Campus News

The ABCs of hand-washing

Carolina’s Allison Aiello added her expertise on disease prevention to the World Health Organization’s guidelines for COVID-19 prevention.

Image showing hands washing with sudsy soap and water.
(Shutterstock image)

A Carolina expert on hand hygiene and ways to prevent disease transmission helped create guidelines that the World Health Organization (WHO) recommends people across the globe follow to stem the spread of the COVID-19 virus. 

The number one recommendation is thorough hand-washing several times each day. 

Allison Aiello, Gillings School of Global Public Health.

Allison Aiello. (Photo courtesy of Gillings School of Global Public Health)

Allison Aiello, professor of epidemiology in Carolina’s Gillings School of Global Public Health and faculty fellow at the Carolina Population Center, chaired a group of scientists and researchers at a February 2019 meeting in Hong Kong. The group, part of a 21-person collaboration, wrote guidelines for personal protective and environmental measures, including hand hygiene, respiratory etiquette, face masks, surface and object cleaning and other environmental measures.  

The guidelines, in a 91-page report, join other protocols that the WHO is using during the COVID-19 virus outbreak. 

A one-page guide to preventing illness that mirrors advice from Aiello’s group is on the Centers for Disease Control and Prevention website and video

Aiello was chosen because of her more than a decade’s research on non-pharmaceutical ways to mitigate and prevent disease, including hand hygiene and mask use, and to reduce the severity of influenza and other respiratory infections. She also has contributed to U.S. guidelines for hand hygiene for healthcare professionals in clinical settings. 

The report recommends good hand hygiene, no matter the outbreak’s level of severity, as a front line of defense. 

Hand hygiene is effective at reducing the spread of respiratory infections through direct contact,” Aiello said. “If people touch surfaces that are contaminated with droplets from a cough or sneeze of an infected individual, hand hygiene can reduce transmission of infection. Hand hygiene, however, does not affect direct transmission by respiratory droplets or aerosols, which are the other modes of transmitting influenza. Hand hygiene is recommended, but it will not protect against direct infection from respiratory droplets or aerosols with influenza. 

Aiello suggests a layered approach to protection. “For example, our research shows that hand hygiene and masks together, were more effective at reducing influenza-like illness, than masks alone,” she said. 

Viruses can survive on surfaces for around 48 hours, Aiello said, so it’s important to wash hands at intervals throughout the day and after touching hightraffic surfaces. 

The recommendation is to wash hands with soap and water for at least 20 seconds, especially after being in a public space or blowing your nose, coughing or sneezing. Some people suggest singing the ABC song to mark the 20 seconds.  

Any song that you like that can be sung for 20-25 seconds is best,” Aiello said. 

Overall, Aiello said, the CDC recommendations are valuable advice during the COVID-19 outbreak, particularly the hand hygiene and other specific recommendations that apply to various age groups in the U.S. 

Sylvie Briand, director of infectious health management at WHO, invited Aiello to join the committee and chair the personal protection group. The report was a collaboration between the WHO Global Influenza Programme and the WHO Collaborating Centre for Infectious Disease Epidemiology and Control at The University of Hong Kong. Benjamin Cowling, a faculty expert on influenza epidemiology and mitigation at the University of Hong Kong, led the creation of the larger report.  

The group’s report is the product of collaboration between the WHO Global Influenza Programme and the WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong.