Sunday, August 14, 2011

Terror on the Toilet

What happened to the girl I used to know?
You let your mind out somewhere down the road.
--Don’t bring me down, The Electric Light Orchestra
I just returned from a refreshing week of vacation.  I saw 11 states and a myriad of bathrooms ranging from the good, to the bad, to one that made my five year-old son break down in tears.
My quadriceps still ache from hovering over toilet seats that I found less than inviting to my lily-white loins.
So this week for Sunday myth busting, I veer from folklore myth to urban legend.  Because before I invest in this device, I have to know:  

Can you really get a disease from a toilet seat?
First of all, a toilet seat, or any other hard and non-living object, is an inhospitable environment for most organisms, viral and bacterial.  If dry, most organisms will die within minutes of being left without their host.  Even the very contagious parasitic diseases like crabs or scabies will die within 24 hours and are unable to adhere to the smooth surface.  An added bonus is that they are visible to the naked eye. 
But what about the wet toilet seat?  I guess the follow up question is “wet with what?”  Urine is actually a sterile fluid.  But in other liquid suspensions, theoretically, things could live a little longer.  One study showed that gonorrhea in secretions lived for 2 hours on a toilet seat.  Herpes virus for four.
But before you place an order for the Sanicone, let’s talk about the joy of skin. Unbroken human skin is a remarkable defense against germs.  Even if you touched a herpes blister directly, the likelihood of transmission would be nil without a break in your skin.  So sitting on a toilet seat, even a wet one, may make you nauseated, but won’t leave you with lasting illness.  But what if it was blood on the seat?  Well, I would hope most would back away from a toilet seat covered in blood but in the heat of the moment, things happen.  However, the CDC in its brochure on blood exposure relates that there is no known risk for Hepatitis B, Hepatitis C, or HIV transmission from blood exposures to intact skin.
In fact, there are very few proven case reports of STDs transmitted via toilet seat--none for herpes, HPV (the virus that causes genital warts) or HIV.  Two case reports of possible toilet transmission of gonorrhea have been documented--one in 1939 from two patients in a hospital sharing the same urinal (one was infected) and another of an 8 year-old girl using an airplane toilet.  She wiped visible purulent fluid from the seat and then cleaned herself with the same hand.  Which is an epic fail of Bathroom 101.
In 1979, two researchers published a study in the New England Journal of Medicine called The Gonoccocus and the Toilet Seat.  Sort of like The Princess and The Pea, only a totally different sort of mattress problem.  The study authors found that as soon as the organism dried out, it was dead.  But what about that two hours that it took to dry?  That is what is called theoretical risk.  This is where laws of transmissability of disease come into play.  In order to spread disease, two basic things are necessary:  
#1 Enough germs to spread the disease (i.e. the inoculum) 
#2  A way to get into the genitourinary system, the bloodstream, or other orifice. 
This NEJM study is a perfect example of #1.  The authors took cultures from 72 public restrooms and found no gonorrhea present.  Moreover, 38 attempts to culture a toilet in a venereal disease clinic also revealed no STDs.  The study authors concluded that the toilet seat was not a viable mode of transmission, largely due to lack of a significant inoculum.
To address #2, the basic use of a toilet seat comes into play.  In other words, the areas that carry contagion are not necessarily those areas in direct contact with the seat.  I don’t know how you use the toilet, but I try not to rub my naughty bits all over in wild abandon on an unfamiliar toilet seat.  Assuming that your skin is intact where it is in contact with the seat, there is very little possibility of disease transmission.  
Even Dr. Abigail Salyers, the former president of the American Society for Microbiology has said, “To my knowledge, no one has ever acquired an STD on the toilet seat -- unless they were having sex on the toilet seat!”  To which I issue a desperate plea to the masses (and pop music icons):

Those scenes in J.R. Ward’s novels are fiction.  Sex in a public bathroom is NOT hot.
What’s more likely to get you in a public bathroom are diseases spread by your hands--influenza, streptococcus, staphylococcus, bacteria that cause diarrhea, and hepatitis A.  But these things are far more likely to show up on the counters, faucets, and door handles. Microbiologists have found that steering wheels have 100 times as many bacteria per square centimeter than a toilet seat does.  Still, I guess if you touched the toilet seat, then ate a bag of Cheetos (you have to lick your fingers with those things), badness could happen.  But if your immune system is healthy and you employ simple hand washing, the likelihood of transmission is minimal.
And what about those toilet seat covers?  Peace of mind only.  And useless if the toilet seat is wet.  Which is why the Maine legislature refused to make toilet seat covers mandatory in public restrooms in 2009.
My next road trip I will plop down free of worry.  You, too, can rest assured that you won’t contract a disease from a toilet seat.  However, snakes in a toilet bowl are a completely different story.

            Carpet python found in a Townsville, AUS toilet.

                            Always check the bowl.    


  1. Jules, is it safe to say that, while I love ELO, I found the rest of this post mildly disturbing. Particularly the pic of the big, nestled snake. ;)

  2. I'd think snake bites on the butt would be far worse.

  3. Eeewwwwww! (that's all I got)

  4. Purell is my friend. I've been in bathrooms so bad I didn't want to touch the sink to wash my hands. Thank goodness for the invention of hand sanitizer. (Unless it doesn't really work like it's supposed to and then... well... ewewew.)

    And now, I must go douse myself with it. This post was gross. ;o)

  5. And people wonder why I don't like public restrooms. I definitely prefer the one at my house that I know is clean because I'm very clean. :) But thanks for the information!

  6. A hole in the ground is actually much safer than the toilet seat, both for shitting and having sex.

  7. I always check the toilet for critters before sitting. Always.

    Love the education you offer, I'll also keep in mind not to wipe a toilet seat with my hand and then licking my fingers. Good advice always.

  8. Suze--I had to take a long, hot shower after this one. Next week I'm back to less scary things, like chupacabras and werewolves

    Alex--I completely agree. I thought I had suppressed all of my nightmares about mutant alligators coming from the sewers, and then I found this.

    Becky--yep, this post reaches new highs of squickolicious, I agree.

    B.E.--I have a bottle of travel Purell hanging from my rearview mirror. Best defense is a good offense.

    Krista--my sister refuses to use public restrooms. We have to stop at a restaurant any time she has to go. Always feel guilty just ordering a coffee, like I'm a toilet usurper or something.

    Gorilla--Just watch out for poison ivy.

  9. Rusty--It's a good plan, especially if you live in Australia, apparently. And finger licking good should never apply to anything with Kohler imprinted on it.

  10. Good information to know. Gotta admit I hadn't thought much about this, but now I will. Oh OH.

  11. OMG, when I saw the snake in the toilet, I almost jumped. Does that really happen? I'm checking every seat from now on.

  12. I think I might have to stick to hovering, the ick factor is to high of the unknown - creepy snakes aside. Great post! :)

  13. Julie, I forgot to say that a relative of mine was in China this summer and when she described some of the "public toilets".....I can't even use the words "restroom or bathroom".... I couldn't believe it, but she had photos! SOME, thank goodness, were "modern" and looked like the public ones we're used to. Others.....were nothing but a HOLE IN THE FLOOR, that women SQUATTED OVER!!! I had so many questions!! My first thought was that I would lose my balance and fall INTO IT, and/or manage to get a bit about Eeewwwww!

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  15. The snake is way scary, but the thought of having sex in a restroom? Waaaaaaay scarier!

  16. OMG, I think I just threw up a little in my mouth. Ugh.

    On a similar note, excellent post. Going to gross out the twitterverse now.

  17. Becky- I hold the dubious distinction of being that girl who really did lose her footing while hovering over a Chinese toilet. I was young, there was wine, you can see how it would happen. -It would've been a lot worse if I was old n sober like now!

  18. Bossy Betty--It's my goal to spread irrational fear everywhere I go.

    Clarissa--I was actually surprised about how many snake in the toilet sightings were reported on the net. As if I didn't have enough to worry about.

    Amy--it's excellent for the quads; I think someone should market the hover workout

    Becky--I cannot imagine trying to balance myself over a public hole. That completely goes against the laws of gravity. No wonder women go to the bathroom in pairs--someone would have to hold you to keep you from going in

    Alleged--I agree, the smell of bleach (and other things) is a lousy aphrodisiac

    Lydia--always happy to induce vomiting, I'm like blogger ipecac. And thanks for the tweet, lady!

    Tracey--at least there was wine.

  19. This is a horror movie post and relevant as we are traveling this week.

    Glad to be a guy and can use the touch nothing technique.

  20. Ive seen some questionable housekeeping practices in restrooms while traveling. But the minute I find a python in the pot, my traveling days are over. YIKES.

  21. I will never sit on a toilet again. Thank God some places do have disposable toilet seat covers. Still, I am wary each time I visit a public restroom, especially when presented with the occasional non-flusher. I always do look before sitting. FYI: snakes or not, nothing is worse than a porta potty. Yuk. :)

  22. Ew. *shudders at snake in toilet*

    Btw, I have a blog award for you. So come by and get it ;) It doesn't have snakes or toilets. :D

  23. Slamdunk--yeah, yeah, flaunt your Y chromosome all you want--we all sit down at some point. Toilet bowl pythons don't discriminate.

    Bryce--Perhaps there's a market for a portable python toilet shield for the really prepared traveler. We could be millionaires.

    Laila--Do not ask me why I know this, but there is a movement of people who believe that sitting on the toilet causes bowel issues, and that we all need to return to the "natural" way of squatting (look up Jonathon Isbit). So perhaps by not sitting, you'll be preventing bowel problems AND making a political statement, too.

    Cherie--Could be Snakes on a Plane. And then not only are there snakes, but you're in a really bad movie, too. Of course, Samuel L. Jackson is with you and that will make it totally worth it. And thank you so much for the award! I'm all warm and fuzzy. Which is understandable because my blog is on fire. Ha.

  24. I was eating breakfast. Not so hungry now. And I'm very glad I'm at home and not on the road :)

  25. Hover. Still hover. It's good exercise too ;)

  26. You can get pregnant from a toilet seat. I'm positive.

  27. Carol--sorry to spoil your meal. It wasn't crab, was it? Maybe clam-mydia? I'm sorry, I couldn't help myself, I was abducted by puns.

    Aleta--I'm with you. Hovering seems to make the most sense. And I wear a lot of skirts so I can avoid the clothing blockage factor.

    Copyboy--what kind of toilet seats do you know? Actually, sperm can survive up to 48 hours in ideal/moist conditions (and up to 5 days in the magic V) although their swimming power diminishes. If they dry out, they're dead within minutes. So theoretically speaking, you could get pregnant from a toilet seat under ideal conditions. Sperm are determined little bastards.

  28. One of my friends saves toilet seat covers so that she can reuse them. Ewwwwwwwww!

  29. Thanks for the reassurance on the safety of toilet seats, however I believe I will continue to "hover".

  30. I think hovering is grosser than the grossest seat. Eww!! I just lay down toilet paper.

    By far, IMHO, the worst public toilets I have seen were in Australia. I haven't been to China though! :)

  31. Well, I geuss thanks are in order for this information! Enlightening indeed. Now what advice do you have for my friends 9 year old who refuses to poo because it's not pink?

  32. My friend found a mouse in her toilet once. She was not happy. In grammar school, a girl climbed on the seat in the stall next to me, to take a peek while I was doing my business. This kept me away from public bathrooms for many years. Today, I appreciate all news about public restrooms, as I am a frequent visitor. Thanks, Julie


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