Objectives: To examine how the frequency of information regarding a real disease threat influences hand washing with soap. Design and setting: The authors installed wireless devices in highway service station lavatories in England to record the proportion of individuals washing hands with soap from May 2009 to January 2010. Participants: Participants were users of men's and women's toilets. Combined there was an average of 6800 participant entrances into the lavatories daily. Primary outcome measure: The primary outcome measure is the proportion of soap usage to the number of entries into the lavatories. Results: Hand-washing rates were positively related to both H1NI coverage in blogs and the news; however, these relationships were stronger for men than for women. Conclusions: Hand washing with soap increases proportionally to the frequency of media key words related to H1N1. Women's hand washing was more strongly associated with incidence of media keywords than men's.