Schools and child care centers recommend it. So do the nation's pediatricians and the U.S. Centers for Disease Control and Prevention. To avoid spreading germs, they say, sneeze or cough into your elbow. The technique works better than coughing into the air or covering your mouth with your hand, which then spreads germs through the things you touch, ABC News says in an April 21 report.
By Leann M. Lesperance, M.D., Ph.D.
and Henry H. Bernstein, D.O.
Harvard Medical School
What Is the Doctor's Reaction?
ABC News recently highlighted "Cough in Your Elbow" -- a neat way to try to limit the spread of germs that you may not have heard about yet. This method, now recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP), works best with another CDC initiative called "Clean Hands Save Lives." Together, an even stronger message about the spread of germs is being sent.
You most likely have heard the "clean hands" message. Washing your hands is one of the best defenses against picking up a cold or other viral illness. Germs can live for a few hours on your hands, so when you then go on to touch something else (for example, a doorknob) or even someone else, someone else can pick up those germs. When your hands touch any part of your face (for example, your mouth, nose or eyes), any viruses or germs that are on the hands can enter the body. Therefore, the best defense during the cold and flu season is to wash your hands frequently, especially before you eat, and to touch your face as little as possible.
Now another way to defend against illness is to "cough in your elbow." Many people already have heard this message and have been spreading the word from coast to coast. Turning your head to cough in your elbow means the germs will land on your arm and not on your hands. That way, the germs will not spread to other people.
What Changes Can I Make Now?
Getting sick is never fun, for children or adults. Fortunately, there are things we can do to limit the spread of germs that cause many illnesses, including colds, flu and gastroenteritis (the stomach flu):
- Wash your hands frequently. You cannot avoid getting germs on your hands, but you can avoid swallowing those same germs later if you wash your hands before holding food. You also will avoid passing those germs on to someone else.
- Cough in your elbow. This will minimize the spread of germs to other people.
- Use an alcohol rub, if a sink is not convenient. These alcohol-based hand rubs are very effective at killing germs. (Many hospitals and doctor's offices now use them regularly.) Many brands are available; you may want to keep a squirt bottle at your desk or in your car. (The alcohol hand rub should not be used in place of hand washing after you use the bathroom.)
- Stay home when you are sick. This won't protect you, but it will protect others. If you need to visit the doctor while you are coughing or sneezing, ask for a mask when you arrive at the office.
- Get a yearly flu shot. This vaccination works, making it less likely that you will get the flu and spread it to others.
- Take a multiple vitamin. In some studies, people who regularly took a multivitamin got fewer colds. The brand of multiple vitamins used is not so important, since most preparations contain roughly the same ingredients.
What Can I Expect Looking to the Future?
Research continues on how best to slow the spread of germs. Some investigators will look for better ways to treat viral illnesses, but preventing an infection from ever happening in the first place is even better. With this in mind, efforts will continue to educate everyone that hand washing (and now coughing in the elbow) are the most important things we can do to prevent the spread of infection.
A handful of products ranging from antiviral facial tissues to antibacterial soaps already are available, and new products will continue to come to market. Good studies are needed showing what is safe and effective for children of all ages, especially infants and very young kids. The bottom line -- in settings where risk of infection is highest (schools, child care, and medical facilities) or when soap and water aren't available -- coughing in the elbow is an important additional measure to hand washing that can help prevent the spread of infections.
