"I have one at the office, one at my house, one in the car," says Rebecca Pierce. Pierce is talking about her hand sanitizer. This flu season, Pierce has been using the clear gel several times a day, whether she's working her call center job in Portland or cleaning homes on the side. "I find hand sanitizer to be pretty convenient if you're on the go. A quick little pump and you're sanitized."
Given that there's a shortage of H1N1 vaccine in states such as Maine, and that, as of today, nine Mainers have died of swine flu, hand gels are gaining prominence in the fight against swine flu.
Schools and businesses have installed gel dispensers. Conference centers and hotels have placed them prominently in the lobby. Maine Medical Center is encouraging all visitors to gel up as soon as they walk through the door.
"Sir, can I ask you to use hand gel on your way into the hospital? We just ask as everyone comes in the door. Thank you," says Vanessa Attfield, a so-called "flu screener." She sits at a table lined with bottles of sanitizer, right by the entrance. One man insists that he just used the gel and, as proof, extends his hands for her to sniff. "No, that's OK," Attfield says. "I do believe you but I have to ask again."
Sales of hand sanitizers have soared, thanks to recommendations by the federal Centers for Disease Control and Prevention and the World Health Organization. But health experts say consumers should know not all hand gels are created equal.
"The alcohol-based gels are the most effective," says Gwen Rogers, a nurse who oversees infection prevention at Maine Med. She says some non-alcoholic gels out there are made of so-called quaternary ammonium compounds. But she says those disinfecting agents are typically used for cleaning countertops and floors.
For human hands, she advises, look for gels that are at least 62 percent alcohol. "It breaks open the cell wall of the bacteria and kills the bacteria and it kills the transient bacteria that you picked up from someplace else and it kills a moderate amount of your normal skin bacteria."
But even better than alcohol-based gels, says Rogers, is good old soap and water. That's because alcohol, as potent as it is, doesn't kill all bacteria. Take, for example, Clostridium Difficile, a bacteria that can cause diarrhea.
"If you have something like that personally or if you're taking care of a patient, that's also when you need to use soap and water," Rogers says. "The alcohol gels don't kill spores and that's what causes this disease."
And Rogers doesn't recommend hand gels for those times when your hands are visibly dirty, as there are that many more layers of dirt that the alcohol has to cut through. So wash your hands when there's a sink, and go waterless when you're on the go.
"But like anything else, it's all about technique," says Dr. Dora Anne Mills, Director of Maine's Center for Disease Control and Prevention. She says that too often people apply hand sanitizer then wipe it off with a paper towel. "The whole purpose of it is to dry on your hands, so you need to put some hand sanitizer on your hands and rub them around to make sure you get into all the cracks and the creases and under your nails a little bit too."
But what about the concern that using too much hand sanitizer could allow microbes to build resistance to alcohol, as they have to some antibiotics? Both Mills and Rogers at Maine Med says there's no evidence to bear that out.
Fears of catching H1N1 have some people going to extremes with hand cleaning. Take Kacey Jo Day, a 16-year-old student from Portland, who keeps floral scented hand sanitizer in her pocket at all times. "When I go to the bathroom I just wash my hands, then after that, I wait for my hands to dry and then use a hand sanitizer so I can make sure they're really clean."
For the record, experts say one mode of hand-cleaning should suffice in protecting you from the virus. It'll probably keep your hands from drying out, too.
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