Sometimes, all the hand sanitizer in the world cannot prevent the inevitable.

College freshmen across the country are being introduced to a whole new world of pathogens and other infections at this time of year.

It starts with just one or two people in a dorm hall, said Dr. David Reitman, medical director of the Student Health Center at American University in Washington. They cough without covering the spray of germs that can reach 30 feet, as measured by Massachusetts Institute of Technology researcher Lydia Bourouiba.

Then comes a sore throat and a general feeling of ickiness that lasts a week or so. It spreads slowly but surely, and soon the whole floor of the dorm is a sick ward. Once again, new students have been struck by the freshman plague.

Brendon Gardner, a freshman at Fordham University in New York, had been warned by older siblings and friends about the cesspool of pathogens he was about to enter, but he still wasn't prepared.

"I figured, eh, wouldn't happen to me. But then it did," said Gardner from his dorm after a week of coughing and a runny nose. "And it was so annoying."

Not a specific pathogen

The freshman plague, Reitman said, is not one particular disease or pathogen, but "refers to viruses that are easily transmissible by people who are living in close quarters in which they easily pass from one person to another."

The plague emerges in freshman dorms because of a perfect storm of factors: a large group of people crammed into a relatively small space, often sharing facilities such as showers, kitchens and bathrooms. This makes it easy for viruses to hop from one victim to the next.

The reason these illnesses appear more commonly in freshman dorms than in upperclassman housing is freshman are exactly that — fresh. They are still learning the ropes of dorm living and have not yet mastered the practices and routines that could keep them healthy.

The best way to avoid catching the plague, Reitman said, is to maintain basic hygiene and healthy habits. Wash your hands often, including your wrists. Use a hand sanitizer, especially before eating. This, as well as avoiding behaviors like sharing drinks or food, can improve one's odds against contracting viruses. And don't smoke. It inflames the respiratory system, he said.

Less obvious ways of dodging the plague are to drink lots of fluids and maintain regular sleep and eating schedules. That's easier said than done for college students.

And there's always the flu vaccine. Although 70 percent of college students in the U.S. say they believe it is important to get a yearly flu shot, only 46 percent say they get vaccinated, according to a National Foundation for Infectious Diseases report in 2017. So, the plague persists.

"I just wanted to stay in bed all day but couldn't because I have 8:30 classes every morning. And in class, I didn't want to talk at all because I sounded like a croaking toad," said Arnav Bhutada, another freshman plague sufferer at Fordham.

Tips for coping

Though freshman plague is not a serious or threatening disease, it can really put a damper on those first months of college. To make it more bearable, take ibuprofen to help ease sore throats and general achiness, Reitman said. Get lots of fluids and sleep, and maybe swap out that pizza and fries for soup at the dining hall.

If more serious symptoms appear — fever above 102 degrees or diarrhea — or the illness persists beyond a week, students should consider seeking medical attention.

Students who are bedridden should curl up with a nice mug of tea, catch up on Netflix and wait for the body to cleanse itself of the virus so they can go back to making the most of their college experience.