To kill germs, it's simple: Wash your hands

Almost 20 years later, drug companies have developed better treatment for the symptoms of the common cold, but still haven't figured out how to get rid of them. And the best way to avoid them is still the same as a Hungarian doctor discovered more than 150 years ago -- simple hand-washing.

"The majority of infections are spread by touching," said Dr. Elaine Larson of the Columbia University School of Nursing.

"People rub their eyes all the time, or pick their nose, or lick their fingers as they're turning pages. This is a great way of introducing bacteria and viruses into your body," said Steven Schweon, coordinator of the infection control and prevention department at St. Luke's Hospital in Bethlehem, Pa.

Keeping your hands away from your face, and washing them, can make a big difference. "Just rubbing with water and wiping with a paper towel removes a lot of germs," Larson said. More are removed by soap. Plain soap doesn't kill bacteria, but instead emulsifies them so they wash down the drain.

Drugstore shelves are now packed with antibacterial soaps, which kill some germs rather than just washing them away. But some researchers believe that home use of antibacterial soaps is no more effective than soap and water, and has the potential to build up antibacterial resistance to antibiotic drugs used to treat illness.

Studies by Larson and other scientists have shown that antibacterial products reduce bacterial counts on hands more than plain soap, but the federal Centers for Disease Control and Prevention recommends antibacterial brands only in hospitals, and in homes where someone is sick, old, or newborn, and therefore more vulnerable to infection.

Alcohol-based hand rubs are another good way to clean hands, particularly in hospitals, according to Dr. John Boyce, chief of infectious diseases section at Hospital of St. Raphael in New Haven, Conn. Boyce coauthored new hand-hygiene guidelines for health-care settings, published in 2002 by the CDC.

Based on the guidelines, the CDC strongly recommends alcohol-based hand rubs in hospitals. "If hands aren't visibly dirty, [hand rubs] do a better job than soap and water at reducing the amount of bacteria on hands, are quicker to use, and are actually easier on the skin," Boyce said.

For the average person, he said, hand rubs can be useful "when you don't have ready access to a sink, water, and clean towels."

Elementary-school students are often considered cold-virus breeding grounds. But when three classrooms in Pennsylvania were instructed on hygiene and hand-sanitizer use, absenteeism because of infectious illnesses dropped significantly, according to an article published last year in the American Journal of Infection Control. Children in study classrooms who cleaned their hands more frequently got sick less often.

In August, the American Society for Microbiology monitored how many people washed their hands in the bathrooms of several large airports. The study, carried out by the company Wirthlin Worldwide, found that New Yorkers (or New York visitors) are the most likely to have germ-ridden hands -- more than 30 percent didn't wash their hands after using the facilities. In contrast, more than 95 percent of passengers in Toronto International Airport washed their hands, probably because the SARS scare was fresh in their minds.

People know they should scrub and apparently feel guilty enough to fib when they don't. A telephone survey by the same company showed that while 95 percent of people stated that they washed in public restrooms, only 68 percent actually did.

No matter how often people soap up, not all infections can be avoided through hand-washing. Some illnesses are extremely infectious, so coming in contact with just a few virus particles is likely to make you sick. The flu is one such example, and hands do not necessarily spread it, Boyce said. Droplets that are transmitted by influenza patients when they sneeze, cough, or even talk can spread the germs -- and the flu vaccine is the best way to stop it.

But for everything including the common cold, salmonella and Hepatitis A, hand-washing makes a difference.

"Getting people to clean their hands as often as they should," Boyce said, "is a problem worldwide."