1 “Hygiene” comes from Hygieia, the Greek goddess of health, cleanliness, and . . . the moon. Ancient Greek gods apparently worked double shifts.
2 The human body is home to some 1,000 species of bacteria. There are more germs on your body than people in the United States.
3 Not tonight dear, I just washed my hands: Antibacterial soap is no more effective at preventing infection than regular soap, and triclosan (the active ingredient) can mess with your sex hormones.
4 Save the germs! A study of over 11,000 children determined that an overly hygienic environment increases the risk of eczema and asthma.
5 Monks of the Jain Dharma (a minority religion in India) are forbidden to bathe any part of their bodies besides the hands and feet, believing the act of bathing might jeopardize the lives of millions of microorganisms.
6 It’s a good thing they’re monks.
7 Soap gets its name from the mythological Mount Sapo. Fat and wood ash from animal sacrifices there washed into the Tiber River, creating a rudimentary cleaning agent that aided women doing their washing.
8 Ancient Egyptians and Aztecs rubbed urine on their skin to treat cuts and burns. Urea, a key chemical in urine, is known to kill fungi and bacteria.
9 In a small victory for cleanliness, England’s medieval King Henry IV required his knights to bathe at least once in their lives—during their ritual knighthood ceremonies.
10 That’s their excuse, anyway: Excrement dumped out of windows into the streets in 18th-century London contaminated the city’s water supply and forced locals to drink gin instead.
11 A seventh grader in Florida recently won her school science fair by proving there are more bacteria in ice machines at fast-food restaurants than in toilet bowl water.
12 There’s no “five-second rule” when it comes to dropping food on the ground. Bacteria need no time at all to contaminate food.
13 The first true toothbrush, consisting of Siberian pig hair bristles wired into carved cattle-bone handles, was invented in China in 1498. But tooth brushing didn’t become routine in the United States until it was enforced on soldiers during World War II.
14 Please don’t squeeze the corncob. In 1935, Northern Tissue proudly introduced “splinter-free” toilet paper. Previous options included tundra moss for Eskimos, a sponge with salt water for Romans, and—hopefully splinter-free—corncobs in the American West.
15 NASA recently spent $23.4 million designing a toilet for the Space Shuttle that would defy zero gravity with suction technology at 850 liters of airflow per minute. That’s a lot of money for a toilet that sucks.
16 In 1843, Oliver Wendell Holmes Sr. campaigned for basic sanitation in hospitals. But this clashed with social ideas of the time and met with widespread disdain. Charles Meigs, a prominent American obstetrician, retorted, “Doctors are gentlemen, and gentlemen’s hands are clean.”
17 Up to a quarter of all women giving birth in European and American hospitals in the 17th through 19th centuries died of puerperal fever, an infection spread by unhygienic nurses and doctors.
18 TV kills! University of Arizona researchers determined that television remotes are the worst carriers of bacteria in hospital rooms, worse even than toilet handles. Remotes spread antibiotic-resistant Staphylococcus, which contributes to the 90,000 annual deaths from infection acquired in hospitals.
19 It is now believed President James Garfield died not from the bullet fired by Charles Guiteau but because the medical team treated the president with manure-stained hands, causing a severe infection that killed him three months later.
20 What on earth made them think manure-stained hands were remotely acceptable to treat anyone?
Bacteria and viruses are everywhere–so many of them in so many places that it’s a wonder we don’t get sick more often. The germs in question aren’t just the ones that cause colds and flu, but also nastier ones that can trigger staph infections, pneumonia and GI illnesses. And long after an infected person leaves the area, pathogens can linger on contaminated surfaces, surviving for several days. Here’s a guide to germ hotspots and how to protect yourself:
The supermarket: Beware of those shopping cart handles! And the child seat: just think of what can leak out of diapers. No one disinfects shopping carts so they’re a breeding ground for whatever ails the customers who pushed them around before you.
- Germ control: Keep sanitizing wipes in your purse or pocket to swab the handles and kid’s seat. Check the product label for an Environmental Protection Agency (EPA) registration number, indicating that it can be used as a disinfectant. Or squirt hand sanitizer on a tissue and wipe.
The Dirtiest Places in Your Home.
At work: Your desk at work could have 400 times more germs than a toilet seat. What’s more, thousands of bacteria can coat your phone. When’s the last time you disinfected your computer keyboard or cleaned the crumbs out of your desk drawers (a feast for germs)? Also be wary of control buttons on the office copier or fax machine, elevator buttons, handles of shared coffee cups and pots, and other communal items.
- Germ control: Use disinfectant wipes daily on the surface of your desk, phone, computer keyboard, desk drawer handles and anything else you habitually touch, and wash your hands after using communal items.
In the kitchen: Sure, you disinfect countertops and cutting boards after readying raw meat or chicken (even raw veggies and fruit) for cooking. But who knew that it’s also important to clean all the other stuff you might handle in the process: microwave controls, salt and pepper shakers, jars of spices and herbs.
I’m no detective but—with barbeque season officially starting the day before—a prime suspect immediately jumped to mind: the norovirus, the most common cause of food poisoning in the world.
The Centers for Disease Control and Prevention estimates that 200,000 Americans contract food poisoning every day. But Philip Tierno, Ph.D., a microbiologist at New York University medical center and author of The Secret Life of Germs, believes the actual number is closer to 800,000.
And in 4 of 5 of food poisoning cases, the attack happens at home—right (on the plate) under your nose.
“Everyone in this country will have at least one incident of sickness this year attributable to a foodborne virus, bacteria, or toxin,” Tierno told Men’s Health. Except that most of us won’t know what hit us. Like my colleague, we’ll chalk up the usually mild symptoms—nausea, diarrhea, cramping—to a stomach bug that’s going around.
We asked Men’s Health contributor Jim Gorman to help us identify the 10 dirtiest foods we put on our plates. His report is shocking, in that it reads like the average American’s grocery list. Read on for the dirt about your favorite foods—and how to protect yourself at the supermarket and your dinner table.
- Germ control: Use disinfectant on everything you handle during food preparation. Don’t forget the refrigerator door, the faucet, and cabinet door handles. Use an antimicrobial cleaner or a mixture of one part household bleach diluted with ten parts water. Sanitize sponges in the dishwasher or by microwaving them for 60 seconds at high power.
A strong immune system fights germs. Nourish your body with these immune-boosting foods.
Public restrooms: Studies have shown that sinks and faucets harbor far more bugs than toilet seats. A study at Johns Hopkins found that water from hands-free faucets is actually dirtier than water from manual ones (researchers suggested that the complex valve systems may promote more bacterial growth, but didn’t test the handles of the manual faucets for germs).
- Germ control: Avoid touching faucets and soap dispensers with bare hands – use a paper towel to turn the water on and off, to push the soap dispenser and to open the bathroom door to leave when you’re done.
Restaurants: We all hope that employees obey the signs and always wash their hands before leaving the restroom, but no one checks on them. Then there’s the rag or sponge used to clean the table before you sit down. But think about less obvious threats: germs can roost on the menus (who disinfects a menu?) and the lemon in your soft drink or iced tea: a study published in Environmental Health in 2007 found that nearly 70 percent of the lemon wedges tested at 21 restaurants contained e. coli and more than 20 other pathogens.
- Germ control: Choose your restaurants with care. Don’t let the menu touch your plate or silverware, and wash your hands after you give it back to the waiter. Order your beverages without lemon.
A final caution: don’t waste money on hand sanitizers that claim to protect against methicillin-resistant Staphylococcus aureus (MRSA), the H1N1 flu virus, Salmonella or E. coli. The U.S. Food and Drug Administration has not approved any such consumer products. Your best bet: wash your hands with soap and water frequently, for 30 seconds per washing. Or, use alcohol-based hand sanitizer (at least 60% alcohol concentration). Sanitizers kill most harmful bacteria and viruses, and don’t contribute to antibiotic resistance.
1 Viruses are not alive: They do not have cells, they cannot turn food into energy, and without a host they are just inert packets of chemicals.
2 Viruses are not exactly dead, either: They have genes, they reproduce, and they evolve through natural selection.
3 Scientists have been debating this issue since 1892, when Dmitry Ivanovsky, a Russian microbiologist, reported that an infection in tobacco plants spreads via something smaller than a bacterium. That something, now called the tobacco mosaic virus, appears on this page (magnified and colorized).
4 Score one for Team Nonliving: After American biochemist Wendell Stanley purified the tobacco mosaic virusinto needlelike crystals of protein, he won a 1946 Nobel Prize—awarded in chemistry, not medicine.
5 Score one for Team Living: Some viruses sneak DNA into a bacterium through its, um, sex appendage, a long tube known as a pilus. If that’s not life, what is?
6 Virus comes from the Latin word for “poison” or “slimy liquid,” an apt descriptor for the bug that causes flu and the common cold.
7 In 1992 scientists tracking a pneumonia outbreak in England found a massive new kind of virus lurking within an amoeba inside a cooling tower. It was so large and complex, they initially assumed it was a bacterium.
8 That über-virus is now called Mimivirus, so named because it mimics bacteria and because French biologist Didier Raoult, who helped sequence its genome, fondly recalled his father telling the story of “Mimi the Amoeba.”
9 Mimivirus contains more than 900 genes, which encode proteins that all other viruses manage to do without. Its genome is twice as big as that of any other known virus and bigger than that of many bacteria.
10 Mamavirus, closely related to Mimivirus but even bigger, also turned up inside an amoeba in a Paris cooling tower. (Maybe somebody should clean those towers.)
11 Mamavirus is so big that it has its own dependent, a satellite virus named Sputnik.
12 Amoebas turn out to be great places to seek out new viruses. They like to swallow big things and so serve as a kind of mixing bowl where viruses and bacteria can swap genes.
13 Viruses are already known to infect animals, plants, fungi, protozoa, archaea, and bacteria. Sputnik and Mamavirus suggest that they can infect other viruses, too.
14 In fact, scratch the whole concept of “us versus them.” Half of all human DNA originally came from viruses, which infected and embedded themselves in our ancestors’ egg and sperm cells.
15 Most of those embedded viruses are now extinct, but in 2005 French researchers applied for permission to resurrect one of them. Some scientists objected, saying the resurrected virus could go on a rampage; the research ministry approved the project.
16 Apocalypse Not: The virus, dubbed Phoenix, was a dud.
17 Then again, other viral relics in our genomes may play a role in autoimmune diseases and certain cancers.
18 Some viral proteins do good. They may have kept your mother’s immune system from attacking you in utero, for instance.
19 A virus called HTLV, which has coevolved with humans for thousands of years, is being used to uncover prehistoric migration patterns. Its modern distribution suggests that Japanese sailors were the first people to reach the Americas, millennia before Siberians wandered across the Bering Strait.
20 We are family: Scientists suspect that a large DNA-based virus took up residence inside a bacterial cell more than a billion years ago to create the first cell nucleus. If so, then we are all descended from viruses.
Whenever I get sick, I have a conversation with my wife, Rachelle, that goes like this:
Her: “How are you doing?”
Her: “Are you sure?”
She just doesn’t trust me when I tell her nothing is wrong—a lack of faith she claims dates to an illness early in our marriage. “You wouldn’t take aspirin because you wanted to see how high your temperature could go,” she recalls. “It was the stupidest reason you ever gave me for not taking care of yourself.”
It wasn’t the last time I put off going for an exam. Recently, a blotchy growth on my hairline went unchecked until its increasing size, nudges from Rachelle and “eww”s from my teenage daughter finally compelled me to see my doctor. It turned out to be an easily treated benign lesion—but the doc made it clear to me that it could have been cancer and really should’ve been checked sooner.
Like a lot of men, I have a thing about doctors. I’m not against them— I just figure medical care is for other guys. “Men like to think they’re indestructible,” says Alan Shindel, MD, codirector of the Men’s Health Program in the department of urology at the University of California, Davis.
We’re not total idiots about health, though. For example, men are more likely than women to get screened for colorectal cancer, and we understand it’s wise to get checked for serious conditions like heart disease and prostate cancer. It’s the out-of-nowhere aches, pains and oddball growths that we tend to blow off. One survey found that a quarter of men who were sick or in pain would wait as long as possible to see a doctor, and 17 percent would wait at least a week.
I finally went to the doctor about the spot on my scalp after I did some online research to assess the odds that it was something serious—and wasn’t reassured by what I read. Men like to be rational. Giving him the facts—as scary as they may be—may turn on a logic switch that makes it difficult to defend dodging his doctor.
Experts agree that not every symptom warrants a trip to the doctor, but some seemingly minor signs shouldn’t be toyed with (in men or women). We asked physicians to tell us the most serious symptoms that often go ignored—and why they shouldn’t be.
- Feeling Tongue-Tied
He’s thinking: I’m having a senior moment.
But it could be: A stroke. When a clot, injury, narrow blood vessel or other problem restricts blood flow to the brain, the result can be a TIA—a transient ischemic attack, which impairs brain function and can make speech difficult. It’s different from the tip-of-the-tongue reaching for an elusive word. “He might find that words can’t come out at all, or he’ll speak words that are different from the ones he intended or mumble things that don’t make sense,” says Steven Kaplan, MD, director of the Iris Cantor Men’s Health Center now under construction at NewYork–Presbyterian Hospital in New York City. Such symptoms warrant an immediate call to the doctor or trip to the ER. Mini-strokes usually last a few minutes and symptoms typically disappear within an hour, but having a TIA means you’re at immediate risk of a more massive stroke. Men have a slightly higher risk of TIAs than women, and risks go up with age, especially after 55. Photo: Stockbyte
- Shortness of Breath
He’s thinking: I’m really out of shape.
But it could be: An impending heart attack. Shortness of breath with exertion such as walking up a flight of stairs could be a sign that the heart muscle isn’t getting enough oxygen—a hallmark of coronary heart disease, which men age 55 and over are at an increased risk for.
“Any condition that makes breathing a struggle, including asthma and allergies, is exacerbated by exertion,” Dr. Shindel says. “But if shortness of breath seems to be getting worse each time, we worry about the heart.” Breathing that’s labored and doesn’t improve warrants a call to 911. An electrocardiogram or EKG (which measures the electrical activity of your heart), a sonogram or ultrasound of the heart, and chest X-rays can help diagnose or rule out a heart problem. Photo: Jupiterimages
- Persistent Pain On One side of the Abdomen
He’s thinking: I probably pulled a muscle.
But it could be: A kidney stone or tumor. One-sided pain that goes away probably is a side stitch or pulled muscle and nothing to worry about. “But if a dull ache is persistent, it should be evaluated by a physician,” says Dr. Kaplan. “It could be many things, but a tumor is one of the first possibilities we consider.” An ache from a tumor won’t likely move around, and may get better if he takes an over-the-counter pain reliever—but will keep coming back. “Any abdominal pain that doesn’t resolve within three days deserves to be checked out.”
Sharp, excruciating pain that hits suddenly and doesn’t improve within an hour warrants a trip to the ER. “If it’s a kidney stone, the pain will radiate from a specific point and can be intense enough to make you vomit,” Dr. Kaplan says. “I’ve had one myself, and it’s so horrible it makes you want to die.” The problem could also be appendicitis, a perforated ulcer or a hernia, so it’s important to get checked out. Photo: Shutterstock
- Toilet-Time Blood
He’s thinking: Must be something I ate.
But it could be: A kidney stone or bladder cancer if blood is in urine; colon cancer if blood is in stools. Bright red spots on tissue after wiping are likely from hemorrhoids. But blood in stools that have become narrower and thinner than usual (like the width of a pencil) could be a sign of cancer. Black, tarry stools might also indicate stomach bleeding from an ulcer. His doctor will likely examine the GI tract via a colonoscopy or upper endoscopy to nail down the problem.
Blood in urine may show up as a subtle pink hue, but he shouldn’t dismiss minuscule amounts or chalk it up to eating beets. “You’d have to eat a whole lot for that to happen,” says Mark Pochapin, MD, director of the Jay Monahan Center for Gastrointestinal Health at NewYork–Presbyterian Hospital/Weill Cornell Medical Center in New York City. Assume any reddish color is blood: One drop can turn the bowl pink. “Even microscopic amounts are a warning,” says Martin Miner, MD, codirector of the Men’s Health Center at The Miriam Hospital and clinical associate professor at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. “If he can actually see red color, he should definitely be evaluated.” Photo: iStockphoto
- Trouble Down Below
He’s thinking: There’s a pill for this.
But it could be: An early warning of cardiovascular disease. “The latest studies find that men in their 40s and 50s with erectile dysfunction may be two to five years away from a cardiovascular event like a heart attack,” Dr. Miner says. A recent study at the Mayo Clinic found that men who had ED in their 40s were 50 times more likely to have heart trouble down the road than men who didn’t. The artery leading to the penis is about half the diameter of the one feeding the heart, so experts think that restricted blood flow from atherosclerosis shows up early down below. An EKG or stress test can identify cardiac problems and a Doppler ultrasound (usually from a urologist) can test blood flow in penile blood vessels.
“The first sign of ED is usually trouble maintaining an erection during sex or not having normal morning erections,” Dr. Miner says. The good news is that the onset of ED, if it’s caused by cardiovascular disease, suggests your man may have a window of opportunity to treat heart disease before it becomes a serious problem. Photo: Jim Arbogast/Thinkstock
- Daytime Fatigue
He’s thinking: I should go to sleep earlier.
But it could be: Obstructive sleep apnea. Spending more time in bed won’t help if fatigue is due to this condition, in which the airway narrows or is blocked during sleep, cutting off breathing and disrupting slumber five to 30 times an hour. “Everyone has a night here and there when he doesn’t sleep well. But if the fatigue doesn’t go away even when he can catch up on rest, sleep apnea could be putting him at risk for health problems such as heart attack, arrhythmias, stroke or even heart failure,” Dr. Shindel says. A sign he’s chronically tired: falling asleep while doing activities during waking hours. “It’s not normal to fall asleep during usual waking hours just because you’re in a dark room,” Dr. Shindel says. Sleep apnea is especially common in overweight men and heavy snorers, but can be treated with breathing devices such as a CPAP (continuous positive airway pressure), an apparatus that you wear at night to keep airways open. Losing weight and surgery to widen the airway can also help. Photo: Stockbyte
- Constant Grumpiness
He’s thinking: I’m just under a lot of stress at work.
But it could be: Depression. Feeling cranky and low because of work hassles or difficult times is normal, but it should dissipate within a few days. With clinical depression, downbeat irritability lasts weeks at a time. “It’s different from run-of-the-mill blues and time for him to talk to his doctor if you’re saying to him, ‘You haven’t been acting like the person I think you really are for weeks’ or he’s lost interest in activities he used to enjoy or isn’t performing at work,” Dr. Shindel says.
Talk therapy and antidepressant medication are the options his doctor will likely suggest first. But if he has symptoms such as fatigue, low sex drive and loss of muscle mass, Dr. Shindel advises getting a blood test for low testosterone, which is sometimes the root cause of depression, especially in men over 40. Testosterone replacement in the form of gel, skin patches or injections can reverse the symptoms, but he should first talk to his doctor carefully about his medical history and the potential risks of testosterone therapy. Photo: Ditigal Vision
- Frequent Urination
He’s thinking: I’m drinking too much coffee.
But it could be: Type 2 diabetes or an enlarged prostate. It might be the coffee—when he’s actually drinking it. But if he often gets up to go twice or more during the night, his body could be trying to get rid of excess blood sugar that’s built up because it can’t get into cells—the problem that defines diabetes. He should first try adjusting what or when he drinks at night to see if that leads to fewer wee-hour trips to the bathroom. “If he still urinates more than he did a month ago, he should get his blood sugar checked, especially if he also has increased thirst, another red flag for diabetes,” Dr. Miner says. Diabetes can usually be controlled with changes in diet and exercise, often combined with medication.
If he’s also feeling like he can’t empty his bladder completely and/or is having a slow or weak stream, dribbling and having trouble getting urine flow started, the problem may be a growing prostate. This small gland surrounds the tube that carries urine out of the bladder, so an increase in size can put the squeeze on urine flow—a common problem in middle-aged and older men. (In men under 50, symptoms could be due to a urinary tract infection.)
Though painless, an enlarged prostate can eventually get worse and lead to acute urinary retention, where he suddenly can’t urinate at all, which is an emergency that often leads to surgery. Treatment ranges from exercises to strengthen muscles in the pelvic floor to medications that relieve symptoms or shrink the prostate. Prostate cancer is also a possibility, especially for men over 50, and if the doctor suspects that, he’ll do a rectal exam and draw blood to check PSA (prostate-specific antigen) levels; higher-than-normal results may indicate prostate enlargement, an infection or cancer. Photo: Thinkstock
- Yellowish Skin
He’s thinking: What yellow skin?
But it could be: Liver trouble. Yellow skin, or jaundice, suggests the liver isn’t functioning right. Possible causes in adults include liver disease, gallstones, pancreatic cancer or a viral hepatitis infection, which causes swelling of the liver.
“Hepatitis A isn’t a disease people think of, but it’s a virus found in contaminated shellfish and can be passed on by people who prepare food and don’t wash their hands,” Dr. Pochapin says. In fact, hepatitis A is one of the most common infectious diseases that’s preventable with a vaccine— worth considering for anyone who hasn’t been inoculated. Symptoms like jaundice, fever, upset stomach and fatigue usually show up within two to six weeks of exposure and get better on their own with a few weeks of rest. (And the virus doesn’t stay in your body after that.) But have him check in with his doctor, who’ll most likely want to run some tests to figure out exactly what’s going on. Photo: Jupiterimages
- A New Spot—Mole, Freckle, Red Patch— On the Skin
He’s thinking: It’ll go away.
But it could be: Skin cancer or seborrheic keratoses— warty, waxy benign lesions that become more common in middle age. Any time a new skin growth appears or an existing one changes in size, color or shape, he should see a doctor. Be especially concerned if a spot or mole gets darker, bleeds, itches or feels irritated—all of which are possible signs of skin cancer, according to the American Academy of Dermatology. The differences in appearance between a benign growth and skin cancer—especially melanoma, the deadliest type—can be subtle. So your physician may want to take a biopsy to make a definite ID.
I know all this from firsthand experience— and when I understood what the dangers may have been, I was glad I saw my doctor. After all, nobody’s indestructible forever. Photo: Jupiterimages
Why he doesn’t want to go to the doctor…and how to get him there
Every woman has that man in her life— her father, husband, brother, boyfriend, friend—who just won’t go to the doctor. Indeed, research shows that men are 24 percent less likely to have seen a physician in the past year than women.
Perhaps it’s no coincidence that men are more likely to be hospitalized for a preventable condition than women. What drives their avoidance? Research shows that it has a lot to do with men wanting to feel, well, manly. A study of 1,000 men found that those who have a more traditional view of masculinity—thinking that a “real” man doesn’t complain about pain, for example—were half as likely to get preventive care as those who didn’t agree with such stereotypes.
And let me tell you what else is going on: denial. Many people use it as a coping mechanism to deal with fear. So he’s probably thinking something like: “If I ignore this, it will go away” or “I don’t like needles and being prodded, so I’d rather just skip it” or “It’s either nothing or something too scary to know about, so I don’t want to go.”
So how can you help your man see the doctor? Talk to him about it. Sit down and have a chat, telling him that getting regular checkups is the best way to catch any potential illness before it becomes harder to treat and possibly life-threatening. Emphasize how important it is for him to be there—and healthy—for his family. Research shows this is the strongest motivator for men to see the doctor, probably because it appeals to their traditional sense of what their roles are. To help him address a symptom, the best dialogue I can suggest is something along the lines of: Let’s agree to tell each other when we’re feeling or seeing something that’s unusual or new for us—no matter how embarrassing—so we can help each other figure out what to do. I’m going to tell you if I have a stomach, gynecological or other issue and get it taken care of so I can stay healthy for you, and I want you to do the same for me.
Asking him to go to the doctor, and, if need be, arranging the visit shows that you’re taking his health (and symptoms) seriously, which can propel him to as well. It also helps remove the stigma he may feel about asking for help. Beforehand, help him organize his questions and concerns in writing and, if he’d like, be there with pen and paper in hand (or send him with a tape recorder) so you can both discuss the doctor’s responses later. When people are anxious, they often don’t hear or process the information they’re given in the moment. Don’t worry about being overbearing: A little nagging can go a long way in helping him protect his health. Photo: Shutterstock
Scarlet fever—the much-feared scourge of the past—is back, with an outbreak in Hong Kong that has killed two children and sickened hundreds. More than 21,000 cases have also been reported in China so far this year, nearly quadruple the rate for the same period in 2010, while infections have tripled in Macau, prompting the Centers for Disease Control (CDC) to issue a warning to travelers to China, Hong Kong, and Macau.
What makes the outbreak particularly alarming is that the strain infecting the region is 60 percent resistant to antibiotics commonly used to treat it, compared to 10 to 30 percent resistance in previous strains, according to a microbiologist from Hong Kong University, reports the Taipei Times. Officials expect the outbreak to continue over the summer. Just how dangerous is scarlet fever–and does the outbreak pose a threat to Americans? Here’s a closer look at this infectious disease.
Find out about the 10 worst disease outbreaks in US history.
What’s behind the reemergence of scarlet fever? Although scarlet fever is no longer as lethal as it was in the 19th century—when it ranked as a leading cause of death in kids—the disease has never fully disappeared. Between 1999 and 2006, there were 9,400 cases of scarlet fever in the US, according to Yahoo! News. Hong Kong scientists who isolated the bacteria in a six-year-old patient found a genetic mutation that may make the new strain more contagious than usual, which could explain the dramatic rise in cases in the affected region.
Is the outbreak likely to spread to the US? So far, there are no reports of any surge in scarlet fever cases in the US. Health authorities warn travelers to Hong Kong, China and Macau to wash their hands frequently and avoid crowded places that lack fresh air to reduce the risk of catching the disease.
What causes scarlet fever? The same bacteria that cause strep throat trigger scarlet fever: Group A streptococcus. In order to cause scarlet fever, the bacteria must produce a certain toxin. It causes a skin reaction, leading to the characteristic bright red rash that gives the disease its name.
The Group A strep bacteria that spark scarlet fever were also the culprits in the 1990 death of Jim Henson, creator of the Muppets, at age 53. Like the child in Hong Kong, he developed toxic shock syndrome, the deadly disorder that struck women who used a certain brand of tampons in the 1980s and developed staphylococcal infections. In Henson’s case, the reason for his strep A infection is unknown, but his illness also included pneumonia, one of the complications of scarlet fever. The bacterial infection progressed with such frightening speed that by the time he went to the hospital, antibiotic treatment was administered too late to save his life. Health authorities believe that Group A strep is becoming more potent and strikes more often than in past, the NY Times reports.
How is it spread? The infection is transmitted through airborne droplets released when an infected person coughs or sneezes. You can also catch it by touching surfaces contaminated by the spray and sharing beverages, food, or eating utensils with an infected person. In rare cases, scarlet fever can be spread by contaminated food, Medscape reports. The incubation period is 12 hours to 7 days and people with the disease can infect others before the symptoms show up.
What are the symptoms? The hallmark of scarlet fever is a sunburn-like rash with tiny red bumps that makes the skin feel rough, like sandpaper. The patient’s tongue often resembles a strawberry–red and bumpy—or may have a whitish coating. Other symptoms include a fever of 101 or higher, a red, sore throat that makes swallowing painful, swollen glands, and less commonly, vomiting or belly pain. After the rash fades, skin on the fingertips and toes may peel.
Who is at risk? Although anyone can get scarlet fever, it is most likely to strike school-age children, according to the CDC. All of the reported Hong Kong cases have occurred in kids. People who have been exposed to the bacteria in the past are usually immune. Medscape reports that about 80 percent of people over the age of 10 have developed lifelong protective antibodies against the disease.
Follow these simple health tips for kids.
How serious is scarlet fever? If treated promptly, it usually clears up without any serious complications. However, if it goes untreated, the bacteria can spread to the tonsils, sinuses, skin, ears, and blood. More serious cases can lead to pneumonia, middle ear infections, rheumatic fever, kidney disease, arthritis, and toxic shock, the condition that killed one of the children in the Hong Kong outbreak.
What is the treatment? Scarlet fever is treated with antibiotics, rest and fluids. Although the Hong Kong strain is resistant to some of the antibiotics used to treat the disease, penicillin still works. Antibiotic resistant bacteria are a growing health threat worldwide, as more and more bacteria are mutated to be resistant to some or all of the common antibiotics, as a result of overuse of these medications.
What are the best ways to prevent scarlet fever? The CDC recommends washing your hands frequently and avoiding sharing eating utensils, linens, towels and other personal items. It’s particularly crucial for anyone with a sore throat to wash his or her hands frequently, to reduce the risk of spreading the bacteria. The germs are most easily transmitted in close quarters, putting family members at risk if there is an infected person in the household. There is no vaccine to prevent scarlet fever or strep throat.
When your bladder isn’t as reliable as you’d like, all sorts of day-to-day situationsbecome unexpectedly stressful. Who wants to worry about embarrassing leaks every time you sit down to giggle over an episode of Modern Family? Here are the top ten bladder triggers, and ways to keep them in check.
- Laughing or sneezing
Why leaks happen
The pelvic floor muscles that support the bladder and urethra are weakened. So when you laugh, the sphincter muscle at the juncture between the urethra and bladder can’t hold as tightly as it should.
What to do
- Schedule bathroom trips at regular, set intervals. Learning to follow a bathroom schedule is known as bladder training, and over time it can help your bladder relearn how not to release unexpectedly.
- Get a referral to a physical therapist who specializes in pelvic floor strengthening. You can learn exercises to regain control over these muscles.
- Practice double voiding. If incontinence seems to be related to your bladder not emptying completely, returning to the bathroom after waiting a few minutes can help eliminate residual urine.
- Don’t get caught out. If you haven’t been to the bathroom in a while and someone launches into a joke, don’t feel self-conscious about excusing yourself. It’s OK to say, “Hold that thought” so you don’t miss out on a good laugh.
- Running, jumping, and exercise
Why leaks happen
“Exercise-induced urinary incontinence” is the term for stress incontinence that happens during physical exertion. When the pelvic floor muscles weaken, the muscles of the bladder and the urethra don’t have the support they need to tighten fully and retain urine. Running, jumping, kicking, and any serious exertion can cause a release.
What to do
- Don’t be afraid to talk about it. It might come as a surprise to know that 30 to 40 percent of women have this problem — it’s not the rare little secret you think it is. Ask your doctor for help.
- Sign up for pelvic floor therapy. A specialist will put you through a program of Kegel exercises designed to build up strength in the deep abdominal muscles that support the bladder.
- Be vigilant about bathroom trips. Go just before a run or game, and don’t be self-conscious about excusing yourself to use the bathroom again during a session.
- Don’t overhydrate. One eight-ounce glass of water before you exercise is plenty, experts say, but many women drink much more. Save the rest for during and after your training.
- Wear a tampon. Inserting a tampon puts pressure on the urethra through the vaginal wall. There are also medical devices called pessaries that do much the same thing.
Why leaks happen
Sexual activity puts pressure on the abdomen, urethra, and bladder, which can trigger stress incontinence. Stimulation and arousal can bring on urge incontinence.
What to do
- Limit fluid intake for an hour prior to sex.
- Use the bathroom just before sex.
- Perform pelvic floor exercises regularly to build up bladder control. Hint:They make sex better too!
- Choose sex positions that make incontinence less likely. With the woman on top, it’s easier to control your pelvic muscles and the stress caused by penetration; entry from behind puts less pressure on the bladder and urethra.
Why leaks happen
Not only is alcohol a bladder stimulant, it’s also a diuretic, causing your body to flush out water through the kidneys. So it’s a double whammy for those struggling with incontinence.
What to do
- Choose water-based mixed drinks. A gin and tonic — with plenty of tonic — is much easier on the bladder than straight whisky.
- Don’t add insult to injury. Mixing one bladder irritant — alcohol — with another, such as coke or a citrus juice, is just going to make leakage more likely.
- Cut back on the celebrating. You’ll enjoy the evening more if you stay dry even if you have to give up that second drink.
- Remember your water chaser. Following wine, beer, or a mixed drink with water flushes the irritating alcohol out more quickly.
- Coffee and tea
Why leaks happen
Caffeine is a double whammy for those with incontinence because it’s a diuretic and it stimulates the bladder. So it makes you have to go more often — and it makes you have to go now.
What to do
- Eliminate caffeine as much as possible. That means black tea and chocolate as well as coffee, experts say. If you can’t start your day without a cup of joe, keep the refills down, and follow it with a glass of water to dilute the stimulating effects. Also, limit your coffee and tea drinking to mornings. If you’re going to be running to the bathroom, you don’t want it to be when you’re trying to sleep.
- Soda pop
Why leaks happen
Soda pop can contain carbonation, caffeine, and cocoa-based flavorings, all of which are among the most irritating bladder triggers. And many experts say diet cola’s worse than coffee for those with incontinence; with the addition of artificial sweeteners, it contains four different bladder irritants.
What to do
- Experiment. When you need an ice-cold refresher, try other options such as lemonade, herbal ice tea, or fizzy water with a splash of juice. When trying to break a cola addiction, gradually reduce your daily intake rather than quitting cold turkey.
Why leaks happen
Medications that relax muscles in other parts of the body often relax the muscles of the bladder and urethra as well. Meanwhile, some medications cause you to produce and expel more urine, while others make you sleepy and less alert. Some examples:
- Alpha-blocking medications that lower blood pressure, such as Cardura (doxazosin), Minipress (prazosin), and Hytrin (terazosin), weaken the bladder’s ability to hold tight.
- Diuretics such as Bumex (bumetanide), Lasix (furosemide), Aldactone(spironolactone), and all the thiazides cause your body to flush liquids.
- Antidepressants and other drugs with anticholinergic effects, such asNorpramin (desipramine), Cogentin (benztropine), Haldol (haloperidol), and Risperdal (risperidone), block a neurotransmitter and in the process can cause bladder spasms.
- Sedatives and sleeping pills such as Ativan (lorazepam), Valium (diazepam), Dalmane (flurazepam), Lunesta (eszopiclone), and Ambien (zolpidem) relax muscles and make you sleep extremely deeply.
What to do
- Check side effects. If you think a medication is affecting your bladder, check the listed side effects to see if urinary problems or incontinence is among them. Even if it’s not in the notes, that doesn’t mean your experience is invalid. Keep track of how the drug is affecting you from day to day, then talk to your doctor about whether it’s possible to switch to an alternative medication.
- Urinary tract infections (UTIs)
Why leaks happen
When a urinary tract infection irritates the lining of your bladder, the result can be strong, sudden urges to urinate. And you may not even know you have a UTI; some are symptomless, at least at first. There may also be other symptoms, such as itching or burning, discharge, or a fishy or foul-smelling odor.
What to do
- Get tested for any suspected case of a UTI.
- If you seem to be getting frequent bouts of UTIs or an infection won’t clear up, ask your doctor about interstitial cystitis, a chronic condition that can lead to incontinence.
- Super-tight jeans, leggings
Why leaks happen
There’s a reason your doctor tells you to wear loose-fitting clothing to prevent vaginal and urinary tract infections. Airflow prevents moisture from becoming trapped and providing a breeding ground for bacteria. Wearing tight jeans, “jeggings,” or thick stretchy leggings for long periods of time can lead to UTIs and bladder infections, which in turn can cause incontinence.
What to do
- Give your body a break. If you want to wear tight jeans for a hot date, do so, but slip into your comfies as soon as you get home.
- Save exercise leggings for class; shower and change before heading home.
- Choose cotton over nylon, and watch that lycra content. The more lycra in the fabric, the more elasticized it is.
- Go one size larger.
Why leaks happen
The lower colon and rectum are located near the bladder and share many of the same nerves. When you have hard, compacted stool in your rectum, these nerves become overactive, with the result that you have sudden and frequent urges to go.
What to do
- Bulk up your diet with fiber. Fiber prevents constipation and has the additional benefit of making the urinary tract muscles function more effectively.
- Take laxatives temporarily to clear your colon and rectum.
- Drink plenty of water at regular intervals.
- Eat more fruits and veggies. The water content in fruits and vegetables helps prevent constipation.
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