Appendix C

Hand-Washing Recommendations to Reduce Disease Transmission From Animals in Public Settings

Hand washing is the single most important prevention step for reducing disease transmission. Hands should always be washed upon exiting animal areas and before eating or drinking. Venue staff should encourage hand washing as persons exit animal areas.

How to Wash Hands

• Wet hands with running water; place soap in palms; rub together to make a lather; scrub hands vigorously for 20 seconds; rinse soap off hands.
• If possible, turn off the faucet by using a disposable paper towel.
• Dry hands with a disposable paper towel. Do not dry hands on clothing.
• Assist young children with washing their hands.

Hand-Washing Facilities or Stations

• Hand-washing facilities should be accessible and sufficient for the maximum anticipated attendance and configured for use by children (low enough for them to reach or equipped with a stool), adults, and those with disabilities.
• Hand-washing stations should be conveniently located in transition areas between animal and nonanimal areas and in the nonanimal food concession areas.
• Maintenance should include routine cleaning and restocking to ensure adequate supply of paper towels and soap.
• Running water should be of sufficient volume and pressure to remove soil from hands. Volume and pressure might be substantially reduced if the water supply is furnished from a holding tank. Therefore, a permanent pressured water supply is preferable.
• The hand-washing station should be designed so that both hands are free for hand washing by having operation with a foot pedal or water that stays on after turning on hand faucets.
• Hot water is preferable, but if the hand-washing stations are supplied with only cold water, a soap that emulsifies easily in cold water should be provided.
• Communal basins, where water is used by more than one person, do not constitute adequate hand-washing facilities.

Hand-Washing Agents

• Liquid soap dispensed by a hand or foot pump is recommended.
• Alcohol-based hand sanitizers can be used if soap and water cannot be made available and are effective against multiple common disease agents (e.g., shiga toxin-producing E. coli, Salmonella, and Campylobacter). However, they are ineffective against certain organisms (e.g., bacterial spores, Cryptosporidium, and certain viruses).
• The U.S. Food and Drug Administration recommends using an alcohol-based hand sanitizer with a concentration of 60% or higher to be effective against common disease agents.
• Hand sanitizers are less effective if hands are visibly soiled. Therefore, visible contamination and dirt should be removed to the extent possible before using hand sanitizers.

Hand-Washing Signs

• At venues where human-animal contact occurs, signs regarding proper hand-washing practices are critical to reduce disease transmission.
• Signs that are reminders to wash hands should be posted at exits from animal areas (exit transition areas) and in nonanimal areas where food is served and consumed.
• Signs should be present to direct all visitors to hand-washing stations upon exiting animal areas.
• Signs with proper hand-washing instructions should be posted at hand-washing stations and restrooms to encourage proper practices.
• Depending on the setting, hand washing signs might need to be available in different languages.

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Date last reviewed: 6/20/2007