Swine flu is the common name for the novel strain of H1N1 influenza first discovered by the Centers for Disease Control and Prevention, or CDC, in April 2009. According to the CDC, swine flu accounted for most cases of flu during the 2009-2010 flu season and, for the 2010-2011 flu season, swine flu replaced an older H1N1 strain in the seasonal flu vaccine. Although transmission of all flu viruses, including swine flu, mainly occurs through inhalation of respiratory droplets from an infected person, washing with hand soap can prevent cases that result from transfer of the virus from the hands to the mucous membranes of the mouth or nose.
Effectiveness
Although authorities such as the CDC and the American Academy of Pediatrics specifically endorse washing with hand soap as a protective measure against swine flu, studies have generally produced mixed results. A 2009 study published in the "Annals of Internal Medicine" found no significant differences in the incidence of infections between households educated on hand hygiene and those who did not receive instruction, perhaps because of problems with compliance. Another study published in the "British Medical Journal" found that people who washed their hands at least 10 times per day were half as likely to contract influenza. The effect was most pronounced among young children and households with a family member who was already sick, so these may be the groups who benefit the most from hand washing recommendations.
Technique
In its "Clean Hands Save Lives!" campaign, the CDC describes proper technique for using hand soaps. According to the CDC, a person should begin by wetting her hands with clean, warm, running water and then apply hand soap. The next step involves rubbing hands together to create a lather and cleaning all surfaces of the hands including often overlooked areas such as between the nails and fingers for at least 20 seconds. Lastly, she dries her hands with a clean, disposable towel or an air hand dryer. Faucet taps and door handles are still considered unclean, so it's best to use the disposable towel or an elbow to turn off the taps and exit the bathroom.
Indications
The "Clean Hands Save Lives!" campaign also identifies appropriate times for using hand soaps. These times include before and after preparing or eating food, tending to someone who is sick or treating a cut or wound. Other times include after going to the bathroom, changing diapers or assisting a child in the bathroom, blowing the nose, coughing, sneezing and handling animals, animal waster or garbage.
Alternatives
There is no evidence to suggest bar soaps are superior to liquid soaps or that antiseptic hand soaps perform better than standard preparations. In addition, hand washing may not be superior to alcohol-based hand sanitizers for hands that are not visibly dirty. Most drug and general stores offer bottles of alcohol-based hand sanitizers that are small enough to fit into a purse, backpack or car, so that people can maintain good hand hygiene even when hand soap and water are not available. For people who find that frequent use of hand soap irritates skin, it may help to carry a small bottle of hand lotion or moisturizer that can be applied after each washing.
References
- CDC: 2009 H1N1: Situation Update
- American Academy of Pediatrics: Frequently Asked Questions about H1N1 Flu (Swine Flu)
- CDC: Swine Flu
- CDC: Clean Hands Save Lives
- "Annals of Internal Medicine;" Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households; B.J. Cowling et al.; Oct. 6 2009
