Year after year, the number of victims climbed. But even as casualties mounted - as the germ grew stronger and spread inside hospitals - the toll remained hidden from the public, and hospitals ignored simple steps to control the threat.

Over the past decade, the number of Washington hospital patients infected with a frightening, antibiotic-resistant germ called MRSA has skyrocketed from 141 a year to 4,723.

These numbers don’t appear in public documents. Washington regulators don’t track the germ or its victims, and Washington hospitals do not have to reveal infection rates.

The Seattle Times analyzed millions of computerized hospital records, death certificates and other documents to track the swath of one of the nation’s most widespread, and preventable, epidemics.

In its investigation - the first comprehensive accounting of MRSA cases in Washington hospitals - The Times gained access to state files that revealed 672 previously undisclosed deaths attributable to the infection.

MRSA, methicillin-resistant Staphylococcus aureus, is spread by touch or contact. It can slip into breaks in the skin as tiny as a mosquito bite.

Six out of seven people infected with MRSA contract it at a health-care facility.

Many people first learned about the germ last fall when the federal Centers for Disease Control and Prevention set off a media frenzy with its announcement that invasive MRSA infections claim at least 18,000 lives a year, more than AIDS.

But MRSA has been quietly killing for decades. And all along, there has been a simple diagnostic test that could have saved countless lives. This quick and painless test, which costs about $20, lets hospitals know who’s infected or a carrier. Once identified, people with the germ can be isolated from other patients and treated.

Federal veterans hospitals screen all patients for MRSA, which has reduced their cases to near zero. Yet not a single community hospital in Washington screens every patient for the pathogen.

Many hospital officials say widespread screening is unnecessary and too burdensome. They say broad infection-control measures, such as washing hands and wearing protective garments, can thwart MRSA’s spread.

But Washington hospitals violate these fundamental safety measures time and again, state and federal inspection reports reveal, from the Tacoma surgeon who refused to wear a mask during surgery to a Spokane blood technician who carelessly brushed her contaminated hands against supplies destined for other patients.

At Harborview Medical Center in the early 1980s, 17 people died during a MRSA outbreak fueled by the failure of the state’s premier trauma center to isolate all infected patients immediately. But to this day, according to confidential records obtained by The Times, Harborview still rooms some MRSA patients with those who don’t have the germ.

Meanwhile, MRSA is infecting and killing more people this year than ever before.

In October 2005, Joyce Allen went in for open-heart surgery at St. Joseph Medical Center in Tacoma. Doctors told her to expect a quick recovery. But during the operation, MRSA slipped into her chest.

Doctors had cut through her sternum, a flat bone that binds the rib cage and protects the heart. When they fused the sternum back together, the contagion was entombed inside.

The blood-rich bone marrow was a perfect hiding spot. Within a week, the germ pushed into her arteries and crept into vital organs.

Physicians resorted to their most powerful antibiotic - vancomycin - known as the “drug of last resort.” For six weeks, twice a day, Allen received intravenous infusions. A suction system sealed her chest and drained away toxic fluid.

“The pain was excruciating. I wanted to die, it hurt so bad,” Allen says.

Antibiotics failed to conquer the infection. By April 2006, as Allen hovered near death, surgeons made the decision they had dreaded: Cut out the sternum.

They sheared away 6 inches of bone with a diamond-coated blade. Then they severed her abdominal muscles near the groin, and stretched the flaps tight across her chest, to shield her heart.

Allen, 57, is crippled for life. She measures each day by the level of pain. On her worst days, she’s unable to pick up her small grandson.

“This germ destroyed my life,” she says.

Disabled, she gave up her customer-service job at a Tacoma cabinet company. She now lives in a trailer in Spanaway, surviving on $877 a month in government benefits.

Nobody knows how the germ got into St. Joseph’s operating room.

Allen says her surgeon was devastated by the infection. Hospital officials suggested that she might have carried the pathogen into the facility, on her skin.

If that were so, screening likely would have detected the germ and allowed doctors to eradicate it beforehand.

Cardiac patients like Allen are among the most vulnerable to MRSA infections and often face prolonged and expensive recoveries, medical research shows.

But St. Joseph didn’t test her for MRSA, according to medical records. When it comes to most cardiac patients, the hospital still doesn’t. On Friday, it said that policy is under review.

Who gets tested for MRSA, and who does not, is a medical game of chance.

Washington hospitals make their own rules. There are no federal or state mandates for screening.

The result is a haphazard array of infection-control policies that often fail to protect the most vulnerable patients, according to a Times survey of the state’s 25 largest hospitals.

MRSA infections often strike critically ill patients or those with weakened immune systems - patients typically treated in a hospital’s intensive-care unit.

But Swedish Medical Center in Seattle doesn’t routinely screen patients in its ICU. Instead, it screens patients having elective surgery.

Sacred Heart Hospital in Spokane does test ICU patients - but not those seeking elective surgery.

The University of Washington Medical Center tests only premature babies.

Valley Medical Center in Renton doesn’t routinely screen any patient group.

The bottom line is that most Washington patients don’t get tested.

Whether to test, and whom to test, are at the core of a bitter national debate within the U.S. health care system.

Those who oppose testing all patients often argue that it undermines patient safety to dedicate limited resources to just one germ.

The reality, they say, is that hospitals often lack the staff, lab resources or space to ramp up existing testing programs or isolate large numbers of patients.

Swedish Medical Center would be hard-pressed to screen its 41,000-plus admissions each year, officials said. Harborview Medical Center, the state’s most crowded hospital, doesn’t have enough private rooms to isolate every patient, officials said.

Some hospitals fear lawsuits. If they screened every patient, results would show who already had the germ upon admission - and who picked it up while in the hospital. Patients could then blame the hospital for their infections.

Federally funded researchers called MRSA a possible epidemic in the early 1980s, following a series of outbreaks in large hospitals nationally. Yet most Washington hospitals began limited screening only within the past three years, The Times found.

“Many hospitals have ignored MRSA for decades,” said Dr. William Jarvis, who retired in 2003 from the federal Centers for Disease Control and Prevention, where he was once acting director.

MRSA can cause painful and treatable skin lesions or slip into the blood. About 1 percent of infections prove fatal, while many others result in crippling injuries.

No one knows how many people carry the germ on their skin. Nationally, medical researchers have estimated that it’s 1 or 2 percent of the general population. Washington hospitals that have initiated selective screening have discovered significantly higher levels - up to 11 percent.

Some surgeons around Seattle so dread the pathogen that they order tests when hospitals won’t.

To control an infection, health officials need to know where it’s been. They need counts, patterns, examples. But in Washington, MRSA’s tracks have largely been obscured.

The state Department of Health asks physicians or medical examiners filling out death-certificate forms to give not only the primary cause of death, but the “chain of events” - the “diseases, injuries, or complications” - that contributed. Without such detail, these forms, when compiled in a database, may miss signs of emerging threats to public health.

But omissions undercut these certificates’ value.

In 2005, Brenda L. Smith, 47, of Puyallup, died at Swedish Medical Center/Providence in Seattle. For “final anatomical diagnosis,” her autopsy lists, at the top, MRSA pneumonia. But her death certificate - which relied on the autopsy report - says only pneumonia, with no mention of MRSA.

That same year, Willie Pompey, of Everett, died at age 58. His death certificate lists kidney failure, but does not account for an underlying reason. Pompey received a kidney transplant in 2002 at Virginia Mason Medical Center, but, because of a post-surgical MRSA infection, his body rejected the new organ. On his death certificate, MRSA is nowhere to be found.

How many examples are there like this? It’s impossible to say. Finding them requires working backward - as The Times had to do - scouring lawsuits or other documents for indications of someone with MRSA, then comparing them against the public health records to see what, if anything, is missing.

A Bainbridge Island plaintiffs’ lawyer, Christopher Otorowski, believes doctors may sometimes omit MRSA from death certificates because the infection is typically picked up in a hospital.

“Unless MRSA is the primary, explanatory cause of the death, I would think the physicians are going to be reluctant to put MRSA on the death certificate because it might implicate the hospital,” he says.

For years, the state health department released a database of death certificates that is used by academics, journalists and others to report on public-health issues. But the state excluded a key component, a field that included doctors’ notes that expanded on factors contributing to the person’s death. The Times discovered the omission this year and insisted upon a complete database.

This new database links 672 deaths to MRSA between 2003 and 2006. The old database didn’t attribute a single death to the germ. It couldn’t have. The state relies on a standardized coding system, used internationally, that has more than 13,000 diagnosis codes - but not a single one for MRSA.

To gauge the prevalence of MRSA, The Times also analyzed a second database, which compiles diagnoses and billing records for patients discharged from Washington hospitals. The state uses this data, which has no individual names, to identify health trends and to analyze costs.

But as with the death certificates, this data set proved incomplete. The Times found dozens of examples where alternative records showed a patient had been treated for MRSA, while the billing database made no mention of it.

Because of these holes, the number of MRSA cases and deaths generated by the newspaper’s analysis amounts to a minimum count, not a complete one.

Nationally, exact numbers are not available either, leaving public-health officials to estimate or extrapolate the scope of the epidemic.

To impede MRSA and other infectious germs, Washington hospitals typically rely on basic strategies - washing hands, isolating patients, sterilizing equipment.

But most of the state’s 25 largest hospitals have been cited for unsanitary conditions or failure to adhere to fundamental safety standards, state and federal regulatory reports since 2005 show.

Last year, at Spokane’s Holy Family Hospital, state Department of Health inspectors discovered the following:

A nurse entered Room 520 and dropped two packets of pills on the floor. Instead of throwing them out, she scooped up the packets and put them in a paper medication cup. She then pried the pills from the packets, dumped them into the contaminated cup and handed it to the patient.

An hour later, in a different room with an infectious patient, a staff member began to leave without washing hands. A second staffer tried to leave without discarding a contaminated gown. Both were headed for public areas of the hospital before state inspectors stopped them.

That afternoon, inspectors watched a phlebotomist draw blood from an infectious patient. Afterward, she brushed her gloved hands against items in a nearby supply cart - supplies destined for other patients.

In all, the four-day inspection cited seven staff members for violating basic infection-control standards, state records show.

Physicians can be the most lackadaisical about infection control.

In April 2006, doctors at the UW Medical Center carried personal items from home into sterile operating rooms and dropped them on the floor. These items included backpacks and satchels, made of porous materials friendly to germs. Hospital administrators told inspectors this was “common practice.”

In November 2006, a physician at St. Joseph Medical Center in Tacoma removed his surgical mask during an operation. He had complained it was uncomfortable. Hospital officials told inspectors the physician was a “repeat” violator and had been warned before to keep his mouth and nose covered.

In hospitals, the most common violation is the failure to wash hands upon entering or leaving a patient’s room.

In the worst cases, as few as 40 percent of staff members comply with hand-washing standards. Doctors are the worst offenders, according to confidential hospital records reviewed by The Times.

Even the best hospitals typically boast no better than 90 percent compliance - which means one out of 10 practitioners may have contaminated hands.

Hospitals remedied all violations spotted during the inspections, records show.

But these violations were all the more brazen because hospital officials - benefiting from a new law - knew the exact day that state inspectors were coming.

In the past, the state health department conducted surprise inspections to ensure that hospitals adhered to health and safety codes, from patient care to building maintenance.

But in 2002, the Washington State Hospital Association issued a 28-page report: “How Regulations are Overwhelming Washington Hospitals.” In it, hospital administrators claimed surprise inspections disrupted patient care.

In Olympia, lawmakers voted unanimously to eliminate surprise inspections starting in July 2004. Today, the Department of Health must provide four weeks’ notice - even the exact hour of arrival.

Hospital officials also had complained that some state inspectors were abrupt and unfriendly.

Lawmakers approved a Band-Aid: Hospital officials now can anonymously evaluate state regulators on whether they were polite enough.

The Legislature receives an annual compilation of these critiques. One hospital official wrote that state inspectors could “do a better job of highlighting the positive,” instead of just looking for problems.

Washington is the only state that legally empowers hospitals to rate the conduct of regulators, according to the Consumers Union, a nonprofit organization that monitors hospital-related legislation.

“What kind of message does that send?” said Lisa McGiffert, who directs the organization’s Stop Hospital Infections project.

Federally commissioned hospital inspectors began surprise inspections in 2004 - the same year Washington eliminated them.

The Joint Commission on Accreditation of Healthcare Organizations sets health-care standards and certifies hospitals to receive federal funding, such as Medicare. For decades, the commission had provided at least a month’s notice before inspections.

But dozens of hospitals exploited the advance notice to temporarily hire more staff, cart in rental medical equipment - which was returned when inspectors left - and conduct dramatic makeovers with fresh sheets and pillows, according to inspector general reports at the U.S. Department of Health and Human Services.

Responding to public criticism, the commission stopped giving notice.

In some Washington hospitals, makeovers now take place just before state inspections, three registered nurses told The Times. The hospitals beef up staffs during planned inspections and, in some cases, have hired extra cleaners to disinfect beds and equipment, the nurses said.

The state hospital association recognizes “more needs to be done” to combat MRSA and is pushing to standardize patient-isolation procedures and increase hand-hygiene compliance, association president Leo Greenawalt said.

When Chuck Velte first saw the woman at a flower show - sitting in a wheelchair, her right leg missing at the knee - he tried not to stare.

It was the spring of 2006, and Velte had knee surgery pending. He couldn’t help but wonder: What happened to the woman’s leg?

So he asked.

“She said that her knee was infected after routine surgery. She called the germ MRSA. I’d never heard of it,” says Velte, who’s now 64.

“I looked at her missing leg and was scared: This could be me.”

Velte asked medical practitioners at Valley Orthopedic Associates in Renton about the germ’s threat. He says they told him: Don’t worry. This infection targets people with weak immune systems, and you’re healthy.

Velte was unconvinced. A former senior analyst at Boeing, he launched into research. He learned patients could infect themselves if dormant MRSA germs were on their skin. The bacterium could drop into a wound during surgery and touch off numerous complications, even death.

Velte didn’t know it, but at least 66 patients who underwent joint surgery the year before suffered amputation of legs, arms or fingers after contracting MRSA, a Times analysis of Washington hospital-billing records shows. For the past decade, the number of such patients stands at 512.

But Velte’s research also turned up a simple safeguard: a nasal swab test that can detect if someone’s a carrier.

Velte demanded to be screened. Doctors questioned its need, but sent him to a laboratory at Valley Medical Center in Renton, where the surgery was scheduled.

“I get there, and my knees are killing me, and the lab guys said they don’t do a MRSA test. They told me to go home,” Velte says.

Velte hobbled to the hospital’s executive offices and plopped in a chair. “I want to see the highest-ranking person here,” he recalls saying. “I’m not leaving here until I get a MRSA test.”

An apologetic administrator arranged for a test. Results arrived four days later.

“I tested positive for MRSA,” Velte says. “My doctor was stunned. He said that if he had operated, it could have been catastrophic.”

To get rid of the germ, Velte scrubbed himself with over-the-counter soap containing chlorhexidine, an antibacterial chemical. He also wiped his house down with bacteria-killing bleach.

He was screened for MRSA again, was cleared and underwent surgery. It was successful.

A year later, MRSA invaded Velte’s life again.

His 92-year-old mother, Rita, lived at a nursing home in Eau Claire, Wis. Last fall, Velte learned she had a festering wound, resembling a giant boil, on her buttocks. He demanded a MRSA test.

“After what I’d been through, I knew it was a possibility,” he says.

A lab report confirmed his suspicions. His mother was infected with invasive MRSA, the worst kind. Within two days, she was gripped by pneumonia, followed by sepsis - blood poisoning - which reached into every vital organ, medical records show.

She suffered a fatal heart attack on Nov. 1 - less than two weeks after she was diagnosed with the germ.

Yet, MRSA did not appear on her death certificate. The official causes of death were heart attack, pneumonia and sepsis.

Velte says he demanded a correction - the truth. After reviewing medical records, the certifying doctor added MRSA.

“I wonder,” Velte says, “how many people die of MRSA and nobody ever knows.”

(CNN) — If you have a fever, headache and runny nose, you might go to Google and type the words “flu symptoms” to see whether you’ve come down with influenza.

Google knows that you might do something like that, and it also knows which U.S. state you’re in. Now, it’s putting that information together in a tool that Google says could detect flu outbreaks faster than traditional systems currently in use.

Google’s new public health initiative, Google Flu Trends, looks at the relative popularity of a slew of flu-related search terms to determine where in the U.S. flu outbreaks may be occurring.

“What’s exciting about Flu Trends is that it lets anybody – epidemiologists, health officials, moms with sick children — learn about the current flu activity level in their own state based on data that’s coming in this week,” said Jeremy Ginsberg, the lead engineer who developed the site.

The tool, which launched Tuesday, operates on the idea that there’s likely to be a flu outbreak in states where flu-related search terms are currently popular.

The Centers for Disease Control and Prevention collaborated with Google on the project, helping validate and refine the model, and has provided flu tracking data over a five-year period, said Dr. Joseph Bresee, chief of the epidemiology and prevention branch in the CDC’s influenza division.

Although it doesn’t replace the need for real viral surveillance data, Flu Trends is a good model, and the CDC looks forward to testing it this flu season, Bresee said.

“We really are excited about the future of using different technologies, including technology like this, in trying to figure out if there’s better ways to do surveillance for outbreaks of influenza or any other diseases in the United States,” he said. “In theory at least, this idea can be used for any disease and any health problem.”

Researchers found a tight correlation between the relative popularity of flu-related search terms and CDC’s surveillance data, Ginsberg said.

In the 2007-08 flu season, Google accurately estimated current flu levels one to two weeks faster than published CDC reports in each of the nine U.S. surveillance regions, Google said in a statement.

Traditionally, influenza surveillance has involved physicians’ reports of patients with flu-like symptoms, lab reports of influenza from nasal and throat swabs, and death certificates.

Only that kind of analysis will detect the spread of influenza strains not covered by the flu vaccine, information that search engine information does not reflect, experts say.

But there has been concern that influenza surveillance systems in place are not fast enough, and the new tool could be useful for the basic purpose of quickly detecting outbreaks, said Dr. Randall Stafford, associate professor of medicine at Stanford University’s Prevention Research Center, who was not involved in the project.

“Sacrificing accuracy may not necessarily carry a big penalty if you’re able to predict increasing flu incidence as well as the other systems, and do it more rapidly,” he said.

Still, there are limitations, Bresee said. The tool may miss cases of influenza spreading among elderly people, because they are less likely to use the Internet than younger people, Stafford said. He also noted that many people who search for flu-related terms have viral infections that are not actually influenza.

Google has also taken into account that people sometimes look for flu-related terms in response to certain news headlines and do not actually have the flu, Ginsberg said. The tool looks for terms that, for example, reflect searches by a person who has chest congestion or wants to buy a thermometer, he said.

Flu Trends may also help doctors make diagnoses, Ginsberg said.

“I would be very hesitant to diagnose influenza at this point in the year, but if the tool tells me influenza in California is really increasing dramatically, I might be more likely or willing to diagnose,” Stafford said.

Influenza is responsible for more than 500,000 deaths worldwide each year, according to the World Health Organization.

Flu Trends cannot be used to identify individual users, the company statement said. The search engine relies on aggregated counts, made anonymous, of how often certain search terms occur each week. But every computer connected to the Internet has its own internet protocol address, or IP address, which reveals its location to Google.

Software engineers and public health experts at Google.org, the company’s philanthropic arm, collaborated on the project, Ginsberg said. The search engine giant turned 10 years old this year.

The overall flu activity in the U.S. is low, although a few states — such as Hawaii, Arkansas, Mississippi, Kentucky, Delaware and Maine — have “moderate” activity, according to Google’s map, based on data current through Monday.

“There’s no question that testing for virus in blood is the only way to get the most information, but having this sort of information earlier does make sense,” Stafford said.

SOURCE: Elizabeth Landau@CNN.COM

In the past few weeks, reports of MRSA cases have become more common throughout the United States and Europe. Staph infections like this are scary buggers, but should we be concerned about a pandemic?

The answer is no. Which isn’t to say that you shouldn’t be taking precautions to prevent the spread of infection, but Dr Chris Ohl reports that the number of cases for MRSA in the past 3-5 years have not increased exponentially. The concern from Health Officials is not in the number of cases reported about the infection, but the lack of knowledge on the part of both hospital employees and the general public on what to look for. The sad truth is that many times a case for MRSA is misdiagnosed as a spider bite or even an ingrown hair that’s become infected.

It’s important to know what to look for, and the proper way to go about treating symptoms. MRSA infections start out as small red bumps, often resembling pimples or spider bites that can quickly turn into deep, painful abscesses.

You should contact a doctor if:

• You or your child has an area of skin that’s red, painful, swollen, and/or filled with pus

• You or your child has inflamed skin and is also feverish or feels sick

• Skin infections seem to be passing from one family member to another or if two or more family members have skin infections at the same time

MRSA is most often colonized within and around the nose, and like many infectious diseases people can have it without ever suffering symptoms. You shouldn’t wait for an outbreak to start taking preventative measures to keep from spreading or contracting the infection. None of these actions are extreme, or require a lot of effort.

• Keeping your hands clean with an antibacterial soap such as GymSoap. Hands should be washed after every visit to the restroom, whenever food or trash is handled, or after sneezing/coughing.

• Do not share personal items like towels, razors, loofahs, clothing, or sheets. Be sure to wipe down athletic equipment with sanitizing wipes before and after each use.

• Shower immediately after exercising (whether it be at the gym or on the field). GymSoap is a highly effective body soap that kills 99.9% of germs and bacteria.

• Keep open wounds covered, and don’t participate in games, practices or other events that involve physical contact if there’s a risk that your open wound(s) will become exposed.

• Sanitize your linens. If you have a cut or sore, wash towels and bed linens in a washing machine set to the “hot” water setting (with added bleach, if possible) and dry them in a hot dryer. Wash gym and athletic clothes after each wearing.

• If you have a skin infection that requires treatment, ask your doctor if you should be tested for MRSA. Doctors may prescribe drugs that aren’t effective against antibiotic-resistant staph, which delays treatment and creates more resistant germs. Testing specifically for MRSA may get you the specific antibiotic you need to effectively treat your infection.

• Use antibiotics appropriately. When you’re prescribed an antibiotic, take all of the doses, even if the infection is getting better. Don’t stop until your doctor tells you to stop. Don’t share antibiotics with others or save unfinished antibiotics for another time. Inappropriate use of antibiotics, including not taking all of your prescription and overuse, contributes to resistance. If your infection isn’t improving after a few days of taking an antibiotic, contact your doctor.

Stanisław Jerzy Lec, a Polish poet, once said “All is in the hands of man. Therefore, wash them often.” Now, more than ever, does that statement hold true. With germs and infections spreading so easily these days, it’s important to take preventative measures to keep oneself safe.

Since the death of Alonzo Smith in the past week, several more cases of MRSA have popped up across Central Florida, including another Liberty High School student. The school, which had been declared clean by Osceola County health officials, has local parents worried and uncertain what to expect. Other cases that have appeared include one student at Stanton Weirsdale Elementary in Marion County, and four employees of Harris Corporation in Brevard County.

MRSA is contracted through skin/skin contact, as well as encounters with cuts and sores. There are several things that one can do to help prevent the spread of this disease.

Keep hands clean by thoroughly washing regularly with an anti-bacterial soap like GymSoap®.

Keep cuts and sores clean and bandaged until they have properly healed.

Avoid contact with with other people’s wounds or bandages.

Do not pop pimples or boils, this should only be done by a doctor.

Avoid sharing personal items such as towels, razors, sponges or loofahs.

By Sarah Scrafford

Although average, healthy people generally do not need to worry about picking up germs, dirt, and diseases from everyday objects, it doesn’t hurt to be careful about limiting your (or that of your loved ones) contact with potential bacterial breeding grounds. The objects you touch every day are potentially loaded with nasties like fecal matter, e. coli, and salmonella. To stay safe, be sure to make a regular habit of washing your hands, be careful about touching your mouth and eyes, and avoid touching these objects as much as you can.

The Office

Your office is a landmine of germs. Here are a few things you should be wary of.

1. Mouse: If you work on your computer throughout the day, germs from everything you’ve touched now live on your mouse, a device that is rarely cleaned.
2. Desktop: You may think the cleaning crew is taking care of it, but most offices have instructions not to clean desktops because people don’t want their papers messed with.
3. Keyboard: Take a hard look at your keyboard and think of the last time you cleaned it. Now think about everything you touch every day, and all of the people who sneeze, cough, or just sit at your computer.
4. Hands: With the office comes handshakes, which leave you susceptible to whatever germs others have to share.
5. Copier: Your sneezing coworker’s virus germs can live on the copier for up to 72 hours.
6. Telephone: Has anyone used your phone recently? Their saliva and germs from their hands are all over your telephone.
7. Candy bowl: The office candy bowl is full of germs, with everyone putting their hands in and sharing what they have. What’s worse, those germs will come into direct contact with your mouth when you eat the candy.
8. The coffee machine: Bacteria and viruses from others’ coffee cups and hands contaminate the office coffee pot.
9. Fax machine: Just like the copier, your office fax machine is a germy breeding ground.

Out and About

Once you leave the office, you’re far from safe from germs. Here we’ll take a look at the dirty objects you come into contact with while shopping, working out, eating, and just living your life.

1. ATM: Germs from the dirty fingertips of every customer before you will wait to greet you at your bank’s ATM.
2. Steering wheel: When you get in the car, one of the first things you’ll touch is your steering wheel-and you’ll leave plenty of germs behind to pick up later.
3. Public reading material: The magazines at your hairdresser’s and your doctor’s office are more than likely never cleaned, and they’re touched by multiple people every day.
4. Restaurant menus: Menus are very rarely washed, but they’re touched by everyone. So many people have touched restaurant menus before you have, you could be getting germs from hundreds of people.
5. Public pens: The pen at your bank, your doctor’s office, and the checkout have all been touched by many, many people before you.
6. Escalator: The escalator is home to hundreds, even thousands of different hands, diapered bottoms, and more.
7. Gas pump: It’s best to wash your hands after pumping gas, as the handle has been touched by numerous gas guzzlers before you.
8. Taxi: Taxis are often home to fecal organisms, and even oral bacterium spready by just talking.
9. Chair armrests: Researchers have found that chair armrests are among the germiest places in public due to their frequent use.
10. Dining tables: The people that dined before you in the mall’s food court may not leave a tip, but they’ll be happy to share plenty of bacteria.
11. Money: Money is handled by many different people, and can contain traces of drugs, fecal matter, viruses, and more.
12. Payphone: Payphones are like your office phone, but much worse. You’ll be subject to the hand, face, and mouth germs from anyone who used the phone before you.
13. Elevator buttons: With dirty elevator buttons, one can only hope that the people who have selected your floor before you have washed their hands recently.
14. Drinking fountain: Drink from a water fountain, and you’ll be subject to the germs of people who have come before you, some even putting their mouths directly on the fountain.
15. Credit card: When you hand over your credit card, it’s touched by a cashier, swiped through a reader where many other people’s cards have been swiped, and may even be placed on a dirty countertop.
16. Soap dispensers: Yes, an object you touch to get clean can be dirty. If the soap isn’t in its own sealed bad, chances are it’s a breeding ground for bacteria.
17. Vending machines: Think twice about popping the top on your soda, or opening up your chips without washing your hands first.
18. Shopping cart: A University of Arizona study has found that almost two-thirds of shopping carts were infected with fecal bacteria, more than the average public bathroom.
19. Pedestrian traffic light button: This heavy traffic area is more than likely not cleaned routinely.
20. Lemon wedges: In 2007, the Journal of Environmental Health found that nearly 70% of lemon wedges in restaurant glasses had disease-causing microbes.
21. The diving board ladder: Your neighborhood pool’s diving ladder is only as clean as the pool is, and is often contaminated with dirty feet from the area around the pool as well as the bathroom floor.
22. Monkey bar handles: All of the children who came before yours have left their mark on playground equipment with colds and other viruses.
23. The gym: Although your gym may clean its equipment, it’s never enough. You can pick up plenty of germs from skin, sweat, and saliva left over from other visitors.

At Home

You may think your home is sacred from germs, but it’s full of often under-cleaned surfaces and sources of bacteria.

1. Doorknob: Remember all those germs you picked up at the office and on your way home? They live on your doorknob now.
2. Vacuum: Your vacuum brush is full of bacteria, and can spread germs from contaminated surfaces to uncontaminated ones.
3. Light switch: This often-touched object is generally not cleaned often enough to eliminate germs.
4. Your contact lens case: Your eyes are the last place you want germs to be near, but a Chinese study has found that 34% of contact lens cases had germs that could cause an inflammatory eye disease.
5. Your pets: Your pets can bring in bacteria from your backyard and the dog park, which can end up on your hands, couch, bed, and flooring.
6. Your bed: More than 84% of US homes have dust mites, which feed off of your dead skin. Your bed is a breeding ground for these mites, as they thrive in the humidity of a bed that’s made up.
7. Shower curtain: Vinyl shower curtains thrive in soap scum, and they’re spread around by your shower spray.
8. Library books: You may be in possession of the book now, but the people who have checked it out before you may have been reading it in the bathroom.
9. TV remotes: Your remotes are frequently touched, and infrequently cleaned.
10. Refrigerator door handle: Your refrigerator door is likely home to bacteria picked up while preparing food like eggs and raw meat.
11. Kitchen sink: Germs love to thrive in this moist environment.
12. Toothbrush: Your toothbrush retails bacteria from your illnesses, and can even be home to fecal matter if you leave it near your toilet.
13. Laundry basket: You can pick up plenty of germs from handling underwear in your laundry basket.
14. Cutting board: Germs and bacterial love to live in the cracks and crevices of cutting boards.
15. Stuffed animals: Stuffed animals get dragged around all over your home, and pick up every bit of dirt along the way.

Everywhere

These dirty objects follow you around wherever you go.

1. Cell phone: Think of all the places where you set your cell phone down, and then think about how closely it rests on your face.
2. mp3 player: Your mp3 player picks up germs much in the same way as your cell phone-by being set down places like your car’s cup holders, or dirty tabletops.
3. Your purse: Women often set their purse on the floor or bathroom counter without thinking of the germs that lurk on those surfaces.

Of course, just because everything we touch is dirty, doesn’t mean that we have to be. Using an anti-bacterial soap like GymSoap® can help to prevent the spread of germs and disease. It’s not just effective against gym-related diseases, but can actually help anywhere there’s a risk.