sneezing

Student guest post: New Study Finds that the Flu has Multiple Ways of Spreading

tsmith — Fri, 21 Jun 2013 07:00:15 +0000

Student guest post: New Study Finds that the Flu has Multiple Ways of Spreading

Image Source: http://www.cejournal.net/?p=1934

The next time somebody in your office or household has the flu, you might want to consider keeping your distance. A new study published this month in Nature Communications suggests that about half of the transmission of influenza A results from inhalation of microscopic infectious droplets created by the coughing and sneezing of people infected with the flu. The flu virus hitches a ride in these droplets, and may infect nearby susceptible people who breathe them in.¹

The influenza A virus generally causes fever, coughing, body aches, runny nose, sore throat, headache, and fatigue. Vomiting and diarrhea may occur, but are more common in children.³ Fever and most other clinical signs usually resolve within 5 to 7 days, but coughing may last two weeks or more.² Children under 2 years old and the elderly are at greatest risk for complications such as pneumonia, and over 90% of influenza deaths are in people over age 65.²

Seasonal outbreaks of influenza are common in the United States, and typically occur during winter months. During and average outbreak, 5% to 20% of the people in a community may become ill with the flu, and up to half of the people in environments like schools and nursing homes may get sick.²

In adults with healthy immune systems, the flu virus is shed in highest numbers during the first 3 to 5 days of illness, making spread of the flu most likely during this time. Children may shed the virus for up to 10 days, and people with weakened immune systems may shed the virus even longer.² In a typical outbreak, a person sick with the flu passes the illness on to an average of 1 to 2 other people.^1,2

Previously, influenza A viruses were thought to be transmitted primarily by direct contact and by larger (but still very tiny) droplets generated by coughing, sneezing, and talking.^1,2,3 These droplets are capable of travelling 1 to 2 meters, where they may come to rest in the eyes, nose, or mouth of a susceptible person and cause them to become sick with the flu. These droplets may also fall upon nearby surfaces and objects, where the flu virus can survive for hours. A person touching these surfaces or objects may get the flu virus on their hands, and then transfer the virus to their eyes, nose or mouth and become ill.^1,2

The recent study, published on June 4, 2013, used a mathematical model of influenza virus transmission to evaluate the data from two previously published studies of the effectiveness of hand hygiene and facemasks for the reduction of transmission of influenza A viruses. It suggests that the flu virus may survive in very tiny droplets created by coughing and sneezing that can remain suspended in the air as an aerosol long enough to be inhaled by nearby susceptible people. The study shows that aerosols are an important route of transmission of the virus, and may account for as much as 50% of the spread of the flu.¹

Image Source: http://www.livescience.com/32307-why-do-bright-lights-make-me-sneeze.html

How you get the flu may determine, in part, how ill you get. Influenza researchers have long suspected that inhalation of aerosols containing the flu virus can lead to more severe illness than exposure to the flu virus by direct contact or by the settling of larger droplets in the eyes, mouth or nose of susceptible people. This is thought to be because larger droplets are trapped by the defense mechanisms of the upper respiratory tract, such as the large surface area of the nasal turbinates and the mucus lining the nose, pharynx, and trachea. Smaller droplets, meanwhile, are capable of being inhaled deep into the lungs, resulting in infection in the lower respiratory tract which can cause more severe disease. The current study found that there was an increased risk for fever plus cough in people suspected to have contracted the flu by inhalation of infective aerosols, which is consistent with current ideas regarding the importance of the route of infection.¹

Understanding the routes of transmission of influenza is also important for designing control measures to reduce the spread of this disease. Interventions such as increased hand hygiene and facemasks help to limit transmission of influenza by larger droplets produced by coughing and sneezing, but may offer little protection from inhaled aerosols.¹ Additional methods for controlling the spread of influenza through aerosols, such as improved ventilation of enclosed spaces, ultraviolet lights (which are capable of killing the flu virus), and minimizing exposure to those infected with the flu could reduce the risk of becoming sick.¹

So, what can you do avoid getting the flu? The most effective way is to get vaccinated before flu season. In the United States, flu season can start as early as October, though the peak months for flu are January and February, and sometimes even later.³ Because the flu strains circulating through the population change from year to year, you should be vaccinated each year. The vaccine is developed to prevent illness caused by the flu strains likely to cause outbreaks during the flu season, but may not prevent illness from novel or unanticipated strains causing outbreaks. Some people, such as babies less than 6 months old and those with allergies to eggs should not receive the flu vaccine.³ So the CDC recommends that you take additional preventive measures, such as good hand hygiene, avoid close contact with people who are sick with the flu, avoid touching your eyes, nose, and mouth, and practice good health habits such as remaining well hydrated, eating a healthy diet, exercising, and getting plenty of rest.⁵

If you do get the flu, what can you do to avoid infecting your family, friends, and colleagues? First, avoid close contact with others. Stay home from school or work if at all possible, and don’t run errands while you are sick. In this way, you can avoid exposing others to your illness. Second, cover your nose and mouth when you cough or sneeze. Experts recommend that you cough and sneeze into a cloth or into your elbow, so that you don’t contaminate your hands, which are commonly implicated in the spread of the flu. This simple practice can reduce the amount of infectious material you spread into your environment. Practice good hand hygiene, particularly before touching doorknobs and other items that may leave the virus where others are likely to become exposed.⁵

References

Cowling, B.J., Dennis, K.M., Fang, V.J., Suntarattiwong, P., Olsen, S.J., Levy, J., Uyeki, T.M., Leung, G.M., Malik Peiris, J.S., Chotpitayasunondh, T., Nishiura, H., & Simmerman, J.M. (2013). Aerosol Transmission is an Important Mode of Influenza A Virus Spread. Nature Communications, DOI: 10.1038/ncomms2922 LINK
Bridges, C.B., Fry, A., Fukuda, Shindo, N., & Stohr, K. (2010). Influenza (Seasonal). In Heymann, D.L. (Ed.). Control of Communicable Diseases Manual. American Public Health Association, Unbound™ Mobile Platform
Centers for Disease Control (February 13, 2013), Key Facts About Influenza (Flu) and Flu Vaccine, accessed at http://www.cdc.gov/flu/keyfacts.htm , June 8, 2013
Centers for Disease Control (May 6, 2013), What You Should Know for the 2013-2014 Flu Season, accessed at http://www.cdc.gov/flu/about/season/flu-season-2013-2014.htm, June 8, 2013
Centers for Disease Control (January 11, 2013) Preventing the Flu: Good Health Habits Can Help Stop Germs, accessed at http://www.cdc.gov/flu/protect/habits.htm, June 8, 2013
Flu Virus Image: Tom Yulsman (May 26, 2009), U.S. and Other Countries Fail to Adequately Monitor Pigs for Flu, accessed at http://www.cejournal.net/?p=1934, June 8, 2013
Sneeze Image: Ben Mauk, photo credit Andrew Davidhazy/RIT (November 28, 2012), Why Do Bright Lights Make Me Sneeze?, accessed at http://www.livescience.com/32307-why-do-bright-lights-make-me-sneeze.html, June 8, 2013

tsmith Fri, 06/21/2013 - 03:00

Tags

General biology

General Epidemiology

infectious disease

influenza

Top 10 new species of 2012

dr. dolittle — Sun, 20 Jan 2013 12:46:56 +0000

Top 10 new species of 2012

The International Institute for Species Exploration at Arizona State University that has just come out with the top 10 new species of 2012! This is the 5th year they have come out with such a list. If you would like to nominate your favorite new species discovered in 2013, click here.

Here are my favorites from the 2012 list:

The snub nose monkey (Rhinopithecus strykeri) from Myanmar that sneezes when it rains:

Photo reconstruction credit: Thomas Geissmann / Fauna & Flora International)

The Spongebob Squarepants sponge (Spongiforma squarepantsii), just because I LOVE that cartoon!:

Photo credit: Thomas Bruns, Interior (left) and exterior (right) views of Spongiforma squarepantsii; center: Dennis E. Desjardin & Andrew Ichimura, SEM photograph of spores of Spongiforma squarepantsii

...and lastly a blue tarantula, Sazima’s Tarantula (Pterinopelma sazimai):

Photo credit left: Caroline Fukushima; center and right: Rogerio Bertani/ Instituto Butantan

To see the other species that made the list, or to learn more about these species, click here.

dr. dolittle Sun, 01/20/2013 - 07:46

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Woah! amazing, that Tarantula spider is so beautiful <3 and the monkey is super cute.

So how many of these "new species" evolved from another species, or doesn't that happen anymore, ...or ever? Fact is these aren't new species at all but old species, newly discovered.

"So how many of these “new species” evolved from another species"

All of them - of course..

In a pandemic climate, public sneezing increases fears of unrelated risks

edyong — Tue, 03 Nov 2009 06:45:44 +0000

In a pandemic climate, public sneezing increases fears of unrelated risks

A friend of mine recently got onto a train and found a group of four seats that were empty except for one woman who was sitting face down. She looked asleep and he looked forward to a quiet journey. As soon as he sat down, the woman lifted her head to reveal streaming, puffy eyes and started sneezing profusely. This happened a few weeks after swine flu first began to dominate the headlines but being English, he was bound to the socially awkward choice of staying in his seat for the sake of avoiding social awkwardness.

Many of us probably have similar stories. At a time when fears of a flu pandemic dominate the headlines, does an innocuous sneeze make people fear the worst? Perhaps, but a new study suggests that hearing someone else sneeze plays with our minds far beyond exaggerated worries about pandemics. They can make us more worried about completely unrelated threats like heart attacks, crime and accidents. They can even affect our political attitudes.

On May 7, 2009, when swine flu had spread to at least 24 countries, a group of researchers from the University of Michigan took it upon themselves to sneeze in front of passers-by on their campus. Led by Spike Lee (no, not that one), the team approached 26 people who had heard the sneeze and 24 controls who hadn't, and asked them to complete a questionnaire for a class project.

Compared to the control group, those who had heard the sneeze felt that "average Americans" were more likely to contract a serious disease, citing risks of 41% compared to just 27%. More surprisingly, they also gave significantly higher estimates for the risk of dying from a heart attack by the age of 50 or of dying from crime or accidents. They even had slightly less faith in US healthcare, although this difference wasn't statistically significant.

Later on in the month, when almost twice as many countries had been infected, Lee performed a similar experiment in a shopping mall. This time, the experimenter asked passers-by to take part in a one-minute survey. Twenty-four of the volunteers received the form without much ado. Another 23 were handed the form by an experimenter who pretended to cough and sneeze at the same time, while covering her mouth with her forearm.

The first question asked people if they would prefer the federal government to allocate $1.3 billion towards the production of flu vaccines or the creation of green jobs. Faced with a sneezing, coughing researcher, almost half (48%) of the volunteers chose to finance the vaccine. Without the symptoms, only 17% did.

Of course, it's possible that being handed a form by a spluttering individual just put the volunteers in a negative and grumpy mindset. But Lee thinks not - a second question about the general direction of the country showed that both groups of volunteers were, on the whole, equally ambivalent about it.

Lee suggests that a minor, everyday event (like a sneeze) can heighten our worries about a whole range of unrelated hazards because it brings to mind a prominent threat (like a flu pandemic). Our emotions are affected by our ability to assess risks, regardless of what those risks are. In this way, the feelings elicited by one threat can feed into our evaluation of others, and sneezing in a pandemic climate can make people more worried about unrelated hazards from heart disease to crime.

Obviously, there's more work to be done. Lee's team haven't actually demonstrated that sneezing in a pandemic era makes people more worried about that specific threat. It would also be interesting to see if the effect they found waxes and wanes over time, and how that related to the amount of concurrent media coverage .

Nonetheless, one thing is clear. Like many aspects of our minds, people are completely unaware of this effect. When asked later, the volunteers didn't twig to the aims of the experiments. And while they assumed that a sneeze could make them overestimate the risk of flu, they didn't think it would make them think differently about the odds of other threats.

Reference: Psychological Science, in press.

More on our bizarre minds:

edyong Tue, 11/03/2009 - 01:45

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I'm trying not to frighten the populace with my "photic sneeze reflex" - sneezing in bright light.
(Actually sneezing in fairly dim light as it happens.)
http://www.google.co.uk/search?hl=en&q=photic+sneeze+reflex+&meta=&aq=f…

Makes perfect sense. We are not shaped by natural selection to have internal probability and actuarial tables in our brains, but we are shaped by natural selection to modulate temperament according to circumstance.

Economists will turn this into "humans are irrational." But economists only say that because they think it make them more attractive to members of the opposite sex. We Darwinists know what is really going on.

Interesting--more evidence as to how easily our thinking process is swayed by emotion and how easily emotion is swayed.

Here in Toronto there was tragic news of a child's death due to h1n1. There was no change in the overall info about h1n1. But fear took over and dramatically increased the number of people willing and eager to get vaccinated. The result--clinics were overwhelmed. People started lining up hours and hours before they opened and several days of mayhem and chaos.

I don't think that this is just about getting sick. It has to do with why we fear planes and trains more than we fear cars, although statistically you're more likely to die in a car accident. If you know someone who has been affected by serious crime it seems far more prevalent than before you knew anyone. The list of examples is endless and is core to the herd instinct of our soceity.

Really interesting, Also can't help thinking the reason there was so much scepticism about the swine flu vaccine was because the conspiracy theorists had organised there campaign against it on youtube and twitter which spread far and wide, whereas the NHS stuck to there posters!!

What do you do when you hear "achoo!"? The etiquette of a sneeze

sporte — Sat, 23 Feb 2008 11:26:11 +0000

What do you do when you hear "achoo!"? The etiquette of a sneeze

Long ago, I worked in a large lab that was divided into several small rooms. For part of that time, I shared one of the small rooms with a graduate student from Taiwan. She was a wonderful person who taught me that many cultural norms are not normal in other cultures.

One moment stands out.

She sneezed.

"Gesundheit" I replied.

She stared at me, clearly puzzled. "What?"

"You know, it's a word we say when people sneeze. It keeps demons from running up your nose"

If she looked puzzled before, now, she was clearly alarmed. I could see her sneaking furtive glances towards the door. Was she was considering the odds of getting around me and escaping?

I was stunned, too. Did I really just say that? Where did that stuff about the demons come from?

A little surprised myself, I explained, no, I didn't really believe that bit about demons, it was something that I'd heard somewhere, and that saying "Gesundheit" was a habit I learned growing up. Oh, and by the way, the proper response was "Thank you."

We both laughed and she thanked me for keeping the demons out of her nose.

These days, I work in a cubical, not a lab. More people are closer by and they sneeze more often, especially this time of year, when several people have been sick.

But I never know what to do anymore. My cubical neighbors don't say anything when other people sneeze. Nor do they seem to worry about it.

But I do. Sometimes I say "Gesundheit," sometimes I don't and, even though they always say "thank you," and I'm definitely not concerned about the demon business anymore, I always wonder if I'm doing something wrong or right.

What do you do when you hear "Achoo"?

sporte Sat, 02/23/2008 - 06:26

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I always say "Gesundheit". It simply means "health"; I always thought that "god bless you" was the one intended to keep the demons away.

Oddly enough, I sneezed in class a few years ago, and of course heard a chorus of "bless you"s. When I commented that I am an atheist, one student pointed out "we didn't say who bless you--it could be Satan bless you!"

I wouldn't have thought that I would have to teach university students that atheists don't believe in Satan any more than in any other of their gods.

I too grew up learning to say gesundheit when someone sneezed, although my father who was polylingual explained that it was from the German for "Good health." I still use it, and I find it much preferable to the "Bless you" that I frequently hear from those who are religiously inclined.

I also grew up saying "gesundheit". My mind was totally blown when I learned that it actually meant something other than "hey, you sneezed".

I say gesundheit. I also sneeze loudly, and in my old office a friend who worked across the room used to call me on the phone to say it...

It might be a southern thing but around here the call and response is to say "Bless you" after each sneeze. Once the series of sneezes has finished a "thank-you" seems to be the proper reply.

Growing up the story offered was that in earlier days sneezing was a sign that you had caught the latest disease and the Blessing was intended to give you divine protection from the evils of disease, presumably inflicted by some malevolent force like Satan or one of his minions.

Of course now we know about germs and that blessings offer little, if any, protection but a blessing after a sneeze offers a gesture of concern and an amenity of an older and gentler southern culture.

I actually say "Mash you". I picked it up from my best friend long ago. We are both atheists, so it doesn't have the "bless you" connotations. (For a while I used Seinfeld's "You are so good looking" line, but that takes too long to get out.)

Oddly enough, most of the time when I say "mash you", the sneezer says "thank you", rather that "what did you just say?". I'm not sure if they think they heard "bless you" or if they think it's safer just not to ask.

I grew up in an Italian-American home. "Salute" is the Italian equivalent of gesundheit and that's what I say to this day.

In my culture we say "grow old" - meaning "may you have a long life." I like it better than bless you since I don't like the religious connotations either.

I say Bless You, which is the English expression. I was told it was to prevent your sneezes turning into the plague.

I say "bless you," because there is no sequence of words that I could utter that would actually influence the sneezer's health, and I'd like them to realize that I'm acknowledging the fact that they sneezed. Bless you is a common-enough phrase, and I just love being thanked. That, and I usually have tissues, so if someone needs one, they're welcome to it :)

I'm an atheist, and I usually say "Bless you." If anyone looks at me funny, I explain, "I have that power."

------

It's purely functional speech, anyway. I don't know an atheist who hesitates to say "goodbye," even though it derives from the phrase "God be with you." It's a form of acknowledgement, like "thank you" or "you're welcome." Functional speech is important in every culture for fostering social inclusion, although it carries no more semantic content than a hearty pant-hoot.

In much of East Asia, sneezes are like farts -- they're never acknowledged in polite situations. Saying anything after she sneezed would be like sitting in a departmental meeting saying, "Jeez, who cut one?" No matter how rank it smells, you don't say anything.

It may well be that there are occasions in East Asia that call for functional speech that don't in the West, although I don't enough to say.

Frankly, I tend to be a bit alarmed when atheists act uncomfortable around casual mentions of God. It smacks of remnants of magical thinking. (Also, I don't understand why some atheists lowercase or otherwise misspell "God." Part of being an atheist is not being afraid to invoke supernatural beings.)

On the other hand, I once had a great time with a theist friend, by constantly invoking the aid of Satan and his minions during a game of pool. "I call upon you, Satan, and all the powers of darkness you command: Help me sink this six ball in the side pocket!" "Dude, you shouldn't joke about that."

It's one of those geographical sayings. From what I've encountered, those who say "gesundheit" (like me) are from the Midwest; those who say "bless you" are from elsewhere.

If anything, I'd say 'Gesundheit'. Luna - I too had heard that saying 'bless you' was connected with the plague, just like the nursery rhyme. Ring, a ring o' roses (the first sign, red dots on your skin), a pocket full of posies (to ward it off), atishoo, atishoo (next sign), all fall down (last sign).

Do you guys in the US really say 'Gesundheit' ? It is so cute to see one of our words (particularly one unrelated to war or anything like that) put to good use in a foreign language.

As somebody pointed out, 'gesundheit' just means 'health', and I am sure that this is already an abbreviation of an older habit of saying 'may you be in good health' (which just takes too long to say).

There are some other interesting cultural differences: I had no idea that 'achoo' is the sound of sneezing in english. Germans usually sneeze by saying 'hatschi' - the first part is quite similar, but at the end the two versions diverge. I would be interested to learn about the french, spanish and italian versions, or even the east asian ones.

A nagging question of etiquette is, obviously, whether to say 'gesundheit'/'bless you' after the first sneeze, or if you rather wait for the end of the entire sequence (usually up to three in germany - are there differences too?) In some regions it is customary to say 'gesundheit' after the first sneeze, and if there is a 2nd or a 3rd one, you add 'schÃ¶nheit' (=beauty) and 'klugheit' (=intelligence) later. Obviously, this is nothing official, more some kind of mocking between friends.

How about "Would you like a tissue?", or "Sounds like you should take a day off"? Failing that, just accept that sneezing is a perfectly normal part of being human, and don't say anything.

In San Antonio, TX a lot of people say "salud" which means health.

I usually just say "Gesundheit," but for what its worth I think I heard Penn Jillette comment once that he likes to say "That's funny" after someone sneezes.

Another problem besides what to say after someone sneezes is how an atheist should reply to others after they respond to your sneeze with "Bless you" or "God bless you."

If they just say "Bless you" I see no big problem, but if they invoke god, should you say something about your non-belief?

@ Richard Simons - Here's how I learned the plague song:

Ring around the rosy [red marks on the skin]
Pocket full of posy [flowers mask the smell]
Ashes, ashes, [burning bodies]
We all fall down. [dead]

Creepy song for kids to sing! I wonder what other variations there are.

Wikipedia reveals a wealth of variations on the rhyme, and questions its origin:
http://en.wikipedia.org/wiki/Ring_around_the_rosy

When I was living in Japan, a sneeze became a cultural learning experience. After I sneezed, I sort of waited for someone to say something. Silence. Turned out they were waiting for me to say (the Japanese equivalent of) "excuse me." I don't recall whether I clued into the this the first time I sneezed ... or the 20th time. (I was there 2 years.) But it did open up an interesting discussion about "gesundheit" and "bless you."

During a weekend driving trip with Japanese friends, I introduced "potty stop" into the Jangish vocabulary.

I usually juggle between saying nothing (I don't see the point), saying "gesundheit" (because it's sensical and socially proper), and, just for kicks, saying "Walter Cronkite."

I get some perplexed looks with that last one.

This has to be one of my favorite scienceblogs.com comment threads ever. :)

(Especially since I'm sneezing a lot lately, thanks to the exhibitionistic tendencies of the white ash tree...)

I'm not an atheist, but I'm also not overtly religious, and yet I do say "bless you." Mostly because I feel like not saying anything to acknowledge the sneeze would be rude. (Although this might be a holdover from my childhood that isn't actually relevant anymore)? I think I'd like to try and remember to switch to "Gesundheit." I like that better than "bless you" for a variety of reasons, and since I'm probably not going to be able to stop myself from saying something - it really is that deeply ingrained - it would be nice to say something that doesn't have any religious overtones.

Oh, and I thought that the reason we say "bless you" is because people believed that the heart stopped beating for a brief period during a sneeze, and the comment was a way of saying, "hey, I hope your heart starts working again now."

#14: "Germans usually sneeze by saying 'hatschi'... I would be interested to learn about ... the east asian ones."

Indonesian says 'hatschi' too.

I go 'hatschi' too instead of 'achoo'.

I never say anything when someone sneezes but my friend will compulsively bless everyone. She did it to a dog too much to everyone's amusement.

The Brights have some very quirky responses to people saying 'God Bless You' :
# Thanks, but I'm already fully blessed.
# Thanks, but I'll take my chances unblessed.
# Thanks, but I'm allergic to blessings.
# Thanks, but Nature beat him to it

I posted a video on how to sneeze, truly gross it is.

"Prosit."

You wouldn't want someone to think that you secretly hope the omen from the gods was a bad one, after all.

(This is Sweden, by the way. And I find it just a tiny bit amusing that the post never mentions the context, other than saying what it's not; i.e. Taiwan.)

I hate it when I sneeze and people say something. Because then I'm supposed to say "thanks", but I can't speak yet, because I have to sneeze once more. Why don't people just leave me alone?

My very cultured uncle did in fact tell me that if you want to be really polite, you don't say anything when someone sneezes -- you just ignore this fauxpas...

I would be interested to learn about the french, spanish and italian versions, or even the east asian ones.

Spanish: ¡ATJÓ ATJÁ ATJÁ! With j like Swiss German ch.

and, just for kicks, saying "Walter Cronkite."

I get some perplexed looks with that last one.

That's because German Krankheit means "illness".

In response to OmegaMom's comment:

It's one of those geographical sayings. From what I've encountered, those who say "gesundheit" (like me) are from the Midwest; those who say "bless you" are from elsewhere.

I'm not sure what part of the midwest you're from, but here in Michigan I've probably only heard "gesundheit" a dozen times in my life. "Bless you" is by far more common here.

For me, I think it's almost a reflex reaction to say it, even though I'm an atheist.

Try saying "damn you" next time and see what kind of reaction you get. Does a pretty good job of underscoring the absurdity of the whole thing.

German is actually a huge ethnic group among Americans. So "gesundheit" was what my family said (Koarts on half of my father's side, my great grandmother spoke German) and what the Frohlings next door said, too, as I recall. I think I switched to bless you, or just bless, or, for more extreme sneeze series, "Oh dear, are you okay? Should I grab you some tissues?" after encountering a sufficient number of people who weren't used to the German and getting lazy enough to stick to words that were easier to spell.
And any blessings I considered to be simply a way of expressing good will, not an actual invocation.

Snowdog,

There are really big German / Polish populations in Western Pennsylvania (Pittsburgh especially), Northern Kentucky (Go to Hoffbrau House in Newport, it rocks), Ohio (Cinci, where my German roots ended up), but maybe it doesn't go up to Michigan.

Since the only people I spend time with are my kids, I have a tendency to say "Go wash your hands!" when I hear a sneeze.

Okay, I made it all the way down to comment #15 before I sneezed. you?

I usually say, "That's just allergies right? I don't have to sterilize the entire area with bleach again, do I?" :-0

It is not widely known; but, when you sneeze your soul momentarily leaves your body. Probably the most appropriate helpful comment would be, "Get back in there!"

Here in the Netherlands people usually just say "gezondheid". yes, it means exactly the same as gesundheit (German and Dutch usually "look" a lot like each other).

But I usually use gesundheit. People never really seem to notice that I use the American/German version.

French people sneeze "atchoum" or "atcha". And we say "A tes souhaits", which basically translates to "Make a wish".

There is also a tradition that you say "Make a wish" for the first sneeze (expected answer "thank you"), then something that could translate as a - non-religious-- blessing of your love life for the second sneeze (expected answer: "may yours last long"), and something to the effect of blessing your lovers for the third one (expected answer: "may yours be it for long"). The whole things kind of rhymes. Then if there's a fourth sneeze I don't know what you are suppose to do - run away maybe?

I was taught to say "bless you" when I heard people sneeze.

I don't know if it is accurate or not, but I was taught that this originated from people thinking that a sneeze was a sign of someone's soul trying to escape their body. The "blessing" (saying bless you) was a way to keep the soul from escaping.

I think the story is funny whether it is accurate or not.

Well I an Italian-Cuban, so usually I use "Salute", very proper and nothing else than wishing the person good health.

But when I am with the Cuban side there are many forms, Salud, which is the "Salute" equivalent, "Que dios te bendiga", which is the "bless you" equivalent and "mamamela" which is profanity in Spanish cultures. Leaves the sneezer stating... "What???" (usually the answer involves "no nada" which mean "Nevermind :)")

But I usually use gesundheit. People never really seem to notice that I use the American/German version.

Did not notice anyone mention the glaringly obvious. Sneezing (plague related) was recognised (very early on) as a symptom of impending death, and like it or not, The "God Bless You" was akin to a small prayer of pity. "How's your insurance?" might be a modern equivalent.

I had pretty bad allergies growing up and I was constantly sneezing. Not little dainty sneezes either, I packed a wallop whenever I sneezed. Still do actually. My dad would drive me up a wall with his reply of "..And she blew the house down!" whenever I sneezed. Drove me insane. Although now I can't help thinking of it every time I hear someone else sneeze.

I say "Bless you" even though I am an atheist, it's just a polite thing to do. Almost every phrase I've heard stems from demons, gods or wishing health on themselves (e.g. Gesundheit, at least according to wikipedia) anyway so I'm not terrible worried about it.