With flu and cold season just around the corner, public health experts are trying to get Canadians to lessen their chances of getting sick by adopting some simple hygiene practices to keep disease-causing germs at bay.

The Health and Hygiene Council of Canada [1] says an international survey suggests that overall, Canadians have the best understanding in the world of the role that good hygiene plays in preventing infection.

But there are gaps between the knowing and the doing, the recently formed council says.

Dr. Brenda Cholin, a medical health officer in North Battleford, Sask., said 90 per cent of Canadians believe that regular hand-washing can prevent influenza.

"But when it comes to actually doing that, only about 40 per cent have their children wash their hands before eating," she told a Toronto news conference Wednesday. "And this is despite risks that we know are in the home."

Mindful that children are especially vulnerable to respiratory diseases like influenza, the council has set an initial priority of encouraging programs in daycare centres and elementary schools that would teach children the importance of hand-washing and other good hygiene.

Council chair Dr. Donald Low, chief medical microbiologist at Toronto's Mount Sinai Hospital [2], said the idea is that the lessons learned in school would translate into better hygiene at home.

"There's no program in place in order to share this information, either with teachers (or) with children at school," he said. "This is not part of the school process."

Low said having children learn the proper way to wash their hands and how often would go a long way to preventing transmission of bacteria and viruses that can cause disease. Hands should be washed by both adults and children before eating or taking medications and after using the washroom or handling pets.

He also suggested that classrooms have dispensers of an alcohol-based hand cleaner, such as those found in hospitals and many businesses.

Kitchen your top war zone
In the home, the kitchen is probably the biggest breeding ground for germs, the council advises. Countertops and other hard surfaces can become contaminated with such bacteria as Salmonella and Listeria from fresh produce and uncooked meat.

"The vast majority of food-borne illnesses occur because the food was not handled or cooked properly and 80 per cent of these cases occur within the home," said Low, noting that up to 13 million cases of disease from contaminated food occur in Canada each year.

Low said kitchen surfaces should be regularly disinfected with alcohol-based cleaners or bleach diluted with water.

It's not clear, he said, whether the myriad number of products on store shelves that claim to kill household germs are in fact effective, so the council is supporting a study that will test these cleaners to see how well they actually work.

"The bottom line is these things aren't going to be magic," he said. "They're not going to protect you if they're not used properly, so what we'd like to do is find out: Do they have any value and how can that value be best enhanced by how they're used?"
For instance, some products may kill bacteria but not viruses, he said. And some viruses -- including influenza -- can survive on hard, moist surfaces for 24 to 48 hours.

The council also targeted the lowly and ubiquitous kitchen cloth as a veritable Petri dish for microbes, and advised it be routinely thrown in the washing machine or even the dishwasher for disinfection.

It's not known whether dish cloths laden with germs actually cause disease, Low said. "I don't know the answer, but we do know that these dish cloths -- because they're wet, because they come in contact with so many different raw (foods) -- it's a perfect environment for these things to replicate in."

As for the coming flu season, Low said it's "going to be an interesting one," because infectious disease experts aren't sure how the 2008-09 strains are likely to behave.

Last year, there was an unexplained rise in one strain's partial resistance to the antiviral drug Tamiflu, which is most often used to treat elderly people in long-term care centres at high risk of dying from influenza. Another of last year's circulating flu strains was resistant to another antiviral, Amantadine, he said.

While doctors don't know yet which strains will dominate this year's flu season in Canada, they advise that people who come down with a respiratory illness follow the steps to prevent others from getting sick -- including frequent hand-washing and coughing or sneezing into their elbow instead of their hand.

Contamination of such objects as doorknobs is a sure-fire way to spread cold and flu viruses.

And Low said people should stay home from work when they are sick to avoid coming in contact with others and making them ill, too.

"We've always had this attitude in the past that the good worker is the worker that's there 365 days, rain, sleet and illness ... I think we have to change our attitude about this. It's not responsible for us to come to work when we're sick."