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Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers - ECDC Health Content

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  • Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers - ECDC Health Content

    Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers - ECDC Health Content
    Scientific Advances Pandemic and Seasonal Influenza

    Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers

    M. Lindsay Grayson,Sharmila Melvani,Julian Druce,Ian G. Barr,Susan A. Ballard,Paul D. R. Johnson,Tasoula Mastorakos and Christopher Birch. Clinical Infectious Diseases 1 February 2009, Vol. 48, No. 3: 285-291.

    This article can be found here.

    Description:
    This paper describes experiments undertaken to compare the effectiveness of different routine hand hygiene protocols (hand washing) in inactivating influenza viruses. The study employed twenty vaccinated, antibody-positive volunteer health care workers who had their hands contaminated with 1 ml of tissue culture infected with live human H1N1 influenza virus before undertaking 1 of 5 different hand hygiene protocols.

    These were: a control (no hand hygiene), a protocol based on washing with soap and water and three alcohol-based treatments with increasing degrees of alcohol concentration.

    The concentrations of influenza A(H1N1) virus on the hands of the patients as well as the natural viability of H1N1 on hands for more than 60 min without hand washing protocol were calculated before and after each treatment by means of viral culture and quantitative real-time reverse-transcriptase polymerase chain reaction (PCR).

    The results of the study found that there was a rapid reduction in culture-detectable and PCR-detectable A(H1N1) after a short (2 minute) period of cutaneous air drying alone. After which 6 out of 20 subjects had no viable H1N1 recoverable. There was also little further reduction in detectable H1N1 virus after 60 min. without washing. The antiviral efficacy for all 4 hand washing protocols was high with all four hand-washing protocols. All succeeded in making virus non-culturable. When looking at the PCR results the washing protocols did not eliminate all virus but they drastically reduced the amounts.

    Washing with soap and water was statistically superior to the three alcohol-based treatments, although the difference was small.

    The authors concluded that both soap and water and alcohol-based hand-rub were highly effective in reducing Influenza virus on human hands with soap and water marginally the most effective.

    ECDC Comment (15/01/2009):
    This is a reassuring finding that both soap and water and alcohol based wipes, if well used, will reduce the risk of influenza transmission through hands. The fact that some influenza virus was detectable through PCR does not necessarily mean that infection risk persists. PCR techniques will detect very low virus levels and non-viable viruses. The fact that both hand washing with soap and water an alcohol wipes was effective was important. This is because there are circumstances where alcohol wipes can be used but traditional hand washing is inconvenient. Equally soap and water is cheaper than alcohol wipes. However it should be remembered that though it is thought that hands (and fomites) can account for transmission of influenza and other infections the importance of this compared to droplet and aerosol transmission is unclear and the source of some controversy.(1)

    Despite that regular hand-washing is recommended by ECDC as a method of preventing respiratory and other infections.(2)

    1. Influenza Team, European Centre for Disease Prevention and Control. Influenza transmission: research needs for informing infection control policies and practice. Eurosurveillance (2007) Volume 12, Issue 19, 10 May
    2. ECDC Personal protective measures against influenza 2006
    -
    <cite cite="http://ecdc.europa.eu/en/health_content/sciadv/090115_sciadv.aspx">ECDC Health Content</cite>

  • #2
    Re: Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers - ECDC Health Content

    More on hand washing which will be one of few effective methods to prevent pandemic influenza tranmission -

    hat tip to Fla Medic for telling me about this blog by Maryn McKenna:

    15 January 2009

    This is what hand hygiene looks like


    Contant reader Robyn pointed out an amazing image in the New England Journal of Medicine issue I discussed below. I missed it (thanks, Robyn!), so I went back and retrieved it. Here's what you're looking at:

    The Cleveland Veterans Affairs Medical Center discovered via a routine nasal swab that a quadriplegic patient was colonized with MRSA; the patient had not had any infections that would have indicated an infection. To satisfy their curiousity over how much MRSA a healthcare worker might pick up from a patient whom they did not know was colonized, they had a health care worker do an abdominal exam of the patient — let's underline that: abdominal; nowhere near his nose. Then they pressed the worker's hand onto a growth medium that had been tuned with antibiotics so that it would allow MRSA to grow but suppress other bacteria.

    That's what you're looking at above. All of that red is MRSA. The image on the right is what grew after the same worker did a hand-sanitizing with alcohol foam and then pressed the same hand onto an identical culture plate. What's growing? Nothing at all.

    Here's the back story, quoted from NEJM (re-paragraphed):
    A 24-year-old man who had quadriplegia due to a traumatic spinal cord injury was found on routine surveillance cultures to have methicillin-resistant Staphylococcus aureus (MRSA) colonization of his anterior nares. He had no history of MRSA infection or colonization.
    To assess the potential implications of the patient's MRSA carriage for infection control, an imprint of a health care worker's ungloved hand was obtained for culture after the worker had performed an abdominal examination of the patient. The MRSA colonies grown from this handprint on the plate (CHROMagar Staph aureus), which contained 6 &#181;g of cefoxitin per milliliter to inhibit methicillin-susceptible S. aureus, are pink and show the outline of the worker's fingers and thumb (Panel A).
    With the use of a polymerase-chain-reaction assay, the mecA gene, which confers methicillin resistance, was amplified from nares and imprint isolates. After the worker's hand had been cleaned with alcohol foam, another hand imprint was obtained, and the resulting culture was negative for MRSA (Panel B).
    These images illustrate the critical importance of hand hygiene in caring for patients, including those not known to carry antibiotic-resistant pathogens.
    The cite is: Donskey, Curtis J., Eckstein, Brittany C. IMAGES IN CLINICAL MEDICINE: The Hands Give It Away. N Engl J Med 2009 360: e3

    Comment


    • #3
      Re: Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers - ECDC Health Content

      How to Wash Your Hands -

      http://www.ext.vt.edu/pubs/nutrition...5/348-965.html



      Wash Hands: Fight Disease-Causing Germs

      Author: Renee R. Boyer, Extension Specialist, Food Safety, Virginia Tech*
      Publication Number 348-965, Revised December 2007



      Why Wash Hands?

      Failure to adequately wash hands is a major cause of infectious diseases. Individuals who practice poor personal hygiene while preparing food may spread diseases such as hepatitis A, salmonellosis, and shigellosis. Studies indicate that onethird (33&#37 of people do not wash their hands after using the restroom. When To Wash Hands?

      Wash hands often because disease-causing germs can easily be transferred to food, surfaces, and people.
      Germs cannot be seen with the naked eye. Warmth and moisture (perspiration) on skin surfaces allow germs to quickly grow into millions.
      Hands should be washed:

      • Before, during, and after preparing food
      • Before eating food
      • After using the restroom
      • After coughing, sneezing, or blowing your nose
      • After changing diapers
      • After handling money
      • After handling trash or taking out garbage
      • After handling (petting) pets or other animals
      • After work or play
      • Whenever hands come in contact with body fluids (i.e. runny nose, watery eyes, saliva)
      • More frequently when someone in the home is sick
      • When hands are dirty

      How To Wash Hands?

      Hands should be washed vigorously by scrubbing with warm, soapy water for at least 20 seconds. Germs can hide underneath fingernails. Thus, rub tips of fingers along the soapy palm of the alternate hand or use a fingernail brush. Rinse hands well and completely dry with a paper towel or air-dryer. Turn the faucet handle off with a paper towel to avoid recontamination. If you will be preparing food, try not to touch potentially contaminated surfaces after washing your hands. Proper handwashing steps are listed on the other side of the page.




      <center></center>

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      • #4
        Re: Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers - ECDC Health Content

        If you are in a public restroom, remember to use the paper towel to open the door if it has a knob and flip off the light switch. (Then get all contaminated again from the next thing you touch )
        The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918

        Comment


        • #5
          Re: Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers - ECDC Health Content

          A little more on hand washing plus discussion hand drying. gs

          According to an American Society for Microbiology survey in 2007, 92% of Americans say they always wash after using a public restroom. But when researchers actually watched, it turned out only 83% did.

          Barely. When people wash their hands, only 33% use soap and only 16% adequately wash. The average hand-washing time was a pathetic 11 seconds, says Charles Peter Gerba, an environmental microbiologist at the University of Arizona in Tucson.

          Air dryers first became popular in the 1970s and were developed to reduce paper waste, save energy and cut maintenance costs. But consumers didn't like them, and today they're in only 6% of public restrooms in the USA, according to the consumer research company Mintel.

          Which works better, paper towels or dryers, is hotly debated.

          Doug Powell, a professor of food safety at Kansas State University in Manhattan, Kan., says numerous papers show that the friction created by using paper towels is actually a key part of the cleaning process. The friction "removes the bacteria, whereas blow dryers tend to disperse them in the air," he says.

          A study by the Mayo Clinic in 2000 found that four potential drying methods paper towel, cloth roller towel, warm-forced-air dryer and "spontaneous room air evaporation" were all about equal in removing bacteria.

          A study at Rutgers found that forced-air drying left slightly more bacteria on hands, while paper towels left slightly less.

          Do warm-forced-air dryers breed bacteria, spewing it back over clean hands? Some research has found bacteria colonizing in the machines, though the findings are flatly denied by the hand-dryer industry.

          Then there's the question of whether blowers actually get hands dry. A study at the University of Westminster in England in 1993 found that because of the time they took, people generally got their hands to only 55%-65% dryness before giving up, which made cross-contamination more likely later.

          There's also anecdotal evidence that people simply don't wash when they see blow dryers because they take so long. "People are busy" and don't want to take the time, says Herbert DuPont, an infectious-disease researcher at the University of Texas School of Public Health.

          Still, it's better to wash your hands and then dry them on your pants than not to wash them at all, the CDC's Bowen says. She did research in Karachi, Pakistan, which found that even when people used their clothing to dry their hands, there was still a 50% reduction in the rate of respiratory and diarrheal illnesses.

          There's one thing a blower can't do, though: It can't be used to open a bathroom door that has been opened by dozens of people who didn't wash their hands.

          Says WebMD's Smith: "The paper towel is a very good friend."

          http://www.usatoday.com/news/health/...u_N.htm?csp=34
          The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918

          Comment


          • #6
            Re: Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers - ECDC Health Content

            so they found log3 reduction after 2min but almost no further reduction after 60min
            "much" reduction after soap or alcohole


            mean reduction 1000-10000 fold after short drying, 6/20 no detectale virus after 2min
            There was minimal reduction in H1N1 after 60 min without HH(=hand hygiene ?)
            no culturable H1N1 after either soap or alcohole

            presented Sept.2007, access restricted


            redo with Rhinovirus !



            earlier study said : flu survives 5min on hands (cold several hours)



            A 2.4-mL aliquot of a hand rub product was sufficient to cover both hands in 96.9&#37; of the subjects
            http://www.ncbi.nlm.nih.gov/pubmed/18538702?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.P ubmed_Discovery_RA&linkpos=3&log$=relatedarticles& logdbfrom=pubmed

            Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all
            (for nosocomial pathogens)
            http://www.ncbi.nlm.nih.gov/pubmed/15489352?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.P ubmed_Discovery_RA&linkpos=4&log$=relatedreviews&l ogdbfrom=pubmed
            I'm interested in expert panflu damage estimates
            my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

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