Don't Cross Your Eyes...They'll Get Stuck That Way!: And 75 Other Health Myths Debunked (13 page)

Hand-shaking is an important tradition in many cultures. In the United States, hand-shaking is particularly important for introductions, making agreements, and bidding farewell. Politicians use hand-shaking to win confidence, approval, and votes. In Kenya, where Rachel works for half of the year, hand-shaking is an expected greeting whenever you meet someone. In fact, a person is expected to shake hands with everyone in the room they enter. Even very young children in Kenya shake hands when they greet adults. Giving up hand-shaking seems like a difficult proposition. Without a handshake, we may feel isolated, missing human contact, or slighted. It may be difficult to know whether you have really reached an agreement if you cannot shake on it. And if you refuse an offered hand, people might think you rude or insulting. But we know that you really do not want to get sick either.

It is absolutely true that you could catch a cold or the flu by shaking someone’s hand. Cold sufferers often get mucus or snot on their hands when they cough and sneeze. If you shake their hand and then touch your own mouth or nose, you could get sick too. Even though this is a real risk, there is a simple way that you can break this cycle. Wash your hands! If you wash your hands before you touch your own mouth or nose, you can easily protect yourself from those germs. An alcohol-based hand sanitizer works very well to clean off your hands if you cannot get to a sink and soap easily. In fact, the alcohol hand rubs work better than soap and water in many studies of hand-washing. You can also train yourself to avoid touching your eyes, nose, or mouth with your hands if you have not had a chance to wash your hands. Keep your hands away from your face unless you know they are clean.

It is also important to remember that many other infections are not passed through hand-shaking. As we talked about in some of the previous chapters, a lot of serious infections are actually not very contagious. You can be very close to most sick people without getting sick yourself, and hand-shaking will not pass most serious infections. Moreover, remember the odds; not everyone is sick! In fact, the majority of the people you meet every day are healthy. While you may meet more infected people during the cold and flu seasons, and while it is not a bad idea to wash your hands regularly (or use hand sanitizer) no matter whose hands you are shaking, most people’s hands are not going to make you sick.

Doctors do a lot of hand-shaking, and they do a lot of hand-shaking with very sick people. In Rachel’s work, she shakes hands with HIV-infected patients all the time. HIV is not passed through hand-shaking, nor are most other serious diseases. As pediatricians, we see countless children with coughs and colds. While these common infections
can
be passed through hand-shaking, even doctors in constant contact with sick people can avoid getting sick most of the time by washing their hands regularly and not touching their mouths or noses very often. The risks of hand-shaking are very small in contrast to the benefits of hand-shaking for greeting each other, for making emotional and business connections, and for affirming our human connections.

Homes

You shouldn’t enter the home of someone who is sick

Many common illnesses, from diarrhea to colds, can be spread inside the house of someone sick. Some of these illnesses are spread either by direct contact with secretions (the gross stuff—snot, phlegm, spit, poop) or by breathing in tiny drops of secretions that have been sneezed or coughed into the air. If a person is sick with a viral or bacterial infection that is spread by their secretions, and if you touch something in the house that has those secretions on it, then you might get sick. For example, doorknobs, dirty tissues, or toys that a sick baby has slobbered on could be contaminated and may pass on infections if you touch those things and then put your hands in your mouth. While germs could be aerosolized or present in the air in tiny liquid droplets, this is more of a risk if you are very close to the infected person. However, as the chapter on breathing the same air as a sick person suggests, it is possible for you to catch a bug from the air in the same house as a sick person. The air within residential houses is typically exchanged for outside air less frequently than the air in office buildings. Although this could allow the germs to hang around in the air, you should remember that the average house has far fewer people potentially sending their germs into that air than the average office building.

So, there is a risk, but it is not a huge risk. Many of these germs, whether bacteria or viruses, do not live for very long once they are outside the body. And for many of them, the greatest risk is when you are very close to the sick person, or when the sick person’s secretions are freshly coughed or sneezed or slobbered onto things. You have to get a certain number of the germs into your body before they have a good chance at making you sick. Even if you touch or breathe in something contaminated, there may not be enough living germs on that thing to make you sick.

Some of the viruses that cause diarrhea, such as rotavirus, are among the most difficult to escape in a house. In studies, rotaviruses have been able to survive for days to weeks on surfaces around the house, and ingestion of as few as ten rotavirus particles can cause infection. If someone in the house has rotavirus, you should probably try to stay away!

Despite the possibility of getting infected, it is important to remember the big picture. Not all infections are spread through the air or through secretions or body fluids; some would require you to directly touch the infected area on the person. And, of course, some illnesses are not contagious at all. Furthermore, even for infections that are spread through the air or through contact with infected secretions, you still may not get infected even if you are in the same house.

How can you escape infection? First of all, good hand-washing (and not sucking on your fingers or picking your nose with dirty hands) can help you to avoid getting infected from even the most infected secretions that may be around the house. Second, a quick visit is unlikely to hurt you. In a study where sick volunteers spent time living in small quarters with healthy volunteers, it took a long time before anyone passed on infections. Even though the sick people and the volunteers were playing board, card, and video games in close contact with each other throughout the study, it took an average of 200 hours of exposure to the sick people in order for the healthy volunteers to get infected themselves. It is also important to remember that the risk of getting infected in public places with a lot of people is higher than the risk you face with a limited number of people over a short time. Going into a house with one or two sick people may be less of a risk than being on a subway or bus with a whole bunch of people.

Beyond hand-washing, the Centers for Disease Control and Prevention offers some suggestions for further decreasing the risk of spreading illnesses like influenza within the house. The CDC suggests that linens, dishes, and utensils used by those who are sick do not need to be cleaned separately, but they do caution against sharing these items unless they have been washed first. The CDC even gives laundry advice; they recommend washing towels and bedsheets with regular laundry soap and tumbling them dry on a hot setting. They also suggest that you should not hold laundry against your body and that you should wash your hands after you handle dirty laundry. It is considered safe to wash the sick person’s eating utensils in either a dishwasher or by hand with water and soap.

You should also know that people are generally contagious before they have any symptoms from their infections—before they even know they are sick. This seems like a depressing piece of news, but we would argue that you never really know when someone might be getting sick, and so the practical thing is to avoid wasting time being concerned about who may or may not infect you. Instead, practice the basic precautions to avoid infections or illness. Wash your hands!

Honey

I have just the thing for that cold … Honey and Vinegar

Rachel’s hair stylist, Jeff, swears that a mixture of hot vinegar and honey will cure any cold or soothe any sore throat. Once, Rachel had the misfortune of going to get her hair cut when she had entirely lost her voice due to a bad cold. While she sat captive in the styling chair, Jeff whipped up a mixture of his hot vinegar and honey cold remedy, and Rachel was strongly encouraged to drink the noxious mixture. Willing to try almost anything once, Rachel forced down the concoction (with only a little gagging) and was grateful that her sense of taste was dulled by her cold. It tasted terrible, and she was left wondering how much it helped.

Jeff is not the only one to recommend honey for a cold or cough. The World Health Organization (WHO) suggests that honey may be a useful treatment for children with colds because it might soothe the throat and provide some cough relief. However, these 2001 guidelines from the WHO recognized that there was no scientific evidence to support that honey actually worked.

Honey might be helpful for a cough or cold for several reasons. Honey is a demulcent, a substance that forms a film or coating over your throat. It is common for cough medicines to contain something that forms this kind of film in your throat because it is thought to be soothing, potentially relieving minor pain and inflammation or irritation of your throat. Honey has also been found to have some antioxidant properties and to stimulate the release of cytokines, chemicals that can cause inflammation but also help your body fight infections.

One good study has been done to look at how honey impacts nighttime coughing and the ability to sleep for coughing children with colds. This study compared honey to a common cough medicine (dextromethorphan), which was flavored and mixed up to look, taste, smell, and feel like honey. As we have mentioned before, studies have shown that dextromethorphan does not help children’s coughs. This was also an important comparison because the parents, children, and investigators were blinded to what the children were receiving; they did not know if they were getting real honey or fake honey. The children were also compared to a group of coughing children who did not receive honey or dextromethorphan. This was a well-designed study. Depending on their age, children received one half to two teaspoons of buckwheat honey or fake honey or no treatment at all before they were supposed to go to bed. In the end, the parents of the children who had honey reported less coughing and fewer symptoms of their colds compared to children who received no treatment. The fake honey was not better than receiving no treatment for any of the outcomes. However, comparing the honey directly with the fake treatment did not show any significant differences. The summary of this study is that, when you compare honey, fake honey (regular dextromethorphan cough medicine), and no treatment, parents rate the honey as the best to help get rid of their children’s nighttime coughs and help the child and parent sleep. It may not work much better than a fake honey, and it may not help for many other cold symptoms, but honey does seem to help with children’s coughs.

Clearly, honey ought to be studied a bit more, but honey may be worth a try when you or your child are coughing and hacking and not sleeping. The one caution is that honey should not be given to children who are under the age of one. There is a small but real risk that infants can get botulism from honey. Botulism is a rare disease that causes paralysis and leads to death if it is not treated. Eating honey in the first year of life has been shown to be a risk factor for infants to develop this serious condition. If your child is older, you should feel free to give honey a chance to help with that cold.

Jeff may have been on the right track about the honey, but the foul vinegar in his cold remedy concoction is a different story. Jeff is in good company with the idea of using vinegar for colds; back around 400
B.C.
, Hippocrates prescribed vinegar for curing persistent coughs. Many advocates of home remedies suggest that honey and apple cider vinegar is a natural cough remedy. While vinegar can help as an antibacterial agent to clean counters or tiles, there is absolutely no evidence that vinegar helps with coughs or cold symptoms. What is good for the bathroom floor is not necessarily good for your throat. There is no evidence that vinegar helps clinically with coughs or other infections. A lack of evidence is just that—a lack. It is possible that someone could still prove that vinegar and honey works for colds, but there is no reason to believe that it will.

The next time Rachel gets a haircut, she may have to be extra careful to emphasize how great honey can be for coughs. After all, it is never good to offend someone wielding a sharp scissors near your hair (or any other part of your body). She will just keep in mind the limitations to honey’s benefits and the good reasons for avoiding terrible-tasting vinegar.

Eating local honey will prevent allergies

Allergies can be debilitating. They can make you feel terrible, and they can interfere with your quality of life. Moreover, many of the medications for allergies, which are all aimed at interfering with how your immune system responds to allergens, can make you feel sleepy. So it’s no wonder that people are looking for other options to fight allergies.

That’s where honey comes in. There is a theory that honey, made by bees, could be a vaccine for allergies.

Let’s back up a step and talk about vaccines first, so you can understand the rationale for why this might work. Vaccines work by giving our body a “taste” of a dangerous infection. Maybe it’s something that looks an awful lot like a dangerous bug. Maybe it’s a virus that has been inactivated or killed. Either way, the body reacts by creating antibodies to what is in the vaccine so that later, when the body comes into contact with the actual pathogen (the real and dangerous germ), those antibodies are primed and ready to kill the virus or bacterium.

The theory with local honey is that it contains the same pollen that may be causing your allergies, but in much smaller amounts. Therefore, your body gets practice, much like it would with a vaccine, to get ready to fight off the allergen. Later, when you are exposed to the actual pollen, your body is ready to go and your allergies will disappear.