Washing your hands is sometimes not enough

I was listening to a radio show the other morning, early in the morning, and the host asked the guest what his advice would be for future generations if an asteroid hit the Earth and wiped out all of our technology and/or our civilization. The guest answered that he would advice future generations to wash their hands. He explained that it wasn’t until societies started to consistently wash their hands that they started to grow. Foodborne diseases decreased, and children were not dying as much from diarrheal diseases.

Of course, this all got me thinking.

I started to think about all the other diseases that cannot be controlled by washing our hands because they’re airborne or droplet-borne, or sexually transmitted, or transmitted by vectors. No amount of hand washing would have helped keep the Black Death at bay. It was caused by Yersinia pestis, a bacteria carried in fleas carried in rats. It killed millions of people, taking out probably about half of the residents of Europe. Imagine that, half of your town gone, dead. Even worse, imagine that you had no clue what was causing the plague and that washing and washing and washing some more was doing nothing. It must have been horrifying.

And then there was smallpox. (I swear, someone somewhere must be wondering why I keep visiting all these infectious disease topic websites.) Smallpox is transmitted by droplets and by infected materials, like handkerchiefs and blankets. Again, hand washing would have been useless. To fully and successfully get rid of smallpox, we had to use a vaccine effort the likes of which we’ve only seen with polio. If a case of smallpox was reported, everyone around the case was vaccinated. This went on for a while until the last case of smallpox happened in the 1970s.

Then there was HIV in the late 1970s and early 1980s. No hand washing there. There was certainly plenty of allegorical “hand washing” when people with HIV infection (and eventual AIDS disease) were abandoned to their own fate. But hygiene for preventing HIV infection? Nope. Safe sex practices like use of condoms prevent that.

Of course, this is not to say that the advice to wash your hands is a bad one. Not at all. It is a very good one. Bugs like norovirus and C. diff survive the use of alcohol sanitizers. For those bugs, you need good, old fashioned washing of the hands with soap and water, vigorous scrubbing, and proper technique. Like this:

 

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If I were asked what I would tell future, post-apocalyptic generations to help them survive, I would tell them to wash their hands, eat a balanced diet, boil their water, and develop vaccines and antibiotics as soon as possible. I might even leave them a how-to guide and tell them to have their brightest read it through and through and become their doctor. Check that, they don’t have to be the brightest. (I’m joking, of course!)

What advice would you leave for them to help them survive?

Featured image credit: Mark Nye, Club of Human Beings / Foter.com / CC BY-NC-ND

I'm a fourth-year doctoral candidate in the Doctor of Public Health program at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen

3 thoughts on “Washing your hands is sometimes not enough

  1. For a post-apocalyptic group?
    Boil water, do not permit vermin to cohabit homes and food storage, boil water for at least 10 minutes of rolling boil and wash hands only with that boiled water.
    The balanced diet is nice, however, it is rare when civilization comes crashing down.
    I’d also include a list for what to watch for when the inevitable disease sweeps through, largely for when one should isolate the ill from the healthy and when that is unnecessary.

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    • We had an infection prevention specialist (and retired US Army Colonel) tell us that boiled water was not necessary for washing hands. Dirty water could be filtered and you can wash your hands with it. Then you’d apply a hand sanitizer. The thinking is that the washing, even with dirty water, washes away what the hand sanitizer won’t kill. I don’t think I want to give that a try, though. So, yeah, boil, boil, boil!

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      • Yeah, his advice is OK for when civilization is still functioning. In a major disaster, that filtered water would still be lousy with all manner of nasty organisms.
        Hand sanitizer would be scarce as well.
        The last time I checked, one isn’t easily improvising a filter that would remove hepatitis A. Though, I do know of some filter feeders that concentrate it. 😉

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