People may be far more at the risk of passing on an infection by shaking someone's hand than in sharing a kiss, according to a report.
Compiled by a group of hygiene experts from the United States and the UK, this is the first detailed report on hand hygiene in the home and community, rather than in hospital and healthcare settings.
Published in the American Journal of Infection Control, the report recommends paying greater attention to good hand hygiene at homes if people have to avoid catching flue or tummy bugs, or protect themselves from organisms like MRSA, salmonella or C. difficile.
The report also suggests that in the event of flu pandemic, good hand hygiene will be the first line of defence during the early critical period before mass vaccination becomes available.
It comes days after a study revealed that indicated that physical barriers, such as regular hand-washing and wearing masks, gloves and gowns might be more effective than drugs in preventing the spread of respiratory viruses such as influenza and SARS.
The report says that good hygiene at home prevents organisms spreading from one family member to another. It states that reducing the number of carriers in the community may help axe the likelihood of infections being carried into health care facilities by new patients and visitors.
According to the researchers, good hygiene at home also means fewer infections, which means fewer patients demanding antibiotics from the GP, and fewer resistant strains developing and circulating in the community. Since cold and flu viruses can be spread via the hands, family members often become infected when they rub their nose or eyes.
In their report, the researchers have detailed how germs that cause stomach infections like salmonella, campylobacter and norovirus can also circulate directly from person to person via our hands.
They say that people often put their fingers in their mouths without being aware of what they are doing, and end up forgetting to wash their hands before preparing foods. They say that stomach germs can be passed on to other persons via this route.
The report suggests that many people also carry MRSA or C.difficile without even knowing about the same. These infections can also be passed around via hand and other surfaces to family members.
"With the colds and flu season approaching, it's important to know that good hand hygiene can really reduce the risks. What is important is not just knowing that we need to wash our hands but knowing when to wash them. Preventing the spread of colds and flu means good respiratory hygiene, which is quite different from good food hygiene. That's why the new respiratory hygiene campaign from the Department of Health in the UK, which advises people to 'catch it, bin it, kill it', is spot on," says Professor Sally Bloomfield, one of the report's authors and the Chairman of the International Scientific Forum for Home Hygiene that produced the report.
The authors say that breaking the chain of infection from one person to another depends on how well people wash their hands. If they do not do it properly, washing with soap and rinsing under running water, then they might as well not do it at all.
They also recommend using an alcohol handrub or sanitiser at all times so that good hand hygiene can still be observed away from home in situations where there is no soap and water available.
"Hand hygiene is just as important when we are outside the home - on public transport, in the office, in the supermarket, or in a restaurant. Quite often it's not possible to wash our hands in these situations, but carrying an alcohol-based hand sanitizer means we can make our hands hygienic whenever the need arises," says Carol O'Boyle of the School of Nursing, University of Minnesota, and a co-author of the report.
The report warns that good hygiene is about more than just washing our hands. Although the hands are the main superhighway for the spread of germs - because they are the 'last line of defence', surfaces from which the hands become contaminated, such as food contact surfaces, door handles, tap handles, toilet seats and cleaning cloths also need regular hygienic cleaning. Clothing and linens, baths, basin and toilet surfaces can also play a part in spreading germs between family members in the home.
"Because so much attention has been paid to getting people to wash their hands, there is a danger that people can come to believe this is all they need to do to avoid getting sick," says Professor Elaine Larson of the Mailman School of Public Health in New York and another co-author.
Professor Bloomfield concurs: "We hear a lot of discussion about whether being "too clean" is harming our immune systems, but we believe that this targeted approach to home hygiene, which focuses on the key routes for the spread of harmful organisms, is the best way to protect the family from becoming ill whilst leaving the other microbes which make up our environment unharmed."
Dr. Val Curtis, Head of the London School of Hygiene & Tropical Medicine's Hygiene Centre concludes: "Handwashing with soap is probably the single most important thing you can do to protect yourselves and your loved ones from infection this Christmas."