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Last updated August 10, 2017, originally published July 22, 2013

By Max Gruber, Contributing Columnist

Okay, so you need to go and you pass by a public toilet.  
Your bladder is yelling at you, you can’t hold on much
longer, but your brain and every one of your  5 senses are
flashing red lights.  The assault of smells from many public
bathrooms are warning you to do anything but use them.

Public toilets have more germs than your own bathroom
due to the amount of people that use them. The truth
about the bacteria living and breeding within toilets is not
for the faint-hearted.

Philip Tierno, MD, director of clinical microbiology and
diagnostic immunology at New York University Medical
Centre and Mt. Sinai Medical Centre in New York City
stated that, "the bulk of the organisms found are basically
faecal-borne bacteria." It is important to note that unless a
person has an open cut or fails to properly wash their
hands, the bacteria is for the most part harmless.

There is however, no skipping around the fact that
diseases such as E. coli, Rotaviruses, Hepatitis A, the
common cold, Salmonella and MRSA amongst other viruses
that can be found in public toilets.

If some of these organisms are alive in the public toilet or
on the toilet seat, when you enter a stall and sit down, you
do in fact put yourself at risk for contracting a disease.

Here's a shocker. Although the majority of people make a
fuss over a toilet seat, it is generally the case that it is
more dangerous what you touch than where you sit.

The disease hotspots within a public toilet are the sinks,
hand driers, door handles and faucets.

Many studies have found that these places have in fact
even more germs and diseases than on a toilet seat. An
ABC News investigation of the germiest spots in public
toilets found that the floor has about 2 million bacteria per
square inch. This means that even if you manage to avoid
touching the bacteria-infested areas, you can still take the
bacteria and diseases with you.

The bacteria stick to the bottoms of your shoes and you
walk in the bacteria through the front door of your home.
Many people do not take off their shoes before they enter
their homes. They then later walk around barefoot. As a
result, you end up with germs from a public toilet on your
feet and hands.

The severity of the spread of diseases can be seen through
a study the American Society for Microbiology performed
which found that although 95% of adults claimed to wash
their hands after using a public toilet, only about 77%
actually did. This can be especially harmful for children as
they tend to touch more things and put their hands in their
mouths, eyes and toys, thus transferring the spread of the
disease and bacteria.

Here are 7 diseases you really can get from public toilets,
so in order to avoid them make sure to wash your hands
thoroughly with soap and be careful where you sit and
what you touch.

1.        Shigellosis:
According to the 1999 World Health Organization Report
by Clemens, Kotloff and Bradford on the ‘Generic protocol
to estimate the burden of Shigella diarrhoea and
dysenteric mortality’, the transmission of the disease is
extremely quick and takes place due to person-to-person
contact. The bacterium is found on toilet seats due to
faecal matter.

Shigellosis can cause symptoms similar to severe food
poisoning such as abdominal pain and in more severe
cases, dysentery. The severity of dysentery is
characterised by cramps, diarrhoea, fever vomiting and
blood in stools. The disease can last for up to one week
and the symptoms are usually observable between 12 to
96 hours.

2.        E. coli:
The well-known and dreaded E. Coli virus can also be
found on toilet seats and its transmission is similar to

The bacterium is transmitted through faecal-oral contact
and latches on to anything it comes into contact with,
whether it is your skin or your personal belongings. The
common symptoms of E. Coli are generally disguised as flu
with the person experiencing nausea and vomiting.
However, the symptoms can worsen until those infected
have bloody diarrhoea and, in its most severe form, kidney
failure and even death.

3.        Hepatitis A:
The infectious Hepatitis A disease lives on toilet seats and
can be transferred through faecal matter. It is not
uncommon to hear about the latest outbreak of Hepatitis A
at restaurants due to a chef not washing their hands after
using the toilet.

The Hepatitis A disease is an acute infectious disease of the
liver and is transmitted person-to-person through direct
contact with an infectious person. Early symptoms of
Hepatitis A can sometimes be mistaken for influenza
however, and especially true in children, there may be no
symptoms at all. The symptoms can last from 2 to 6
months and include fatigue, fever, nausea, jaundice, bile
and appetite loss.

4.        Salmonella:
Bloomfield and Barker from the Department of
Pharmaceutical and Biological Sciences at Aston University
in the United Kingdom wrote a paper about the survival of
Salmonella in bathrooms and toilets in domestic homes.

Their research can be applied to public toilets which found
that salmonella is extremely difficult so much so that you
almost have to hope that no one with salmonella has used
the public toilet. Those with salmonella develop diarrhoea,
fever vomiting and abdominal cramps. The infection can
become extremely dangerous if it spreads from the
intestines to the blood stream which can cause death
unless treated properly. However, due to the durability of
the infection which can withstand freezing as well high
temperatures, the treatment of salmonella can sometimes
be slower than treating other infections.

5.        Crab Louse:
A parasite which is approximately a 2mm long, grey insect
can be contracted from public toilets. The parasite attaches
itself to pubic hair which for example can come into
contact with the toilet seat. Once attached to the hair, it
feeds off human blood and although slow moving they
breed quickly and can live for several weeks. The main
symptoms of the infestation is itching in the pubic-hair
area and in some infestations, a grey-blue colour may
appear on the skin where the parasites have been feeding.
Although commonly associated with sexually transmitted
diseases, crab lice can also be transferred through dirty
towels and clothing.

6.        Scabies:
Characterised by the World Health Organisation as a water-
based diseased in 2010, the parasite, scabies, is usually
transmitted via skin-to-skin contact. Found on wet
surfaces in a public toilet, scabies is a skin infection caused
by a tiny mite burrowing its way under the skin that
causes the symptom of intense itching and superficial
burrows. Those infected with scabies may also notice
rashes appearing on their hands, feet, elbows, writs, back
buttocks and genitals. The elderly and people with low
immune systems can be susceptible to crusted scabies
causing scaly rashes, and thick crusts of skin that contain
thousands of mites. Although medications and treatments
are available, due to the possibility of reinfection, the
whole household or even community may need to be

7.        STDs:
With varying opinions as to whether or not STDs can be
contracted from public toilets whilst the organisms do not
survive for long periods of time outside of the body there
is still the possibility of contracting a sexually transmitted
infection whilst using a public toilet. Although unlikely to
occur, the
transmission of STDs can occur in public toilets
if they enter an open cut or sore. Current University of
Illinois professor at The School of Molecular and Cellular
Biology and ex-President of the American Society of
Microbiology Abigail Salyers stated that to her knowledge,
no one has ever acquired an STD on the toilet seat. Due to
the conditions which do not support the survival and
spread of STDs, the odds of infection from just sitting
down on a public toilet are miniscule.

Next time you are desperate for the toilet, make sure to
keep in mind the above 7 diseases you may be at risk of
contracting. Always keep a bottle of hand sanitizer to get
rid of the germs having exited the public toilet and washed
your hands thoroughly. As many of the diseases can be
passed from the toilet surfaces or floor, try to keep your
personal belongings from touching the floor and other

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The bathroom floor of a public toilet has 2 million
germs per square inch.
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