Barbara Babkirk was at a business networking event in Freeport recently, holding a coffee cup, when an acquaintance walked up and, seeing her occupied hand, greeted her with an elbow bump.

Afterwards, both women concluded that forgoing the customary handshake made sense during a flu epidemic.

"I am surprised that (most people still) extend their hand," said Babkirk who owns the Heart At Work career counseling practice in Portland.

There's a reason for that, in the view of Godfrey Wood, chief executive officer of the Portland Regional Chamber. It's how Americans express their good will when they encounter someone.

"It's an important part of how we engage people, how we meet them," he said.

But the H1N1 outbreak, and the impending start of the seasonal flu, are testing the conventions of handshaking etiquette this fall in Maine.

In the business world, and during a gubernatorial race that seems to have half the state on the campaign trail, the custom is coming under scrutiny. Even Maine's Catholic churches are asking parishioners not to shake hands during the Sign of Peace or hold hands during the Our Father.

In our germaphobic world, a gesture meant to convey good feelings has become a death grip.

The anxiety is shared across the country.

A Fox News poll last month showed that 40 percent of Americans thought a pat on the back was a good substitute for a handshake. A smaller share would go with a fist bump, a greeting popularized by President Obama.

Hands can easily carry the flu virus, said Dr. Dora Anne Mills, Maine's public health director. Often warm and moist, palms can keep the virus alive for as long as eight hours.

But hands aren't the real problem. It's when someone touches their eyes, nose or mouth with their hands. So if you shake hands, Mills said, keep your hands away from your face until you can wash them.

"We haven't stopped shaking hands at the Maine Center for Disease Control," Mills said. "But we do have a lot of hand sanitizer around."

The origin of handshakes is in dispute. One thought is that knights in medieval times would extend open hands to show they weren't carrying weapons.

Different styles have evolved in different cultures. But experts in non-verbal communication say that touching hands can convey very personal feelings, as pressure and warmth are conveyed from fingertips to the brain.

Those feelings are important in the business world, where first impressions are critical. A handshake is so common at a business meeting, or during a job interview, that pulling away may send a message that's taken the wrong way.

"A handshake is the physical greeting that goes with your words," said Dorothea Johnson, founder and former owner of The Protocol School of Washington.

Johnson lives in Falmouth and appears as the etiquette expert on "The Ellen DeGeneres Show." She said that if people choose not to shake hands, they should put the emphasis on the health issue, not on themselves.

"It's better to say, 'Let's not shake hands,' rather than, 'I don't shake hands,''' she said.

That decision can be trickier during a job interview.

Babkirk, who said she's happier with a smile and eye contact, would suggest that a client shake hands with an interviewer, then wash after the meeting.

That opinion is shared by Jim Elkins, owner of Career Planning Services in Scarborough. A handshake is so ingrained in the culture of the job interview that a client would appear rude by rejecting one.

Elkins worries about these scenarios: The interviewer tours a client around to meet other workers and managers. Does the client shake their hands?

The interviewer is a member of a minority race. Does one run the risk of offending a potential employer by not shaking hands?

The compromise recommended by Mills and others is to carry hand sanitizer, and use it. She keeps bottles in her car, purse and jacket pockets. Wood has a bottle in his car; containers of alcohol wipes are spread around his office.

Along with bumper stickers, hand sanitizer may become a must-have in Maine's race for governor, in which 21 candidates have registered.

Les Otten, a Republican candidate from Bethel, keeps wipes in his car and a bottle of sanitizer on his desk. "I'm conscious of it, but I still shake hands with everybody," he said.

Otten has already suffered a bout of conjunctivitis, the contagious eye condition.

A former part owner of the Boston Red Sox, Otten sometimes wears his World Series ring and lets kids try it on while he's campaigning.

"I'm sure that's how I got pink eye," he said.

Like many Mainers, Otten is frustrated about the vaccine shortage that has prevented him from getting a seasonal flu shot. He tries hard not to touch his face after shaking hands, until he can wash.

"I'll do my best to prevent it," he said, "but I'm almost resigned to it. And if I do get the flu, there's a bunch of DVDs I haven't watched, and I'll be home doing that."