What’s in a Handshake? Exploring the Best Form of Greeting to Prevent Hand to Hand Spread of Viruses

Abstract

Background: Respiratory and enteric viruses are highly contagious pathogens that can be spread by contaminated hands and surfaces. We hypothesized that alternatives to handshake greetings that reduce the time and surface area of hand contact would be associated with decreased transfer of viral particles. Methods: In a simulation of hand-contact greetings, volunteers (N = 22) used a keyboard contaminated with the benign bacteriophage MS2 and then performed a handshake and fist bump with additional volunteers. To assess viral transfer, hands were cultured for MS2, and plaque-forming units (PFU) were compared for the different types of hand contact. Additional simulations (N = 10) were conducted to compare viral transfer with the fist bump versus a cruise tap greeting (ie, a modified fist bump involving single knuckle contact). Results: The handshake greeting resulted in significantly greater transfer of MS2 than the fist bump (1.31 vs 0.54 log10 PFUs, P < .001) (Fig. 1A), but the frequency of transfer of virus was high for both greetings (91% transfer by handshake vs 59% by fist bump). The cruise-tap greeting did not result in reduced transfer of viral particles in comparison to the fist bump (Fig. 1B), and the frequency of transfer remained high (70%). Conclusions: The fist-bump and cruise-tap greetings could potentially reduce transmission of viruses in comparison to the handshake, but transfer occurred frequently, even with these greeting methods. To eliminate hand-to-hand transmission of respiratory and enteric viruses, alternative greeting methods that do not involve physical contact are needed.Funding: NoneDisclosures: None