Debate has erupted over the efficacy of washing one’s hands and using alcohol-based hand sanitizers to help prevent being infected with the H1N1 influenza virus.

Many authorities say evidence is weak that hand washing will significantly ward off infection, noting that a person is more likely to contract the virus from nearby contaminated persons sneezing or coughing, which releases the virus in water droplets into the air that are easily inhaled.

Nevertheless, the Centers for Disease Control and Prevention (CDC) recommends that “washing your hands often will help protect you from germs. CDC recommends that when you wash your hands - with soap and warm water - that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.”

“I would agree that hand washing alone is not going to prevent transmission of influenza viruses. However, it is still a good practice to prevent co-infection with other viruses that can be transmitted by manual contact,” a top government public health official told HSToday.us. “There is honest disagreement as to the extent of hand hygiene effectiveness. At this point we are recommending hand washing as just one of the standard measures for protection against the virus.”

A recent study in Australia, however, found that washing hands regularly with soap and water or alcohol-based hand sanitizers was effective in eliminating H1N1 from hands.

Another new study published in the British Medical Journal found that washing hands and using face masks can control the spread of H1N1 more effectively than vaccines and antiviral drugs.

The report was based on a review of 59 studies on the efficacy of physical ways to prohibit spread of respiratory viruses.
The study concluded that washing hands frequently, wearing masks, gloves and gowns around sick patients were the most effective ways to avoid contracting flu in hospital and emergency settings.

Other authorities, though, contend that because of the nature of H1N1 and other respiratory viruses, hand-washing isn’t as effective as just staying away from sick people who are openly sneezing and coughing into the immediate environment.

But other authorities say the virus can still be acquired from one’s hands if the person’s hands were just contaminated and then the person touches areas of his or her face, especially the mouth, nose and eyes, the later of which studies show is an important entry point for respiratory viruses.

Mark Nicas, an adjunct professor at the University of California-Berkeley School of Public Health, has said he believes that a significant number of person do contract influenza through hand contact. "I think that hand contact accounts for maybe one-third of influenza infections," he has said.

The bottomline, all authorities say, is to use all precautions that are available, and to seek medical care in the event of a worsening flu-like sickness. They also say that people who are most at risk to complications – and even possible death – from H1N1 infection should be vaccinated as soon as the vaccine is available.

People who are not necessarily in high risk categories but who get sick and experience severe symptoms should consider taking Tamiflu, the authorities said.

Another government public health official said “we have to use every precautionary tool we have at our disposal, which includes regular washing of hands and use of hand sanitizers.”

The official said the H1N1 virus “is nasty” and that “we can’t let our guard down.”

While authorities are split on the effectiveness of hand washing, the official said there’s enough data “out there” to indicate that it can be effective in certain cases, “therefore we continue to recommend repeated hand washing.”