Effectiveness Of Hand Washing Research Articles

Efficacy of two hygiene methods to reduce soil and microbial contamination on farmworker hands during harvest

To prevent fresh produce-associated outbreaks, effective hand hygiene is critical, although determining the effectiveness of hand hygiene interventions in the agricultural environment has not been well studied. The primary purpose of this study was to compare the effect of two hand hygiene interventions on the concentrations and presence of soil (A600 nm of hand rinsate) and microbes on the hands of agricultural field workers. We compared hand washing with soap, a two-step alcohol-based hand sanitizer (Two-Step ABHS) intervention, and not conducting hand hygiene (control). Hand rinsates from 159 farm workers, on two produce farms in Nuevo Leon, Mexico during May 2013, were analyzed spectrophotometrically for indicator bacteria (coliforms, Enterococcus, generic Escherichia coli), and for Bacteroidales 16s rDNA. The hand washing with soap group, compared to the control group, had significantly lower amounts of soil on hands (A600 nm 0.005 vs. A600 nm 0.236, p < 0.001), but had no significant differences in concentrations or proportions of indicator bacteria. The Two-Step ABHS group, compared to the control group, had significantly lower amounts of soil (A600 nm 0.099 vs A600 nm 0.236, p < 0.001), significantly lower concentrations of indicator bacteria (geometric mean Log CFU per hand 1.5 vs 3.3 for coliforms, p < 0.001; 3.1 vs 4.1 for Enterococcus, p < 0.05), and a significantly lower proportion of samples positive for coliforms (53% vs 100%, p < 0.001) and the Bacteroidales AllBac marker (69% vs 90%, p < 0.05). The secondary purpose of our study was to evaluate the sustained effect of hand washing and Two-Step ABHS after 30 min of jalapeño harvest. The hand washing group had significantly lower soil compared to the control group, but no group had significantly different amounts of bacteria than the control group. Two-Step ABHS may be useful for hand hygiene in an agricultural field environment, especially when soap and water are not available.

Can Hand Washing Influence Hedonic Food Consumption?

ABSTRACTThe act of hand washing has been a routine part of hygienic practices across time and society. Aside from its physiological effects, hand washing has also been shown to symbolically cleanse individuals of their transgressions. However, most research demonstrating the metaphorical effect of hand washing has mainly been focused within the domain of morality. The objective of the current research is to explore the role of hand washing on consumption behavior, and more specifically, hedonic food consumption. Across two studies, this article establishes the role of hand washing after hedonic food consumption as well as prior to a hedonic food choice. In Study 1, washing one's hands after consumption of hedonic food decreased perceived guilt. In Study 2, washing one's hands prior to choice led to an increased likelihood of choosing a more hedonic (compared to less hedonic) food item. Thus, by washing one's hands, individuals are provided with a license to indulge in hedonic foods without the guilt that is commonly associated with such a choice. Several implications for consumer behavior research and the effects of hand washing on food decision making are discussed.

Inefficacy of alcohol-based hand rub on mites in a patient with hyperkeratotic scabies.

The World Health Organization is strongly promoting alcohol-based hand rubs to interrupt transmission of pathogens within the healthcare environment, and in some hospitals they are being recommended in cases of scabies. However, there are no studies that demonstrate the efficacy of such hand rubs against scabies. To evaluate the viability of Sarcoptes scabiei after the application of various topical antiseptics used for hand hygiene, and the effect of hand washing on the number of parasites present on the skin surface of a patient with scabies. We applied three different topical antiseptics (two alcohol-based and one povidone-iodine-based) to the skin of one hand that was affected by scabies, and took a skin scraping of each area to evaluate the viability of the mites over time. A skin scraping of a control area without antiseptic application was also taken. We also tested the antiseptics directly on the mites. Statistical comparison between the percentages of vital mites in the different samples was assessed using the χ(2) test. We also captured a dermoscopic image of the other hand before and after hand washing to count the number of parasites on the skin surface. Topical antiseptics did not reduce the number of living mites compared with control skin, and hand washing did not reduce the number of parasites on the skin surface. Application of topical antiseptics does not reduce the viability of S. scabiei, and is therefore unable to prevent the transmission of scabies. The usefulness of hand washing in preventing transmission of scabies to new subjects remains to be investigated.

Analysis of gunshot residues produced by .38 caliber handguns using inductively coupled plasma-optical emission spectroscopy (ICP OES)

A new analytical method is proposed for the collection and quantification of gunshot residues (GSRs) from firearms using inductively coupled plasma optical emission spectrometry (ICP OES). Lead (Pb), barium (Ba) and antimony (Sb) concentrations in GSR from .38 caliber Taurus® handguns were monitored, and three important methodologies were evaluated such as: i) the collection region of the hand of the shooter; ii) tape-type versus swab collectors; and iii) GSR quantification from the right and left hands. Pb, Ba and Sb were found in four of the hand regions analyzed (palm, back, thumb and forefinger palm (TF-palm), and thumb and forefinger back (TF-back)), with their concentrations increasing as a function of the number of shots (one, three and five). Lead was found to be the most abundant species present. In terms of relative analytical sensitivity, higher concentrations of these three elements are mainly found in the back, TF-palm and TF-back regions. The effect of hand washing was also evaluated, which the TF-palm and the TF-back regions maintained sensitivity for the detection of three elements (concentrations higher than 4.56μgL−1) for only three and five shots. Among the collection devices analyzed, swab collectors (dry, moistened with EDTA, and moistened with water) presented higher sensitivity than tape-type collectors (adhesive, double-sided and adhesive-plaster). Additionally, swabs are a more economical collection device, providing a simple and fast collection method that does not require microwave digestion. Pb, Ba and Sb concentrations were also evaluated on the left and right hands. It was observed that Pb is mainly found on the right hand, whereas Ba and Sb concentrations are similar on both hands. ICP OES is therefore a powerful tool for GSR analysis, providing multielemental quantification of Pb, Ba and Sb.

An investigation of the effects of a hand washing intervention on health outcomes and school absence using a randomised trial in Indian urban communities

To evaluate how an intervention, which combined hand washing promotion aimed at 5-year-olds with provision of free soap, affected illnesses among the children and their families and children's school absenteeism. We monitored illnesses, including diarrhoea and acute respiratory infections (ARIs), school absences and soap consumption for 41 weeks in 70 low-income communities in Mumbai, India (35 communities per arm). Outcomes from 847 intervention households (containing 847 5-year-olds and 4863 subjects in total) and 833 control households (containing 833 5-year-olds and 4812 subjects) were modelled using negative binomial regression. Intervention group 5-year-olds had fewer episodes of diarrhoea (-25%, 95% confidence intervals [CI] = -37%, -2%), ARIs (-15%, 95% CI = -30%, -8%), school absences due to illnesses (-27%, 95% CI = -41%, -18%) and eye infections (-46%, 95% CI = -58%, -31%). Further, there were fewer episodes of diarrhoea and ARIs in the intervention group for 'whole families' (-31%, 95% CI = -37%, -5%; and -14%, 95% CI = -23%, -6%, respectively), 6- to 15-year-olds (-30%, 95% CI = -39%, -7%; and -15%, 95% CI = -24%, -6%) and under 5 s (-32%, 95% CI = -41%, -4%; and -20%, 95% CI = -29%, -8%). Direct-contact hand washing interventions aimed at younger school-aged children can affect the health of the whole family. These may be scalable through public-private partnerships and classroom-based campaigns. Further work is required to understand the conditions under which health benefits are transferred and the mechanisms for transference.

The impact of hand washing time and soap on the surface of silicone hydrogel contact lenses: a pilot study

Purpose: Debris or residue remaining on contact lenses (CL) can disturb vision and cause discomfort. Hand washing is strongly advocated by practitioners to keep CL clean and comfortable. Hand soap has changed from the more traditional bar to the fragrant cream-based soap in a pump bottle. If care is not taken to properly rinse off the soap, residue may end up on the CL. This study investigates the effect of hand washing and hand soaps on CL parameters.

How dramatic were the effects of handwashing on maternal mortality observed by Ignaz Semmelweis?

Questions remain about how much evidence is needed to accept or at least to consider an observation as providing sufficiently strong evidence to justify a change in clinical practice,1,2 even when the key outcome measure is objective, definitive and clinically very important. Maternal death is one such outcome, and Ignaz Semmelweis’ observation of the reduction in maternal deaths associated with the introduction of handwashing in a maternity hospital in Vienna provides an illustrative example.3,4 A plot of the rate of maternal deaths every month from January 1841 until May 1847 shows substantial variability and some evidence of a pattern in the changes, possibly related to the seasons.5 After handwashing was introduced in June 1847, deaths were less frequent and showed less monthly variability in the period up to February 1849. How much analysis is needed to convince people that this is an effect of handwashing and not a chance association, or a reflection of bias?2 Eyeballing the plot shown in Figure 1, many observers might consider the reduction in deaths following the introduction of handwashing to be real and significant. When considering the high risk of bias in studies using historical controls, Glasziou et al.1 suggested considering an effect as likely to be real if a risk ratio of between 5 and 10 has been observed. In this case, a comparison of the average monthly mortality rate before the introduction of handwashing (10.65%, blue points) and after it (1.98%, red points) yields a risk ratio of 5.38. We can explore these data in more depth by analysing this interrupted time series with a Seasonal AutoRegressive Integrated Moving Average model. The monthly mortality rate can be formulated as follows: MRt=B×H+AR×MRt-1+MA×Et-12+Et where MR = mortality rate, t = month, B = handwashing coefficient, H = 0 (before the introduction of handwashing), H = 1 (after the introduction of handwashing), AR = first-order autoregressive coefficient, MA = monthly moving average coefficient and E = random error. Figure 1. Monthly mortality rate from puerperal fever. The estimations of the three coefficients of the model are presented in the table below. This yields an estimated absolute reduction in maternal mortality of 8.87%, which is highly statistically significant (P = 0.0042). The reduction is also of great human significance: for every 11 women examined after handwashing, one fewer died. The analysis could be extended to take into account the data from the two clinics concerned, and to cover an earlier period, during which postmortem examinations were not done routinely.6 This discovery happened before the germ theory take off with the work of Louis Pasteur in the early 1860s. The miasma theory was prevalent and no strong explanation was available to support this impressive observation. These different levels of analysis strongly support the existence of a beneficial impact of handwashing on the risk of maternal mortality. This is not to suggest that data of this level of confidence are sufficient to introduce changes in clinical practice, which is influenced by medical tradition and cultural and other factors.4,6 In Semmelweis’ case, the evidence of an important impact of handwashing on maternal mortality should at least have led traditional medical practices to have been questioned.

Detaching the ties of ownership: the effects of hand washing on the exchange of endowed products

Recent studies have demonstrated that the ownership of a product leads to a biased perception of its aspects. Based on research on embodied cognition, we argue that the physical action of hand washing can reset the cognitive system to a more neutral state by reducing the asymmetrical perception of owned and not owned products. In three studies, we examined the effects of hand washing on the endowment effect by asking owners of a product to exchange it for a similar one. As expected, in Experiment 1, we showed that hand washing doubled the percentage of participants who exchanged an owned product for an alternative product. In Experiment 2, we replicated this finding and showed that only the action of hand washing and not a prime of physical cleaning elicited this effect. In Experiment 3, we again replicated the hand washing effect on exchange rates and examined the effect of hand washing on product evaluations. The results of all experiments suggest that hand washing reduces decision preferences that are biased by ownership.

Coliform Sources and Mechanisms for Regrowth in Household Drinking Water in Limpopo, South Africa.

Resource-limited communities throughout the developing world face significant environmental health problems related to the myriad of coliform sources within those communities. This study comprehensively investigated contamination sources and the biological and chemical mechanisms sustaining them in two adjacent communities in rural Limpopo, South Africa. An 8-month study was conducted of household (n = 14) and source water quality, measurements of biofilm layers on the inside of household water storage containers and water transfer devices, and also hand-based coliforms and hand-washing effectiveness. A 7-day water container incubation experiment was also performed to determine the biological and chemical changes that occur in a household water storage container independent of human interference. Results indicate that household drinking water frequently becomes contaminated after collection but before consumption (197 versus 1,046 colony-forming units/100 mL; n = 266; p < 0.001). The most important contamination sources include biofilm layers on the inside of storage containers (1.85 ± 1.59 colony-forming units/cm2; n = 44), hands (5,097 ± 2,125 colony-forming units/hand; n = 48), and coliform regrowth resulting from high assimilable organic carbon (AOC) levels during storage. A maximum specific growth rate, μmax, of 0.072 ± 0.003 h-1 was determined for total coliform bacteria on AOC, and a high correlation between AOC concentrations and the growth potential of total coliform bacteria was observed. These results support the implementation of point-of-use water treatment and other interventions aimed at maintaining the safe water chain and preventing biological regrowth.

Exploring the gap between hand washing knowledge and practices in Bangladesh: a cross-sectional comparative study

BackgroundHand washing is considered as one of the most effective hygiene promotion activities for public health in developing countries. This study compared hand washing knowledge and practices in BRAC’s water; sanitation and hygiene (WASH) programme areas over time.MethodsThis study is a cross-sectional comparative study between baseline (2006), midline (2009) and end-line (2011) surveys in 50 sub-districts from the first phase of the programme. Thirty thousand households from 50 sub-districts were selected in two steps: i) 30 villages were selected from each sub-district by cluster sampling, and ii) 20 households were chosen systematically from each village. The matched households were considered (26,404 in each survey) for analysis. Data were collected from households through face-to-face interview using a pre-tested questionnaire. Respondents were the adult female members of the same households, who had knowledge of day-to-day household activities related to water, sanitation and hygiene.ResultsA gap between perception and practice of proper hand washing practices with soap was identified in the study areas. Hand washing practice with soap before eating was much lower than after defecation. In baseline data, 8% reported to wash their hands with soap which significantly increased to 22% in end line. Hand washing knowledge and practices before cooking food, before serving food and while handling babies is considerably limited than other critical times. A multivariate analysis shows that socio-economic factors including education of household head and respondent, water availability and access to media have strong positive association with hand washing with soap.ConclusionGap between knowledge and practice still persists in hand washing practices. Long term and extensive initiatives can aware people about the effectiveness of hand washing.

Quality appraisal in systematic reviews of public health interventions: an empirical study on the impact of choice of tool on meta-analysis

IntroductionSystematic reviews are a cornerstone of evidence-based public health. The method of appraising the quality of different intervention and observational study designs in such reviews remains an important challenge. This...

Topical application of chlorhexidine to neonatal umbilical cords for prevention of omphalitis and neonatal mortality in a rural district of Pakistan: a community-based, cluster-randomised trial

Umbilical cord infection (omphalitis) is a risk factor for neonatal sepsis and mortality in low-resource settings where home deliveries are common. We aimed to assess the effect of umbilical-cord cleansing with 4% chlorhexidine (CHX) solution, with or without handwashing with antiseptic soap, on the incidence of omphalitis and neonatal mortality. We did a two-by-two factorial, cluster-randomised trial in Dadu, a rural area of Sindh province, Pakistan. Clusters were defined as the population covered by a functional traditional birth attendant (TBA), and were randomly allocated to one of four groups (groups A to D) with a computer-generated random number sequence. Implementation and data collection teams were masked to allocation. Liveborn infants delivered by participating TBAs who received birth kits were eligible for enrolment in the study. One intervention comprised birth kits containing 4% CHX solution for application to the cord at birth by TBAs and once daily by family members for up to 14 days along with soap and educational messages promoting handwashing. One intervention was CHX solution only and another was handwashing only. Standard dry cord care was promoted in the control group. The primary outcomes were incidence of neonatal omphalitis and neonatal mortality. The trial is registered with ClinicalTrials.gov, number NCT00682006. 187 clusters were randomly allocated to one of the four study groups. Of 9741 newborn babies delivered by participating TBAs, factorial analysis indicated a reduction in risk of omphalitis with CHX application (risk ratio [RR]=0·58, 95% CI 0·41-0·82; p=0·002) but no evidence of an effect of handwashing (RR=0·83, 0·61-1·13; p=0·24). We recorded strong evidence of a reduction in neonatal mortality in neonates who received CHX cleansing (RR=0·62, 95 % CI 0·45-0·85; p=0·003) but no evidence of an effect of handwashing promotion on neonatal mortality (RR=1·08, 0·79-1·48; p=0·62). We recorded no serious adverse events. Application of 4% CHX to the umbilical cord was effective in reducing the risk of omphalitis and neonatal mortality in rural Pakistan. Provision of CHX in birth kits might be a useful strategy for the prevention of neonatal mortality in high-mortality settings. The United States Agency for International Development.

When Too Much Is Not Enough: Obsessive-Compulsive Disorder as a Pathology of Stopping, Rather than Starting

BackgroundIn obsessive-compulsive disorder (OCD), individuals feel compelled to repeatedly perform security-related behaviors, even though these behaviours seem excessive and unwarranted to them. The present research investigated two alternative ways of explaining such behavior: (1) a dysfunction of activation—a starting problem—in which the level of excitation in response to stimuli suggesting potential danger is abnormally strong; versus (2) a dysfunction of termination—a stopping problem—in which the satiety-like process for shutting down security-related thoughts and actions is abnormally weak.MethodIn two experiments, 70 patients with OCD (57 with washing compulsions, 13 with checking compulsions) and 72 controls were exposed to contamination cues—immersing a hand in wet diapers —and later allowed to wash their hands, first limited to 30 s and then for as long as desired. The intensity of activation of security motivation was measured objectively by change in respiratory sinus arrythmia. Subjective ratings (e.g., contamination) and behavioral measures (e.g., duration of hand washing) were also collected.ResultsCompared to controls, OCD patients with washing compulsions did not differ significantly in their levels of initial activation to the threat of contamination; however, they were significantly less able to reduce this activation by engaging in the corrective behavior of hand-washing. Further, the deactivating effect of hand-washing in OCD patients with checking compulsions was similar to that for controls, indicating that the dysfunction of termination in OCD is specific to the patient's symptom profile.ConclusionsThese results are the first to show that OCD is characterized by a reduced ability of security-related behavior to terminate motivation evoked by potential danger, rather than a heightened initial sensitivity to potential threat. They lend support to the security-motivation theory of OCD (Szechtman & Woody, 2004) and have important implications both for research into the biological mechanisms underlying OCD and for the development of new treatment approaches.

Anal cleansing practices and faecal contamination: a preliminary investigation of behaviours and conditions in schools in rural Nyanza Province, Kenya

To learn how children in rural schools in Nyando District, Kenya clean themselves after defecation. Six focus group discussions were held with boys and girls ages 12-15 in three rural schools in mid-2009. Parents were interviewed in one setting. In early 2010, a survey of head teachers was conducted in 114 schools in Nyanza Province, Kenya, to assess the provision of anal cleansing materials and handwashing water and soap in schools. Anal cleansing behaviour is linked with access to materials, age, social pressure, perceived personal risk of illness and emotional factors. Materials used for anal cleansing include schoolbook paper, leaves, grasses, stones, corncobs and one's own hands. Students have knowledge gaps in terms of personal hygiene. They were forthcoming with information on their anal cleansing practices. Almost no schools budgeted for or provided anal cleansing materials regularly. Anal cleansing is a necessary human activity. However, because of social taboos, there are few articles on the topic. School health plans overlook it as well. Researchers need to determine if and how current practices could harm child health to inform policy.

Development of an intervention to reduce transmission of respiratory infections and pandemic flu: Measuring and predicting hand-washing intentions

This was an exploratory pilot study forming part of a programme of work to develop and trial an effective web-based intervention to reduce the risk of transmission of respiratory infections by promoting hand washing and other preventive behaviours in pandemic and non-pandemic contexts. The main purpose of this study was to confirm that the behavioural determinants we had identified from theory were related as predicted to intentions and to establish the validity of our measures of behavioural intentions. Participants (N = 84) completed a self-report web-delivered questionnaire measuring intentions to engage in hand washing and the hypothesised behavioural determinants of intentions, based on the theory of planned behaviour and protection motivation theory. In a factorial 2 × 2 design, half of the participants were first randomised to receive messages about potential negative consequences of pandemic flu (the “high-threat” condition) and half were assigned to receive “coping” messages describing the rationale and effectiveness of hand washing for reducing the risk of infection. A substantial proportion of variance in intentions was explained by measures of attitudes (instrumental and affective), social norms (descriptive and injunctive), perceived behavioural control (especially, access to hand gel) and perceived risk (in particular, the likelihood of catching pandemic flu). Our measures of intentions were sensitive to between-group differences, and although our design did not permit causal inference (particularly in view of selective dropout among those required to read most web pages), the pattern of differences was in the expected direction, that is, hand-washing intentions tended to be stronger in those receiving the high-threat message and coping messages. This study provided encouraging confirmation that our intervention development was proceeding correctly. Measures of intentions proved sensitive to group differences, and the behavioural determinants included in the study explained a substantial proportion of the variance in intentions. The study also provided useful indications that our high-threat message might increase hand-washing intentions, that providing hand gel might be beneficial and that it would be necessary to actively manage the risk of selective dropout in the intervention group.

Germ Simulation: A Novel Approach for Raising Medical Students Awareness Toward Asepsis

Medical student procedural training has become increasingly limited amid concerns for patient safety. Because simulation education has been shown to be effective for early skills training, we used germ simulation for teaching hand hygiene principles and aseptic technique in urinary catheterization (UC). We hypothesized that posttraining, students would demonstrate proficiency comparable to surgery residents. Seventy-five clinical clerks, second-year medical students, underwent the simulation training. Sixty-four volunteered to have their asepsis scores compared with 21 residents who were credentialed for UC placement. We used simulated germs to objectively quantify effectiveness of hand washing and maintenance of aseptic technique during UC. A task-specific check list was also used for assessing UC skills. Students completed a posttraining feedback survey. Compared with residents, students after simulation training washed their hands with equal effectiveness at baseline (P = 0.2), maintained better sterility (P = 0.05), and had a higher technical proficiency score during UC (P < 0.001). Students believed that it was a great idea to use simulated germs to highlight effectiveness of hand washing (100%) and they indicated that they would pay extra attention when washing hands (97%). We describe a novel approach to germ simulation and a training approach to teach aseptic technique in UC. Students reported a heightened awareness of the importance of hand hygiene and aseptic precautions during UC. Further studies are needed to see if this could lead to a reduction in hospital-acquired infections.

Risk Factors for Hand, Foot, and Mouth Disease and Herpangina and the Preventive Effect of Hand-washing

Hygiene and social distancing are recommended control measures for hand, foot, and mouth disease (HFMD) and herpangina. However, empirical data to support this recommendation are limited. During an outbreak of HFMD and herpangina due to infection by the human enterovirus 71, we defined a case as a vesicular papular rash on the hands, feet, buttocks, or oral mucosa and onset from April 30 to June 26, 2008. We selected 176 HFMD and herpangina case-children and a stratified random sample of 201 asymptomatic control-children; frequency matched according to residency status. We administered a questionnaire to the parents about their children's exposures and hygienic behaviors. Risk factors for HFMD and herpangina included playing with neighborhood children (odds ratio [OR]: 11 [95% confidence interval (CI): 6.2-17]), visiting an outpatient clinic for another reason ≤ 1 week before onset (OR: 20 [95% CI: 5.0-88]), and community exposures to crowded places (OR: 7.3 [95% CI: 4.1-13]). By using a score summarizing responses to 4 hand-washing questions, we found that 50% of the case-children and 2.5% of control-children had a poor score of 1 to 3, whereas 12% of the case-children and 78% of control-children had a good score of ≥ 7 (OR: 0.00069 [95% CI: 0.0022-0.022]) after we adjusted for residency, age, and community exposures by using logistic regression. Hand-washing by preschool-aged children and their caregivers had a significant protective effect against community-acquired HFMD and herpangina from the human enterovirus 71 infection.

Risk Factors for Hand, Foot, and Mouth Disease and Herpangina and the Preventive Effect of Hand-washing

Risk Factors for Hand, Foot, and Mouth Disease and Herpangina and the Preventive Effect of Hand-washing

Self-learning Effects of Hand Washing Using a Visual Aid for Care Workers in Nursing Homes

Self-learning Effects of Hand Washing Using a Visual Aid for Care Workers in Nursing Homes

Influenza Virus Contamination of Common Household Surfaces during the 2009 Influenza A (H1N1) Pandemic in Bangkok, Thailand: Implications for Contact Transmission

Rational infection control guidance requires an improved understanding of influenza transmission. We studied households with an influenza-infected child to measure the prevalence of influenza contamination, the effect of hand washing, and associations with humidity and temperature. We identified children with influenza and randomly assigned their households to hand washing and control arms. Six common household surfaces and the fingertips of the index patient and symptomatic family members were swabbed. Specimens were tested by real-time reverse-transcription polymerase chain reaction (rRT-PCR), and specimens with positive results were placed on cell culture. A handheld psychrometer measured meteorological data. Sixteen (17.8%) of 90 households had influenza A-positive surfaces by rRT-PCR, but no viruses could be cultured. The fingertips of 15 (16.6%) of the index patients had results positive for influenza A, and 1 virus was cultured. Index patients with seasonal influenza infections shed more virus than did patients with pandemic influenza infection. Control households had a higher prevalence of surface contamination (11 [24.4%] of 45) than did hand washing households (5 [11.1%] of 45); prevalence risk difference (PRD), 13.3%; [95% confidence interval {CI}, −2.2% to 28.9%]; P = .09). Households in which the age of the index patient was ≤8 years had a significantly higher prevalence of contamination (PRD ,19.1%; 95% CI, 5.3% -32.9%; P = .02). Within the strata of households with secondary infections, an effect of lower absolute humidity is suggested (P = .07). We documented influenza virus RNA contamination on household surfaces and on the fingertips of ill children. Homes with younger children were more likely than homes of older children to have contaminated surfaces. Lower absolute humidity favors surface contamination in households with multiple infections. Increased hand washing can reduce influenza contamination in the home.