Americans know how to protect themselves when they hear about an outbreak of the flu. According to a national survey, in response to a flu virus sweeping the country, 66 percent of adults wash their hands more thoroughly or more frequently.

The findings are from the fifth annual Healthy Hand Washing Survey conducted by Bradley Corporation, a leading manufacturer of commercial hand washing products.

However, the survey also reveals most Americans could use a gentle reminder to continue lathering up for a full 20 seconds since 55 percent wash up for just 15 seconds or less. The Centers for Disease Control and Prevention suggests singing “Happy Birthday” twice to allow enough time to remove and rinse off germs.

“Good hand hygiene is one of the most important and easiest things people can do to reduce the risk of getting sick and spreading germs to others. Using soap and warm water for a good 20 seconds is highly effective in removing bacteria, viruses and other disease-causing microorganisms from the surface of the skin,” says medical microbiologist Michael McCann, Ph.D., a professor of biology and associate dean of the College of Arts and Sciences at Saint Joseph's University in Philadelphia.

The survey also shows that Americans go to great lengths to avoid coming into contact with germs in a public restroom. They commonly operate the toilet flusher with their foot (64 percent); use a paper towel when touching the restroom door (60 percent); open and close doors with their behind (48 percent); and use their elbow to avoid touching anything with their hands (39 percent).

The Healthy Hand Washing survey queried 1,015 American adults (18 years and older) about their hand washing habits.