If you want to stay healthy this winter while everyone around you is coming down with colds and flu, sing the birthday song while you wash your hands, and don't stop scrubbing until you've finished the last "happy birthday to you."

If you want to stay healthy this winter while everyone around you is coming down with colds and flu, sing the birthday song while you wash your hands, and don't stop scrubbing until you've finished the last "happy birthday to you."

It's not the song that's important. It's the time it takes to sing it, or hum it to yourself while you lather and scrub. You could even go for a second chorus, washing all the while.

That's the advice of doctors, nurses and others who work around sick people all the time.

"Dirty hands are the number one way diseases get spread," says Mary Huey, an oncology nurse at Rogue Valley Medical Center in Medford. In a typical work day, Huey washes her hands more times than she can count to avoid bringing infections to patients who are trying to beat cancer.

Chemotherapy means cancer patients "don't have much of an immune system," Huey says. "Infections are a big problem for chemo patients."

Thorough and frequent hand-washing is one of the easiest defenses against illness, says Dr. Ruth Rabinovitch, a Medford physician who specializes in infectious diseases.

"We auto-inoculate," she explains. "We touch doorknobs and our hands work our way to our nose or eyes."

Rabinovitch says mucus membranes provide an opportune entry point for some infectious agents. Skin has many layers of cells to ward off bacteria and viruses, but the mucus membranes have just a single layer of cells.

"It's not as sturdy for preventing infection," she says.

So the key is to wash long enough to actually remove bacteria from the hands. Washing for 15 seconds in ordinary soap and water reduces the bacteria count 10-fold, Rabinovitch says. Washing for 30 seconds is even more effective.

"The biggest error people make is not spending enough time (washing)," she says. Humming a little ditty in your head while you wash will remind you to stay at the task long enough to get it done right.

Special soaps aren't necessary. It's the friction of soap and water that does the job, Rabinovitch says. "Cleaning your hands in soap and water is completely adequate."

She says cool water works just as well as warm, but warm water produces more lather and it's likely to be more comfortable, which makes the washing more pleasant.

Alcohol gels are effective, too, for those times when soap and water aren't available. The alcohol kills bacteria on contact. Keeping your hands and fingers away from your face and out of your nose will help reduce the likelihood of auto-inoculation, Huey says.

And no, frequent hand washing doesn't necessarily lead to chapped hands.

"If you dry them really well, they won't get chapped," Huey says, "but if you don't, you're going to get chapped hands."

Reach reporter Bill Kettler at 776-4492 or e-mail bkettler@mailtribune.com.