Warm water, soap and 30 seconds of sudsing action can make a difference

By Dennis Thompson

(HealthDay News) -- With fears of flu all around this year, the reminders to "wash your hands" have become stronger than ever from schools, businesses and government officials.

At the moment, it seems to be working as people lather up in restrooms and rub on hand sanitizer when they're out and about. But when the flu scare passes, will everyone fall back into old habits?

Public health officials sure hope not.

Hand washing foils a wide array of illnesses caused by bacteria and viruses and has always been one of the top means of preventing communicable disease.

"It's been shown through research and clinical experience that hand washing is essential in reducing infections," said Dr. Georges Benjamin, executive director of the American Public Health Association.

Bacteria and viruses simply don't spread that well through the air. They drift a few feet before settling on an object, said Dr. Will Sawyer, a general practitioner at Sharonville Family Medicine in Cincinnati and creator of HenryTheHand.com, a Web site that promotes hand washing. Sawyer is a sponsor of National Hand-Washing Awareness Week, Dec. 6-12.

Germs get into the body when they stick to the hands and then the hands touch the eyes, nose or mouth.

For example, respiratory syncytial virus (RSV), which is highly contagious and causes cold-like symptoms, spreads when someone sneezes or coughs. However, you'd have to be standing very close to catch RSV directly, doctors say. Instead, the virus lands on a surface and is transmitted by the hands through the eyes, nose or mouth. One of every 13 visits to a pediatrician and one of every 38 emergency department trips was attributed to RSV in a study published in February in the New England Journal of Medicine.

"Our hands are truly the vector that transmit and cause disease," Sawyer said. "We're transporting the germs via our hands. If we don't reduce the density of virulent organisms on our hands, they essentially become germ weapons."

Hands also help spread germs by transporting bacteria and viruses from object to object. That's why hand washing is so important in certain professions.

For example, think of doctors or nurses spreading germs by failing to wash their hands between patients. It can happen even if they only touch something in a patient's room. A recent study found that about 40 percent of MRSA (methicillin-resistant Staphylococcus aureus) infections in hospitals are transmitted through contact with surfaces. MRSA is an antibiotic-resistant "superbug" known to cause severe infections in hospital patients and nursing home residents.

"One of your first duties is to not make your patients sick," Benjamin said. "We carry diseases with us from patient to patient and from ourselves to patients all the time. By washing your hands before you interact physically with the patient, you reduce transmission of germs from you to your patient."

Food service workers also can spread much disease if they fail to take hand washing seriously.

According to the U.S. Centers for Disease Control and Prevention, an estimated 76 million Americans contract a food-borne illness each year, and 5,000 die from their illness. Much of that illness is caused by cross-contamination, with hands transmitting salmonella and E. coli.

"You want to wash your hands so you don't contaminate the food you're working with," Benjamin said. "You grab a lot of things. Sometimes you're touching things that are clean, and sometimes you are touching things that are dirty."

The best way to wash hands is with good old soap and water. "Soap breaks up the greases and oils that are on your hands and helps clean them," Benjamin said. "Warm water helps emulsify the soap real well and makes it soft and bubbly."

First get the hands wet under warm running water, and then use soap to work up a good lather. "Simply taking your hands and running them under the water doesn't do it," Benjamin said. "You really need to vigorously scrub your hands."

Lather all the surfaces of your hands, which should take 15 to 30 seconds. "The sudsing action is what helps loosen up these virulent organisms," Sawyer said.

Then rinse under running water to carry away the germs with the soap.

Hand sanitizers have become a popular option, which Sawyer and Benjamin find acceptable if there's no access to soap and water.

"Hand sanitizer, if it's more than 60 percent alcohol, will help kill most organisms that aren't encapsulated," Sawyer said.

The problem is that some pretty nasty bugs are encapsulated, which means they're protected by an outer covering. One example is C. difficile, a difficult-to-treat bacteria that causes diarrhea and inflammation of the colon and is "ravaging hospitals and nursing homes," Sawyer said.

So if you want to play it completely safe with your health and the health of those around you, wash your hands often. Wash them before and after meals, after going to the bathroom, before any activity where you'll touch your eyes, nose and mouth, and whenever they just feel unclean.

"Make it part of your daily habit," Benjamin said. "It shouldn't be something people don't think of, or think of as something special. It's part of your daily hygiene."

On the Web

To learn more about the importance of hand washing, check out information from the Nemours Foundation. http://kidshealth.org/parent/general/sick/hand_washing.html

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