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by Laurie Sullivan

“Kiss the girls, shake hands with the boys…” It was one of the first rules of social etiquette I learned from my father.
When rituals like shaking hands are ingrained at such a tender age, it’s hard NOT to stick out your hand to just about everyone you meet, both old friends and new acquaintances. For, middle-aged Australian blokes like me, it’s pretty much a reflex action.
But, when travelling, shaking hands with all and sundry is not always a good idea.
Sure, it’s safe enough in Australia and other developed countries with high standards of sanitation and hygiene. You’re unlikely to end up with a handful of germs (unless it’s the flu season).
But, the same can’t be said for less developed destinations you might visit. Of the world’s 7 billion-plus people, only around 4.5 billion have access to toilets or latrines – meaning that 2.5 billion do not have proper sanitation, according to the United Nations.
In addition, an estimated 1.1 billion people still defecate in the open.

It’s all about the, er, bottom line…

Shaking hands enables some potentially severe diseases to be passed literally from hand (theirs) to mouth (yours). The pathogens that cause polio, and the much more common Hepatitis A, traveller’s diarrhoea, and influenza can all be transmitted by the faecal-oral route, which can make touching or handling everyday items like door handles and money a source of infection, too.
Hard as it may be to break the handshaking habit of a lifetime, it’s better to smile warmly and give a friendly nod while keeping your arms resolutely by your sides than possibly getting crook in a foreign country for days (or longer). Not only can a gastro illness disrupt your holiday, but it may be financially costly, too.
In South Asia , the Namaste is a touch-free option used by Hindus. Hands pressed together with fingers pointing upwards, it’s both a greeting and a farewell.
What got me thinking about shaking hands – or not – and other forms of greetings was a UK study published recently in the American Journal of Infection Control.
It examined how readily germs were transferred from germ-laden gloved hands to sterile ones during three forms of physical greeting – a traditional handshake, as well as the more recent high five and fist-bump. High fives and fist-bumps are known as ‘dap greetings’ and aren’t exactly new: US President Barack Obama and the Dalai Lama have fist-bumped in public (a sure sign that a new ‘dap’ is due to be rolled out any day now).

Fist-bump the more hygienic option

You’ve probably already guessed what the study’s revealed:
- The handshake transferred nearly twice as many bacteria as a high five, and
- With its smaller area of contact, the fist-bump passed on significantly fewer bacteria than a high-five – up to 90% less than a handshake.
Also, when it came to the handshake, the longer the contact and the stronger the grip, the more bacteria were transferred. (So much for dad’s admonishment that a bloke’s hand shake should always be delivered with a “good firm grip”, and not be like “holding a dead fish”.)
The authors of the study concluded that the fist-bump is by far the more hygienic greeting and adopting it healthcare settings like hospitals was a good way to reduce the transfer of infectious diseases.
(It’s long been recognised that healthcare providers’ hands can spread potentially harmful germs to patients, resulting in healthcare-associated infections (HAIs). Worldwide, HAIs are a leading cause of preventable illness and death – particularly for more susceptible hospital patients.)

Done right, soap and water is best solution

But, the UK researchers also observed that when people greet one another there is always likely to be some form of physical contact. And, that means a transfer of germs.
So, unless you can resolve never again to get physical when greeting someone – particularly overseas– you need to get habitual about another ritual: The one dad (and mum) probably began to work on about the same time as shaking hands – washing them.
Washing your hands is one of the most important ways of preventing illness, wherever you are – especially after using the toilet and before eating. Think of it as ‘do-it-yourself vaccination’.
But, it’s important to do it properly:
- First, wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
- Work up a generous lather by rubbing your hands together for at least 20 seconds (not forgetting the backs, between fingers, and under nails).
- Rinse them under clean, running water.
- Dry them using a clean cloth or paper towel, or air drier.

Alcohol-based sanitiser a handy alternative

While soap and water remains the gold standard method, it’s not always available – especially overseas. The answer is an alcohol-based hand sanitiser containing at least 60% alcohol.
An alcohol-based sanitiser will otherwise eliminate MOST germs, but is not as effective when hands are visibly dirty or greasy. There is something of an art to using hand sanitisers effectively, too:
- Apply the sanitiser to the palm of one hand (the correct amount will be on the label).
- Rub the top and bottom of each hand in turn.
- Continue rubbing over all surfaces until your hands are dry.
Studies have shown that a sanitiser with an alcohol concentration between 60–95% kills more germs that those with lower concentrations or no alcohol at all.
Non-alcohol based sanitisers are far less effective when it comes to killing certain germs such as Cryptosporidium and norovirus. They are also more likely to irritate your skin than alcohol-based ones, according to the CDC.
Hand hygiene is important in any setting, but particularly when you are travelling in a developing country.
Not only does it remove germs that could cause you to get sick, but it also protects your travelling companions and other people you may fist-bump into along the way.