Nupur Sashti, MPH, works as an epidemiologist for the Tennessee Department of Health’s FoodNet program. She received her BS, with honors, at the University of Georgia in Genetics and received her MPH from Emory University. In her role at the health department, she focuses on creating and sustaining collaboration between the State Public Health Laboratory (SPHL) and the epidemiologists in the FoodNet program.  Her key areas include weekly visits to the SPHL which serves two purposes: 1) helps foster communications and 2) conveys Salmonella and E. coli Bionumerics data. In FoodNet, she is involved with the attributions and outbreak working group. Additionally, she visits select clinical and commercial laboratories on a monthly basis as part of her other Emerging Infections Program’s duties.

Q: What can the best thing I can do to avoid germ transmission in public restrooms?

A: Wash your hands WELL.

• Wet your hands with clean, running water (warm or cold) and apply soap; rub your hands together to make a lather and scrub them well (be sure to scrub the backs of your hands, between your fingers, and under your nails); continue rubbing your hands for at least 20 seconds; rinse your hands well under running water.
• If possible, turn off the faucet using a disposable paper towel.
• Dry your hands using a clean disposable paper towel or air dry them. Do not dry hands on clothing.
• Assist young children with washing their hands.

Q: Toilet Seats: Hygienic or hideously horrible?

A. What lurches near the nucleus of elimination activities? Recent findings have found bacteria commonly associated with feces on toilet surfaces. Try to avoid toilets if there visible elements on the seat or in the toilet. It is not a bad idea to use a toilet seat cover. Remember many people use their foot to flush the toilet, so if you hand flush, be sure to wash your hands especially well. (Wait– aren’t you doing that already?)
Panic aside; remember that the toilet seat is not a common vehicle for germ transmission. Many of these disease causing organisms survive only briefly and for likely transmission to occur there needs to be open wound on the buttocks or thighs. It is possible, but chances are highly unlikely.

Q: Toilets, Faucets and Handles, Oh my!! How likely is it that I will catch a germ while using public restrooms?

A. A recent study released in the journal PloS ONE analyzed bacteria from 10 bathroom surfaces in both men’s and women’s bathrooms. They looked at door handles (on both sides), stall handles (on both sides). They found bacteria commonly associated with skin on all surfaces and bacteria associated with the gut on toilet surfaces. Floor samples revealed the ‘most diverse bacterial communities’, possibly due to deposits from the bottom of shoes.

In conclusion, many different types of bacteria exist in various bathroom surfaces. Transmission is best avoided by washing your hands effectively after a bathroom visit. In addition, using barriers such as toilet seat covers and avoiding dirty toilets will help to decrease transmission opportunities. Given a healthy immune system and adequate hygienic practices, germ transmission is very unlikely to occur.

Additional Resources

What can you catch in restrooms?

Bacteria Flourish in Public Restrooms

Public bathroom bacteria uncovered, thanks to gene sequencing

Microbial Biogeography of Public Restroom Surfaces