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Last year, Americans spent over $170 million on hand sanitizers. But soap and water are usually (although not absolutely always) better for getting rid of germs.

The single most common bacterial "stomach bug" is the familiar E. coli. We all have E. coli in our digestive tracts and even in our bloodstreams most of the time, but certain strains of E. coli can cause serious inflammation and irritation in the colon along with watery diarrhea, bloating, and gas.

Relatively rare strains of E. coli also cause most urinary tract infections, many cases of gallbladder inflammation, pneumonia, and even meningitis.

The most common way of getting an E. coli infection is transferring the microbe from feces to the mouth, but it usually isn't human feces that is the source of the infection. Most E. coli infections are acquired from animal feces present in invisible traces in uncooked meat or eggs.

Obviously, if you want to avoid an E. coli infection, you need to wash you hands. But what should you wash them with?

Surprisingly Effective (and Ineffective) Hand Cleansers for Preventing E. coli

The Center for Public Health at the University of Georgia tested a variety of methods for preventing the spread of E. coli in commercial kitchens. They tested washing hands with plain tap water, regular liquid soap, antibacterial soap, and alcohol-based hand sanitizer gel. They also tested washing hands with regular liquid soap followed by the application of an alcohol-based hand sanitizer, and washing the hands with regular liquid soap followed by use of a nailbrush.

The smallest amount of E. coli was removed by use of the alcohol-based hand sanitizer gel. Even washing hands under the faucet was better than using sanitizer gel, even if they were washed with liquid soap first.

Other studies have found that the only kind of alcohol-based sanitizer that removes bacteria and viruses from the hands is a foaming sanitizer called Sani-Twice. It is almost as effective as washing the hands with soap and water. It is only recommended when soap and water are not available.

But if you really want to get bacteria off your hands, you have to scrub under your nails.

And For Preventing Transmission of Colds and Flu?

As you might guess by now, the only proven methods of preventing the transmission of colds and flu from person to person involve washing hands with soap and water.

Chemicals don't kill colds and flu viruses, but washing the hands simply sends them down the drain.

How often should you wash your hands? A good rule of thumb is to wash your hands with soap and water every time you can, but especially after you have handled vomit or feces, or when you come in from a public place. Try to avoid putting your hands on your face, and always wash your hands before you eat, even if it is inconvenient. Be sure to wash your fingertips, where you pick up the most germs.

  • Lau CH, Springston EE, Sohn MW, Mason I, Gadola E, Damitz M, Gupta RS. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study. BMC Pediatr. 2012 May 15.12:52. doi: 10.1186/1471-2431-12-52.
  • Lin CM, Wu FM, Kim HK, Doyle MP, Michael BS, Williams LK. A comparison of hand washing techniques to remove Escherichia coli and caliciviruses under natural or artificial fingernails.J Food Prot. 2003 Dec. 66(12):2296-301. Erratum in: J Food Prot. 2004 Mar
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