains. Plus, the stress of air travel may increase the chances of picking up a new infection or triggering an existing one.
Avoiding germs on international flights is even harder. “When people from all over the world crowd together in a confined space for hours at a time, you’re going to be surrounded by all sorts of germs,” Dr. Sattar says. “Some passengers may be moving back and forth from parts of the world where certain diseases are widespread.”
And don’t count on an airplane cabin being sanitized before you board. It’s hard to know how often aircraft are cleaned, says Elizabeth Scott, PhD, codirector of the Simmons Center for Hygiene and Health in Home and Community, and director of the Program in Public Health at Simmons College in Boston. But on 24-hour flights, they aren’t cleaned at all.
The Strategy
Keep your bags off the floor. Store any carry-on luggage in the overhead compartment. You’ll need to stow your purse or briefcase for takeoff, but once you’re free to move around, move your bag to your seat.
Disinfect nearby surfaces. Keep disinfectant wipes in your purse or briefcase. Use them to clean your tray table, the armrest, headphones—anything you touch.
Stay hydrated. A study published in the Journal of Environmental Health Research found that dry airplane air increases your chances of getting the sniffles. A thin layer of mucus in your nose and throat normally flushes out bacteria and viruses. If the air is dry, this lining dries out, too—and you’re more vulnerable to infection.
Be wary of bathrooms. Airplane restrooms are tiny, cramped, and used frequently, Dr. Gerba notes. “On any given flight, 50 people may use the same toilet—75 if it’s a discount airline,” he says.
If you gotta go, be sure to wash your hands with soap and water once you’ve finished your business. Then use a paper towel to turn off the water and open the door. As an extra precaution, you may want to use a hand sanitizer before you get back to your seat.
Ask to be reseated. If you’re sitting near a coughing or sneezing passenger, ask the flight attendant if you can move. If another seat is available, or if someone is willing to switch with you, the attendant may be able to accommodate you.
6. Hospitals
You probably think of hospitals as places to get well. And they are—usually. But sometimes they can make you sick.
“Any infection you can catch outside the hospital you can catch inside, too,” Dr. Gerba says. Among the most worrisome hospital-acquired infections: staph (Staphylococcus aureus), MRSA (methicillin-resistant Staphylococcus aureus), and Clostridium difficile.
Staph infections cause a red, pimple-like rash that usually responds to antibiotics. If it doesn’t, it may be MRSA—which, incidentally, can appear in otherwise healthy people. C. difficile are fecal bacteria. They cause diarrhea as well as more serious conditions such as colitis and sepsis, which spreads through the bloodstream.
Does it work?
Astragalus
Don’t bother
“There really are no good data on astragalus,” says Margaret Lewin, MD, clinical assistant professor of medicine at Cornell University and chief medical director of Cinergy Health. Also, much like medications such as aspirin and beta-blockers, astragalus gets circulated throughout the body and therefore could cause unwanted side effects.
“I’m really concerned about mucking around with the immune system with immunostimulants and immunomodulators,” Dr. Lewin says. “I would be wary of astragalus, especially if you have any kind of immune deficiency.”
That’s a Fact
A dry mouth is a welcome mat for germs. “Saliva does two things to protect you against illness: It provides a sticky place to trap viruses and bacteria, and it contains germ-fighting antibodies,” says Margaret Lewin, MD, clinical assistant professor of medicine at Cornell University and chief medical director of Cinergy Health. You can wash away potential illnesses with lots of hydrating fluids, she says.
Health-care workers can transmit any of these bacteria by touching surfaces or handling items with unwashed hands. If you touch the same surfaces or items, you can become infected, too.
The Strategy
Get a flu vaccine. It’s the best way to avoid the flu, which is known to raise the risk of certain kinds of staph infection.
Wash your hands—and remind others to do the same. Whether you’re a visitor or a patient, you can help stop the spread of bacteria and other germs by washing your hands with soap and water or using an alcohol-based hand sanitizer. And watch to be sure that health-care workers are scrubbing up, too—even if they wear gloves when providing care.
Watch where you put your hands. Doorknobs, television remotes, bed rails, toilets—any surface that people touch can become a repository for bugs. Ideally, these surfaces are disinfected daily. But it’s best to be cautious and limit your contact with them as much as possible.
7. Workplaces
These days, many of us spend so much time on the job that we view our colleagues as an extended family. We share everything with each other—including more than a few germs.
“Disease transmission is more frequent when many people are indoors together in a confined space,” Dr. Sattar observes. “I call air the environmental equalizer. You may not drink the water in your workplace, and you may not eat the food. But you have to breathe the same air as everyone else.” And if that air is heavily contaminated with disease-causing germs, infections will spread more easily.
The Strategy
Don’t eat at your desk. You might save time by multitasking, but you’re also increasing your chances of getting sick. Every object in your workspace—your phone, your keyboard, your stapler, your pen—is a potential hangout for germs. “One study found 400 times more germs on an average desktop than on a toilet seat,” Dr. Gerba says.
Disinfect. Use disinfectant wipes to clean any shared supplies and equipment, such as telephones, fax machines, printers, and photocopiers.
Keep your hands to yourself. Try to avoid shaking hands during cold and flu season. If you must, be sure to wash your hands or use hand sanitizer as soon as you can afterward.
Clean up before heading home. If you keep a water bottle or coffee cup at your desk, empty and wash it at the end of each workday. And of course, don’t share cups or bottles with anyone else.
Maintain your distance. Avoid close contact with anyone who has a cold or flu. And if you get sick, by all means stay home.
8. Gyms
We go to the gym to get fit, right? So it’s hard to imagine that we might come home with more than our gym bags and water bottles. But shared surfaces in gyms—not to mention their locker rooms—are perfect environments for germs to flourish.
“Staph and MRSA thrive in hot, sweaty places,” Dr. Gerba says. “They tend to lurk around where people wear the same gym clothes and use the same towels for several days or several workouts.”
The fungus that causes athlete’s foot also loves showers and locker rooms, Dr. Sattar says. “When people already contaminated with the fungus walk barefoot on these warm, damp surfaces, it’s quite easy for the fungus to spread to others who are also walking barefoot.”
Many gyms try to head off the spread of infection by providing spray bottles near workout stations and pieces of equipment. “Gym managers suggest that you spray the equipment after you use it, but it’s not clear what products are being used, if everyone uses them, or if they’re effective,” Dr. Scott says.
The Strategy
Be nosy. Ask the gym staff what kind of disinfectant they use and how they know it’s working. If you don’t like the answer, ask if you can bring your own instead.
Carry sanitizer with you. When you grasp handrails or barbells, you’re also grasping all of the microbial crud that the people before you left behind. So it’s a good idea to clean your hands with sanitizer every time you change equipment.
Practice downward dog safely. Who knows whether your yoga studio disinfects the mats they use? You’re better off investing in your own. Be sure to keep it clean by washing and disinfecting according to the manufacturer’s instructions.
Skip the bare feet. When you’re in the locker room, wear flip-flops at all times, including in the shower.
Use a bandage if necessary. If you have any cuts or scrapes, keep them covered while you’re working out.
9. Day Care and Schools
Like peanut butter and jelly, day-care centers and germs just seem to go together. In fact, several of our experts describe these facilities as “pits of disease.”
Children of all ages are in day care, with the youngest often still in diapers. This makes cleanliness a real concern. “If diaper-changing areas aren’t kept meticulously clean and separate from the rest of the facility, germs can be transmitted,” Dr. Scott says. “That’s especially true if the staff doesn’t practice good hand hygiene.”
What’s worse, toddlers love to put things into their mouths; it’s how they make sense of their world. Older kids often transmit germs by touching their own faces. “Studies show that they may touch their faces 81 times an hour,” Dr. Gerba says.
Many of the same germs found in day-care centers—especially rotovirus and norovirus, both of which cause digestive symptoms—can circulate around elementary, middle, and high schools, too. MRSA is becoming a big concern for scholastic athletic facilities, as the bacteria can linger on surfaces such as barbells and mats.
The Strategy
Teach good hand hygiene. Encourage kids to wash their hands with soap and water for 20 seconds, and to repeat many times a day. For extra protection, they can use alcohol-based hand sanitizer. A study of 285 elementary-school students found that kids were less likely to miss school because of gastrointestinal illness if they used sanitizers and if their desks were disinfected daily, Dr. Gerba says.
Hit the shower. Because MRSA can spread through skin-to-skin contact, student athletes should take showers with soap and water after wrestling matches and all other athletic events or practices.
Stay on schedule. Be sure that your child’s recommended vaccinations are up-to-date.
Skip school when necessary. When kids get sick, they should be kept home from school or day care until they’ve been fever free for at least 24 hours.
10. Play areas
Kids almost assuredly look at a play area and see nothing but opportunities for fun. As the grownup, you need to see it for what it really is: a place for germs to congregate.
The Strategy
Watch their hands. Occasionally remind kids to keep their fingers out of their mouths and noses and away from their faces in general. (Remember, the face presents many different pathways into the body.) If you see a wayward finger probing around, tell your kid to stop.
Keep an eye on playmates, too. If you see other children who are coughing, wiping runny noses, or showing other signs of an illness that could be passed along, gently steer your kid to a different area, Dr. Carrico suggests.
Be prudent when poolside. Fecal matter can find its way into the water, causing swimmers to fall ill. Several disease outbreaks associated with water parks have been reported to the Centers for Disease Control and Prevention; even more may have gone unreported.
Stress to your kids that they need to keep the water out of their mouths whenever they go swimming. Make sure that they wash their hands after they get out of the water, especially if they’re going to eat.
The CDC advises parents to bathe their kids—particularly their kids’ bottoms—before going swimming. And if a child has diarrhea, be polite and keep him or her out of the water altogether.
Show your zoo savvy. Petting zoos are popular, but kids may be putting their hands on more critters than you’d care to imagine: Many disease outbreaks related to Escherichia coli have been linked to petting zoos and similar venues.
When you visit any attraction that allows children to interact with animals, leave food, drinks, strollers, baby bottles, and pacifiers outside the area. Stay away from any animals that look sick, and remind kids not to touch their faces until their hands are clean.
Work up a lather. Once you leave a play area, have your kids wash their hands with soap and water. If none are available, then use an alcohol-based hand sanitizer instead. Keep in mind that when the weather turns colder, a kid’s hands can get dry and chapped just like a grown-up’s—and putting sanitizer on broken skin can really hurt. You can protect your child’s skin by applying lotion or moisturizer as needed.
11. Dorms
For the average college student, housekeeping ranks low on the list of priorities—somewhere between “skip party to study for test” and “start researching term paper due 4 months from now.” But your college-bound teen or twenty-something could benefit from a lesson in dorm-room hygiene.
As Dr. Scott notes, most colleges leave dorm-room cleaning to the students—and they aren’t always savvy about what a thorough cleaning entails. But a tidy room, combined with good personal hygiene, can help them to stay healthy during what can be a very stressful time.
College campuses pose many of the same health risks as lower-grade schools, in terms of infectious illness. “At college, though, students live in close quarters with each other, and they spend their days in one crowded classroom after another,” Dr. Scott says.
One illness that can hit college campuses especially hard is bacterial meningitis, or meningococcal disease. It’s an inflammation of the membranes that cover the brain and spinal cord, causing high fever, headache, stiff neck, nausea, and vomiting. Dorm-dwelling college freshmen are at particular risk for infection, which is why it’s recommended that they get a meningococcal vaccine before heading off to college.
The Strategy
Clean up before moving in. Things can be hectic on moving day, but if time permits, you should give your kid’s dorm room a thorough cleaning and disinfecting to clear out any lingering germs.
Target surfaces. Give your college student a supply of disinfectant wipes and encourage him or her to do at least a surface cleaning on a regular basis. Pay particular attention to any area that comes into contact with food, such as a microwave or refrigerator, as well as shared surfaces such as desktops and computer keyboards and mice.
Make some suds. College students will wash clothes without laundry detergent to save a few pennies. But they really need the soap in order to get rid of odor, soil, dirt, and bacteria.
Strip the bed. Bedding and towels should be washed in hot water at least weekly. The high temperature helps remove germs from fabrics.
Avoid mold and mildew. Wet or damp laundry should be hung on a drying rack. Putting it away before it’s dry can invite mildew and mold.
Slip on flip-flops. Asking college students to wear flip-flops isn’t too big of a stretch. A nonslip pair is good for protecting feet from the fungi that inhabit dorm bathrooms and showers.
Scrub up. By now it goes without saying that washing hands well can go a long way toward keeping germs at bay. Soap and water are best, but when they aren’t handy, an alcohol-based hand sanitizer will do.
Pamper your immune system. Late nights and pizza runs are college traditions, but both can punish the body’s natural defenses if they become habits. Gently remind your college student to get plenty of rest and eat lots of immune-boosting fruits and vegetables, both of which will fortify his or her disease resistance.
12. Your Home
Though they don’t help pay the rent or mortgage, hordes of bacteria and viruses may be living quite comfortably under your roof. Even keeping your home spotless might not be enough to evict these unwelcome guests, unless you know precisely where they might be hunkering down.
Reality Check 
Colds and flu are most contagious before symptoms appear.
“Not necessarily true,” says Erika Schwartz, MD, chief medical officer of www.healthandprevention. com. You may be contagious before symptoms set in, but you aren’t necessarily most contagious then.
Usually you know when you’re coming down with something. Those early symptoms—fatigue, sore throat, general malaise—should be your cue to take extra-good care of yourself by eating well and getting plenty of rest.
“It’s also the time to stay home,” Dr. Schwartz says. “Too many people go to work and public places when they’re sick. But by not toughing it out, you protect yourself and everyone around you.”
The Strategy
De-germ your kitchen sink. Which would you rather eat from, your toilet or your kitchen sink? Neither is very appetizing, of course, but the average kitchen sink is home to 1,000 times more bacteria than the average toilet. It isn’t all that surprising, when you consider the bits of food that swirl around and down the drain, not to mention the gunk in that stinky pit known as the garbage disposal.
According to Dr. Fraser, the sink is one of two spots in the kitchen that she cleans “religiously.” She pours a teakettle of boiling water over the entire sink surface and down both drains to kill germs and get rid of the drain odors. Youcan do this yourself, but be sure that your drainpipes can handle the hot water. As an alternative, mix 1 tablespoon of bleach (or a capful from the bleach jug) into a gallon of water and clean the sink and drains with this solution.
The other must-clean spot is the refrigerator, where old food and crusty spills can feed germs. Once a week, Dr. Fraser tosses out any leftovers and gives the shelves and other surfaces a wipe-down—first with soap and water, then with diluted bleach.
Sanitize your sponge. If you use a sponge to clean off countertops and other kitchen surfaces, it soaks up a lot of potentially nasty germs. You should clean it regularly so that you aren’t smearing its microbial contents all over the rest of your kitchen. To do this, simply dampen the sponge and then microwave it for a minute, or run it through the dishwasher on the drying cycle.
Keep a clean carpet machine. When you run the vacuum, it sucks in bacteria along with food for those bacteria, so the germs can continue to thrive in the vacuum bag. Use antibacterial bags if they’re available for your vacuum model, and replace them regularly. Change the bag outdoors, so the inevitable cloud of debris won’t infiltrate the rest of your home.
Take off your shoes. The world is a dirty place, and you can step into all kinds of foul material as you go about your business. Why track the germ-laden remnants of the day into your home? Leave your shoes by the door instead.
Turn up the heat on laundry. Dirty clothing may be dirtier than you think. Dr. Gerba has written at length in scientific journals about how much fecal matter is in an average adult’s worn underwear (one-tenth of a gram, the equivalent of one-quarter of a peanut), and how many nasty bacteria and viruses can survive in cold or warm water. (It’s quite a few, since if you start with 100 million bacteria and reduce them by 99 percent, you still have a million left.)
The take-home message from several of Dr. Gerba’s studies is to wash laundry in hot water whenever possible, use bleach in the washer if you can, and dry clothing on the hot setting. Even this won’t kill all of the germs, but it’ll help. Also, wash your hands after you transfer the laundry from the washer to the dryer.
The Pros Know
Kathy J.Helzlsouer, MD, MHS
Director of the prevention and research
center at Mercy Medical Center in Baltimore
Dr. Helzlsouer investigates how to prevent the spread of viruses and bacteria, and she practices what she preaches every day.
When I was in medical school, one of my professors came into class on the first day and said, “Colds are a psychosomatic illness.” He then went on to explain the connection between mind and body and how periods of stress make us more vulnerable to getting sick. And it’s true. There have been plenty of studies to show that people have a limited response to vaccines when they are under stress and an increased response to them when they are managing stress with relaxation techniques, sleep, and a healthy diet.
To manage my own stress, and thus to keep my immune system in the best shape possible, I get enough sleep, eat well, and practice deep breathing. I also wash my hands before and after I see a patient; I don’t want to give them anything, and I don’t want to get anything from them.
When something is circulating around the office, like a gastrointestinal virus, I clean all of the doorknobs down with disinfectant wipes. I am particularly careful when it comes to common touch areas. Anything that anyone has touched can become contaminated with what that person had on his or her hands. That’s why you should always wash your hands.