Books as Fomites:
how much ‘culture’ can
one good book provide?
Jay Watson
Dara Wegman-Geedey, PhD
Year of the Book presentation
16 April 2008
First things first….
 WHAT is a fomite?
 Current usage: a fomite is any inanimate object that
transfers pathogens from one host to another or from a
natural reservoir to a susceptible host
 Origins:
The word fomite is a back-formation from the plural
fomites, which was originally the Latin plural of the
singular, fomes, literally meaning “touchwood” or
“tinder.”
In classical Latin, fomites was pronounced like a
concatenation of English "foe" + "me" + "tays"; but "foe"
+ "mites" has now become a common pronunciation,
and "fomite" (also pronounced with a long 'i') is the
singular form in English. (http://en.wikipedia.org/wiki/Fomites)
Properties of “good” fomites…
 Varies for bacteria, but in general:
 non-porous surfaces
 moderate humidity (approx 45-65%)
 must also consider cell walls, endospores,
possible VNC status
 Varies widely for viruses, but in general:
 non-porous surfaces
 moderate humidity (approx 45-50%)
 presence of microbes
A brief history of books as fomites….
 Mostly anecdotal from late 1800s/early 1900s – no
definite study data




Diphtheria in US: 2 children handling books at a
farmhouse where diphtheria had been present years prior
Smallpox in US: 1 person borrowing books from a library
in neighboring town where a smallpox outbreak had
occurred
Scarlet fever in US: 1 person from book in which “a
young sufferer had used pieces of his peeling skin as
bookmarks”
streptococci/pneumococci in France: lab isolations from
books handled by infected patients
 Ringworm from XIVth century parchment, Yucel &
Kantarcioglu, 1998
Books/paper as fomites in popular
culture
 Microban folders, local Staples, 2007
 Microbeguard’s Food Touch  paper liners, AP
release Jan 2007
 Seinfeld episode: “The Bookstore,” April 1998
 Paper currency, Pope et al., 2002
 England/Wales Public Health (Control of
Disease) Act, 1984, Atensteadt, 2006
 Paper towel litter, Harrison, et al., 2003
Our questions…
 Would the environmental conditions of the
library support growth of pathogens?

Would the conditions in special collections
differ in support of pathogen growth compared
to the standard library stacks?
 Would the physical make-up of a book (e.g.,
cloth vs paper) affect the survival of
pathogens?

Would survival of pathogens differ on various
types of information storage materials?

books, periodicals, microfilm. microfiche
Effect of Library Environment on
Pathogen Growth
 Environment of each floor and Special Collections was
evaluated from at least 10 positions to find average
temperature, humidity, light
 Representative incubation sites chosen: 2nd floor stacks,
special collections, control in lab incubator
 Staphylococcus aureus, S. epidermidis and Escherichia
coli stock cultures were grown overnight in tryptic soy
broth
 Diluted samples of S. aureus, S. epidermidis and E. coli
were spread plated separately on tryptic soy agar plates

Replicates made for placement in each incubation area
 TSA plates were evaluated daily for three days
 Colonies counted by visual examination of the plates
Library Environs Results, Control
Growth of Model Pathogens in Microbiology Lab Incubator
12
10
# of Colonies (log10)
8
6
4
2
0
12/18/2007
S. aureus
12/19/2007
S. epidermidis
12/20/2007
E. coli
Control
Library Environs Results, part 2
Growth of Model Pathogens in the 2nd Floor Stacks of Tredway Library
10
9
8
# of Colonies (log10)
7
6
5
4
3
2
1
0
12/18/2007
S. aureus
12/19/2007
S. epidermidis
12/20/2007
Lab Incubation
E. coli
Control
Library Environs Results, part 3
Growth of Model Pathogens in Special Collections of Tredway Library
10
9
8
# of Colonies (log10)
7
6
5
4
3
2
1
0
12/18/2007
S. aureus
12/19/2007
S. epidermidis
12/20/2007
Lab Incubation
E. coli
Control
Library Environment Conclusions
 Library and special collections environmental
conditions support growth of a Gram negative
organism (E. coli) but fail to support growth of
Gram positive bacteria (Staphylococcus sp.)
 But these conditions don’t kill the Gram
positive organisms either. Returning them to
optimal conditions resulted in maximum
expected growth.
Effect of Materials on Pathogen
Survival
 Store-bought spray bottles were evaluated and calibrated
for delivery of appropriate “spritz” size
 S. aureus and E. coli cultures were grown overnight in
TSB
 Books, periodicals, microfilm and microfiche (substrates)
“retired” from the library were inoculated with either diluted
spritzes of S. aureus or E. coli
 Substrates were immediately sampled using PetriFilm
direct contact method to determine survival of model
pathogens

Sampling repeated at one week intervals for a one month
period
Materials Effect on Survival Results
Magazin
e
Book
1
Prelim
One
Two
2
Film
1
2
CD
1
2
Fiche
1
2
S. aureus
++
++
+++
+++
+
+
+++
+++
+++
E. coli
+
++
++
+
+
+
+++
+++
++
S. aureus
+
+
++
++
+
+
++
++
+++
E. coli
+
+
+
+
+
+
+
+
-
S. aureus
+
+
++
+
+
+
+++
++
++
E. coli
+
-
+
-
+
+
+
-
-
Materials Effect on Survival
Conclusions (in progress)
 Survival on non-porous surfaces appears
better than on non-porous for both model
organisms
 Survival of Gram positive S. aureus appears
better on all surfaces than the Gram negative
E. coli
The take-home message….
 WASH your hands after handling potential
fomites

use liquid handsoap that does not contain
Triclosan or other antimicrobials



don’t need to select for the strong ones, just need
to remove bacteria from your hands
30 seconds: “Happy Birthday” twice
all surfaces, under nails
 Alcohol-based hand sanitizers okay – but
only if no running water available
Acknowledgements
 Student researchers:



Rihana Al-Ghalayini ‘09
Christine Bridge ’08
Jay Watson ’08
 Special thanks:



to the library staff for donating “retired” books, journals,
microfilm and microfiche from the Tredway Library
collection.
and to Alyssa Tillary ‘10 who helped plate cultures for
the environmental conditions study in the library.
and to 3M for the first 200 PetriFilms: donated as part of
the 3M Microbiology University Program.