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As flu scare ebbs, will hand-washing dry up?

In summer 2003, researchers descended on airport bathrooms in the U.S. and Canada and discovered a dirty truth: More than 20 percent of restroom visitors left without washing their hands.

But there was one big exception: In Toronto, which had just endured a deadly outbreak of severe acute respiratory syndrome, fewer than 5 percent of people left dirty-handed. During that outbreak, public health officials had repeatedly urged people to protect themselves by washing their hands.

Sound familiar? Just weeks ago, Americans were hearing similar, daily pleas from health officials and even President Barack Obama as initial fears about a new flu virus, called H1N1 or swine flu, peaked.

In a phone survey in early May, 67 percent of adults said they or others in their homes were washing their hands more often, the Harvard School of Public Health reported. Richard Besser, acting chief of the Centers for Disease Control and Prevention, said the increase might produce health benefits well beyond controlling H1N1.

But as coverage of the outbreak wanes, will Americans keep scrubbing? Whether folks kept washing in the Toronto airport is unknown, because the study was not repeated there.

For now, those who make it their business to promote hand-washing — to prevent flus, colds, food poisoning, infectious diarrhea, skin infections and other hand-borne illnesses — are hopeful but doubtful.

“I’m sure there are more people washing hands, but I don’t think it’s going to last,” said B. Susie Craig, a food safety specialist and hand-washing expert at Washington State University’s extension service.

“Americans have very short memories,” said Dan Dunlop, president of Jennings, a North Carolina marketing company that has designed hand-washing promotions for hospitals. Even in hospitals, changing behavior can be tough, he noted. “It takes a major cultural shift. When we do one of these campaigns, it is pervasive. We have stickers on patients; we have signs in every bathroom.”

If changing hand-washing behavior were simple, “we wouldn’t have so many people getting sick each year,” said Doug Powell, a food scientist at Kansas State University.

Of course, remaining flu fears could make a difference. But experts say businesses, schools and hospitals that want to keep soap dispensers flowing might want to consider:

• The voice of authority. Just as federal health officials enlisted Obama to endorse hand-washing, Dunlop has enlisted hospital CEOs and medical chiefs to inspire hand-washing in their troops. School principals, PTA presidents and restaurant managers could do likewise, he said.

• The audience. “With younger people, what seems to work is being blunt and gross,” Powell said. Powell, who writes at barfblog.foodsafety.ksu.edu, tells his students that when they eat without washing their hands first, they may be eating feces.

• Social pressure. In one unpublished study, Craig found that petting-zoo visitors who left a barn through a crowded exit washed their hands more often than those who left by a less-crowded door.

• Keeping supplies up. Powell said he hears often about bathrooms in schools, college dormitories and other germ hotspots that lack soap.

It takes about a month to learn a new health habit, said Judy Daly, a professor of pathology at the University of Utah in Salt Lake City and a spokeswoman for the American Society for Microbiology, which co-sponsored the airport study.

So if you started washing your own hands more frequently this month, just keep it up, she said: “Pretty soon it will be automatic.”