Statistics indicate that washing hands with soap and water is the most effective step in flu prevention. That said, soap and water isn't always available, which is where hand sanitizers come into play. However, according to WebMD reporting, a recent study found that staff in long-term care facilities who relied too much on hand sanitizers over hand washing actually reported more outbreaks of norovirus-related illness.

Experts address some of the most commonly asked questions pertaining to flu prevent and soaps and sanitizers.

What is the active ingredient in hand sanitizers?
Hand sanitizers have a form of alcohol, such as ethyl alcohol, as an active ingredient. It works as an antiseptic. Other ingredients may include water, fragrance, and glycerin.

Which bugs can hand sanitizers prevent?
"Alcohol-based hand sanitizers are clearly a very useful and important method to prevent most bacterial and viral infections, with rare exceptions," says Aaron E. Glatt, MD, executive vice president of Mercy Medical Center, Rockville Centre, Long Island, N.Y. He is a spokesman for the Infectious Diseases Society of America.

Hand sanitizers won't work, he says, against the infection caused by C. diff.

What about the study finding more norovirus outbreaks with use of hand sanitizers?
In the study, published in the American Journal of Infection Control, CDC researchers looked at the use of hand sanitizers by the staff in 91 long-term care facilities. In those where the staff were equally or more likely to use the hand sanitizers over soap and water for routine hand hygiene, the chance of an outbreak was nearly six times greater.

"It's one study,” says Glatt.

More research is needed, he and other experts say.

So, is handwashing better than hand sanitizers to prevent infection spread?
Both are important, say Glatt and Brian Sansoni, spokesman for the American Cleaning Institute.

"Soap and water are number one," says Sansoni. "Hand sanitizers are a very effective additional tool." The sanitizers are meant to supplement, not replace, good old-fashioned soap and water washing, he says.

What is the best way to wash hands?
Proper hand washing involves ''20 to 30 seconds of vigorous scrubbing with soap and warm water,” Glatt says. “It's the physical rubbing that does a lot of the work. But the soap is important."

What is the best way to use hand sanitizers?
To use hand sanitizers properly, use one or two squirts or pumps, Sansoni says. Rub hands together briskly, front and back, between fingers, around and under the nails, until hands are dry.

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