It's an idea that makes intuitive sense. After all, that firm grasp of a business contact's hand can convey more than a friendly greeting or a sign of respect. Those foreign fingers could be coated with microbes waiting to hitch a ride on your own.

Next stop: the vulnerable mucous membranes in your nose or mouth, or surrounding your eyes. Perfect portals for viral invasion.

"There's no question a lot of viruses - flu viruses, cold viruses - can be transmitted on hands. No question about it," says Dr. Andrew Simor, an infectious diseases expert at Toronto's Sunnybrook Health Sciences Centre.

But just because it can happen, does that mean it actually does? And how often? How much does hand-to-hand contact contribute to the spread of influenza and the bugs that cause what we call the common cold - rhinoviruses, human coronaviruses, respiratory syncitial virus and others?

Odd as it may seem, the science on this isn't well charted. Despite the fact that these viruses predictably inflict illness on a fair slice of the population year after year, scientists aren't clear what part of spread is attributable to which behaviours.

Does sneezing without covering the mouth spread germs more effectively than sneezing into a hand or sleeve? Is touching a bus pole more of an infection risk than gripping an extended hand? Would wearing gloves all season guarantee a cold-and-flu free winter?

No one knows.

Infectious diseases experts admit they haven't got enough proof to mount a campaign to halt the handshake. And they aren't ready to go into battle unarmed.

"We're talking about major cultural change without understanding what the impact is," says Dr. Allison McGeer, head of infection control at Toronto's Mount Sinai Hospital.

"And there's two ways of looking at it. The first is to say: 'Hey, you know, if we touched elbows (instead), would that be a problem?' And I think most people would agree it's probably not a problem. And so you could just say: 'Go for it, let's do it, it might help."'

"And the opposite thing is: Well, you know, maybe there's something about physical contact that's valuable and useful and kind of human. And should we really be making discussions about removing human contact - which many of us think is a problem anyway in cities and big organizations - when we don't know if it's going to make a difference?"

Simor isn't convinced it would.

"Common practice in Oriental countries like Japan is not to shake hands but to bow. I'm not aware that they have any lower rates of influenza and common colds," he notes.

Dr. Michael Osterholm thinks cultural rites like shaking hands are too deeply engrained to be cast off to protect against illnesses many people still view as a minor irritants.

That balance might shift in a flu pandemic, but for now, "the juice is not worth the squeeze," says Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

"I don't think people would comply with it. We could recommend it until we're blue in the face. I just don't think people perceive it to be a big risk with regular flu or cold season. So I don't think it's a practical issue."

Toronto's Roman Catholic archdiocese proves that point.

During the SARS outbreak, churches were instructed to suspend the practice of having parishioners shaking hands during the mass to show a "sign of peace." But when the crisis passed, handshaking resumed.

And churches are not encouraged to alter the practice during cold-and-flu season, said Neil MacCarthy, director of communications for the archdiocese.

Even within public health circles, the tradition could be hard to break. Osterholm attended a professional meeting last winter while in the throes of a nasty headcold. He declined to shake hands with colleagues to lower their risk of catching his bug.

"And it took many of them aback. At the same time it was interesting because after they thought about it for awhile, they thanked me. But it was so foreign to them."

As for bumping elbows - the occasionally suggested alternative to the handshake - Osterholm sees that as a non-starter.

"I think it's a very logical public health message to extend to the public but I don't think that dog will hunt."

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Some ideas from infectious disease experts about minimizing the risk of getting colds and flu during the winter season.

Cheek kissing - Giving friends a peck on the cheek as a greeting isn't likely to be a big risk, says Dr. Andrew Simor. Buss away!

Communion - The common cup in church is a potential source of infection, says Dr. Michael Osterholm. "That is as close to swapping spit with an entire community as I can know."

Shaking hands - The jury is out on this one. Says Dr. Jeffrey Duchin: "It couldn't hurt to stop shaking hands. It certainly is something that might help. But no one can tell you how much it might help or if it would make a big difference ultimately."

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