On Germaphobia

On Germaphobia“Let kids be kids.” “Everything spreads germs. Stop being germaphobes and let your kids have fun.”  These were some of the comments from a lively exchange on the Moms Against Cooties Facebook page following a May 22 post on “How to Keep Kids Healthy and Prevent Illness at the Water Park.”  Is the Water Quality and Health Council’s concern over water parks really germaphobia?

What is germaphobia?  It is a persistent, abnormal, and irrational fear of germs that compels one to avoid exposure to them, despite the awareness and reassurance that they are not all dangerous.

What is FUN to a kid about water parks?  Kids like to sit on top of water spouts (it feels good) and open their mouths so the spout of water can shoot into their mouths (it feels good).  In the water park blog cited above, the WQ&HC addresses the first issue of children sitting atop water spouts, and points out the likelihood of this practice contaminating the play water with feces. Is this a real or imagined possibility?  Well, this type of behavior is believed responsible, for example, for a 2007 outbreak of diarrhea affecting at least 50 people who visited an Idaho municipal park in which diapered children frequently sat on top of splash features (see Centers for Disease Control and Prevention report).

Fecal germs may be spread by water spouts almost instantly (within seconds) of contamination because (a) the spray water may be insufficiently chlorinated or (b) the chlorine, which does not kill germs instantly, may not have had sufficient “contact time” with the germs to kill them.  In either case, the contaminated water is now available to enter the mouths of other children.

So, are we germaphobic? Well…

Do we have a persistent fear of germs? No, we agree that children should not and cannot be raised in a germ-free environment. Samuel Johnson’s famous quote is often only partially repeated: The full quote is “in the absence of information perception is reality”. Germaphobes, lacking the information needed to assess the risk from exposure to particular germs, may be acting on the perception that all germs are bad. We as the Water Quality & Health Council are trying to reduce germaphobia by acting as a source of reliable information to counteract the misperceptions that abound.

On a social level, perhaps this situation was summed up most clearly by one of our readers who commented:

“…I don’t want my 2 year old to have your kids poop particles in his mouth. My kids absolutely don’t live in a bubble, but if you can do something as simple as keeping your child’s booty off of the water spout or changing a dirty diaper in order to keep a hundred kids from getting e. coli or some kind of stomach virus—why wouldn’t you do it?”

Parent to Parent

All of the members of the Water Quality & Health Council are parents–some lucky enough to be grandparents–as well as health scientists.  We want what’s best for our children both from a health and enjoyment standpoint. We agree that some exposure to germs is healthy, as it helps build immunity.  We also believe that parents are the first and most important teachers of hygiene.  That said, our sole intention in any public communication is to offer information we think could be helpful to readers in making their own decisions on health and hygiene.

A Common Sense Guideline

Here’s a common sense guideline on hygiene:  If a particular behavior puts others at risk for infection, then it may be time to consider a change in behavior.  Let’s consider immunizations.  Most parents immunize their children against a series of diseases so they will not fall ill. But widespread immunization also helps ensure that others—including those who cannot be immunized (e.g.,  immunocompromised children) —will not become ill.  The greater the population of immunized individuals, the greater the level of protection for those cannot be immunized.  For that reason, health authorities recommend that all children who can be immunized should be immunized.

Teaching proper hand-washing is another basic but important public health measure that helps interrupt the spread of disease.  If I teach my children to wash their hands properly after using the bathroom, your child may not be exposed to an infected door knob that could make you and/or your child contract norovirus or some other contagious illness and miss work and school.  The Centers for Disease Control and Prevention provides online educational resources for child care providers with lessons for children on such topics as covering coughs with a tissue (and properly disposing of the tissue) or coughing into their sleeve to avoid spreading germs via hand contact.  Are measures like these simply going too far?  You are the parent; we are just the messengers.  You be the judge, after all, it is YOUR and YOUR CHILD’S HEATH we are talking about.

Bruce Bernard, PhD, is President of SRA Consulting, Inc. and Associate Editor of the International Journal of Toxicology. His wife confirms that he is far too analytical to be a germaphobe.