In the small chapel at Christ Church in Andover, a bottle of hand sanitizer sits next to the hosts and wine to be distributed at Communion.
The image might seem odd, but it's becoming more and more common in churches and synagogues throughout the Merrimack Valley and Southern New Hampshire, as houses of worship take extra precautions to prevent members from catching or spreading the H1N1 virus.
"People who are the most vulnerable are the ones confined to close spaces, and church is one of those places," said the Rev. Jeffrey Shilling-Gill, pastor at Christ Church in Andover.
Shilling-Gill and the Rev. Adam Shoemaker use hand sanitizer before going to the altar to celebrate the Eucharist at Christ Church. They repeat the process before giving out Communion, and again before dismissing the faithful after the liturgy.
At the church's main sanctuary, there are two bottles of hand sanitizer on the altar, and one by the choir loft, in the kitchen, in the rest rooms and at the entrance of the church.
The Archdiocese of Boston and the Catholic Diocese of New Hampshire have instituted precautions following recommendations from the Department of Health and Human Services. They include covering your mouth and nose when sneezing, cleaning your hands with soap often and staying home when you are sick.
What congregations should do during the flu season was even discussed during the Evangelical Lutheran Church of America bishop's convocation in Worcester last week.
The Rev. Barbara Reifschneider, pastor of Redeemer Lutheran Church in Lawrence, has been ahead of the trend. She has been using hand sanitizer for the past two years. She said most of her parishioners are elderly and she didn't want them to get sick due to the spread of germs.
News reports of increasing cases of H1N1, or swine flu, have made people more aware of their hygiene, said Rabbi Robert S. Goldstein of Temple Emanuel in Andover.
Before the High Holy Days of Rosh Hashana and Yom Kippur in September, Goldstein had antibacterial bottles installed throughout the temple.
"As the rabbi, I encourage people to take care of themselves and stay home (if they're sick)," he said. But he said he has not seen a drop in attendance or less physical contact between people.
Goldstein said he still shakes hands with members as they leave the synagogue after sabbath services Friday night, Saturday morning and Saturday night.
"Personally, I'm much more careful," he said. "I use antiseptic lotion before and after shaking hands with people. I never used to do it, but now do it."
Ministers said the fear of spreading the swine flu is mostly for children, the elderly and young adults who are in college and attend worship services when they come home.
At Groveland Congregational Church, the Rev. Lance C. Dallaire, pastor, said hand sanitizer is located at the entrance of the church, in the kitchen, in the fellowship hall, in all Sunday school classes and in the four restrooms.
Dallaire also sent a note home to the church's 350 families asking them to stay home if they or their children are not feeling well.
"It's for the concern of public safety and health," he said. "We have to be proactive in preventing the spread of germs."
At most churches, there is a portion of the service when attendants wish each other peace, typically accompanied by a handshake. That, too, is changing because of the fear of spreading the flu.
During the passing of the peace, Shilling-Gill of Christ Church in Andover has told parishioners not to worry about offending people by not shaking hands. Instead, he said members should bow to one another, smile, nod or verbally wish "Peace be with you."
"Perhaps a fist or elbow bump if you want to be really cool about the whole thing," he wrote in the church newsletter.
The Rev. Robert Murray of St. James Church in Haverhill suggests a friendly wave or a head nod.
Dallaire said he has made similar comments to members of Groveland Congregational Church.
"There are times when saying hello verbally, waving your hands and even a smile will substitute a person to person contact so that we don't spread germs," he said.
New Hampshire has taken the same approach. The Catholic Diocese of New Hampshire is asking that the sign of peace be shared without touching hands or kissing, by meaningful eye contact, smiles, and a bow of the head in reverence to one another.
Another tradition shared by Christians that has been affected by the swine flu scare is the taking of the bread and wine during Communion.
At Christ Church, Shilling-Gill asks that people dip the host into the wine instead of drinking directly from the cup, as is usually done.
The Catholic Diocese of New Hampshire recommends that parishioners should receive Communion in their hands, and not on their tongue. And it says wine should not be distributed at all.
The Rev. Robert Murray of St. James Church in Haverhill recently wrote about the swine flu regulations in the church bulletin after several parishioners asked him about it.
Although the Archdiocese of Boston has not issued an official policy like the Catholic Diocese of New Hampshire, Murray said common sense is key.
Those attending services with a cold or a flu should not drink from the cup, he said.
"We receive the fullness of the symbol of Holy Communion when we receive from both species, but we receive the full grace of the Eucharist whether we share in the cup or the bread only," Murray wrote in the bulletin.
Dallaire said Groveland Congregational Church parishioners have been very supportive and understanding of the new policies.
"We take it from scripture, the gospel and common sense, which is a gift from God," he said.
Symptoms of H1N1 or swine flu
Fever over 100 degrees
Head and body aches
Diarrhea and vomiting
Severe illness, pneumonia and respiratory failure
Source: New Hampshire Department of Health and Human Services
Category: Public Health