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As kids head back to school, parents know well that sniffles and sneezes are inevitable. But there are also stomach bugs to deal with. As NPR's Allison Aubrey explains, there are some simple steps parents can take to help prevent them.

ALLISON AUBREY: If you've got young kids, maybe you've never considered how one part of the morning routine may increase their odds of getting an upset stomach. It's the packing of lunch with just your typical foods.

Ms. MAYA NEEHOUSE: Vanilla yogurt and pretty much tuna salad.

Mr. MIKE NEEHOUSE: I normally pack yogurt and fruit and a sandwich. For me, it's normally a salad. Yeah, salad and fruit.

AUBREY: Mike and Maya Neehouse say they normally pack their lunches in those insulated lunch bags - the ones with Velcro at the top. This makes it easy to carry to school or work. But what happens when they get there? The food sits for hours in an office cubicle or a classroom cubby with no refrigeration. And that can be a problem.

Ms. SARA SWEITZER (Researcher, University of Texas): For chilled foods for your, you know, your turkey sandwich, your cut vegetables, you want that to be at 40 degrees or below.

AUBREY: Sara Sweitzer is a researcher at the University of Texas. She was curious to know just how quickly packed lunches warmed to unsafe temperatures. So she and her colleagues used a temperature gun to test the lunches of 235 children at a Texas daycare.

Ms. SWEITZER: We found that over 97 percent of the perishable foods were within the unsafe temperature zone.

AUBREY: Wow. So did that surprise you?

Ms. SWEITZER: It did surprise us because we saw quite a few ice packs, and so you're just mentally thinking that oh, the food must be chilled.

AUBREY: Now, it takes a few hours at these warmer temperatures for bacteria to multiply enough to make us sick. So it's important to point out that none of the kids in this study got sick that day. But it's a reality check on how quickly food can go bad. So if you want to keep bagged lunches safe, here's three things to try.

First, put your insulated lunch bags in the freezer overnight, so that they're starting out much cooler in the morning. Second, when using ice packs, use two of them and bookend them on either side of the perishable foods. Third, this is probably most important one; wash your hands and your counters before you make lunches. Sweitzer says this is so basic but people often forget it, especially if they're rushing around in the morning.

Ms. SWEITZER: They were just busy or maybe combing their hair or taking care of something else, and then if you go make a sandwich, you've just transferred germs into that food.

AUBREY: Now keeping your hands clean may seem like a small matter, but there have actually been dozens of studies over the last 15 years aimed at improving hand hygiene and cutting infection rates, mostly in hospitals.

Don Goldmann of Harvard Medical School says parents and schools could learn a lot from this. For instance, just telling medical staff to clean their hands doesn't work so well. What really makes a difference is having dispensers of hand sanitizer everywhere, from patient rooms to hallways, and nurses stations.

Mr. DON GOLDMANN (Harvard Medical School Professor): It's best done if you follow what a nurse or doctor actually does and put the alcohol where they can't miss it.

AUBREY: Nurses sometime need to sanitize their hands up to 40 times in an hour, and clearly, that's entirely too much for school kids. But Goldman says children could be taught when contamination is most likely and encouraged to put a splash of sanitizer on their hands at these moments. After going to the bathroom is an obvious one. But also after mingling and touching each other, especially when something's going around.

Mr. GOLDMANN: It's not impossible. I actually think that if you're really vigilant and on top of your game you will do it every time you're about to touch something else or somebody else.

AUBREY: A few years ago Goldmann and his colleagues tested how effective hand sanitizers were in reducing absenteeism in 3rd, 4th and 5th grade classrooms. They found that when bottles of sanitizers and wipes were kept around and students were cued to use them, they ended up missing significantly fewer days due to stomach bugs.

So go ahead and put those little bottles of sanitizer in your kids' backpacks, but recognize their limitations. The same study also found sanitizing hands does not do much to prevent sniffling and sneezing. In fact, it was not effective at all in reducing absences due to the common cold.

Allison Aubrey, NPR News.

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