As the number of swine flu cases grows, President Obama called on Americans Wednesday to help halt the disease's spread by remembering to wash their hands. With so much high-tech medicine available, some may wonder how such a simple step could help. Yet health experts say that basic hygiene is not only more effective, but also more practical.
"Simple, common-sense precautionary measures such as hand-washing with soap and water is more effective than overwhelming people" with instructions, says Georges Benjamin, executive director of the American Public Health Association.
Hand-washing
Studies prove that hand-washing dramatically reduces the spread of infection and is even a lifesaver. Even before the outbreak of swine flu, the World Health Organization reported that regular hand-washing -- after using the toilet and before eating -- could save more lives than any other medical intervention, cutting worldwide deaths from diarrhea by nearly half and acute respiratory infections by 25%.
Although viruses don't pass through the skin, they can live on the hands and enter the body when people touch their mouths, eyes or noses, says William Schaffner, an infectious-disease expert and professor at Vanderbilt University School of Medicine.
And people touch their faces a lot -- 16 times an hour for adults and more than 80 times an hour for children under age 2, says Charles Gerba, a microbiology professor at the University of Arizona.
Alcohol-based gels also kill the flu virus, although they're most effective if people rub their hands up to the wrist until all of the liquid has dried, about 15 to 20 seconds, Schaffner says.
There's no point in wearing gloves, he says, because they can spread the flu virus just as well as bare hands. And people who wear gloves often incorrectly assume they can skip hand-washing.
Flu viruses, like many germs, prefer warm, moist environments, so they live on hard surfaces such as doorknobs for only a few minutes, Schaffner says. But because doorknobs are used through the day, they're frequently reinfected.
Hand-washing 101
Scrub with warm water and soap: This strips away oils from the skin and removes germs, says William Schaffner, an infectious-disease expert and professor at Vanderbilt University School of Medicine. It's best to wash for at least 20 seconds. Teachers often tell kids to wash their hands for as long as it takes to sing the ABCs.
Use a paper towel on handles: Protecting your hands while grasping faucets and knobs can help you avoid picking up germs, says Georges Benjamin, executive director of the American Public Health Association.
Covering your cough
Most flu germs are transmitted through the air, as viruses cling to respiratory droplets expelled when people cough or sneeze, Schaffner says.
Because these wet droplets are heavy, they quickly fall to the ground. So people are at risk of infection only if they are within 3 feet of a coughing, sneezing person. It's much harder to catch the flu from a stranger passing by in a wide-open space, such as the street, Schaffner says.
People can block some of that viral transmission, however, by covering their mouth and nose with a tissue or their hand, he says. Some doctors also recommend sanitizing the hands after sneezing or coughing into them.
Staying home when sick
The incubation period for the flu is about one to four days, says Martin Blaser, former president of the Infectious Disease Society of America. But people are most contagious when they're coughing.
Staying home, however, could save the life of someone else's child or grandparent, says Schaffner.
Babies are especially vulnerable to the flu because their immune systems aren't fully developed. And frail, elderly people can succumb quickly to the flu, especially if they develop complications, such as bacterial pneumonia.
Beyond compromising the lungs, the flu can impair organ function across the body. That's why people with underlying heart and kidney disease are so vulnerable to the flu.
In an average year, about 200,000 people are hospitalized because of the flu, and 36,000 die, Schaffner says.
For now, the only people who need to take extraordinary steps -- such as wearing masks or avoiding public places -- are those who have compromised immune systems, such as people with AIDS or who are having chemotherapy, says Terri Ades, director of cancer information at the American Cancer Society. Because people going through chemo are so vulnerable to infection, they're generally advised to avoid crowded places, even without the threat of swine flu, she says.
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