The single most important thing you can do to prevent a dangerous infection

Hand washing is more important than you think—but you probably don’t do it right

Published: October 14, 2014 04:30 PM

There’s good reason to worry about infectious diseases right now, and not just because of Ebola. A nasty infection called enterovirus D68 has sent hundreds of children across the U.S. to emergency rooms this fall, some with mysterious poliolike symptoms. And flu season is now beginning in earnest, a particular threat to children and older adults. All that has underscored the importance of good hygiene, since the surest way to prevent infections is to keep them from spreading. But most people—including many doctors and nurses—aren’t very good at the single most effective way of doing that: hand washing.

Why is hand washing so important? Hands are teeming with germs. Using gene-sequencing techniques, researchers at the University of Colorado at Boulder found that the average hand contains about 150 different species of bacteria. They are also often contaminated with viruses, including those that cause the flu and EV-D68.

Diseases are often spread when you touch a contaminated surface with your hands, and then your eyes, nose, or mouth. Don’t think you are much of a face-toucher? Researchers at the University of California at Berkeley found that over the course of just three hours, people touched their eyes, nose, and mouth an average of 15.7 times per hour.

See our advice on how to prevent and treat the flu, including our advice on flu vaccines.  

Of course, germs often spread when you sneeze into your hand, which is one reason experts recommend that you sneeze into your elbow instead, and that you avoid shaking hands during flu season, too. (British researchers have recently even suggested replacing handshakes with fist bumps, since that’s much less likely to spread germs, they found.)

Washing hands isn’t all that complicated, of course. Yet plenty of us don’t do it properly. One study at Michigan State University in East Lansing reported that only 5 percent of the 3,749 people observed in restrooms washed their hands correctly. Fifteen percent of men and 7 percent of women didn’t wash their hands at all.

6 steps to germ-free hands

1. Use clean running water to wet your hands. Filling the sink defeats the purpose if the sink was contaminated. Temperature of the water doesn’t matter.

2. Lather up with regular soap. No need for special products containing triclosan or other antibacterials. In fact, you should avoid them, since overuse of them may breed hard-to-kill antibiotic resistant bacteria and pose other health threats

3. Take your time. Scrub for at least 15 to 30 seconds.  One simple way to gauge the amount of time you should wash is to hum the “Happy Birthday” song from beginning to end twice.

4. Rinse with running water. Temperature doesn’t matter, again. Use a towel to turn off the faucet, which may be contaminated.

5. Dry your hands well. Use a clean towel. Damp hands are more likely to pick up germs, and spread them, too.

6. Use alcohol-based hand sanitizer if soap and water isn’t available. Alcohol won’t cut through dirt or grease, or kill germs hidden below them, but it’s a good back up. Just make sure the product is at least 60 percent alcohol (ethanol or isopropanol). And make sure you put on enough so it takes at least 10 to 15 seconds to dry, says Elaine Larson, R.N., Ph.D., professor of epidemiology at the Mailman School of Public Health at Columbia University.

—Catherine Winters

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