If hand sanitisers kill 99.99% of germs, then who are those 0.01% who survive? There are three major kinds of germs which remain active even when you have used your sanitiser.

Norovirus

Among them, is the norovirus that causes diarrhoea and vomiting outbreaks in places like cruise ships and schools. It is superior to many other viruses because it has a protein capsid, which is resistant to the effects of alcohol.

Norovirus is a group of viruses that causes common illnesses and is also very contagious. It is especially active in the colder month and comes back seasonally. The first norovirus outbreak occurred in Norwalk, Ohio, USA, in a school in 1968, this is where it gets it name from.

Enterococcus faecium

The next on the list is enterococcus faecium, and it lives in the gut. As per a 2024 study titled Enterococcus faecium: evolution, adaptation, pathogenesis and emerging therapeutics, published in Nature journal, it is a Gram-positive bacterium that is a core member of the intestinal microbiota of humans and animals and an opportunistic pathogen that causes life-threatening infections, particularly among hospitalized patients. It mutates in a way that it absorbs carbohydrates and forms a gooey, slime-like substance called the biofilm, which makes it resistant to alcohol.

Clostridium Difficile

Another one is clostridium difficile. This is responsible for causing horrendous diarrhoea and vomiting in hospitalised patients. It also has a remarkable ability to respond to environmental stressors including alcohol gel by going to sleep. It produces spores and allows all metabolic activity.

Clostridium difficile (C. diff) is a type of bacteria that can cause colitis, a serious inflammation of the colon. Infections from C. diff often start after you've been taking antibiotics. It can sometimes be life-threatening.

Why Do You Label Read 99.99%?

Apart from the germs and pathogens, another reason why your label reads that it kills 99.99% is to avoid any legal hassles. If someone uses a specific product and falls sick, then the person cannot sue the company as the company did not give a 100% safety guarantee against the germs.

A better way to be healthy is always to clean your hands with soap and water and wear gloves wherever is possible.

Growing fatty liver disease in India is significantly affecting both male and female fertility, said doctors ahead of World Liver Day.

World Liver Day is observed annually on April 19 to raise global awareness about liver-related diseases, the importance of early detection, and preventive measures. The liver is the second largest organ in the body and a vital "silent worker," often showing no signs of damage until late stages.

With nearly one in three adults is affected by fatty liver, the silent disease is now emerging as an important but often ignored cause behind infertility in India.

Poor liver health is causing health issues, such as irregular periods in women and falling sperm counts in men, affecting their reproductive health.

Rising Liver Disease Cases

A recent study published in The Lancet Gastroenterology & Hepatology journal showed that the Metabolically Dysfunctional-Associated Steatotic Liver Disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), affected 1.3 billion people around the globe in 2023.

India has also shown a sharp rise in MASLD prevalence, up 23.19 per cent from 1990 to 2023. India’s age-standardized MASLD prevalence rate rose from 10,191 per 100,000 in 1990 to 12,555 per 100,000 in 2023.

The findings show that the spike is increasingly driven by rising metabolic risk factors, including high blood sugar and obesity.

The alarming study estimates the numbers to further spike by over 38 percent to reach 1.8 billion cases by 2050, causing substantial health and economic impacts worldwide.

“We are seeing a big increase in fatty liver cases, even in younger people in their late 20s and 30s. Earlier, it was mostly seen in older patients, but now, due to poor lifestyle and diet habits, it is becoming very common in the young population also in India,” said Dr. Saurabh Singhal, Senior Consultant & Director, Centre for Liver-GI Diseases and Transplantation (CLDT) at Aakash Healthcare.

Also read: NAFLD to MASLD: Experts Explain Why This Common Yet Dangerous Liver Condition Got Renamed

"Almost every second patient we see has some degree of fatty liver. Many people do not even know they have it because it shows very few symptoms in the early stage. That is why it is called a silent disease,” added Dr Amit Miglani, Director & HOD, Gastroenterology, Asian Hospital, Faridabad.

Impact On Women’s Fertility

In India, around 8 per cent of women face infertility, and doctors are now seeing a strong link between fatty liver and difficulty in conceiving. The problem is more common in women with PCOS.

Dr. Hrishikesh Pai, Consultant Gynecologist & IVF Specialist, Lilavati Hospital, Mumbai, explains, “In women, fatty liver is closely linked with hormonal imbalance. We are seeing more patients with Polycystic Ovary Syndrome and irregular periods, where fatty liver is also present. This affects ovulation and makes it difficult to conceive.”

The doctors noted fatty liver affects how the body handles insulin and hormones, which are very important for regular periods and pregnancy.

Impact On Male Fertility

Infertility is no longer only a woman’s issue. In India, 30-40 per cent of infertility cases are linked to men, and doctors say cases are rising.

As per the experts, liver problems directly affect hormones like testosterone in men.

In addition to obesity, fatty liver is leading to low sperm count and poor sperm quality.

Studies show that sperm count in Indian men has dropped sharply over the last few decades, which is a growing concern. Doctors stated that "liver problems can also increase body stress, which further damages sperm health".

How To Prevent?

Fortunately, the progression of fatty liver disease can be stopped if people lose weight early in the course of the disease and adopt healthy eating habits and exercise regularly, said Dr. Vikas Jindal, Consultant, Dept of Gastroenterology at the CK Birla Hospital, Delhi

Further, the doctors stated that although liver disease is becoming a common problem, the worrying part is that people realize it very late.

They recommended:

• a liver health evaluation once a year, especially at-risk people like those with obesity, diabetes, altered liver parameters in blood test, fatty liver, hepatitis, or cirrhosis in family members.”

• Liver health and overall metabolic health must also be checked early in fertility treatment.

• Make simple lifestyle changes like healthy food, regular exercise, and weight control.

Cancer is often feared as a silent disease, but in many cases, the body does give early warning signs. The challenge is that these signals are either ignored, misunderstood, or detected too late.

A large number of cancer cases are diagnosed at advanced stages—not because symptoms were absent, but because they were overlooked or diagnosis was delayed.

Understanding the early signs and the reasons behind delayed detection can help save lives.

Speaking to HealthandMe, Dr Siddharth Sahai, Director & Unit Head - Medical Oncology, Max Super Speciality Hospital, Dwarka, shared seven signs of cancer that should not be neglected.

1. Unexplained weight loss

Losing weight without trying—especially more than 4–5 kilos in a short time—can be an early sign of cancers such as stomach, pancreas, or lung cancer.

2. Persistent fatigue

Feeling unusually tired despite adequate rest could signal underlying issues like blood cancers or colon cancer. This kind of fatigue does not improve with sleep.

3. Changes in bowel or bladder habits

Chronic constipation, diarrhea, blood in stool, or changes in urination patterns should not be ignored. These may point toward colorectal, bladder, or prostate cancer.

4. A lump or thickening in the body

Any new lump—especially in the breast, neck, or underarms—needs medical evaluation. Not all lumps are cancerous, but it’s important to rule it out early.

5. Persistent cough or hoarseness

A cough lasting more than 2–3 weeks, or voice changes, could be early signs of lung or throat cancer, especially in smokers.

6. Unusual bleeding or discharge

Bleeding between periods, after menopause, blood in urine, or unusual discharge can be warning signs of cancers such as cervical, uterine, or bladder cancer.

7. Non-healing sores or skin changes

Sores that do not heal, changes in moles, or new skin growths could indicate skin cancer or oral cancer (especially in tobacco users).

Also read: New Breast Cancer Guidelines Recommend Mammograms Every Two Years for Women

Why Cancer Diagnosis Often Gets Delayed

Dr Sahai also mentioned six common causes of delayed cancer diagnosis

Factors that contribute to late detection include:

1. Lack of awareness

Many people are not aware that these symptoms could be linked to cancer. They often dismiss them as minor issues like acidity, infection, or weakness.

2. Ignoring symptoms due to busy lifestyles

In both urban and rural settings, people tend to delay doctor visits due to work commitments, family responsibilities, or simply hoping the problem will resolve on its own.

3. Fear and denial

The fear of being diagnosed with cancer leads many individuals to avoid medical consultation. Denial becomes a major barrier, especially when symptoms are mild initially.

4. Limited access to healthcare in some areas

In smaller towns and rural regions, access to diagnostic facilities and specialists is still limited. This leads to delays in proper testing and referrals.

5. Financial constraints

Concerns about the cost of investigations and treatment often prevent timely medical attention. Many patients wait until symptoms worsen significantly.

6. Misdiagnosis or delayed referral

In some cases, early symptoms may mimic common illnesses. Without timely screening or specialist referral, diagnosis can be delayed.

The Importance Of Early Detection

Dr Sahai stressed that early detection significantly improves cancer outcomes. Most cancers, if identified in the initial stages, are treatable and even curable. The key lies in listening to your body and acting without delay.

Simple steps like regular health check-ups, cancer screening (such as mammography, Pap smear, or oral screening), and timely consultation can make a crucial difference.

Ignoring symptoms may seem convenient in the short term—but early action can save not just time, but life itself.

Earlier this week, in shocking news, an investigative BBC report showed that more than 330 children in Pakistan have contracted HIV due to the reuse of syringes in a hospital in Pakistan’s Punjab.

The incident captured on camera was filmed over 32 hours inside THQ Taunsa Hospital in late 2025 and showcased persistent unsafe practices, including the reuse of syringes on multi-dose vials, and other unhygienic practices at the healthcare facility.

In an interview with HealthandMe, Dr Ishwar Gilada, the President Emeritus of the AIDS Society of India, spoke about how reusing needles raises health risks.

The Mumbai-based top infectious disease expert noted that the risk of HIV transmission is much less for reused syringes and that the risk is potentially higher for hepatitis B and hepatitis C.

Dr. Gilada, the only Indian serving on the International AIDS Society (IAS) Governing Council, also stressed that the probability of transmission may vary depending on factors such as viral load and the amount of blood present. However, the danger is never zero, he said, stressing the importance of safe and single-use injection practices critical in every healthcare setting.

Risks Of Reusing Syringes

Dr Gilada noted that all the transfusion-transmissible infections can be transmitted, albeit with lesser chances than blood transfusion.

Other than HIV, it can raise the risk of several infections, including:

• Hepatitis B,
• Hepatitis C,
• Syphilis,
• Malaria,
• Ebstein-Barr virus infection,
• Tetanus infection,
• Septicemia,
• Bacterial endocarditis.

Importantly, Dr. Gilada stated that even a tiny amount of infected blood can cause transmission.

However, there is a simple principle in microbiology - the chances of transmission are directly proportional to the inoculum.

"The higher the inoculum, the more the chances. Lower inoculum lowers the risks, but the odds are not zero," the expert added.

Does HIV Spread Through Reused Syringes? How?

Dr Gilada said that the chances of infections are usually through freshly used needles.

"In the needle that was used 15-20 minutes earlier, the blood clots in the bore of the needle. Usually, a drop of blood remains in used needles due to 'capillary action'.

"When the same needle is pricked in the new patient, that drop gets mixed with his/her blood by 'surface tension'. The chance of getting HIV infection through such a mix-up is around 0.1per cent if the previous person had HIV," the expert said.

However, he added that "it will also depend on the HIV viral load of the source person. Those with high viral load can lead to higher chances, but if the source person is on ART and is virally suppressed, the chances are near zero".

Also read: Why India Must Shift Towards Prophylaxis Care For Hemophilia

How Can One Prevent?

Dr. Gilada said that prevention is only through good hygiene practices, such as:

• Using spirit to wipe the body part to be injected,
• Needles should be disposed of in impervious containers.
• The containers should be disposed of in local municipal facilities
• Recycling of any type of needles should be a strict no.