Among young adults in the military, the most common cause of lost time from duty is respiratory illness. It's a problem health officials have long tried to combat with everything from ultraviolet radiation and dust suppression to disinfectant vapors and antibiotics. For many years, an adenovirus vaccine was the weapon of choice. But manufacturers have discontinued its production. Now new research indicates that the best bet may be enforcing a simple hand-washing regimen. According to a report in the August issue of the American Journal of Preventive Medicine, navy recruits ordered to frequently wash their hands experienced a substantial reduction in respiratory ailments.

Margaret A. K. Ryan of the Naval Health Research Center in San Diego and her colleagues assessed a program dubbed Operation Stop Cough, implemented at a recruit training command center in Illinois. As part of the program, commanding officers instructed recruits to wash their hands at least five times a day. To facilitate this task, the navy installed liquid-soap dispensers at all sinks and allowed wet sinks to pass inspection. In addition, drill instructors received monthly education from preventive medicine personnel on the importance of handwashing. The program proved effective. In comparison with weekly rates of illness among recruits during the year before Operation Stop Cough started, Ryan's team found 45 percent fewer cases of respiratory ailment during the two years after implementation.

Unfortunately, the time-constrained recruits had difficulty sticking to the washing schedule. But civilians might do well to follow it. Vaccine shortages present a problem not only to the military but to the general public as well. And though it's not a substitute for vaccines, hand washing is critical in preventing and controlling infectious disease, writes Joel C. Gaydos of the Defense Department's Global Emerging Infections Surveillance and Response System in a commentary accompanying the report. "My impression is that in settings where visible soiling of hands is unusual, as in most offices, people are not inclined to wash their hands before eating," he notes. "Re-emphasizing handwashing in our daily lives may provide significant benefits with little effort or cost, especially during the respiratory disease season."