Cruise tap versus handshake: using common sense to reduce hand contamination and germ transmission on cruise ships

Transfer of methicillin-resistant Staphylococcus aureus by fist bump versus handshake

“…The fist bump is frequently discussed as a potential alternative to the handshake that might reduce the risk for pathogen transfer between patients and personnel or among patients. 2,9,10 However, we found that the burden of MRSA was similar on the palmar and dorsal surfaces of the hands of MRSA-colonized patients and fist bump and handshake greetings resulted in similar frequencies of MRSA transfer (16% vs 22% transfer, respectively). Transfer was significantly reduced with a modified fist bump that reduced the area of contact to a single knuckle and when patient hand hygiene was performed before a handshake.…”

“…Each participant served as an internal control and performed 4 greetings with their dominant hand in sequence from least to greatest contact: (1) cruise tap (the dorsal surface of one knuckle touches the dorsal surface of another knuckle), 10 (2) fist bump (one fist meets another with the dorsal side of all 4 ulnar proximal phalanges touching), (3) handshake, and (4) handshake after patient hand hygiene using 2 mL of alcohol gel. The participants were coached to ensure appropriate hand hygiene as previously described.…”

“…In addition to the traditional fist bump, we tested a modified fist bump called the cruise tap that further reduces the surface area of contact by allowing contact only between 1 knuckle of each hand. 10…”

Vessel sanitation inspection scores and acute gastroenteritis outbreaks on cruise ships

“…Health care providers offering pre-travel services should emphasize the importance of rigorous hand sanitation aboard and actively encourage use of ship-board greetings that do not involve touching of potentially contaminated palms or fingertips [11]. They should also strongly discourage self-medication for AGE aboard cruise ships.…”