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.

Is this picture too gross? Will you think about washing your hands? H1N1 edition

Those ubiquitous signs, “Employees Must Wash Hands” probably don’t have the desired effect. Jon Stewart says, they sure ain’t keeping the piss out of your Happy Meals.

Some people have told us images like the one below, are too graphic and will offend people. Maybe. I’m offended that people don’t wash their hands which can lead to other people barfing and spreading things like the H1N1 virus. The U.S. Centers for Disease Control seems to agree, and has called for new food safety messages using new media.

So with all those germ factories … I mean students … returning to the confined quarters of residence living, here’s some tips for not barfing:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

• If you are sick with flu-like symptoms, stay home for at least 24 hours after your fever is gone. Keep away from others as much as possible.

• Wash your hands often especially after you cough or sneeze.  Alcohol-based hand cleaners are also effective, but are best used after proper handwashing.

VP Biden says dumb things about swine flu

While on the road for several hours yesterday after visiting family, I finally settled on National Public Radio. I hear lots of good stuff on NPR when I’m in the mood for it. Just a few miles from home, I heard a story about some bad risk communication from an uninformed political figure. That’s always fun in my line of work…

According to the NPR story aired yesterday (heard by clicking Listen Now), when asked about the outbreak of swine flu on the Today show, U.S. vice president Joe Biden said he has told his family,

“I wouldn’t go anywhere in confined places now. It’s not that you’re going to Mexico – it’s that you’re in a confined aircraft and when one person sneezes, it goes all the way through the aircraft.”

Dr. Mark Gendreau, whose research has focused on flying and the spread of diseases, was quoted as saying that a sneeze would only travel about 3 feet. Only people two seats in front or two seats behind a sneezer on an airplane were in danger of contacting infected droplets.

Dr. Gendreau recommended washing hands often and using alcohol-based hand sanitizers to limit the spread of infection.

Biden also told the Today show that, if they had another form of transportation, he does not suggest that his family ride the subway.

In response, New York Mayor Michael Bloomberg, who often rides the subway to work, said,

“I feel perfectly safe on the subway and taking the subway does not present any more risks than anything else.”

The text version of the NPR story now available online states that,

“[T]he vice president’s office [later] issued a statement translating Biden-speak into bureaucratese: Biden was merely restating the same advice the Obama administration is giving everyone, to avoid unnecessary travel. The statement also reiterated the now-familiar admonition to cover your face when you cough.”

That’s not what I heard.

Avoid sickness this flu season, get a flu shot and wash your hands

Seasonal influenza will probably be on the rise again.  The flu season lasts from approximately October through March, with peak months being January and February.  In all likelihood I’ll probably come down with the flu this season, from a combination of stress and little sleep (part of my life as a veterinary student).  But I’ve increased my chances for a flu-less flu season by getting a flu shot.  The flu shot, in combination with precautions such as washing your hands frequently, covering your cough and sneeze and staying home when sick are good ways for people to protect themselves and their families from infection.

Anyone, including healthy people, can get the flu.  The FDA has approved four antiviral drugs to fight influenza A, but they don’t always work because flu virus strains can become resistant to one or more of these medicines. They also aren’t a cure-all for the flu.  It’s best to avoid getting the flu rather than treating it as quickly as you can once you’ve got it.

Unfortunately the flu is very contagious. It can be caught from breathing in droplets in the air from someone sneezing, coughing or talking. The flu also is spread when people touch something with the flu viruses on it such as a doorknob or handrail, and then touch their eyes, nose or mouth. People can spread flu from one day before symptoms appear to seven days after symptoms go away.

Since handwashing is a great practice to help prevent the flu (along with preventing foodborne illnesses), I’ve been washing mine like crazy.  But I’m also glad to hear about other practices put in place to reduce flu exposure.  The priest at my church has instructed parishioners to give a verbal sign of peace during mass, rather than a handshake.  I couldn’t be happier about it.  I can remember many times that I’ve been standing next to a person in mass, and after watching them cough into their hands for most of the service, the last thing I want to do is shake their germy hands.  

When I visited Japan this past summer, I noticed that it was common custom for a person to wear a facemask in public if they were suffering from the flu.  The Japanese were so polite during my visit, and I think it’s fitting that they were considerate enough to protect those around them from their germs.  Of course facemasks are also worn in many other countries for health reasons, though I haven’t seen anyone using one here in Kansas.  If the trend could catch on I would be gung-ho for wearing a facemask.  Then again I’m a bit of a germaphobe.

They are many (debatable) remedies you can buy to boost your immune system.  But the best flu prevention still remains the flu shot.  Go out and get yours today, and keep washing those hands.  Have a healthy flu season.