Put Your Hands Together and Fight the Flu

Reading time: 4 – 6 minutes

Although the immediate threat of H1N1 — the swine flu — appears to be benign, experts say that the emerging strain could return in a more virulent form in future flu seasons [1]. And with increasing reports of the swine flu close to home, hand washing is more important than ever. Indeed, hand washing is the best way to prevent infection and illness. Some scientists estimate that as much as 80% of all infections are transmitted by unwashed hands [2]. Hand washing is the single most important thing you can do to prevent the spread of infection and to stay healthy. As simple as it may be, there’s a trick to effectively washing your hands with soap and water.


Kids learn early on in preschool that to truly prevent the spread of germs, you’ve got to wash your hands. Nevertheless, a dab of soap and a quick rinse isn’t effective. The key is to wash your hands for at least 20 seconds to ensure that you’ve removed the microbes. By rubbing your hands with soapy water, you pull dirt and oil from your skin. The soap lather suspends any germs trapped inside and are then washed away when rinsing.

The right way to wash your hands

When washing you hands with soap and water, follow these steps:

  1. Wet your hands and wrists with warm running water and apply soap.
  2. Rub your hands, including the fingers, palm to palm in a circular fashion.
  3. With palms still together, intertwine the fingers and rub in between them.
  4. In a circular fashion, rub the back of each hand with the opposite palm, making sure not to ignore the knuckles and fingers.
  5. Rub each thumb by gripping it with the opposite hand.
  6. Continue washing hands for 20 seconds. Here’s a trick: sing the ABC’s to yourself.
  7. Rinse your hands and wrists thoroughly under warm running water. Keep your hands lower than your elbows to avoid water flowing up the arms and then back down onto the hands, contaminating them.
  8. Don’t turn off the water! Dry your hands completely using a clean or disposable towel.
  9. Using the towel, turn off the faucet. If in a public restroom, use the towel to grasp the door handle and open the door, then discard the towel.

If soap and water aren’t available, use an alcohol-based hand sanitizer.

While alcohol-based hand sanitizers reduce the number of germs on skin, they aren’t necessarily more effective at reducing influenza A H1N1 virus on human hands. A recent study evaluated the effectiveness of routine hand hygiene against live human influenza A virus H1N1 using soap and water hand washing or one of three different types of alcohol-based hand rubs (61.5% ethanol gel, 70% ethanol plus 0.5% chlorhexidine solution, or 70% isopropanol plus 0.5% chlorhexidine solution) [3]. Hand washing with soap and water was found to be statistically superior to all three alcohol-based treatments.

For a visual demonstration on the effectiveness of hand washing, check out the publication linked below from the University of Georgia College of Agriculture and Environmental Sciences. An experiment was performed to show the difference in the amount of bacteria on an unwashed hand, a rinsed hand, a washed hand and a sanitized hand. The experiment involved touching agar plates (special food used to grow bacteria in a laboratory) with or without hand hygiene and then incubating them for 24 hours. Food, Hands and Bacteria illustrates the importance not only of hand washing but washing for more than 20 seconds [4].

To promote the importance of proper handwashing, CDC-TV released a video late last year, “Put Your Hands Together,” in its “Health Matters” series, presented below.

Put Your Hands Together. Flash Player 9 is required.


  1. Swine flu could come back in more virulent form after summer, European experts say. BMJ 338:b1792. 2009 Apr 29.
  2. Put Your Hands Together. National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID) and National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED). 2008 Oct 13.
  3. Grayson et al. Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human volunteers. Clin Infect Dis. 2009 Feb 1;48(3):285-91.
    View abstract
  4. Food, Hands and Bacteria. Prepared by Estes Reynolds. Accessed 2009 May 6th
About the Author

Walter Jessen, Ph.D. is a Data Scientist, Digital Biologist, and Knowledge Engineer. His primary focus is to build and support expert systems, including AI (artificial intelligence) and user-generated platforms, and to identify and develop methods to capture, organize, integrate, and make accessible company knowledge. His research interests include disease biology modeling and biomarker identification. He is also a Principal at Highlight Health Media, which publishes Highlight HEALTH, and lead writer at Highlight HEALTH.