[crpatino]

Even in US settings, compliance with basic hygiene protocols may be below 50% [1]. This happens mostly in overcrowded facilities where personnel has been cut to run at or near capacity most of the time.

The most salient factor is indirect contact. Health care workers are aware that they must wash their hands after having contact with a sick patient, but it is extremely hard to remember to take similar steps after touching any surface such patient might have touched himself, even if it looks clean to the bare eye.

[1] http://prosperouswaydown.com/ebola-game-changer/

[ghshephard]

" Health care workers are aware that they must wash their hands after having contact with a sick patient"

Take that a step up - Health Care workers must wash their hands after having contact with any patient and before touching any patient (and themselves for that matter).

http://www.cdc.gov/features/handwashing/

It takes 20 seconds, and is probably one of the most effective ways of preventing the spread of various infections/diseases.