“Hand Shaking, Mezuzah Kissing, and Double Dipping – time for a public health announcement”

So how did this shiur title come about? I was standing at Kiddush observing what I am sure many of you have observed, the art of double dipping. For those that do not know, this is when one takes an object (usually a cracker) and dips it in the hummus (or other dip) bites the object and then proceeds to dip that object (bitten side) back into the dip (thus the double dip). Maybe this time was the time that broke the camels back, as I was so angry and disgusted, I thought to myself there must be some sources on this that I can research and make into a shiur. I am not sure if we can call this a shiur proper, but more a collection of random sources and hopefully some food for thought.

1) The Life Of Poo by Professor Adam Hart

“Observations in 2003 found 39 per cent of women and 63 per cent of men did not wash their hands after using a public toilet.

As a result Professor Hart, from Gloucestershire University, warned that we should think twice about shaking people’s hands, to avoid the spread of germs.

He said: “Poor hand hygiene is a major cause of all food-borne illness outbreak, yet very few of us wash our hands properly, while almost none of us do so on a regular basis.

From a young age I was taught (by my mum) that people do not wash their hands when they leave the toilet – which I can confirm I personally witnessed on many an occasion myself. I think this is where the ‘minhag’ of having ‘builders mugs’ comes from (hands up guilty people). This always left me with a fear regarding the hygiene of people’s hands, especially after a Shabbat morning shaking 150 hands in shul after which you find yourself eating finger foods at the Kiddush. Whatever happened to that excellent reputation for hygiene that served the Jewish people so well during the bubonic plague in the middle ages?

2) BBC ARTICLE ON HANDWASHING

In 2002 my Zaida passed away in the Royal London Hospital. He had fallen over at home and broken a bone. Whilst in hospital he contracted MRSA and died after a short illness. This death was entirely preventable.

Hand hygiene campaign ‘cut superbug infections’

4 May 2012

The campaign to improve hand hygiene in hospitals in England and Wales contributed to a significant fall in the rates of superbug infections, according to a report.

The study published on the BMJ website showed the amount of soap and hand gel being used tripled during the campaign.

At the same time, levels of MRSA and C. difficile infections in hospitals fell.

The government has since dropped the campaign, but said its ambition was to “wipe out” such infections.

Hospital superbugs were once a real fear for many patients. In response the Clean Your Hands campaign , funded by the Department of Health, was introduced in all hospitals by June 2005.

Alcohol gels were put by bedsides, posters reminded staff to wash their hands and there were regular checks to ensure hands were kept clean.

By 2008, the total amount of soap and alcohol gel being purchased by hospitals trebled, going from 22ml per patient per day to 60ml per patient per day.

Rates of MRSA more than halved in the same time period and C. diff infections fell by more than 40%.

‘Success story’

One of the report’s authors, Dr Sheldon Stone from the Royal Free University College London Medical School, estimated that around 10,000 lives were saved because of the campaign.

He told the BBC: “It’s been a real British success story, we’ve gone from being the dirty man of Europe to being world leaders.

“What we need to do is keep up the momentum and stay at the forefront of world hand hygiene.”

A spokesman from the Department of Health said: “The Clean Your Hands campaign was successful in its aim to highlight the importance of good hand hygiene practice across the NHS. We know this has been successful.

“The challenge now is to ensure the NHS embeds the good practice highlighted in the campaign to achieve our ambition to wipe out avoidable healthcare-associated infection.

  • “We know real progress has been made in this area as MRSA bloodstream infections have dropped by 41% and C. difficile by 30% across the NHS in England since 2009/10.”

3) EMAIL FROM SHUL IN BEIT SHEMESH NOVEMBER 2015

Which brings me to my next source. An email sent to a community in Israel in 2015.

The context of this email is actually quite sad as it related to one particular member who was undergoing a treatment that left their immune system weakened and it would be dangerous for them to catch flu or winter bug. On this particular Friday night the queue to fist bump the Rav was rather large on the Friday night and was followed by lots of laugher. The email request went unheeded.

From:

Date: 2 November 2015 11:39:19 am GMT+2

Subject: Special – A recommendation regarding handshaking from some healthcare professionals

We would like to make a recommendation to refrain from handshaking.

It’s known and PROVEN  that germs travel quickly through hand to hand transmission. The Centers for Disease Control and Prevention estimates 80 percent of all infections are transmitted by hands.

People are already infected with viruses, and it is only going to get worse as the winter progresses. For some individuals that could mean catching a bothersome cold that may linger for days; for others (elderly, immune compromised), it could be quite serious and lead to (ch”v) serious illness.

It is wonderful that we have customs that engender camaraderie such as shaking hands (for greeting ‘shabbat shalom’, acknowledging ‘yasher koach’), but we can find creative ways to express friendship and warmth without spreading (potentially dangerous) germs. For example, replacing handshakes with “fist bumps” showed 90% reduction in hand-to-hand bacterial transmission.*.

Raising awareness regarding transmission of disease will help. Frequent hand washing can help curb the spread of flu and other conditions (we should always have antibacterial soap available at washing stations, and possibly investigate installing purell-type gel dispensers)

By having people refrain from handshaking, we can at the very least be a part of the solution to prevent spread of illness, and at best, actually improve public health in our community.

Thank you

Concerned members and health professionals

http://www.apic.org/Resource_/TinyMceFileManager/Fist_bump_article_AJIC_August_2014.pdf

Mela and Whitworth*, “The fist bump: A more hygienic alternative to the handshake.” American Journal of Infection Control, August 2014.

The non-members of our shul do not feel it is appropriate to be signees, but all of the following people have reviewed, agreed with, and encouraged this position.

Dr. M B

Dr. M G

Dr. S G

L L, CNM

*******************

Dr. H A

Dr. R S

4) Ilan Youngster et al, “Can religious icons be vectors of infectious diseases in hospital settings?” American Journal of Infection Control 37 (2009): 861-3.

Nosocomial infections are of great concern in hospital settings. Health professionals and their medical equipment have long been known to act as vectors of infectious diseases. Even though tremendous resources are allocated to infection control, an estimated 5% to 10% of hospitalized patients acquire a nosocomial infection, resulting in approximately 120,000 deaths yearly in the United States alone, totaling 4.5 to 5.7 billion US dollars in additional patient care costs. A recent report estimated that 25% of patients on the pediatric ward acquire a nosocomial viral infection during their hospital stay. Numerous studies have been published trying to assess the relative importance of different objects in the hospital environment as vectors of infectious diseases. Cultures taken from stethoscopes, othoscopes, blood pressure cuffs, hands, and even physician’s ties have all revealed highly pathogenic flora. Accordingly, most medical personnel are aware of the importance of disinfecting these items. Even though the Mezuzah is touched and even kissed by a large part of -patients and visitors in Israeli hospitals, to the best of our knowledge, its role as a fomite has never been evaluated.

facts

Of the 10 members of the cleaning staff interviewed, only 1 reported ever cleaning the Mezu- zah prior to the interventional program. The most common explanation for avoiding the Mezuzah during the daily cleaning routine was that, being a religious artifact, the staff believed they were not allowed to clean it, or they were afraid of ruining it.

5) Rabbi Dr. Ari Zivotofsky on OU.org Jewish Action Reader “Tzarich Iyun: Kissing the Mezuzah”

First a random story about mezuzah that I found quite funny:

During a shiur he once gave in Beit Shemesh, Rabbi Dr. Abraham J. Twerski quipped, “I see people enter a room, kiss the mezuzah and then watch TV for a half hour. I would rather they kissed the TV and then watched the mezuzah for a half hour.”

FACT: There is no Talmudic source obligating one to kiss the mezuzah, although there may be a source for touching the mezuzah. Kissing the mezuzah seems to have been introduced by the Arizal (sixteenth century), and is thus a relatively recent custom

(BT Avodah Zarah 11a)

Onkelos the son of Kalonymus became a proselyte. The emperor sent a contingent of Roman [soldiers] to pursue him, but he enticed them by [citing] Scriptural verses, and they converted to Judaism…. The Emperor then sent another Roman cohort….they seized him and were walking, Onkelos saw the mezuzah affixed to the doorway. He placed his hand on it and asked them, “What is this?” They said, “You tell us.” Onkelos replied, “The universal custom is a mortal king dwells within and his servants keep guard over him from without; but with the Holy One, Blessed be He, His servants dwell within while He keeps guard over them from without, as it says, ‘Hashem yishmor tzetcha u’vo’echa me’atah v’ad olam’ (Psalms 121:8). They too converted to Judaism. He [the emperor] sent for him no more.

The Rema in Darkei Moshe (YD 285), citing the Maharil, mentions the Onkelos story as the basis for the custom of touching the mezuzah. Note that while Onkelos touches the mezuzah, there is no mention of him kissing it.

There are many 20th century sources quoting this minhag of kissing the mezuzah. Chovat Hadar—citing the Chida who quotes the Arizal—states that one should kiss the mezuzah by placing one’s middle finger over the word Shakai, then kiss that finger and pray to God to be protected from the yetzer hara (Rabbi Yaakov Yeshaya Blau, 1976; p. 14)

Despite the wide spread custom, many authorities disagree with it Rabbi Yosef Eliyahu Henkin in Eidut Le’Yisrael (p. 159) objects to kissing the mezuzah (and sefer Torah) with one’s mouth or even with a cloth (and most likely with one’s hand as well). Instead he prefers the Sephardic, or more accurately, the Georgian (Soviet) custom of pointing and “blowing” a kiss. He offers two reasons for this. Firstly, he feels that kissing implies too much familiarity, a level of closeness that one cannot purport to have with a Torah or a mezuzah. Secondly, he opines that kissing a mezuzah even via one’s fingers or hand spreads germs, a hygienic-based halachic problem mentioned in Shulchan Aruch, OC 170:15.

6) Voz Iz Neias Website: Bnei Brak – Fearing Germs, Ger Rabbi Discontinues Mouth to Mouth Drinking from Rebbe’s Cup

 Here is a news source that confirms a practical application of the above discussions regarding handshaking and hygiene.

Rabbi Yaakov Aryeh Alter, current rabbi of the Hasidic dynasty of Ger, instructed his disciples in Jerusalem a few weeks ago to toast with individual and disposable plastic cups containing a few drops of wine from the rabbi’s own glass.

Hasidic Jews have toasted from the same cup at events and meals for at least 200 years.

Yeshiva students who recently came from the United States and sought to meet the rabbi were asked by his aides not to shake the rabbi’s hand when they see him in his Bnei Brak home.

A popular story about the rabbi’s grandfather, Abraham Mordechai Alter – the dynasty’s second head and a prominent writer and authority – says that when he visited Israel in the early 1900s, he rebuked a man who hesitated about drinking from the communal glass of wine.

“A hundred Jews sipped from this glass, and yet you think the wine isn’t clean enough,” the popular legend quotes him as saying

7) Shmiras Shabbas 48:11 vs Rav Shlomo Zalman Auerbach on Kiddush cup sharing

On a related subject, I remembered studying some years ago in the Ben Ish Chai that when making Kiddush if the guests round the table would be disgusted by sharing a cup then the baal habayit should pour out the wine into smaller cups before tasting from the cup. Unfortunately, I could not pin point that source however Rabbi Solomon found me these:

js 

Yalkut Yosef 271:38

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Conclusion

I think there is a degree of sensitivity here, obviously these issues will bother some of us more than others. However I think we can work towards improving hygiene in general, such as having anti-bacterial gels at Kiddush tables. When you think about a community as a whole, there are vulnerable groups within it such as the elderly and little babies who are more susceptible and perhaps we could do more to ensure they are protected as best can be. Let’s make sure our cleaners are cleaning the mezuzot. Let’s make sure we wash our hands after the toilet and train our children too also. Coming back to double dipping, in Pirkei Avot we are enjoined to do things that are perceived by others in a positive light, let’s try and be more sensitive to each other and try not to do things that may disgust others.

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