The Invisible Threat

One out of four visits to a doctor's office is a result of someone getting sick from an infectious disease, such as a cold, the flu, or food poisoning - usually caused by germs. While no one can completely avoid these diseases, you can greatly reduce the chances that you - or a friend - will get ill by following the simple steps in this brochure. You'll be likely to stay healthy, feel better, increase your productivity at home, work, or at school - not to mention the reductions in your medical bills.

You might even save a life! Statistics from the American Medical Association show that deaths from infectious diseases jumped 58 percent from 1980 to 1992. The very young, very old, immune-compromised, pregnant women, and the severely ill are especially vulnerable. People taking antibiotics or antacids are also at greater risk of getting ill from some germs.

Germs are virtually everywhere - at home, at work, at school and outdoors. They're on our hands, on our pets, in the air, on everyday objects like toys and doorknobs, and in our foods. And some germs cause infectious diseases.

Germs are bacteria or viruses so small they are invisible to the naked eye. But once inside the body - through injury, by eating contaminated foods, through the nose, or many other means - they can multiply rapidly and make us very sick.

Until recently, many people thought we had won the "war" against infectious diseases. More and more vaccines and drugs were effective at preventing or treating these diseases. Bacteria, however, are smarter -and tougher - than we thought. They have grown increasingly resistant to antibiotics, requiring higher doses. Some bacteria, such as E. coli, are producing new strains, like E.coli O157:H7* that are far more dangerous. But as this booklet shows, you can fight back! By focusing on certain problem areas and taking some simple steps, you can make your world healthier - and safer, too.

* E.coli 0157:H7 is a virulent toxin-producing strain of the bacteria E.coli that can lead to very serious illness, even death.

How They Spread and How to Fight Back!

One of the most common ways people get sick is by touching an unclean or contaminated hand to places where germs can enter the body (the mouth, nose, or eye). Hands can pick up germs through bathroom use, contact with other people - like shaking hands - or by touching an object, such as a doorknob. Remember, hand-to-face contact can spread germs. And there is an easy, effective way to fight back: wash your hands frequently.

• Use soap; many leading brands have the word "antibacterial" on the label.

• Scrub your hands vigorously with soap for at least 10-15 seconds.

• Wash your hands immediately after using the bathroom, changing a diaper, coughing, or sneezing.

• Wash before and after preparing food, particularly raw meat, poultry, fish, or eggs.

• Always wash immediately before feeding a child or eating a meal or snack.

• Wash hands after engaging in activities that may spread germs, such as taking out the garbage, using public transportation, using playground equipment, or petting an animal.

Keep surfaces clean!

Germs aren't choosy about where they hang out. While bathrooms and diaper-changing areas are obvious sources, people can pick germs up from just about any surface. Doorknobs, light switches, telephone handles, computer keyboards, faucet handles, countertops, floors, toys - and other surfaces frequented by hands and (children's) mouths - all can act as transfer points for hitchhiking germs. And don't be fooled by appearances. Even the cleanest looking surfaces can harbor germs, and some germs can survive for weeks! There is an easy, effective way to fight back: clean with a proven disinfectant.

• Cleaning with regular soap or detergent alone does not kill germs. It only displaces them.

• Use a disinfectant cleaner or a disinfectant spray that is registered with the U.S. Environmental Protection Agency and that is proven effective against a wide variety of viruses (read product labels).

• Follow the manufacturer's directions.

• After you remove trash, clean those areas with a disinfectant.

• When family members are ill, disinfect doorknobs, bathrooms, and telephones.

• KEEP ALL CLEANING SUPPLIES OUT OF THE REACH OF CHILDREN.

Fighting food-borne pathogens

The Centers for Disease Control and Prevention estimates that 500 people die and 20,000 more suffer illness from E.coli 0157:H7 poisoning each year in the United States. Children, older people, and the immune-compromised are especially at risk. Experts estimate that one of every five Americans will suffer some type of food-borne illness each year. Animal products, such as fish, meats, poultry, and dairy products, are the most frequent hosts of foodborne pathogens. However, germs can be carried on virtually any food.

Once in the home, food-borne germs can be transferred to another carrier, such as a knife, cutting board, sponge, or counter - and spread to other foods, surfaces, or hands. This is called "cross-contamination," and it can happen, for instance, if the blood or "juice" of a chicken contaminated with salmonella is on a cutting board that is being used to cut raw vegetables. Take the following steps to fight food-borne disease:

Shopping

• Take time to inspect your supermarket. Ask what precautions they are taking to assure food safety.

• Check expiration, "sell by" or "use by" dates of animal products. If the product feels slimy, has a foul odor, or appears discolored, don't buy it.

• Select fruits and vegetables that are free of mold and decay (avoid brown spots, soft areas, and discoloration). Then wrap fruits and vegetables in plastic; do not place uncovered raw items directly on the checkout conveyor belt.

• Make sure eggs are free of cracks.

• Select canned foods free of dents and cracks (bulging lids may indicate a food- poisoning threat).

• Make sure that different meat products are not touching one another in their "fresh" cases.

• Avoid cross-contamination in your shopping cart; don't allow raw meat, poultry, or seafood juice to drip onto other groceries. Ask the store to wrap these items in plastic before placing them in your cart.

• Buy perishables last, keep them in the coolest part of your car or in a cooler, and drive directly home and refrigerate them immediately.

Storing and Serving

• Wash lids of food cans and necks of water cooler bottles before opening them.

• Do not reuse dishes and utensils during food preparation unless you have washed them. For instance, don't place cooked hamburgers on a plate that held raw ones.

• If the contents of canned food forcefully sprays when the can is opened, or looks frothy and bubbly, return the can to the store or throw it away.

• If the food in your refrigerator or freezer doesn't smell or appear as it should, throw it away.

• Do not leave perishables out. Immediately date and refrigerate leftovers.

• Keep your refrigerator at 40 degrees F or below and your freezer at 8 degrees F or below. (Use a thermometer to check the temperature.)

• Freeze meat and poultry if not using it within 2-3 days; freeze seafood if not using it within 1 day.

• Store leftovers in shallow dishes that cool quickly.

• Overwrap packages of raw meat, poultry, or fish, or place them on a dish before refrigerating so that their juices won't drip and cross-contaminate other foods.

Preparing Food

• Always wash your hands thoroughly with soap and water and dry them with a clean towel or paper towel before and after preparing food.

• Rinse or peel raw produce thoroughly (even organic produce).

• Thaw frozen food in the refrigerator, not on the kitchen counter. Bacteria multiplies more quickly at room temperature.

• Keep raw meat, poultry, fish, and eggs separate from other foods. Designate one utensil for raw food and another for cooked; for instance, use one spatula to place hamburger patties on the grill and another to remove them.

• Clean and disinfect surfaces, utensils, and cooking equipment after any contact with raw meat, eggs, poultry, or seafood to reduce cross-contamination.

Cooking

• Buy a meat thermometer and use it! Check to see that food is thoroughly cooked by inserting the tip of the thermometer into the thickest parts of the meat or poultry.

• Avoid unpasteurized juices or boil them for 30 seconds before drinking; consider switching to pasteurized juice.

• Cook meat and poultry to their proper temperatures as specified in recipes. Cook red meat to a minimum of 160¡ F throughout. Cook poultry to a minimum of 180¡ F throughout.

• Never eat rare or medium-rare hamburgers.

• Avoid raw seafood. Do not eat raw seafood if you are immune-compromised.

• Cooked fish should flake with a fork.

• Never eat unpasteurized milk or cheese.

• Cook eggs until yolk and whites are firm. Don't eat raw cookie dough, cake batter, or Caesar salads unless pasteurized eggs have been used.

Community Infection Control

• Hospitals, doctors' and dentists' offices: It is your right to ask your doctor, dentist, or other health professional how they fight the spread of germs in offices. They may also provide advice about preventing infection at home.

• Schools and day care centers: Ensure that caregivers teach and promote hand washing. Make sure the staff is trained in safe food preparation and can identify symptoms of food-borne illness. Make sure they follow a routine cleaning and disinfection program.

• Grocery stores and restaurants: Avoid establishments with records of poor public health performance. If food preparation takes place in sight, check whether the kitchen is clean and food handlers wear protective gloves. Food preparation certification is required in some states; ask if your food handlers are certified. Check whether restaurant wait staff have clean hands and whether there is a sign posted in the restroom requiring employees to wash their hands.

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