Don't Kiss That Chick!

The Centers for Disease Control (CDC) warns that while baby chicks are cute, they can also be a source of Salmonella infection, especially for children. Since 1990, more than 35 outbreaks of Salmonella have been associated with live poultry. "It is important to know that infections from live poultry can occur at any time of the year, not just during the spring" said Dr. Casey Barton Behravesh, a veterinary epidemiologist at CDC. 

A chick or duckling may look perfectly normal and clean still carry Salmonella germs in their droppings and on their bodies (feathers, feet, and beaks) and make people sick with diarrhea, vomiting, fever, and/or abdominal cramps. Sometimes, people can become so sick from a Salmonella infection that they have to go to the hospital. Young children, elderly persons, and those with weakened immune systems are more likely than others to develop severe illness. When this occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites and can cause death unless the person is treated promptly with antibiotics.

Bottom Line

What should you do?

• Wash hands thoroughly with soap and water right after touching live baby poultry or anything in the area where they live and roam. Use hand sanitizer if soap and water are not readily available. Adults should supervise hand washing for young children.
• Don’t let children younger than 5 years of age handle or touch chicks, ducklings, or other live poultry. Don't give live baby poultry as gifts to young children.
• Don't snuggle or kiss the birds, or let them touch your mouth.
• Keep live poultry outside and away from human food.  Don’t eat or drink in an area where the birds live or roam.
• Don’t clean any poultry equipment, such as cages, inside the house.

Do you wash your hands correctly?

Recently my wife & I enjoyed soup sampling at ChowdaFest at a middle school in Westport, CT. In the restroom of this public school I saw sign on how to wash your hands, aimed no doubt for the young students. What struck me about the sign was the length of time to wash, sing the Alphabet song twice, it suggested. That means about 20 seconds of hand washing. This is longer than advice I gave a few years ago, sing the Happy Birthday song twice, for about 10 to 15 seconds of washing.

Today we accept hand washing as good hygiene, but this was not always the case. Before germs were discovered and defeated, bad air or demons were blamed for illness. We know better now and yet we still get hand washing wrong.

Here's the right way to wash according to the Mayo Clinic.

• Wet your hands with running water.
• Apply soap.
• Lather well.
• Rub your hands vigorously for at least 20 seconds.
• Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.
• Rinse well.
• Dry your hands with a clean or disposable towel or air dryer.
• If possible, use your towel to turn off the faucet [and open the bathroom door]

Bottom Line

Always wash your hands after:

• Preparing food, especially raw meat
• Using the toilet or changing a diaper
• Touching an animal, animal toys, leashes, or animal waste
• Blowing your nose, coughing or sneezing into your hands
• Treating wounds or caring for a sick or injured person
• Handling garbage, household/garden chemicals, or anything really dirty like soiled shoes

Update: was watching the Tonight Show and guest Tim Allen mentioned handwashing and the Happy Birthday song. Jay responded, with yes, about 21 seconds?

Working While Sick

If your office is like mine, there are quite a few people at this very moment sniffling, coughing, wheezing, and otherwise sharing their cold germs with co-workers. It's flu season and, while I hope you got your flu shot and are protected from the flu, sadly there is no protection from the common cold. Yes, there are the preventative steps of isolation, hand washing, and wearing a facemask but no shot or pill will kill the cold virus that gets past these barriers.

Ideally you would stay home and rest when sick but you might not have that choice. If must work, here are 7 tips for working while sick from the blog Mind Your Decisions.

1. Get as much rest as you can. Get to bed early while sick.

2. Reschedule meetings and phone calls that you conduct. The idea is that you want look and feel your best when making a business presentation or conducting business. I would argue that you should not be in a small room with others when sick. Use the phone instead.

3. Work in short shifts.  You'll tire quickly when sick so work in short bursts and try to recuperate in between.

4. Do mindless tasks. Now is not the time for accounting or detailed work; you'll make way too many careless mistakes. Catch up on email, clean the desk, plan future assignments.

5. Use Home remedies to feel better:  soup, tea, healthy foods.

6. Ask for help. Delegate

7. Be considerate of co-workers.

"Cover your mouth and nose with a tissue when you cough or sneeze, throw the tissue in the trash after using it, and wash your hands frequently. And do not share your food or drink!"

Bottom Line

For remedies that work and those that don't check out the Mayo Clinic at www.mayoclinic.com/health/cold-remedies/ID00036

Fight Bad Breath with Hydrogen Peroxide?

“A sad soul can kill quicker than a germ.”
-John Steinbeck

In our home we always keep a bottle of Hydrogen Peroxide for cuts, especially cat scratches. Even after washing with soap & water, the cat scratches I get from our two furry friends will turn red and leave a scar unless I apply Hydrogen Peroxide (H.P.) because cats have really dirty toenails. It never occurred to me that H.P. could have other uses. The label on the bottle suggests using it as a mouth wash? Yuck!

H.P. is a powerful germ killer and whitener. BargainBabe.com lists many ways for putting this to use:

1. Soak your toothbrush in H.P. to keep it germ free
2. As a mouthwash it kills the germs that cause bad breath (but will my tongue forgive me?).  May also help against gingivitis (gum disease).
3. Makes a toothpaste when mixed with salt and baking soda
4. As a cleaner for kitchen counters, cutting boards, lunch boxes
5. Dilute 1/4 cup of H.P. with a sink of cold water to wash fruits & vegetables
6. Dilute it even more (1 part in 32) when watering plants to stop root rot
7. Dab on pimples
8. Soak feet in H.P. for calluses & corns & foot fungus
9. Use 1 cup instead of beach to brighten white clothes when washing (it's a main ingredient of OxiClean)
10. Spritz on hair to bring out natural highlights?
11. Fights mold on the shower walls and curtain

Bottom Line

See more ideas at BargainBabe.com like killing fungi in your fish tank (without killing the fish I hope). Please try these at your own risk. I'll vouch for cuts but have yet to try out the other suggestions above.

When you really gotta go

“You do live longer with bran, but you spend the last fifteen years on the toilet”
-Alan King

I was surprised when I looked-up "Diarrhea" on WebMd and it described it as, "very common and usually not serious. Many people will have diarrhea once or twice each year." That may be true in America but in developing nations diarrhea has been the #1 cause of deaths in infants due to dehydration. Today campaigns to educate mothers about Oral Re-hydration Solution (a mixture of salts, sugar, and water) has knocked diarrhea down to the #2 slot for infant mortality with pneumonia as the current top killer.

I was also surprised by the once or twice a year claim. But then I suffer from irritable bowel syndrome which the article does mention as an exception. I learned that many things can cause diarrhea like chewing gum. Gum?!

"dietetic candy" or "chewing gum" diarrhea, in which a sugar substitute, such as sorbitol, is not absorbed by the body but draws water from the body into the bowel

Other causes include:

• "Stomach flu": a virus that infects the gut, usually lasts for two days
• Infection by bacteria (food poisoning)
• Infections by other organisms
• Eating foods that upset the digestive system
• Allergies to certain foods
• Medications
• Radiation therapy
• Diseases of the intestines
• Malabsorption
• Hyperthyroidism
• Some cancers
• Laxative abuse
• Alcohol abuse
• Digestive tract surgery
• Diabetes
• Competitive running
• Following constipation, especially for people who have irritable bowel syndrome [I'll vouch for that]

Treatment

For a mild case, just let it run its course. Or use over-the-counter medicines like Pepto-Bismol, Imodium A-D, and Kaopectate. Follow the instructions on the package.

In addition, drink at least six 8-ounce glasses of fluid per day like fruit juice without pulp, broth, or soda (without caffeine), chicken broth (without the fat), tea with honey, and sports drinks.

Instead of drinking liquids with your meals, drink liquids between meals. Drink small amounts of fluids frequently.

Bottom Line

"Contact your doctor if you have prolonged diarrhea or a fever that lasts more than 24 hours. Also see your doctor promptly if vomiting prevents you from drinking liquids to replace lost fluids." - WebMD

A Fatal Cantaloupe?

"Acting in 'Star Wars' I felt like a raisin in a giant fruit salad, and I didn't even know who the cantaloupes were."
- Mark Hamill (Luke Skywalker)

Who knew that cantaloupes could be deadly? The Centers for Disease Control and Prevention, says 72 people across 18 states have fallen ill with listeriosis, traced back to contaminated cantaloupes. The fruits come from Colorado's Rocky Ford region and were shipped between July 29 and Sept. 10. Thirteen people have died.

The illness and death were caused by the bacteria listeria which causes diarrhea, muscle aches and fever. The disease primarily affects older adults, pregnant women, newborns, and adults with weakened immune systems. Listeria monocytogenes is found in soil and water. Animals can carry the bacterium without appearing ill and can contaminate meats and dairy products. When Listeria bacteria get into a food processing factory (like the cantaloupe factory), they can live there for years.

Listeria is killed by pasteurization and cooking so you're most likely to catch it from ready-to-eat foods like hot dogs and deli meats which were contaminated after factory cooking but before packaging. Unlike most bacteria, Listeria bacteria can grow and multiply in some foods in the refrigerator so it's recommended that you eat your sliced deli meats within a few days of purchasing - old meat could make you sick.

Bottom Line

How can you protect yourself from listeria?

• Thoroughly cook raw food, such as beef, pork, or poultry to a safe internal temperature. See http://perpetualpreparedness.blogspot.com/2011/09/is-it-done-yet.html
• Rinse raw fruits and vegetables thoroughly under running tap water before eating.
• Keep uncooked meats separate from cooked foods and ready-to-eat foods. Avoid cross-contamination by washing hands, knives, counter tops, and cutting boards after handling and preparing uncooked foods.
• Do not drink raw (unpasteurized) milk.
• Consume perishable and ready-to-eat foods as soon as possible. Don't assume the fridge will keep it safe for weeks.

Is It DONE Yet?

While barbecuing on Labor Day my coals were quite hot and I was surprised at how quickly everything cooked. That's not necessarily a good thing. With a hot flame it's easy to burn the outside while the inside is still undercooked. While I enjoy meats with a bit of red or pink inside there's a risk of sickness if the center is not sufficiently hot. The Centers for Disease Control and Prevention estimate that every year about 48 million people in the United States become ill from harmful bacteria in food; of these, about 3,000 die.

The signs and symptoms of foodborne illness range from upset stomach, diarrhea, fever, vomiting, abdominal cramps, and dehydration, to more severe illness including death. This can be prevented by cooking food to a safe temperature.

According to the CDC, many people assume that if a hamburger is brown in the middle, it is done. According to US Dept of Agriculture research, 1 out of every 4 hamburgers turns brown before it reaches a safe internal temperature. The only safe way to know if hamburger is safe is to measure 160 °F in the center.
The CDC would like everyone to know that "Thermometers Aren't Just for Turkey Anymore". The food thermometer should be placed in the thickest part of the food and should not be touching bone, fat, or gristle. Check the temperature in several places to make sure the food is evenly heated. Make sure to clean your food thermometer with hot, soapy water before and after every use! Imagine you stick the thermometer into meat that is under cooked and bacteria clings to the thermometer. Then later you stick the thermometer into meat properly cooked but now you've reinserted the bacteria!

Cross contamination from bacteria can also occur if you put cooked meat back onto the plate that held the raw meat. I saw one friend rightly freak out after carefully cooking chicken on the grill, another person then started to place raw meat on the grill right next to his chicken. My friend knew the risk of cross contamination.
Raw meat can contaminate everything it touches including your hands! Be sure to wash hands with soap and warm water for 20 seconds after handling uncooked meat.

Bottom Line

While watching a cooking competition show for professional chefs, two contestants were challenged to cook filet mignon rare, medium and well done for three judges. I was surprised to see they used thermometers to measure the degree of doneness. I thought "real" professionals could tell by the firmness of the meat.

So I learned that thermometers were not just for safety but also for cooking food "just right".

New Rules for Pork

(Lisa) “I’m going to become a vegetarian”
(Homer) “Does that mean you’re not going to eat any pork?”
“Yes”
“Bacon?”
“Yes Dad”
“Ham?”
“Dad all those meats come from the same animal”
“Right Lisa, some wonderful, magical animal!”
- The Simpsons

I love a juicy pork chop but I've given up ordering chops at restaurants. They come out dry as leather almost every time. The reason for this is trichinosis, a parasitic disease caused by eating roundworm larvae in undercooked meat. This used to be quite common and some hypothesize that it's the reason behind the Jewish Kosher law forbidding pork. But today Trichinosis is no longer a problem in commercially grown pork and hasn't been for years. So the USDA has issued new guidelines saying that it's OK to eat pork that is still pink and it's OK to cook it to 145 F instead of 160 F as previously recommended.

"We found it was perfectly acceptable and that 160 was probably overkill," says Elisabeth Hagen, USDA's undersecretary for food safety.

The new guidelines focus on killing Salmonella which, sadly, is far too common in foods today like eggs and spinach. Cook meat to "145 for all whole cuts of red meat, 160 for ground red meat and 165 for poultry". When your whole cut of meat reaches 145 degrees, let it sit for three minutes the USDA recommends. The external temperature will be higher and will continue to cook the center for added safety without overcooking.

The 160 F is needed to kill bacteria like Salmonella that reside on the outside of the meat. Usually an internal temperature of 145 indicates that the outside has reached 160. When meat is ground, like hamburger, the bacteria can get mixed into the center and so every part of the meat must reach 160 (or 165 for chicken since Salmonella is more prevalent in poultry).

Bottom Line

Old habits can be hard to kick but I'm looking forward to juicer pork roast and chops.

Dirty Foods

“The more serious the illness, the more important it is for you to fight back, mobilizing all your resources-spiritual, emotional, intellectual, physical.”
- Norman Cousins

The Centers for Disease Control and Prevention estimates that 200,000 Americans experience food poisoning every day. This number could be as high as 800,000, according to Philip Tierno, author of The Secret Life of Germs. "Everyone in this country will get sick at least once this year from a foodborne virus, bacteria, or toxin," he says. But we may not know it and blame the mild symptoms—nausea, diarrhea, cramping—to a stomach flu.

Where do these germs come from? MensHealth.com identifies the “10 Dirtiest Foods.”  I’ll cover some highlights but be sure to read the entire article for all the details.

1. Chicken: Don’t be fooled by commercials of Perdue chickens enjoying a good life. Most chickens are raised in very dirty coops under crowded conditions. As a result, one in 10 chickens carry germs that can make you ill. To protect yourself
- Buy free range chickens which are raised (supposedly) in cleaner environments
- Do not wash chickens or chicken parts in the sink. This spreads the germs to anything that touches the sink. Instead put the chicken directly into a pan/pot and let heat kill the germs.
- Chicken should be cooked to a temperature of 180°F. Use a thermometer – don’t trust the color of juice when pricked.
- If the chicken touched a cutting board, clean the board and knife with a mild, diluted bleach solution.

2. Eggs: pasteurization has reduced the risk of dirty eggs to 1 in 200,000. But given the millions of eggs consumed in America, eggs sicken an estimated 660,000 people annually and kill 300.
- Only buy pasteurized eggs.
- Never use a cracked egg in a carton.
- Store eggs in the coldest part of your fridge (not in the fridge door).
- Wash your hands after handling eggs.
- Cook eggs to 160°F

3. Hamburger: In one USDA test, 53% of the ground chuck examined was infected with Clostridium perfringens which can cause illness.
- Buy beef that is "treated by irradiation" to kill germs
- 1 Tbsp. of Fresh oregano can kill E. coli in one pound of beef
- Cook beef to 160°F

4. Fresh fruit – because most fruit is eaten raw, any germs on the outside will not be killed by cooking. For example, Cantaloupe grows on the ground and has a netted exterior that makes it easy for Salmonella to sneak on; and once on it's hard to clean off.
- Clean the exterior of all fruits prior to eating. Wash your hands afterwards.
- Washing fruits will also remove any pesticides that were sprayed on.

5. Fresh vegetables : my mother is paranoid about washing lettuce. She grew up on a farm and has seen how dirty field conditions are for the produce and the workers. You also want to wash spinach and scallions thoroughly..
- "Just because something is wrapped in cellophane doesn't mean it's free of pathogens." Don’t be lulled by claims of being "triple washed."

6. Deli Meats: cold cuts have been labeled "high risk" of causing listeriosis by a joint team of researchers from the USDA, FDA, and CDC. The Listeria germ grows rapidly on cut meat even with ideal refrigeration; and then the cold cut is eaten without further cooking. The most likely source of Listeria-contaminated cold cuts is the deli slicer. Without regular cleaning, the blade can transfer bacteria from roast beef to turkey to pastrami and back.
- Toss any meat that is a week old
- Slather on the mustard. Researchers found that mustard killed off 90 percent of three potent pathogens—Listeria, E. coli, and Salmonella—within 2 hours.

Bottom Line

We like to think the food we buy is clean but the truth is that it’s not. The advice above will help prevent some common sources of illness.

More germs

“Keyboards are a lunch counter for germs. We turn them over in a lot of studies and we are amazed at what comes out of a keyboard.”-Charles Gerba

Have you every heard the expression “filthy lucre” used to describe money. It’s truer than you think. Scientists in Geneva found that a strain of H1N1—i.e. swine flu—can live on paper money for up to 3 days. This is why I’m dismayed when I see a cook at a deli or food cart handling the money and working with food with the same hands.

The idea of dirty money is not new. I recall a story years ago about bills in California testing positive for drugs. In the 1982 novel, The White Plague, by Frank Herbert, contaminated money is used to spread a virus created by a crazed biochemist.

But there’s more to be wary of than dollar bills. ConsumerReports.org lists 7 things dirtier than money.

1. Doctors’ neck ties (Does he ever wash his ties? I don’t.)
2. The office candy bowl (or bowls of bar snacks)
3. Library books and keyboards (do you lick your fingers when turning the pages?)
4. Bathroom door handles (did the person before you wash his/her hands?)
5. Public Telephone receivers
6. Grandchildren (Kids in the 4-to-12-age range are a notorious reservoir for germs)
7. Shared seats like the movies, theater, opera, train or bus

Bottom Line

When mom told you to wash your hands before eating, she was right. Our hands are often less clean then we know. Check out my blog Germ Theory & Dr. Lister for a history of germs and hand washing.

Germ Theory & Dr. Lister

“Expect the best, plan for the worst, and prepare to be surprised.”-Denis Waitley

Did you know that Listerine, the antiseptic mouthwash, was named after Dr. Joseph Lister who discovered the idea of antiseptic surgery by killing bacteria in 1867? Prior to Dr. Lister, a surgeon would put on their gore splatter overcoat, take the dirty saw off the wall, sharpen their knife on the sole of their boot, and then hack away as quickly as possible (2-3 minutes max) to avoid contamination from the “air”.

While great advances were made in anatomy and surgerical technique in the early 1800s, the vast majority of patients would die days later from infection. Going to the hospital was always a LAST resort; only used when at death’s door. Even today, at least 100,000 Americans each year are "left vulnerable to surgical infections", see Hospital infection survey: Too many patients still at risk.

Antiseptic means anti-sepsis (pus). Lister learned about the germ theory of disease and rot from the research of Louis Pasteur. Lister confirmed that bacteria was also cause of surgical pus and infection but he had a problem. He could not “Pasteurize” patients by heating them up. Fortunately he had heard that Carbolic acid was useful in deodorizing sewage so he decided to try it as a germ killer. It worked and deaths from amputations declined greatly. This discovery was praised and studied by the leaders of Medical Science (the French and Germans) but largely ignored by the British and Americans until overwhelming evidence proved that Lister was correct.

One reason for opposition to antiseptics was the damage it did to living tissue. Sure it kills germs but it can damage flesh too. Surgeons lived by the skill of their hands which Carbolic acid would turn to red puffy hamburger. The America Chief of Surgery at Johns Hopkins, William Stewart Halsted, invented the rubber glove to protect the pretty hands of his favorite nurse (and future wife) from acid damage.

The Germans improved upon Lister’s idea for clean surgery. Instead of killing germs (antiseptic) by spraying everything in acid, why not prevent germs (aseptic) by use of hand washing, clean gowns, surgical masks, and sterile instruments? This worked too and didn’t harm the doctors and nurses.

Bottom Line

When the British Medical Journal surveyed 11,000 physicians for the most significant medical breakthrough in the past 150 years, the winning answer was Sanitation. Today we take it for granted that we can drink water straight from the faucet and not catch cholera. We go to hospitals today with the assumption that we will survive.

During emergencies the first casualty is usually sanitation. Floodwaters and power outages allow sewage to mix with drinking water. Food spoils without refrigeration. Toilets overflow and human waste is improperly disposed of. People are crowded together, with stress induced weakened immune systems, and germs spread.

So keep Dr. Lister in mind and remember that germs can kill. After an emergency, boil your water and cook food completely; toss out anything spoiled. Clean ALL wounds no matter how minor. You can use Listerine for this! It was used in surgery (in stronger concentration) for decades before it became a mouthwash.

Hospital Germs

“When a lot of remedies are suggested for a disease, that means it can't be cured.” - Anton Chekhov (Russian playwright)

What is it about doctors and a casual attitude towards germs? I wrote earlier, Did you forget to wash your hands?, about the history of hand washing and how doctors resisted the idea that dirty hands could kill. Now a new study shows that unwashed scrubs can also kill, Hospital Scrubs Are a Germy, Deadly Mess.

Some medical personnel wear the same unlaundered uniforms to work day after day. ... At the University of Maryland, 65% of medical personnel confess they change their lab coat less than once a week, though they know it's contaminated. Fifteen percent admit they change it less than once a month. Superbugs such as staph can live on these polyester coats for up to 56 days.

Bottom Line

Dirty scrubs spread bacteria to patients and, when worn in public, allow superbugs to escape to places like restaurants. Scrub germs can cause extreme diarrhea, dehydration, inflammation of the colon, and even death. They are difficult germs to kill. "Only scrubbing with bleach removed [them]".

In recognition of this problem some hospitals are returning to laundering scrubs and/or prohibiting wearing the scrubs outside the hospital.

Garage Genome Hackers

“A sad soul can kill quicker than a germ” - John Steinbeck

All technology, perhaps even all knowledge, is a double edged sword. Scientists are often horrified to learn that their “peaceful” discovery leads to new weapons of mass destruction. And sometimes inventions created for the purpose of war (like radar and GPS) have amazing peacetime applications.

The new kid on the block which could cure diseases or create plagues is home-based genetic experiments as discussed in New Scientist magazine, entitled Rise of the garage genome hackers.

[Katherine] Aull's lab is a closet less than 1 square metre in size in the shared apartment she lives in. Yet amid the piles of clothes she recently concocted vials of an entirely new genetically modified organism. Aull, who works as a synthetic biologist for a biotech company by day, created her home lab after hearing about a contest on the science fiction website io9.com for "mad scientists with homebrew closet labs, grassroots geneticists, and garage genome hackers".

These young (unregulated) scientists are creating microbes for biological computers, bacteria that could help rice plants process nitrogen more efficiently, and glow-in-the-dark bacteria to detect deadly melamine contamination. Advocates of closet genome hacking compare themselves to “the Homebrew Computer Club hackers of the 1970s [who] spawned the first personal computers."

This does not make me feel any better. Despite the many virtuous computer hackers who create free-ware, games, etc., it only takes a one dedicated black hat to create a computer virus that destroys data worldwide. Likewise a rogue genome hacker could wreck havoc.

In 1982, Frank Herbert (best known for Dune), wrote the (prophetic?) novel, The White Plague. In the book, a bomb planted by the IRA kills the wife and children of a molecular biologist. He retaliates by creating a plague to kill all the women in Ireland so that the IRA can experience the same loss. The plague spreads and there is world-wide chaos.

Bottom Line

Inexperienced hackers could pose a significant public health threat, warns Richard Ebright, a biochemist at Rutgers University in Piscataway, New Jersey. "Without any oversight from an institution, colleagues or peers, the probability that a cataclysmic entity might be constructed by someone unaware of known cautions is significant." - New Scientist

Did you forget to wash your hands?

Archimedes, as he was washing, thought of a manner of computing the proportion of gold in King Hiero’s crown by seeing the water flowing over the bathing-stool. He leaped up as one possessed or inspired, crying, “I have found it! Eureka!” - Plutarch (A.D. 46?–A.D. c. 120)

Today it is common knowledge that you should wash your hands before eating and after using the bathroom. It is even required by law for employees who handle food. However this was not always the case.
In the 1840's at the Vienna General Hospital in Austria one in ten mothers died after giving birth from childbed fever. This was a higher rate of death than other hospitals and higher than mothers who gave birth at home with the help of a midwife. Dr Ignac Semmelweis was determined to find a cure. What he discovered in 1847 was the importance of hand washing. Doctors laughed at this idea but interns who followed it found that the occurrence of childbed fever dropped to 1-2%, a five fold improvement! But still the other doctors scoffed at the idea and it took 50 years and the discovery of germ theory before hand washing became common practice in hospitals.
Returning to modern times it is not uncommon to find people who won't bother to wash their hands or wash incorrectly. (Did you know you could be doing it wrong?)

1. Wet hands with warm water
2. Lather hands with vigorous scrubbing to create friction (both friction and soap are necessary)
3. Scrub while counting to at least 15! Some sites recommend singing the "Happy Birthday" song to yourself twice.
4. Rinse hands and dry with a paper towel
5. Use the paper towel to turn off the faucet. Other wise your clean hands could be contaminated by a dirty faucet.
6. I've also noticed many people using the paper towel to open the bathroom door. The door handle is touched by a lot of dirty hands.

Bottom Line
Hand washing is greatly under-rated. So many colds and illness could be prevented by more people washing their hands more often. One of the key recommendations in an article on protecting yourself from bird flu was "Stay Healthy" by "washing your hands regularly".