Povidone-iodine hand wash and hand rub products demonstrated excellent in vitro virucidal efficacy against Ebola virus and modified vaccinia virus Ankara, the new European test virus for enveloped viruses

Abstract

BackgroundThe recent Ebola virus (EBOV) epidemic highlights the need for efficacious virucidal products to help prevent infection and limit the spread of Ebola virus disease. However, there is limited data on the efficacy of virucidal products against EBOV, because the virus has a high biosafety level and is only available in a few laboratories worldwide.The virucidal efficacy of antiseptics and disinfectants can be determined using the European Standard EN14476:2013/FprA1:2015. Modified vaccinia virus Ankara (MVA) was introduced in 2014 as a reference virus for the claim ‘virucidal active against enveloped viruses for hygienic hand rub and hand wash’. For EBOV, also an enveloped virus, the suitability of MVA as a surrogate needs to be proven.The aim of this study was to test the in vitro efficacy of four povidone iodine (PVP-I) formulations against EBOV: 4 % PVP-I skin cleanser; 7.5 % PVP-I surgical scrub; 10 % PVP-I solution; and 3.2 % PVP-I and 78 % alcohol solution. The formulations were tested with MVA to define the test conditions, and as a secondary objective the suitability of MVA as a surrogate for enveloped viruses like EBOV was assessed.MethodsAccording to EN14476, a standard suspension test was used for MVA. Large-volume plating was used for EBOV to increase test sensitivity and exclude potential after-effects. All products were tested under clean (0.3 g/L BSA) and dirty (3.0 g/L BSA + 3.0 mL/L erythrocytes) conditions with MVA for 15, 30, and 60 s. The concentration-contact time values obtained with MVA were verified for EBOV.ResultsViral titres of MVA and EBOV were reduced by >99.99 % to >99.999 % under clean and dirty conditions after application of the test products for 15 seconds.ConclusionsAll products showed excellent virucidal efficacy against EBOV, demonstrating the important role PVP-I can play in helping to prevent and limit the spread of Ebola virus disease. The efficacy against both test viruses after 15 s is helpful information for the implementation of guidance for people potentially exposed to EBOV, and confirms the excellent virucidal efficacy of PVP-I against enveloped viruses. MVA was found to be a suitable surrogate for enveloped viruses like EBOV.

The Disinfection Characteristics of Ebola Virus Outbreak Variants

“…Although it is reasonable to assume the scrubbing action during hand washing could sufficiently remove or rinse away Ebola-contamination, we should consider alternatives to 0.05% NaOCl until empirical data is generated supporting the currently acted practice of using 0.05% NaOCl. Perhaps alcohol-based (70% EtOH) as suggested by the WHO2 or povidone-iodine based solutions23 should be considered as alternatives as both have shown rapid inactivation of Ebola virus. It is noteworthy that although 70% EtOH is efficient at inactivating Ebola after 1 min of contact, the Makona variant was still viable on 2/9 replicates and in our previously generated data, on 3/9 replicates9.…”

New and emerging infectious diseases (Ebola, Middle Eastern respiratory syndrome coronavirus, carbapenem-resistant Enterobacteriaceae, Candida auris): Focus on environmental survival and germicide susceptibility

“…A >4-log 10 reduction of an Ebola strain was achieved in 15 seconds using the following povidone-iodine solutions: 4%, 7.5%, 10%, and 3.2% iodine with 78% alcohol. 59 Therefore, data suggests that hand antisepsis for skin contamination with Ebola virus can be obtained with either povidone-iodine or 70%-80% alcohol (although proper PPE should always be worn).…”

Emerging infectious diseases: Focus on infection control issues for novel coronaviruses (Severe Acute Respiratory Syndrome-CoV and Middle East Respiratory Syndrome-CoV), hemorrhagic fever viruses (Lassa and Ebola), and highly pathogenic avian influenza viruses, A(H5N1) and A(H7N9)

“…68 A >4 log10 reduction of an Ebola strain was achieved in 15 seconds using the following povidone iodine solutions: 4%, 7.5%, 10%, and 3.2% iodine with 78% alcohol. 70 Consistent use of appropriate PPE with strict adherence to donning and doffing protocols is crucial to preventing acquisition of EVD during patient care. [65][66][67] A key component of reducing HCP risk is proper training in PPE donning and doffing with ongoing training to maintain competency.…”