Appendix C

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

Hand washing is the most important prevention step for reducing disease transmission associated with animals in public settings. Hands should always be washed when exiting animal areas, after removing soiled clothing or shoes, and before eating or drinking. Venue staff members should encourage hand washing as persons exit animal areas.

How to Wash Hands

• Wet hands with running water; place soap in palms; rub hands together to make a lather; scrub hands thoroughly for 20 seconds (e.g., the amount of time it takes to sing the ABC song); and rinse soap off hands.
• If possible, turn off the faucet 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 or stations should be accessible, sufficient for the maximum anticipated attendance, and accessible by children (i.e., low enough for children to reach or equipped with a stool), adults, and persons with disabilities.
• Hand-washing facilities stations should be conveniently located in transition areas between animal and nonanimal areas and in the nonanimal food concession areas.
• Maintenance of hand-washing facilities and stations should include routine cleaning and restocking to ensure an 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 pressurized water supply is preferable.
• Hand-washing stations 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 hand faucets are turned on.
• Hot water is preferable, but if the hand-washing facilities or stations are supplied with only cold water, a soap that emulsifies easily in cold water should be provided.
• Communal basins, in which water is used by more than one person, are not adequate hand-washing facilities.

Hand-Washing Agents

• Liquid soap dispensed by a hand or foot pump is recommended.
• Alcohol-based hand sanitizers (concentration of >60%) may be used if soap and water cannot be made available and the sanitizers are effective against multiple common disease agents (e.g., Shiga toxin-producing Escherichia coli, Salmonella species, and Campylobacter species). However, they are ineffective against some organisms (e.g., bacterial spores, Cryptosporidium species, and certain viruses).
• Hand sanitizers are less effective on visibly soiled hands. Therefore, as much visible contamination and dirt as possible should be removed 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 remind visitors to wash hands should be posted at exits from animal areas (i.e., exit transition areas) and in nonanimal areas where food is served and consumed (Figure).
• Signs should be posted that direct all visitors to hand-washing stations when exiting animal areas.
• Signs with proper hand-washing instructions should be posted at hand-washing stations and restrooms to encourage proper practices.
• If appropriate for the setting, hand-washing signs should be available in different languages.
   

* Sign available at http://www.nasphv.org/documentscompendiaanimals.html. Additional information on animals in public settings and zoonotic diseases is available at http://www.cdc.gov/healthypets.

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Date last reviewed: 4/23/2009