British athletes have been warned against shaking hands with rivals and dignitaries at the London Olympics.
The British Olympic Association is concerned about illness damaging the host nation's chances of success.
Asked if handshakes should be avoided, BOA chief medical officer Ian McCurdie said: "I think, within reason, yes.
"The greatest threat to performance is illness and possibly injury. We are talking about minimising risk of illness. It is all about hand hygiene."
Around 10,000 athletes are set to take part in the Games, with British athletes set to share rooms, while eating with competitors from more than 200 other competing nations.
McCurdie added: "Being at an Olympic Games means you are normally inside a bubble and so there is effectively quite a limited number of people that you interact with when you are away in another country.
"In London we do not believe that is going to be the case. The variety of people the athletes and support staff are going to interact with is going to be huge.
"At an Olympic Games or any major event the performance impact of becoming ill or even feeling a little bit ill can be significant.
"Essentially we are talking about minimizing risk of illness and optimising resistance. Minimizing exposure and getting bugs into the system and being more robust to manage those should that happen. Hand hygiene is it."
However, with thousands of athletes and hundreds more dignitaries involved in the Olympics, it might not be easy to avoid handshakes for the duration of the Games.
"Obviously there are concerns about keeping in a tip top physical condition but [the BOA advice] does seem a bit extreme," said Liz Wyse, an etiquette adviser from Debrett's.
"If somebody extends their hand in a friendly greeting and you don't give your hand back because of hygiene concerns that could look very rude.
"It is a bid of a sad thing if people are worried about shaking hands in case it spreads disease."
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