Is That Spa Clean Enough to Do Your Pedicure?

As the sun makes less of a cameo appearance and enjoys more of a starring role these days, and as we start shedding layers of clothes, our thoughts have taken a downward turn—to our feet! Are we really ready to bare these things? Shouldn’t we do something to spiffy them up? But wait—what was that we heard about spa pedicures and their association with infection?

To help you weigh wisely whether that hot pink pedicure is worth the risk, we got together with Ann Marie Pettis, director of Infection Prevention at Strong Memorial and Highland hospitals.

Scripts: We have our fingers (and toes!) crossed that warmer weather is afoot—which equals bare and sandaled feet. We’ve heard, however, that spa pedicures might be linked to some risks for infection. Can you elaborate?

Pettis: There’s potential for exposure to and subsequent infection from fungi and blood borne pathogens, such as hepatitis B and C, as well as HIV. This is because there’s a slight risk of a small amount of bleeding if pedicurists use instruments too aggressively and then don’t sanitize them adequately. Another common germ which is often found on the skin of healthy individuals is Staph aureus, which could make its way into the spa. Germs commonly found in water, such as Pseudomonas, might potentially be found at the spa as well.

Really, the pedicure instruments and the foot bath present the greatest risk. If you get a pedicure when you have a rash, cut, or even bug bites, you could make yourself more vulnerable to infection—and you also increase the chance of sharing an infection with the next customer. Another recommendation along these lines is to avoid waxing or shaving your legs for at least 24 hours before your treatment, since doing so can create tiny skin abrasions, opening you up to the possibility of infection.

Scripts: So are there ways to prevent infection at the spa? Can we still schedule our pedicures if we take certain precautions, or should tootsies never be handed over for treatment?

Pettis: I actually get a spa pedicure myself occasionally. My advice is to take a look around, and inquire about the spa’s sanitation practices before you kick off your shoes and socks. Feel free to ask the owner how they disinfect the instruments and foot bath between each customer. Make sure that they use an Environmental Protection Agency-approved disinfectant. Technically, the Department of Health is responsible for ensuring that spas meet sanitary standards, but with the large number of spas out there, this is a tall order—so, ultimately, you need to do your own “due diligence.” Since they’re at increased risk for infection as well as serious complications if an infection does occur, people with diabetes should be particularly cautious in evaluating the hygienic conditions of their go-to spa.

Some spas encourage customers to bring their own instruments, which they then store for your next visit. Not sharing instruments definitely decreases the risk of exposure to anyone else’s germs. And speaking of tools, your pedicurist should never trim any callous on your feet with a razor. Instead, they should carefully use a pumice stone (to avoid abrasions or bleeding).

Finally, try to be the first customer of the day. A spa is likely to be cleanest before all the “foot traffic” tromps through.

Scripts: Makes perfect sense. How can we tell, after returning home from the spa, if we might have picked something up?

Pettis: Keep an eye out for redness, tenderness, or rash in the area. If any of these show up post-pedicure, consider contacting your care provider.

Ann Marie Pettis directs Infection Prevention at both the University of Rochester Medical Center (Strong Memorial Hospital and Golisano Children’s Hospital) and affiliate Highland Hospital. An infection preventionist with more than 30 years’ experience, she’s published articles in peer-reviewed journals and trade publications, and lectures locally, nationally, and internationally. Leadership roles include serving as past president of Western New York Infection Control Organization and the Association for Professionals in Infection Control and Epidemiology (APIC) Finger Lakes Chapter. She recently completed her term as chair of the APIC Communications Committee.

A couple years back, she spoke to Scripts with some smart advice on whether or not handshakes should be taboo during cold and flu season. You can see that “Let’s (Not) Shake on It” video post here. Just a couple months ago, she talked with us again about finding a balance between cleanliness and germs (see here).

Runny-Nosed Kids: Is the Whole Family Doomed?

Aaaaaaaaachoooo!

If you’re living with a sniffly, sneezy tot, new research out of URMC bears some unpleasant news: You and fellow housemates are probably doomed to suffer through the same cold, too.

In fact, infectious disease expert Dr. Ann Falsey, who helped with the study, says that mere exposure to school-age children ups your odds of experiencing unpleasant cold symptoms (in the study, persons with lung disease who caught colds were more likely to suffer from runny noses, sore throats and coughs if they’d had contact with kids).

The study, which drew upon a databank of 1,000 samples of sputum and nasal secretions from people with chronic obstructive pulmonary disease, or COPD, recently published in the Journal of Clinical Virology. We spoke to Falsey to learn more.

Scripts: In your research, you point out that not everyone who catches a cold exhibits classic symptoms.

Falsey: That’s true. In everyday life, a good number of people have no symptoms, and are oblivious to the fact they’ve come down with a cold. In our study, more than one-third of the folks infected with a rhinovirus (the bug that causes most colds) showed had no noticeable symptoms. That might be because the particular virus is less severe (some are wimpier than others), or it might have to do with the host – that is, the person catching the cold. Maybe they’ve already developed immunity against the virus, so they’re more or less unaffected. Or maybe they have underlying health complications, like heart or lung disease, that make them more susceptible to more severe bouts of illness.

The real interesting piece, for us, was what happened when kids came into the mix.  Even when we controlled every other factor, having contact with kids singlehandedly predicted symptomatic colds.  In fact, folks with symptoms were about twice as likely to have had contact with school-age children as people whose infections didn’t become symptomatic. Maybe this is because kids, when sick, produce a much bigger “viral load” (they’re better breeding grounds for the bug). It may also be because their hand hygiene is less sophisticated. They put everything, including their fingers, in their mouths. They use their sleeves in place of tissues. Things like that.

Scripts: Indeed, kids are germ-factories. If one family member’s sick with a cold, what can you do to keep sickness from spreading to your whole house?

Falsey: It’s a challenge, for sure. Kids, like you said, are masters at propagating illness. The average infant will suffer eight to 10 colds before their first birthday (think about that as they blow out the candle!)

The best thing you can do is to wash your hands frequently, and be generous in applying alcohol-based hand sanitizer. Cold viruses love to hang out on door knobs, toys, and high-contact surfaces, so clean them often.

All this said, parenting is a full-contact sport. Kids will nuzzle runny noses into your shoulder.  They’ll cough without shame (and without covering). So you do the best you can.

Scripts: Understandable. If someone does fall ill, is there anything that will speed recovery?

Falsey: Only time, unfortunately. But you can make kids (or yourself) feel better as you heal. Hydration helps keep mucous runny, so drink plenty of water. Over the counter medicines can help adults with decongestion. Some studies even suggest a hot bowl of chicken soup – thanks the salty steam it releases – can sooth sore nasal passages.

The bottom-line: If you’re a parent, or spend lots of time with others’ tots, take heart – by the time the kids are ready for college, you’ll have built up immunity to just about everything!

Ann Falsey, M.D., is a professor of Medicine at the University of Rochester and an infectious disease expert at Rochester General Hospital. Falsey is a senior author of the aforementioned study, which was led by first author Anurag Gandhi, M.D., an infectious disease fellow at URMC.

Want more ways to shield your family from wintertime illness? Check out this recent interview with infectious disease specialist John Treanor, M.D. In int, he explains the power of flu shots — and squashes some common misconceptions surrounding them.

When Coughs Cross the Line: Simple Sniffles, or Something Serious?

It’s that time of year. Your home, school, or office sounds like a veritable orchestra of sniffles, coughs and sneezes.

Between the frantic tissue-grabbing, you might wonder: How do I know if the congestion is normal, or if it’s indicative of something worse? How long should I slog through symptoms before calling a doctor for advice?

These are all-too-common questions — so this week, we wanted to share some common sense, courtesy of URMC pulmonologist (lung disease specialist) Dr. Irene Perillo. In this week’s video post, she gives telltale symptoms (colored phlegm, long-lasting fevers and more) that might suggest something besides a simple cold virus is afoot. The knowledge is vital, she adds, since a cough that lingers too long might be evidence that a secondary bacterial infection — like pneumonia — has taken hold.

To hear Dr. Perillo, watch the clip below.

Did you know?

Though a cough that hangs around too long might actually be worth worrying about, most are short-lived, and caused by one of three common triggers:

1)      Post-nasal drip. If a cold virus has your nose running like a faucet, it’s possible that some of that congestion is tickling the back of your throat – prompting your throat muscles to cough in attempt to expel the irritant.

2)      Heart burn. Reflux disease (or GERD) – a chronic condition in which acid accidentally flows backward from the stomach and into the windpipe – also can irritate the throat, prompting coughing spells.

3)      Cough-variant asthma. Sometimes, asthma suffers don’t just wheeze – they cough if exposed to certain triggers, like heavy perfume or even cold air.

To learn about the care URMC provides to patients with pulmonary diseases – or for information on making an appointment with a specialist – click here

Could Sugar Supercharge Some Antibiotics?

While modern medicine boasts more and more implantable devices – items like urinary catheters, heart valves, even artificial hips – it’s important to note that these novel products carry some unique risks.

One in particular has to do with infection. It turns out that everyday bacteria have a nasty habit of building even hardier colonies atop foreign, implanted surfaces than they would on regular body surfaces (which are fed by rich blood supplies).

The result? Foreign-body-based bacterial fortresses are often trickier for standard antibiotics to penetrate and kill. As a result, these infections have wicked way of coming back, and in a worst case scenario, the only sure way to eradicate them is to remove the foreign body altogether. Such surgeries can be daunting for already-weak patients.

According to new research out of Boston University (still preliminary, of course), scientists suggest that pairing sugars with certain antibiotics might one day supercharge them, helping the medicine penetrate resilient colonies and kill bad bacteria for good.

To hear URMC infectious disease specialist Dr. John Treanor comment on the findings, watch the clip below.

John Treanor, M.D., professor of Medicine, Microbiology and Immunology, serves as the chief of the Infectious Diseases Division of the Department of Medicine at the University of Rochester Medical Center. He is a widely recognized expert in influenza and vaccine research.