We have all been in one situation where we couldn’t wipe out butts clean  for lack of toilet paper when we’re outside at a late night party or a public john and suddenly discovered the last toilet paper has ran out.

One gram of feces can contain 10 million viruses, one million forms of bacteria, one thousand parasite cysts, and a hundred worm eggs, according to the United Nations Department of Social and Economic Affairs. So now you’re walking around with all of those possible threats, separated from the greater world by one layer of denim and another of thin underoos.

Fecal matter on your clothing and body can, sometimes in ways unnoticed, spread particles to your hands, and then throughout your environment and even into your body—as hand-to-mouth germ transfer is common through simple acts like eating and drinking.

“In terms of hygiene, it’s absolutely unacceptable” not to wipe, says Aaron Glatt, chair of medicine at South Nassau Communities Hospital and spokesperson for the Infectious Disease Society of America. “Find something to clean yourself off with,” he implores. “Use water or leaves. Do everything possible.”

The situation can be worsened by the type of poop in question, adds Philip M. Tierno, a professor of microbiology and pathology at NYU School of Medicine. “If you have loose stool, it can spread further,” Tierno says. Naturally, such feces seeps into clothing and breaks that barrier to the world outside your pants more easily.

The risk is greater for women. An unclean anus is positioned dangerously close to the vagina, creating a entryway for bacteria into the urethra, leading to a possible urinary tract infection.
This is one reason Tierno recommends people, particularly women, go to places outside the range of normal, well-restocked bathrooms carrying at least a packet of tissues and alcohol-based sanitizer. In other words, plan ahead if you’re going to a summer festival, remote nature area, or highway rest area in the rural south.

Because fecal matter is an output of the body, all the infectious diseases and bacteria one carries are brewed into it by the time it’s slated for release. E. coli, enterococcus, diarrheal parasites, and other germs whose effects range from annoying to deadly are spread through excrementNorovirus, the leading cause of illness and outbreaks from contaminated food in the US, is a gut rider.

It may be of some comfort to know that if you have access to hole over which to squat and a shower in your near future, you are—globally speaking—lucky.

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