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Delivering chicken soup to your to your bestie who’s been throwing up? Sitting in a conference room with a coughing colleague? Wondering why you’re under pressure to get a flu shot? Life offers frequent reminders that sometimes it’s not cool to go viral. Most of us think we know how to avoid common infections, or at least minimize our chances of catching that cold or stomach bug. Even so, at SH101, we learned a few things developing this quiz, and we figure you’ll learn a few things taking it.

Here’s why common infections matter. Given the intensity and pace of a school semester, getting sick can leave its mark—and not a good one. In a 2015 survey of more than 19,000 students one in three of those who had experienced a cold, flu, or sore throat in the last 12 months said it had hurt them academically (in most cases, a lower grade for an exam or course, according to the National College Health Assessment). That’s in addition to the serious health complications that can sometimes arise from commonplace illnesses, even in otherwise healthy people.

1. What’s the best way to sneeze or cough?

A.Into your printed assignment for good luck
B.Into your elbow or upper sleeve
C.Into your hands
D.Into a cough-catcher
E.Into a tissue
F.Letting it go free and loud in your fav. café in order to release your chi and om
Click for the answer


D. Into a cough-catcher

The cough-catcher is a real thing—a small envelope-like device containing a filter. Feeling a cough or sneeze coming on, you whip it out of your pocket (speed matters) and stick your nose and mouth in it. The cough-catcher is inexpensive, more discreet than wearing a mask, and good for multiple uses. In tests, the cough-catcher was the most effective method of containing germs, according to the science journal PLoS One (2011).

+ Check out the cough-catcher


E. Into a tissue

Tissues can work quite well for containing airborne germs, as long as they don’t tear. In the same PLoS One study, 4-ply tissues “opened and ready in the hand” were more effective than shielding the cough or sneeze with a hand. Toss the tissue afterward and wash your hands with soap (see question 4).


B. Into your elbow or upper sleeve

Coughing and sneezing into your inner elbow or upper sleeve helps contain the germy, aerosolized particles, says the CDC. This keeps them off your hands, so you can’t transport them to your eyes, nose, and mouth, where they find an easy way into the body. In a study, 10 people were filmed working at their desk for three hours; they touched their eyes, nostrils, and lips an average of 16 times an hour (Journal of Occupational and Environmental Hygiene, 2008).


A. Into your assignment

Cold viruses can live for six hours outside a human body. We couldn’t find any data on how long they live on paper, or whether the nature of your assignment may shorten or prolong their will to live. Again, assume that surfaces are commonly contaminated, practice good hand washing hygiene, and avoid touching your eyes, nose, or mouth.


C. Into your hands

F. Letting it go free and loud in the Café

Coughing and sneezing into your hands means you’ll likely spread live viruses to anything you touch—like faucets, doorknobs, and countertops. Coughing or sneezing freely, without containing it, spreads infectious droplets into the air, where they can be inhaled by others, and onto surfaces, including any nearby food, dishes, or utensils.

+ Common cold (Mayo Clinic)

2. What’s that pain you’re feeling?

You’re unusually tired but pushing through. Now you’re getting a sharp pain in the left of your abdomen. What condition might cause this?

B.Mononucleosis (mono)
C.Bad karma
Click for the answer


B. Mononucleosis (mono)

  • Once in a rare while, mono causes an innocent spleen to burst—usually in the first month of the illness during strenuous physical activity. That’s a medical emergency, so get on it. But it’s more likely that mono will hurt your grades than your spleen. You’ll have a sore throat and maybe a headache or fever, and feel fatigued for weeks. Some mono-stricken students have to take time out or repeat classes.
  • Mono is usually caused by the Epstein-Barr virus (EBV). This virus is common and stays with you forever—although mono symptoms don’t. There’s no cure for mono, but while you’re waiting it out, acetaminophen or ibuprofen can help alleviate the symptoms.
  • You can get mono from kissing a currently or recently infected person. And from sharing toothbrushes, cups, or utensils.
    • Downside: You can’t always know who has (or has had) mono. People can spread mono to someone
      else while they’re sick and for up to a year later.
      Mono symptoms appear four to six weeks after exposure.
    • Upside: Mono is not spread via respiratory droplets, so you’re less likely to catch it from your roommate than, say, a cold or flu. Outbreaks are rare.
  • Also good to know: Appendicitis pain tends to begin around your navel or on the lower right side of your abdomen, according to the Mayo Clinic.

+ Mononucleosis (Mayo Clinic)

3. Think you know how to wash up?

Conscientious hand washing is key to avoiding some common infections. What’s the most effective way to wash your hands?

A.Using hand sanitizer containing at least 60 percent alcohol
B.With running water and soap while singing three verses of Beyoncé’s “Fever”
C.In the saliva of an ovulating unicorn by the light of a crescent moon
D.It’s more about the drying than the washing
Click for the answer


B. With running water and soap while singing three verses of Beyoncé’s “Fever”

The song is to time yourself. To effectively wash your hands, you need to soap up for 20 seconds, which seems to take forever. The standard self-timing advice is to sing “Happy Birthday” twice, but SH101 staffers felt that could be improved on. Beyoncé’s “Fever” is metaphorical—she’s singing about being in love—but love is a sickness, obvs.

+  Beyoncé’s “Fever” (YouTube)
Strictly, “Fever” is not Beyoncé’s song. It was first recorded by Little Willie John in 1956, and pretty much everyone has covered it since. Beyoncé used it to promote her perfume brand. This video includes lyrics.


A. Hand sanitizer containing at least 60 percent alcohol

Here’s what the CDC says: “Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs and might not remove harmful chemicals.” Hand sanitizer doesn’t work against the norovirus, for example.

Here’s what you need to know about hand washing, according to the CDC:

  • Many diseases and conditions are spread by unclean hands. What we think of as the common cold is actually a cluster of similar symptoms that can be caused by any one virus out of hundreds. Those viruses can live for up to six hours outside a human body, and are commonly spread by people touching a contaminated surface and then touching their eyes, nose, or mouth.
  • Soap is preferable, especially if your hands are visibly dirty or greasy, says the CDC. Here’s how:
    • Wet your hands with clean, running water
      (warm or cold), turn off the tap, and apply soap.
      If clean, running water is not available, use soap
      and whatever water you have access to.
    • Lather your hands by rubbing them together
      with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
    • Scrub your hands for at least 20 seconds.
    • Rinse your hands well under clean, running water.
    • Dry your hands using a clean towel or air-dry them.
  • Don’t skip the drying. “Germs can be transferred more easily to and from wet hands,” says the CDC. Using a clean towel or air-drying seems to work best.

4. Which of these does not give you significant protection from the flu?

A.Hand washing
B.A healthy lifestyle (good nutrition, sleep, and physical activity)
C.Vitamin supplements
D.Organic snail venom
Click for the answer

Trick question! None of these will protect you from the flu. By far the most effective flu preventative is the flu shot. Here’s why:

  • The flu shot works pretty well Flu viruses are highly contagious. The only two ways of developing immunity to a particular virus are through vaccination or natural exposure; vaccination is safer. The flu shot provides protection from the influenza viruses that are likely most predominant in any given season. For young, healthy people with relatively strong immune systems, the vaccine’s effectiveness is more than 65 percent. This is not a perfect vaccine, but if you don’t get it, your protection is zero percent. Your flu shot also helps protect people around you who are at higher risk of complications from influenza. You cannot get flu from the flu shot.
  • Hand washing is great but doesn’t work for this Flu viruses spread predominantly in droplets sneezed, coughed, or exhaled by an infected person; these are inhaled by others. A study found that people within six feet of a patient with the flu could be exposed, according to the Journal of Infectious Disease (2013). Hand washing is far more effective against germs that are commonly spread via contaminated surfaces, such as colds and noroviruses. + Influenza (Mayo Clinic)
  • Healthful habits are great but don’t work for this While good habits are vital for health, they cannot equip us with the antibodies that can fight off a specific virus. “What we know now is that [healthy behaviors like] good diet and good sleep are not enough to prevent all illnesses,” says Dr. Timothy Lahey, associate professor of medicine and associate professor of microbiology and immunology at the Geisel School of Medicine, Dartmouth College, New Hampshire. “Influenza and other vaccine-preventable infections are good examples. If the immune system has not seen a particular infection before, it cannot mount the high-quality, fully protective immune responses needed for protection.”
  • Vitamin supplements don’t work Do not fall for the hype, experts say. “When you walk into GNC and buy a vitamin that says it boosts immunity, I think that’s largely nonsense,” says Dr. Paul Offit, chief of the division of infectious diseases at Children’s Hospital of Philadelphia. “If this industry was regulated by the FDA (Food and Drug Administration), they wouldn’t be on the shelf.” In 2008, the manufacturers of Airborne, a vitamin and herbal supplement that had been marketed as “boosting” the immune system and improving germ resistance, agreed to refund $23.3 million to consumers as a penalty for false advertising.
  • Organic snail venom will kill you, if it’s from sea snails Sea snails are super-venomous; the venom can kill a human in half an hour. It is useful to neuroscientists, however, in the study of nerve cells, and may help them develop treatments for various diseases. “‘Milking’ the live snails is a hazardous business,” said the journal Nature (2004). So definitely don’t do that.

5. Match the pathogen images to the diseases

5 different pathogens under a microscope

A.Mononucleosis (mono)
B.Influenza (flu)
C.Strep throat
D.Urinary tract infection (UTI)
Click for the answers

Influenza under a microscopeInfluenza (flu) Cute from a distance, spiky up close, and so commonplace that it may seem relatively benign, but actually it’s far more deadly than HIV and AIDS.

The flu is so commonplace that it’s easy to forget how much damage it can do—including to otherwise-healthy adults. From 1976 to 2007, influenza and its complications killed between 3,000 and 49,000 people a year, according to the CDC. For comparison, in 2013, 7,000 deaths were caused directly by HIV, and an additional 13,000 people died who were diagnosed with AIDS, according to the CDC.

UTI under a microscope Urinary tract infections (UTIs) Fluffy on the outside, it’s prone to sneaking in then sending people dashing to the pharmacy for pain relief. UTIs are the most common bacterial infection, and they can be shockingly uncomfortable. Most cases are caused by bacteria from the gastrointestinal tract (E. coli) spreading from the anus to the urethra. For obvious anatomical reasons, UTIs are far more common in people with vaginas. UTIs can be triggered by sex; it’s helpful to pee after intercourse to flush out the urethra. UTIs can be treated with over-the-counter pills and prescribed antibiotics. Untreated UTIs can lead to kidney infections, which can cause serious health complications.

+  UTIs (Mayo Clinic)

Strep throat under a microscopeStrep throat This bacterium lurks in pairs or gangs, hits its targets when they’re down, and makes them sore, itchy, or maybe even obsessive.

If you have a sore throat, sometimes with swollen lymph nodes, fever and chills, headache, or a rash, it may be caused by a bacterium, Streptococcus pyogenes or group A streptococcus. Strep is highly contagious. It spreads through airborne droplets and shared food. Research suggests that strep throat can trigger obsessive-compulsive behavior and tics in some children, according to the Journal of Neuroimmunology (2006). Strep throat is treated with antibiotics. The same bacterium can cause a bunch of other conditions, from relatively mild (such as impetigo) to serious, such as necrotizing fasciitis (“flesh-eating bacteria”), streptococcal toxic shock syndrome, and pneumonia.

+  Strep throat (Mayo Clinic)

Mononucleosis under a microscopeMononucleosis (mono) It looks innocuous enough, spreads through intimacy, and is loyal to a fault—staying with its targets forever.

     See question 3.

Norovirus under a microscopeNorovirus Like a flaky love interest, it shows up without warning, turns its targets weak and fluttery, and leaves them drained.

     See question 2.

6. Can you keep your stomach from turning?

The norovirus causes diarrhea, vomiting, and stomach pain. It is responsible for outbreaks in places where people hang out together waiting for something exciting to happen, such as Adele concerts, cruise ships, and political party conventions. Can you correctly answer these yes/no questions about the gut-wrenching norovirus?

A.Disinfecting wipes do not kill the norovirus—yes or no?
B.Most disease outbreaks related to contaminated foods are caused by food workers infected with the norovirus—yes or no?
C.Each gram of diarrhea from an infected person contains 5 billion particles of norovirus—yes or no?
D.Being exposed to only 20 viral particles is enough to make someone sick—yes or no?
E.Norovirus is named for a northern English scientist who initially believed the cause was bacterial: In his dialect, “not a virus” sounds like “norravirus”—yes or no?
Click for the answer

All these statements are true except for #5, which our editor made up while visiting family in northern England. Here’s what you need to know about this gut-wrenching bug:

  • Norovirus is a highly contagious stomach bug. Even minimal exposure to an infected person’s feces or vomit can make you sick.
  • Noroviruses become airborne when someone throws up or flushes a toilet. Make it a habit to lower the toilet lid before you flush and keep your toothbrush in the cabinet.
  • Norovirus is hard to kill. It can survive many common disinfectants and hand sanitizers, freezing temperatures, and heat. It can hang out on countertops, dishes, toilet flushes, and doorknobs for up to two weeks.
  • The CDC recommends that when someone in your home has a gastrointestinal illness, you clean with chlorine bleach solution (5–25 tablespoons of household bleach per gallon of water). And wash your hands thoroughly and frequently, using soap (again, hand sanitizer won’t work).
  • Norovirus is the leading cause of disease outbreaks from contaminated food in the US. Infected food workers touching ready-to-eat foods, dishes, and surfaces cause about 70 percent of these outbreaks. When you’re sick, don’t prepare food for others. If you think you got ill from food, report it to your local health department.

+ Norovirus (Mayo Clinic)

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Article sources

Tim Lahey, MD, associate professor of medicine and associate professor of microbiology and immunology, Geisel School of Medicine, Dartmouth College, New Hampshire.

Paul Offit, MD, professor of vaccinology and professor of pediatrics, University of Pennsylvania School of Medicine.

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Mayo Clinic. (2016). Strep throat. Retrieved from https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/dxc-20165964

Nelson, L. (2004, June 24). Venomous snails: One slip, and you’re dead. Nature, 429, 798–799.

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Tang, J. W., Nicolle, A. D. G., Pantelic, J., & Tham, K. W. (2011). Qualitative real-time Schlieren and shadowgraph imaging of human exhaled airflows: An aid to aerosol infection control. PLoS One, 6(6), e21392. Retrieved from https://www.researchgate.net/publication/51469766_Qualitative_Real-Time_Schlieren_and_Shadowgraph_Imaging_of_Human_Exhaled_Airflows_An_Aid_to_Aerosol_Infection_Control

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