I would use this book up to 5th grade. After reading this book I would provide a visual activity for the students. I would spread glitter all over my hands and then ask my students to shake my hand then ask them to shake somebody elses hand and then ask them to sit down. I would tell everyone to look at their hands. I would ask them to raise your hands if they have glitter on them. (everyone would raise their hand) I would say did you see how fast those “germs” spread. Then, I would go into a lesson about washing hands and keeping your hands to yourself so germs don’t spread as fast. In the lower grade the class could also make a lice bug to show and have an anchor chart of ways to stop germs from spreading.