How to clean the bacteria out of your shower

We all do it: get in a steaming, hot shower, and just soak it all in.  Whether it's a few moments to relax at the end of the day, or the way you start your day, it's an easy escape. 

But for Mary Lou Area, she and her doctors, believe those showers are to blame for her constant coughing.  Her coughing started while she was traveling back and forth to take care of her dying mother, "And the coughing kept getting worse where I would just cough up Kleenexes full of stuff," Area said.

She was recovering from pneumonia and initially just wrote it off as lingering symptoms.  But after weeks of coughing to the point of exhaustion, she went to see a specialist, "He said, 'You may have this really weird thing,'" said Area.  The weird thing the pulmonologist diagnosed her with was Nontuberculous Mycobacterium Complex or NTM. "I thought, 'That's ridiculous,'" said Area.

But it is real.

NTM often hits women around 50 years old who are slim, Caucasian and otherwise in good health. "For a number of patients, I am absolutely persuaded that showers are the primary means by which they were infected," said Dr. Michael Iseman, professor of medicine at National Jewish Health and the University of Colorado.

Iseman specializes in the treatment of complicated or multi-drug-resistant tuberculosis or disease due to nontuberculous mycobacteria.

Iseman told Marchetta he and other physicians who specialize in treating rare respiratory infections are seeing a spike in the number of NTM cases. "We see hundreds if not approaching a thousand patients a year with this condition," Iseman said. 

And he has also seen evidence showers are to blame. "We've actually surveyed the showers and the water system in these individual's homes and have found, in a modest number of cases, there's an exact fingerprint identity with the organism from the patient's lungs to the organism in the showerhead," said Iseman.

Professor Norman Pace at the University of Colorado at Boulder agrees, "The stuff you see on this showerhead is bacteria," said Pace. "NTM pulmonary disease is heavily under-diagnosed and probably more prevalent in the community than we think."  Pace and his graduate students spearheaded a recent study that found 30 percent of showerheads harbor significant levels of disease-causing bacteria.

"Nasty is the word. I'd throw this one away and get another one," Pace said looking at a sample showerhead. 

"These buildups that people usually think of as calcium deposits or soap scum, are really biological," said grad student and researcher Kim Ross.

Pace said all of us are bathed in bacteria every day, most of it harmless.  But in the shower potentially harmful bacteria have a direct route to your respiratory system, "What that steam-like material is, is microscopic droplets of water and when you inhale those, you are, of course, inhaling whatever is contained in the water," said Pace.

That includes bacteria that is breeding in your household pipes. "I truly believe I got it from a showerhead," said Area of her NTM diagnosis.

Area said she often stood in a steaming hot shower for 30 minutes at a time before she was diagnosed.  She had a portion of her lung removed because of the disease and will be taking multiple antibiotics for years to come to treat the disease,"It's hard to enjoy your life when you feel not so hot."

There are efforts under way to get the National Institutes of Health, the Centers for Disease Control and Prevention and the Environmental Protection Agency to participate in more aggressive research and awareness campaigns.

In the meantime, the experts suggest removing and soaking showerheads in bleach or germ-killing cleaning agents, such as vinegar, as part of a regular cleaning routine.

If they do not come clean, Pace said throw them out and replace them, but keep in mind the bacteria will reappear even on a new showerhead.