Reducing viral contamination from finger pads: handwashing is more effective than alcohol-based hand disinfectants

Tuladhar, E.; Hazeleger, W.C.; Koopmans, Marion; Zwietering, Marcel H.; Duizer, Erwin; Beumer, R.R.

doi:10.1016/j.jhin.2015.02.019

Cited by 82 publications

(59 citation statements)

References 29 publications

(33 reference statements)

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“…Actually, hand washing with soap and the use of alcohol-based disinfectants have been proven to be efficient at removing viruses, especially respiratory ones, from artificially contaminated hands [27]. Gastroenteritis-associated nonenveloped viruses are, however, known to be more resistant to disinfection procedures [28]. Hydroalcoholic hand rub that passes the EN 14476 viral norm or specific tests is needed to kill NVs.…”

Section: Discussionmentioning

confidence: 99%

Contamination of healthcare workers' mobile phones by epidemic viruses

Pillet

Berthelot

Gagneux‐Brunon

et al. 2016

Clinical Microbiology and Infection

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Mobile phones (MPs) are potential reservoirs of nosocomial bacteria, but few data are available concerning viruses. We aimed to evaluate the presence of virus RNA from epidemic viruses including metapneumovirus, respiratory syncytial virus, influenza viruses, rotavirus (RV) and norovirus on the MPs used by healthcare workers (HCWs) and to relate it to hygiene measures. An anonymous behavioural questionnaire about MP use at hospital was administered to the HCWs of four adult and paediatric departments of a university hospital. After sampling personal (PMP) and/or professional MPs (digital enhanced cordless telephone, DECT), virus RNAs were extracted and amplified by one-step real-time reverse transcription-quantitative PCR. The molecular results were analysed in a masked manner in relation to the behavioural survey. Questionnaires from 114 HCWs (35 senior physicians, 30 residents, 32 nurses, 27 nurses' assistants) working either in adult (n = 58) or paediatric (n = 56) departments were analysed. Medical personnel used their PMP more frequently than paramedical HCWs (33/65 vs. 10/59, p <0.001). MPs were used during care more frequently in adult wards than in paediatric ones (46/58 vs. 27/56, p <0.001). Virus RNA was detected on 42/109 (38.5%) collected MPs, with RV found on 39, respiratory syncytial virus on three and metapneumovirus on one. The presence of virus RNA was significantly associated with MPs from the paediatric HCWs (p <0.001). MPs routinely used in hospital, even during care, can host virus RNA, especially RV. Promotion of frequent hand hygiene before and after MP use, along with frequent cleaning of MPs, should be encouraged.

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Section: Discussionmentioning

confidence: 99%

Contamination of healthcare workers' mobile phones by epidemic viruses

Pillet

Berthelot

Gagneux‐Brunon

et al. 2016

Clinical Microbiology and Infection

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“…This led the authors to conclude that handwashing with hand soap and water is more effective than hand hygiene with an alcohol-based product for removal of norovirus from hands. 1 Sterillium as hand rub was chosen in this study because it had shown a higher infectivity reduction of MNV1 on stainless steel discs in clean and dirty conditions compared to the ethanol-based (95% w/w) Sterillium Virugard (BODE Chemie). In our opinion, analysing the efficacy of a disinfectant against MNV1 in a carrier test is not the appropriate model because there are conflicting data for MNV inactivation by the alcohols using different test assays.…”

mentioning

confidence: 99%

Alcohol hand rub or soap and water for removal of norovirus from hands – the debate continues

Steinmann

Becker

Bischoff

et al. 2015

Journal of Hospital Infection

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“…Three representative mucus samples were selected (no. 1, 10, and 19), and the effectiveness of EBD against IAV in mucus or saline was examined using in situ inactivation tests conducted under established guidelines (finger pad protocol, ASTM E1838; hand wash protocol, EN14476) (32,33,47).…”

Section: Viruses and Cells Madin-darby Canine Kidney (Mdck) Cells Wementioning

confidence: 99%

Situations Leading to Reduced Effectiveness of Current Hand Hygiene against Infectious Mucus from Influenza Virus-Infected Patients

Hirose

Nakaya

Naito

et al. 2019

mSphere

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Both antiseptic hand rubbing (AHR) using ethanol-based disinfectants (EBDs) and antiseptic hand washing (AHW) are important means of infection control to prevent seasonal influenza A virus (IAV) outbreaks. However, previous reports suggest a reduced efficacy of ethanol disinfection against pathogens in mucus. We aimed to elucidate the situations and mechanisms underlying the reduced efficacy of EBDs against IAV in infectious mucus. We evaluated IAV inactivation and ethanol concentration change using IAV-infected patients’ mucus (sputum). Additionally, AHR and AHW effectiveness against infectious mucus adhering to the hands and fingers was evaluated in 10 volunteers. Our clinical study showed that EBD effectiveness against IAV in mucus was extremely reduced compared to IAV in saline. IAV in mucus remained active despite 120 s of AHR; however, IAV in saline was completely inactivated within 30 s. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the time required for the ethanol concentration to reach an IAV inactivation level and thus for EBDs to completely inactivate IAV was approximately eight times longer in mucus than in saline. On the other hand, AHR inactivated IAV in mucus within 30 s when the mucus dried completely because the hydrogel characteristics were lost. Additionally, AHW rapidly inactivated IAV. Until infectious mucus has completely dried, infectious IAV can remain on the hands and fingers, even after appropriate AHR using EBD, thereby increasing the risk of IAV transmission. We clarified the ineffectiveness of EBD use against IAV in infectious mucus. IMPORTANCE Antiseptic hand rubbing (AHR) and antiseptic hand washing (AHW) are important to prevent the spread of influenza A virus (IAV). This study elucidated the situations/mechanisms underlying the reduced efficacy of AHR against infectious mucus derived from IAV-infected individuals and indicated the weaknesses of the current hand hygiene regimens. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the efficacy of AHR using ethanol-based disinfectant against mucus is greatly reduced until infectious mucus adhering to the hands/fingers has completely dried. If there is insufficient time before treating the next patient (i.e., if the infectious mucus is not completely dry), medical staff should be aware that effectiveness of AHR is reduced. Since AHW is effective against both dry and nondry infectious mucus, AHW should be adopted to compensate for these weaknesses of AHR.

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Reducing viral contamination from finger pads: handwashing is more effective than alcohol-based hand disinfectants

Cited by 82 publications

References 29 publications

Contamination of healthcare workers' mobile phones by epidemic viruses

Contamination of healthcare workers' mobile phones by epidemic viruses

Alcohol hand rub or soap and water for removal of norovirus from hands – the debate continues

Situations Leading to Reduced Effectiveness of Current Hand Hygiene against Infectious Mucus from Influenza Virus-Infected Patients

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