Attack Of The Germs!

No one likes being sick, especially with the flu. The body aches, the fevers, and the congestion all leave us desperate for ways to end the misery. Indeed, it’s growing increasingly hard to ignore the commercials telling us to stock up on flu-fighting products, like disinfectants and hand sanitizers. But how much do these items really help you avoid becoming the flu’s next victim, and do they have other consequences that we should be aware of?

Let’s first take a look at how many of the popular disinfectants work. Cleaners like Lysol have different types of salts in them that kill germs by disrupting important protein interactions, which causes the pathogen to stop functioning normally. These salts can also work by breaking up the membrane that surrounds bacteria and some viruses, essentially breaking open the pathogen and causing everything inside it to leak out. In both of these cases, the germs stop growing or are killed altogether.

Alcohol-based hand sanitizers work in a similar manner. At concentrations of at least 60%, ethyl alcohol (or ethanol) is effective at killing some viruses, including influenza viruses. Ethanol works by changing the shape of proteins, and therefore interferes with their ability to properly interact with other proteins. Ethanol can also disrupt membranes.

 

Image of Influenza virus from the CDC highlighting proteins on the outer surface that help the virus infect cells, and the viral genome located inside.

While killing off the germs that can make us sick sounds like a good way to stay healthy, the problem with using disinfectants and sanitizers to do this is that these products kill nearly all of the microbes in our environment. While there are many microbes that make us sick, there are also many that we need to help keep us healthy. If we kill those microbes off too, then we may put ourselves at risk for developing other health problems. 

On and within our bodies live millions and millions of good microbes that do things from helping us digest food, to helping keep bad microbes out of our bodies. These good microbes encompass the population known as the microbiome. The microbiome populations shift depending on the location of the body. For example, we have good bacteria that live on our skin, the population of which differs from the population of good bacteria that live in our digestive tracts. There is increasing interest in exploring the functions of the different microbiome populations, and many studies are showing that the microbiome has important roles in keeping us healthy. For example, it is thought that irregularities in the gut microbiome population may have a role in some inflammatory bowel diseases like Crohn’s disease and ulcerative colitis. It is possible that killing off the beneficial microbes in and on our bodies counteracts any good effect from killing off germs.

 

Keeping our good microbes around is only part of the story. According to the CDC, we are currently on the brink of a public health crisis due to the increasing numbers of microbes that are becoming resistant to common antibiotics. Due to our overuse and misuse of antibiotics, we have created strains of bacteria that are no longer susceptible, or able to be killed, by standard treatments. As bacteria populations are constantly exposed to antibiotics, many of those bacteria will be killed because they are sensitive to the antibiotic, but there will be some that are naturally able to withstand the actions of the antibiotic. Eventually, the population of bacteria that was initially a mix of sensitive and resistant will transition to a population of bacteria that is completely resistant, as all of the susceptible bacteria are killed off. What is the impact on us? In 2013, the CDC reported that at least 2 million people in the United States become infected with antibiotic-resistant bacteria, and that at least 23,000 of these people die from their infections.

Perhaps the most well-known case is MRSA, or methicillin-resistant Staphylococcus aureus. Staph bacteria are common and normally cause minor skin infections; however, MRSA has been highlighted in the media several times over recent years due to the outbreaks of invasive infections it has caused due to its resistance to standard antibiotics. MRSA is but one example of the bacterial strains that develop resistance to antibiotics due to constant exposure to them.

As we continue the cycle of overuse and misuse of antibiotics, we eventually will find ourselves at a point where no antibiotics will be effective against bacterial pathogens. Many public health experts suspect that point is near. There is reason to believe that constant use of disinfectants will eventually lead to the development of germs that are resistant to those disinfectants, just as we see happening with bacteria and antibiotics.

So how do we keep ourselves healthy without potentially setting ourselves up for other health problems later? We can start by limiting our use of disinfectants, and go back to simpler, tried-and-true methods of preventing the spread of communicable diseases. Despite the popularity of disinfectants and hand sanitizers, the CDC still maintains that hand-washing is one of the best ways to avoid spreading and catching viral and bacterial infections from others. Wash your hands before you eat, and avoid touching your hands to your eyes and nose.  If you are sick, do your best to sneeze or cough into the crook of your elbow (i.e., do the “Dracula sneeze”) rather than into your hands, and wash your hands frequently to avoid spreading your germs to others.

 

Of course, use soap that does not contain antimicrobial additives, like triclosan, to avoid encouraging the development of strains resistant to this compound. Soap is a potent killer of germs all by itself - it does not need supplemental antibiotics. While some companies are moving away from including triclosan, it is still present in many products, so be sure to check your labels.

Disinfectants have their place; they’re good for cleaning up food preparation areas that have come into contact with raw meat, for example. And, in times when you’re without clean water and soap, hand sanitizer can be a great tool for keeping your hands clean. But as with most things in life, these items should be used with care and arguably in balance with other washing methods in order to avoid creating greater problems down the line.

Contributed by:  Kelly Hallstrom
Visit Kelly’s blog, You Don’t Have To Be A Rocket Scientist
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CDC Threat Report on Drug-Resistant Bacteria:

http://www.cdc.gov/drugresistance/threat-report-2013/

CDC and hand washing:

http://www.cdc.gov/handwashing/

 

Greenblum, S., Turnbaugh, P., & Borenstein, E. (2011). Metagenomic systems biology of the human gut microbiome reveals topological shifts associated with obesity and inflammatory bowel disease Proceedings of the National Academy of Sciences, 109 (2), 594-599 DOI: 10.1073/pnas.1116053109