While the health hazards of increasingly competitive holiday shopping now include stampedes and pepper-spraying, bargain hunters must also guard against more mundane hazards: other people's cold and flu viruses.
Shopping centers that teem with people also teem with germs. But alcohol-based hand sanitizers and good hand washing can defeat most common microbes.
"My wife won't go anywhere without hand sanitizer in her purse. I put some into my jacket pocket. You just use those frequently when you're out and about," said Dr. William Schaffner, chairman of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn.
He said he doesn't obsess about germs, he's just "attentive to them."
Before hitting the mall, it pays to plan how you'll deal with germy hot spots:
Hand sanitizers and hand washing cannot protect you from what's floating in the air, Schaffner said. "The great hazard is being that close to so many people and being in everyone's breathing space."
"It's not too late, by any means, to get your influenza vaccine," he said. "If you're out and about, all those pharmacies are open and they would welcome your coming in and giving you your influenza vaccine.
"We live in a world that's not sterile, but what we'd like to do is be hygienic, so let's try to avoid the obvious coughers and sneezers in the crowd. Go to another counter until they've passed," Schaffner added. "If you are coughing and sneezing, put off your shopping a bit, which would be the kindest thing from a public health point of view."
If you must sneeze or cough, do so in the crook of your elbow, a technique publicized during the 2009 swine flu pandemic and mastered by lots of schoolchildren, said Dr. Jeffrey Boscamp, a pediatric infectious diseases specialist at Hackensack University Medical Center in New Jersey. You may not be doing your fellow men and women any favors if you cough into your hand because "the next thing you know, you're shaking hands."
Public restrooms can be a germ-laden nightmare, but they're also where you can wash away unwelcome microbes. Although soap dispensers and faucet handles "can be a little nasty," after being touched by people who have just done their business in the stalls, you can wash your hands thoroughly, then grab a paper towel and quickly turn off the faucet with the towel, Schaffner said.
Boscamp pointed out a bigger bathroom risk from germ-laden door handles. Even if you wash your hands, you're "at the mercy of people who don't wash theirs," he said. "Sometimes I've been crazy enough to keep my paper towel in my hand."