A sneeze is a rapid, involuntary reflex action designed to forcefully expel foreign particles or irritants from the nasal passage and respiratory tract. This expulsion of air is the body’s natural defense mechanism, often triggered by dust, allergens, or infectious agents. Because the explosive nature of the action can propel droplets at high speeds, improper technique significantly impacts public health. Understanding the correct method for containing this expulsion is a clear step everyone can take to minimize the transmission of germs.
Essential Sneeze Technique
The primary goal of covering a sneeze is to contain the infectious aerosol droplets forcibly ejected from the nose and mouth. Using a disposable tissue is the most effective method, as it creates a physical barrier that can be immediately discarded. The tissue should cover both the mouth and the nose completely to trap the expelled air and mucus.
When a tissue is not available, the best alternative is to sneeze into the inside of the elbow, often called the “vampire sneeze.” This method is superior to using a bare hand because the elbow makes minimal contact with other people or common objects. Directing the sneeze into the upper sleeve or crook of the arm traps the majority of droplets on fabric, which is less likely to transfer pathogens than a hand.
Covering the mouth and nose with a bare hand is ineffective and harmful. Germs are simply transferred to the hand, where they are easily spread to surfaces like doorknobs, phones, and other people upon contact. Regardless of the covering method used, always turn your face away from others before sneezing to direct the expelled air away from nearby individuals.
The Dangers of Suppressing a Sneeze
The urge to suppress a sneeze by pinching the nose or tightly closing the mouth should be avoided due to the significant internal pressure generated. A typical sneeze naturally builds pressure in the respiratory system, and holding it in can increase that pressure by a factor of 5 to 24 times. This redirection of force can lead to unexpected physical harm.
The high pressure has nowhere to escape and is instead forced into connected internal cavities, particularly through the Eustachian tubes that link the nose and middle ear. This can cause a temporary spike in pressure, potentially resulting in a ruptured eardrum. The sudden force can also lead to the rupture of small blood vessels in the eyes or face, causing temporary redness or bruising.
The sudden pressure from a suppressed sneeze has caused laryngeal injuries or even a small tear in the throat in documented cases. Holding a sneeze can also force infected mucus back into the sinuses, potentially leading to congestion or a secondary sinus infection. The safest action is always to let the sneeze occur, using the proper technique to contain the droplets.
Hygiene and Cleanup Protocols
Immediately following a sneeze, the focus must shift to eliminating contamination and preventing secondary spread. If a disposable tissue was used, it should be placed directly into the trash. Tissues should never be left on surfaces or reused, as they are a concentrated source of expelled pathogens.
Regardless of whether a tissue or the elbow was used, hand hygiene is essential. Handwashing with soap and clean, running water should last for at least 20 seconds, covering the backs of the hands, between the fingers, and under the nails. This ensures the physical removal of any residual germs that may have contacted the hands.
If soap and water are not accessible, an alcohol-based hand sanitizer containing at least 60% alcohol should be used as an alternative. Any immediately surrounding surfaces that may have been contaminated by errant droplets—such as a desk, phone, or keyboard—should be wiped down with a disinfectant cleaner. Regular cleanup of these high-touch areas reduces the opportunity for germs to spread.