Swine flu vs. the globs

BALTIMORE — When Sandy Summers picks up her children - ages 6 and 10 - at elementary school, they're greeted with squirts of hand sanitizer.

"When they get in the car, I put a glob on their hands," said the nurse. "If they're going to eat a snack in the car, I make them use some. ... If I go to the grocery store, when I get in the car, the first thing I do is use the sanitizer. If I forget to use it before I touch the steering wheel, I put a whole bunch on my hands and just wipe it all over the steering wheel.

"With the flu season approaching, I find that we're using it more."

Hand sanitizer has grown into a more than $112 million-a-year industry in the United States, and sales have been rising, in large part because of swine flu. With the mantra "wash your hands" virtually being shouted from the rooftops - President Barack Obama has encouraged it; Sesame Street's Elmo is sharing the message in public service announcements - many people are using alcohol-based sanitizer as a quick and convenient alternative to good old soap and water.

And while efforts are being made to more frequently disinfect surfaces where the flu virus may live - subway cars and buses in Washington are undergoing weekly cleanings - governments and businesses are putting out sanitizer in hopes that people will protect themselves and others by using the stuff. Liberally.

"Everyone has a role to playin stopping the spread of flu," said David Paulson, spokesman for the Maryland's Department of Health and Mental Hygiene. "Everyone has to take personal responsibility. That means keeping clean, covering your cough, getting the vaccine."

The conventional wisdom among public health officials is that hand sanitizer works well, but soaping up at the sink is best because it is the only way to wash off dirt. But others say hand sanitizer may actually be better, especially since so few people wash their hands properly and because the gels are always at the ready.

"It's actually better than soap," said Dr. Philip M. Tierno Jr., director of clinical microbiology and immunology at New York University Langone Medical Center. "Soap and water does not kill germs. Soap and water washes them off your skin."

"The best thing you can do for yourself is wash appropriately with soap and water, 15 to 20 seconds," he said. "[But] most people don't wash appropriately because they don't do it long enough, suds up appropriately, don't get in between the digits."

Alcohol-based hand sanitizers work only if their alcohol concentration is greater than 60 percent (some products have 40 percent), experts say.