Mini Reviews

Cough/Sneeze Etiquette?

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It’s heading into Influenza season. Very soon. Any moment now. Any minute. Well, hopefully after all this hot air blows out of Australia but it doesn’t hurt to get our guards up. Especially since so many people around me are dropping off like flies to some summer cold.

Whenever some sick person around me sneezes or cough, I automatically get very antsy about whether they’re sneezing into their hand or their elbow. It’s the elbow! Get with the times people! I cry. In my head. With fists shaking. (This is all in my head).

Then I thought about whether this had actually been investigated. So off I go googling a storm and all I find is one study from September of 2013 (eons ago) by Zayas and his crew. That is really all I find and thankfully, Zayas et al also feel that there should be more.

Infectious respiratory diseases such as the pandemic Influenza, the furiously mutating avian Flus and more worryingly, the reemerging Mycobacterium Tuberculosis are all spread via aerosols. Droplets coughed or sneezed from infected individuals are carried in the air and then breathed in by unsuspecting patients. Thus, it is of particular importance that we all do cover our mouths, use tissue blockades and do all manners of cough etiquette in order to prevent transmitting serious diseases to others. And while there is some belief that this is somewhat helpful, the September 2013 paper tells us it is really not that helpful. Not even when coughing into the elbow.

In fact, all it does is expel the particles in another direction. There appears to be no difference between using a tissue or not either. This is bad bad bad, because while pathogens are getting very good at reinfecting human bodies and spreading exponentially, we’re not doing very much to stop them from getting into us. Zayas et al conclude that we need more studies on cough etiquette to improve on ways to prevent the leak of infectious droplets from our mouths. Their paper is in no way a comprehensive one, so the scientific community would do well to hop on it no matter how trivial it may seem because ultimately, its results could have broad implications in greatly reducing the spread of pandemics and break that Influenza season.

The only saving grace is that although using our hands to cover our mouths may not block many droplets from being released into the air, we are better off using something else like our elbow or a tissue because once we shake someone’s hand or touch a surface, we inadvertantly transfer bits of the virus/bacteria/fungi from our hands to them.

Plus, we’d all do very well just by washing our hands thoroughly with soap and water. The power of soap!

Effectiveness of cough etiquette maneuvers in disrupting the chain of transmission of infectious respiratory diseases 2013 Zayas et al. http://www.biomedcentral.com/1471-2458/13/811

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