The Centers for Disease Control (CDC) on Tuesday last week reported that it observed a growing trend of diarrhea cases from the beginning of this year, and with schools opening and people returning to work after the Lunar New Year holiday, diarrhea cases are expected to rise.
There were 142,814 hospital visits for diarrhea in the first week of last month, followed by 171,756 visits the second week, and while the weekly number significantly dropped between Feb. 16 and Feb. 21, this is attributed to the closure of many outpatient clinics during the Lunar New Year holiday. During the holiday itself, diarrhea cases accounted for 10.1 percent of all emergency room visits.
The CDC on Tuesday last week said it also received 122 reports of clustered diarrhea cases in four weeks, mostly in the food and beverage and accommodation industries, and that 83.8 percent of the tested cases were caused by norovirus infection. It said norovirus activity has been rising in several regions globally as well.
As norovirus is highly contagious and primarily transmitted through direct contact with infected people, consuming contaminated food or water and touching contaminated surfaces, the CDC urged people to frequently wash their hands thoroughly with soap and water, adding that alcohol-based sanitizers are ineffective against norovirus.
Alongside promoting good hygiene during the COVID-19 pandemic, the CDC has constantly reminded people about the importance of handwashing with soap, particularly at key times such as after using the toilet and before meals, to reduce the risk of infection, especially diarrhea-related and respiratory infections.
However, a loose online self-reported survey by Yahoo last month, which cited the CDC’s call for people to practice good hand hygiene to prevent norovirus, showed that only 64.5 percent of over 6,800 respondents said they wash their hands before meals. A previous survey by the CDC released in 2013 even showed that over 60 percent did not wash their hands properly, and nearly 50 percent did not have the habit of washing their hands with soap.
Similarly, a US national survey by the National Foundation for Infectious Diseases last year found that 48 percent of US adults admitted forgetting or choosing not to wash their hands at key times, while a survey released by a US company this year showed 44 percent said they just rinsed their hands with water without using soap.
Meanwhile, there were many discussions on social media in recent years about whether people should use soap bars or liquid soap in public restrooms, due to concerns over contamination.
A local newspaper in 2013 collected liquid soap from 20 public restrooms for microbial testing and found that half of them had a bacterial count exceeding the legal limit, including one that was 32,000 times the limit. A similar experiment by a TV news network in 2024 found that four in 10 soaps in public restrooms had a bacterial count exceeding legal limits, and also showed clips of insects and impurities found in the samples. Other news outlets that cited the reports also presented confusing advice from health experts, as some said that proper handwashing is still effective if hands are properly rinsed and dried, while others said that skipping soap is acceptable if people fear contamination.
The Food and Drug Administration at the time responded to the 2013 report by saying that it conducts inspections on liquid soap products according to the Statute for Control of Cosmetic Hygiene, and that proper handwashing with soap — lathering up, scrubbing long enough, rinsing thoroughly with water and drying — is the most effective method for preventing infections. It also advised public restrooms to use touchless sealed-system soap dispensers rather than refillable soap dispensers, and said that refillable dispensers must be routinely cleaned and dried before being refilled to reduce contamination.
However, there are no specific regulations regarding the hygiene level of soap at public restrooms, only scattered guidelines to provide soap and put up effective handwashing signs, including public restroom management and maintenance guidelines regulated by the Environmental Management Administration, as well as regulations for food businesses regulated by local governments.
If the government wants to promote proper handwashing, especially at schools and in public settings, related agencies, including the environmental, education, interior and health ministries should first address public concerns over soap contamination so people not only understand the importance of using soap, but also feel safe using it.
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