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Wednesday, November 3, 2010

Managing risk of infection

Greeting my sister

Several years ago, my youngest sister was being treated for cancer at a time when I had next to no knowledge of important practical things to do regarding contact with a person whose resistance was at its lowest. I went to visit her in hospital and was slightly taken aback when her husband intercepted me before I could hug her. He asked me to use the ‘dry’ disinfectant provided in the room to sterilise my hands before doing anything else.

What surprised me was not the gentle request by my brother-in-law, which I understood immediately, but the fact that it had never occurred to me without being prompted. In my eagerness to greet my sister, I had so easily disregarded something absolutely fundamental for someone in her condition.

Healthy humans and hygiene

Let’s face it, human beings are not by nature very hygienic creatures. Nor, let me hasten to add, should they be, under normal circumstances. I’m pretty sure that most of the micro-organisms that we share are passed on by bodily contact or exchange of bodily fluids. We touch, hug, kiss, shake hands, pass each other items that have been handled by strangers, share computer keyboards and ATM buttons, we fondle animals, wipe our noses and other portions of our anatomy, open and close doors recently touched by strangers, or pick up goods, coins in an airport or shop without giving a thought to the state of health of the last person to touch the item.

As I said, under normal circumstances, I don’t think this matters a great deal. All life forms do somewhat the same thing in matters of hygiene, and if anything, it probably does more good than harm for the survival of humanity to share bugs around and condition everyone to them. Humans seem to be thriving on it, going by world population statistics, in spite of some rather grotesque departures in hygiene from what many conventional folk might regard as acceptable. Usually, I’m all for a pragmatic approach. Over-concern for hygiene is generally counter-productive and if you could see what organisms you shared by daily contact with people and were too worried by it, you would probably die of stress before the bugs got you!

Sick people and hygiene

But, when it comes to people whose resistance to infection is down, the story changes  dramatically. Cancer patients have been bombarded with drugs designed to lower the immune system so that beneficial effects of some treatments can occur. This is where we have to change our attitude completely.


Hospital procedures are very interesting when it comes to these matters. It’s hardly surprising that hospital staff are totally with it when it comes to contact with patients and risk of infection. They know how important it is for you. But from their point of view, they don't want you passing anything on to them either! It is possible, for example, to enter a hospital as an outpatient, be treated, and leave the hospital without direct physical contact with another human being, and that’s the way it should be.

Minimising contact

If you are being treated for cancer and you know your resistance is down because of the treatment you are receiving, you need to be very aware of how to minimise direct contact with any other person. In your own household, it’s maybe a different matter, but you have more control there over who you touch, when, and how to minimise risk from that contact.

Public contact and places

But in a public place, be very conscious of who and what you are touching. Make sure you sterilise your hands after being in a place where you can’t avoid physical contact. Keep a careful personal hygiene routine. Every risk minimised helps you. Diseases that are usually of minor significance for a healthy person may be deadly for you or me. Even a bad cold or flu for a normally healthy person is no big deal – they might be in bed for a week and feel terrible, but in most cases it’s not life threatening. For a cancer patient undergoing treatment, it can quickly lead to pneumonia and put you in mortal danger.

Beneficial effects

I have been fortunate in this respect since I started treatment for cancer. In fact, so far I have had no flu, no infections and surprisingly, fewer allergies than ever before [touch wood!] I feel sure that this is partly due to careful hygiene management while my body is wide open to invasion and attack from micro-organisms of one sort or another, thanks to my own awareness of it, and especially to Tracey’s untiring determination to keep the household as free of opportunistic sources of infection as possible. That sometimes involves barring the doorway to sniffling friends!

It’s very much in your interests as a person being treated for cancer that you manage contact with everyone else carefully. Not doing so could have severe consequences for you. Don’t be afraid of offending someone by refusing bodily contact if you’re having cancer treatment. It’s your life that’s at risk, not theirs. You may need to make it clear to them to respect that – most people do so immediately. 

When I visited my sister in hospital that first time, I certainly didn’t think about it properly at all. But then at that time, cancer was something that other people might suffer from, not me.


  1. I liked the line in "The Bucket List" when Jack Nicholson's character (the cranky, terminally ill patient) says "More people die from visitors than disease".

  2. I love my visitors, just as long as they keep me at arm's length when my immune system is accepting all visitors!

  3. I find it incredible when people treat it as a joke. I have had one person laugh at me on two different occasions when I've tried to get them to physically back-off. I want to smack people like that so hard and tell them I'll be sure to mention their attitude if they cause the funeral. They don't get it - that something very minor for them could turn into pneumonia for Den, with no good ending to the story.

    Vent over.


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