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Sandboxes, a common installment in play grounds or backyards, offer a small, beach like patch of sand, where kids can play and build sand castles. however, sandboxes are extremely unsanitary, considering a few factors. One of the largest factors of this unsanitary nature is that uncovered sandboxes are viewed as litter boxes by wild animals, pets, and, unfortunately, also children. And if the prospect of fecal matter in a kid's play area isn't already disgusting, parasites that live in the colon end up in the sand box, and it's only a matter of time before someone ingests an egg or a pin-worm crawls into a toddler's colon. There's another layer to this grossness, unfortunately. Toddlers are often sticky, dirty, and they will get there hands on everyone and everything. Basically, lots of toddler's aren't the cleanest, and this leads to germs. Germs in the sandbox, germs that toddlers will wade through for hours on end.

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So there I was at a kid's birthday party, my 13-month-old daughter playing merrily with her brother in the sandbox, when she suddenly decided that she was hungry. Into her mouth it went-all of the sand-and though I was up with a leap and a "No," I was too late. I laughed nervously while furiously fishing sand out of her mouth (it's surprisingly hard to do, by the way) as other parents looked on with a mixture of unease and relief- Gross, but thank God it wasn't mine. My friend, the host who owned the sandbox, appeared. "Did I ever tell you," she said, "that I think my cat poops in there?"

Kids love sandboxes. Parents do not, and for good reason. When public health-testing organization NSF International sampled 26 different items in public places-toys at doctors' offices, children's library books, playground sandboxes-for a 2008 study on germs, they found that sandboxes were far and away the germiest of all, harboring nearly 2,000 times more bacteria, yeast, and mold per square inch than the door handles of public restrooms.

Of course, bacteria, yeast, and mold aren't all bad. Many are actually quite good for us. Not so for the other microbial gifts that sandboxes sometimes leave for kids: parasitic worms. Like giant litter boxes, uncovered sandboxes invite animals-raccoons, dogs, cats-to use them as bathrooms, which essentially turns them into giant parasite Petri dishes. And that's bad, because even if your kids don't eat handfuls of sand like mine do, they probably do put their fingers in their mouths an awful lot-and parasites are transmitted by what is not-so-euphemistically called the fecal-oral route, meaning they go from one animal (or kid's) butt straight to the next kid's mouth. Bon appétit!

OK, I know you're rolling your eyes, thinking: But most kids who play in sandboxes don't get sick. Fair enough. But it's also possible that kids are getting sick and we just don't know it. Doctors are not required to notify the government when they diagnose these infections-so no one is closely monitoring them or their epidemiology-and many kids who get parasites probably either never get diagnosed with them, as symptoms can be mild and spontaneously resolve, or their diagnoses are kept quiet. (Are you really going to tell your friends that your kid just got dewormed?) And when little Annie does get parasites, her parents also aren't going to tie it back to that time three weeks ago when she played in a sandbox. The fact is that a large proportion of Americans-many of them kids-are infected by parasites, and sandboxes are a known hot spot. "There is a real threat," says Laila Woc-Colburn, an infectious disease specialist at the Baylor College of Medicine in Houston.

Consider what happened when researchers at McGill University tested the surface sand from sandboxes at 10 local day care centers in 1991. Two of the sandboxes, they discovered, were contaminated with eggs of a parasite called . Once a child eats them, the eggs hatch in his or her body into larvae, which can burrow into the liver, lungs, central nervous system, or eyes. Sometimes the infection is asymptomatic, but when it's not and is not properly diagnosed and treated, it can cause liver damage, lung damage, or blindness. (An earlier 1979 study found that a whopping 39 percent of residential sandboxes in Kansas contained Toxocara eggs. Perhaps unsurprisingly, research suggests that 1 out of every 7 Americans over the age of 6 has been infected with this parasite.)

The McGill study also reported that one of the sandboxes with Toxocara eggs was co-contaminated with the eggs of , a parasitic worm that can, occasionally, cause intestinal blockage and stunted growth. Another parasite kids can get from sandboxes is Toxoplasma gondii, which is spread by cats and believed to chronically infect more than 1 out of every 6 Americans. In one study, researchers in Japan spied on three urban sandboxes at night using camcorders and found that over the course of five months, cats pooped in the boxes 961 times, and dogs pooped in them 11 times. They calculated that one of the sandboxes contained more than 1.5 million viable Toxoplasma eggs per square foot of sand, yet children need only ingest a single egg to get sick.

Although Toxoplasma infections are typically mild-some people get flu-like symptoms, while others feel fine, though most will harbor the parasite for the rest of their lives-individuals with compromised immune systems can fall very ill, and when women become infected during pregnancy, their babies can develop brain or vision damage or become sick later in life. (Some research also suggests that the parasite can affect behavior and personality. So the next time an aggressive driver cuts you off, calm yourself with the thought that he might be infested.)

Let's also not forget pinworms, the tiny little worms that live in your intestines, scurry down to your anus while you sleep, and lay their eggs there every night. Nearly half of all American kids are believed to have pinworms at any given time (and when they do, their parents usually have them too), but they're tough to diagnose: You basically have to set an alarm for a few hours after you go to sleep and then inspect your anus for crawling worms. (No, I'm not kidding.) As Austin, Texas-based pediatrician Ari Brown wrote in her best-selling book Toddler 411, sandboxes are an excellent place for kids to catch pinworms, because pinworms cause kids' butts to itch; then they scratch their butts, getting pinworm eggs on their fingers; then they build sandcastles studded with worm eggs.

I've left my favorite (as in: most absolutely terrifying) sandbox parasite for last. It's called Baylisascaris procyonis, and it is a roundworm that typically infects raccoons.

As many as 4 out of 5 raccoons carry this parasite, and infected coons typically poop out thousands, if not millions, of eggs a day-perhaps right on your lawn. In a 2009 study, researchers found raccoon poop in more than half of the suburban Chicago backyards they sampled. Once there, the parasite's eggs are virtually indestructible, except with exposure to very high heat. One scientist who has studied them recommends using an acetylene torch to incinerate the bastards.

Human infections with Baylisascaris seem to be very, very rare, although no one really knows why, considering everything I wrote above. But thank goodness, because the parasites are extremely dangerous. "If eggs are accidentally ingested by a human," a recent clinical report explained, "larval infection can lead to devastating neurological disease and death." One-third of cases are fatal. In 2009, two kids from Brooklyn caught it; one developed permanent brain damage, and the other went blind in one eye. Another child fell ill with it in Canada in 2009, presumably after-you guessed it!-playing in a sandbox. He was lucky because he was diagnosed and treated quickly, but the infection nevertheless robbed him of the ability to speak, gave him a seizure disorder, and damaged his eyesight.

So, yes, sandboxes are gross and can be dangerous. This is not to say that you should never let your kids play in them, because the danger is remote-they only rarely cause serious illness (my daughter's sandy snack seems to have done her no harm, although I haven't had her tested). If you own your own sandbox, though, consider covering it at night to keep out animals. If you have dogs or cats, make sure they are regularly checked for worms, and keep them out of the sandbox so they never wonder whether it might work well as a toilet. If you suspect that raccoons are pooping on your lawn, check out this Centers for Disease Control and Prevention guide to cleaning up their hazardous excrement.

As for public sandboxes: It kind of goes without saying, but if they smell bad, stay away. Also, (try to) keep your kids from putting their hands (or all the sand) in their mouths when they play, and make them wash their hands afterward. (Hand sanitizer won't kill worm eggs, Woc-Colburn says, so best to do it the old-fashioned way.) Would it be crazy to steer your kids away from public, always-uncovered sandboxes just in case? No, particularly if your kids have other sources for creative hands-on play. Brown, for one, has advised parents against them. And if your sandbox-frequenting kid does get really sick-symptoms of parasitic infections vary but can include fever, coughs, stomach pain, eye pain, or seizures-of course, take him to the pediatrician, and mention his sandbox use and any other relevant info, such as that you suspect your cat poops in it. Chances are high that your kid is never going to get really sick from sand play, but it's good to know about the risk just in case, even though it means-and for this I apologize-that you will never be able to look at a sandbox the same way again.
Read more of Slate's parenting coverage, including:

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Sandboxes Are Disgusting! Are You Sure You Want Your Kids Playing in Them?

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So there I was at a kid's birthday party, my 13-month-old daughter playing merrily with her brother in the sandbox, when she suddenly decided that she...

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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SPARTANBURG, S.C. - On a hot summer day last month, Sydney, 15, and Laney, 8, were enjoying their last two weeks of freedom before school started. The sisters tried to do flips over a high bar at a local playground.

"You've got to pull your hips into the bar, like you've got to kick up like that," explained their mother, Selena.

"I tried to kick! I did this - you told me not to stick out," said Laney indignantly.

Both girls have been diagnosed with mental illnesses - Sydney with bipolar disorder and Laney with a similar illness called disruptive mood dysregulation disorder. The family asked that their last name not be used to protect the girls' privacy.

School has been a real challenge for them. That's not unusual for the 1 in 5 children with a mental illness. They often suffer anxiety, difficulty focusing and social challenges. Half of them drop out of high school, in part because many schools don't manage to meet their needs.

Selena has spent the past eight years trying to get the girls the resources to help them succeed. Like a lot of parents of kids with mental health issues, she's had to be her children's biggest advocate.

"It's definitely a journey. It wasn't easy," she said, even though she's a school guidance counselor herself.

"I used to cry the night before, because I didn't want to go to school."

Sydney describes class as "boring, distracting. It's hard to pay attention. It's overwhelming." She struggles to focus or process information, which makes her so anxious and depressed that she often has to leave school in the middle of the day.

She wants to be a rock star like Courtney Love. Every so often she pretends to take drag from a bubble gum cigarette. But she's an extremely sensitive kid, and school has been a painful experience.

"I used to cry the night before, because I didn't want to go to school," she said.

Laney on the other hand is a ball of chaotic energy. At school, she often gets frustrated and acts out. Sometimes, she is sent home.

Schools do not all screen students for mental health issues, and the practice varies widely across states. Even if students are successfully identified, many areas lack the community-based mental health treatment options that would be needed to help them. Just 38 percent of youth with a mood disorder such as depression or bipolar disorder receive treatment services. In 2014, the federal government announced $48 million in new grants to support teachers, schools and communities in recognizing and responding to mental health issues. Still, many students' mental health problems continue to go unidentified and untreated.

When Selena first noticed the girls were having problems, she took them to the doctor. Sydney started taking medication at the age of 7 and Laney at just 4, but it wasn't a quick fix.

"The brain is complex," said Selena. "It's not like you just take a medicine and it fixes it." It took years to get the girls' diagnoses and prescriptions right.

Selena said she needed to educate teachers about her daughters' illnesses. "I really tried to do my homework. I did a lot of research. Obviously I talked to parents online in a support group," she said.

Schools are starting to better recognize that mental health is key to academic and social success, said Darcy Gruttadaro, director of advocacy at the National Alliance on Mental Illness, a grassroots organization headquartered outside Washington, D.C.

"Kids spend six hours a day in school, and mental health is essential to learning.

"Kids spend six hours a day in school, and mental health is essential to learning. So schools that are very data-driven understand that in order for some kids to succeed, their mental health needs must be met," she said.

Nonetheless, schools vary greatly in the degree to which they are willing and able to accommodate mental health issues. "Some are doing a lot and training teachers on how to recognize warning signs and talk to families. And others are doing very little to understand the needs of students and how to work with families," said Gruttadaro.

Sydney's and Laney's public schools were willing to make accommodations - but the girls' struggles continued. So, Selena transferred both to a smaller charter school called High Point Academy.

Principal John Hurley said he's seen a growing number of students coming in with mental health diagnoses. The school wants to help - but teachers are not well prepared to handle these issues.

"My training in mental health was one chapter in a book that we covered in one day," recalled Hurley. Many teachers have experience with attention deficit hyperactivity disorder, he said, but they don't have the tools to draw on when dealing with mood disorders.

"Because we're left in the dark, we have to fumble around to figure out what works best."

"Because we're left in the dark, we have to fumble around to figure out what works best," explained Hurley. "Sometimes you can be wildly successful, and sometimes you can fail miserably and you could have done the exact same thing for two different students."

That's a pretty good description of what happened with Laney and Sydney.

Laney started High Point in the second grade and, by October, had already begun acting out.

"A lot of the times she didn't like to write, so ... she'd get frustrated and she might tear up her paper just depending on how she was feeling," said her second grade teacher, Erica Smith. Occasionally, Laney would also tear up other students' assignments.

Selena was thrilled when Smith reached out and asked for advice. They started communicating almost daily, sharing tips about how best to reach Laney. They developed an individualized education plan, and Smith had a "safe spot" in the classroom where Laney could go to cool down until she could rejoin the class.

At the same time, Laney's doctor adjusted her medications to help balance her mood. The solutions worked - pretty soon Laney was thriving. But Selena knew from experience that what works with one kid doesn't always work with the other.

Selena helped get Sydney an individualized education plan that gave her extra time on tests, fewer assignments and two periods a day with special education teacher Pam Smith, who has a background in mental health.

"I really feel we had everything we could have had that was available to us to meet her needs," said Pam Smith. "I really feel that we went over and above sometimes."

"I started realizing it just wasn't working. I can't send my child somewhere every day and ignore the fact that it's having a negative impact on her mental health."

But nothing seemed to work. Sydney had trouble making friends and often shut down in class. She kept falling further behind.

"I started realizing it just wasn't working. I can't send my child somewhere every day and ignore the fact that it's having a negative impact on her mental health," said Selena.

So in March, she pulled Sydney out of High Point and home-schooled her for the rest of the year.

She looked for a therapeutic school for Sydney to attend this year, but she couldn't find one in her area. So this year, Sydney is attending an online school from home, while Selena works and Laney goes to the third grade at High Point. It's not an ideal solution. Selena wanted Sydney to be in a brick and mortar school with other kids, but she said she's had to learn to be flexible.

"You think as a parent you're supposed to just say, 'Get up and go back to school' the next day. And so you really have to sometimes stop and take stock of what's going on and maybe change the path," she said.

As for Sydney, she said she was looking forward to studying from home. For the first time in years, she said she hadn't been crying ahead of the first day of school.

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One out of five children have mental illness, and schools often don't help

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School has been a real challenge for them. That's not unusual for the 1 in 5 children with a mental illness. They often suffer anxiety, difficulty focusing and social challenges.

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Part One in an NPR Ed series on mental health in schools.
You might call it a silent epidemic.

Up to one in five kids living in the U.S. shows signs or symptoms of a mental health disorder in a given year.

So in a school classroom of 25 students, five of them may be struggling with the same issues many adults deal with: depression, anxiety, substance abuse.

And yet most children - nearly 80 percent - who need mental health services won't get them.

Whether treated or not, the children do go to school. And the problems they face can tie into major problems found in schools: chronic absence, low achievement, disruptive behavior and dropping out.

Experts say schools could play a role in identifying students with problems and helping them succeed. Yet it's a role many schools are not prepared for.

Educators face the simple fact that, often because of a lack of resources, there just aren't enough people to tackle the job. And the ones who are working on it are often drowning in huge caseloads. Kids in need can fall through the cracks.
"No one ever asked me"
Katie is one of those kids.

She's 18 now. Back when she was 8, she had to transfer to a different school in Prince George's County, Md., in the middle of the year.

"At recess, I didn't have friends to play with," she recalls. "I would make an excuse to stay inside with the teachers and finish extra work or do extra credit."

We're not using Katie's last name to protect her privacy. She's been diagnosed with bulimia and depression.

She says that in the span of a few months, she went from honor roll to failing. She put on weight; other kids called her "fat." She began cutting herself with a razor every day. And she missed a ton of school.

"I felt like every single day was a bad day," she says. "I felt like nobody wanted to help me."

Katie says teachers acted like she didn't care about her schoolwork. "I was so invisible to them."

Every year of high school, she says, was "horrible." She told her therapist she wanted to die and was admitted into the hospital.

During all this time, she says, not a single principal or teacher or counselor ever asked her one simple question: "What's wrong?"

If someone had asked, she says, she would have told them.
Who should have asked?
We talked to educators, advocates, teachers and parents across the country. Here's what they say a comprehensive approach to mental health and education would look like.
The family
The role: The first place to spot trouble is in the home, whether that trouble is substance abuse, slipping grades or a child who sleeps too much. Adults at home - parents, siblings, other relatives - are often the first to notice something going on.

The reality: Many families do not know what to look for. Sometimes a serious problem can be overlooked as "just a phase." But it's those sudden changes - angry outbursts, declining grades, changes in sleeping or eating - that can signal problems. When something unusual crops up, families can keep in close touch with the school.
The teacher
The role: During the week, many students see their teachers even more than their own families. Teachers are in a prime spot to notice changes in behavior. They read essays, see how students relate with other kids and notice when they aren't paying attention.

The reality: Teachers already have a ton on their plates. They're pressured to get test scores up, on top of preparing lessons and grading assignments. Plus, many teachers receive minimal training in mental health issues. But when they do see something concerning, they can raise a flag.
The social worker
The role: Social workers act like a bridge. If teachers come to them with a concern - maybe a child is acting withdrawn - one of the first things they'll do is call home. They see each child through the lens of their family, school and community. They might learn that a family is going through a divorce or homelessness.

The reality: There aren't enough of them. According to one model, every school should have one social worker for every 250 students. The reality is that in some schools, social workers are responsible for many more.
The counselor
The role: In some schools, counselors focus solely on academics: helping students pick classes and apply to college. But in others, they also act a lot like social workers, serving as a link to families and working with students who need support.

The reality: Like school social workers, there just aren't enough counselors. On average nationwide, each counselor is responsible for nearly 500 students. The American School Counselor Association recommends a caseload nearly half that size.
The special education teacher
The Role: Special education teachers may start working with students when a mental health problem affects the ability to do school work. They are primarily responsible for working on academic skills.

The reality: Again, there aren't enough of them. Nearly every state has reported a shortage of special education teachers. Half of all school districts say they have trouble recruiting highly qualified candidates.
The school psychologist
The Role: Here's one job that, on paper, is truly dedicated to student mental health. School psychologists are key players when it comes to crisis intervention and can refer students to outside help, such as a psychiatrist.

The reality: If you sense a pattern here, you're right. In the U.S., there is just one school psychologist for every 1,400 students, according to the most recent data available from the National Association of School Psychologists.
The school nurse
The role: Most any school nurse will tell you, physical and mental health are tough to separate. That puts nurses in a prime spot to catch problems early. For example: A kid who comes into the nurse's office a lot, complaining of headaches or stomach problems? That could be a sign of anxiety, a strategy to avoid a bully, or a sign of troubles at home.

The reality: The U.S. Department of Health and Human Services recommends at least one nurse for every 750 students, but the actual ratio across the country can be much higher.
The principal
The role: As the top dogs in schools, principals make the big decisions about priorities. They can bring in social-emotional, anti-bullying and suicide-prevention programs.

The reality: Principals also have a lot on their plates: the day-to-day management of student behavior, school culture and teacher support.
Getting help, and "excited for life"
Katie says things started to turn around for her when she met a nurse at the Children's National Health System in Washington, D.C., who finally showed interest in what was wrong.

Now, she's begun college and wants to be a pediatric nurse.

"I'm doing a lot better now" she says. " Obviously, I mean, I'm a lot happier. I'm excited for school. I'm excited to graduate. I'm excited for life."

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Mental Health In Schools: A Hidden Crisis Affecting Millions Of Students

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An estimated 20 percent of children show signs or symptoms of a mental health problem. It's a destructive force in schools, but most educators don't have the training or resources to help.

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Mental health. it's a big issue in daily life, and at school, it seems to be affecting many students-without any support from the school. 1 in 5 students have it, and it is mostly sprouting directly from school, which seems strange, until you take a closer look. I don't know why, but teachers (and parents), seem to ignore what's really going on. the teachers like this act ignorant, almost. as toxic masculinity builds up, bullying is much more common, and it builds up into a mental  issue, a fear, a problem much more serious. but when i bring this up, a comment about how lots of student, particularly males, are creating this toxic environment, the teacher looks surprised. "I haven't noticed that." or "Are you sure you aren't exaggerating a little?" or "boys will be boys, you can't really blame them, right?". it's such a weird behavior, and i find it hard to believe that teachers "Haven't noticed" how toxic and depressing these environments are becoming. As a middle school-er with ADHD and anxiety who also uses They/Him pronouns, instead of sticking with what i was assigned at birth, the pressure is real, and it's difficult. it hurts. If we tried harder to make school a safer place, not somewhere i need to wear a face that's not mine to get through the day, Maybe then these issues wouldn't be happening so frequently. I don't want school to be somewhere that occasionally makes me feel as if i am no longer in my body and someone else is directing me, or as if i'm stuck in a strange trance where everything else around me fades out. it just shouldn't be something i have to live with like this.

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Opinion | Is the Drive for Success Making Our Children Sick? (Published 2016)

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Across the country, children are experiencing depression, anxiety and even physical strain because of the pressures of school.

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this article is super helpful when studying how viruses and bacteria evolve, and how they do it. this article talks about how these organisms are evolving to become vaccine resistant. This is bad because they now need to develop more vaccines to fight these evolved organisms. this will cost a lot, and will not be easy. this increased price along with these new strains will make it extremely difficult to fight off.

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Bacteria and other microbes can make us sick. But there's a lurking danger with some germs that's far more frightening than a bout of food poisoning or an infected wound. Today, drugs exist to fight most of these germs. They're called antibiotics. Before these medicines came along, common infections frequently killed people. And that's where the danger lies: What will happen if antibiotics no longer kill germs?

Already some antibiotics have lost their superpowers. Many others are beginning to lose theirs. Biologists describe this problem as resistance. Across the globe, germs are becoming resistant to antibiotic medicines. In a sense, these "superbugs" have begun to laugh at those former wonder drugs.

But resistance is no laughing matter. As germs toughen up against drugs that are supposed to slay them, treatable conditions such as TB - tuberculosis - can spread. And surgeries that rely on antibiotics could turn from life-saving to life-threatening.

The threat is huge

"Alarming levels" of drug-resistant bacteria already exist in many parts of the world. That's the conclusion of a 257-page report published in April. It was issued by the World Health Organization (WHO).

This United Nations agency, based in Geneva, Switzerland, recently reviewed how well these germ slayers perform in 114 countries. In some places, it found, antibiotics no longer work for half of all people being treated against common diseases. Those diseases include pneumonia and gonorrhea.

The Centers for Disease Control and Prevention (CDC), based in Atlanta, Ga., also has been investigating the problem . It estimates that in the United States alone, antibiotic-resistant infections now sicken some two million people each year. At least 23,000 of them die.

But even antibiotic-resistant germs that don't kill can be a problem. Their infections become harder to treat - and more expensive. Consider one estimate - $233 million - published May 20 in the journal Antimicrobial Resistance and Infection Control. That's how much researchers calculated that it costs the United States each year to deal with just one resistant superbug. That germ causes a lung disease known as pneumonia.

Drug-immune bugs that flourish in the human gut can enter the environment with every flush of the toilet. Researchers discovered how big this problem is when they analyzed wastewater from 11 sites in one French city. Antibiotic-resistant bacteria tainted 96 percent of their samples. A May 1 paper in Clinical Infectious Diseases describes the disturbing details.

Some scientists have scouted for such germs in the environment. They collected superbugs at hospitals. Then they probed the germs, identifying parts of their genes that appear to make them resistant to antibiotics. Next, the researchers looked in the outdoor environment for that same genetic fingerprint of superbugs. And they turned up that superbug DNA in 71 places - from the soil and sea water to human wastes. The researchers reported their findings May 8 in Current Biology.

Why it's happening

Drug designers have created antibiotics to kill bacteria, as well as some fungi and other germs. But sometimes, a few treated germs survive. They survive because they're stronger. Or they may have certain genetic mutations that allow them to break down the drug. They might even have evolved a way to keep the drugs from harming their operational machinery. Over time, all germs susceptible to a drug will die off. That will leave behind only superbugs - those microbes that medicines can't kill.

This is not surprising. In fact, it's quite natural. Part of evolution, it's known as survival of the fittest.

Scientists stumbled onto the first antibiotic, penicillin, around 1930. Since then, research has produced a medicine cabinet full of additional ones. It appeared that these would make many of the worst bacterial infections ever more manageable. So, during the 1970s, drug developers began focusing on noninfectious health problems, such as cancer and heart disease. As a result, in the past 30 years, no new types of antibiotics have been developed.

Right now, bacteria are outsmarting antibiotics faster than developers can make new ones. And there are no signs things will change, says Stewart Cole. He directs the Global Health Institute at the Ecole Polytechnique Fédérale de Lausanne in Switzerland.

Writing in the May 12 Philosophical Transactions of the Royal Society B, he argues that the "golden age" of antibiotic development "is a distant memory, and the likelihood of there being another seems slim." This lack of new types of germ killers, he says, has been allowing superbugs to morph and thrive.

One of the most famous of them is known as MRSA (pronounced MER-sah). The letters stand for methicillin-resistant Staphylococcus aureus . Methicillin is a widely used antibiotic. And Staph aureus is a germ that can cause boils, food poisoning, toxic-shock syndrome and more. These bacteria sicken (and sometimes kill) by releasing potent natural poisons - called toxins - into the body.

Despite its name, MRSA is resistant to far more antibiotics than just methicillin. That makes this superbug particularly nasty in hospitals and prisons. These are places where people often have open wounds or weak immune systems. Both increase a person's chance of picking up an infection.

Too much of a good thing

Drug resistance can develop at any time. But its likelihood climbs as the use of an antibiotic increases. And this is especially true when an antibiotic is overused. That's when a doctor prescribes it for infections it has no hope of curing.

For instance, doctors sometimes prescribe antibiotics to treat an infection before they learn if the disease is caused by bacteria. If viruses are responsible, then antibiotics will be useless. The reason: Antibiotic medicines do not kill viruses. Yet by giving an antibiotic to someone with a viral infection, that drug will reach good bacteria living in our bodies. And over time, some of these bacteria will become resistant to the drug.

Last year, the CDC reported that up to half of the antibiotics that U.S. doctors prescribed went to people who didn't actually need them.

Take, for example, someone who visits a doctor for a lingering cough. Viral infections cause most coughs. So a viral cough won't be helped by drugs and will tend to go away on its own. Yet 71 percent of the time, doctors will still prescribe antibiotics for patients coming in with a common cough, a May 21 study finds.

"I think there's this perception among both doctors and patients that coughs don't go away without antibiotic treatment," Jeffrey Linder told Science News for Students . Linder, who coauthored the new report, is a doctor at Brigham & Women's Hospital in Boston, Mass. He and Michael Barnett, also from the hospital, tracked the drugs that doctors prescribed during more than 3,000 U.S. clinic visits between 1996 and 2010. They reported their findings in the Journal of the American Medical Association .

A small number of people who visit a doctor with a cough turn out to have bacterial pneumonia. These cases do require antibiotic treatment. But Linder says doctors should easily be able to recognize these few from the hordes of people coming in with a routine, viral cough.

Perilous profit

Antibiotic overuse also has become a problem on farms. In the United States, animals - not people - receive about 80 percent of all antibiotics. Sometimes the drugs are used to save an infected animal or prevent disease from spreading through a herd. More often, though, feed suppliers put small amounts of these drugs into the food that will be given to healthy animals. These antibiotics help speed the animals' growth. And this has boosted farmers' profits.

But using antibiotics just to beef up livestock is "a direct threat to human health," argues Kellogg Schwab. He's an environmental microbiologist at Johns Hopkins University in Baltimore, Md. Earlier, he and his coworkers detected bacteria that are resistant to antibiotics in the exhaust air blowing out of farm buildings. That suggests these superbugs can spread through the air from animals to people.

SteveOehlenschlager / iStockphoto

Germs that are immune to antibiotics also can hitch a ride into your body through ground beef or the chicken breast on your cutting board. Biologists have found that much of the fresh beef, pork and poultry sold in grocery stores contains bacteria resistant to antibiotics.

Even if those germs don't sicken us or cause other immediate harm, they can offload their resistance genes into other bacteria that normally live inside our bodies. Sometimes, like with the MRSA superbug, resistance is carried on circular pieces of DNA called plasmids. These plasmids can slip easily from one bacterial cell into another.

In this way, our gut microbes can become "a reservoir of resistance," says Sharon Peacock. She's a microbiologist at the University of Cambridge in England. Later, "when we actually get sick and need an antibiotic, we may already carry a resistance gene" that may keep that drug from working, she says.

In the United States, farmers have fought against banning antibiotics as growth promoters. They say it will reduce their profits because more animals will get sick, slowing their growth. But that's not been the experience in other countries.

The U.S. Food and Drug Administration, or FDA, has proposed banning antibiotic use in healthy animals. But for more than 30 years, the livestock industry and Congress have fought such action. Recently, the FDA stepped up its efforts to end this practice.

In December 2013, FDA laid out a plan to phase out within three years the use of antibiotics on farms to boost livestock growth. Its stated reason: concern that farm use of these drugs has made more germs immune to the antibiotics needed to fight life-threatening infections in people. And that's a worry because the same germs that sicken animals often sicken people.

Antibiotic resistance is a complex and growing problem. Many microbiologists worry that the time when antibacterial medicines no longer work could be coming. Thankfully, doctors and many patients are becoming more aware of the problem. Researchers also are hard at work creating new tools to keep superbugs from taking over.
Next: How scientists are trying to tackle the problem
Power Words

antibiotic A germ-killing substance prescribed as a medicine (or sometimes as a feed additive to promote the growth of livestock). It does not work against viruses.

bacterium (plural bacteria) A single-celled organism forming one of the three domains of life. These dwell nearly everywhere on Earth, from the bottom of the sea to inside animals.

boils (in medicine) A skin infection that starts as a hard, red, painful lump. Eventually, it gets bigger, softens and fills with pus. A common source of these is a bacterium known as Staphylococcus aureus.

bioengineer A researcher who applies technology for the beneficial manipulation of living things. Bioengineers use the principles of biology and the techniques of engineering to design organisms or products that can mimic, replace or augment the chemical or physical processes present in existing organisms. This field includes researchers who genetically modify organisms, including microbes. It also includes researchers who design medical devices such as artificial hearts and artificial limbs.

Centers for Disease Control and Prevention, or CDC An agency of the U.S. Department of Health and Human Services, CDC is charged with protecting public health and safety by working to control and prevent disease, injury and disabilities. It does this by investigating disease outbreaks, tracking exposures by Americans to infections and toxic chemicals, and regularly surveying diet and other habits among a representative cross-section of all Americans.

cholera A bacterial disease that infects the small intestine, causing sever diarrhea, vomiting and dehydration. It is spread by germs from feces that contaminate water or food.

DNA (short for deoxyribonucleic acid) A long, spiral-shaped molecule inside most living cells that carries genetic instructions. In all living things, from plants and animals to microbes, these instructions tell cells which molecules to make.

evolution A process by which species undergo changes over time, usually through genetic variation and natural selection, that leave a new type of organism better suited for its environment than the earlier type. The newer type is not necessarily more "advanced," just better adapted to the conditions in which it developed.

fungus (plural: fungi) Any of a group of unicellular or multicellular, spore-producing organisms that feed on organic matter, both living and decaying. Molds, yeast and mushrooms are all types of fungi.

gene A segment of DNA that codes, or holds instructions, for producing a protein. Offspring inherit genes from their parents. Genes influence how an organism looks and behaves.

germ Any one-celled microorganism, such as a bacterium, fungal species or virus particle. Some germs cause disease. Others can promote the health of higher-order organisms, including birds and mammals. The health effects of most germs, however, remain unknown.

gonorrhea A serious disease that can infect the genitals, rectum and throat. This sexually transmitted disease is very common, especially among people between the ages of 15 and 24. Untreated, it can cause infertility or death. "Untreated gonorrhea may also increase your chances of getting or giving HIV - the virus that causes AIDS," according to the U.S. Centers for Disease Control and Prevention.

growth promoter (in livestock agriculture) A medicine, usually an antibiotic, added in small doses to the feed given to animals raised for meat. Used as a preventive medicine, it can reduce the risk that animals will become sick, which would slow their growth. And that would decrease a farmer's profits.

immune system The collection of cells and their responses that help the body fight off infection.

infection A disease that can be transmitted between organisms.

influenza (or flu) A highly contagious viral infection of the respiratory passages causing fever and severe aching. It often occurs as an epidemic.

livestock Animals raised for meat or dairy products, including cattle, sheep, goats, pigs, chickens and geese.

microbe Short formicroorganism. A living thing that is too small to see with the unaided eye, including bacteria, some fungi and many other organisms such as amoebas. Most consist of a single cell.

microbiology The study of microorganisms, principally bacteria, fungi and viruses. Scientists who study microbes and the infections they can cause or ways that they can interact with their environment are known as microbiologists.

mutation Some change that occurs to a gene in an organism's DNA. Some mutations occur naturally. Others can be triggered by outside factors, such as pollution, radiation, medicines or something in the diet. A gene with this change is referred to as a mutant.

plasmid A small circular loop of DNA that is separate from the main chromosomal DNA of bacteria.

pneumonia A lung disease in which infection by a virus or bacterium causes inflammation and tissue damage. Sometimes the lungs fill with fluid or mucus. Symptoms include fever, chills, cough and trouble breathing.

resistance (as in drug resistance) The reduction in the effectiveness of a drug to cure a disease, usually a microbial infection. (as in disease resistance) The ability of an organism to fight off disease.

superbug A popular term for a disease-causing germ that can withstand medicines.

toxic shock syndrome A rare and potentially deadly bacterial infection caused by Staphylococcus aureus. This bacterium release toxins - natural poisons - into the body of its host. Symptoms include a sudden high fever, muscle aches, vomiting, diarrhea, a rash and sometimes seizures.

toxin A poison produced by living organisms, such as germs, bees, spiders, poison ivy and snakes.

tuberculosis A bacterial disease that causes unusual growths in the lungs or other tissues. Untreated, it can kill. The infection usually spreads when a sick individual coughs (or talks, sings or sneezes), spewing germs into the air.

virus Tiny infectious particles consisting of RNA or DNA surrounded by protein. Viruses can reproduce only by injecting their genetic material into the cells of living creatures. Although scientists frequently refer to viruses as live or dead, in fact no virus is truly alive. It doesn't eat like animals do, or make its own food the way plants do. It must hijack the cellular machinery of a living cell in order to survive.

World Health Organization An agency of the United Nations, established in 1948, to promote health and to control communicable diseases. It is based in Geneva, Switzerland. The United Nations relies on the WHO for providing international leadership on global health matters. This organization also helps shape the research agenda for health issues and sets standards for pollutants and other things that could pose a risk to health. WHO also regularly reviews data to set policies for maintaining health and a healthy environment.

Citations

E. Landhuis. " The war on superbugs." Science News for Students. July 16, 2014.

B. Harder. " Joining the Resistance: Drug-immune microbes waft over hogs." Science News. Jan. 1, 2005.

A.L. Mascarelli. " Infectious animals." Science News for Students. April 17, 2013.

J. Raloff. " Antibiotics afield." Science News. Nov. 26, 2005.

J. Raloff. " Growth-promoting antibiotics: On the way out?" Science News. March 23, 2012.

J. Raloff. " Retail meats host drug-resistant bacteria." Science News. Oct. 20, 2001.

N. Seppa. " Danes keeping drugs out of livestock." Science News. April 8, 2003.

Original Journal Source: M. Barnett and J. Linder. Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010. Journal of the American Medical Association (JAMA). Published May 21, 2014. doi: 10.1001/jama.2013.286141.

Original Journal Source: J. Nesme et al. Large-scale metagenomic-based study of antibiotic resistance in the environment. Current Biology. Published May 8, 2014. doi: 10.1016/j.cub.2014.03.036.

Original Journal Source: S. Peacock. Health care: Bring microbial sequencing to hospitals. Nature. Published May 29, 2014. doi:10.1038/509557a.

Original Journal Source: B. Spellberg, J. Bartlett and D. Gilbert. The future of antibiotics and resistance. New England Journal of Medicine. Published Jan. 24, 2013. doi: 10.1056/NEJMp1215093.

Original Journal Source: S. Cole. Who will develop new antibacterial agents? Philosophical Transactions of the Royal Society B. Published May 12, 2014. doi: 10.1098/rstb.2013.0430.

Original Journal Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Antibiotic-resistant threats in the United States, 2013.

Original Report Source: World Health Organization. Antimicrobial resistance global report on surveillance, 2014.

Teachers' questions: Superbugs: A silent health emergency

Esther Landhuis is a freelance journalist in the San Francisco Bay Area. She worked on her high school newspaper and spent a decade studying biology before discovering a career that combines writing and science.

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Have antibiotics become too popular? Overusing these medicines fuels resistant germs that pose a global health threat.

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It’s in the blood.

Mosquitoes are deadly critters, they leave behind malaria and other deadly diseases.it’s not the mosquito’s fault, but it is a danger that is uncomfortably easy to encounter.

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Mental heath is a big issue. especially in are schools. heavy work load is affecting the mental heath of students, causing depression, suicidal thoughts, and drug over dose, all because of school related stress.

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Mental heath is a big issue. especially in are schools. heavy work load is affecting the mental heath of students, causing depression, suicidal thoughts, and drug over dose, all because of school related stress.

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It's not like anybody believes their shopping carts are clean. Most supermarkets place a dispenser of sanitizing wipes nearby, as if to hint at the exact opposite.

But in case you were on the fence, yes, they're gross.

A study of 85 random shopping carts conducted by Dr. Charles P. Gerba found that 50 percent carried E. coli, while 72 percent contained coliform bacteria. "The exceptionally high level of coliform bacteria suggests that fecal material may be involved in cart contamination," the report further stated.

In other words, your cart most likely harbors bathroom germs.

According to Donna Duberg, an assistant professor of clinical laboratory science at Saint Louis University, these pathogens find their way into our carriages through a number of avenues. "Certainly children can be a source of the germs," she explains, as toddlers often ride in carts when accompanying their parents, but Duberg doesn't downplay the role of the consumers either. "We may bring in germs with our hands," she adds.

Depending on our immune systems, many of these pathogens have the potential to make us sick, too. "Especially the fecal coliforms," notes Elizabeth Scott, an assistant professor of biology at Simmons University in Boston. "The concern is that we can pick up pathogens from the cart that can be transmitted directly to our mouths or to other foodstuffs."

Is this really that big of a concern, though? Germs are everywhere, from to They're always going to be present, so how bad could a shopping cart be?

Duberg cites Gerba's findings for the answer: "[There are] 138,00 total bacteria per square inch of a shopping cart - an amount which exceeds the number of bacteria in the average public restroom," she says. "These are fecal bacteria capable of causing illness."

Unfortunately, fecal germs aren't the only bacteria to be wary of. "There are bacteria capable of causing food-borne illnesses such as Salmonella, Shigella, Listeria, and, of course, E. coli O157H7 that may be hiding in the food we are purchasing, especially the fruits and vegetables and raw meats," says Duberg. "You can tell by doing a quick scan of food recalls," such as these online safety alerts posted by the FDA, she adds.

Taking both fecal and food-borne pathogens into account, it's no wonder there are disinfecting wipes in almost every supermarket. But as it turns out, they may not be as effective as we think.

"In theory, it's a good idea, but rather hard to achieve," explains Scott. "Where do you apply the disinfectant? How effective is the disinfectant? It's much better to practice careful hand hygiene and use alcohol hand sanitizer and hand washing."

Duberg adds that most of the wipes are utilizing benzalkonium chloride - and not bleach or alcohol - a disinfecting agent. This means that in order to sanitize, shoppers should be thoroughly wetting the surface areas (handles, grates, coffee cup holders) with the wipes. But if a shopper wanted to disinfect, Duberg says most brands of benzalkonium chloride recommend you leave the surfaces wet for up to four minutes.

The good news, she adds, is that if you thoroughly wet the surfaces with a benzalkonium chloride wipe, "you're going to get way over 99 percent" of the germs.

Or, if you'd rather skip that step, you can just grab a hand-held basket instead. Baskets might contain the same pathogenic bacteria as a cart, but as Scott says, "If it's baskets vs. carts, at least baskets aren't used to carry kids."

But just to be safe, you should probably make time to wipe down the basket, too.

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Maybe a bit grosser than you initially thought.

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Cell vs. virus: A battle for health - Shannon Stiles

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When she was 9 years old, Ann Albright went to the doctor with odd flulike symptoms. She was exhausted. She had to go to the bathroom frequently in the middle of the night. She was always thirsty. Even her vision was blurry.

After a few tests, the doctor pulled Albright's mother aside.

"I still remember it very vividly," says Ann Albright, now more than 40 years later. "My mom left the room with the doctor and came back in with tears running down her cheeks."

The verdict: diabetes, a disease that affects the way people process food.

At the time, the 1960s, the diagnosis meant that young Ann would never have the carefree childhood her mother wanted for her. For the rest of her life, she would have to give herself shots several times a day. She would need to be very careful about what she ate. And she might not realize all of her dreams in life.

"In the era I was diagnosed, most people were told they'd have a shorter life span," Albright says. "As a little girl with diabetes moving into adulthood, I wondered would I be able to have kids? Would I be able to have a life?"

Science has come a long way since then, says Albright, partly as a result of her own efforts: She's now a doctor and diabetes researcher at the Centers for Disease Control and Prevention in Atlanta. Since her diagnosis, researchers have developed better technologies, more effective medicines and a sharper understanding of how diabetes works.

Despite the advances, though, scientists still can't answer a lot of basic questions about what causes diabetes. There still is no cure. And living with the disease remains difficult.

"Everything changes" after a diabetes diagnosis, says Ali Reed, a pediatric endocrine fellow at the University of California, San Francisco. "Life becomes more complicated."

What's more, diabetes is on the rise - in both adults and kids. One version of the disease, called type 2 diabetes, is increasing at an especially alarming rate.

Scientists have linked type 2 diabetes with obesity. So now, more than ever, doctors are urging young people to start developing healthy habits as early as possible.
Breakdown
Diabetes refers to a group of diseases, but there are two main kinds: type 1 and type 2. In both types, the trouble begins with the body's ability to deal with sugar.

Sugar is the body's main fuel source. When you eat, your digestive system breaks down your food into basic parts, including proteins, fats and a simple sugar called glucose. Glucose gets absorbed through the intestines. From there, it enters the bloodstream. Circulating blood delivers glucose to all the cells, which convert it into energy.

At least, that's what's supposed to happen. In people with diabetes, however, sugar can't get from the bloodstream into the cells. A hormone, or messenger molecule, called insulin is normally responsible for that transfer. But in diabetics, insulin doesn't do its job.

As a result, sugar builds up in the bloodstream. When levels of sugar in the blood stay high, the condition is called chronic. And for reasons scientists don't yet understand, chronically high blood sugar can lead to blindness, kidney damage, limb amputations, heart attacks and more.

"It's not a death sentence, but it's a very serious disease," Albright says.
Two types
Exactly how diabetes affects a patient's life depends in part on which type of diabetes a person has. There are important differences between the two main types.

Type 1 diabetes is the kind Albright has. In this version of the disease, the body stops producing insulin. Symptoms usually begin in kids or teenagers.

After they're diagnosed and for the rest of their lives, type 1 diabetics need to regularly test their blood sugar levels with a pinching tool that draws a little blood. They also have to give themselves shots of insulin several times a day to control blood sugar levels. So far, scientists don't know how to prevent type 1 diabetes.

Type 2 diabetics make insulin, but their bodies don't use the hormone properly. Type 2 diabetes is far more common than type 1, and most people who have type 2 are adults. These days, though, more and more kids are coming to their doctors with symptoms of type 2 diabetes.

Doctors already know that adults who develop type 2 diabetes tend to be overweight or obese. And as kids have become increasingly overweight, the disease has started appearing at younger and younger ages.

Shorrocks/iStockphoto

As recently as a decade ago, type 2 diabetes was called "adult-onset" because kids just didn't get it.

"When this disease we used to only see in adults started happening in adolescents, it was just shocking to people," Albright says. "Pediatricians just didn't know what to do."
Healthy living
Doctors already knew that adults who develop type 2 diabetes tend to be overweight or obese. (Scientists can't yet explain why.) And as kids have become increasingly overweight, the disease has started appearing at younger and younger ages.

In the United States, two out of three adults are now overweight, according to the CDC. Nineteen percent of kids between the ages of 6 and 11 are overweight, compared with 7 percent just 20 years ago. Over the same period, the proportion of overweight teens rose from 5 percent to 17 percent.

(You can find out whether you are overweight by plugging numbers into a calculator at an online site. Also, see the sidebar "Understanding Body Mass Index" at the bottom of this article.)

Like their type 1 peers, type 2 diabetics have to monitor blood sugar levels. But they often rely on drugs instead of insulin shots. Frequently, they can get the disease under control by simply exercising more and eating reasonable portions of healthy foods.

"We now know that we can prevent or postpone type 2 diabetes by having [adults] at very high risk lose 5 to 7 percent of their body weight," Albright says.

Scientists don't yet know whether the same is true for overweight kids. The trend is so new that CDC researchers are still working to gather basic information about how the disease works in young people.

But it can't hurt to play soccer instead of video games, and to choose fruits and vegetables over junk food.

"There's no harm in having healthier lifestyle habits," Albright says. "Get to know what's going into your body. Make it fun."
Seeking answers
Weighing more than you should doesn't mean you're doomed to develop diabetes. The disease is far more complex than that. And while research has come a long way, plenty of questions remain.

Doctors don't know, for example, why certain ethnic groups have particularly high rates of diabetes, including American Indians, Hispanics and African Americans. Nor can doctors say for sure why the chances of getting diabetes go up if your parents or siblings have it.

Both relationships suggest that genes play a role in setting people up for diabetes. But something in the environment has to push those genes into action, and scientists aren't sure what those triggers are. It's also not clear which genes are involved.

"People spend their whole careers trying to understand this stuff," Albright says.

If you learn you have diabetes, don't despair. There's plenty you can do to live a long and healthy life. Also, know you're not alone.

Reed encourages all newly diagnosed kids to go to one of the nation's many diabetes camps. It can be hugely reassuring, she says, to be surrounded by other kids who feel like you do.

"It's really amazing," Reed says. "It's a very supportive and tolerating environment for kids who are often the only ones at their school with diabetes. At diabetes camp, everyone is going through it together."
Going Deeper:

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When she was 9 years old, Ann Albright went to the doctor with odd flulike symptoms. She was exhausted. She had to go to the bathroom frequently in the middle

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How do cancer cells behave differently from healthy ones? - George Zaidan

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Lung cancer- it's fatal, and tobacco usage is making it worse. since so many people use tobacco, lung cancer is more common now. tobacco is addictive, bad for you, and disturbingly popular. This makes lung cancer so much more common, mostly because of this tobacco "obsession". Tobacco needs to be harder to obtain- it's not a good trend at all.

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Lung Cancer Lesson for Kids - Video & Lesson Transcript | Study.com

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Learn about lung cancer and how mutated cells form cancerous tumors in the lungs. Discover the different causes of lung cancer, such as genetics,...

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Kids learn about the disease cancer in the science of biology including how it starts, different forms, treatments, symptoms and prevention.

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Mental health. it's a big issue in daily life, and at school, it seems to be affecting many students-without any support from the school. 1 in 5 students have it, and it is mostly sprouting directly from school, which seems strange, until you take a closer look. I don't know why, but teachers (and parents), seem to ignore what's really going on. the teachers like this act ignorant, almost. as toxic masculinity builds up, bullying is much more common, and it builds up into a mental  issue, a fear, a problem much more serious. but when i bring this up, a comment about how lots of student, particularly males, are creating this toxic environment, the teacher looks surprised. "I haven't noticed that." or "Are you sure you aren't exaggerating a little?" or "boys will be boys, you can't really blame them, right?". it's such a weird behavior, and i find it hard to believe that teachers "Haven't noticed" how toxic and depressing these environments are becoming. As a middle school-er with ADHD and anxiety who also uses They/Him pronouns, instead of sticking with what i was assigned at birth, the pressure is real, and it's difficult. it hurts. If we tried harder to make school a safer place, not somewhere i need to wear a face that's not mine to get through the day, Maybe then these issues wouldn't be happening so frequently. I don't want school to be somewhere that occasionally makes me feel as if i am no longer in my body and someone else is directing me, or as if i'm stuck in a strange trance where everything else around me fades out. it just shouldn't be something i have to live with like this.

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Opinion | Is the Drive for Success Making Our Children Sick? (Published 2016)

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Across the country, children are experiencing depression, anxiety and even physical strain because of the pressures of school.

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Sandboxes, a common installment in play grounds or backyards, offer a small, beach like patch of sand, where kids can play and build sand castles. however, sandboxes are extremely unsanitary, considering a few factors. One of the largest factors of this unsanitary nature is that uncovered sandboxes are viewed as litter boxes by wild animals, pets, and, unfortunately, also children. And if the prospect of fecal matter in a kid's play area isn't already disgusting, parasites that live in the colon end up in the sand box, and it's only a matter of time before someone ingests an egg or a pin-worm crawls into a toddler's colon. There's another layer to this grossness, unfortunately. Toddlers are often sticky, dirty, and they will get there hands on everyone and everything. Basically, lots of toddler's aren't the cleanest, and this leads to germs. Germs in the sandbox, germs that toddlers will wade through for hours on end.

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So there I was at a kid's birthday party, my 13-month-old daughter playing merrily with her brother in the sandbox, when she suddenly decided that she was hungry. Into her mouth it went-all of the sand-and though I was up with a leap and a "No," I was too late. I laughed nervously while furiously fishing sand out of her mouth (it's surprisingly hard to do, by the way) as other parents looked on with a mixture of unease and relief- Gross, but thank God it wasn't mine. My friend, the host who owned the sandbox, appeared. "Did I ever tell you," she said, "that I think my cat poops in there?"

Kids love sandboxes. Parents do not, and for good reason. When public health-testing organization NSF International sampled 26 different items in public places-toys at doctors' offices, children's library books, playground sandboxes-for a 2008 study on germs, they found that sandboxes were far and away the germiest of all, harboring nearly 2,000 times more bacteria, yeast, and mold per square inch than the door handles of public restrooms.

Of course, bacteria, yeast, and mold aren't all bad. Many are actually quite good for us. Not so for the other microbial gifts that sandboxes sometimes leave for kids: parasitic worms. Like giant litter boxes, uncovered sandboxes invite animals-raccoons, dogs, cats-to use them as bathrooms, which essentially turns them into giant parasite Petri dishes. And that's bad, because even if your kids don't eat handfuls of sand like mine do, they probably do put their fingers in their mouths an awful lot-and parasites are transmitted by what is not-so-euphemistically called the fecal-oral route, meaning they go from one animal (or kid's) butt straight to the next kid's mouth. Bon appétit!

OK, I know you're rolling your eyes, thinking: But most kids who play in sandboxes don't get sick. Fair enough. But it's also possible that kids are getting sick and we just don't know it. Doctors are not required to notify the government when they diagnose these infections-so no one is closely monitoring them or their epidemiology-and many kids who get parasites probably either never get diagnosed with them, as symptoms can be mild and spontaneously resolve, or their diagnoses are kept quiet. (Are you really going to tell your friends that your kid just got dewormed?) And when little Annie does get parasites, her parents also aren't going to tie it back to that time three weeks ago when she played in a sandbox. The fact is that a large proportion of Americans-many of them kids-are infected by parasites, and sandboxes are a known hot spot. "There is a real threat," says Laila Woc-Colburn, an infectious disease specialist at the Baylor College of Medicine in Houston.

Consider what happened when researchers at McGill University tested the surface sand from sandboxes at 10 local day care centers in 1991. Two of the sandboxes, they discovered, were contaminated with eggs of a parasite called . Once a child eats them, the eggs hatch in his or her body into larvae, which can burrow into the liver, lungs, central nervous system, or eyes. Sometimes the infection is asymptomatic, but when it's not and is not properly diagnosed and treated, it can cause liver damage, lung damage, or blindness. (An earlier 1979 study found that a whopping 39 percent of residential sandboxes in Kansas contained Toxocara eggs. Perhaps unsurprisingly, research suggests that 1 out of every 7 Americans over the age of 6 has been infected with this parasite.)

The McGill study also reported that one of the sandboxes with Toxocara eggs was co-contaminated with the eggs of , a parasitic worm that can, occasionally, cause intestinal blockage and stunted growth. Another parasite kids can get from sandboxes is Toxoplasma gondii, which is spread by cats and believed to chronically infect more than 1 out of every 6 Americans. In one study, researchers in Japan spied on three urban sandboxes at night using camcorders and found that over the course of five months, cats pooped in the boxes 961 times, and dogs pooped in them 11 times. They calculated that one of the sandboxes contained more than 1.5 million viable Toxoplasma eggs per square foot of sand, yet children need only ingest a single egg to get sick.

Although Toxoplasma infections are typically mild-some people get flu-like symptoms, while others feel fine, though most will harbor the parasite for the rest of their lives-individuals with compromised immune systems can fall very ill, and when women become infected during pregnancy, their babies can develop brain or vision damage or become sick later in life. (Some research also suggests that the parasite can affect behavior and personality. So the next time an aggressive driver cuts you off, calm yourself with the thought that he might be infested.)

Let's also not forget pinworms, the tiny little worms that live in your intestines, scurry down to your anus while you sleep, and lay their eggs there every night. Nearly half of all American kids are believed to have pinworms at any given time (and when they do, their parents usually have them too), but they're tough to diagnose: You basically have to set an alarm for a few hours after you go to sleep and then inspect your anus for crawling worms. (No, I'm not kidding.) As Austin, Texas-based pediatrician Ari Brown wrote in her best-selling book Toddler 411, sandboxes are an excellent place for kids to catch pinworms, because pinworms cause kids' butts to itch; then they scratch their butts, getting pinworm eggs on their fingers; then they build sandcastles studded with worm eggs.

I've left my favorite (as in: most absolutely terrifying) sandbox parasite for last. It's called Baylisascaris procyonis, and it is a roundworm that typically infects raccoons.

As many as 4 out of 5 raccoons carry this parasite, and infected coons typically poop out thousands, if not millions, of eggs a day-perhaps right on your lawn. In a 2009 study, researchers found raccoon poop in more than half of the suburban Chicago backyards they sampled. Once there, the parasite's eggs are virtually indestructible, except with exposure to very high heat. One scientist who has studied them recommends using an acetylene torch to incinerate the bastards.

Human infections with Baylisascaris seem to be very, very rare, although no one really knows why, considering everything I wrote above. But thank goodness, because the parasites are extremely dangerous. "If eggs are accidentally ingested by a human," a recent clinical report explained, "larval infection can lead to devastating neurological disease and death." One-third of cases are fatal. In 2009, two kids from Brooklyn caught it; one developed permanent brain damage, and the other went blind in one eye. Another child fell ill with it in Canada in 2009, presumably after-you guessed it!-playing in a sandbox. He was lucky because he was diagnosed and treated quickly, but the infection nevertheless robbed him of the ability to speak, gave him a seizure disorder, and damaged his eyesight.

So, yes, sandboxes are gross and can be dangerous. This is not to say that you should never let your kids play in them, because the danger is remote-they only rarely cause serious illness (my daughter's sandy snack seems to have done her no harm, although I haven't had her tested). If you own your own sandbox, though, consider covering it at night to keep out animals. If you have dogs or cats, make sure they are regularly checked for worms, and keep them out of the sandbox so they never wonder whether it might work well as a toilet. If you suspect that raccoons are pooping on your lawn, check out this Centers for Disease Control and Prevention guide to cleaning up their hazardous excrement.

As for public sandboxes: It kind of goes without saying, but if they smell bad, stay away. Also, (try to) keep your kids from putting their hands (or all the sand) in their mouths when they play, and make them wash their hands afterward. (Hand sanitizer won't kill worm eggs, Woc-Colburn says, so best to do it the old-fashioned way.) Would it be crazy to steer your kids away from public, always-uncovered sandboxes just in case? No, particularly if your kids have other sources for creative hands-on play. Brown, for one, has advised parents against them. And if your sandbox-frequenting kid does get really sick-symptoms of parasitic infections vary but can include fever, coughs, stomach pain, eye pain, or seizures-of course, take him to the pediatrician, and mention his sandbox use and any other relevant info, such as that you suspect your cat poops in it. Chances are high that your kid is never going to get really sick from sand play, but it's good to know about the risk just in case, even though it means-and for this I apologize-that you will never be able to look at a sandbox the same way again.
Read more of Slate's parenting coverage, including:

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Sandboxes Are Disgusting! Are You Sure You Want Your Kids Playing in Them?

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So there I was at a kid's birthday party, my 13-month-old daughter playing merrily with her brother in the sandbox, when she suddenly decided that she...

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this article is super helpful when studying how viruses and bacteria evolve, and how they do it. this article talks about how these organisms are evolving to become vaccine resistant. This is bad because they now need to develop more vaccines to fight these evolved organisms. this will cost a lot, and will not be easy. this increased price along with these new strains will make it extremely difficult to fight off.

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Bacteria and other microbes can make us sick. But there's a lurking danger with some germs that's far more frightening than a bout of food poisoning or an infected wound. Today, drugs exist to fight most of these germs. They're called antibiotics. Before these medicines came along, common infections frequently killed people. And that's where the danger lies: What will happen if antibiotics no longer kill germs?

Already some antibiotics have lost their superpowers. Many others are beginning to lose theirs. Biologists describe this problem as resistance. Across the globe, germs are becoming resistant to antibiotic medicines. In a sense, these "superbugs" have begun to laugh at those former wonder drugs.

But resistance is no laughing matter. As germs toughen up against drugs that are supposed to slay them, treatable conditions such as TB - tuberculosis - can spread. And surgeries that rely on antibiotics could turn from life-saving to life-threatening.

The threat is huge

"Alarming levels" of drug-resistant bacteria already exist in many parts of the world. That's the conclusion of a 257-page report published in April. It was issued by the World Health Organization (WHO).

This United Nations agency, based in Geneva, Switzerland, recently reviewed how well these germ slayers perform in 114 countries. In some places, it found, antibiotics no longer work for half of all people being treated against common diseases. Those diseases include pneumonia and gonorrhea.

The Centers for Disease Control and Prevention (CDC), based in Atlanta, Ga., also has been investigating the problem . It estimates that in the United States alone, antibiotic-resistant infections now sicken some two million people each year. At least 23,000 of them die.

But even antibiotic-resistant germs that don't kill can be a problem. Their infections become harder to treat - and more expensive. Consider one estimate - $233 million - published May 20 in the journal Antimicrobial Resistance and Infection Control. That's how much researchers calculated that it costs the United States each year to deal with just one resistant superbug. That germ causes a lung disease known as pneumonia.

Drug-immune bugs that flourish in the human gut can enter the environment with every flush of the toilet. Researchers discovered how big this problem is when they analyzed wastewater from 11 sites in one French city. Antibiotic-resistant bacteria tainted 96 percent of their samples. A May 1 paper in Clinical Infectious Diseases describes the disturbing details.

Some scientists have scouted for such germs in the environment. They collected superbugs at hospitals. Then they probed the germs, identifying parts of their genes that appear to make them resistant to antibiotics. Next, the researchers looked in the outdoor environment for that same genetic fingerprint of superbugs. And they turned up that superbug DNA in 71 places - from the soil and sea water to human wastes. The researchers reported their findings May 8 in Current Biology.

Why it's happening

Drug designers have created antibiotics to kill bacteria, as well as some fungi and other germs. But sometimes, a few treated germs survive. They survive because they're stronger. Or they may have certain genetic mutations that allow them to break down the drug. They might even have evolved a way to keep the drugs from harming their operational machinery. Over time, all germs susceptible to a drug will die off. That will leave behind only superbugs - those microbes that medicines can't kill.

This is not surprising. In fact, it's quite natural. Part of evolution, it's known as survival of the fittest.

Scientists stumbled onto the first antibiotic, penicillin, around 1930. Since then, research has produced a medicine cabinet full of additional ones. It appeared that these would make many of the worst bacterial infections ever more manageable. So, during the 1970s, drug developers began focusing on noninfectious health problems, such as cancer and heart disease. As a result, in the past 30 years, no new types of antibiotics have been developed.

Right now, bacteria are outsmarting antibiotics faster than developers can make new ones. And there are no signs things will change, says Stewart Cole. He directs the Global Health Institute at the Ecole Polytechnique Fédérale de Lausanne in Switzerland.

Writing in the May 12 Philosophical Transactions of the Royal Society B, he argues that the "golden age" of antibiotic development "is a distant memory, and the likelihood of there being another seems slim." This lack of new types of germ killers, he says, has been allowing superbugs to morph and thrive.

One of the most famous of them is known as MRSA (pronounced MER-sah). The letters stand for methicillin-resistant Staphylococcus aureus . Methicillin is a widely used antibiotic. And Staph aureus is a germ that can cause boils, food poisoning, toxic-shock syndrome and more. These bacteria sicken (and sometimes kill) by releasing potent natural poisons - called toxins - into the body.

Despite its name, MRSA is resistant to far more antibiotics than just methicillin. That makes this superbug particularly nasty in hospitals and prisons. These are places where people often have open wounds or weak immune systems. Both increase a person's chance of picking up an infection.

Too much of a good thing

Drug resistance can develop at any time. But its likelihood climbs as the use of an antibiotic increases. And this is especially true when an antibiotic is overused. That's when a doctor prescribes it for infections it has no hope of curing.

For instance, doctors sometimes prescribe antibiotics to treat an infection before they learn if the disease is caused by bacteria. If viruses are responsible, then antibiotics will be useless. The reason: Antibiotic medicines do not kill viruses. Yet by giving an antibiotic to someone with a viral infection, that drug will reach good bacteria living in our bodies. And over time, some of these bacteria will become resistant to the drug.

Last year, the CDC reported that up to half of the antibiotics that U.S. doctors prescribed went to people who didn't actually need them.

Take, for example, someone who visits a doctor for a lingering cough. Viral infections cause most coughs. So a viral cough won't be helped by drugs and will tend to go away on its own. Yet 71 percent of the time, doctors will still prescribe antibiotics for patients coming in with a common cough, a May 21 study finds.

"I think there's this perception among both doctors and patients that coughs don't go away without antibiotic treatment," Jeffrey Linder told Science News for Students . Linder, who coauthored the new report, is a doctor at Brigham & Women's Hospital in Boston, Mass. He and Michael Barnett, also from the hospital, tracked the drugs that doctors prescribed during more than 3,000 U.S. clinic visits between 1996 and 2010. They reported their findings in the Journal of the American Medical Association .

A small number of people who visit a doctor with a cough turn out to have bacterial pneumonia. These cases do require antibiotic treatment. But Linder says doctors should easily be able to recognize these few from the hordes of people coming in with a routine, viral cough.

Perilous profit

Antibiotic overuse also has become a problem on farms. In the United States, animals - not people - receive about 80 percent of all antibiotics. Sometimes the drugs are used to save an infected animal or prevent disease from spreading through a herd. More often, though, feed suppliers put small amounts of these drugs into the food that will be given to healthy animals. These antibiotics help speed the animals' growth. And this has boosted farmers' profits.

But using antibiotics just to beef up livestock is "a direct threat to human health," argues Kellogg Schwab. He's an environmental microbiologist at Johns Hopkins University in Baltimore, Md. Earlier, he and his coworkers detected bacteria that are resistant to antibiotics in the exhaust air blowing out of farm buildings. That suggests these superbugs can spread through the air from animals to people.

SteveOehlenschlager / iStockphoto

Germs that are immune to antibiotics also can hitch a ride into your body through ground beef or the chicken breast on your cutting board. Biologists have found that much of the fresh beef, pork and poultry sold in grocery stores contains bacteria resistant to antibiotics.

Even if those germs don't sicken us or cause other immediate harm, they can offload their resistance genes into other bacteria that normally live inside our bodies. Sometimes, like with the MRSA superbug, resistance is carried on circular pieces of DNA called plasmids. These plasmids can slip easily from one bacterial cell into another.

In this way, our gut microbes can become "a reservoir of resistance," says Sharon Peacock. She's a microbiologist at the University of Cambridge in England. Later, "when we actually get sick and need an antibiotic, we may already carry a resistance gene" that may keep that drug from working, she says.

In the United States, farmers have fought against banning antibiotics as growth promoters. They say it will reduce their profits because more animals will get sick, slowing their growth. But that's not been the experience in other countries.

The U.S. Food and Drug Administration, or FDA, has proposed banning antibiotic use in healthy animals. But for more than 30 years, the livestock industry and Congress have fought such action. Recently, the FDA stepped up its efforts to end this practice.

In December 2013, FDA laid out a plan to phase out within three years the use of antibiotics on farms to boost livestock growth. Its stated reason: concern that farm use of these drugs has made more germs immune to the antibiotics needed to fight life-threatening infections in people. And that's a worry because the same germs that sicken animals often sicken people.

Antibiotic resistance is a complex and growing problem. Many microbiologists worry that the time when antibacterial medicines no longer work could be coming. Thankfully, doctors and many patients are becoming more aware of the problem. Researchers also are hard at work creating new tools to keep superbugs from taking over.
Next: How scientists are trying to tackle the problem
Power Words

antibiotic A germ-killing substance prescribed as a medicine (or sometimes as a feed additive to promote the growth of livestock). It does not work against viruses.

bacterium (plural bacteria) A single-celled organism forming one of the three domains of life. These dwell nearly everywhere on Earth, from the bottom of the sea to inside animals.

boils (in medicine) A skin infection that starts as a hard, red, painful lump. Eventually, it gets bigger, softens and fills with pus. A common source of these is a bacterium known as Staphylococcus aureus.

bioengineer A researcher who applies technology for the beneficial manipulation of living things. Bioengineers use the principles of biology and the techniques of engineering to design organisms or products that can mimic, replace or augment the chemical or physical processes present in existing organisms. This field includes researchers who genetically modify organisms, including microbes. It also includes researchers who design medical devices such as artificial hearts and artificial limbs.

Centers for Disease Control and Prevention, or CDC An agency of the U.S. Department of Health and Human Services, CDC is charged with protecting public health and safety by working to control and prevent disease, injury and disabilities. It does this by investigating disease outbreaks, tracking exposures by Americans to infections and toxic chemicals, and regularly surveying diet and other habits among a representative cross-section of all Americans.

cholera A bacterial disease that infects the small intestine, causing sever diarrhea, vomiting and dehydration. It is spread by germs from feces that contaminate water or food.

DNA (short for deoxyribonucleic acid) A long, spiral-shaped molecule inside most living cells that carries genetic instructions. In all living things, from plants and animals to microbes, these instructions tell cells which molecules to make.

evolution A process by which species undergo changes over time, usually through genetic variation and natural selection, that leave a new type of organism better suited for its environment than the earlier type. The newer type is not necessarily more "advanced," just better adapted to the conditions in which it developed.

fungus (plural: fungi) Any of a group of unicellular or multicellular, spore-producing organisms that feed on organic matter, both living and decaying. Molds, yeast and mushrooms are all types of fungi.

gene A segment of DNA that codes, or holds instructions, for producing a protein. Offspring inherit genes from their parents. Genes influence how an organism looks and behaves.

germ Any one-celled microorganism, such as a bacterium, fungal species or virus particle. Some germs cause disease. Others can promote the health of higher-order organisms, including birds and mammals. The health effects of most germs, however, remain unknown.

gonorrhea A serious disease that can infect the genitals, rectum and throat. This sexually transmitted disease is very common, especially among people between the ages of 15 and 24. Untreated, it can cause infertility or death. "Untreated gonorrhea may also increase your chances of getting or giving HIV - the virus that causes AIDS," according to the U.S. Centers for Disease Control and Prevention.

growth promoter (in livestock agriculture) A medicine, usually an antibiotic, added in small doses to the feed given to animals raised for meat. Used as a preventive medicine, it can reduce the risk that animals will become sick, which would slow their growth. And that would decrease a farmer's profits.

immune system The collection of cells and their responses that help the body fight off infection.

infection A disease that can be transmitted between organisms.

influenza (or flu) A highly contagious viral infection of the respiratory passages causing fever and severe aching. It often occurs as an epidemic.

livestock Animals raised for meat or dairy products, including cattle, sheep, goats, pigs, chickens and geese.

microbe Short formicroorganism. A living thing that is too small to see with the unaided eye, including bacteria, some fungi and many other organisms such as amoebas. Most consist of a single cell.

microbiology The study of microorganisms, principally bacteria, fungi and viruses. Scientists who study microbes and the infections they can cause or ways that they can interact with their environment are known as microbiologists.

mutation Some change that occurs to a gene in an organism's DNA. Some mutations occur naturally. Others can be triggered by outside factors, such as pollution, radiation, medicines or something in the diet. A gene with this change is referred to as a mutant.

plasmid A small circular loop of DNA that is separate from the main chromosomal DNA of bacteria.

pneumonia A lung disease in which infection by a virus or bacterium causes inflammation and tissue damage. Sometimes the lungs fill with fluid or mucus. Symptoms include fever, chills, cough and trouble breathing.

resistance (as in drug resistance) The reduction in the effectiveness of a drug to cure a disease, usually a microbial infection. (as in disease resistance) The ability of an organism to fight off disease.

superbug A popular term for a disease-causing germ that can withstand medicines.

toxic shock syndrome A rare and potentially deadly bacterial infection caused by Staphylococcus aureus. This bacterium release toxins - natural poisons - into the body of its host. Symptoms include a sudden high fever, muscle aches, vomiting, diarrhea, a rash and sometimes seizures.

toxin A poison produced by living organisms, such as germs, bees, spiders, poison ivy and snakes.

tuberculosis A bacterial disease that causes unusual growths in the lungs or other tissues. Untreated, it can kill. The infection usually spreads when a sick individual coughs (or talks, sings or sneezes), spewing germs into the air.

virus Tiny infectious particles consisting of RNA or DNA surrounded by protein. Viruses can reproduce only by injecting their genetic material into the cells of living creatures. Although scientists frequently refer to viruses as live or dead, in fact no virus is truly alive. It doesn't eat like animals do, or make its own food the way plants do. It must hijack the cellular machinery of a living cell in order to survive.

World Health Organization An agency of the United Nations, established in 1948, to promote health and to control communicable diseases. It is based in Geneva, Switzerland. The United Nations relies on the WHO for providing international leadership on global health matters. This organization also helps shape the research agenda for health issues and sets standards for pollutants and other things that could pose a risk to health. WHO also regularly reviews data to set policies for maintaining health and a healthy environment.

Citations

E. Landhuis. " The war on superbugs." Science News for Students. July 16, 2014.

B. Harder. " Joining the Resistance: Drug-immune microbes waft over hogs." Science News. Jan. 1, 2005.

A.L. Mascarelli. " Infectious animals." Science News for Students. April 17, 2013.

J. Raloff. " Antibiotics afield." Science News. Nov. 26, 2005.

J. Raloff. " Growth-promoting antibiotics: On the way out?" Science News. March 23, 2012.

J. Raloff. " Retail meats host drug-resistant bacteria." Science News. Oct. 20, 2001.

N. Seppa. " Danes keeping drugs out of livestock." Science News. April 8, 2003.

Original Journal Source: M. Barnett and J. Linder. Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010. Journal of the American Medical Association (JAMA). Published May 21, 2014. doi: 10.1001/jama.2013.286141.

Original Journal Source: J. Nesme et al. Large-scale metagenomic-based study of antibiotic resistance in the environment. Current Biology. Published May 8, 2014. doi: 10.1016/j.cub.2014.03.036.

Original Journal Source: S. Peacock. Health care: Bring microbial sequencing to hospitals. Nature. Published May 29, 2014. doi:10.1038/509557a.

Original Journal Source: B. Spellberg, J. Bartlett and D. Gilbert. The future of antibiotics and resistance. New England Journal of Medicine. Published Jan. 24, 2013. doi: 10.1056/NEJMp1215093.

Original Journal Source: S. Cole. Who will develop new antibacterial agents? Philosophical Transactions of the Royal Society B. Published May 12, 2014. doi: 10.1098/rstb.2013.0430.

Original Journal Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Antibiotic-resistant threats in the United States, 2013.

Original Report Source: World Health Organization. Antimicrobial resistance global report on surveillance, 2014.

Teachers' questions: Superbugs: A silent health emergency

Esther Landhuis is a freelance journalist in the San Francisco Bay Area. She worked on her high school newspaper and spent a decade studying biology before discovering a career that combines writing and science.

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Have antibiotics become too popular? Overusing these medicines fuels resistant germs that pose a global health threat.

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Lung cancer- it's fatal, and tobacco usage is making it worse. since so many people use tobacco, lung cancer is more common now. tobacco is addictive, bad for you, and disturbingly popular. This makes lung cancer so much more common, mostly because of this tobacco "obsession". Tobacco needs to be harder to obtain- it's not a good trend at all.

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Lung Cancer Lesson for Kids - Video & Lesson Transcript | Study.com

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Learn about lung cancer and how mutated cells form cancerous tumors in the lungs. Discover the different causes of lung cancer, such as genetics,...