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Pediatric Infectious Diseases

Although illness is most prevalent during the winter months, sickness can occur year-round, so it's important to take measures every day of the year to help keep yourself and your family healthy. Lori Patterson, M.D., pediatric infectious disease specialist at Children’s Hospital, offers the following information about germs and infection prevention.


Q. What are the common types of germs?


A. A wide variety of microbes in our environment can cause diseases in humans. Bacteria and viruses are the two most common, while fungi and parasites are less common. Within these subclasses are literally hundreds of different microbes that cause disease.


Q. Where are the most common places that germs live in the home?


A. Germs are especially prevalent on frequently touched surfaces: doorknobs, television remotes, kitchen and bathroom faucets, refrigerators, light switches, microwaves, computer keyboards, telephones and toilet handles. If someone in the home is ill with a respiratory virus (such as RSV, influenza or various cold viruses), that virus may easily be found on these surfaces during the winter months. The good news is these viruses can only survive for one to two hours on such a surface, but the bad news is that during that time, another person may pick up the infection from that surface. In bathrooms, viruses and bacteria that cause gastrointestinal illness, such as rotovirus and hepatitis A, are of concern year-round; these are hardier germs that can survive for many days on hard surfaces.


Around holidays, another area to be cautious about is the kitchen. Food safety is important year round: foods should be kept at proper temperatures (keep hot foods hot and cold foods cold!), fruits and vegetables should be thoroughly washed (the length of time under the water is more important than the temperature of the water); and care should be used with cooking and food preparation surfaces (sinks, cutting boards and counters).


Thanksgiving and Christmas pose a special risk because turkey is so prevalent on the menu. Raw poultry, such as turkey, can harbor salmonella and campylobacter, two bacteria that cause gastrointestinal illness. Many cooks think they must wash their turkey before cooking it; however, this is actually NOT recommended. Washing a turkey contaminates the sink as well as any surrounding area that is splashed in the washing process. Even the most thorough attempts at cleaning these surfaces may miss some of the splashes. Properly cooking a turkey will kill all the germs, regardless of whether the turkey is washed.


Keeping the hard surfaces of your household clean is one of the keys to minimizing illness. I believe a surface disinfectant, such as Clorox wipes, should be on every household shopping list – they are easy to use and effective in fighting household germs in the kitchen, bathroom and throughout the house.


Q. How are germs spread?


A. Respiratory infections (strep throat, influenza) are spread through coughs and sneezes, either when another person inhales the droplets or when the droplets land on a hard surface that is then touched by another person. Gastrointestinal viruses are spread through the fecal-oral route, which is when a person touches a contaminated surface, then puts his hand to his mouth, such as when eating. Individuals who share drinks can also share illnesses such as infectious mono, strep throat and some kinds of meningitis.


Q. How can parents minimize the spread of illnesses?


A. The best method to prevent infection is to wash hands frequently throughout the day, especially before eating; after using the bathroom; after blowing your nose, sneezing or coughing; after returning home from school or work; after changing a diaper; or after tending to ill family members. Also, try to encourage children to avoid touching their eyes, nose or mouth, although this will be difficult, especially for younger children. Using alcohol-based hand sanitizers also is very helpful, especially if you do not have access to hand washing facilities when out in public.


Immunization also is key! I can’t stress that enough. Children should be up-to-date on their immunizations and also should receive the influenza vaccine each year (the vaccine can be given in children as young as 6 months of age). Shots or Flumist can be given even through December to provide protection for the remainder of the winter.


Children, especially toddlers and preschoolers, usually are the ones who introduce the flu into a household. Studies have proven that when there is broad flu vaccine coverage in young children, the occurrence of the flu drops significantly in the adult population, so vaccinating your children can help not only them but also you and other family and friends.


Practicing other good health habits is also helpful. Poor diet and a lack of sleep can contribute to a weakened immune system, causing such a person to be more likely to become ill upon exposure to viruses or bacteria.


Also avoid cigarette smoke, and as much as possible, limit young children’s exposure to large groups of children, such as group daycare settings or church nurseries.


There have been some suggestions that perhaps Americans have become excessive about eliminating exposure to harmless microbes as well as harmful germs through overuse of such products as hand sanitizers and cleaning supplies. This has, perhaps, led to the development of somewhat weaker immune systems. Parents should try to strike a balance, which can be hard to do. Talk to your pediatrician or family practice physician for guidance if you are unsure about how much is too much.


Q. How can parents educate their children about hand washing?


A. Parents should teach children about the importance of hand washing, but they also should be good hand washing role models. Proper hand washing depends on the length of time rather than the temperature of the water; using water hot enough to kill the viruses and bacteria would scald the hands. The best temperature is one that is comfortable enough to keep the hands in for about 20 seconds. To wash hands properly, wet the hands, and then lather well. Then rub the hands together under the water for about 20 seconds to thoroughly rinse away the soap as well as any organisms on the hands.


Q. How can parents make hand washing fun?


A. Children often forget or are too rushed to wash their hands because it is a distraction from their playtime. It’s not second nature to them, as it is to many adults. However, parents can make hand washing more appealing by purchasing colorful, child-friendly soaps with interesting shapes and designs or liquid soap products that turn into a foam when pumped from the dispenser. Also, encourage children to sing a song while washing their hands; they will think it’s for fun, but it actually helps them to wash for the proper amount of time. The "Happy Birthday” song (sung twice) and "Yankee Doodle” both are about the right length.