APHL responds to “banned words,” remains focused on CDC’s budget

APHL responds to “banned words,” remains focused on CDC’s budget | www.APHLblog.org

By Scott J. Becker, executive director, APHL

Recent news concerning limits on language permissible in CDC budgetary communications has drawn considerable attention in the media. As a longstanding partner of CDC, APHL shares its commitment to science-based work to protect the public’s health and improve its health status. We are heartened by CDC Director Fitzgerald’s statement that CDC remains committed to evidence-based work described using all appropriate language, and we are confident that CDC will continue to serve all communities, including those most vulnerable and diverse.

Our primary focus is on ensuring that CDC receives funding that will enable APHL members – local, state and territorial public health laboratories – to do the vital work necessary to detect and respond to public health threats. We feel strongly that, while the words CDC uses in their budget submission are extremely important, the funding levels are at least equally deserving of our attention.

We look forward to working with the Administration and Congress to ensure the best scientific evidence is used in all public health decision making and that all public health professionals are able to use language that appropriately conveys the public health policies and programs that allow for improvement for the health of our nation.

You can also read Scott Becker’s letter to the editor of The Washington Post on this matter.

 

The post APHL responds to “banned words,” remains focused on CDC’s budget appeared first on APHL Lab Blog.

Is the government telling women not to drink? How many microbes in the human body?

homepage_734x546pxThe headlines called it “incredibly condescending” (Alexandra Petri, ComPost),  “unrealistic” (Jia Tolentino, Jezebel), and “bonkers” (Olga Khazan and Julie Beck, The Atlantic.) The post from the aptly named Brandy Zadrozny at The Daily Beast) was

The lowdown on lead

Ruhiyyih Degeberg, MPH, senior specialist, Environmental Health, APHL

Six months ago I transitioned from the newborn screening program at APHL into the environmental health program. As I set out to learn as much as I could about many areas of environmental health, it was a study on lead poisoning that really struck me. Researchers linked the violent crime rate of the boomer generation to the amount of lead in the atmosphere due to things like lead in gasoline and paint. Looking at the graphs featured in that study, you can see a nearly identically shaped curve showing the removal of lead from gasoline and the decline in violent crime. The notion that environmental exposure to lead could have such a drastic impact on an entire generation was astounding.

When it comes to addressing lead poisoning, prevention is the primary focus. Countless studies have shown that elevated blood lead levels in early childhood are associated with intellectual deficits later in life. While there are treatments available for victims of lead poisoning, preventing exposure particularly in young kids is far more effective.

Where does lead exposure occur?

While the use of lead in manufacturing in the US has been greatly limited over the years, many leaded materials remain in our homes or come into the US from other countries. Most people know about lead in paint, but it can also be found in other common items such as older bathtub glazes, some imported toys and even some imported candies.

The lowdown on lead | www.APHLblog.orgOne of the most common sources of lead exposure is through dust. Scraping or sanding lead paint off the walls can leave contaminated dust particles floating in the air. Before attempting to remove lead paint or other building materials from your home, call the Department of Housing and Urban Development’s hotline at 800-RID-LEAD to get advice on safe removal.

Additionally, lead dust is also a significant concern at some shooting ranges. In fact, a 2014 study found that the top source of lead exposure for kids in Alaska was a firing range. Before going to a firing range, be sure to ask if they use lead bullets.

According to CDC, there is no safe lead level. They do, however, set a reference level for children – the level at which CDC recommends taking action. The current reference level is five micrograms per deciliter of blood. (This much-needed change came in 2012 after 20 years at the same level, 10 micrograms.) The CDC’s Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) will meet this fall to discuss lowering the reference level of lead in children even further.

What can you do to prevent lead poisoning? Most importantly, be informed. Understand the risks associated with lead exposure, know where it may be found and be vigilant about avoiding it in your environment. Guidelines for blood lead level testing vary by age and risk-level (where you live, work, etc.) Ask your physician how often they recommend you and your family members be tested.

Here are a few additional resources:

 

From The Lorax to the Laboratory

by Vanessa Burrowes, APHL-CDC Emerging Infectious Disease Laboratory Fellow, North Carolina State Laboratory of Public Health

When I was a kid, I was pretty curious about everything around me. If I wasn’t asking a million questions to increasingly exasperated adults or devouring an adventure book series like The Boxcar Children, you could usually find me outside playing in the dirt getting scraped up and loving every minute of it. While those explorations certainly led me to science in an indirect way, it was Dr. Seuss who led me straight there.

From The Lorax to the Laboratory | www.aphlblog.org

On a dreary rainy day when I was four years old, my preschool teacher sat several of us down to watch a movie in the hopes of abating our restlessness. I sat there with my peers for my first viewing of the original version of Dr. Seuss’s The Lorax. I returned home that evening filled with a horrific fear of the future. I dreaded that, like the world of the Lorax, my world too would someday become grey, poisoned and hopeless, full of Humming Fish walking out of lakes and brown Bar-ba-loots gloomily dragging their feet away to escape such a heavily polluted place. The Once-ler’s profound advice that, “Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not,” triggered a driving sense of responsibility within me at a very young age. From that day forward, I decided to dedicate my life to protecting the environment and the health of those living in it with the hope of preventing such a dreadful event from happening. Even at four years old, The Lorax definitely gave me perspective on the role I could play during my time on earth.

Many years later as I started thinking about possible careers, my parents tried to push me, their oldest child, into pursuing medical school. They were both immigrants from families with no prior science background and worked hard throughout their lives to become chemists. My mother wanted both of her daughters to pursue science careers and take advantage of the growing field of opportunities the U.S. had to offer female scientists, especially if there was the chance for us to become financially independent which seemed most tangible in medicine. I respected my mom’s feminist ideology and followed through by shadowing in the oncology unit at Aultman Hospital in Canton, Ohio for about three months during high school. Try as I might, I didn’t enjoy working under flickering fluorescent lights, racing back and forth between nurses to help aid dying patients, or viewing various body fluids being projected everywhere. Maybe I picked the wrong unit to begin exploring medical careers, but I knew from that experience that while I was still very interested in science, I ultimately wanted to find a much more controlled environment where I could do my best to help prevent people from getting to that terminal stage of disease in the first place.

As college approached, I was feeling a bit lost. While I definitely still felt a love of science, I also toyed with the idea of being a lawyer or a judge and even started looking into political science degree programs. This all stemmed from my short-lived, very “successful” role as a sharp-witted, intelligent prosecuting attorney (complete with a sweet drawn-on mustache) in a 5th grade play. I loved the thrill of the investigative work, probing through clues until arriving at some semblance of an answer. But was it a good career choice for me?

It wasn’t until later that I realized that I could have it all.

During the summer of 2007 I was selected as one of 30 students from around Ohio to attend the REAL (Regents Environmental Academy for Learning) Summer Science Program at Bowling Green State University. I gained an overview of basic concepts of biology, chemistry, pollution and toxicology, but my favorite workshop was on epidemiology, my first exposure to public health. We were given a fictional case study where 15 out of 20 kindergarten students had contracted an unknown bacterial illness after visiting a local zoo. To uncover the cause for the outbreak, we reviewed hospital files, patient records and poured through interview transcripts. By investigating all of these factors, we were able to pinpoint the strain and source of the ingested bacteria. The thrill of the detective work involved in solving this case, as well as insight into the interconnected dynamics of disease transmission, ignited my interest in pursuing public health as a career. It seemed to feed all of my interests: science, detective work and a strong desire to help improve our world.

I’m currently an APHL/CDC Emerging Infectious Diseases (EID) Laboratory fellow working at the North Carolina State Laboratory of Public Health (NCSLPH). This fellowship has given me several opportunities to communicate my findings from various projects and ideas with public health leaders and stakeholders from the North Carolina Department of Health and Human Services.

One of the coolest moments of my fellowship so far may have been when I was unexpectedly put in charge of leading a research and development (R&D) meeting with NCSLPH’s research collaborative company, bioMérieux, during a site visit to their headquarters in Durham, NC. As I was en route to their building, I learned that my boss couldn’t make it with me. After talking myself through an initial bout of nervousness, I realized that I was confident that I knew what parts of our procedures needed to be improved and was able to advise them on troubleshooting issues that had arisen during our experiments. Not only did the staff astutely listen and actively ask for my input, but they also took all of my advice into consideration. When I received the final version of the protocol, I noticed that many of my suggestions were incorporated. For the first time in my life, I felt that people were finally asking me for constructive input and respecting my contributions to a given project.

But, I have to be very honest. Without question, the ultimate moment of my EID fellowship so far was when I finally fulfilled a lifelong dream of wearing the full personal protective equipment (PPE) necessary to work in a BSL-3 suite. I donned the PAPR, Tyvek suit, booties… the works! All the movies, TV shows and news clips showing people wearing these suits make them look like the ultimate scientist superheroes (and smartest villains for the shameless Breaking Bad fan in me). Now I pretty much work full-time in this superhero scientist suit. As part of the project I mentioned before, I’m working with Brucella spp (highly pathogenic, #1 cause for laboratory acquired infections) to submit protein spectral data to bioMérieux to build their MALDI-TOF Vitek MS database for BSL3 pathogens. While the PPE does allow me to feel like a scuba diver exploring the unknown depths of the microbiological ocean, it still takes me a long time to physically get into the thing so the magic has worn off a bit. I look more like the Michelin tire mascot on most days, but I still feel like a scientific superhero inside! I hope I can make this my uniform to wear while riding into a future public health battle!

I like to think that the work I’m doing as an EID fellow has a significant impact on protecting the public (even though it doesn’t include that awesome mustache from my time as a prosecutor). I still have my whole career ahead of me and who knows what’s in store. I’m not worried about that right now; I’m too busy having the time of my life.

Could funding cuts to food safety programs make you sick?

By Michelle Forman, senior media specialist, APHL

Could funding cuts to food safety programs make you sick? | www.aphlblog.orgWhen public health works, no one sees it.

That’s a common adage at APHL and is most frequently used when referring to the gross lack of – and ever plummeting – funding for valuable public health programs. But what does it mean? When do we see public health and when does it vanish into the background?

The public health system comprises many areas from healthy eating to smoking cessation to biomonitoring to newborn screening. To answer this question, we’re going to focus on food safety – something that impacts every person in the United States – by following the journey of peanuts as they pass through the food system and into your lunch bag.

(Note: Peanuts were chosen to make a point. They are not inherently risky. As of the original date of this post, there is no current known outbreak associated with peanuts. This journey could feature any food item.)

Our peanuts were grown on a large farm that distributes its harvests for use in many different products.

After being roasted, they are shipped to another facility to be ground into a paste. That paste is then used to make peanut butter for cookies, crackers, ice cream, dog treats and many other products.

In a perfect situation, our peanuts are grown using the safest growing practices; thoroughly roasted to kill pathogens acquired on the farm; processed in facilities that ensure utmost safety and cleanliness in accordance with all food safety guidance provided to them; sent to stores, restaurants and other food service facilities where they will be purchased and consumed by families trusting that they are receiving peanut butter crackers free of Salmonella. Public health has worked in the form of inspectors, guidelines, regulations, sample testing, quality assurance, staff training and public education to ensure that a perfect situation can and will exist most of the time. Although you never saw public health working to prevent you from getting sick, it was there.

Even when all goes right – even when there are not blatant safety oversights along the way – sneaky Salmonella can find its way in. What then?

Our peanuts have picked up Salmonella after roasting (there’s likely no more heating to kill that nasty pathogen) in the processing facility. They are then mixed with more and more peanuts, shipments from other farms, passing through machine after machine, being ground into peanut paste, infecting huge lots of peanuts along the way. Our peanuts are now causing a silent outbreak deep within the processing facility.

The lots of infected peanut paste – soon to be peanut butter – go unsuspected and are sent to the next phase of processing where they will become cookies, crackers, ice cream, dog treats, etc.

Suzy Public loves peanut butter cookies, so she picks up a package during a routine grocery store visit. Two days later, Suzy is very sick.

Vomiting takes a turn to more severe symptoms so Suzy does the right thing and heads to her doctor. In keeping with clinical care guidelines, Suzy’s doctor orders a stool sample which is then sent to a clinical lab where it tests positive for Salmonella. This is obviously important information for Suzy’s doctor who needs to determine the most effective treatment, but it is also important for the public at large, especially for those in her community.

Additional testing at the public health laboratory could link Suzy’s Salmonella to other cases in her area or across the country.

While clinical labs must submit a report alerting epidemiologists of Suzy’s Salmonella, many states don’t require clinical labs to submit isolates (a sample of the Salmonella that made Suzy sick) to the public health lab. The report allows epidemiologists to gather initial exposure information on cases, but identifying potential outbreaks among sporadic cases can be tough without additional information. An isolate allows the public health lab to subtype or get DNA fingerprints from the Salmonella (more on this below), providing greater information and more rapid outbreak detection. So why wouldn’t states require these isolates be submitted? There are likely different reasons for this; one common reason is simply that the states lack resources. Some states can afford to have a courier pick up and deliver those isolates, but not every state is able. It is hard to mandate that the clinical labs handle shipments on their own time and dime. Additionally, some states simply cannot process all of those isolates at their current funding level. Requiring all clinical labs to send those isolates would put an enormous workload on already understaffed public health laboratories.

Once the investigation has been opened, an epidemiologist or public health nurse will contact Suzy Public to begin the investigation to nab the culprit. The first question they will ask Suzy is to list everything she consumed in the week or so prior to getting sick. These interviews allow disease detectives to track patterns in sick individuals’ diets. If everyone ate peanut butter crackers, they can target their investigation.

Could funding cuts to food safety programs make you sick? | www.aphlblog.org

Delays in testing or reporting will delay these disease detectives, and that means Suzy and the others who were made ill may not remember so far back. Even if they do remember and the disease detectives can identify a common food item in their diets, that product may already be off the shelves and in more people’s homes thus exacerbating the outbreak. Additionally, departments of public health face staff shortages that mean overloaded epidemiologists and public health nurses. Their ability to conduct thorough interviews requires ample time – and time is limited when staff are carrying a workload suited for several people.

If that isolate was sent to the public health lab, additional testing is done to confirm Salmonella and to subtype the pathogen. There are over 2,500 subtypes of Salmonella, so the first step in outbreak detection is determining which type has made this individual sick. PFGE testing delves further into the identification of the pathogen by identifying its DNA fingerprint. For example, there could be multiple outbreaks associated with Salmonella Typhimurium at the same time but that doesn’t mean it is the same culprit. Isolating the DNA fingerprints is like a detective pulling fingerprints from a crime scene – when there are multiple offenses committed, fingerprints can link them to the same perpetrator. The DNA fingerprints are then entered into the PulseNet database, a system used to detect clusters nationally. This information is used by epidemiologists to further target their investigation.

But staff shortages in public health laboratories mean not all isolates can be tested, and those that are tested could be delayed. That means less information is making its way into the PulseNet database or it is being entered too late.

Delays or gaps in information make the investigation extremely difficult.

The case of the contaminated peanuts is a complicated one. We know the contaminated peanut butter used to make Suzy’s cookies caused her illness, but identifying those cookies as the source is only the beginning of the investigative process. Was it the flour, sugar, salt, eggs, peanuts, or one or more of the other ingredients that made Suzy sick? And what about the people who were sickened by peanut butter crackers? Or energy bars? Finding the common denominator – and drilling all the way down to where contamination occurred – is very difficult. These complicated investigations can last upwards of a year, but they are being closed without resolution simply because public health departments don’t have the means to keep them open. No resolution means contamination at the processing facility could continue and more people could become ill. It also means the rest of the industry cannot learn from the outbreak and implement changes to improve product safety.

Rapid detection leads to faster recalls of contaminated products. That means fewer people get sick. But our public health system does not have the means to investigate every case of foodborne illness. There are not enough resources to follow up on every cluster.

Without question, more outbreaks would be found if there were sufficient resources to detect and investigate them all. Simply put, funding cuts are ultimately causing more people to get sick.

Advocates continue to work hard to convince decision makers that increasing funding for the public health system is a very good investment in our population. Healthy people are better for every aspect of society. While the advocates are working, public health professionals continue to seek more ways to improve the system with fewer staff and fewer resources. Whole genome sequencing, for example, could provide more information to better understand outbreak clusters, and that could mean less follow up testing which could mean operating with fewer staff. However, implementation of advancements such as whole genome sequencing requires time and money that the system simply does not have.

Every day that you wake up without foodborne illness, thank the public health system. Waking up healthy did not happen without the dedicated men and women working hard to prevent the spread of dangerous bacteria.

When public health works, no one sees it… but it still needs adequate support to continue protecting our health. The disease identification system described above operates on only $40 million annually and is in immediate need of at least an additional $10 million as indicated in the 2015 budget request. To realize significant improvements, CDC funding for food safety should be doubled at a minimum.

Tell Congress that more money is needed for food safety! Follow these two simple steps:

  1. Here is a letter telling Congress that more funding is needed for public health. Complete the information and it will be sent to your elected officials.
  2. Copy the following sentence and paste it into the letter to draw attention to the specific needs for food safety: I am especially concerned with the need for funding to improve our nation’s food safety system. CDC’s food safety office is in immediate need of an additional $10 million as indicated in the 2015 budget request. Without this funding, more Americans will get sick from foodborne illness.

 

 

Anthrax, false research, triglycerides, mea culpa, cellphone freedom

Accidental anthrax

Which is the more likely threat to public safety?  A single big release of deadly organisms by terrorists, the nightmare that fuels much bioweapons research and a string of lookalike novels that are nearly a genre in …

The post Anthrax, false research, triglycerides, mea culpa, cellphone freedom appeared first on PLOS Blogs Network.

MERS-CoV: Why We Are Not Panicking

By Tyler Wolford, Specialist, Laboratory Response NetworkPublic Health Preparedness and Response Program; and Stephanie Chester, Senior Specialist, Influenza Program, Infectious Disease Program, APHL

MERS-CoV: Why We Are Not Panicking | www.aphlblog.orgBy now you have probably heard that CDC has confirmed two cases of Middle East Respiratory Syndrome (MERS-CoV) infection in the US. Both were imported from Saudi Arabia; travelers became sick on their journey and sought care here in the US. This is the kind of stuff that typically gets us, infectious disease and preparedness folks, amped up, reaching for coffee and telling our loved ones we might be working late. We know that MERS-CoV is a serious infection – as of mid-May 2014, there have been 536 laboratory-confirmed cases and 145 deaths of MERS-CoV. However, the laboratory community is accustomed to responding to these situations—and that’s good news for public health. We have written, tested and rewritten preparedness plans, policies and procedures for dealing with novel and/or unexpected events and pathogens. We have dealt with white powders (more times than we can count), influenza A(H3N2)v, re-emerging vaccine preventable diseases and many other threats. In addition, we were given a lengthy (roughly two-year) heads-up with MERS-CoV. And while we know not to expect this luxury every time (we’re looking at you, 2009 H1N1 pandemic), the lead time meant that CDC, public health laboratories, health departments and clinicians were alerted and prepared well before the first US two cases occurred. Efforts by CDC and the public health labs ensured that, when the first cases arrived, they could be rapidly identified so proper precautions and epidemiologic investigations could begin. What are the reasons for our relative calmness despite the arrival of MERS-CoV on our shores? We were – and still are – prepared as the case count mounted on the other side of the Atlantic. Here are the specifics:

  • Planning. MERS-CoV was first reported in 2012 in Saudi Arabia. Once transmission became sustained in the Middle East, public health officials knew it was likely that a case would arrive in the US: we just didn’t know when. We had time to plan our response.
  • An approved test. CDC rapidly developed a real-time reverse transcriptase polymerase chain reaction (rRT-PCR) test which was granted emergency use authorization (EUA) by the FDA on June 5, 2013, and deployed the same month to 44 state public health laboratories and one local public health laboratory.
  • Infrastructure. The Laboratory Response Network (LRN) provided critical infrastructure for rapid distribution of the MERS-CoV test to public health laboratories across the US.
  • Training. Once laboratories received the test, they trained their staff and completed proficiency testing to demonstrate that they were trained and ready to perform testing should the need arise.
  • Experience. With health departments and physicians on alert, over 150 patients with MERS associated symptoms have been tested using the CDC assay. All were found to be negative.  This testing provided valuable opportunities for laboratories to familiarize themselves with the test.
  • Communication. CDC, APHL and other partner organizations have maintained timely communications with states, and others partners to keep everyone abreast of the current situation.
  • Dedication. Our public health labs are full of amazing scientists who are willing to spend countless hours, seven days a week to ensure rapid test results.

So if we aren’t panicking now that we have MERS-CoV cases in the US, what are we doing? We’re sprinting to keep pace with MERS-CoV and so far we have performed well, managing every step in the process with precision.

  • Indiana promptly notified CDC of a presumptive positive MERS-CoV infection and CDC rapidly confirmed this result.
  • CDC and Indiana started epidemiologic investigations and tested samples from close contacts of the infected patient.
  • APHL and CDC began communications immediately after the first case was confirmed.
  • APHL, in collaboration with CDC, held a laboratory alert call on May 6, 2014, to provide state and local public health labs with a situational update and to review laboratory testing guidance.
  • Currently CDC is distributing new proficiency testing panels so labs can refresh their competency on the CDC MERS-CoV test.

MERS-CoV is a serious threat that deserves the highest level of preparedness and attention.  Fortunately for the American public, we in the public health system are poised to handle MERS-CoV and other health threats whenever, wherever and however they enter our country. This is why we aren’t panicking, but it’s also why public health requires steady support.  Pathogens have no regard for budgets, funding cycles or economic trends. They won’t wait, and neither can we.

Project Tycho: Vaccines prevent diseases!

Tycho Brahe, Image from Wikipedia

Tycho Brahe, Image from Wikipedia

I just heard about a new “big data” project called Project Tycho. They chose the name Tycho in honor of Tycho Brahe who made tons of detailed observations of the stars and planets. After his death, his data was used by Kepler to formulate the laws of planetary motion. This project wants to connect the vast amounts of public health data to scientists and policy researchers to improve their understanding of contagious diseases and their spread. Their undertaking is incredible; they digitized weekly Nationally Notifiable Disease Surveillance System reports from 1888-2013. Now that all of the data is digitized they are working their way through standardizing it and making it amenable to analysis. This entire dataset is available for search online.

Recently, the New England Journal of Medicine published their description of the project along with data from the first analysis done on this new resource. They looked at 8 different vaccine preventable diseases (smallpox, polio, measles, rubella, mumps, hepatitis A, diptheria, pertussis) and looked at the rate of incidence before the introduction of a the vaccine. They assumed that there were no other major reasons that the rate of infection of the diseases would change other than the vaccination increase. They estimated that 103.1 million cases of these 8 diseases had been prevented since 1924. Now when you think back that sometimes these diseases can be fatal, these vaccination programs have made a huge difference in child health, and population health in general.

This data also exposes increased rates of 4 of these diseases (measles, mumps, rubella, and pertussis) in recent years. This could be attributed to pockets where vaccination rates have dropped due to personal or religious reasons. It’s not really possible to know definitively with this particular data. While the rates of these diseases seem incredibly low and the perceived risk of infection seems low, the current rates of infection are low due to years and years of vaccination. The risk of the unvaccinated is actually much higher than it would appear.

This large data project will be invaluable resource in evaluating vaccine program effectiveness and it will help to guide and record future vaccination programs.


Filed under: Follies of the Human Condition, This Mortal Coil Tagged: Big Data, Centers for Disease Control and Prevention, disease surveillane, Tycho, Tycho Brahe, vaccine

Don’t Fear the Toilet Seat!

Photo via Cheezburger.comFomite” isn’t a word that most people hear very often. However, if you’re a microbiologist (or are under the influence of one), you are likely to find yourself considering fomites as you go about your day. Fomites are everywhere, are difficult to avoid, and while it’s a good idea to be aware of fomites, they should not be feared.

It could be a TV remote control. A pen on one of those chains at the bank. A doorknob. A subway pole. All potential fomites. Basically, any inanimate object could transmit infectious agents (e.g., bacteria, viruses) from one person to another. Things can be contaminated as a result of handling, droplets from a cough/sneeze, or contact with other bodily fluids. I educated the audience (and embarrassed my friend…) hissing “Fomites!” (loudly, apparently) during the movie Contagion.

Despite the fact that we’re surrounded by fomites, fear isn’t warranted. If you are in good health, and practise common-sense hygiene (e.g., washing your hands … more than once a day …) then you probably have little to worry about. People often worry about items that are much less dangerous than one might think.

The item that may be most feared: the toilet seat. Not surprising as bathrooms are hardly havens of hygiene. What many people worry about is the possibility of acquiring a sexually transmitted pathogen – “venereal disease” (VD), “sexually transmitted disease” (STD), or “sexually transmitted infection” (STI). STI has come into greater use, reflecting that many of these pathogens may be asymptomatic, or cause mild symptoms that may not be recognized as “disease” in infected individuals. While there is certainly cause for concern about rates of STIs (particularly the increasing incidence of multi-drug-resistant gonorrhoea;  also, gonorrhoea, chlamydia, and syphilis can lead to serious complications, such as pelvic inflammatory disease, resulting in chronic pain and/or infertility) toilet seats are not going to put you at risk of these infections.

Why not? Well, microbes have diverse lifestyles. The bacteria that cause chlamydia, syphilis, and gonorrhoea are transmitted primarily by sex—close contact between skin/mucous membranes. Able to attach to the epithelial cells of the urethra, cervix and other regions of the urogenital tract, these bacteria invade, sometimes spreading to other parts of the body in later stages of infection. Outside of the host, though, these cells are surprisingly fragile, susceptible to stresses of the external environment—ill-equipped to lurk and linger infectiously on the surface of the toilet seat (very different from hardier bacteria that aren’t spread sexually, like E. coli, Mycobacterium tuberculosis, and many others).

Perhaps the most feared sexually transmitted pathogen is HIV, but this virus too is unlikely to remain viable for long outside of the body and blood. HIV is usually transmitted through a cut/break in skin or mucous membranes, and the chances of getting this virus from a toilet seat are incredibly miniscule. Ditto for those pesky genital herpes viruses.

So, while squatting over the toilet might be a good workout for your quadriceps, it’s probably unnecessary if you’re just trying to prevent your butt from touching a toilet seat. How to protect yourself? Get tested, use condoms, and take responsibility for your sexual relationships. Oh, and if a partner tries to tell you that he/she acquired an STI from a toilet seat, Science Cat can assure you that you would be justified in being highly skeptical of such a claim.

Tanya Noel teaches introductory and medical microbiology at the University of Windsor in Windsor, ON, Canada. She’s interested in improving science education at the post-secondary level, and is the proud owner of three cats who feature regularly in her #Caturday tweets. Follow @TCNoel on Twitter.

Photo via Cheezburger.com

More info about STIs:
Sexually Transmitted Diseases – Information from CDC http://www.cdc.gov/std/

Sexually Transmitted Infections (STI), Sexual Health Facts, and Information for the Public (Public Health Agency of Canada) http://www.phac-aspc.gc.ca/std-mts/faq-eng.php