The spread of viral epidemics – like the current coronavirus outbreak – could be significantly slowed if just a handful of major airports had better hand hygiene, according to a new study published in the journal Risk Analysis.

Airports are like candy shops for communicable diseases. Thousands of people from all corners of the world are suddenly jammed together in one place, their immune systems not prepped for one another’s microbial mates. There’s also a bunch of touchable surfaces for this bacteria and viruses to wait on while hitchhiking, from toilet doors and security kiosks to the tray from the food canteen. 

A study back in 2018 took swabs from 90 different surfaces at an airport and found a host of pathogenic viruses on 67 percent of samples taken at a children’s play area, half of all luggage trays at the security check area, half of the buttons at a pay terminal, a third at passport control points, as well as in 14 percent of swabs taken from stair handrails.

This mix of shared breathing space and touchable surfaces makes airports incredibly influential spaces in viral outbreaks, helping them go international, like the current coronavirus outbreak that’s creeping its way around the globe. However, it appears that it’s surprisingly easy to reduce this influence: good old fashioned hand washing. 

In the new study, researchers worked out that better handwashing in just 10 international airports could potentially slow the spread of a contagious disease by as much as 37 percent. In fact, increasing the prevalence of clean hands in all airports worldwide by just 10 percent could slow the rate of diseases' spread across the planet by about 24 percent.

"Seventy percent of the people who go to the toilet wash their hands afterwards. The other 30 percent don't. And of those that do, only 50 percent do it right," study author Professor Christos Nicolaides, from the University of Cyprus and fellow at the MIT Sloan School of Management, said in a statement.

The team reached their findings by scoping out the 120 most influential airports in spreading disease. Interestingly, they found that the location of an airport was the most important factor, not so much its busyness or traffic. Tokyo and Honolulu, for example, are not massively busy airports, but their location made them prime interchanges for pathogens, acting as gateways between the East and West while hosting many long-range direct flights. 

As shown by previous studies, cleaner hands could be achieved simply through education, posters, public announcements, social-media nudges, and improved access to handwashing facilities.

"Eliciting an increase in hand-hygiene is a challenge, but new approaches in education, awareness, and social-media nudges have proven to be effective in hand-washing engagement," Prof Nicolaides said.