If there is something that people get to hear very often when airborne diseases pose a threat, it is the advice on coughing/sneezing hygiene and frequent handwashing. There is something else that gets very little or no emphasis — avoiding spitting in public. Like cough, spitting too, according to doctors and public health officials, can lead to spread of infections.
In a city like Chennai, people spitting on roads continues to be a common sight. Doctors and public health officials say that many spit on the road while travelling by two-wheelers, cars or buses, with no second thought about others on the road.
When respiratory infectious diseases such as H1N1 influenza peaks in the State, and now, with the outbreak of the coronavirus disease in China, the emphasis is largely on cough etiquette and hand hygiene. Spitting is most often the last thing to be emphasised.
This, despite Tamil Nadu having a legislation that prohibits spitting — The Tamil Nadu Prohibition of Smoking and Spitting Act, 2002. The Act prohibits both smoking and spitting in places of public work or use and public service vehicles, mandates display of boards pinpointing that both are offences, and are punishable with fine.
With the enforcement of the Cigarettes and Other Tobacco Products Act, this Act took the back seat, and along with it went the prohibition on spitting, a public health official said.
Spitting in a public place indicates both lack of civic sense and poor awareness on hygiene practices. “Of course, a lot has changed in the last 10-20 years, but people continue to spit in public. People should be made to feel that spitting does not reflect good on them. From a health perspective, spitting can spread infectious agents to others,” a senior doctor of the Rajiv Gandhi Government General Hospital said.
Like cough and sneeze, droplets from the spit of an infected person can transmit infections to others, especially under favourable conditions, doctors said.
Leading by example
There are instances where places have been declared spit-free. T. Jacob John, retired professor of virology, Christian Medical College, Vellore, who was instrumental in making the college and the hospital campuses spit-free zones, said, “It has been taught in various classes that Singapore and the U.K. banned spitting because of the high prevalence of tuberculosis. If everybody stops spitting, it will influence or force a person with TB to stop spitting. Spit-free is not about aesthetic cleanliness but also about public health,” he said.
“Covering the mouth while coughing, covering the nose while sneezing and not spitting are three important hygiene practices. It is necessary to control the spread of respiratory-transmitted infections such as TB, influenza, common cold, pneumonia-causing viruses such as SARS and also the present coronavirus,” he added.
The institution put up signboards on campuses and buildings in Tamil, Telugu, Hindi and English. “All security staff are trained to gently tell a person, who spits, to look at the signboards. Prior to the campaign, people would spit on the campus, especially at the building corners,” he added. Officials said that this required a behavioural change, and awareness should begin at school level.
A senior health official said that enforcement, by way of imposing a fine, was one of the ways through which spitting in public places could be prevented.