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Foot-In-Mouth Prevention

There are simple and easy ways to prevent various infections that impediment the well-being of children and adults, through low-cost convenient methods that would take about 40-60 seconds. One of these, handwashing with clean water and soap, lies within our households.

There are simple and easy ways to prevent various infections that impediment the well-being of children and adults, through low-cost convenient methods that would take about 40-60 seconds. One of these lies within our households, in the simple daily practice, of handwashing with clean water and soap.

Hand hygiene is a cost-effective strategy towards preventing various gastrointestinal diseases, urinary tract infections and respiratory infections caused by viruses, bacteria and fungi. The Covid pandemic taught us the importance of handwashing as our ritual of control, became a central pillar towards prevention against the spread of the Coronavirus. Washing our hands at regular intervals – before meals, after using toilet, and after contact with contaminated surfaces such as door knobs, helps guard against infections. Soap molecules destabilise micro-organisms that reside on hands and the rubbing of hands disintegrates them. The pandemic taught that the risk of microbial infections transmitted via air, water or other surfaces can be reduced by just washing hands thoroughly with water and soap.

Let us understand the kind of diseases that one is susceptible to if hands are not washed properly, as microbes have no boundaries when it comes to transmission. They can merrily work their way through water, air, food, or other medium. The diseases include:

1. Diarrhoea: Commonly caused by bacteria such as E. coli, viruses such as rotavirus/noroviruses and parasites like Giardia, children are particularly susceptible to it. These can spread through food and water mainly, and handling these with unclean hands can bring you down. Handwashing can reduce the risk of diarrhoea by 47%, and prevent dehydration and impediments to cognitive performance among children.

2. Acute Respiratory Infections: These are commonly caused by Streptococcus pneumoniae, Klebsiella pneumoniae, rhinoviruses, influenza viruses, coronaviruses and Tuberculosis. Handwashing can reduce exposure to these by over 24%, and prevent sickness and hospitalisations.

3. Typhoid: An acute diarrhoeal disease accused by Salmonella, this can lead to severe sickness within hours if left untreated. There are vaccines to combat typhoid, but one can still be affected. Given that various strains circulate in different years, vaccines are unable to guarantee full protection. But they can help in getting away with mild symptoms. However, handwashing with soap prior to contact with food such as during preparation, handling, or consumption, can drastically reduce the contamination of food and water, and prevent the disease.

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4. Hepatitis A: A common viral infection caused by contaminated food and water, and improper handwashing can create havoc in the body through the symptoms of jaundice.

5. Foot Mouth Disease: It is caused by enteric viruses, and enters the body through oral route. So does the Polio viruses, which are almost eradicated. Improper handwashing, touching or even consuming contaminated food and water, and animal handling can lead to these infections which have serious implications.

6. Stunting And Malnutrition: Repeated bouts of diarrhoea and gastrointestinal diseases or respiratory distress can cause poor physical growth in early life, affecting development and cognitive performance.

7. Poor Immunity: Repeated occurrences of preventable diseases may take a toll on the immune system, and its ability to respond causing weakness, loss of appetite, and nutrition deficiencies. This lowers quality of life, especially when the body is inflicted with infections like MRSA (Methicillin-Resistant Staphylococcus Aureus). Handwashing works as a critical line of defence.

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8. Worm Infestation: Soil-transmitted helminths are one of the most common sources of infections, and include species like the roundworm (Ascaris lumbricoides), whipworm (Trichuris trichiura) and hookworms (Necator americanus and Ancylostoma duodenale). These are transmitted through the ingestion of eggs by children and individuals exposed to contaminated soil. These worms wreak havoc on nutritional status, causing diseases such as anaemia, malabsorption of nutrients and poor physical health. Hence, handwashing prior to a meal for 40-60 seconds can vastly reduce the risk.

9. Antibiotic Resistance: Handwashing can reduce the risk of infectious diseases, lowering the need for treatment with antibiotics, and reduce antibiotic resistance like drug-resistant tuberculosis or even amethicillin-resistant stubborn staph infection. It can extend the efficacy of antimicrobials and antibiotic agents which in today’s times seems to be a challenge.

Our world has witnessed various outbreaks and diseases in recent years due to the culmination of various factors, including unprecedented changes to environment, temperature and precipitation fluctuations. As trends in previous epidemics have shown, good hygiene practices and behavioural improvements increase with an increase in fear of disease, but wane over time.

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While the benefits of the habit of handwashing were communicated widely through national awareness programmes at the peak of the Coronavirus epidemic, we need to sustain such behaviours even as vaccination coverage increases and the risk of disease decreases

While the benefits of the habit of handwashing were communicated widely through national awareness programmes at the peak of the Coronavirus epidemic, we need to sustain such behaviours even as vaccination coverage increases, and the risk of disease decreases. Handwashing allows us to keep our guard up against diseases and infections, so it is important to continue to advocate for this simple, everyday practice in households and communities.

Covid has given us the impetus to normalise this fundamental public health intervention across healthcare facilities, schools, communities, and homes as an effective method towards disease control. Let us not forget the magnitude of economic and financial costs arising from morbidity and mortality costs of treatment, income loss, school absence and lost productivity due to sickness and ill-health. Just think about it: these costs can be avoided by integrating a simple, low-effort practice into daily lives.

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(With contribution from Pankhuri Jain of BDO in India)

Dhrubaa Ghosh Healthcare Advisory Expert, BDO in India

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