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Delivering chicken soup to your roommate who’s been throwing up? Sitting in a lecture hall with a coughing classmate? Wondering why you’re under pressure to get a flu shot? College and university living offers frequent reminders that sometimes it’s not cool to go viral. Most of us think we know how to avoid common infections, or at least minimize our chances of catching that cold or stomach bug. Even so, at SH101, we learned a few things developing this quiz, and we figure you’ll learn a few things taking it.

Here’s why common infections matter. Given the intensity and pace of a school semester, getting sick can leave its mark—and not a good one. In a 2016 survey of more than 43,000 Canadian undergraduates, one in five of those who had experienced a cold, flu, or sore throat in the last 12 months said it had hurt them academically (in most cases, a lower grade for an exam or course, according to the National College Health Assessment). That’s in addition to the serious health complications that can sometimes arise from commonplace illnesses, even in otherwise healthy people.

1. What’s the best way to sneeze or cough?

A.Into your printed assignment for good luck
B.Into your elbow or upper sleeve
C.Into your hands
D.Into a cough-catcher
E.Into a tissue
F.Letting it go free and loud in the dining hall in order to release your chi and om
Click for the answer


D. Into a cough-catcher

The cough-catcher is a real thing—a small envelope-like device containing a filter. Feeling a cough or sneeze coming on, you whip it out of your pocket (speed matters) and stick your nose and mouth it. The cough-catcher is inexpensive, more discreet than wearing a mask, and good for multiple uses. In tests, the cough-catcher was the most effective method of containing germs, according to the science journal PLoS One (2011).

+ Check out the cough-catcher


E. Into a tissue

Tissues can work quite well for containing airborne germs, as long as they don’t tear. In the same PLoS One study, 4-ply tissues “opened and ready in the hand” were more effective than shielding the cough or sneeze with a hand. Toss the tissue afterward and wash your hands with soap (see question 4).


B. Into your elbow or upper sleeve

Coughing and sneezing into your inner elbow or upper sleeve helps contain the germy, aerosolized particles, says Health Canada. This keeps them off your hands, so you can’t transport them to your eyes, nose, and mouth, where they find an easy way into the body. In a study, 10 people were filmed working at their desk for three hours; they touched their eyes, nostrils, and lips an average of 16 times an hour (Journal of Occupational and Environmental Hygiene, 2008).


A. Into your assignment

Cold viruses can live for six hours outside a human body. We couldn’t find any data on how long they live on paper, or whether the nature of your assignment may shorten or prolong their will to live. Again, assume that surfaces are commonly contaminated, practise good hand washing hygiene, and avoid touching your eyes, nose, or mouth.


C. Into your hands

F. Letting it go free and loud in the dining hall

Coughing and sneezing into your hands means you’ll likely spread live viruses to anything you touch—like faucets, doorknobs, and countertops. Coughing or sneezing freely, without containing it, spreads infectious droplets into the air, where they can be inhaled by others, and onto surfaces, including any nearby food, dishes, or utensils.

+ Common cold (Canadian Centre for Occupational Health and Safety)

2. What’s that pain you’re feeling?

You’re unusually tired but pushing through. Now you’re getting a sharp pain in the left of your abdomen. What condition might cause this?

B.Mononucleosis (mono)
C.Bad karma
Click for the answer


B. Mononucleosis (mono)

  • Once in a rare while, mono causes an innocent spleen to burst—usually in the first month of the illness during strenuous physical activity. That’s a medical emergency, so get on it. But it’s more likely that mono will hurt your grades than your spleen. You’ll have a sore throat and maybe a headache or fever, and feel fatigued for weeks. Some mono-stricken students have to take time out or repeat classes.
  • Mono is usually caused by the Epstein-Barr virus (EBV). This virus is common and stays with you forever—although mono symptoms don’t. There’s no cure for mono, but while you’re waiting it out, acetaminophen or ibuprofen can help alleviate the symptoms.
  • You can get mono from kissing a currently or recently infected person. And from sharing toothbrushes, cups, or utensils.
    • Downside: You can’t always know who has (or has had) mono. People can spread mono to someone
      else while they’re sick and for up to a year later.
      Mono symptoms appear four to six weeks after exposure.
    • Upside: Mono is not spread via respiratory droplets, so you’re less likely to catch it from your roommate than, say, a cold or flu. Outbreaks are rare.
  • Also good to know: Appendicitis pain tends to begin around your navel or on the lower right side of your abdomen, according to the Mayo Clinic.

+ Mononucleosis (University of Guelph)

3. Think you know how to wash up?

Conscientious hand washing is key to avoiding some common infections. What’s the most effective way to wash your hands?

A.Using hand sanitizer containing at least 60 percent alcohol
B.With running water and soap while singing three verses of Beyoncé’s “Fever”
C.In the waters of a bubbling brook by the light of a crescent moon
D.It’s more about the drying than the washing
Click for the answer


B. With running water and soap while singing three verses of Beyoncé’s “Fever”

The song is to time yourself. To effectively wash your hands, you need to soap up for 20 seconds, which seems to take forever. The standard self-timing advice is to sing “Happy Birthday” twice, but SH101 staffers felt that could be improved on. Beyoncé’s “Fever” is metaphorical—she’s singing about being in love—but love is a sickness, obvs.

+  Beyoncé’s “Fever” (YouTube)
Strictly, “Fever” is not Beyoncé’s song. It was first recorded by Little Willie John in 1956, and pretty much everyone has covered it since. Beyoncé used it to promote her perfume brand. This video includes lyrics.


A. Hand sanitizer containing at least 60 percent alcohol

Here’s what Health Canada says: “Antiseptic skin cleansers should be recommended for use on lightly soiled hands only as a second-line approach or when soap and water are not available.” The FDA in the US adds: “Sanitizers do not eliminate all types of germs and might not remove harmful chemicals.” Hand sanitizer doesn’t work against the norovirus, for example.

Here’s what you need to know about hand washing, according to Health Canada and the Public Health Agency of Canada:

  • Many diseases and conditions are spread by unclean hands. What we think of as the common cold is actually a cluster of similar symptoms that can be caused by any one virus out of hundreds. Those viruses can live for up to six hours outside a human body, and are commonly spread by people touching a contaminated surface and then touching their eyes, nose, or mouth.
  • Soap is preferable, especially if your hands are visibly dirty or greasy, says Health Canada. Here’s how:
    • Wet your hands and wrists with clean, running water (warm or cold), turn off the tap, and apply soap. If clean, running water is not available, use soap and whatever water you have access to.
    • Lather your hands by rubbing them together
      with the soap. Be sure to lather the backs of your
      hands, between your fingers, and under your nails.
    • Scrub your hands for at least 20 seconds.
    • Rinse your hands well under clean, running water.
    • Dry your hands using a clean towel or air-dry them.
    • Turn off the running water with a towel or cloth if possible.
  • Don’t skip the drying. “Germs can be transferred more easily to and from wet hands,” says the CDC in the US. Using a clean towel or air-drying seems to work best.

4. Which of these does not give you significant protection from the flu?

A.Hand washing
B.A healthy lifestyle (good nutrition, sleep, and physical activity)
C.Vitamin or homeopathic supplements
D.Organic snail venom
Click for the answer

Trick question! None of these will protect you from the flu. By far the most effective flu preventative is the flu shot. Here’s why:

  • The flu shot works pretty well Flu viruses are highly contagious. The only two ways of developing immunity to a particular virus are through vaccination or natural exposure; vaccination is safer. The flu shot provides protection from the influenza viruses that are likely most predominant in any given season. For young, healthy people with relatively strong immune systems, the vaccine’s effectiveness is more than 65 percent. This is not a perfect vaccine, but if you don’t get it, your protection is zero percent. Your flu shot also helps protect people around you who are at higher risk of complications from influenza. You cannot get flu from the flu shot.
  • Hand washing is great but doesn’t work for this Flu viruses spread predominantly in droplets sneezed, coughed, or exhaled by an infected person; these are inhaled by others. A study found that people within six feet of a patient with the flu could be exposed, according to the Journal of Infectious Disease (2013). Hand washing is far more effective against germs that are commonly spread via contaminated surfaces, such as colds and noroviruses. + Influenza (Government of Canada)
  • Healthful habits are great but don’t work for this While good habits are vital for health, they cannot equip us with the antibodies that can fight off a specific virus. “The flu shot has protein in it that is [similar to] the protein in the influenza virus. Your immune system responds to that and develops antibodies, and the antibodies protect you if you’re exposed to that strain of influenza later,” says Dr. Bonnie Henry, Deputy Provincial Health Officer for the Province of British Columbia and Associate Professor of Medicine at the University of British Columbia.Can your healthy habits create those antibodies? Unfortunately, no. “Health behaviours strengthen the immune system to some extent in the sense that the healthier we are in general, the more likely our immune system is able to handle exposure to all types of infections. But the reality is that none of those things are sufficient to prevent exposure to this virus or eliminate your chances of getting the flu,” says Dr. Shelly McNeil, Clinical Investigator at the Canadian Centre for Vaccinology, Nova Scotia.
  • Vitamin and homeopathic supplements don’t work “There are homeopathic products called nosodes that some homeopathic practitioners say will protect from infections and are vaccine substitutes. These have never been shown to have any benefit, and Health Canada has recently required them to be labelled, noting the product is not a vaccine or an alternative to vaccination. They don’t have any active ingredients that help your body fight off infection. They can’t replace immunization,” says Dr. Henry. In 2008, the manufacturers of Airborne, a vitamin and herbal supplement that had been marketed as “boosting” the immune system and improving germ resistance, agreed to refund $23.3 million to consumers as a penalty for false advertising.
  • Organic snail venom will kill you, if it’s from sea snails Sea snails are super-venomous; the venom can kill a human in half an hour. It is useful to neuroscientists, however, in the study of nerve cells, and may help them develop treatments for various diseases. “‘Milking’ the live snails is a hazardous business,” said the journal Nature (2004). So definitely don’t do that.

5. Match the pathogen images to the diseases

5 different pathogens under a microscope

A.Mononucleosis (mono)
B.Influenza (flu)
C.Strep throat
D.Urinary tract infection (UTI)
Click for the answers

Influenza under a microscopeInfluenza (flu) Cute from a distance, spiky up close, and so commonplace that it may seem relatively benign, but actually it’s far more deadly than HIV and AIDS.

The flu is so commonplace that it’s easy to forget how much damage it can do—including to young, otherwise-healthy adults. Every year, between 10–20 percent of the Canadian population is infected with influenza and an estimated 20,000 are hospitalized.

UTI under a microscope Urinary tract infections (UTIs) Fluffy on the outside, it’s prone to sneaking in then sending people dashing to the pharmacy for pain relief. UTIs are the most common bacterial infection, and they can be shockingly uncomfortable. Most cases are caused by bacteria from the gastrointestinal tract (E. coli) spreading from the anus to the urethra. For obvious anatomical reasons, UTIs are far more common in people with vaginas. UTIs can be triggered by sex; it’s helpful to pee after intercourse to flush out the urethra. UTIs can be treated with over-the-counter pills and prescribed antibiotics. Untreated UTIs can lead to kidney infections, which can cause serious health complications.

+  UTIs (The Kidney Foundation of Canada)

Strep throat under a microscopeStrep throat This bacterium lurks in pairs or gangs, hits its targets when they’re down, and makes them sore, itchy, or maybe even obsessive.

If you have a sore throat, sometimes with swollen lymph nodes, fever and chills, headache, or a rash, it may be caused by a bacterium, Streptococcus pyogenes or group A streptococcus. Strep is highly contagious. It spreads through airborne droplets and shared food. Research suggests that strep throat can trigger obsessive-compulsive behaviour and tics in some children, according to the Journal of Neuroimmunology (2006). Strep throat is treated with antibiotics. The same bacterium can cause a bunch of other conditions, from relatively mild (such as impetigo) to serious, such as necrotizing fasciitis (“flesh-eating bacteria”), streptococcal toxic shock syndrome, and pneumonia.

+  Strep throat (HealthLinkBC)

Mononucleosis under a microscopeMononucleosis (mono) It looks innocuous enough, spreads through intimacy, and is loyal to a fault—staying with its targets forever.

     See question 3.

Norovirus under a microscopeNorovirus Like a flaky love interest, it shows up without warning, turns its targets weak and fluttery, and leaves them drained.

     See question 2.

6. Can you keep your stomach from turning?

The norovirus causes diarrhea, vomiting, and stomach pain. It is responsible for outbreaks in places where people hang out together waiting for something exciting to happen, such as in residence, on cruise ships, and at hip vegetarian restaurants. Can you correctly answer these yes/no questions about the gut-wrenching norovirus?

A.Disinfecting wipes do not kill the norovirus—yes or no?
B.Most disease outbreaks related to contaminated foods are caused by food workers infected with the norovirus—yes or no?
C.Each gram of diarrhea from an infected person contains 5 billion particles of norovirus—yes or no?
D.Being exposed to only 20 viral particles is enough to make someone sick—yes or no?
E.Norovirus is named for a northern English scientist who initially believed the cause was bacterial: In his dialect, “not a virus” sounds like “norravirus”—yes or no?
Click for the answer

All these statements are true except for #5, which our editor made up while visiting family in northern England. Here’s what you need to know about this gut-wrenching bug:

  • Norovirus is a highly contagious stomach bug. Even minimal exposure to an infected person’s feces or vomit can make you sick.
  • Noroviruses become airborne when someone throws up or flushes a toilet. Make it a habit to lower the toilet lid before you flush and keep your toothbrush in the cabinet.
  • Norovirus is hard to kill. It can survive many common disinfectants and hand sanitizers, freezing temperatures, and heat. It can hang out on countertops, dishes, toilet flushes, and doorknobs for up to two weeks.
  • Health Canada recommends that when someone in the residence has a gastrointestinal illness, you clean with chlorine bleach solution (5–25 tablespoons of household bleach per gallon of water). And wash your hands thoroughly and frequently, using soap (again, hand sanitizer won’t work).
  • Over 300 outbreaks of norovirus occur every year, according to the Public Health Agency of Canada, making its prevalence second only to the common cold.

+ Norovirus (Government of Canada)

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Article sources

Tim Lahey, MD, associate professor of medicine and associate professor of microbiology and immunology, Geisel School of Medicine, Dartmouth College, New Hampshire.

Paul Offit, MD, professor of vaccinology and professor of pediatrics, University of Pennsylvania School of Medicine.

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