Five common ways germs are spread:

It's back to school time and we all know what that means. Shopping, getting back into a night time routines and runny noses.

One of the most common ways children get colds is by rubbing their nose or eyes after cold virus germs have gotten on their hands.

Here are five common ways germs are spread between people.

• Nose, mouth, or eyes to hands to others:
  Germs can spread to the hands by sneezing, coughing, or rubbing the eyes and then can be transferred to other family members or friends. Simply washing your hands can help prevent such illnesses as the common cold or eye infections.
  
  
• Hands to food:
  Usually germs are transmitted from unclean hands to food by an infected food preparer who didn’t wash his or her hands after using the toilet. The germs are then passed to those who eat the food. This is easily prevented by always washing your hands after using the toilet and before preparing food items.
  
  
• Food to hands to food:
  Germs are transmitted from raw foods, such as chicken, to hands while preparing a meal. The germs on the hands are then transferred to other uncooked foods, such as salad. Cooking the raw food kills the initial germs, but the salad remains contaminated.
  
  
• Infected child to hands to other children:
  Germs are passed from a child with diarrhea to the hands of the parent during diaper changing. If the parent doesn’t immediately wash his or her hands, the germs that cause diarrhea are then passed to others.
  
  
• Animals to people:
  Wash your hands after petting animals or touching any surfaces they come into contact with.

Make sure your child knows to use soap and warm water. He should scrub all over -- including the back of his hands, between fingers, and around nails -- for about 20 seconds, about the time it takes to sing the Happy Birthday song twice. Then rinse well in warm water, dry with a paper towel, and use the towel to turn off the water.

Beware of Top Germ Spots

A 2005 study of germs in schools found that classroom water fountain spigots and plastic cafeteria trays were the germiest spots in school. The spigot had 2,700,000 and the tray 33,800 bacteria per square inch, compared with 3,200 on the restroom toilet seat. This is most likely because toilet seats get cleaned regularly, while trays and water fountains may not be.

Bring a Pencil Box

Supply your child with his own pencils, crayons, erasers, rulers, and other classroom supplies. He'll have less risk of picking up an illness from sharing these objects. Consider packing mechanical pencils, which don't need to be sharpened. Then your child can avoid the class pencil sharpener, a potential germ hotspot.

Keep Backpacks Clean

As any parent knows, school backpacks can get pretty gnarly from long-forgotten lunches and all the other things children stuff into them. Have your child clean out his backpack regularly. Then clean the inside of the backpack periodically. Use a wet cloth or sanitary wipe to remove dripped milk and stuck-on food or crumbs. Always make sure to pack lunches in a bag or lunchbox, not loose in a backpack, to keep backpacks cleaner. And while your child is cleaning out his backpack, remind him to bring dirty gym clothes home to wash and to clean rotting food out of his locker.

Teach Your Child Germ Etiquette

Teach your child to stay away from sick children as much as possible. "When children see another child hacking or sneezing, they should move away from the person, not mingle," Tierno says. On the other hand, your child should cover coughs and sneezes to prevent spreading infection if he is sick. When possible, sneeze into a tissue and throw it in the trash right after. Then wash his hands. Otherwise, he should cough or sneeze into crook of his elbow, not his hands.