Rightly or wrongly, a good outbreak can be exciting. Don’t get me wrong, it’s not the impact of illness that interests me – I’m not that heartless. What fascinates me is what we learn when a new “bug” pops up or what we “relearn” when we get hit by “bug” we know how to handle. When it comes to infection prevention, we cannot relax and become comfortable because everything is ticking along smoothly and most importantly, just because nothing has happened in a while we cannot afford to lower our defences.
That said, keeping ourselves and others healthy is about finding the balance between being too cavalier and too paranoid. Take a recent article I read about the cleanliness level of highchairs in restaurants in the UK. The BBC revealed that restaurant highchairs are dirtier than tables at several different restaurants. Surprisingly to some, the highchairs tested at McDonald’s were cleaner than the tables. While the level of bacteria found on the highchairs was significantly higher than expected, it was still not at a level that would cause health concerns. Of concern was the fact that coliform bacteria were found, as this type of bacteria is associated with waste from humans and animals. In fact, coliform bacteria are often referred to as "indicator organisms" because they indicate the potential presence of disease-causing bacteria, particularly in water. Thankfully, the bacteria found on the highchairs can easily be removed and/or killed with diligent cleaning, sanitizing or disinfection.
The question is if as a society we need to start to panic that highchairs in restaurants could be the harbingers of doom for our babies. Let’s mull this over and use a little common sense.
- Unlike viruses, bacteria have the ability to reproduce. When conditions are favourable such as if the right temperature and nutrients are available, some bacteria like Escherichia coli can divide every 20 minutes. This means that in just 7 hours one bacterium can generate 2,097,152 bacteria.
- A large percentage of infections and outbreaks are spread by contaminated hands. Appropriate hand washing practices can reduce the risk of foodborne illness and other infections. According to the WHO, adherence to HH by HCWs ranges from 5% to 89% with the overall average being 38%! If healthcare workers have poor hand hygiene practices, you can be sure the public is much worse.
- Highchairs in many restaurants are often stored in readily accessible areas, meaning they could be considered a high touch surface.
- Depending on the restaurant, highchairs may sit for some time between usages.
- Cloths used to clean surfaces where food is prepared need to be changed regularly or thoroughly disinfected to prevent the growth of bacteria. Bacteria on uncleaned cloths can transfer to the hands of staff then on to work surfaces, equipment and utensils.
What does this mean? Well, pathogens are easily spread from hands to surfaces and surfaces to hands. Restaurants tend to use the reuse cloths for cleaning tables. As the cloth picks up food and germs it has the ability to redeposit the soil and/or pathogens to another surface helping them spread and proliferate. Bacteria can quickly reproduce, so if you have a highchair that has not been cleaned for a while, was poorly cleaned after its last use or in an area where you have umpteen people and kids touching it (most likely with dirty hands), you can be assured that germs will be present and they are likely multiplying at an alarming rate.
What is my take-home message? If I’m concerned with protecting my loved ones - and young ones in particular who have undeveloped immune systems and are more susceptible to picking things up – then I’m not going to panic or become paranoid about how well a restaurant has cleaned the highchair. I am going to assume that it has been touched by others after it has been cleaned. I am going to assume that it has been sitting around for a while between usage and I’m going to assume that it’s dirty. I am going to clean the highchair before I put my young one it in.
Thankfully, my young one is well past the highchair stage. He has not yet gotten past the stage of me having to nag him to wash his hands before he eats!