The thought of the many germs on public toilet seats often leaves many women apprehensive about catching contagious infections, especially sexually transmitted diseases like gonorrhoea, chlamydia, herpes and other genital infections. And because they tend to have germ phobia, they often prefer crouching to seating on the toilet seats. But is it true women catch diseases from toilet seats or it’s just a myth?

Dr Kenneth Ruzindana, a consultant gynaecologist at Kibagabaga Hospital, says it is extremely unlikely that you’ll catch diseases from a toilet seat in a public restroom.

"Most germs like those that cause common colds can’t survive long on cold surfaces like the toilet seat. Women also need not worry about syphilis and gonorrhoea when using a restroom since venereal diseases require sexual contact for transmission,” he says.

In fact, there’s no evidence that anyone has ever caught a venereal disease from using a public restroom.

"According to the Center for Disease Control and Prevention, you’d basically get an STI from a toilet by rubbing an open wound or mucous membrane all over fluids left there by someone who had used the toilet only seconds before,’’ Dr Iba Mayele, a gynaecologist at Clinic Galien in Kimironko, Gasabo District.

Dr Harold Oster, an infectious disease specialist at Scripps Clinic Medical Group in San Diego, California, USA, says toilet seats are not common vectors (transmission channels) of infections.

"If you use the toilet seat in the usual manner, it is very unlikely that you will become infected with any disease-causing microbe. Specifically, there is no evidence that HIV (the virus that causes AIDS) or the viruses responsible for hepatitis B or C (chronic forms of liver inflammation) can be spread in this manner.

"There are some organisms that conceivably could be acquired by contact with toilet seats, such as the strep (streptococcus) and staph (staphylococcus) bacteria that we routinely carry on our skin. It is possible that you could become colonized with a specific organism (become a carrier) after sharing a toilet seat with someone carrying that organism. But I think that the risk of such transmission is very small, and I personally do not worry too much about it,” he says.

Oster explains that some infections are commonly spread in restrooms in areas other than the toilet.

"The classic source for bathroom infections is the reusable towel roller -- the device that holds a length of cloth toweling that you pull down for drying your hands. Other people end up using the same area to dry their hands, aiding in the potential spread of infections. Towel rollers can spread several different viruses and have been linked to outbreaks of conjunctivitis (also called pinkeye), inflammation of the membrane that lines the inner surface of the eyelids and the front of the eye. It is also possible that touching contaminated doorknobs and faucets can spread these sorts of infections, as well as the viruses that cause colds,” he adds.

Dr Ruzindana also affirms that it’s a myth to catch an STD from a toilet seat since these causative germs can’t survive outside the body for a long time.

However, he says, there are some diseases one needs to worry about when using a public restroom. One of them is the norovirus.

"This particular germ (found in fecal matter) lasts longer on surfaces than others and can easily find its way onto faucet handles and doorknobs as well as other surfaces. That’s why it’s essential to thoroughly wash your hands after using a public lavatory, much as studies have shown that not everyone does this. So it’s okay to be a little nervous when using a public restroom at work, the theatre or a ballpark – just make sure your hands are thoroughly clean upon leaving,” he explains.

Dr Ruzindana also notes that the case may be the same for urinary tract infection.

"The pathogenesis of urinary tract infection in women begins with colonisation of the vaginal introitus by uropathogens from the fecal flora, followed by ascension via the urethra into the bladder. Because the anus and the vagina neighbour each other, the disease causing pathogens from the anus easily colonise the vagina,” he says.

Dr Ruzindana explains that toilet seats are not the reason for UTIs, but for anatomical reasons, the urinary tract infection is caused by the meatus urinary close to the anus where bacteria are always present. The bacteria can ascend along the urethra towards the bladder and proliferate in the urine.

He says there are many things we should be worried about like door knobs, stairs handrail, elevator buttons, hand-shaking and many more because these transmit germs easily.

Dr Ian Shyaka Gashugi, a general practitioner at Rwanda Military Hospital, Kanombe, it is important to understand that most of the genital infections in women aren’t related to toilet use.

"Practices such as flashing the toilet water first, putting various antiseptics inside the toilet and on the seat, avoiding dirty public toilets, and keeping one’s personal hygiene can minimise chances of getting these infections from the restroom,” he says.