Skip Navigation LinksSkip Navigation Links
Centers for Disease Control and Prevention
Safer Healthier People
Blue White
Blue White
bottom curve
CDC Home Search Health Topics A-Z spacer spacer
Blue curve MMWR spacer

Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: Type 508 Accommodation and the title of the report in the subject line of e-mail.

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.

FIGURE. Hand-washing sign*

Directions for washing hands
Wet hands with running water
Place soap into palms
Rub together to make a lather
Scrub hands vigorously for 20 seconds
Rinse soap off hands
Dry hands with disposable paper towels, not on clothing
After going to the toilet
Upon exiting animal areas
Before eating
Before preparing foods
After removing soiled clothes or shoes
Return to top.

* Sign available at Additional information on animals in public settings and zoonotic diseases is available at

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

All MMWR HTML versions of articles are electronic conversions from typeset documents. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version ( and/or the original MMWR paper copy for printable versions of official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to

Date last reviewed: 4/23/2009


Safer, Healthier People

Morbidity and Mortality Weekly Report
Centers for Disease Control and Prevention
1600 Clifton Rd, MailStop E-90, Atlanta, GA 30333, U.S.A


Department of Health
and Human Services