Wash your hands – and save the world from superbugs (by Val Curtis)

We’re always being told that we should wash our hands, but many of us still find reasons to skip this basic everyday habit; maybe the water is too cold, or too hot, the soap doesn’t smell nice or we’re just in too much of a hurry. But now the results of a huge new study, just published in the Lancet, mean that we no longer have any excuses. This simple everyday practice could be vital, not just for our own and our family’s health, but for that of the country and even all of our species.

Researchers at the University of Southampton randomly divided more than 20,000 people from GP lists into two groups, one of which was invited to visit a website designed to encourage people to wash their hands, while the other group didn’t get access. After three years of follow-up, Paul Little and his team found that those in the website group reported having fewer colds, flu and gastroenteric infections. Participants’ immediate families saw similar health benefits. And these self-reported findings were confirmed as those in the handwash website arm of the study also showed up less often in GPs’ surgeries and were prescribed fewer antibiotics. The effects weren’t huge, with 10% to 20% reductions in infections and consultations. But small effects multiplied to population level to produce huge benefits from what was a cheap, automated and easily accessed intervention.

So this study at last provides some robust evidence to confirm what we’ve long suspected. Handwashing has three big benefits: first, it saves us catching infections from those around us. Second, it prevents people around us catching our germs. And third, it saves doctors’ time and the national economy money.

However, what this study didn’t trumpet is that there are nowadays even more important reasons to be concerned about handwashing. Our species is in a longstanding evolutionary arms race with pathogens, and while technological developments such as vaccines, antibiotics and sanitation have recently given us the upper hand, the bugs are fighting back. Respiratory viruses such as swine flu, Sars and bird flu have the potential to mutate and become superbugs that can be both devastating in their capacity to kill and in their ability to transmit themselves from person to person.

Our best form of attack against pandemic flu is defence. Regular handwashing by everybody in any place where such bugs arise means such superviruses can’t get a foothold, and can’t get out and spread.

Equally scary is the rise of the bacterial superbugs that can’t be controlled by existing antibiotics. Because antibiotics have been overused to control infections, E coli, Staphylococcus aureus and Klebsiella, for example, are evolving ways around them. Soon we are likely to be returned to the medieval days when a small wound or a routine operation can be deadly. Hip replacements, for instance, may lead to blood poisoning and sepsis and become too dangerous to contemplate. Death in childbirth could return to the levels it was in the 1840s when Ignaz Semmelweis first introduced hand hygiene in hospitals. But again, the superbugs can be contained if we deny them the chance to pass from person to person. Hands are the superhighway on which such infections travel, and handwashing with soap is the roadblock.

We reviewed the evidence recently and we found that globally less than one in five people wash their hands when they should. This results in some 650,000 needless deaths a year, largely in countries with high levels of endemic infections. In these calculations we didn’t factor in the potential future lives that might be saved in preventing global pandemics of influenza and antibiotic-resistant infections, nor of pandemic cholera and other gastroenteric infections.

Handwashing is thus a global issue, one for which we need all hands on deck. First of all, we need the soap companies to step up. The world’s poorest countries have the biggest infection loads and hence the greatest need of handwashing, but because they are poor they don’t offer the biggest commercial opportunity. However, almost every household buys some soap products for daily activities, and poor countries represent some of the fastest-growing markets. Responsible companies are realising that have a duty to promote handwashing as they reap the benefits of market growth in the developing world. We need governments around the world to put handwashing higher on the agenda for hospitals, schools and homes, and for international organisations such as Unicef, the World Bank, the UK’S Department for International Development and USAID to support them in these efforts. We need leadership from the UN, the World Health Organisation and bodies such as the Global Public Private Partnership for Handwashing to help translate the good intentions of the new sustainable development goal on hygiene into concrete action on handwashing.

So now we have no excuse. The evidence is clear that we need to wash our hands more often, first of all for selfish reasons, because it will stop us catching infections from those around us, and because it will protect our loved ones from catching our infections. But we need to do more.

Handwashing is a moral cause, something that we should both do and that we should advocate for globally. It’s our best hope in our species’ battle against invisible microbes that are out-evolving us, and that could beat us if we don’t stop them through the simple behaviour of washing our hands.


Source: www.theguardian.com