Originally published in The Ottawa Citizen Friday, November 12, 2004
Original Title: Infection control for dummies

Infection control can be a complicated matter, especially for viruses that spread as easily as the flu. The flu can spread through direct hand-to-hand contact, via airborne droplets (fomites) after a sneeze, and with contact with recently touched surfaces such as doorknobs, telephones, countertops and desks.

Preventing infection does depend upon “boosting your immune system,” but not in the way some believe it to be.

Our immune system begins at birth as a bunch of raw army recruits. They are healthy and strong but lack experience at recognizing and fighting the enemy. With training and combat they gain experience and become more efficient in their role as a standing army. Some are selected for special-forces duty and reconnaissance missions. They are able to track down and identify their target so that the army can move in and destroy it.

Our immune system follows this analogy. It has the potential to respond to threats from viruses and bacteria. Indeed, it will respond well to minor threats such as colds and minor cuts and scratches. But other pathogens, like the measles virus, polio, diphtheria, meningitis, typhoid and hepatitis, among others, can overwhelm the immune system. It tries to fight back, sometimes succeeding but with great collateral damage to organs and other structures.

If the system is trained to recognize these pathogens before the war, it stands a greater chance of protecting the body. This is the underlying reason why vaccines work.

Vaccines stimulate the immune system to develop antibodies, the body’s special forces that will seek out, identify and target the invader for the main battle group. Without these specific antibodies, the immune system is not co-ordinated to quickly prevent the attack and damage; you either lose the battle, suffer collateral damage or play a game of attrition — a draining experience.

Some argue that exposure to the pathogen is the preferred route of developing immunity, as opposed to using a vaccine. Indeed, the infected person will create antibodies and immunity if they survive the real infection. But this may come at a cost of permanent damage.

The vaccines contain either killed or weakened strains of the organism that have orders of magnitude less potential to cause harm compared to the original virus or bacterium.

Indeed, some will disagree with me and cite Internet references or studies that indicate the opposite. The response is that the studies to support vaccine use far outnumber the ones that imply the opposite. There is no conspiracy.

The flu vaccine is a “best assumptions” vaccine. It is predicated on what flu virus strains we expect will come into Canada and the United States from other regions of the world. If the assumption proves incorrect or incomplete, the importance of proper hygiene practices becomes more apparent.

What other infection control measures can people take for the upcoming flu season?

If you have the flu, isolate yourself from others and do not go to school or work. Wearing a properly fitted surgical mask and goggles with side protectors will help prevent catching the virus from an infected person or transmitting it to a caregiver.

Ineffective hand washing after sneezing into a tissue or coughing into the hand will leave viral/bacterial organisms on the hands. The perfect cleanser does not exist. However, a combination of products will offer substantial protection.

Soaps are excellent detergents and remove grit, grime, dirt, soil, and other organic compounds. The non-antimicrobial soaps fail to remove resident disease-causing bacteria from the skin but do remove some transient bacteria. Sharing a plain soap bar has the potential to spread disease because it can become contaminated.

Numerous studies indicate that alcohol (ethanol) washes dramatically reduce hand bacteria and viral counts after washing for 30 seconds. The alcohol gels should be used for at least 20 to 30 seconds and cover the entire hand and under the nails. Apply about a nickel- to quarter-size blob in the palm. If the hands dry in less than 15 seconds, insufficient gel was used.

There is an antiviral flu medication available called Tamiflu. It must be used close to the onset of the flu and will only reduce, not eradicate the symptoms and duration of the illness.

Carry a small squeeze bottle of alcohol gel with you and use it routinely to prevent the usual winter colds and flu this season.