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Andrup L, Krogfelt KA, Stephansen L, Hansen KS, Graversen BK, Wolkoff P, Madsen AM. Reduction of acute respiratory infections in day-care by non-pharmaceutical interventions: a narrative review. Front Public Health 2024; 12:1332078. [PMID: 38420031 PMCID: PMC10899481 DOI: 10.3389/fpubh.2024.1332078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Children who start in day-care have 2-4 times as many respiratory infections compared to children who are cared for at home, and day-care staff are among the employees with the highest absenteeism. The extensive new knowledge that has been generated in the COVID-19 era should be used in the prevention measures we prioritize. The purpose of this narrative review is to answer the questions: Which respiratory viruses are the most significant in day-care centers and similar indoor environments? What do we know about the transmission route of these viruses? What evidence is there for the effectiveness of different non-pharmaceutical prevention measures? Design Literature searches with different terms related to respiratory infections in humans, mitigation strategies, viral transmission mechanisms, and with special focus on day-care, kindergarten or child nurseries, were conducted in PubMed database and Web of Science. Searches with each of the main viruses in combination with transmission, infectivity, and infectious spread were conducted separately supplemented through the references of articles that were retrieved. Results Five viruses were found to be responsible for ≈95% of respiratory infections: rhinovirus, (RV), influenza virus (IV), respiratory syncytial virus (RSV), coronavirus (CoV), and adenovirus (AdV). Novel research, emerged during the COVID-19 pandemic, suggests that most respiratory viruses are primarily transmitted in an airborne manner carried by aerosols (microdroplets). Conclusion Since airborne transmission is dominant for the most common respiratory viruses, the most important preventive measures consist of better indoor air quality that reduces viral concentrations and viability by appropriate ventilation strategies. Furthermore, control of the relative humidity and temperature, which ensures optimal respiratory functionality and, together with low resident density (or mask use) and increased time outdoors, can reduce the occurrence of respiratory infections.
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Affiliation(s)
- Lars Andrup
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Science and Environment, Molecular and Medical Biology, PandemiX Center, Roskilde University, Roskilde, Denmark
| | - Lene Stephansen
- Gladsaxe Municipality, Social and Health Department, Gladsaxe, Denmark
| | | | | | - Peder Wolkoff
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anne Mette Madsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
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Bayer G, Shayganpour A, Bayer IS. Efficacy of a New Alcohol-Free Organic Acid-Based Hand Sanitizer against Foodborne Pathogens. TOXICS 2023; 11:938. [PMID: 37999590 PMCID: PMC10674435 DOI: 10.3390/toxics11110938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
In light of the global health crisis triggered by the COVID-19 pandemic, numerous experts have deemed the utilization of hand sanitizers imperative as a precautionary measure against the virus. Consequently, the demand for hand sanitizers has experienced a substantial surge. Since the beginning of 2020, the utilization of alcohol-free hand sanitizers has been increasingly favored due to the potential risks associated with alcohol poisoning, flammability, as well as the adverse effects on skin lipid dissolution, dehydration, and sebum reduction, which can lead to severe cases of eczema and norovirus infections. In this study, we developed an aqueous hand sanitizer that does not contain alcohol. The sanitizer consists of naturally occurring, food-grade organic acids, including lactic, citric, and azelaic acids. Additionally, food-grade ammonium sulfate and a small amount of povidone-iodine (PVPI) were included in the formulation to create a synergistic and potent antibacterial effect. The effectiveness of the hand sanitizer was evaluated against four common foodborne pathogens, namely Clostridium botulinum, Escherichia coli, Listeria monocytogenes, and Staphylococcus aureus, via in vitro testing. The organic acids exhibited a synergistic inhibitory function, resulting in a 3-log reduction in CFU/mL. Furthermore, the presence of povidone-iodine and ammonium sulfate enhanced their antibacterial effect, leading to a 4-log reduction in CFU/mL. The hand sanitizer solution remained stable even after 60 days of storage. During this period, the detection of additional triiodide (I3-) ions occurred, which have the ability to release broad-spectrum molecular iodine upon penetrating the cell walls. This alcohol-free hand sanitizer may offer extended protection and is anticipated to be gentle on the skin. This is attributed to the presence of citric and lactic acids, which possess cosmetic properties that soften and smoothen the skin, along with antioxidant properties.
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Affiliation(s)
- Gözde Bayer
- DS Bio ve Nanoteknoloji A. Ş, Lavida City Plaza 45/7, 06530 Ankara, Türkiye;
| | - Amirreza Shayganpour
- Smart Materials, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy;
| | - Ilker S. Bayer
- Smart Materials, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy;
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Oral mitis group streptococci reduce infectivity of influenza A virus via acidification and H2O2 production. PLoS One 2022; 17:e0276293. [DOI: 10.1371/journal.pone.0276293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022] Open
Abstract
Members of the mitis group streptococci are the most abundant inhabitants of the oral cavity and dental plaque. Influenza A virus (IAV), the causative agent of influenza, infects the upper respiratory tract, and co-infection with Streptococcus pneumoniae is a major cause of morbidity during influenza epidemics. S. pneumoniae is a member of mitis group streptococci and shares many features with oral mitis group streptococci. In this study, we investigated the effect of viable Streptococcus oralis, a representative member of oral mitis group, on the infectivity of H1N1 IAV. The infectivity of IAV was measured by a plaque assay using Madin-Darby canine kidney cells. When IAV was incubated in growing culture of S. oralis, the IAV titer decreased in a time- and dose-dependent manner and became less than 100-fold, whereas heat-inactivated S. oralis had no effect. Other oral streptococci such as Streptococcus mutans and Streptococcus salivarius also reduced the viral infectivity to a lesser extent compared to S. oralis and Streptococcus gordonii, another member of the oral mitis group. S. oralis produces hydrogen peroxide (H2O2) at a concentration of 1–2 mM, and its mutant deficient in H2O2 production showed a weaker effect on the inactivation of IAV, suggesting that H2O2 contributes to viral inactivation. The contribution of H2O2 was confirmed by an inhibition assay using catalase, an H2O2-decomposing enzyme. These oral streptococci produce short chain fatty acids (SCFA) such as acetic acid as a by-product of sugar metabolism, and we also found that the inactivation of IAV was dependent on the mildly acidic pH (around pH 5.0) of these streptococcal cultures. Although inactivation of IAV in buffers of pH 5.0 was limited, incubation in the same buffer containing 2 mM H2O2 resulted in marked inactivation of IAV, which was similar to the effect of growing S. oralis culture. Taken together, these results reveal that viable S. oralis can inactivate IAV via the production of SCFAs and H2O2. This finding also suggests that the combination of mildly acidic pH and H2O2 at low concentrations could be an effective method to inactivate IAV.
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Selam MN, Habte BM, Marew T, Bitew M, Getachew T, Getachew S, Abate A, Mitiku M, Matsabisa M, Birhanu G. Evaluation of quality and antimicrobial efficacy of locally manufactured alcohol-based hand sanitizers marketed in Addis Ababa, Ethiopia in the era of COVID-19. Antimicrob Resist Infect Control 2022; 11:126. [PMID: 36209192 PMCID: PMC9547578 DOI: 10.1186/s13756-022-01163-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/29/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has been rapidly spreading across the globe since the World Health Organization (WHO) has declared the disease outbreak as a global pandemic on March 11, 2020. Hand hygiene, via either regular handwashing with soap and water or using hand sanitizers, is among the various measures that need to be followed to control the outbreak of the disease. Alcohol-based hand sanitizers (ABHS) are the "gold standard" for hand disinfection because of their broad antimicrobial spectrum of activity, easy availability, better safety profile, and general acceptability to users. This study aimed at evaluating the physicochemical quality and antimicrobial efficacy of the locally manufactured ABHS marketed in Addis Ababa, Ethiopia. METHODS A cross-sectional survey was used to collect ABHS from Addis Ababa marketplaces. A total of 25 sample products were randomly selected from different categories of hand sanitizer manufacturers. The physicochemical evaluation of the products was carried out as per the United States Pharmacopoeia and WHO standards. Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Staphylococcus aureus, Salmonella spp., and Shigella spp clinical isolates were used for the antimicrobial efficacy test. RESULTS The Fourier Transform Infrared result confirmed that all the test products met the identification test for ethanol. The majority (68%) of ABHS complied with the test for ethanol content (75-85% v/v). However, only 3 products fulfilled the hydrogen peroxide content (0.112-0.137% v/v). LPC307 showed the maximum zone of inhibition of 12 mm against Escherichia coli whereas MPC204 exhibited only 3 mm. LPC101 was found to be more sensitive to Shigella and Klebsiella Spp with minimum inhibitory concentration values of 20% and 10%, respectively. The sample product LPC101 showed a minimum bactericidal concentration of 20% against Escherichia coli, Pseudomonas aeruginosa, and Klebsiella spp. CONCLUSION One-third of the tested ABHS did not comply with the WHO ethanol content limit and the majority of the products failed to meet the label claim for hydrogen peroxide content. Besides, nearly all products proved that they have activity against all the tested pathogenic microorganisms at a minimum concentration from 10 to 80%; though, they did not show 99.9% bacteriostatic or bactericidal activities as claimed. The study findings suggested regular monitoring of the quality of marketed ABHS considering the current wide use of these products.
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Affiliation(s)
- Muluken Nigatu Selam
- grid.7123.70000 0001 1250 5688Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Bruck Messele Habte
- grid.7123.70000 0001 1250 5688Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Tesfa Marew
- grid.7123.70000 0001 1250 5688Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Molalegne Bitew
- Bio and Emerging Technology Institute, Addis Ababa, Ethiopia
| | - Tigist Getachew
- Bio and Emerging Technology Institute, Addis Ababa, Ethiopia
| | | | - Atlaw Abate
- Ethiopian Food and Drug Authority, Addis Ababa, Ethiopia
| | - Mequanint Mitiku
- grid.7123.70000 0001 1250 5688Department of Medical Laboratory, Tikur Anbessa Specialized Hospital, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Motlalepula Matsabisa
- grid.412219.d0000 0001 2284 638XDepartment of Pharmacology, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300 South Africa
| | - Gebremariam Birhanu
- grid.7123.70000 0001 1250 5688Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia ,grid.412219.d0000 0001 2284 638XDepartment of Pharmacology, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300 South Africa
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Kim S, Park JO, Lee HA, Park HA, Lee CA, Wang SJ, Jung EJ. Unintended beneficial effects of COVID-19 on influenza-associated emergency department use in Korea. Am J Emerg Med 2022; 59:1-8. [PMID: 35772222 PMCID: PMC9233888 DOI: 10.1016/j.ajem.2022.06.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/05/2022] [Accepted: 06/21/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions, including hand hygiene, wearing masks, and cough etiquette, and public health measures such as social distancing, used to prevent the spread of coronavirus disease 2019 (COVID-19), could reduce the incidence rate of respiratory viral infections such as influenza. We evaluated the effect of COVID-19 on the incidence of influenza in Korea. METHODS This retrospective study included all patients who visited five urban emergency departments (EDs) during the influenza epidemic seasons of 2017-18, 2018-19, and 2019-20. Influenza was defined as ICD-10 codes J09, J10, and J11, determined from ED discharge records. The weekly incidence rates of influenza per 1000 ED visits during the 2019-20 season, when COVID-19 became a pandemic, were compared with those of 2017-18 and 2018-19. The actual incidence rate of the 2019-20 season was compared with the predicted value using a generalized estimation equation model based on 2017-18 and 2018-19 data. RESULTS The weekly influenza incidence rate decreased from 101.6 to 56.6 between week 4 and week 5 in 2020 when the first COVID-19 patient was diagnosed and public health measures were implemented. The weekly incidence rate during week 10 and week 22 of the 2019-20 season decreased most steeply compared to 2017-18 and 2018-19. The actual influenza incidence rate observed in the 2019-20 season was lower than the rate predicted in the 2017-18 and 2018-19 seasons starting from week 7 when a COVID-19 outbreak occurred in Korea. CONCLUSIONS The implementation of non-pharmaceutical interventions and public health measures for the COVID-19 epidemic effectively reduced the transmission of influenza and associated ED use in Korea. Implementing appropriate public health measures could reduce outbreaks and lessen the burden of influenza during future influenza epidemics.
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Affiliation(s)
- Sola Kim
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; Department of Emergency Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Ju Ok Park
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; Department of Emergency Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Hang A Park
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; Department of Emergency Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Choung Ah Lee
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; Department of Emergency Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Soon-Joo Wang
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; Department of Emergency Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Eun Ju Jung
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
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Pham TM, Yin M, Cooper BS. The potential impact of intensified community hand hygiene interventions on respiratory tract infections: a modelling study. Proc Math Phys Eng Sci 2022; 478:20210746. [PMID: 35582391 PMCID: PMC9092223 DOI: 10.1098/rspa.2021.0746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/07/2022] [Indexed: 12/02/2022] Open
Abstract
Hand hygiene is among the most fundamental and widely used behavioural measures to reduce the person-to-person spread of human pathogens and its effectiveness as a community intervention is supported by evidence from randomized trials. However, a theoretical understanding of the relationship between hand hygiene frequency and change in risk of infection is lacking. Using a simple model-based framework for understanding the determinants of hand hygiene effectiveness in preventing viral respiratory tract infections, we show that a crucial, but overlooked, determinant of the relationship between hand hygiene frequency and risk of infection via indirect transmission is persistence of viable virus on hands. If persistence is short, as has been reported for influenza, hand-washing needs to be performed very frequently or immediately after hand contamination to substantially reduce the probability of infection. When viable virus survival is longer (e.g. in the presence of mucus or for some enveloped viruses) less frequent hand washing can substantially reduce the infection probability. Immediate hand washing after contamination is consistently more effective than at fixed-time intervals. Our study highlights that recommendations on hand hygiene should be tailored to persistence of viable virus on hands and that more detailed empirical investigations are needed to help optimize this key intervention.
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Affiliation(s)
- Thi Mui Pham
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mo Yin
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Division of Infectious Diseases, University Medicine Cluster, National University Hospital of Singapore, Singapore
| | - Ben S. Cooper
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
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Chen H, Zhu Z, Ai C, Zhao Y, He C, He M, Chen B. Evaluating the mitigation strategies of COVID-19 by the application of the CO 2 emission data through high-resolution agent-based computational experiments. ENVIRONMENTAL RESEARCH 2022; 204:112077. [PMID: 34560060 PMCID: PMC8452542 DOI: 10.1016/j.envres.2021.112077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/12/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
The negative consequences, such as healthy and environmental issues, brought by rapid urbanization and interactive human activities result in increasing social uncertainties, unreliable predictions, and poor management decisions. For instance, the Coronavirus Disease (COVID-19) occurred in 2019 has been plaguing many countries. Aiming at controlling the spread of COVID-19, countries around the world have adopted various mitigation and suppression strategies. However, how to comprehensively eva luate different mitigation strategies remains unexplored. To this end, based on the Artificial societies, Computational experiments, Parallel execution (ACP) approach, we proposed a system model, which clarifies the process to collect the necessary data and conduct large-scale computational experiments to evaluate the effectiveness of different mitigation strategies. Specifically, we established an artificial society of Wuhan city through geo-environment modeling, population modeling, contact behavior modeling, disease spread modeling and mitigation strategy modeling. Moreover, we established an evaluation model in terms of the control effects and economic costs of the mitigation strategy. With respect to the control effects, it is directly reflected by indicators such as the cumulative number of diseases and deaths, while the relationship between mitigation strategies and economic costs is built based on the CO2 emission. Finally, large-scale simulation experiments are conducted to evaluate the mitigation strategies of six countries. The results reveal that the more strict mitigation strategies achieve better control effects and less economic costs.
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Affiliation(s)
- Hailiang Chen
- College of Systems Engineering, National University of Defense Technology (NUDT), 410073, 109 Deya Road, Kaifu District, Changsha City, Hunan province, China.
| | - Zhengqiu Zhu
- College of Systems Engineering, National University of Defense Technology (NUDT), 410073, 109 Deya Road, Kaifu District, Changsha City, Hunan province, China; Research Group of Multi-scale Networked Systems, Informatics Institute, University of Amsterdam (UvA), Science Park 904, 1096 XH, Amsterdam, P.O. Box 94323, Netherlands.
| | - Chuan Ai
- College of Systems Engineering, National University of Defense Technology (NUDT), 410073, 109 Deya Road, Kaifu District, Changsha City, Hunan province, China.
| | - Yong Zhao
- College of Systems Engineering, National University of Defense Technology (NUDT), 410073, 109 Deya Road, Kaifu District, Changsha City, Hunan province, China.
| | - Cheng He
- Department of Environment Science and Engineering, Fudan University, 200082, 2005 Songhu Road, Yangpu District, Shanghai City, China.
| | - Ming He
- Command and Control Engineering College, Peoples Liberation Army Engineering University, 210001, 1 Haifu Lane, Qinhuai District, Nanjing City, Jiangsu Province, China.
| | - Bin Chen
- College of Systems Engineering, National University of Defense Technology (NUDT), 410073, 109 Deya Road, Kaifu District, Changsha City, Hunan province, China.
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Phi 6 recovery from inoculated fingerpads based on elution buffer and methodology. J Virol Methods 2022; 299:114307. [PMID: 34606796 PMCID: PMC9757907 DOI: 10.1016/j.jviromet.2021.114307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/24/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022]
Abstract
Phi 6 (Φ6) bacteriophage is a proposed surrogate to study pathogenic enveloped viruses including SARS-CoV-2-the causative agent of COVID-19-based on structural similarities, BSL-1 status, and ease of use. To determine the role of virus-contaminated hands in disease transmission, an enhanced understanding of buffer and method performance for Φ6 recovery needs to be determined. Four buffer types and three methodologies were investigated for the recovery of Φ6 from human fingerpads over a 30 min duration. Phosphate buffered saline (PBS), PBS + 0.1 % Tween, 0.1 M glycine + 3% beef extract, and viral transport medium were evaluated as buffers for recovery of Φ6 via a dish, modified glove juice, and vigorous swabbing method. Φ6 concentrations on fingerpads were determined at 0-, 5-, 10-, and 30-min post-inoculation. While there were observed differences in virus recovery across buffer and method types depending on the time point, log PFU recovery based on buffer type or methodology was not significantly different at any time point (P > 0.05). The results presented in this study will allow for future work on Φ6 persistence, transfer between hands and surfaces, and efficacy of hand hygiene methods to be performed using a well-characterized and validated recovery method.
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Akita S, Fujioka M, Akita T, Tanaka J, Masunaga A, Kawahara T. Effects of Hand Hygiene Using 4% Chlorhexidine Gluconate or Natural Soap During Hand Rubbing Followed by Alcohol-Based 1% Chlorhexidine Gluconate Sanitizer Lotion in the Operating Room. Adv Wound Care (New Rochelle) 2022; 11:1-9. [PMID: 33563102 PMCID: PMC9831244 DOI: 10.1089/wound.2020.1352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective: Hand hygiene using either 4% chlorhexidine gluconate (CHG) or natural soap during hand rubbing, followed by alcohol-based 1% CHG sanitizer lotion in the operating room was compared to assess bacterial reduction, skin moisture, skin texture, and hand hygiene using qualitative questionnaires. Approach: A crossover study with 36 professional scrub nurses at two medical centers was performed to compare 4% CHG followed by alcohol-based 1% CHG sanitizer lotion, the Two-stage method with handwashing using natural soap followed by alcohol-based 1% CHG sanitizer lotion, and the Waterless method, after a period of 10 days of use. The study completely followed CONSORT, www.consort-statement.org. Results: There was no significant difference in bacterial reduction based on the bacterial colony-forming units between the two methods. The skin moisture and skin roughness scores were not significantly different between the two methods. The Waterless method was significantly better than the Two-stage method regarding "foaming," "quality," "longevity" (p < 0.0001, p < 0.0001, and p < 0.0001, respectively), but "disappearance" was significantly better by the Two-stage method (p = 0.0095) during washing and rubbing. Immediately after washing and rubbing, the Waterless method was significantly better regarding "tightness" and "moisture," whereas the Two-stage method was significantly better regarding "stickiness" (p = 0.0114, p = <0.0001, and 0.0059, respectively) Innovation: The Waterless method using natural soap during handwashing followed by alcohol-based 1% CHG sanitizer lotion was as effective as the Two-stage method of 4% CHG followed by alcohol-based 1% CHG sanitizer lotion. Conclusion: Handwashing using natural soap is simple and superior to hand scrubbing in several aspects.
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Affiliation(s)
- Sadanori Akita
- Department of Plastic Surgery, Wound Repair and Regeneration, School of Medicine, Fukuoka University, Fukuoka, Japan.,Correspondence: Department of Plastic Surgery, Wound Repair and Regeneration, School of Medicine, Fukuoka University, Fukuoka 8140180, Japan
| | - Masaki Fujioka
- Department of Plastic and Reconstructive Surgery, National Hospital Organization, Nagasaki Medical Center, Nagasaki, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical & Health Science, Hiroshima University, Hiroshima, Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical & Health Science, Hiroshima University, Hiroshima, Japan
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Barcenilla-Guitard M, Espart A. Influence of Gender, Age and Field of Study on Hand Hygiene in Young Adults: A Cross-Sectional Study in the COVID-19 Pandemic Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413016. [PMID: 34948626 PMCID: PMC8700841 DOI: 10.3390/ijerph182413016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
The effectiveness of hand hygiene (HH) on reducing the transmission of contagious diseases is widely known, although its use has been commonly associated with the area of healthcare. During the COVID-19 pandemic, HH was one of the main measures established to contain the transmission of this virus. The identification of the main barriers and facilitators of HH in young adults (aged 18-29 years old) will contribute to the better planning of HH training and its posterior success. A total of 716 young adults participated in the study by completing the ad hoc online questionnaire (#YesWeHand), which analyzed, among other aspects, the age range, gender and field of study that they belonged to. From the total participants, 81.3% indicated knowing how to perform HH correctly, while 49.4% affirmed having received training. The main reason for performing HH was concern for their own safety and that of others (75.8%), while forgetfulness (36.5%) was the main reason for not performing HH. In the group of young adults, being female, aged between 22 and 25 years old, and having studied in the area of Health Sciences, had a positive influence on correct HH. It is deemed necessary to maintain HH beyond the primary education stages, and to adapt it to different fields of education, ages, and genders, in order to maximize its success. Given the overrepresentation of participants from the healthcare field, it would be desirable to conduct more studies to ensure a better representation of the different educational levels and fields of study of the participants, in order to identify, in a more reliable way, the variables that influence HH.
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Affiliation(s)
| | - Anna Espart
- Department of Nursing and Physiotherapy, Serra Húnter Lecturer, University of Lleida, 25198 Lleida, Spain
- Faculty of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
- Development of Healthy Organizations and Territories (DOTS), 25001 Lleida, Spain
- Research Group of Health Care (GRECS), Lleida Institute for Biomedical Research, Dr. Pifarré Foundation, IRBLleida, 25198 Lleida, Spain
- Correspondence:
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Abstract
Health care-acquired viral respiratory infections are common and cause increased patient morbidity and mortality. Although the threat of viral respiratory infection has been underscored by the coronavirus disease 2019 (COVID-19) pandemic, respiratory viruses have a significant impact in health care settings even under normal circumstances. Studies report decreased nosocomial transmission when aggressive infection control measures are implemented, with more success noted when using a multicomponent approach. Influenza vaccination of health care personnel furthers decrease rates of transmission; thus, mandatory vaccination is becoming more common. This article discusses the epidemiology, transmission, and control of health care-associated respiratory viral infections.
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Affiliation(s)
- Joshua G Petrie
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Thomas R Talbot
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, 1161 21st Avenue South, A-2200 MCN, Nashville, TN 37232, USA.
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Mohamed IMA, Ogawa H, Takeda Y. In vitro virucidal activity of the theaflavin-concentrated tea extract TY-1 against influenza A virus. J Nat Med 2021; 76:152-160. [PMID: 34550554 PMCID: PMC8456404 DOI: 10.1007/s11418-021-01568-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/08/2021] [Indexed: 01/25/2023]
Abstract
The annual spread of influenza A virus (IAV) infection is a global concern. We examined the IAV-inactivating potential of theaflavin-concentrated tea extract TY-1, which contains abundant polyphenols, including concentrated theaflavins and catechins. TY-1 exhibited concentration- and time-dependent virucidal activity against IAV. Specifically, 5.0 mg/mL TY-1 induced a 1.33 and ≥ 5.17 log10 50% tissue culture infective dose/mL reduction of the viral titer compared with dextrin as the diluent control within 30 min and 6 h reaction time, respectively. The high virucidal activity of TY-1 was attributed to the combined additive activities of multiple virucidal components, including theaflavins, which led to an investigation of the virucidal mechanism of action of TY-1. Western blotting revealed that TY-1 treatment reduced the band intensity of hemagglutinin and induced the appearance of additional high molecular mass bands/ladders. In addition, TY-1 treatment also reduced the band intensity of neuraminidase (NA). A hemagglutination assay revealed that TY-1 reduced hemagglutination activity, and an NA assay revealed reduced NA activity. These results indicated that TY-1 caused structural abnormalities in IAV spike proteins, possibly leading to their destruction. Reverse transcription polymerase chain reaction (PCR) targeting the IAV genome and electron microscopic observation of viral particles revealed that upon application of TY-1, the PCR products dissipated, which indicates that TY-1 destroyed the IAV genome, and the number of viral particles reduced. Overall, TY-1 exhibited multiple modes of IAV-inactivating activity. Our findings support the possible future practical use of TY-1 as a virucidal supplemental agent that can contribute to IAV infection control.
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Affiliation(s)
- Israa M A Mohamed
- Graduate School of Animal and Veterinary Sciences and Agriculture, Obihiro University of Agriculture and Veterinary Medicine, 2-11 Inada, Obihiro, Hokkaido, 080-8555, Japan
- Department of Animal and Poultry Hygiene and Environmental Sanitation, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Haruko Ogawa
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, 2-11 Inada, Obihiro, Hokkaido, 080-8555, Japan
| | - Yohei Takeda
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, 2-11 Inada, Obihiro, Hokkaido, 080-8555, Japan.
- Research Center for Global Agromedicine, Obihiro University of Agriculture and Veterinary Medicine, 2-11 Inada, Obihiro, Hokkaido, 080-8555, Japan.
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13
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Ijaz MK, Nims RW, de Szalay S, Rubino JR. Soap, water, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): an ancient handwashing strategy for preventing dissemination of a novel virus. PeerJ 2021; 9:e12041. [PMID: 34616601 PMCID: PMC8451441 DOI: 10.7717/peerj.12041] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/02/2021] [Indexed: 12/23/2022] Open
Abstract
Public Health Agencies worldwide (World Health Organization, United States Centers for Disease Prevention & Control, Chinese Center for Disease Control and Prevention, European Centre for Disease Prevention and Control, etc.) are recommending hand washing with soap and water for preventing the dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. In this review, we have discussed the mechanisms of decontamination by soap and water (involving both removal and inactivation), described the contribution of the various components of formulated soaps to performance as cleansers and to pathogen inactivation, explained why adherence to recommended contact times is critical, evaluated the possible contribution of water temperature to inactivation, discussed the advantages of antimicrobial soaps vs. basic soaps, discussed the differences between use of soap and water vs. alcohol-based hand sanitizers for hand decontamination, and evaluated the limitations and advantages of different methods of drying hands following washing. While the paper emphasizes data applicable to SARS-CoV-2, the topics discussed are germane to most emerging and re-emerging enveloped and non-enveloped viruses and many other pathogen types.
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Affiliation(s)
- M. Khalid Ijaz
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, New Jersey, United States
- Department of Biology, Medgar Evers College of the City University of New York (CUNY), Brooklyn, New York, United States
| | - Raymond W. Nims
- RMC Pharmaceutical Solutions, Inc., Longmont, Colorado, United States
| | - Sarah de Szalay
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, New Jersey, United States
| | - Joseph R. Rubino
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, New Jersey, United States
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14
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Efficacy of Removing Bacteria and Organic Dirt from Hands-A Study Based on Bioluminescence Measurements for Evaluation of Hand Hygiene When Cooking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168828. [PMID: 34444577 PMCID: PMC8394668 DOI: 10.3390/ijerph18168828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/14/2021] [Accepted: 08/19/2021] [Indexed: 12/04/2022]
Abstract
The objective of this study was to evaluate the efficacy of dirt removal (bacteria and organic matter) of several hand-cleaning procedures. The results from the hand hygiene experiment indicated that washing hands with warm water and soap for 20 s is the most effective method investigated when hands are either dirty or greasy. Even if not proper washing, rinsing under running water for 5 s is a cleaning procedure that may significantly reduce the probability of cross-contamination, as it removes 90% of the hands’ dirt. Although less effective than water and soap, the usage of antibacterial wipes was significantly more effective than wet wipes, indicating that they are a better choice when water and soap are not available. The results of this study enable us to inform consumers about the effectiveness of hand-cleaning procedures applied in their homes when cooking. Moreover, it can make consumers understand why, during the COVID-19 pandemic, authorities recommended washing hands as a preventive measure of infection and using an anti-bacterial hand gel or wiping hands with an antimicrobial wipe if water and soap are not available.
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15
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Chandrakanth P, Duggirala V, Narendran K, Narendran V. Do it yourself automatic liquid dispenser for the COVID-19 aeon. Indian J Ophthalmol 2021; 69:999-1000. [PMID: 33727480 PMCID: PMC8012935 DOI: 10.4103/ijo.ijo_2996_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Prithvi Chandrakanth
- Retina Fellow, Vitreo-Retina Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Varun Duggirala
- Medical Officer, IOL and Cataract Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Kalpana Narendran
- Senior Medical Officer and Head of Department, IOL and Cataract Services and Paediatric Ophthalmology, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - V Narendran
- Chief Medical Officer, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
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16
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Hart KM, Stapleton F, Carnt N, Arundel L, Lian KY. Optometry Australia's infection control guidelines 2020. Clin Exp Optom 2021; 104:267-284. [PMID: 33769228 DOI: 10.1080/08164622.2021.1887704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Optometry Australia's infection control guidelines 2020 deliver a revision of the paper: Infection control guidelines for optometrists 2016. A review of recent literature was undertaken, with information collected from peer-reviewed journal articles, guidelines from professional societies, government health departments and instructions from equipment manufacturers. This information was used to provide an update on current infection control best practice. The guidelines are presented in two sections: standard precautions and transmission-based precautions. The standard (routine) precautions section covers: hand hygiene; personal protective equipment; safe handling and disposal of sharps; routine environmental cleaning; reprocessing of reusable equipment, instruments and contact lenses; respiratory hygiene and cough etiquette; aseptic and clean technique; and waste management. The transmission-based precautions section covers considerations for optometry staff and/or patients when standard precautions alone may not be sufficient to prevent the spread of an infectious agent; particularly relevant during the COVID-19 pandemic. Finally, a comprehensive list of disinfection or sterilisation techniques to use on reusable devices, instruments or equipment in optometric practice is provided in an Appendix.
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Affiliation(s)
- Kerryn M Hart
- Member Support and Optometry Advancement, Optometry Australia, South Melbourne, Australia.,School of Medicine (Optometry), Faculty of Health, Deakin University, Waurn Ponds, Australia
| | - Fiona Stapleton
- School of Optometry and Vision Science, the University of New South Wales, Kensington, Australia
| | - Nicole Carnt
- School of Optometry and Vision Science, the University of New South Wales, Kensington, Australia
| | - Luke Arundel
- Member Support and Optometry Advancement, Optometry Australia, South Melbourne, Australia
| | - Ka-Yee Lian
- Private Practitioner, EyeQ Optometrists Camberwell, Camberwell, Australia
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17
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Miller SL, Nazaroff WW, Jimenez JL, Boerstra A, Buonanno G, Dancer SJ, Kurnitski J, Marr LC, Morawska L, Noakes C. Transmission of SARS-CoV-2 by inhalation of respiratory aerosol in the Skagit Valley Chorale superspreading event. INDOOR AIR 2021; 31:314-323. [PMID: 32979298 DOI: 10.1101/2020.06.15.20132027] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/26/2020] [Accepted: 09/15/2020] [Indexed: 05/22/2023]
Abstract
During the 2020 COVID-19 pandemic, an outbreak occurred following attendance of a symptomatic index case at a weekly rehearsal on 10 March of the Skagit Valley Chorale (SVC). After that rehearsal, 53 members of the SVC among 61 in attendance were confirmed or strongly suspected to have contracted COVID-19 and two died. Transmission by the aerosol route is likely; it appears unlikely that either fomite or ballistic droplet transmission could explain a substantial fraction of the cases. It is vital to identify features of cases such as this to better understand the factors that promote superspreading events. Based on a conditional assumption that transmission during this outbreak was dominated by inhalation of respiratory aerosol generated by one index case, we use the available evidence to infer the emission rate of aerosol infectious quanta. We explore how the risk of infection would vary with several influential factors: ventilation rate, duration of event, and deposition onto surfaces. The results indicate a best-estimate emission rate of 970 ± 390 quanta/h. Infection risk would be reduced by a factor of two by increasing the aerosol loss rate to 5 h-1 and shortening the event duration from 2.5 to 1 h.
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Affiliation(s)
- Shelly L Miller
- Mechanical Engineering, University of Colorado, Boulder, CO, USA
| | - William W Nazaroff
- Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - Jose L Jimenez
- Department of Chemistry and CIRES, University of Colorado, Boulder, CO, USA
| | - Atze Boerstra
- REHVA (Federation of European Heating, Ventilation and Air Conditioning Associations), BBA Binnenmilieu, Den Haag, The Netherlands
| | - Giorgio Buonanno
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, Italy
| | | | - Jarek Kurnitski
- REHVA Technology and Research Committee, Tallinn University of Technology, Tallinn, Estonia
| | - Linsey C Marr
- Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Lidia Morawska
- International Laboratory for Air Quality and Heath (ILAQH), WHO Collaborating Centre for Air Quality and Health, School of Earth and Atmospheric Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
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18
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Miller SL, Nazaroff WW, Jimenez JL, Boerstra A, Buonanno G, Dancer SJ, Kurnitski J, Marr LC, Morawska L, Noakes C. Transmission of SARS-CoV-2 by inhalation of respiratory aerosol in the Skagit Valley Chorale superspreading event. INDOOR AIR 2021; 31:314-323. [PMID: 32979298 PMCID: PMC7537089 DOI: 10.1111/ina.12751] [Citation(s) in RCA: 317] [Impact Index Per Article: 105.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/26/2020] [Accepted: 09/15/2020] [Indexed: 05/02/2023]
Abstract
During the 2020 COVID-19 pandemic, an outbreak occurred following attendance of a symptomatic index case at a weekly rehearsal on 10 March of the Skagit Valley Chorale (SVC). After that rehearsal, 53 members of the SVC among 61 in attendance were confirmed or strongly suspected to have contracted COVID-19 and two died. Transmission by the aerosol route is likely; it appears unlikely that either fomite or ballistic droplet transmission could explain a substantial fraction of the cases. It is vital to identify features of cases such as this to better understand the factors that promote superspreading events. Based on a conditional assumption that transmission during this outbreak was dominated by inhalation of respiratory aerosol generated by one index case, we use the available evidence to infer the emission rate of aerosol infectious quanta. We explore how the risk of infection would vary with several influential factors: ventilation rate, duration of event, and deposition onto surfaces. The results indicate a best-estimate emission rate of 970 ± 390 quanta/h. Infection risk would be reduced by a factor of two by increasing the aerosol loss rate to 5 h-1 and shortening the event duration from 2.5 to 1 h.
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Affiliation(s)
| | - William W Nazaroff
- Civil and Environmental EngineeringUniversity of CaliforniaBerkeleyCAUSA
| | - Jose L. Jimenez
- Department of Chemistry and CIRESUniversity of ColoradoBoulderCOUSA
| | - Atze Boerstra
- REHVA (Federation of European Heating, Ventilation and Air Conditioning Associations)BBA BinnenmilieuDen HaagThe Netherlands
| | - Giorgio Buonanno
- Department of Civil and Mechanical EngineeringUniversity of Cassino and Southern LazioCassinoItaly
| | | | - Jarek Kurnitski
- REHVA Technology and Research CommitteeTallinn University of TechnologyTallinnEstonia
| | - Linsey C. Marr
- Civil and Environmental EngineeringVirginia TechBlacksburgVAUSA
| | - Lidia Morawska
- International Laboratory for Air Quality and Heath (ILAQH)WHO Collaborating Centre for Air Quality and HealthSchool of Earth and Atmospheric SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
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19
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Bardi MJ, Oliaee MA. Impacts of different operational temperatures and organic loads in anaerobic co-digestion of food waste and sewage sludge on the fate of SARS-CoV-2. PROCESS SAFETY AND ENVIRONMENTAL PROTECTION : TRANSACTIONS OF THE INSTITUTION OF CHEMICAL ENGINEERS, PART B 2021; 146:464-472. [PMID: 33262558 PMCID: PMC7694560 DOI: 10.1016/j.psep.2020.11.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 05/05/2023]
Abstract
The impacts of different operational temperatures, and organic load (OL) on the fate of SARS-CoV-2 during the anaerobic co-digestion of food waste (FW) and sewage sludge (SS) was evaluated. The lab-scaled batch reactors (i.e. R1-R7) were performed under psychrophilic, mesophilic, and thermophilic conditions and the OL of systems was 1.5, 3.5, 6 gVS/L. The performance parameters showed that at higher OL the stability of systems failed and low biogas was produced. In contrast, increasing of operational temperature of systems induced more biogas generation due to the increment of metabolic activity of bacteria. Therefore, R1-R7 achieved biogas yield of 202.5, 249, 187, 260, 246, 163, and 300 mL/gVS respectively. Both SARS-CoV-2 genes i.e. ORF1ab, and N genes were detected in the effluent of psychrophilic reactors i.e. R1, and R2, with a total concentration of 46 × 103, and 11 × 103 copies/L respectively. In R3, no viral genes were observed, when the VFAs was accumulated up to 2000 mg/L and caused a pH drop to 5.6. At the mesophilic condition, the viral concentration was significantly declined, and no viral genes were observed at an OL of 3.5 gVS/L. Furthermore, the synergistic effect of temperature and accumulation of intermediate metabolites provided a sever condition for SARS-CoV-2 survival at an operational temperature and OL of 50 °C, and 1.5 gVS/L respectively.
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Affiliation(s)
- Mohammad Javad Bardi
- Faculty of Civil Engineering, Division of Environmental Engineering, Babol Noshirvani University of Technology, Babol, Iran
| | - Mohammad Amin Oliaee
- Faculty of Civil Engineering, Division of Environmental Engineering, Babol Noshirvani University of Technology, Babol, Iran
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20
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Fikri Nur Fahmi M, Nirwati H, Supriyati S. The safety behavior on the health screening system during pandemic COVID-19 in the university setting. BIO WEB OF CONFERENCES 2021. [DOI: 10.1051/bioconf/20214103006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background: Universitas Gadjah Mada (UGM) had been creating health screening system as health promoting university (HPU) program. The Coronavirus Disease (COVID-19) was improve the potentially risk among health screening system officer. This study was aimed to explore the safety behavior of the health screening system officer during pandemic in UGM. Method: Qualitative study had been done in UGM Yogyakarta. This study was carried out in April – June 2021. In-depth interview and observation had performed to collect data. The research subject were health screening system officer and the leader of HPU in the faculty setting. Data was analyzed by using Open Code 4.02 software. Trust-worthiness was carried out by using triangulation and peer debriefing. Result: Five of 18 faculties had applied health screening system structurally. The infrastructure, officers’ recruitment system, and activities were varied among faculty. During the pandemic, officer should be involved in the preventing and controlling COVID-19 in their faculty. Meanwhile, the health screening system had been conducting in different setting by considering the safety principles. In addition, officers expressed their need to improve their capacity for conducting regular activities. Conclusion: The health screening system activities during pandemic in UGM was considering safety principles.
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21
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Weber TP, Stilianakis NI. Fomites, hands, and the transmission of respiratory viruses. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:1-3. [PMID: 33284735 DOI: 10.1080/15459624.2020.1845343] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Thomas P Weber
- European Commission, Directorate General for Health and Food Safety, Brussels, Belgium
| | - Nikolaos I Stilianakis
- European Commission, Joint Research Centre (JRC), Ispra, Italy
- Department of Biometry and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany
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22
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Yang Chan EY, Shahzada TS, Sham TST, Dubois C, Huang Z, Liu S, Ho JYE, Hung KKC, Kwok KO, Shaw R. Narrative review of non-pharmaceutical behavioural measures for the prevention of COVID-19 (SARS-CoV-2) based on the Health-EDRM framework. Br Med Bull 2020; 136:46-87. [PMID: 33030513 PMCID: PMC7665374 DOI: 10.1093/bmb/ldaa030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Non-pharmaceutical measures to facilitate a response to the COVID-19 pandemic, a disease caused by novel coronavirus SARS-CoV-2, are urgently needed. Using the World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework, behavioural measures for droplet-borne communicable diseases and their enabling and limiting factors at various implementation levels were evaluated. SOURCES OF DATA Keyword search was conducted in PubMed, Google Scholar, Embase, Medline, Science Direct, WHO and CDC online publication databases. Using the Oxford Centre for Evidence-Based Medicine review criteria, 10 bottom-up, non-pharmaceutical prevention measures from 104 English-language articles, which published between January 2000 and May 2020, were identified and examined. AREAS OF AGREEMENT Evidence-guided behavioural measures against transmission of COVID-19 in global at-risk communities were identified, including regular handwashing, wearing face masks and avoiding crowds and gatherings. AREAS OF CONCERN Strong evidence-based systematic behavioural studies for COVID-19 prevention are lacking. GROWING POINTS Very limited research publications are available for non-pharmaceutical measures to facilitate pandemic response. AREAS TIMELY FOR RESEARCH Research with strong implementation feasibility that targets resource-poor settings with low baseline health-EDRM capacity is urgently needed.
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Affiliation(s)
- Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Nuffield Department of Medicine, University of Oxford, Oxford OX37BN, UK
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- GX Foundation, Quarry Bay, Hong Kong SAR, China
| | - Tayyab Salim Shahzada
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- GX Foundation, Quarry Bay, Hong Kong SAR, China
| | - Tiffany Sze Tung Sham
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- GX Foundation, Quarry Bay, Hong Kong SAR, China
| | - Caroline Dubois
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- GX Foundation, Quarry Bay, Hong Kong SAR, China
| | - Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Sida Liu
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- GX Foundation, Quarry Bay, Hong Kong SAR, China
| | - Janice Ying-en Ho
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Kevin K C Hung
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Accident & Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kin On Kwok
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Rajib Shaw
- Graduate School of Media and Governance, Keio University, Fujisawa 252-0882, Japan
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23
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Coiffard L, Couteau C. Un produit de santé peut-il changer de statut au gré des circonstances ? Éléments de réflexion avec l’exemple précis du savon. MÉDECINE & DROIT 2020. [PMCID: PMC7985184 DOI: 10.1016/j.meddro.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Le savon est un produit cosmétique d’usage courant, en cette période de pandémie, puisque son utilisation fait partie des gestes barrières. Capable de prévenir une maladie, la COVID-19, il devrait donc être commercialisé sous un statut de médicament. Si l’on considère l’histoire du savon, on se rend compte de la complexité de son statut. Selon les périodes, il a été considéré comme un produit d’hygiène et/ou comme un excipient ou encore comme une substance active, permettant la réalisation de médicaments ou de cosmétiques destinés à traiter aussi bien la gale que les brûlures, de réaliser des purges ou de mettre au point des préparations pour adoucir ou blanchir les mains ou pour allonger les cils. L’emploi du terme « savon » étant extrêmement galvaudé, l’établissement d’une réglementation visant à clarifier cette situation s’imposerait.
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Wataganara T, Ruangvutilert P, Sunsaneevithayakul P, Sutantawibul A, Chuchotirot M, Phattanachindakun B, Russameecharoen K. Minimizing cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic. J Perinat Med 2020; 48:931-942. [PMID: 32681782 DOI: 10.1515/jpm-2020-0228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/28/2020] [Indexed: 12/18/2022]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated infection (COVID-19) is affecting populations worldwide. This statement may serve as guidance for infection prevention and safe ultrasound practices during the COVID-19 pandemic. Ultrasound examination is a fundamental part of obstetric care, yet it is a potential vector for transmission of SARS-CoV-2. Decontamination methods should always be implemented for ultrasound equipment, especially in the presence of suspected or confirmed COVID-19 cases. There must be workflow policies to protect pregnant women and healthcare providers from nosocomial cross transmission of SARS-CoV-2. Cleaning and disinfecting of equipment must be in accordance with their potential of pathogen transmission. Consider using telemedicine and genetic technologies as an adjunctive of obstetric ultrasound to reduce patient crowding. Patient triage and education of healthcare providers of infection prevention are crucial to minimize cross contamination of SARS-CoV-2 during obstetric ultrasound.
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Affiliation(s)
- Tuangsit Wataganara
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Pornpimol Ruangvutilert
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Prasert Sunsaneevithayakul
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Anuwat Sutantawibul
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Monsak Chuchotirot
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Buraya Phattanachindakun
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Kusol Russameecharoen
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
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Wang MX, Gwee SXW, Chua PEY, Pang J. Effectiveness of Surgical Face Masks in Reducing Acute Respiratory Infections in Non-Healthcare Settings: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2020; 7:564280. [PMID: 33102503 PMCID: PMC7546829 DOI: 10.3389/fmed.2020.564280] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/17/2020] [Indexed: 01/24/2023] Open
Abstract
Background: Acute respiratory illnesses (ARIs) are the most common respiratory infectious diseases among humans globally. Surgical mask (SM) wearing has been shown to be effective in reducing ARI among healthcare workers. However, the effectiveness of SM in reducing ARI in the non-healthcare settings remains unclear. This review aims to summarize and assess the association between SM wearing and ARI incidence, from existing interventional and observational studies conducted in non-healthcare settings. Methods: Systematic literature searches conducted in PubMed, Cochrane Library, and Embase databases identified 503 unique studies. After screening, 15 studies (5 randomized controlled trials and 10 observational studies) were assessed for reporting and methodological qualities. Proportions of ARI episodes in each group and adjusted summary statistics with their relevant 95% CIs were extracted. Data from 10 observational studies were pooled using the generic inverse variance method. Results: A total of 23,892 participants between 7 and 89 years old involved across 15 studies from 11 countries were involved. Key settings identified were Hajj, schools, and in-flight settings. A modest but non-significant protective effect of SM on ARI incidence was observed (pooled OR 0.96, 95% CI 0.8–1.15). Subgroup analysis according to age group, outcome ascertainment and different non-healthcare settings also revealed no significant associations between SM use and ARI incidence. Conclusion: Surgical mask wearing among individuals in non-healthcare settings is not significantly associated with reduction in ARI incidence in this meta-review.
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Affiliation(s)
- Min Xian Wang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
| | - Sylvia Xiao Wei Gwee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
| | - Pearleen Ee Yong Chua
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
| | - Junxiong Pang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
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26
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Poon WCK, Brown AT, Direito SOL, Hodgson DJM, Le Nagard L, Lips A, MacPhee CE, Marenduzzo D, Royer JR, Silva AF, Thijssen JHJ, Titmuss S. Soft matter science and the COVID-19 pandemic. SOFT MATTER 2020; 16:8310-8324. [PMID: 32909024 DOI: 10.1039/d0sm01223h] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Much of the science underpinning the global response to the COVID-19 pandemic lies in the soft matter domain. Coronaviruses are composite particles with a core of nucleic acids complexed to proteins surrounded by a protein-studded lipid bilayer shell. A dominant route for transmission is via air-borne aerosols and droplets. Viral interaction with polymeric body fluids, particularly mucus, and cell membranes controls their infectivity, while their interaction with skin and artificial surfaces underpins cleaning and disinfection and the efficacy of masks and other personal protective equipment. The global response to COVID-19 has highlighted gaps in the soft matter knowledge base. We survey these gaps, especially as pertaining to the transmission of the disease, and suggest questions that can (and need to) be tackled, both in response to COVID-19 and to better prepare for future viral pandemics.
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Affiliation(s)
- Wilson C K Poon
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Aidan T Brown
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Susana O L Direito
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Daniel J M Hodgson
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Lucas Le Nagard
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Alex Lips
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Cait E MacPhee
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Davide Marenduzzo
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - John R Royer
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Andreia F Silva
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Job H J Thijssen
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
| | - Simon Titmuss
- Edinburgh Complex Fluids Partnership (ECFP), SUPA and School of Physics & Astronomy, The University of Edinburgh, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK.
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27
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Giesen N, Sprute R, Rüthrich M, Khodamoradi Y, Mellinghoff SC, Beutel G, Lueck C, Koldehoff M, Hentrich M, Sandherr M, von Bergwelt-Baildon M, Wolf HH, Hirsch HH, Wörmann B, Cornely OA, Köhler P, Schalk E, von Lilienfeld-Toal M. Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO). Eur J Cancer 2020; 140:86-104. [PMID: 33068941 PMCID: PMC7505554 DOI: 10.1016/j.ejca.2020.09.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/20/2020] [Accepted: 09/02/2020] [Indexed: 01/08/2023]
Abstract
Since its first detection in China in late 2019 the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious disease COVID-19 continue to have a major impact on global healthcare and clinical practice. Cancer patients, in particular those with haematological malignancies, seem to be at an increased risk for a severe course of infection. Deliberations to avoid or defer potentially immunosuppressive therapies in these patients need to be balanced against the overarching goal of providing optimal antineoplastic treatment. This poses a unique challenge to treating physicians. This guideline provides evidence-based recommendations regarding prevention, diagnostics and treatment of SARS-CoV-2 infection and COVID-19 as well as strategies towards safe antineoplastic care during the COVID-19 pandemic. It was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) by critically reviewing the currently available data on SARS-CoV-2 and COVID-19 in cancer patients applying evidence-based medicine criteria.
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Affiliation(s)
- Nicola Giesen
- Department of Haematology and Oncology, Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany.
| | - Rosanne Sprute
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Center for Integrated Oncology (CIO ABCD), German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Maria Rüthrich
- Department of Haematology and Medical Oncology, Clinic for Internal Medicine II, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
| | - Yascha Khodamoradi
- Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, Frankfurt Am Main, Germany
| | - Sibylle C Mellinghoff
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Center for Integrated Oncology (CIO ABCD), German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Gernot Beutel
- Department for Haematology, Haemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO)
| | - Catherina Lueck
- Department for Haematology, Haemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO)
| | - Michael Koldehoff
- Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Marcus Hentrich
- Department of Medicine III - Haematology/Oncology, Red Cross Hospital, Munich, Germany
| | - Michael Sandherr
- Specialist Clinic for Haematology and Oncology, Medical Care Center Penzberg, Penzberg, Germany
| | - Michael von Bergwelt-Baildon
- Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Internal Medicine III, LMU University Hospital, DKTK Partner Site Munich, BZKF Partner Site Munich, CCC-Munich, Munich, Germany
| | - Hans-Heinrich Wolf
- Department of Haematology, Oncology and Haemostaseology, Internal Medicine III, Südharzklinikum, Nordhausen, Germany
| | - Hans H Hirsch
- Transplantation & Clinical Virology, Department Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland; Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Bernhard Wörmann
- Division of Haematology, Oncology and Tumor Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Center for Integrated Oncology (CIO ABCD), German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Philipp Köhler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Center for Integrated Oncology (CIO ABCD), German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Enrico Schalk
- Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Haematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Marie von Lilienfeld-Toal
- Department of Haematology and Medical Oncology, Clinic for Internal Medicine II, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
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28
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Zhou Q, Lai X, Zhang X, Tan L. Compliance measurement and observed influencing factors of hand hygiene based on COVID-19 guidelines in China. Am J Infect Control 2020; 48:1074-1079. [PMID: 32522610 PMCID: PMC7833598 DOI: 10.1016/j.ajic.2020.05.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Higher requirement is put forward in the measurement of hand hygiene (HH) during a pandemic. This study aimed to describe HH compliance measurement and explore observed influencing factors with respect to coronavirus disease 2019 (COVID-19) guidelines in China. METHODS Compliance was measured as the percentage of compliant opportunities based on criteria for 17 moments. The criteria for compliance included HH behavior, procedure, duration, hand drying method, and the overall that counts them all. The observed influencing factors included different departments and areas and protection motivation. Descriptive analysis and logistic regression were performed. RESULTS The compliance of overall criteria, HH behavior, procedure, duration, and hand drying method were 79.44%, 96.71%, 95.74%, 88.93%, and 88.42%, respectively, which were significantly different from each other (P < .001). Meanwhile, the overall and hand drying method compliance in semi-contaminated areas (odds ratio [OR] = 1.829, P < .001; OR = 2.149, P = .001) and hygienic areas (OR = 1.689, P = .004; OR = 1.959, P = .015) were significantly higher than those in contaminated area. The compliance with HH behavior for the motivation of patient-protection (OR = 0.362, P < .001) was lower than that for the motivation of self-protection. CONCLUSIONS HH compliance was firstly measured using different criteria for 17 moments according to COVID-19 guidelines in China. The measurement of HH compliance needs clearer definition and comprehensive practice. Contaminated areas and motivation of patient-protection contribute to lower compliance, which may be addressed by allocating more human resources and increasing supervision and education.
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29
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Golin AP, Choi D, Ghahary A. Hand sanitizers: A review of ingredients, mechanisms of action, modes of delivery, and efficacy against coronaviruses. Am J Infect Control 2020; 48:1062-1067. [PMID: 32565272 PMCID: PMC7301780 DOI: 10.1016/j.ajic.2020.06.182] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 12/13/2022]
Abstract
Background The emergence of the novel virus, SARS-CoV-2, has posed unprecedented challenges to public health around the world. Currently, strategies to deal with COVID-19 are purely supportive and preventative, aimed at reducing transmission. An effective and simple method for reducing transmission of infections in public or healthcare settings is hand hygiene. Unfortunately, little is known regarding the efficacy of hand sanitizers against SARS-CoV-2. Methods In this review, an extensive literature search was performed to succinctly summarize the primary active ingredients and mechanisms of action of hand sanitizers, compare the effectiveness and compliance of gel and foam sanitizers, and predict whether alcohol and non-alcohol hand sanitizers would be effective against SARS-CoV-2. Results Most alcohol-based hand sanitizers are effective at inactivating enveloped viruses, including coronaviruses. With what is currently known in the literature, one may not confidently suggest one mode of hand sanitizing delivery over the other. When hand washing with soap and water is unavailable, a sufficient volume of sanitizer is necessary to ensure complete hand coverage, and compliance is critical for appropriate hand hygiene. Conclusions By extrapolating effectiveness of hand sanitizers on viruses of similar structure to SARS-CoV-2, this virus should be effectively inactivated with current hand hygiene products, though future research should attempt to determine this directly.
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30
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Affiliation(s)
- Reza Dehbandi
- Department of Environmental Health Engineering, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Ali Zazouli
- Department of Environmental Health Engineering, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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31
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Lourith N, Pungprom S, Kanlayavattanakul M. Formulation and efficacy evaluation of the safe and efficient moisturizing snow mushroom hand sanitizer. J Cosmet Dermatol 2020; 20:554-560. [PMID: 32531816 PMCID: PMC7323351 DOI: 10.1111/jocd.13543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/02/2020] [Accepted: 06/03/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Snow fungus or snow mushroom or white jelly mushroom (Tremella fuciformis), the edible mushroom, was formulated into hand sanitizer in form of moisturizing alcohol-based hand rub (ABHR) gel. METHODS The stable base ABHRs were developed. The preferred bases were incorporated with various concentrations of snow mushroom extract. The stable and preferred snow mushroom ABHR was moisturizing and sanitizing efficacies evaluated in 20 human volunteers in comparison with its placebo. RESULTS The stable hand sanitizer gel bases containing 66.5% of ethanol and 0.3% of triclosan were developed and incorporated with the extract of snow mushroom polysaccharide. Of which, the preparations containing 10% of snow mushroom and 0.3% of gelling agent gained the highest preferences as assessed in 20 Thai volunteers. The snow mushroom hand sanitizer was proved to be none irritated in the same group of the volunteers as was the placebo. The snow mushroom gel significantly (P < .05) moist the skin better than the placebo at all time of the interval assessment until the end of the study at 180 minutes. The hand sanitizers were confirmed on their anti-septic, at which the efficacies of the active and placebo ABHR were comparable (P = .90). CONCLUSIONS Snow mushroom ABHR gel with its confirmed moisturizing and sanitizing efficacies is presented. It is meetings with the recommendation on hand hygienic improvement to combat the infections of diseases spreading. The preparation can be frequency applied with its proved skin hydrating efficacy co-contributes in a good condition of hand hygiene.
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Affiliation(s)
- Nattaya Lourith
- School of Cosmetic Science, Mae Fah Luang University, Chiang Rai, Thailand.,Phytocosmetics and Cosmeceuticals Research Group, Mae Fah Luang University, Chiang Rai, Thailand
| | - Sathaporn Pungprom
- School of Cosmetic Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Mayuree Kanlayavattanakul
- School of Cosmetic Science, Mae Fah Luang University, Chiang Rai, Thailand.,Phytocosmetics and Cosmeceuticals Research Group, Mae Fah Luang University, Chiang Rai, Thailand
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32
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Zhang N, Chen W, Chan PT, Yen HL, Tang JWT, Li Y. Close contact behavior in indoor environment and transmission of respiratory infection. INDOOR AIR 2020; 30:645-661. [PMID: 32259319 DOI: 10.1111/ina.12673] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/29/2020] [Accepted: 03/25/2020] [Indexed: 05/05/2023]
Abstract
Close contact was first identified as the primary route of transmission for most respiratory infections in the early 20th century. In this review, we synthesize the existing understanding of the mechanisms of close contact transmission. We focus on two issues: the mechanism of transmission in close contact, namely the transmission of the expired particles between two people, and the physical parameters of close contact that affect the exposure of particles from one individual to another, or how the nature of close contact plays a role in transmission. We propose the existence of three sub-routes of transmission: short-range airborne, large droplets, and immediate body-surface contact. We also distinguish a "body contact," which is defined with an interpersonal distance of zero, from a close contact. We demonstrate herein that the short-range airborne sub-route may be most common. The timescales over which data should be collected to assess the transmission risk during close contact events are much shorter than those required for the distant airborne or fomite routes. The current paucity of high-resolution data over short distances and timescales makes it very difficult to assess the risk of infection in these circumstances.
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Affiliation(s)
- Nan Zhang
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Wenzhao Chen
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Pak-To Chan
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Hui-Ling Yen
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Julian Wei-Tze Tang
- Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
- Respiratory Sciences, University of Leicester, Leicester, UK
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
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33
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Zhang N, Jia W, Wang P, King MF, Chan PT, Li Y. Most self-touches are with the nondominant hand. Sci Rep 2020; 10:10457. [PMID: 32591572 PMCID: PMC7320184 DOI: 10.1038/s41598-020-67521-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 05/22/2020] [Indexed: 02/08/2023] Open
Abstract
Self-touch may promote the transfer of microorganisms between body parts or surfaces to mucosa. In overt videography of a post-graduate office, students spent 9% of their time touching their own hair, face, neck, and shoulders (HFNS). These data were collected from 274,000 s of surveillance video in a Chinese graduate student office. The non-dominant hand contributed to 66.1% of HFNS-touches. Most importantly, mucous membranes were touched, on average, 34.3 (SE = 2.4) times per hour, which the non-dominant hand contributed to 240% more than the dominant hand. Gender had no significant effect on touch frequency, but a significant effect on duration per touch. The duration per touch on the HFNS was fitted with a log–log linear distribution. Touch behaviour analysis included surface combinations and a probability matrix for sequential touches of 20 sub-surfaces. These findings may partly explain the observed variation in the literature regarding the microbiome community distribution on human skin, supporting the importance of indirect contact transmission route in some respiratory disease transmission and providing data for risk analysis of infection spread and control.
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Affiliation(s)
- Nan Zhang
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, People's Republic of China
| | - Wei Jia
- Zhejiang Institute of Research and Innovation, The University of Hong Kong, Lin An, Zhejiang, People's Republic of China
| | - Peihua Wang
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, People's Republic of China
| | | | - Pak-To Chan
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, People's Republic of China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, People's Republic of China. .,School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, People's Republic of China.
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34
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Atolani O, Baker MT, Adeyemi OS, Olanrewaju IR, Hamid AA, Ameen OM, Oguntoye SO, Usman LA. COVID-19: Critical discussion on the applications and implications of chemicals in sanitizers and disinfectants. EXCLI JOURNAL 2020; 19:785-799. [PMID: 32636732 PMCID: PMC7332783 DOI: 10.17179/excli2020-1386] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/07/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Olubunmi Atolani
- Department of Chemistry, University of Ilorin, P.M.B. 1515, Ilorin, Nigeria
| | | | - Oluyomi Stephen Adeyemi
- Department of Biochemistry, Medicinal Biochemistry, Infectious Diseases, Nanomedicine & Toxicology Laboratory, Landmark University, PMB 1001, Omu-Aran 251101, Kwara State, Nigeria
| | | | | | - Oloduowo M. Ameen
- Department of Chemistry, University of Ilorin, P.M.B. 1515, Ilorin, Nigeria
| | | | - Lamidi A. Usman
- Department of Chemistry, University of Ilorin, P.M.B. 1515, Ilorin, Nigeria
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35
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Chan TK. Universal masking for COVID-19: evidence, ethics and recommendations. BMJ Glob Health 2020; 5:bmjgh-2020-002819. [PMID: 32461227 PMCID: PMC7254130 DOI: 10.1136/bmjgh-2020-002819] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Tak Kwong Chan
- Pharmacology and Pharmacy, Hong Kong University, Hong Kong, Hong Kong
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36
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Xiao J, Shiu EYC, Gao H, Wong JY, Fong MW, Ryu S, Cowling BJ. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings-Personal Protective and Environmental Measures. Emerg Infect Dis 2020; 26:967-975. [PMID: 32027586 PMCID: PMC7181938 DOI: 10.3201/eid2605.190994] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
There were 3 influenza pandemics in the 20th century, and there has been 1 so far in the 21st century. Local, national, and international health authorities regularly update their plans for mitigating the next influenza pandemic in light of the latest available evidence on the effectiveness of various control measures in reducing transmission. Here, we review the evidence base on the effectiveness of nonpharmaceutical personal protective measures and environmental hygiene measures in nonhealthcare settings and discuss their potential inclusion in pandemic plans. Although mechanistic studies support the potential effect of hand hygiene or face masks, evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza. We similarly found limited evidence on the effectiveness of improved hygiene and environmental cleaning. We identified several major knowledge gaps requiring further research, most fundamentally an improved characterization of the modes of person-to-person transmission.
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37
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Namara F, Omona K, Mbabazi S. Barriers and motivators to participation in hand washing promotion programs at household level among refugees in Rhino Settlement, Arua District _ Uganda. COGENT MEDICINE 2020. [DOI: 10.1080/2331205x.2020.1757184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Frank Namara
- Department of Public Health, Uganda Red Cross Society Kampala Uganda
| | - Kizito Omona
- Faculty of Health Sciences, Uganda Martyrs University Kampala Uganda
| | - Scovia Mbabazi
- Faculty of Health Sciences, Uganda Martyrs University Kampala Uganda
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38
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Chen X, Ran L, Liu Q, Hu Q, Du X, Tan X. Hand Hygiene, Mask-Wearing Behaviors and Its Associated Factors during the COVID-19 Epidemic: A Cross-Sectional Study among Primary School Students in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082893. [PMID: 32331344 PMCID: PMC7215913 DOI: 10.3390/ijerph17082893] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/14/2022]
Abstract
Although the emphasis on behaviors of hand-washing and mask-wearing was repeated during the pandemic of Coronavirus Disease 2019 (COVID-19), not everyone paid enough attention to this. A descriptive statistic was used to make sense of the status of hand hygiene and mask-wearing among primary school students in Wuhan, China. A binary logistic regression analysis was conducted to identify the risk factors affecting the behaviors of hand-washing and mask-wearing. p < 0.05 (two-sides) was considered as significant at statistics. 42.05% of the primary school students showed a good behavior of hand-washing, while 51.60% had a good behavior of mask-wearing. Gender, grade, out-going history, father’s occupation, mother’s educational background, and the time filling out the survey were significantly associated with hand hygiene, whereas grade, mother’s educational background, and residence were associated with mask-wearing. The behaviors of hand-washing and mask-wearing among primary school students were influenced by gender, grade, and other factors, therefore, parents should make efforts of behavior guidance whereas governments should enlarge medium publicity.
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Affiliation(s)
- Xuyu Chen
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (X.C.); (L.R.); (Q.L.); (X.D.)
| | - Li Ran
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (X.C.); (L.R.); (Q.L.); (X.D.)
| | - Qing Liu
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (X.C.); (L.R.); (Q.L.); (X.D.)
| | - Qikai Hu
- School of Mathematics and Statistics, Wuhan University, Wuhan 430071, China;
| | - Xueying Du
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (X.C.); (L.R.); (Q.L.); (X.D.)
| | - Xiaodong Tan
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (X.C.); (L.R.); (Q.L.); (X.D.)
- Correspondence: ; Tel.: +86-1350-713-5465
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Dingman D, Wu J, Murphy HM. School-based, blacklight handwashing program can improve handwashing quality and knowledge among pre-school aged children. EVALUATION AND PROGRAM PLANNING 2020; 78:101731. [PMID: 31756601 DOI: 10.1016/j.evalprogplan.2019.101731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 09/23/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
In the United States, lack of proper handwashing is associated with respiratory and gastrointestinal illnesses. Interventions to improve handwashing practices have led to an increase in handwashing knowledge and behavior, and decreases in gastrointestinal illnesses. Most studies have evaluated their interventions in the context of reported handwashing rates by observation, reduction of illnesses, as well as reduced absences, however none of these studies examined handwashing quality or knowledge as outcome measures. The objective of this paper is to present the results from a handwashing program with a special focus on the evaluation methods. A pre-post design was used to evaluate a handwashing program that took place in two pre-schools the northeast of the United States. The program utilized a black light technology to demonstrate to children the importance of good quality. The evaluation consisted of assessing knowledge and quality of handwashing using a linear puzzle and individual handwashing observation, respectively. Students from both schools improved on both knowledge and quality over time (p-values 0.071 and <0.001, respectively). The present study demonstrates that the use of black light technology as an educational tool may help to improve handwashing quality among pre-school aged children, even after only one instructional session.
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Affiliation(s)
- Deirdre Dingman
- Department of Social Behavioral Science, College of Public Health, 1301 Cecil B. Moore, 9th Floor, Ritter Annex, Temple University, Philadelphia, PA, 19122, USA.
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, College of Public Health, 1301 Cecil B. Moore, 9th Floor, Ritter Annex, Temple University, Philadelphia, PA, 19122, USA.
| | - Heather M Murphy
- Department of Epidemiology and Biostatistics, College of Public Health, 1301 Cecil B. Moore, 9th Floor, Ritter Annex, Temple University, Philadelphia, PA, 19122, USA.
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Mumma JM, Durso FT, Ferguson AN, Gipson CL, Casanova L, Erukunuakpor K, Kraft CS, Walsh VL, Zimring C, DuBose J, Jacob JT. Human Factors Risk Analyses of a Doffing Protocol for Ebola-Level Personal Protective Equipment: Mapping Errors to Contamination. Clin Infect Dis 2019; 66:950-958. [PMID: 29471368 DOI: 10.1093/cid/cix957] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Doffing protocols for personal protective equipment (PPE) are critical for keeping healthcare workers (HCWs) safe during care of patients with Ebola virus disease. We assessed the relationship between errors and self-contamination during doffing. Methods Eleven HCWs experienced with doffing Ebola-level PPE participated in simulations in which HCWs donned PPE marked with surrogate viruses (ɸ6 and MS2), completed a clinical task, and were assessed for contamination after doffing. Simulations were video recorded, and a failure modes and effects analysis and fault tree analyses were performed to identify errors during doffing, quantify their risk (risk index), and predict contamination data. Results Fifty-one types of errors were identified, many having the potential to spread contamination. Hand hygiene and removing the powered air purifying respirator (PAPR) hood had the highest total risk indexes (111 and 70, respectively) and number of types of errors (9 and 13, respectively). ɸ6 was detected on 10% of scrubs and the fault tree predicted a 10.4% contamination rate, likely occurring when the PAPR hood inadvertently contacted scrubs during removal. MS2 was detected on 10% of hands, 20% of scrubs, and 70% of inner gloves and the predicted rates were 7.3%, 19.4%, 73.4%, respectively. Fault trees for MS2 and ɸ6 contamination suggested similar pathways. Conclusions Ebola-level PPE can both protect and put HCWs at risk for self-contamination throughout the doffing process, even among experienced HCWs doffing with a trained observer. Human factors methodologies can identify error-prone steps, delineate the relationship between errors and self-contamination, and suggest remediation strategies.
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Affiliation(s)
- Joel M Mumma
- School of Psychology, Georgia Institute of Technology, Atlanta
| | - Francis T Durso
- School of Psychology, Georgia Institute of Technology, Atlanta
| | | | | | - Lisa Casanova
- School of Public Health, Georgia State University, Atlanta
| | | | - Colleen S Kraft
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta.,Department of Pathology and Laboratory Medicine, Emory University, Atlanta
| | - Victoria L Walsh
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta
| | - Craig Zimring
- School of Architecture, Georgia Institute of Technology, Atlanta
| | - Jennifer DuBose
- School of Architecture, Georgia Institute of Technology, Atlanta
| | - Jesse T Jacob
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta
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Casanova LM, Erukunuakpor K, Kraft CS, Mumma JM, Durso FT, Ferguson AN, Gipson CL, Walsh VL, Zimring C, DuBose J, Jacob JT. Assessing Viral Transfer During Doffing of Ebola-Level Personal Protective Equipment in a Biocontainment Unit. Clin Infect Dis 2019; 66:945-949. [PMID: 29471475 DOI: 10.1093/cid/cix956] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Personal protective equipment (PPE) protects healthcare workers (HCWs) caring for patients with Ebola virus disease (EVD), and PPE doffing is a critical point for preventing viral self-contamination. We assessed contamination of skin, gloves, and scrubs after doffing Ebola-level PPE contaminated with surrogate viruses: bacteriophages MS2 and Φ6. Methods In a medical biocontainment unit, HCWs (n = 10) experienced in EVD care donned and doffed PPE following unit protocols that incorporate trained observer guidance and alcohol-based hand rub (ABHR). A mixture of Φ6 (enveloped), MS2 (nonenveloped), and fluorescent marker was applied to 4 PPE sites, approximating body fluid viral load (Φ6, 105; MS2, 106). They performed a patient care task, then doffed. Inner gloves, face, hands, and scrubs were sampled for virus, as were environmental sites with visible fluorescent marker. Results Among 10 HCWs there was no Φ6 transfer to inner gloves, hands, or face; 1 participant had Φ6 on scrubs at low levels (1.4 × 102). MS2 transfer (range, 101-106) was observed to scrubs (n = 2), hands (n = 1), and inner gloves (n = 7), where it was highest. Most (n = 8) had only 1 positive site. Environmental samples with visible fluorescent marker (n = 21) were negative. Conclusions Among experienced HCWs, structured, observed doffing using ABHR protected against hand contamination with enveloped virus. Nonenveloped virus was infrequent on hands and scrubs but common on inner gloves, suggesting that inner gloves, but not necessarily ABHR, protect against hand contamination. Optimizing doffing protocols to protect against all types of viruses may require reinforcing careful handling of scrubs and good glove/hand hygiene with effective agents.
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Affiliation(s)
- Lisa M Casanova
- Division of Environmental Health, School of Public Health, Georgia State University
| | | | - Colleen S Kraft
- Department of Pathology and Laboratory Medicine, Emory University
| | - Joel M Mumma
- School of Psychology, Georgia Institute of Technology
| | | | | | | | - Victoria L Walsh
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine
| | - Craig Zimring
- School of Architecture, Georgia Institute of Technology, Atlanta
| | - Jennifer DuBose
- School of Architecture, Georgia Institute of Technology, Atlanta
| | - Jesse T Jacob
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine
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Peters A, Frat E, Iten A, Sauser J, Schibler M, Pittet D. Alcohol-based hand rub and influenza A: the danger of publishing a flawed study with no clinical relevance. J Hosp Infect 2019; 104:120-122. [PMID: 31606432 DOI: 10.1016/j.jhin.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Affiliation(s)
- A Peters
- Infection Control Program and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - E Frat
- Intermountain LDS Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
| | - A Iten
- Infection Control Program and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - J Sauser
- Infection Control Program and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - M Schibler
- Infectious Diseases Division and National Reference Centers for Influenza and Emerging Viruses, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - D Pittet
- Infection Control Program and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Abstract
Gastrointestinal and respiratory viruses are particularly common during winter months, and reducing risk of transmission is challenging. Transfer of bacteria from the hands of one person to another is dramatically reduced with a fist bump compared to a handshake. If the same is true for viruses, should we recommend this change in greeting in the winter?
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[Influenza infection: An update for clinicians]. Rev Med Interne 2019; 40:158-165. [PMID: 30638964 DOI: 10.1016/j.revmed.2018.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/16/2018] [Accepted: 12/21/2018] [Indexed: 12/29/2022]
Abstract
Lower respiratory infections remain the deadliest communicable disease in the world. Influenza infections are particularly involved, whether intrinsically, or more frequently, by promoting bacterial infections and superinfections. The flu is also responsible for the decompensation of many comorbidities and could lead to some myocardial infarction and stroke. The effect of antiviral therapies is limited but preventives measures, such as vaccination, remain a major public health issue. The flu is a major challenge at all levels and all times, from vaccine prevention, to the recognition of atypical forms, and the early management of bacterial complications.
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Moncion K, Young K, Tunis M, Rempel S, Stirling R, Zhao L. Effectiveness of hand hygiene practices in preventing influenza virus infection in the community setting: A systematic review. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2019; 45:12-23. [PMID: 31015816 PMCID: PMC6461122 DOI: 10.14745/ccdr.v45i01a02] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hand hygiene is known to be an effective infection prevention and control measure in health care settings. However, the effectiveness of hand hygiene practices in preventing influenza infection and transmission in the community setting is not clear. OBJECTIVE To identify, review and synthesize available evidence on the effectiveness of hand hygiene in preventing laboratory-confirmed or possible influenza infection and transmission in the community setting. METHODS A systematic review protocol was established prior to conducting the review. Three electronic databases (MEDLINE, Embase and the Cochrane Library) were searched to identify relevant studies. Two reviewers independently screened the titles, abstracts and full-texts of studies retrieved from the database searches for potential eligibility. Data extraction and quality assessment of included studies were performed by a single reviewer and validated by a second reviewer. Included studies were synthesized and analyzed narratively. RESULTS A total of 16 studies were included for review. Studies were of low methodological quality and there was high variability in study design, setting, context and outcome measures. Nine studies evaluated the effectiveness of hand hygiene interventions or practices in preventing laboratory-confirmed or possible influenza infection in the community setting; six studies showed a significant difference, three studies did not. Seven studies assessed the effectiveness of hand hygiene practices in preventing laboratory-confirmed or possible influenza transmission in the community setting; two studies found a significant difference and five studies did not. CONCLUSION The effectiveness of hand hygiene against influenza virus infection and transmission in the community setting is difficult to determine based on the available evidence. In light of its proven effectiveness in other settings, there is no compelling evidence to stop using good hand hygiene practice to reduce the risk of influenza infection and transmission in the community setting.
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Affiliation(s)
- K Moncion
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - K Young
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - M Tunis
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - S Rempel
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - R Stirling
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - L Zhao
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
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Ikonen N, Savolainen-Kopra C, Enstone JE, Kulmala I, Pasanen P, Salmela A, Salo S, Nguyen-Van-Tam JS, Ruutu P. Deposition of respiratory virus pathogens on frequently touched surfaces at airports. BMC Infect Dis 2018; 18:437. [PMID: 30157776 PMCID: PMC6116441 DOI: 10.1186/s12879-018-3150-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/15/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND International and national travelling has made the rapid spread of infectious diseases possible. Little information is available on the role of major traffic hubs, such as airports, in the transmission of respiratory infections, including seasonal influenza and a pandemic threat. We investigated the presence of respiratory viruses in the passenger environment of a major airport in order to identify risk points and guide measures to minimize transmission. METHODS Surface and air samples were collected weekly at three different time points during the peak period of seasonal influenza in 2015-16 in Finland. Swabs from surface samples, and air samples were tested by real-time PCR for influenza A and B viruses, respiratory syncytial virus, adenovirus, rhinovirus and coronaviruses (229E, HKU1, NL63 and OC43). RESULTS Nucleic acid of at least one respiratory virus was detected in 9 out of 90 (10%) surface samples, including: a plastic toy dog in the children's playground (2/3 swabs, 67%); hand-carried luggage trays at the security check area (4/8, 50%); the buttons of the payment terminal at the pharmacy (1/2, 50%); the handrails of stairs (1/7, 14%); and the passenger side desk and divider glass at a passport control point (1/3, 33%). Among the 10 respiratory virus findings at various sites, the viruses identified were: rhinovirus (4/10, 40%, from surfaces); coronavirus (3/10, 30%, from surfaces); adenovirus (2/10, 20%, 1 air sample, 1 surface sample); influenza A (1/10, 10%, surface sample). CONCLUSIONS Detection of pathogen viral nucleic acids indicates respiratory viral surface contamination at multiple sites associated with high touch rates, and suggests a potential risk in the identified airport sites. Of the surfaces tested, plastic security screening trays appeared to pose the highest potential risk, and handling these is almost inevitable for all embarking passengers.
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Affiliation(s)
- Niina Ikonen
- Department of Health Security, National Institute for Health and Welfare, P.O.Box 30, 00271 Helsinki, Finland
| | - Carita Savolainen-Kopra
- Department of Health Security, National Institute for Health and Welfare, P.O.Box 30, 00271 Helsinki, Finland
| | - Joanne E. Enstone
- School of Medicine, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Ilpo Kulmala
- VTT Technical Research Centre of Finland Ltd, Espoo and Tampere, Finland
| | - Pertti Pasanen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anniina Salmela
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Satu Salo
- VTT Technical Research Centre of Finland Ltd, Espoo and Tampere, Finland
| | - Jonathan S. Nguyen-Van-Tam
- School of Medicine, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Petri Ruutu
- Department of Health Security, National Institute for Health and Welfare, P.O.Box 30, 00271 Helsinki, Finland
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Carnero AM, Kitayama K, Diaz DA, Garvich M, Angulo N, Cama VA, Gilman RH, Bayer AM. Risk for interspecies transmission of zoonotic pathogens during poultry processing and pork production in Peru: A qualitative study. Zoonoses Public Health 2018; 65:528-539. [PMID: 29602269 DOI: 10.1111/zph.12463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Indexed: 12/14/2022]
Abstract
Interspecies transmission of pathogens is an unfrequent but naturally occurring event and human activities may favour opportunities not previously reported. Reassortment of zoonotic pathogens like influenza A virus can result from these activities. Recently, swine and birds have played a central role as "mixing vessels" for epidemic and pandemic events related to strains like H1N1 and H5N1. Unsafe practices in poultry markets and swine farms can lead to interspecies transmission, favouring the emergence of novel strains. Thus, understanding practices that lead to interspecies interactions is crucial. This qualitative study aimed to evaluate poultry processing practices in formal and informal markets and the use of leftovers by swine farmers in three Peruvian cities: Lima (capital), Tumbes (coastal) and Tarapoto (jungle). We conducted 80 direct observations at formal and informal markets and interviewed 15 swine farmers. Processors slaughter and pluck chickens and vendors and/or processors eviscerate chickens. Food safety and hygiene practices were suboptimal or absent, although some heterogeneity was observed between cities and chicken vendors versus processors. Both vendors (76%) and processors (100%) sold the chicken viscera leftovers to swine farmers, representing the main source of chicken viscera for swine farms (53%). Swine farmers fed the chicken viscera to their swine. Chicken viscera cooking times varied widely and were insufficient in some cases. Non-abattoired poultry leads to the sale of poultry leftovers to small-scale swine farms, resulting in indirect but frequent interspecies contacts that can lead to interspecies transmission of bacterial pathogens or the reassortment of influenza A viruses. These interactions are exacerbated by suboptimal safety and hygiene conditions. People involved in these activities constitute an at-risk population who could play a central role in preventing the transmission of pathogens between species. Educational interventions on hygiene and food safety practices will be important for reducing the risk of interspecies influenza transmission.
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Affiliation(s)
- A M Carnero
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - K Kitayama
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - D A Diaz
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura (AB PRISMA), Lima, Peru
| | - M Garvich
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura (AB PRISMA), Lima, Peru
| | - N Angulo
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura (AB PRISMA), Lima, Peru
| | - V A Cama
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - R H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A M Bayer
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Chabrelie A, Mitchell J, Rose J, Charbonneau D, Ishida Y. Evaluation of the Influenza Risk Reduction from Antimicrobial Spray Application on Porous Surfaces. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:1502-1517. [PMID: 29278668 DOI: 10.1111/risa.12952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 04/14/2017] [Accepted: 11/16/2017] [Indexed: 05/04/2023]
Abstract
Antimicrobial spray products are used by millions of people around the world for cleaning and disinfection of commonly touched surfaces. Influenza A is a pathogen of major concern, leading to up to 49,000 deaths and 114,000 hospitalizations per year in the United States alone. One of the recognized routes of transmission for influenza A is by transfer of viruses from surfaces to hands and subsequently to mucous membranes. Therefore, routine cleaning and disinfection of surfaces is an important part of the environmental management of influenza A. While the emphasis is generally on spraying hard surfaces and laundering cloth and linens with high temperature machine drying, not all surfaces can be treated in this manner. The quantitative microbial risk assessment (QMRA) approach was used to develop a stochastic risk model for estimating the risk of infection from indirect contact with porous fomite with and without surface treatment with an antimicrobial spray. The data collected from laboratory analysis combined with the risk model show that influenza A infection risk can be lowered by four logs after using an antimicrobial spray on a porous surface. Median risk associated with a single touch to a contaminated fabric was estimated to be 1.25 × 10-4 for the untreated surface, and 3.6 × 10-8 for the treated surface as a base case assumption. This single touch scenario was used to develop a generalizable model for estimating risks and comparing scenarios with and without treatment to more realistic multiple touch scenarios over time periods and with contact rates previously reported in the literature. The results of this study and understanding of product efficacy on risk reduction inform and broaden the range of risk management strategies for influenza A by demonstrating effective risk reduction associated with treating nonporous fomites that cannot be laundered at high temperatures.
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Affiliation(s)
- Alexandre Chabrelie
- Department of Biosystem and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
| | - Jade Mitchell
- Department of Biosystem and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
| | - Joan Rose
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
| | | | - Yoshiki Ishida
- Procter & Gamble International Operations S.A., Singapore Branch, Singapore
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Kampf G. Efficacy of ethanol against viruses in hand disinfection. J Hosp Infect 2018; 98:331-338. [PMID: 28882643 PMCID: PMC7132458 DOI: 10.1016/j.jhin.2017.08.025] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 06/26/2017] [Accepted: 08/31/2017] [Indexed: 12/12/2022]
Abstract
Ethanol is used worldwide in healthcare facilities for hand rubbing. It has been reported to have a stronger and broader virucidal activity compared with propanols. The aim of this review was to describe the spectrum of virucidal activity of ethanol in solution or as commercially available products. A systematic search was conducted. Studies were selected when they contained original data on reduction of viral infectivity from suspension tests (49 studies) and contaminated hands (17 studies). Ethanol at 80% was highly effective against all 21 tested, enveloped viruses within 30 s. Murine norovirus and adenovirus type 5 are usually inactivated by ethanol between 70% and 90% in 30 s whereas poliovirus type 1 was often found to be too resistant except for ethanol at 95% (all test viruses of EN 14476). Ethanol at 80% is unlikely to be sufficiently effective against poliovirus, calicivirus (FCV), polyomavirus, hepatitis A virus (HAV) and foot-and-mouth disease virus (FMDV). The spectrum of virucidal activity of ethanol at 95%, however, covers the majority of clinically relevant viruses. Additional acids can substantially improve the virucidal activity of ethanol at lower concentrations against, e.g. poliovirus, FCV, polyomavirus and FMDV although selected viruses such as HAV may still be too resistant. The selection of a suitable virucidal hand rub should be based on the viruses most prevalent in a unit and on the user acceptability of the product under frequent-use conditions.
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Affiliation(s)
- G Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany.
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