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Exhortations to wash your hands more are a major plank in the efforts to stop swine flu, but how much does it really help? We have been warned to make sure we wash our hands properly to stop the spread of swine flu. The government's adverts show the disease spreading quickly by touch. Sneeze into your hands, they suggest, and you will leave highly infectious fingerprints everywhere you go. It is a scary prospect. But there is something we can do, the adverts tell us. Use a tissue, throw it away, and then wash your hands. Catch it, bin it, kill it, as the posters say. But even though ordinary flu is a common illness, scientists are not in agreement about exactly how it - or swine flu - is spread. The government's position, as stated on the DirectGov website is: "To reduce the risk of catching or spreading the virus you should... wash your hands regularly with soap and water." But there is no evidence that hand washing reduces the spread of swine flu, according to an epidemiologist at the London School of Hygiene and Tropical Medicine, Wolf-Peter Schmidt. "There have been a small number of trials in schools. I would rate that two of these trials have been of good quality and both these studies do not show any effect on respiratory illnesses in general." He said laboratory experiments on the common cold have been interesting but, in terms of flu, are not conclusive. "It was shown that the common cold virus can be spread from surfaces and fingers to people if they touch their eyes, and they can then become affected with the cold. This has not been shown for flu. "The fact it's been shown for one respiratory virus may suggest that it also works this way for influenza. But that has never been shown in the lab or the real world." He said there is more evidence that flu mainly spreads when we talk, cough and sneeze. But the Department of Health has said it is satisfied there is enough evidence to suggest flu is spread through direct contact. "Several studies have documented both the major contribution played by contaminated hands in the transfer of infection and the effectiveness of hand hygiene in healthcare and community settings," a spokesperson says. "At least one study has demonstrated that influenza virus is readily inactivated within 30 seconds by a commercially-marketed alcohol hand disinfectant, following experimental contamination of hands." Dr Schmidt is concerned about the quality of studies in this area. But even if you were to accept the studies were inconclusive, there are those who say the circumstantial evidence in favour of hand washing is overwhelming. Common sense tells you hand washing will ward off flu, said John Oxford, professor of virology at St Bart's and the Royal London Hospital. "No one's done the billion pound experiment where you infect somebody deliberately," he says. "But I don't think it's necessary. I wouldn't put money into that at this stage. I would go with all the circumstantial evidence.