Don’t kiss or shake or H1N1 can get you

Many French, Eastern Europeans and Italians have stopped kissing each other on the cheeks when they meet. Same goes for many living in Quebec, Montreal and some Islamic and South American countries. Also, doctors say, the ever popular air kiss is being done from a greater distance.

Infectious disease specialists from the World Health Organization and Centers for Disease Control say the world hasn’t suddenly become more hostile. But rather, the pandemic of H1N1 has put the fear of flu into of lots of people.

sharesmiles buttonSome – not nearly enough, researchers say – have learned that that courtesy check kissing is a proven way to pick up germs. What many haven’t figured out is that shaking hands is even more of a sure bet when it comes to moving bacteria around.

Surprisingly, this includes many health care workers.

For the last couple of weeks I’ve had a relative being treated for pneumonia in one of Seattle’s large hospitals. Everyone wore face masks and gowns and dispensers of germicide where attached to walls everywhere you looked. But every time a new physician, nurse or tech showed up, they introduced themselves and thrust out their ungloved hand.

It’s not as if this self-contamination is a secret.

A study 36-years ago in the New England Journal of Medicine talked about the mechanism of contamination with rhinovirus, which brings us the common cold.

Another study funded in part by the CDC was published earlier this month in the Annals of Internal Medicine again examined hand hygiene. It confirmed the earlier research that addressed the role of unwashed hands in transmitting influenza virus.

The lessons learned from these studies have rarely been more important. The H1N1 influenza has spreads to almost every corner of the country with 47 states now reporting widespread illness from that strain of flu.

“It doesn’t matter whether it’s a cold virus or the H1N1,” says Dr. David Egilman, a specialist in occupational and internal medicine and professor at Brown University. “The same mechanism will spread flu or cold virus from person-to-person or from person-to-object-to-person.”

The mechanism of contamination is well documented. Someone sneezes into their hand, that hand pushes open a door. The next person shoving open that door picks up the germs. Often within minutes, the NEJM study reported, that person rubs the freshly contaminated hand in their eyes or picks their nose. Instantly, the bacteria has a new home in which to fester and breed.

Dr. Val Curtis, director of the Hygiene Centre at the London School of Hygiene & Tropical Medicine, told NPR last week that “Hands are a superhighway for the bacteria and viruses…”

This self-inoculation – nose picking and eye rubbing – is far more common than any of us would like to admit. Hand-to-nose contact is an extremely natural and frequent human behavior.

Egilman, Angad Kochar, a researcher on his staff, and infection control specialists at the National Institutes of Health believe this H1N1 pandemic world of ours would be a less contaminated place if people just stopped shaking hands.

“When meeting someone, it is a near universal custom to shake hands.  It can be seen as offensive should a person hold their hand out for a greeting and be turned down,” Egilman says, “However, we encourage this “anti-social” behavior for the sake of health.”

He says there’s good data that shows viruses are spread more widely by hand contact than by droplet spread by sneezing or coughing

There is no “need” to shake hands says Egilman but he admit that it’s sometimes awkward not to do so without souring the relationship with patients, co-workers and clients.

A student at Brown University drew a simplistic illustration for a button saying “DO NOT SHAKE HANDS.”

Egilman who is marketing the student’s button says it can be worn people in hospitals, medical research facilities, schools and businesses.

“Join us in our fight against infectious disease. Wear a pin, point to it and you’ll have the perfect explanation for why you cannot shake someone’s hand!” explains the website http://www.smilesnotgerms.org

Any profits from the buttons will be sent to a non-profit group that funds nursing and medical schools in Africa.


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