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Title: Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human volunteers.
Austin Authors: Grayson, M Lindsay ;Melvani, Sharmila;Druce, Julian;Barr, Ian G;Ballard, Susan A;Johnson, Paul D R ;Mastorakos, Tasoula;Birch, Christopher
Affiliation: Infectious Diseases Department, Austin Health, Heidelberg, Victoria 3084, Australia
Issue Date: 1-Feb-2009
Publication information: Clinical Infectious Diseases; 48(3): 285-91
Abstract: Although pandemic and avian influenza are known to be transmitted via human hands, there are minimal data regarding the effectiveness of routine hand hygiene (HH) protocols against pandemic and avian influenza.Twenty vaccinated, antibody-positive health care workers had their hands contaminated with 1 mL of 10(7) tissue culture infectious dose (TCID)(50)/0.1 mL live human influenza A virus (H1N1; A/New Caledonia/20/99) before undertaking 1 of 5 HH protocols (no HH [control], soap and water hand washing [SW], or use of 1 of 3 alcohol-based hand rubs [61.5% ethanol gel, 70% ethanol plus 0.5% chlorhexidine solution, or 70% isopropanol plus 0.5% chlorhexidine solution]). H1N1 concentrations were assessed before and after each intervention by viral culture and real-time reverse-transcriptase polymerase chain reaction (PCR). The natural viability of H1N1 on hands for >60 min without HH was also assessed.There was an immediate reduction in culture-detectable and PCR-detectable H1N1 after brief cutaneous air drying--14 of 20 health care workers had H1N1 detected by means of culture (mean reduction, 10(3-4) TCID(50)/0.1 mL), whereas 6 of 20 had no viable H1N1 recovered; all 20 health care workers had similar changes in PCR test results. Marked antiviral efficacy was noted for all 4 HH protocols, on the basis of culture results (14 of 14 had no culturable H1N1; (P< .002) and PCR results (P< .001; cycle threshold value range, 33.3-39.4), with SW statistically superior (P< .001) to all 3 alcohol-based hand rubs, although the actual difference was only 1-100 virus copies/microL. There was minimal reduction in H1N1 after 60 min without HH.HH with SW or alcohol-based hand rub is highly effective in reducing influenza A virus on human hands, although SW is the most effective intervention. Appropriate HH may be an important public health initiative to reduce pandemic and avian influenza transmission.
Gov't Doc #: 19115974
DOI: 10.1086/595845
Journal: Clinical Infectious Diseases
Type: Journal Article
Subjects: Alcohols.pharmacology
Hand Disinfection.methods
Human Experimentation
Influenza A Virus, H1N1 Subtype.drug effects.isolation & purification
RNA, Viral.genetics
Virus Cultivation
Appears in Collections:Journal articles

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