Our Latest Perspectives Posts

A True Viral Video: Spreading Germs is Easy
Written by Joan B. Rose, PhD

If we could see how easy it is to spread the germs that make us sick, measures such as hand hygiene and surface disinfection might improve by leaps and bounds. In the animated video, “The Sneeze: How Germs are Spread,” Francois Chew and Ruby Petersen Unger help us visualize germ transmission and infection through a series of common events as guests gather for a party.

As the video begins, germs are portrayed as steadily multiplying in a human mouth until they are explosively launched by a sneeze onto the person’s hand. Germs and mucous are vividly depicted as a splat of green slime sullying the hand. The hand proceeds to deliver a subset of its microscopic population to a doorknob as the sneezer enters the house. Germs lurking on the doorknob are then easily transferred to the next guest to arrive at the gathering. Their passage into the house quickly results in the contamination of a tray of party food.
Chew and Petersen Unger’s video can help us remain mindful of how readily germs are transferred by hand contact to frequently touched surfaces. This is one “viral” video that should be shared widely as we enter the cold and flu season.

To help prevent the spread of germs:

  1. Get your seasonal flu vaccination, aka “flu shot:” According to the Centers for Disease Control & Prevention, the flu vaccine represents the single best strategy for preventing flu.
  2. Stay home if you are sick: This is a simple courtesy to others.
  3. Avoid sneezing into your hands: Use disposable tissues, if available, and discard used tissues; thoroughly wash hands after using tissues. If tissues are unavailable, sneeze instead into the crook of your elbow.
  4. Disinfect frequently touched surfaces, especially during cold and flu season: Door knobs, sink faucets, toilet handles, hand rails and other commonly touched surfaces can be cleaned and then wiped down with disinfectants, such as a dilute solution of ordinary household chlorine bleach.

Simple Chlorine Bleach Surface Disinfectant*

1/4 cup ordinary household chlorine bleach

1 gallon cool water

Mix bleach and water and apply to surfaces. Leave wet for 10 minutes, then rinse.

*Make solutions daily, as bleach loses effectiveness over time. Never combine ammonia-containing products with chlorine bleach.

Joan Rose, PhD, is the Homer Nowlin Chair in Water Research at Michigan State University and a member of the Water Quality and Health Council.

TESTING

Staying One Step Ahead of Legionnaires’ Disease

Legionella bacterium attaching to an amoeba

Legionella bacterium attaching to an amoeba; the amoeba provides protection from harmful environmental conditions

Photo courtesy of Dr. Barry Fields, CDC

Two large Quebec City buildings and a Chicago hotel are reported sites of exposure to Legionella bacteria that resulted in over 100 recent cases of Legionnaires’ disease and 13 deaths.

In Quebec City, officials suspect building cooling systems became colonized with high numbers of the bacteria (CNN Health report), causing ten deaths and 165 cases of illness. The J.W. Marriot Chicago experienced an outbreak of 10 cases of Legionnaires’ disease between July 16 and August 15; three of these cases were fatal. The Chicago Tribune reported the primary source of the outbreak was a decorative fountain in the hotel’s main lobby (see Water Wall in Hospital Dispenses Legionella for a report on a 2010 Legionnaires’ disease outbreak). A September 1 Chicago Tribune report states that the fountain has been removed.

Legionella was first detected as the pathogen responsible for an outbreak of pneumonia among attendees to a 1976 Philadelphia American Legion convention; 29 attendees died after being infected by exposure to bacteria through the hotel air-conditioning system. Legionella is transmitted by inhaling the bacteria in the mist of the water, produced typically in the indoor water of hot tubs, decorative water walls or fountains, swimming pools and cooling towers of large buildings, in addition to air-conditioning systems. According to the Mayo Clinic website, Legionella can travel through the air for as much as four miles. Most people exposed to the bacteria do not become ill, according to CDC, but of those who do, the majority can be treated successfully with antibiotics. Whereas healthy people usually recover from Legionnaires’ disease (see CDC Patient Fact Sheet), it causes pneumonia-like symptoms and can lead to death in the elderly, smokers and people with weakened immune systems.

Legionella: Modus Operandi

The key to controlling Legionnaires’ disease is understanding Legionella’s watery ecological niche. Legionella thrives in recirculating water systems maintained between 35 and 55 degrees Celsius (95 to 131 degrees Fahrenheit). It dwells in biofilms, intricately guarded microbial communities that form on wet surfaces. Biofilms provide excellent “cover” for Legionella, supplying both nutrients and protection from harm. According to Kwaik et al., Legionella’s ability to infect and even multiply within certain single-celled organisms such as some amoeba (see photo above) contributes to its hardiness and provides a “Trojan Horse” mode of transportation.

Controlling Legionella

Two of the most important factors in controlling Legionella in water circulating systems are minimizing scale buildup in the system and eliminating zones of temperature that support proliferation of the bacteria. Scale provides the type of uneven surface that supports biofilm development, a safe haven for bacteria. Temperature zones in the 35 to 55 degree Celsius range creates Legionella comfort zones, enhancing its growth potential.

The Environmental Protection Agency (EPA) lists the following methods for disinfecting water circulating systems to control Legionella: thermal (super heat and flush); hyperchlorination; copper-silver ionization; ultraviolet light sterilization; ozonation and instantaneous steam heating systems. In Legionella: Drinking Water Health Advisory, EPA recommends a disinfection strategy of combining two or more of these methods because “some methods have not always proven completely successful or have not provided permanent protection from recolonization.”

In their recent review of Legionella disinfection methods in hospital drinking water, Lin et al. (2011) recommend individual methods be validated in a stepwise fashion. These steps could be applied to any institution for the purpose of minimizing Legionella exposure:

  1. Laboratory evidence demonstrates Legionella disinfection
  2. Anecdotal reports of success in controlling Legionella in individual hospitals
  3. Peer-reviewed and published reports of success in controlling Legionella growth and preventing cases of Legionnaires’ disease in individual hospitals on a prolonged basis
  4. Reports confirming success from multiple hospitals over a prolonged period of time

Given what we know about Legionella and its complex survival mechanisms, a thoughtful approach is warranted to stay one step ahead of Legionnaires’ disease.

Joan B. Rose, PhD, is the Homer Nowlin Chair in Water Research at Michigan State University and a member of the Water Quality and Health Council.

TESTING

A Guide to Safe Reusable Grocery Bag Use

Grocery BagEnvironmental consciousness and municipal “bag taxes” are curtailing consumer use of new plastic and paper shopping bags in many areas of the US. Consumers, myself included, are getting better at remembering to “BYOB”—“Bring Your Own Bag”—to the marketplace. In my view, this paradigm shift in American shopping is positive from the perspective of resource conservation. However, as a consumer advocate concerned about food safety, a word to the wise is in order:

  • Wash Reusable Bags: Reusable shopping bags are only as clean as the items with which we fill them. In a 2010 study by researchers at the University of Arizona and Loma Linda University, and supported by the American Chemistry Council, reusable bags were collected at random from consumers as they entered grocery stores. The researchers found “large numbers of bacteria in almost all bags and coliform bacteria in half.” They learned from interviews that “reusable bags are seldom if ever washed and often used for multiple purposes.”

  • To help reduce cross-contamination and the risk of foodborne illness, the US Department of Agriculture’s (USDA’s) 2010 Dietary Guidelines for Americans recommend cleaning reusable grocery bags regularly. USDA suggests canvas and cloth bags be washed in the washing machine; plastic reusable bags can be washed by hand with hot, soapy water. The researchers found bag washing reduces bacteria by more than 99.9 percent.

  • Separate Foods in Bagging: At the check-out, consumers can request that clerks bag raw meats, poultry and fish separately from ready-to-eat foods to avoid cross-contamination. In addition, most clerks will place these items in plastic bags before packing.  If not, ask for it. According to the USDA dietary guidelines, raw meats, poultry and fish should be kept separate from ready-to-eat foods all along the path from the grocery cart to the consumer dinner table. One way to accomplish this in grocery bagging is to designate specific reusable bags for raw meats, poultry or fish and only fill them with those products. You may also wish to designate separate bags for raw fruits and vegetables. Put fresh fruit and vegetables in plastic produce bags at the grocery store to ensure an impervious separation between produce and the cloth bag. Finally, I keep a few lightweight fabric bags handy (rolled up in my purse works for me) to use for non-food purchases, such as drug store items.

  • Don’t Store Reusable Bags in the Trunk of Your Car: It might be the most convenient place to store bags for trips to the grocery store, but the trunk of the car is actually one of the worst storage places. The dark, warm (sometimes humid, depending on the region of the country in which you live) environment of the car trunk incubates “bag bacteria,” rasing the risk of foodborne illness. The researchers found a tenfold increase in bacteria in reused bags to which meat juice was added followed by a two-hour storage period in a car trunk. Ideally, store your reusable grocery bags in your home in a dry environment with good air circulation.

According to the Centers for Disease Control and Prevention, each year 48 million people, or one in six Americans, contract foodborne illnesses; 128,000 Americans are hospitalized and 3,000 die as a result of unsafe foods. Greater public education is needed to avoid adding to these statistics as a result of improper grocery bag reuse.

Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.

TESTING

Cantaloupe Contamination: What Consumers Can Do to Help Reduce their Risk of Foodborne Illness
Written by Linda Golodner

The rough texture of the cantaloupe rind provides many potential attachment points for dirt and associated bacteria.

The evidence is mounting that cantaloupe food safety deserves increased attention from both producers and consumers. Three recent contamination incidents support the need for new approaches. First, an unidentified farm in southwestern Indiana is believed to be the source of Salmonella-contaminated cantaloupe that infected 141 people in 20 states between July 7 and August 4, and resulted in the deaths of two people from Kentucky. According to news reports, the farm in question agreed to suspend cantaloupe sales for the rest of the season. In another incident last month, Burch Farms in North Carolina produced Listeria-contaminated honeydew melons, necessitating a recall of cantaloupe and honeydew melons from that farm (see FDA News Release); no illnesses were reported from that incident.

Finally, last October I reported on a tragic foodborne illness outbreak involving cantaloupe and Listeria bacteria. Thirty people died and nearly 150 were sickened by consuming cantaloupe produced by Jensen Farms in Colorado. The US House of Representatives Committee on Energy and Commerce released a report outlining multiple operational problems contributing to the cantaloupe contamination at Jensen Farms. The report emphasized two probable causes of contamination: a change in processing equipment and a decision not to chlorinate cantaloupe wash water. FDA voluntary guidelines for producers include measures to reduce bacterial contamination on harvested fruit by using antimicrobial solutions, such as chlorine, in cantaloupe wash water.

What’s a Consumer to Do?

The cantaloupe fruit grows in direct contact with soil, which naturally hosts bacteria that can be harmful to humans. Furthermore, if animal manure or inadequately composted animal manure is used as a crop fertilizer, the likelihood of disease-causing bacteria is greatly increased.

Removing soil and debris from cantaloupe rind is particularly important because its rough texture provides ample attachment points for bacteria. By cutting into a cantaloupe without first washing the fruit, consumers risk contaminating the edible fruit via the knife as it transports bacteria from the rind to the flesh.

Recommendationsi for avoiding foodborne illness from cantaloupe

Regardless of the actions that may have been taken by cantaloupe producers to reduce contamination, consumers need to be aware that their purchased cantaloupe could contain harmful bacteria attached to the rind.

  1. Using a clean vegetable brush, scrub cantaloupe rind under running water, then rinse under running water.
  2. Immerse the whole cantaloupe in a sanitizing solution made by mixing ½ teaspoon of regular, unscented laundry bleach for each gallon of water for 2 minutes. Note: This treatment is meant for the skin of the melon only, not the flesh. Regarding the bleach sanitizing solutions, no more than the specified ½ teaspoon of bleach per gallon of water is needed. More is not better!
  3. Dispose of sanitizing solution.
  4. Rinse cantaloupe again under running water.
  5. Once cantaloupe is cut, wrap pieces in a sanitary packaging material; refrigerate immediately at 41 degrees F or lower, as bacteria can grow rapidly on cut cantaloupe.

iBased on recommendations from a news release by the Wisconsin Department of Agriculture, Trade, and Consumer Protection and FDA.

TESTING

For Disinfecting Sponges, Microwaving is a Simple Solution
Written by Barbara Soule, RN, MPA, CIC, FSHEA

Ah, the lowly kitchen sponge.  It is the seemingly perfect scrubbing tool that can take repeated use and abuse as it helps you scrub the dishes, wipe up food debris and even clean the kitchen sink.  However, as we all know, you don’t get something for nothing in this world!  From a microbiological point of view, the sponge may be the most contaminated item in your home (University of Arizona Information for News Media).   And how do you clean the sponge that just contacted foods such as raw egg, uncooked meat or raw vegetables?  Run it under water, adding some soap for good measure then squeezing a couple times? Toss it in the dishwasher or washing machine?  A team of researchers from the University of Florida found that another kitchen mainstay, the microwave oven, may offer the simplest effective option for disinfecting sponges (journal abstract).

A Mobile Home for Germs

After a short period of normal use, invisible microbes take up residence in sponges.  Coliform bacteria (the type of bacteria likely to be in poop, sorry) begin to thrive in the many nooks and crannies of damp sponges, supported by moisture and nutrients in food debris; viruses may find a comfy place to hang out.  In a process known as cross-contamination, germs may hitch a ride on the kitchen sponge from one surface to another as the kitchen gets a wipe-down.  All of this activity has the potential to expose your family to disease-causing germs, such as norovirus (aka “the stomach bug”), E. coli and Salmonella.  Microbiologist Dr. Chuck Gerba made the interesting observation in a 2004 New York Times interview that some of the cleanest-looking kitchens often have bacteria all over the kitchen because “clean” people wipe up so frequently.  Amusingly, some of the cleanest kitchens, Gerba jokes, are in the homes of bachelors who rarely wipe up countertops.

Most of us would like to be able to use and reuse sponges without dreading the consequences of spreading germs. The University of Florida team reported simply microwaving sponges (wet, never dry) for two minutes at high power killed or inactivated over 99 percent of all the living pathogens in sponges and cleaning pads that had been soaked in a “witch’s brew” of fecal bacteria, viruses, protozoan parasites and bacterial spores (University of Florida News). The researchers recommend “zapping” kitchen sponges every other day or so. This is a simple and effective method when carried out properly (with the emphasis on “properly” because improper microwaving of sponges can cause severe skin burns and has the potential to start a fire).

Microwave Sponges Safely

The research team emphasizes three points of precaution when microwaving sponges:

  • To guard against the risk of fire: Ensure sponge is completely wet before placing in the microwave oven.
  • To guard against burns: Be careful when removing sponge from the microwave oven as it will be hot and there may be steam when the microwave is opened.
  • To guard against electrical shorting: Sponges should have no metallic content.

According to the Centers for Disease Control and Prevention, each year one in six Americans (48 million) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne illness.  Properly microwaving sponges on a regular basis is one step that could go a long way to help keep your family healthy and prevent costly medical visits.

Barbara M. Soule, R.N. MPA, CIC, is an Infection Preventionist and a member of the Water Quality & Health Council.


1High power may vary among microwave ovens, but this point is not addressed by the researchers. The researchers used a Sharp, Model R-630D microwave oven with a rotating glass plate, a frequency of 2,459 MHz, and power of 1,100 watts.

TESTING

Risky Behavior: Eat Raw Cookie Dough? Just Say No!
Written by Linda Golodner

Pre-packaged, ready-to-bake cookie dough is believed to have caused a 2009 E. coli outbreak in 30 states.  Cookie dough should not be eaten raw.

Pre-packaged, ready-to-bake cookie dough is believed to have caused a 2009 E. coli outbreak in 30 states. Cookie dough should not be eaten raw.

As delicious as it may be, unbaked, commercial, prepackaged cookie dough can make you sick. That’s the conclusion of a Centers for Disease Control and Prevention (CDC) investigative study of a 2009 E. coliO157 outbreak in 30 states. Seventy-seven patients, mostly female and under the age of 19, contracted gastrointestinal illness between mid-March and early July, 2009; 35 were hospitalized.

Investigative teams uncovered the common factor of commercial raw cookie dough consumption in the seven days leading up to illness. The offending product was traced to a single processing plant, resulting in a recall that included 3.6 million packages of ready-to-bake cookie dough.

Flour: A Potential Culprit

Despite the excellent investigative work of CDC in uncovering the source, the specific cause of the outbreak has not been identified; there is no evidence of intentional contamination. Cookie dough ingredients include flour, pasteurized eggs, chocolate chips, molasses, sugar, margarine, baking soda and vanilla extract. Flour stands out as a prime suspect because an unpasteurized variety was purchased by the cookie dough producer in large quantities and would have been used in all cookie varieties implicated in the outbreak. One 1993 study found 12.8 percent of raw flour tested positive for E. coli and 1.3 percent tested positive for salmonella.

CDC suggests food processors consider using pasteurized flour in ready-to-bake and ready-to-cook foods that are likely to be consumed without baking or cooking. Pasteurized flour is heated to destroy pathogens. The study notes the Food and Drug Administration has been advised by several cookie dough producers that in the wake of the outbreak they have begun using pasteurized flour.

Food Safety Education Begins at Home

According to the CDC report, another study of risky eating behaviors among young adults found 53 percent of college students consume unbaked cookie dough. CDC investigators reported several patients who became sick after eating the cookie dough admitted to buying the product with the sole intention of eating it unbaked. Although package directions specify the need to bake the product, this warning is sometimes ignored. When making your own cookie dough, use pasteurized eggs when available, and don’t be tempted to taste before popping unbaked cookies in the oven.

Because cookie dough may be contaminated in the unbaked state, it is important that consumers assume any surface with which raw dough makes contact, including knives, hands and preparation surfaces, is contaminated. Cleaning, then disinfecting such surfaces can help guard against cross-contamination. After removing all food debris from a surface, such as a counter, apply a simple chlorine bleach solution made by adding just ½ tablespoon of household bleach to ½ gallon of water; let air dry.

In our fast-paced society, partially prepared food products are great conveniences that save families precious time. Along with the benefits of such products, however, comes a responsibility to read and follow package directions, which should be clear and easy to understand. Parents of growing children can teach food safety measures by modeling them day to day and working them into meal-preparation discussions. Bon appétit!

Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.


1Richter, K.S., Dorneanu, E., Eskridge, K.M., Rao, C.S., 1993, Microbiological quality of flours. Cereal Foods World 38, 367-369.

TESTING

Salmonella Outbreak Linked to Dog Food
Written by Linda Golodner

Certain Diamond Pet Foods products have been recalled due to contamination with the bacterium Salmonella Infantis

Certain Diamond Pet Foods products have been recalled due to contamination with the bacterium Salmonella Infantis
CDC podcast on this topic

At least fourteen people in nine states have been infected with Salmonella Infantis as a result of contact with contaminated dry dog food, according to a report from the Centers for Disease Control and Prevention (CDC). Although no deaths have been reported, five of the patients were hospitalized. Those infected range in age from less than one year to 82 years old. No dogs have been reported sickened.

CDC determined that all of the ill individuals had handled dry Diamond Pet Foods produced in one Gaston, South Carolina, plant. A list of products recalled can be found on this Food & Drug Administration (FDA) website and on the Diamond Pet website. Pet owners can learn how to obtain a refund for recalled products here. For questions on the recall, CDC has posted the following telephone number for Diamond Pet Foods: (800) 442-0402.

I blogged last November on the issue of pet products and Salmonella contamination, and said that FDA had announced a year-long effort to collect and analyze samples of pet products for Salmonella bacteria. The program began last October and will extend until September, 2012. An FDA statement notes the agency became involved in the outbreak investigation early last month when the Michigan Department of Agriculture and Rural Development detected Salmonella during retail surveillance sampling. Salmonella was also detected in Ohio by the state Department of Agriculture and in South Carolina during an FDA inspection. In addition to those states, recalled products were distributed in Alabama, Florida, Georgia, Kentucky, Maryland, North Carolina, New York, Pennsylvania, Tennessee, and Virginia. According to the FDA, Diamond Pet Foods is working directly with distributors and retailers to remove recalled products as quickly as possible. Meanwhile, pet owners can reduce the ever-present risk of illness from contaminated pet products:

Pet Owner Safety Tips

Purchase and Storage

  • Purchase products in good condition (with no damage to packaging).
  • Store dry products in a cool, dry place (under 80 °F).

Pet Boundaries

  • Keep pets away from household food storage and preparation areas.
  • Keep pets away from garbage and household trash.
  • Supervise young children around pets and keep them away from pet feeding areas.

Clean up after your pet: Dispose of pet feces in a tightly sealed plastic bag.

Food/Preparation

  • Wash your hands for 20 seconds with hot water and soap before and after handling pet products.
  • Use a clean, dedicated scoop or spoon to transfer pet food to feeding bowl; do not use your pet’s feeding bowl as a scooping utensil.
  • Wash pet food bowls thoroughly with hot, soapy water to clean.
  • Disinfect feeding bowls periodically (see downloadable poster):
    • Wash with hot soapy water to clean; thoroughly rinse off soap
    • Sanitize with chlorine bleach solution (1/4 cup bleach + 1 gallon water); leave wet for 10 minutes
    • Rinse and dry.

Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.

TESTING

Rocky Ford Cantaloupe Growers Association Highlight Safety and Transparency
Written by Linda Golodner

Rocky Ford cantaloupe being planted at Hirakata Farms, Colorado

Rocky Ford cantaloupe being planted at Hirakata Farms, Colorado (Photo courtesy of BCDemocratOnline.com)

Spring cantaloupe planting is under way in Colorado, and following a tragic foodborne disease outbreak last year, growers are determined to regain consumer confidence. In 2011, over 30 people died and at least 146 were sickened during a Listeria outbreak traced to contaminated cantaloupe (see January 20, 2012 blog). Jensen Farms, the source of the Listeria outbreak, is located near Holly, Colorado, about 100 miles east of the Rocky Ford region, which was initially identified in news reports as the “epicenter” of the outbreak. Those reports took an economic and reputational toll on all Rocky Ford cantaloupe growers. This spring, as cantaloupe seeds are being pressed into Colorado soil, growers are taking aggressive measures to shore up their practices to avoid a repeat of last season’s catastrophe.

Rocky Ford Growers Association: According to The Durango Herald, growers have formed an association with self-imposed rules to promote safe cantaloupe production. The newspaper reports farmers who join the association must agree to twice-a-year safety audits—one announced and one unannounced—conducted by state Agricultural Department inspectors. Only association members will be allowed to use the Rocky Ford trademark. According to the newspaper article, Jensen Farms will not be asked to join the association reportedly due to its distance from the Rocky Ford region. It is unclear, according to the newspaper, whether Jensen Farms will resume cantaloupe production this year.

Post-harvest Produce Processing 

Growers in the new association will adhere to stringent food safety standards developed by Colorado State University and California researchers to avoid the problems that led to Listeria contamination at Jensen Farms. In particular, cantaloupe post-harvest processing will include rapid cooling and chlorine disinfectant in wash water.  Both measures help curtail the growth of Listeria and other bacteria; both were lacking in the Jensen Farms packing shed.

Seed-to-Store Tracking

In an effort to provide increased transparency for customers, including consumers, the Rocky Ford Growers Association has hired a tracking company to monitor cantaloupe from seed to store, identifying any problems along that path.  KOAA.com reports consumers can use smartphones to read a QR code on a sticker that tracks produce back to the seed and farm from which it originated and the date of its harvest.  In some cases the sticker will be on individual melons, in other cases they may be on packing crates.

Going Forward

Rocky Ford cantaloupe growers are to be commended for their aggressive food safety measures, which could serve as a model for other growers. The only good that can come from a tragedy as serious as last year’s outbreak is earnest determination to increase the safety of food processing.  Consumers should remember that they can play a role in food safety too:

  • Wash fresh produce thoroughlyunder running water just before eating, cutting or cooking, paying special attention to the convoluted outer skin of produce such as cantaloupe. (see www.FoodSafety.gov for more information).
  • Clean and sanitize food-contact surfaces (see the FDA web page, “Keep Listeria out of Your Kitchen”).

Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.


1QR codes are small, 2-dimensional, square icons on products and advertising material that one can hold a smart phone up to in order to access product information instantly.

TESTING

Hand, Foot and Mouth Disease Highlights Need for Hygiene in Child Care Settings
Written by Fred Reiff, PE

hand sores associated with Hand, foot and mouth disease

Image of hand sores associated with Hand, foot and mouth disease; image courtesy of CDC

Hand, foot and mouth diseasei is a viral illness caused by coxsackievirus. Afflicting mostly children, coxsackievirus normally causes mild fever and rash or sores on the palms of the hands and soles of the feet, and sores or blisters in the mouth. Recently, the US Centers for Disease Control and Prevention (CDC) reported coxsackievirus A6 in four states. Previously seen only in some European and Asian countries, the “A6” strain causes more severe symptoms and more hospitalizations. An April 20 article in USA Today states the virus “can hit kids and adults hard, causing fingernails and toenails to fall off two to three weeks after the illness has passed.”

The Reno Gazette-Journal cited 30 cases of hand, foot and mouth disease in Nevada’s Washoe County in a March 30 article. According to the article, in addition to the Nevada cases, 46 other cases had been reported in California, Connecticut and Alabama. The April 20 USA Today article indicates the virus is spreading around the country and that, according to one physician, about 25 percent of cases are in adults.

According to CDC, the cases were identified as unusual by healthcare providers or by health departments that contacted CDC for diagnostic assistance. Coxsackievirus A6 was identified in clinical specimens collected from 25 of 34 patients. The majority of those infected, 70 percent, had exposure to a child care facility or school. Hand, foot and mouth disease is not a “reportable” illness in the United States, meaning that physicians are not obliged to report diagnoses of the illness to government agencies. However, as healthcare providers and health departments contacted CDC with questions, and the significance of clinical results became clear, attention was focused on this uncommon strain of coxsackievirus.

Coxsackievirus is spread by person to person contact, especially during summer and autumn months. According to WebMD, there is no treatment for hand, foot and mouth disease other than pain relievers, such as acetaminophen. Infection usually lasts about one week. CDC notes that transmission of the virus can be reduced by maintaining good hygiene, including frequent hand-washing and disinfecting surfaces in child care settings.

Advice for Preventing Hand, Foot and Mouth Diseaseii

  • WASH YOUR HANDS often and carefully, especially after using the bathroom, preparing food or drinks and changing diapers.
  • DISINFECT ITEMS AND HARD SURFACES by washing them with hot, soapy water, then applying a solution of two tablespoons of bleach and four cups of water; rinse with clear water and dry.
  • LIMIT CONTACT WITH INFECTED PERSONS by avoiding hugging, kissing or sharing cups or utensils.

Finally, CDC recommends contacting your health provider if you suspect a severe case of hand, foot and mouth disease.

Fred Reiff, P.E., is retired from the Pan American Health Organization, and lives in the Reno, Nevada area.


iVesicular pharyngitis and vesicular stomatitis with exanthema
iiBased on recommendations from the Washoe County, Nevada Health District

TESTING

Innovative “Solar Bottle Bulb” Lighting the Darkness with the Help of Bleach Disinfectant
Written by Bruce Bernard, PhD

Recycle a clean, clear plastic, one-liter beverage bottle by filling it with water and three tablespoons of chlorine bleach, secure the bottle in a hole in a metal roof, and you have all the technology needed to illuminate the dark interiors of thousands of homes of the world’s poorest people. In an ingenious use of optics and chlorine chemistry, and for very little money, 55 watts of solar energy are streaming into formerly unlit homes in communities in Brazil and the Philippines. Many of the homes being outfitted with the device were perpetually dark due to the close, side-by-side construction of rudimentary dwellings. Now the spirits of residents are brightening along with their interior dwellings: Daylight is penetrating their living quarters.

The solar bottle bulb was invented by a group of resourceful Massachusetts Institute of Technology students; bulbs take approximately an hour to install. Solar bottle bulbs are positioned to rest partly above and partly below the roof surface, protruding from the interior ceiling. During the daytime sun rays stream into the water bottle, bending (refracting) and internally reflecting to produce a bright light source that does not depend on an electrical connection. As an example of the physical phenomena responsible for this lighting technology, the brilliance and “fire” of diamonds are caused by light refracting and reflecting throughout the crystal.

Chlorine Bleach Helps Light up the Darkness

Good sunlight refraction and reflection depend upon a clear water medium, just as a diamond’s brilliance depends on its clarity. Chlorine bleach plays the role of destroying the microorganisms that could proliferate inside the bottles, reducing the clarity of the water. As for maintenance, water and bleach must be replaced, but only every five years. It is not clear how long the beverage bottles hold up in this role (caps are protected from cracking with sealant—see the video), but replacing them should not be too great a hurdle.

Solar bottle bulbs are a wonderfully safe, cheap, energy-efficient lighting technology being supplied to those who need it most! Kudos to the inventors and the installers!

Bruce Bernard, PhD, is President of SRA International, Inc. and Associate Editor of the International Journal of Toxicology.

TESTING

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