Dirty naira notes as vectors of transmissible diseases - THE NATION
Although it is very central to every country’s economic activities, paper money can also serve as vectors for transmissible diseases, foisting grave public health consequences.
Research and medical experts say dirty and mutilated naira notes can become breeding grounds for diseases – bacterial and fungi – that can lead to catastrophic out-of-pocket medical expenses for treatment and sometimes death for Nigerians.
According to a report on bacteria and fungi found on banks notes published in Medscape, a medical journal, there are overwhelming indications suggesting that fomites, including money, can serve as reservoirs of pathogens. It was authored by a team of medical researchers.
The report, which tested paper money and coins in use in many countries, found that 89 per cent of the paper notes tested in Nigeria had bacterial contamination, especially those from meat sellers, transportation workers, beggars, and food vendors.
“Currency notes contaminated with parasites were found in a study performed in Nigeria. Notes were found to be contaminated with Ascaris lumbricoides (eight percent), Enterobius vermicularis (seven percent), Trichuris trichiura (three percent) and Taenia sp. (four percent).
Moreover, parasitic contamination was most prevalent on dirty/mutilated notes collected from butchers, farmers and beggars.
“Laboratory simulations have shown that pathogens can survive on banknotes. Moreover, indirect evidence of hand-to-hand and fomite-to-hand contact has shown that banknotes are viable modes of transmission.
In addition, it seems that wet hands can transfer larger numbers of infectious agents and that the transfer of pathogens can easily occur when fingers are moist,” the report said.
The report further revealed that dirty naira notes contained the following bacteria – Escherichia coli, Staphylococcus aureus, Coagulase-negative staphylococci, Salmonella sp, Streptococcus sp, and Aerobacter sp.
To further corroborate the result of the above research, another study in the United States revealed that the same bacteria they were able to culture on a toilet slab, were also found on a tattered and dirty currency. This poses terrible health consequences, the report claimed.
A study, published on US National Library of Medicine National Institutes of Health, showed that over 11.8 per cent (24 million) of the Nigerian population is estimated to suffer from a serious fungal infection yearly.
As the most populous country in Africa, too many patients die of fungal infection that is not diagnosed or treated. Money collected from most local food sellers is highly contaminated, and the presence of infectious agents on banknotes is indicative of poor hygiene in the person who recently handled the banknotes.
Moreover, the manner in which the banknotes were kept in food outlets can influence the presence of these infectious agents on the currency.
Seeing people hide and keep money in very private and unlikely places is a big challenge, especially among traders, market women, transport workers etc.
Some go as far as putting their earnings for the day in their bras, pants, socks and other underwear which perpetually have interactions with bodily fluids – posing great health hazard to the person indulging in this act and the person receiving these monies at a later time, either as balance or payment for goods and services.
Views from medical experts
Clinical experts who spoke with The Nation were unanimous about the presence of pathogens in tattered naira notes.
The Head of Clinical Laboratory Services and Diagnostic Pathologist of Royal Specialist Hospital, Abuja, Uche Onyechege, said major pathogens that can be found on dirty, tattered naira notes include Staphylococcus Eros, which basically have a lot of species.
“One thing about these species of bacteria is that they are so ubiquitous – they are found everywhere. They are in the air you breathe, the surface you touch, on your skin, etc.
Second is Salmonella, which is the causative agent for Typhoid. Typhoid started from a food vendor in Maryland, United States, especially food vendors who not only sell food but cook the food almost simultaneously.
“While cooking, they sometimes exchange monies with their customers – either by giving them their change or accepting payment for the food bought.
This way, they contaminate the food they are either cooking or selling with Salmonella. The Staphylococcus and Salmonella are the two commonest pathogens you can find on a tattered nira note.
“Although it has not been medically proven that a dirty and tattered naira note can be a carrier for viruses like the dreaded Ebola and Lassa fever, we still need to apply health caution and due diligence in handling these notes.
We have Staphylococcus Eros, Staphylococcus albos, Staphylococcus epidermis (which can be found on the surface of your skin).
One thing about these species is that they are not always harmful. Some are pathogenic, while others are non-pathogenic.
“Pathogenicity is disease causing. Staphylococcus found on the skin is not harmful, but when you have broken tissues (injuries or open sore) on your skin, they can enter in, interact and cause harm.
Staphylococcus Eros and Albos are the pathogenic bacteria. However, on a normal skin, they help maintain the concentration of melanin and also the oil produced by the skin pore, which cleanses the skin more than your soap can do.
These bacteria play a major role in making sure that your skin is well taken care of,” Onyechege said.
Also giving insights on the health hazards of having dirty and mutilated naira notes in circulation, the Director of Laboratory Services, Dr. Hassan’s Hospital and Diagnostic Centre, and Chairman of Steering Board, West African Postgraduate College of Medical Laboratory Science, Dr. Godswill Okara, said the nature of Nigerian environment makes it easy for dirty naira notes to serve as breeding grounds for harmful microbial organisms that abound.
“We are in a hot and humid environment, and the currency notes are paper based documents. So, it is very easy for it to get wet in a humid environment and become a breeding ground for fungal and other microbial organisms. To this extent, it poses a threat to health.
“People can get mainly fungal infections like aspergillosis, which is a fungal organism that causes respiratory infections when one breathes it in.
Fungal infections are one of the most difficult infections to treat; they need protracted injection of anti-fungal drugs, and because of how difficult it is to treat fungal infections, a patient is subjected to taking the drug for months before you eradicate the problem, and especially in immune-compromised individuals.
“The thing with viral organisms or agents is that they don’t usually survive outside a living cell. For practical purposed, viral infections don’t survive outside the human cell or tissue.
It is mainly fungal and bacterial spores. Bacterial spores are a kind of stage in the life cycle of microbial organisms, as a survival strategy when the nutrient they feed on is not readily available.
To avoid dying off, they will form spores that will enable them go into dormancy; When a person comes in contact with it, and it gets into the person’s system, it germinates and establish infection.
“Fungal and bacterial organisms can form spores. Apart from respiratory diseases, people can also get skin infections, eye infections, and can also get into the blood and cause what we call bacteremia – infection of the blood by fungal organisms, which is very difficult and critical condition to treat.
Apart from the transmission of infections from dirty notes, the offensive odour associated with it could trigger asthmatic attacks and can cause atopic diseases like running nose and catarrh reactions,” Okara said.
Also, the former Chief Medical Director of Lagos University Teaching Hospital (LUTH), Professor Akin Osibogun, explained that, in general, some bacteria and other organisms can be transmitted through non-living things like the naira notes, table tops and even through handshakes.
“If somebody has just been to the toilet and didn’t clean his hands properly, and you are shaking such person, you may actually be receiving some bacteria through the handshake. For naira notes, the dirtier the note, the more likely that they are going to be carrying various organisms.
“Some of the notes we see in circulation are actually a disgrace to all of us. We should not wait until they become so tattered because they are a symbol of our nationality.
You have to balance that against the cost of having to print new notes, but against the cost to health, it will be far higher.
More importantly, the dirtier they are, the more likely that they will harbor organisms that can transmit various infections. These infections can vary from simple respiratory tract viruses. The common cold can actually be transmitted through such dirty notes.
“Viruses causing simple respiratory tract infections and gastrointestinal disorders can be transmitted through dirty naira notes. From the health perspective, it is ideal for us to change our naira notes periodically.
There cannot be any precision as to how often; there just have to be a balance between the financial cost and the health cost,” Osibogun said.
Beyond CBN’s directive on mutilated naira notes
When the Central Bank of Nigeria (CBN) gave a three-month ultimatum last year for bank customers to deposit dirty naira notes in their banks, the apex bank might not have been thinking about the health implications of the over N7.9trillion dirty, tattered and unfit banks notes in circulation at that time.
Perhaps, it was more concerned about the financial indices and economic implications of the notes, and how unfit they were for automated teller machines (ATMs), over-the-counter payments, and other related exchanges.
In retrospect, that laudable initiative by the CBN was supposed to significantly reduce the number of unfit notes and shield denizens from the hazards that these notes would have wrecked on their health.
However, because of the poor personal and environmental hygiene of many Nigerians, there is still a preponderance of these unfit notes in circulation. People simply failed to take advantage of the ‘cash repatriation’ window.
There are a few diseases that their exact mode of transmission is yet to be known. Some are through sexual relations, sharing of sharp objects, presence of vectors like – rats, bats etc. However, a few others are contracted through droplets like coughing, sneezing and indiscriminate spiting.
At the moment, the world is being ravaged by one of the deadliest diseases – the novel coronavirus, notorious for its transmission through contact with an infected person (hand shaking, touching, coughing, sneezing etc.).
Even the World Health Organisation (WHO) has acknowledged that the above listed modes of transmission might not be the only mode of contracting it.
Experts caution that this is the more reason members of the public should begin to pay closer attention to how they use, handle and keep money, which is most times the closest thing to their hands, for millions of people interact with physical cash every day without knowing its level of exposure to pathogens.
According to Okara, many Nigerians need to be educated on how they keep money because keeping naira notes in certain parts of the body can be harmful.
“Keeping money in certain parts of the body is a very unhealthy habit that should be discouraged. We should ensure that currency notes are put in purses to avoid crushing and rumpling it, to avoid it getting wet and becoming a growth medium for these microbial organisms,” he said.
For Osibogun, the best way to avoid falling into the ‘trap’ is for everybody to develop personal hygiene habit. “Concerning some beggars, especially in the North, who have several infections like leprosy.
Some are seen changing money for pedestrians and motorists. From the individual perspective, the way to reduce the risk of passing such organisms in the North is to try and wash our hands often; once you just finish a financial transaction involving handling of money, before you touch any other thing, you should wash your hands,” he said.
Finally, as experts advised, every time people engage in any transaction that involves handling the naira note, they should wash their hands immediately with soap and water or use an alcohol-based hand rub, even if their hands are not visibly dirty.