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Islam is a holistic belief system, and it takes into account the physical, emotional, and spiritual well-being of individuals and societies.  Although care of the person is important, safeguarding communities, including its weakest members, is of paramount importance.  More than 1400 years ago, Prophet Muhammad, may the mercy and blessings of God be upon him, was teaching his followers hygiene practices that are still applicable until the end of time.

From the traditions of Prophet Muhammad, we find evidence that clearly indicates Islam’s stance on coughing and sneezing openly.  Prophet Muhammad instructed the believers to cover their faces when sneezing. The most visible effect of sneezing and coughing without covering the mouth is the spread of airborne bacteria and viruses. Besides, droplets invisible to the naked eye may fall onto surfaces or other people.

Islam referred to as the religion of cleanliness.  “Truly, God loves those who turn unto Him in repentance and loves those who purify themselves.”  (Quran 2:222)  In the traditions of Prophet Muhammad cleanliness mentioned as half of faith. Therefore, it is important to keep the body fresh and clean, and Islam insists on several practices to facilitate this.  The private parts washed after using the toilet and Muslims must pay particular attention to being clean before praying.  They wash their hands, faces, (including rinsing the mouth and nose) arms and feet, a minimum of five times per day.  Prophet Muhammad insisted that the believers wash their hands, before praying, before and after eating and upon waking up in the morning.

Infection control in Islam includes isolation and quarantine.  Prophet Muhammad, may the mercy and blessings of God be upon him, instituted strategies that are today implemented by public health authorities.  He commanded his followers not to travel to places known to be afflicted with illness, and he advised those in the contaminated areas or communities not to leave and spread the disease further afield.  He said, “If you hear that there is a plague in a land, do not enter it; and if it (plague) visits an area while you are therein, do not go out of it.” He also counseled ill people not to visit healthy people.

During the worldwide outbreak of SARS, quarantine officials arranged for appropriate medical assistance, which sometimes included medical isolation and restricted travel movements.  The CDC says separation is necessary not only for the patient’s comfort but also to protect members of the public.  Many levels of government around the world are legally able to compel sick, infectious people to remain in quarantine or isolation to stop the spread of disease.

The teaching and principles of Islam are designed to benefit all of the humankind.  Rules and recommendations for personal hygiene and cleanliness promote the well-being of individuals and communities.  Infection control is inherent in Islamic hygiene behavior.  Washing the hands, covering the mouth when sneezing or coughing, voluntary isolation, when one is feeling unwell, and restricted travel is an efficient and comprehensive public health strategy. Nowadays, measures taken to prevent the spread of infections and viruses conform almost exactly to the hygiene and infection control practices taught by Prophet Muhammad.

Hygiene etiquette involves practices that prevent the spread of illness and disease. A critical time to practice good hygiene etiquette is when you are sick, especially when coughing or sneezing. Serious respiratory illnesses like influenza, respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS) are spread by coughing or sneezing, and unclean hands. To prevent the transmission of all respiratory infections in healthcare settings, including influenza, the following infection control measures should implement at the first point of contact with a potentially infected person. They should incorporate into infection control practices as one component of Standard Precautions.

1.Visual Alerts.

Post visual alerts (in appropriate languages) at the entrance to outpatient facilities (e.g., emergency departments, physician offices, outpatient clinics) instructing patients and persons who accompany them (e.g., family, friends) to inform healthcare personnel of symptoms of a respiratory infection when they first register for care and to practice Respiratory Hygiene/Cough Etiquette.

2. Respiratory Hygiene/Cough Etiquette

The following measures to contain respiratory secretions recommended for all individuals with signs and symptoms of a respiratory infection.

  1. Cover your mouth and nose with a tissue when coughing or sneezing. Use in the nearest waste receptacle to dispose of the tissue after use.
  2. If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands.
  3. Perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after having contact with respiratory secretions and contaminated objects/materials.

Cough etiquette is of particular important for infection control measures in healthcare settings, such as emergency departments, doctor’s offices, and clinics. Healthcare facilities should ensure the availability of materials for adhering to Respiratory Hygiene/Cough Etiquette in waiting areas for patients and visitors.

  1. Provide tissues and no-touch receptacles for used tissue disposal.
  2. Provide conveniently located dispensers of alcohol-based hand rub; where sinks are available, ensure that supplies for hand washing (i.e., soap, disposable towels) are consistently available.

3. Masking and Separation of Persons with Respiratory Symptoms

During periods of increased respiratory infection activity in the community (e.g., when there increased absenteeism in schools and work settings and increased medical office visits by persons complaining of respiratory illness), offer masks to persons who are coughing. Either procedure masks (i.e., with ear loops) or surgical masks (i.e., with ties) may be used to contain respiratory secretions (respirators such as N-95 or above are not necessary for this purpose). When space and chair availability permit, encourage coughing persons to sit at least three feet away from others in common waiting areas. Some facilities may find it logistically easier to institute this recommendation year-round.

4. Droplet Precautions

Advise healthcare personnel to observe Droplet Precautions (i.e., wearing a surgical or procedure mask for close contact), in addition to Standard Precautions, when examining a patient with symptoms of a respiratory infection, particularly if fever is present.

One final practice that helps prevent the spread of respiratory disease is avoiding close contact with people who are sick. If you are ill, you should try to distance yourself from others, so you do not spread your germs. Distancing includes staying home from work or school when possible.

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