C18: c-Difficile

Here is a real strange hypothesis, but quite possibly is valid and important. 

Much is made about the hand to mouth contamination of the c-difficile spores, and most of the initiatives are related to hand and surface cleaning.

Overlooked (not even considered) is the anus to anus transmission through toilet water.

There is a huge assumption that when someone uses a toilet, and it is properly flushed, the pores are flushed away. This assumption needs to be reconsidered. If someone who is infected with c-difficile uses a toilet, it is quite possible that even after flushing, some of the spores will survived the flush and are still in the toilet water. 

But how does that get transmitted?

This is the simple part. When stool lands in the water, a reciprocal bubble of water will splash up and often splash on the anus of the person using the toilet. Even a drop of water will have a similar drop leap up above the surface of the water (not going to discuss fluid dynamics here). Stool often will cause a large splash of water (close to the size of the stool) to splash up onto the person using the toilet. When this happens the spores in the water that were splashed onto the person using the toilet can now enter the anus, and infect this user.

This happens in residential and industrial toilets, but more so in institutional toilets. Institutional toilets have higher water levels as they try to avoid the stool soiling porcelain surfaces. These higher water level make it easier for the anus to be splashed by toilet water.


Simply add chlorine or other sporicidal agents to the toilet water. Toilets that have tanks can have chlorine pucks added to the tanks, which will automatically add chlorine at each flush. Toilets without tanks will need a device which will bleed chlorine into the water with each flush. It's that simple.

What can you do to protect yourself if you have to use the facilities in a hospital or long term care facility. For the first part you can flush the toilet before you use it, and or, add a chlorine or other agent to the water, such as Lysol, before you use it. This means bringing some with you, but these institutions could have it available for you to use, with instructions.

But it may take more than that. Institutional toilets are often high pressure systems. They are quite violent a flush, but this is to ensure all the toilet water is removed. However, the violence of the flush will spray some of the water on the toilet seat and other surfaces, contaminating those surfaces, which should now be cleaned after each flush.