THE ENGLISH slang word runs is so graphic, referring to diarrhea and obviously derived from what you do when you’re about to do what has to be done.

Diarrhea is so common in developing countries, especially during summer, that we’ve begun to believe it’s normal, another one of those inevitable inconveniences in life. But we forget that diarrhea can, and should be, prevented. The runs can be dangerous. In many cases, even if it seems mild, the diarrhea can be a sign of food poisoning. For very young children and for the elderly, diarrhea can even be fatal.

We think of preventive measures mainly as a question of hygiene and cleanliness, like washing one’s hands before and after eating. No wonder that hand disinfectants (“sanitizers”) have become popular, almost standard fare now in most people’s bags. I worry though that it could lull us into a sense of false complacency.

The World Health Organization (WHO) has five keys to safer food, which show that you need more than sanitizers to keep from running to the toilet because of the runs. The five keys are: (a) keep clean, (b) separate raw from cooked food, (c) cook thoroughly, (d) keep food at safe temperatures, and (e) use safe water and raw materials.

Now that I have to care for elderly parents and my own very young children, I’ve become very conscious of these keys and thought I should point out some of those measures that people are less aware of.

The first key is keeping clean and yes, that means washing our hands with soap before meals. But we often forget that we also have to wash them before preparing and handling food. And even as we do that, are we sure that other people in our home, especially the household help, are doing likewise?

Hand-washing is even more important before and after toilet duty, especially if the person has the runs. The germs can be passed on with hand-shaking, and other surprising channels. One piece of advice I never forgot comes in relation to flying on planes, where diarrhea germs are easily picked up. So you washed your hands after using the toilet, but you might pick up germs from the toilet doorknob, handled by a previous passenger with the runs and who wasn’t as conscientious as you about handwashing!

Back to our homes and the five keys to keeping germs at bay: Keeping clean also means that our kitchen areas and utensils are clean, which takes us to the second key for food safety. When WHO reminds us about separating raw food from cooked dishes, it’s because raw foods, especially meats and seafoods, are teeming with microorganisms. WHO therefore recommends that we use separate equipment and cutting boards. Some households even use boards with different colors.

The third key is cooking thoroughly. That means bringing foods to a boil. For meats, juices should be clear, not pink. A common problem in the Philippines when eating out is that many of the foods are frozen and then reheated through microwaving, which is not enough to kill germs that may have proliferated while the food was in the fridge. (Besides the public health angle, there’s nothing worse than eating food that’s warm on the surface and cold inside.) Asians tend to prefer their meals piping hot, which makes sense in terms of public health.

The fourth key relates to safe temperatures. Our tropical climate is problematic. Cooked foods kept at room temperature for more than two hours are an invitation to food poisoning. So, is food safe if kept in the fridge? Not exactly either. There are germs that thrive in the cold so you shouldn’t keep foods too long in the fridge either. Eggs – raw or cooked – are especially problematic because they’re favored breeding grounds for salmonella, bacteria which causes food poisoning. It’s not surprising that so many cultures have developed ways to preserve eggs for longer life, usually by salting them. Incidentally, so-called century eggs from the Chinese aren’t really a hundred years old. They’re eggs wrapped in wood, clay, salt and ash and buried for a few months.

The last key is using safe water and raw materials. Summer brings out vendors with all kinds of enticing refreshments, but are we sure about the water and ice used for preparations? Vendors will also offer enticing fruits, spread out on ice, but once they’re cut open, you’ll never be sure about the kind of hands and utensils they’ve been in contact with.

A final word: What if in your rush to eat, you drop the food? The Americans talk about a five-second rule; we tend to be more generous, giving 30 seconds to three minutes, arguing that when the food hits the floor, the germs scatter out of fright and that it takes time for them to regroup and attack the food.

Sorry, but there have been studies done around this, and the minute the food lands on the floor, the germs are all over it. No reprieve. It’s almost like they run for the food and if you’re stubborn and still insist on retrieving and eating, you might be doing some running yourself afterwards.