Today, much scientific evidence shows that handwashing is the main barrier to curb the spread of many diseases, such as coronavirus (COVID-19). However, just over 170 years ago, handwashing as a preventive measure was not a custom (least among doctors) and the mortality rate, for this reason, was very high.

Several years before Louis Pasteur discovered that infectious diseases were caused by microorganisms, the Hungarian Physician Ignaz Semmelweis found that handwashing could reduce deaths from infection. During his work as Obstetrician at the Vienna General Hospital, he realized that maternal mortality at the clinic attended by midwives and their apprentices was 2%, while in doctors and students, the figure ranged from 10% to 20%. The infection that appears in women after delivery is called postpartum fever.

Semmelweis set about researching and cross-linking information between the two clinics of the hospital. There, he realized that midwives only cared for pregnant women; students attended pregnant women after dissecting corpses, and doctors did so after performing autopsies.

A definitive test for the investigator was to see that a colleague died after being cut while dissecting a child’s corpse. The symptoms experienced were very similar to those of women suffering from puerperal fever. So, he supported the existence of contamination by cadaveric particles.

In May 1846, he installed a lavatory at the entrance to the delivery room of the student clinic and asked them to wash their hands before and after attending to the women in labor. The maternal mortality rate fell from 18.3% in April of that year to 1% in August.

Defense filter

Today we know that infections are transmitted in several ways: by air (such as chickenpox or tuberculosis), by contaminated food, and by contact.

“Handwashing is recommended for airborne or contact infections because hands tend to be contaminated and then we touch things or put our hands on our faces”, explains Dr. Humberto Vásquez, Infectologist at the Clínica International, to El Comercio.

The Specialist explains that although there are bacteria on the hands that live there and are part of our natural flora, there are others that are transitory and can be harmful. “We know we must wash our hands, but many times we don’t do it.”

Dr. Vásquez adds that, in areas where there is no water access, people should reserve part of the water they use for consumption and use it for cleaning tasks.

Regarding the relevance of using or not using gel alcohol, Dr. Julio Cachay, Infectologist at the Clínica Ricardo Palma, considers that it is a complementary tool.

“We should wash with soap and water especially when we see dirty hands. We complement with gel alcohol to keep hands disinfected for a little longer.”

The expert reminds us that germs can survive for several hours on surfaces, so cleaning is important, especially in places where we know that there may be sick people.

Experts recall that there are three types of handwashing: social, which we all do on any occasion; clinical, made by technicians, nurses, and doctors, which is done with much more detail; and surgical, similar to the clinical but done much more in-depth, using a nail brush which is mandatory before performing any surgery.

Dr. Julio Cachay
Infectologist at Clínica Ricardo Palma