Can you tell me how to sneeze on Sesame Street?

Michéle Samarya-Timm, a registered environmental health specialist with the Somerset County Department of Health in New Jersey (represent) writes:

The recent New Zealand study that most people are not properly containing their coughs and sneezes comes as no surprise, as I still see air sneezes wherever I go.

Look around. Children have been taught – and are following — proper respiratory etiquette by covering their coughs and sneezes. It’s the adults we need to reach for disease prevention behavioral change. As we talk about doing the “Dracula sneeze” maybe its time to reach adults by tapping into our inner children and bring those of my generation back to what we learned when our role models had googley eyes, and skin of orange, purple or blue felt.

Close your eyes, and hum Sunny Day- Sweepin’ the clouds away…

And there we are with Count von Count – who should be the poster child for the “Dracula Sneeze.” Early on (circa 1971) we see him counting flowers – because flowers make one sneeze. Then we can count the sneezes (Ah-ha-ha-ha!). Unfortunately, Count doesn’t use his hands. Or his cape. Or anything to catch his sneezes. But he could be useful counting 20 seconds of handwashing… (20 *Wonderful* seconds!)

And sneezes can be contagious. Especially in groups. The Sneeze Song illustrated that – with cows, chickens and swine. Not a good prospect to think that the shopping mall, the train station or the barnyard could have a plethora of airborne diseases from indiscriminate sneezing. With an end message of “cover your coughs and sneezes” this clip could be a generation-catching public service announcement.

At least Ernie and Bert recognize sneezing etiquette. Ernie has been known to offer his handkerchief to Bert. It’s what friends do. (That, and put their noses back on.) And remember, Ernie knows about personal cleanliness. After all, when we first met him in 1969 Ernie was scrubbing to get clean. Ernie’s penchant for cleanliness brought us some great handwashing songs. Forget the ABC’s …singing “everybody wash” encourages all around you to join in with good, clean and considerate handwashing fun.

Still not convinced that the Children’s Television Workshop has the makings to remind us old timers to cough and sneeze into the crook of our arms? Enlist Kermit the Frog – who really (really!) loves his elbows:

I love my elbows!
They really top my list
I love my elbows,
Even more than my wrists

We teach people to sing when handwashing…maybe we’d make some progress if we ask them to hum like Kermit while sneezing?

And if you don’t know what a sneeze is, just ask Guy Smiley and the panel on What’s My Part? The nose knows (but still could use a partnering elbow.)

Obviously, I’m a child of the Sesame Street generation. The Muppets taught us lifetime lessons – sharing, counting (in Spanish, too!), the people in our neighborhood, how to handle a Grouch, and that sometimes things are not like the others.

Maybe we should consider using bits from our youth – like the Sesame Street format and characters — to bring healthy messages to an older audience.

Rebranding some scenes from our youth can use our nostalgia to encourage a grown-up culture of cough-etiquette antics. I love my elbows. Everybody wash. And if you sneeze incorrectly, you don’t get your nose back.

Most don’t do the Dracula when sneezing or coughing

Observational research is so much more meaningful – either direct or with video – than self-reported surveys. Of course, everyone says they wash their hands, but they don’t.

Same with blowing the nose or coughing. Health types have been promoting the Dracula-move – expelling your inner germs into the crook of your arm – but when medical students secretly watched hundreds of people cough or sneeze at a train station, a shopping mall and a hospital in New Zealand, most people failed to properly prevent an airborne explosion of infectious germs.

The work was done in the capital city of Wellington over two weeks last August, at the tail end of a worrisome but fairly mild wave of swine flu illnesses. It was a time when the pandemic was international news, and public health campaigns were telling children and adults to be careful about spreading the virus.

The good news is that about three of every four people tried to cover their cough or sneeze, in at least a token attempt to prevent germs from flying through the air.

The bad news is that most people — about two of three — used their hands to do it.

Study author Nick Wilson, an associate professor of public health at the Otago University campus in Wellington, said,

"When you cough into your hands, you cover your hand in virus. Then you touch doorknobs, furniture and other things. And other people touch those and get viruses that way.”

Only 1 in 77 pulled the Dracula move, and about 1 in 30 used a tissue or hankerchief.

The researchers didn’t report numbers on this, but several times they saw people spit on the floor, including at the hospital.

Wilson’s team logged 384 sneezes and coughs.