Jeremy Laurance: Fiction it may be, but we should all learn how to avoid contagion

Medical Life

Jeremy Laurance@jeremylaurance
Friday 21 October 2011 10:13

Gwyneth Paltrow, Matt Damon, Kate Winslet – they are all in it up to their necks. Foaming at the mouth in Paltrow's case. Steven Soderbergh's Contagion premiered in Venice last week. I haven't seen it, but from the reviews it sounds scarily credible: an unidentified virus sweeps around the world, threatening millions and causing panic. Very like the scenarios that the World Health Organisation has been urging us to prepare for, in fact.

The 2009 swine flu pandemic may have been a damp squib and a new strain of bird flu identified last month may pose a low risk to humans, but scientists remain grimly confident that sooner or later the world will face a scenario not wholly unlike that presented in the movie.

Soderbergh made an interesting comment in answer to a reporter's question. He said he was more careful to wash his hands after making the film.

It would be funny, wouldn't it, if a Hollywood movie achieved more in the teaching of personal hygiene than 150 years of health education. Most people do not realise quite how critical the hands are in the spread of infection.

You soon learn when you are caught in an epidemic, however. People remember the 2003 outbreak of Severe Acute Respiratory Syndrome (Sars) as an over-hyped scare that amounted to very little. It didn't feel like that to the doctors and nurses on the front line. They were wrestling with a mystery virus that struck patients with unnerving speed and ferocity and then began cutting down those caring for them.

The Prince of Wales hospital in Hong Kong admitted 180 patients with Sars in the first month of the outbreak, 100 of them medical staff who had caught it from their patients. Dr Tom Buckley, head of the intensive care unit, described how staff became aware that anything they touched could spread death. Computer keyboards and telephone handsets were wrapped in clingfilm, which was changed each day. When he went home at night to his wife and children he showered and changed before greeting them, used separate cutlery, and slept in a separate room.

Ignaz Semmelweis, a Hungarian physician, discovered in 1847 that hand-washing by obstetricians and midwives could prevent puerperal fever, an infection following childbirth that killed up to a third of women in European hospitals in the mid-19th century. Semmelweis became known as the "saviour of women", but more than a century and a half later, one in four doctors and nurses still do not wash their hands consistently between patients.

It is a fair bet that the public – you and I – are even worse. I was recently laid low by a gastric bug that can only have spread thanks to poor personal hygiene – my own or someone else's. I am shortly off on a long trek in Nepal, one of the countries named as a reservoir of bird flu. I shall be taking the hand sanitiser with me.

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