You're about to sneeze. Quick! What should you do? The conventional wisdom seems to be that you raise your upper arm to cover your nose and mouth, a maneuver known as the "Dracula sneeze."

But here's the problem. Coughing or sneezing into your sleeve seems, well, kinda nasty.

And there is this: Earlier this month, after Health and Human Services Secretary Kathleen Sebelius chided a reporter for sneezing into his hand at a news conference, conservative talker Rush Limbaugh weighed in.

"Elitist snobs advising us to sneeze on our arms," Limbaugh called Sebelius and her ilk, who apparently want us all to become "hick hayseeds."

Limbaugh may have been joking – and we must point out that sneezing into your shirt is different than wiping your nose with it. It's true, though, that Sebelius and public health officials advocate the Dracula sneeze.

Last week, ah-choo etiquette became an issue at a Kansas City, Mo., City Council committee meeting. Councilman Russ Johnson leaned away from his colleagues and sneezed noisily into the air. Councilwoman Sharon Sanders Brooks, sitting next to him, scowled and shifted away, pantomiming that Johnson should cover his sneezes with his elbow.

Most schoolkids have already been indoctrinated. For many adults, though, it's a matter of re-education. "Now whenever I cough or sneeze, it's always in my elbow," said Kansas City Health Department spokesman Jeff Hershberger.

"We discovered a really valuable product," said etiquette expert and author Lizzie Post. "Its brand name is Kleenex, and they make pocket tissues.

"If you're dressed really nicely, slip a couple of tissues into your pocket or purse, and take them out if you need to. It also prevents you from doing the cough or sneeze into your elbow."

Post might be on to something. On the Prepare Metro KC disaster preparedness Web site (www.preparemetrokc.org), "Cover your mouth and nose with a tissue" is the first recommendation. (Then throw the tissue away and wash your hands or use sanitizer.)

The second recommendation: "If a tissue is not available, cough or sneeze into your sleeve instead of on your bare hands." If you have a cold (or worse) and you sneeze into your hand, you're likely to touch things other people will touch. They will touch their own eyes, ears and mouths. Then they could get what you have.

Comedian Kelly Urich said he was approaching Howie Mandel germophobe status: "I do sneeze into my hand to prevent spreading germs, and I immediately Purell my hands."

Jeanette Hernandez Prenger has a different approach. If she can't grab a handkerchief in time, she will bring the back of her hand and wrist up to her face, "so I don't look like a hillbilly." Sneezing into a sleeve is "gross," she said.

With her method, she can wash her hands immediately and not mess up her outfit, said Prenger, president of Ecco Select in Kansas City, a staffing agency.

And hand-washing is important.

"Our hands are the biggest culprits when it comes to spreading these types of viral infections," said Nina Shik, director of nursing practice and clinical excellence at the University of Kansas Hospital.

She, too, has had to retrain herself to sneeze into her sleeve.

But "I wear a lab coat, which is really easy to wash," Shik said. "If I was wearing silk or something that needs to be dry-cleaned, that might be a problem."

But not as big a problem as catching the flu. Even Dracula knows that.