LONDON , England -- Two kisses on the cheek or three ? The age-old dilemma may become moot as worries of infectious disease hang in the air . A couple kisses at a swine flu virus prevention and detection medical mobile unit in Mexico City . Common forms of greeting , such as handshakes and kisses on the cheek , are coming under scrutiny as the H1N1 virus , commonly known as swine flu , steadily spreads around the world . In Mexico , which has had the largest outbreak of the virus , the Ministry of Health is advising people to avoid shaking hands and kissing people as a greeting . Some couples are donning surgical masks when they kiss to avoid contagion . Dr. Sanjay Gupta , CNN 's chief medical correspondent who has been covering the epidemic from Mexico , is advocating the `` el-bump , '' or bumping of elbows , as a greeting . `` It 's not as cool as the fist bump , but safer , '' he wrote on micro-blog site Twitter . Follow Dr. Gupta 's 'tweets ' Dr. Richard Dawood , medical director of the Fleet Street Travel Clinic in London , refers to the shift in etiquette as `` social distancing . '' `` People do n't want to get too close . There is going to be a move towards less handshaking , less greeting people with a kiss . There may well end up being fewer meetings , '' he told CNN . The World Health Organization is advising people to practice preventive measures like avoiding close contact with people who appear unwell and those who are coughing and have a fever . The global health agency is also directing people who live in areas where flu cases have surfaced to follow additional precautions set out by their national and local health authorities . Even countries where the virus has n't been confirmed are taking precautionary measures . At a news conference earlier this week , Lebanon 's health minister recommended that people stop using the conventional greeting of three kisses to the cheek . See where cases have been confirmed » . `` We 're heading toward a world where everyone is going to be suddenly much more conscious of those who are coughing and sneezing , '' Dawood said . People will have to be much more conscious of hygiene and stay out of close proximity with others when they are n't feeling well , he said . Are you changing your etiquette because of the swine flu epidemic ? Tell us in the SoundOff below . The H1N1 virus is a hybrid of swine , avian and human flu strains . It is a respiratory disease that is contagious , and believed to be spread through coughing , sneezing and close contact . Learn more about the virus » . Since the outbreak surfaced in Mexico , it has spread to at least 11 countries . The number of confirmed cases has reached 331 , with the hardest hit areas in the western hemisphere , the WHO said Friday . People tend to be scared of what they do n't understand , especially when it comes to disease , Dawood said . Watch Dr. Gupta report on a new scientific discovery about the virus » . He worries about how people will react as tensions rise . People historically have resorted to socially ostracizing those who have suffered from diseases like typhoid and leprosy , he noted . The flu outbreak will pose another test . `` Hopefully we do n't see that again . We will have to control our urges in our relations to other people , '' Dawood said .
Move towards 'social distancing ' as people worry about swine flu epidemic . Mexico 's Health Ministry directing people to avoid handshakes and kissing . Comment: Follow CNN 's Dr. Sanjay Gupta on Twitter .