We welcome you to our blog, where our idea is to offer you useful, interesting content, and above all, scientifically proven. From Babygiène we will always focus on hygiene and the baby's environment. How could it be otherwise, we launched this first post on hand hygiene to answer many of the questions that you will be asking yourself these days.

Coronavirus & Co

Following the declaration of a pandemic by the World Health Organization (WHO); We see how the containment measures of the SARS-CoV-2 coronavirus, better known as COVID-19, are tightened to try to stop and eradicate it. Although it is a complicated and worrying situation, we must remain calm and follow all directions from reliable sources and healthcare professionals. We take this opportunity to thank them for the great work they are doing these days, their professionalism, and above all, the calm they transmit to us even knowing that the vast majority of the population has panicked.

This pandemic must teach us something: today it is a coronavirus and tomorrow it could be any other pathogen. All the hygienic measures we take cannot be temporary. We must think in the long term, in the collective and not in the individual.

Because the big problem is not the “coronavirus pandemic”; the big problem is the "panic pandemic". From stocking out supermarkets to running online "Recipes" to create your own hydroalcoholic gel at home. As many of our mothers would say: the soda experiments.

Why you should not make your own hydroalcoholic gel for hand hygiene

We have all gone to ask Mr. Google how you can make an antiseptic gel at home. And Mr. Google has answered us. Unfortunately, our reference search engine does not have the criteria to decide which result is the most reliable; and unless we add the correct magic words and the initials "OMS" we will surely not reach the guide that said organization released.

Oh, but does the WHO have a recipe guide? Well, if the WHO says so, we do it, right?

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Well, no. Precisely, The guide published by the WHO is for health personnel who, after the shortage of alcohol-based gels, sets the guidelines for the preparation of this antiseptic. Now, in our houses we do not have the measurement material (test tubes, pasteaur pipettes ...) or the ingredients in pure concentrations. Sorry, but hydrogen peroxide from the supermarket and distilled water from the iron are not the best options.

In the pharmacy there is no antiseptic hand gel, what do I do?

Wash your hands. Sorry, let's specify better: wash your hands properly. This means that for 40-60 seconds you must follow the steps that we teach you below to perform proper hand hygiene.

Hand hygiene with soap and water: does it work?

To answer this question, we will first go back to a curious historical fact and then, we will dive into bacteria, viruses and other pathogens so that you understand why HYGIENE, in capital letters, is so important.

Autopsies and deliveries

In 1846 Ignaz Semmelweis observed how the Vienna Hospital, of the two maternity units existing, one of them had a much higher mortality rate than the other due to puerperal fever. After evaluating the similarities and differences between each unit, I observe an illuminating fact: In the first unit, deliveries were attended by students who had performed autopsies in the morning, while in the second unit, deliveries were attended only by midwives.

One of Semmelweis' colleagues who worked in the autopsy area made an accidental cut with the scalpel and within a few days presented the same symptoms as puerperal fever. Tying up dots, Semmelweis determined that there were "cadaveric particles" that passed from the hands of the students to the pregnant women, infecting their blood and causing them to die. Today we know that these "particles" are pathogens that cause infections.

Thanks to this discovery, hand hygiene and disinfection were established, which lowered mortality after delivery to less than 2%.

What do we have in our hands

Human skin is colonized by bacteria; specifically, according to several studies carried out between 1938 and 1998, the skin of the hands of health personnel can present between 39 thousand and 4.6 million bacteria.

The bacteria on our hands can be differentiated into two groups: transitory and resident.

The transient bacterial flora lies so superficial on our skin and they are organisms most frequently associated with infections. These types of pathogens are the ones that we can remove more easily with proper hygiene.

The resident bacterial flora is in the deep layers of skin and they are organisms less likely to be associated with infectious processes.

Alcohol-based soap or gel?

The normal soap it has minimal microbial activity, however can remove lightly attached transient bacterial flora. That is, if you have sneezed on your hand or touched a surface that could be infected, proper hand hygiene with soap and water would eliminate pathogens. If we do not have soap and water, we can use hydroalcoholic gel.

Now, not all soaps or all alcohol-based gels work for all microorganisms. Luckily, for the topic that concerns us with the coronavirus COVID-19, soap and water works perfectly, and so does the gel, although we would use the latter mainly for healthcare personnel and for more exposed groups.

Healthcare personnel dealing with patients should preferably use disinfectant gel due to its speed and effectiveness, which is necessary in the hospital setting.

And for a flu? Gastroenteritis? Serving?

It depends. Each bacterium, virus, fungus and microorganism in general is made up of a structure. Some bacteria have a "capsule" that protects them, some viruses have an envelope and others do not, there are microorganisms that produce resistant spores ... Lipids, proteins ... Depending on the composition of the pathogen, it will be more or less easy to destabilize its structure to eliminate it.

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Therefore, from there I refer to the "recipes" that run online; A homemade alcohol-based gel is not the same as a gel intended for sanitary use:

• Alcohol concentration is related to effectiveness: a 60% concentration is equivalent to a hand cleaning with soap and water. The effective concentrations are between 60-95%. Higher concentrations are less effective; the less water in the formulation, the more difficult it is to denature proteins.

• To increase effectiveness from alcohol or isopropanol other antiseptics are usually added, such as chlorhexidine, quaternary ammonium compounds, triclosan, among others. They all attack differently, so where one does not go, the other does.

• Many of these antiseptics present a decrease in its effectiveness in the presence of visible dirt. In other words, for them to work optimally, we must carry out hand hygiene with soap and water or have practically clean hands.

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A clear example where hygiene with soap and water is more effective than any disinfectant is with bacteria Clostridium difficile, causing diarrhea and more serious intestinal conditions. This particular pathogen creates spores that can survive on a surface for weeks or months.

Conclusions

Let's avoid the pandemic of fear, let's stay calm. Regular and regular hand cleaning is effective against microorganisms.

Healthcare personnel need antiseptic gels on a daily basis; they are exposed, so if we use this type of gels, let's do it with our heads. Using them is not a substitute for washing our hands.

We have lived in an age where the shadow of a pandemic seemed far away; We have had false security. We have relaxed, and measures as simple as washing your hands correctly (not with a little water, soap, 5 seconds, and that's it) we have parked as unnecessary. Reeducation for us and education for our children.

Bibliography

CDC Morbidity and Mortality Weekly Report. Guideline for Hand Hygiene in Health-Care Settings Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC / SHEA / APIC / IDSA Hand Hygiene Task Force; 2002 Oct; Vol. 51 / RR-16

Price PB. Bacteriology of normal skin: a new quantitative test applied to a study of the bacterial flora and the disinfectant action of mechanical cleansing. J Infect Dis 1938; 63: 301–18.

Larson E. Effects of handwashing agent, handwashing frequency, and clinical area on hand flora. Am J Infect Control 1984; 11: 76–82.

Maki D. Control of colonization and transmission of pathogenic bacteria in the hospital. Ann Intern Med 1978; 89 (Pt 2): 777–80.

Larson EL, Norton Hughes CA, Pyrak JD, Sparks SM, Cagatay EU, Bartkus JM. Changes in bacterial flora associated with skin damage on hands of health care personnel. Am J Infect Control 1998; 26: 513–21.

Oughton MT1, Loo VG, Dendukuri N, Fenn S, Libman MD. Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile. Infect Control Hosp Epidemiol. 2009 Oct; 30 (10): 939-44