Assistant City Collector Maria Mansolillo, keeps a bottle of Purell on her desk at Providence City Hall, as do some of her coworkers.

The Providence Journal / Kathy Borchers

Chantel Abreu sits behind a counter in the collector’s office at Providence City Hall, greets coughing and sneezing taxpayers and handles the documents they pass her with their germy hands.

In her personal battle against swine flu, she’s not letting her defenses down. When there’s a break in the line, she reaches for her trusty can of Lysol disinfectant, sprays it liberally and then wipes down the counter and glass in front of her.

“I’ll never do it in front of the customer,” she says. “That’s rude.”

When she can’t get to the bathroom to wash her hands with soap and water — “I’m hysterical about washing my hands” — she resorts to Plan P — the Purell in dispensers on her coworkers’ desks.

“She comes over and uses mine all the time,” says Maria Mansolillo, her supervisor, who points to the bottle on her desk. Mansolillo admits to keeping a tiny container in her purse and has given them to her husband and daughter at college. “You just can’t be too careful,” she says.

A disease named after pigs has many people keeping their hands squeaky clean these days. That’s because hand-washing and sanitizing are always included in health advisories about the best ways to prevent the spread of seasonal flu and swine flu, also called H1N1.

Now it’s common to see sanitizer dispensers everywhere — for sale on pharmacy shelves, in government buildings, schools and supermarkets, and on desktops, in purses and in cars.

Sales of Purell, one of the many brands of alcohol-based hand sanitizers, are reportedly doing remarkably well. But how well is a secret. Marc Boston, spokesman for Johnson & Johnson, says the company won’t release any sales figures.

Woonsocket-based CVS/pharmacy also would not provide specifics on hand-sanitizer sales.

“Like all other retailers we didn’t initially have supply on hand to meet that demand,” says spokesman Michael DeAngelis. “We had to ramp up very quickly.”

EVEN WITHOUT FLU, we’ve got one big germ party on our hands. Studies have suggested that 10,000 to 1 million bacteria can be found on a human hand. One study looked at a group of college students and observed up to 150 different varieties of bacteria on a typical hand, but as many as 5,000 different kinds were found overall.

You have to go back more than 150 years to trace the beginnings of hand-sanitizing for disease prevention, according to the Centers for Disease Control and Prevention.

In 1846, Hungarian physician Ignas Semmelweis realized that babies delivered at his hospital by students and physicians had a higher rate of mortality than those delivered by midwives. The reason, it turned out, was that the students and physicians would go from autopsies to delivering babies and, despite washing their hands with soap and water, would apparently transmit “cadaverous particles” to their patients. Semmelweis began requiring hand-cleansing with a chlorine solution. The mortality rate plummeted.

Today, the CDC promotes the importance of hand-cleansing on its Web site, in videos and on posters. So does the state Department of Health in its communications and presentations to community groups and schools.

The CDC recommends washing with soap and running water or using alcohol-based hand rubs as effective ways of killing germs. In its guidelines for health-care workers, the CDC states that alcohol-based products are even more effective than soap or antimicrobial soaps. Some people use soaps and spray cleansers labeled “antibacterial.” Theories that they lead to resistant strains have “not been proven,” according to the Environmental Protection Agency, but health officials are not recommending that the public use them to fight germs.

With officials’ recommendations about hand-washing comes advice about avoiding germs in the first place. Some are traditional tips, such as covering when coughing and sneezing and not touching your hands to your nose, mouth or eyes.

BUT THESE DAYS there are more unusual practices, too. The Roman Catholic Diocese of Rhode Island has advised against hand-shaking during the sign of peace at Mass, and urged priests not to share consecrated wine with parishioners. Sports squads are told to refrain from open-handed, after-game hand slapping between teams or teammates.

But since you can’t keep your hands in your pockets all day, frequent hand-sanitizing isn’t just for health-care workers or the obsessively clean anymore.

In Cranston schools, there are dispensers at most main entrances “so kids can get a shot of hand sanitizer on the way in and on the way out,” says Assistant School Supt. Judith Lundsten.

While visiting a school one day, she saw a principal ask a student coming out of the bathroom whether he had washed his hands. Outside of school, Lundsten says, she has seen people sanitizing their hands, too, at supermarkets, for example.

“I think it’s becoming part of the culture,” she says.

Of course, hand-sanitizing has long been common in health-care settings. It’s just become even more pronounced.

ONE DAY in late October at Our Lady of Fatima Hospital, hospital staff arriving in the cafeteria were greeted with a table with information about hand hygiene as part of International Infection Prevention Week. A TV screen showed a video of nurses dancing while rapping about clean hands. And visitors willing to write down the ways they prevent infection were rewarded with a bag of goodies — hand cleansers and trinkets promoting hand-sanitizing.

Upstairs, at the entrance to a patient floor in the medical surgical unit, a sign above a dispenser of sanitizer read, “All hands to the pump!” About 10 years ago, Fatima added alcohol-based rubs to its arsenal of hand sanitizing weapons.

At one of the hallway dispensers, respiratory therapist Gail Marrapese chatted with a coworker while they casually pumped sanitizer into their hands.

“We’ve all been going the extra step lately,” said Marrapese.

Even people visiting patients will use the dispensers “when they come on the floor,” said nurse manager Karen Torbik.

Marlene Fishman, the hospital’s director of nosocomial infection, heads Fatima’s campaign to prevent the spread of seasonal and swine flu and other diseases in the hospital. Some efforts are highly visible, such as the signs and the display on the cafeteria table, while others are more covert, such as when she walks the hallways to monitor staffers’ hand hygiene and records how well they do on her clipboard.

“The fact we are preparing for a pandemic highlights the need and the awareness,” says Fishman. The goal with hand-washing, she says, “is to make it automatic so it’s not something they think about.”