Live webchat with Dr Dawn Harper
This is an edited transcript of a webchat with Dr Dawn Harper on 4 September 2009 about how to avoid catching colds and flu, and how to prevent them taking out the family if one person gets a horrid lurgy. Dawn's a part-time GP in Gloucestershire and a regular on lots of programmes and in the press.
morningpaper: Can you tell me the correct procedure involving alcohol gels and handwashing? What is the best way to teach one's children's hands of germs without turning them into Lady Macbeth?
DrDawnHarper: I know what you mean - you don't want to turn your children into neurotics but hand washing before eating and after visiting the toilet is a good habit to teach them. Soap and water are effective against most of the bugs but if they aren't available then an alcohol hand wash will do the same thing
UnquietDad: My mother is obsessed with the children hand-washing 'properly' all the time ie between fingers and backs of hands, too. Is she right or does she fuss too much?
DrDawnHarper: I'm afraid for once mum probably is right! Most germs are spread via our hands and simple washing with soap goes a long way to keeping bugs at bay. Between the fingers and the base of the nails are common places to be missed.
rubyslippers: Interested to know whether those sprays and things that promise to kill 99.9% of bugs are any good? Also, what is the point of anti-bac hand gel when viruses are on the loose? Surely good hand washing is the best thing?
DrDawnHarper: To be honest I don't mind whether people use soap and water or sanitising gels - both will do the trick. As for looking after ill people, you can minimise the spread of infection by cleaning hands and surfaces regularly and coughing or sneezing into a tissue and disposing of it immediately. Viruses can live for up to 24 hours in an ordinary tissue but 99.9% of them are killed within minutes in an anti-viral tissue so worth considering if you are out and about.
oneopinionatedmother: Don't you think too much concern over hygiene makes people less resistant to bugs and more prone to allergies? Hence the vast increase in allergies in recent years, particularly in cleaner homes?
DrDawnHarper: There has been a lot of debate about our obsession with cleanliness, and one theory for the rise in allergic diseases is that we have become too clean, which has left our immune systems with something else to look for. I'm not a fan of bleaching and disinfecting everything in sight, but handwashing should be routine and is an important part of preventing the spread of coughs and colds from person to person.
shineoncrazydiamond: I am very sceptical about anti-bac hand gels and tissues coated with special anti-lurgy ingredients. In fact, I believe studies have shown that the hand gels are ineffective and nothing really beats a proper wash of hands at regular points during the day. Do you believe that the use of these gels has made us complacent (plus poorer), when in reality we should be just using soap and water as it is just as good?
belgo: shineoncrazydiamond, in my experience I agree with that. I have seen many healthcare workers replace good hand washing techniques with a splash of alcohol gel, and I cannot believe that to be as effective as good hand washing. I also dislike alcohol gels because they dry out my skin and give me a rash. I would much rather wash my hands properly with soap and water.
DrDawnHarper: Good old-fashioned soap and water is perfectly effective and that's what we use at home, but the gels do have a useful place when you are out and about.
shineoncrazydiamond: Thank you, Dr Dawn. Belgo, I agree, yes. I refuse to use them in fact. Seems daft to me. I am not a compulsive hand washer or anything, but it seems to make sense to wash your hands after a supermarket shopping trip or putting the bins out or something. And I bet a lot of people don't.
carriemumsnet: My sister is due to give birth to much longed-for twins in Oct and has been, understandably, very worried about swine flu during pregnancy and now swine flu once they're born. I remember being obsessed with my precious first born about visitors washing their hands before they touched her (London suddenly seemed so dirty!). But given that they're due in what might be the middle of a flu pandemic are there any other precautions she /her visitors should take to protect the babes (and her) from infection? For example, can the virus live on clothes? Just thinking how we always pick up newborns and clutch them to our chests (clucky? moi?). Should we be disinfected or change first if we've just come off the tube?
Also any particular advice about keeping colds and flu (and swine flu) at bay during last few weeks of pregnancy? Should she be avoiding my snotty school-age children?
DrDawnHarper: Being a mum is always fraught with worry and being a new mum even more so. If your sister is planning to breastfeed her twins they will benefit from some of her antibodies, which will help them in their early days. As for contact with health professionals, it should be routine practice for them to wash their hands before touching her babies. Your children will no doubt want to cuddle their new cousins but if they are full of cold delaying this is probably a good idea.
carriemumsnet: I meant more the steady stream of visitors fresh from the tube rather than hospital staff, who I'd hope would be relatively sterile. Anything other than hand washing?
DrDawnHarper: Sorry, I nearly missed your second question there. To be honest as long as your sister's twins are healthy, simple hand washing should be all that is necessary.
StripeySuit: What are these Kleenex Anti-Viral Tissues all about? A tissue's a tissue, innit?
DrDawnHarper: The Kleenex Anti-Viral tissue has a middle layer that traps and kills viruses within minutes of contact, whilst an ordinary tissue will trap the virus but it could survive for up to 24 hours so could easily be passed onto anyone who touched that tissue.
hairycaterpillar: Seriously, anti-viral tissues? Surely there cannot be any evidence base to show they are any better than just normal tissues being disposed of hygienically?
DrDawnHarper: You are right, if tissues are disposed of hygienically and quickly then that is good enough, but in fact viruses can live for up to 24 hours in an ordinary tissue so if it is left lying around it is possible that someone else could pick it up. It's not always possible to 'bin it' immediately and that is where anti-viral tissues are useful.
CMOTdibbler: But surely the point of tissues is that you bin them after use, and it's not like the viruses are going to be jumping out of the bin are they? Any actual evidence for whether using antiviral tissues will actually cut down on transmission rates? And the 99.9% figure is always suspicious to me.
DrDawnHarper: You are right, we should be disposing of tissues straight away and that is the whole point of the Catch it, Bin it, Kill it campaign, but there are times when that isn't always practical, like when you are travelling, in which case an anti-viral tissue is a good solution.
The viruses don't jump about, you're right, but it surprises most people to learn that 80% of bugs are passed by hand, not by coughs and sneezes, so leaving dirty tissues around could leave other people exposed to your bugs.
belgo: Can you damage your nose by regular ferocious nose blowing?
DrDawnHarper: You won't damage your nose but you could cause yourself to have a nosebleed.
WreckOfTheHesperus: I was always told that you should keep your mouth closed outside on a cold day if you have a sore throat, as the cold air makes it worse. It this true? And does getting cold really make a cold worse?
DrDawnHarper: That's a new one on me! But there was some research from Cardiff a couple of years back that supports the old wives' tale that you should wrap up warm if you go out in the cold to protect yourself from getting a cold. They found that people with cold extremities were more likely to succumb to viruses, and the theory is that if you are cold there is less blood supply to your nose and, therefore, fewer of the immune cells get to the nose, which is where most bugs enter.
WreckOfTheHesperus: Thank you. Also, my DD came home with umpteen colds from nursery last year, which she duly passed on to me and DP. Is there anything preventative at all that we can do to reduce the number of colds that she catches? And will all these colds have the effect of building up her immune system or weakening it?
DrDawnHarper: British adults can expect to get on average two or three colds a year, whilst kids are more likely to get between four and eight because their immune systems are not as well developed. There is an argument that exposing them to bugs will help build their immune system but as there are over 200 viruses that cause coughs and colds (some of which change, too) it is impossible to be immune to all of them. A good balanced diet, regular exercise and a good night's sleep all help boost the immune system.
AddictedtoHeatmagazine: Does going out with wet hair make you more susceptible to catching a cold?
DrDawnHarper: Take a look at my answer to wreckofthehesperus - it could be possible that cold hair will make you more likely to catch a cold.
AddictedtoHeatmagazine: Thank you - so my mum was right - bah!
StripeySuit: How long does virus sneezed into the air live for?
DrDawnHarper: I'm not sure what you mean? Are you saying that if you have a cold and go out and about getting your supplies etc that you are potentially spreading your bugs around? This is true but, of course, we have to be practical. In an ideal world, if you are poorly with a cough or cold, it is best to keep any unnecessary travel to a minimum, but I fully understand that life has to go on and if you have to go out then paying attention to the "Catch it, Bin it, Kill it" guidelines will help minimise spread.
StripeySuit: Sorry, no, meant others in house 'visiting' you in 'confinement'? Is there any point trying to stay away from people you live with when ill?
DrDawnHarper: Oh I see! Sorry. If you are feeling pretty miserable with a cold some people like just being left alone but others like company. I don't think you have to put yourself in total solitary, but I wouldn't go around hugging healthy friends and putting them at risk. A sneeze will leave your nostrils at over 90mph, which means that anyone in a 5ft radius could be infected, so if you are receiving visitors just keep them at arms length.
CMOTdibbler: If my DS gets a cold, it always ends up as a chest infection. Is there anything we can do to stave this off this winter?
StripeySuit: CMOT, my DP was just diagnosed with bronchiectasis and now has a simple physio exercise to clear her lungs everyday which makes it harder for infections to take hold.
DrDawnHarper: If your child is struggling with lots of chest infections, do take him to your GP, particularly if there is a family history of asthma as it could be that he has that tendency in which case your GP will be able to advise you on how to manage things.
CMOTdibbler: Been back and forward to GP for two years - just seems that he is very mucus-y once he gets a cold at the start of the season, and then that is it for the winter. I may try StripeySuit's suggestion to do preventive physio. We had to do it to clear his massive chest infection a couple of years ago.
WreckOfTheHesperus: When are you infectious with a cold? A lot of people seem to think that you're only infectious for the first couple of days?
DrDawnHarper: I'm afraid whenever you are coughing or sneezing you should assume that you are infectious. There are over 100,000 potentially infectious droplets in a single sneeze!
rubberduck: Will you and/or your children be having the swine flu vaccine this winter?
DrDawnHarper: I always have the flu jab - I missed it one year and paid the price! I guess it's just an occupational hazard. If you see enough cases you are bound to succumb at some stage and I'm sure I will do the same with the swine flu vaccine.
belgo: To keep a child's high temperature under control, should ibuprofen and paracetamol be used alternately, or one or the other? Would you recommend vitamin supplements for children during the winter months? What about for a breastfed baby?
DrDawnHarper: Both paracetamol and ibuprofen will help bring a child's temperature down, so I often advise using them in alternation. There is some evidence that ibuprofen is slightly more effective so worth trying first.
As for vitamin supplements, if your child has a good balanced diet he should be getting all the vitamins he needs without needing to supplement. In some cases, there are specific indications for supplementing but unless your doctor has advised this I'm a firm believer in trying to get all a child's nutrition into him with food.
RubbderDuck: Recent research has brought up a lack of vitamin D playing a part in avoiding a cold/flu. From memory though, there aren't many foods that contain vit D naturally (eggs and dairy?). Given that our lack of sun in this country is legendary, wouldn't it be worth supplementing for those children who can't or won't eat a great deal of dairy products?
DrDawnHarper: We certainly haven't had much sun this summer, but in fact you need surprisingly little sun exposure to ensure enough vitamin D - even just 15-30 minutes a day should do the trick and whilst it may look cloudy out there the rays do get through.
theseboobsaremadeformilking: Is it OK to go swimming with a 15 month old who has a cold. My swim teacher said it was fine.
DrDawnHarper: To be honest, he is unlikely to come to any harm but if he has a cold he probably doesn't feel his best and you are potentially just exposing others to his bugs. I would probably put it off this week and think of something else to do until he is back on form.
belgo: Would going swimming whilst ill with a cold not increase a sick child's chances of developing infections secondary to that cold, for instance an ear infection, due to the warm bug infested water having more of a chance to infect a susceptible child?
DrDawnHarper: Some children are susceptible to ear infections following a cold. These tend to be middle ear infections also called otitis media. Swimming can increse the chances of an outer ear infection (otitis externa).
belgo: Is it true that there is a wonder cure for all cold sore viruses, but the pharmaceutical companies won't let on because they make so much money out of cold sore treatments?
DrDawnHarper: If there is I wish I knew about it! No I don't think so, I certainly haven't heard of it. The pharmaceutical companies are constantly working on this sort of thing though and if they ever found it I think they would be sitting on a goldmine so we would soon hear about it!
This webchat was sponsored by Kleenex Anti-Viral Tissues