A natural history of hygiene

In unpacking the Pandora's box of hygiene, the author looks into its ancient evolutionary history and its more recent human history. Within the box, she finds animal behaviour, dirt, disgust and many diseases, as well as illumination concerning how hygiene can be improved. It is suggested that hygiene is the set of behaviours that animals, including humans, use to avoid harmful agents. The author argues that hygiene has an ancient evolutionary history, and that most animals exhibit such behaviours because they are adaptive. In humans, responses to most infectious threats are accompanied by sensations of disgust. In historical times, religions, social codes and the sciences have all provided rationales for hygiene behaviour. However, the author argues that disgust and hygiene behaviour came first, and that the rationales came later. The implications for the modern-day practice of hygiene are profound. The natural history of hygiene needs to be better understood if we are to promote safe hygiene and, hence, win our evolutionary war against the agents of infectious disease.     

Hygiene and uncertainty in qualitative accounts of hepatitis C transmission among drug injectors in Serbia

Hepatitis C virus (HCV) infection is a significant cause of mortality and morbidity related to injecting drug use. In Serbia, recent estimates suggest that approximately a third of drug injectors are hepatitis C positive. We undertook the first qualitative study of drug injecting in Serbia with a focus on exploring drug injectors' accounts of hepatitis C risk. Drawing upon 67 qualitative interviews with drug injectors in Belgrade, we explore accounts of hepatitis C risk and its transmission. We find that accounts portray a social context of pervasive risk in relation to hepatitis C. Hepatitis C is characterised as ubiquitous among drug injectors, and as a hardy virus with immense transmission potential. Narratives of hygiene emerge as core to accounts of transmission, in which the virus is linked to dirt, including dirty environments, dirty drugs and dirty injecting equipment. These hygiene narratives not only have symbolic function but also appear to stem from ambiguities in accounts wherein hepatitis C is conflated with the signs, symptoms and transmission routes of hepatitis A. In addition, accounts portrayed hepatitis C risk management as a responsibility of individuals in the absence of secure trust or certainty in knowledge about risk, including in relation to others' disclosed antibody status. Hygiene narratives are a core and symbolic feature of injectors' accounts of hepatitis C transmission. There is an urgent need for health promotion fostering hepatitis C risk awareness and risk avoidance among drug injectors in Serbia.     

Comparison of sporadic cases of Salmonella Typhimurium with other Salmonella serotypes in Castellon (Spain): case-case study

Introduction

Salmonella infections (SI) are common in Spain. The aim of this study was to appraise risk factors and the clinical characteristics of sporadic Salmonella Typhimurium infections compared with other sporadic salmonella serotype infections (OSI).

Terra firma‐forme dermatosis

Terra firma‐forme is a benign condition characterized by cutaneous hyperpigmentation resembling dirt. Despite its typical clinical presentation, the disorder is not well‐known by physicians. Prompt recognition can avoid useless investigations and therapies. Vigorous swabbing of the skin with isopropyl alcohol‐soaked gauze pads results in complete healing.