Virucidal Activity of World Health Organization–Recommended Formulations Against Enveloped Viruses, Including Zika, Ebola, and Emerging Coronaviruses

Siddharta, Anindya; Pfaender, Stephanie; Vielle, Nathalie J.; Dijkman, Ronald; Friesland, Martina; Becker, Benedikt; Yang, Jaewon; Engelmann, Michael; Todt, Daniel; Windisch, Marc P.; Brill, Florian H. H.; Steinmann, Joerg; Steinmann, J.; Becker, Stephan; Alves, Marco P.; Pietschmann, Thomas; Eickmann, Markus; Thiel, Volker; Steinmann, Eike

doi:10.1093/infdis/jix046

Cited by 185 publications

(167 citation statements)

References 12 publications

(17 reference statements)

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“…after removing gloves. Two WHO recommended formulations (based on 80% ethanol or 75% 2-propanol) have been evaluated in suspension tests against SARS-CoV and MERS-CoV, and both were described to be very effective [14]. No in vitro data were found on the efficacy of hand washing against coronavirus contaminations on hands.…”

Section: Discussionmentioning

confidence: 99%

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

Kampf

Todt

Pfaender

et al. 2020

Journal of Hospital Infection

3,439

3,071

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S U M M A R YCurrently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62e71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05e0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.

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Section: Discussionmentioning

confidence: 99%

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

Kampf

Todt

Pfaender

et al. 2020

Journal of Hospital Infection

3,439

3,071

View full text Add to dashboard Cite

show abstract

“…Another important consideration in selection of hand hygiene agents, particularly in resource-poor countries, is cost and availability. Alcohol-based hand rub formulations proposed by the WHO have recently been shown to be effective against enveloped viruses including emerging Zika, EBOV, SARS-CoV and MERS-CoV in vitro [51], and may be a more freely available and cost-effective alternative to medicated cleansers/antiseptics. Since hand rubs cannot properly cleanse soiled hands [2], a phased approach as recommended by the National Institute for Health and Care Excellence [52] may be an optimized approach to handle situations where increased hand hygiene is warranted.…”

Section: Discussionmentioning

confidence: 99%

Bactericidal and Virucidal Activity of Povidone-Iodine and Chlorhexidine Gluconate Cleansers in an In Vivo Hand Hygiene Clinical Simulation Study

et al. 2018

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IntroductionStandard in vitro and in vivo tests help demonstrate efficacy of hand hygiene products; however, there is no standard in vivo test method for viruses. We investigated the bactericidal and virucidal efficacy of povidone-iodine (PVP-I) 7.5% scalp and skin cleanser, chlorhexidine gluconate (CHG) 4% hand cleanser and the reference hand wash (soft soap) in 15 healthy volunteers following European Standard EN1499 (hygienic hand wash test method for bacteria), which was adapted for virucidal testing.MethodsSeparate test series were performed for bactericidal (Escherichia coli) and virucidal [murine norovirus (MNV)] testing. After pre-washing and artificial contamination of hands with test organisms, volunteers underwent testing with 3 and 5 mL of each product for contact times of 15, 30 and 60 s according to a Latin-square randomization. The number of test organisms released from fingertips into sampling fluids was assessed before and after hand washing and mean log10 reduction factor (RF) was calculated. RFs (test-reference) were compared using a Wilcoxon–Wilcox multiple comparisons test per EN1499; efficacy was concluded if p ≤ 0.01.ResultsPVP-I 7.5% and CHG 4% cleansers both passed EN1499 requirements against E. coli, with statistically significantly greater (p ≤ 0.01) mean log10 RFs compared with reference soft soap across all tests (PVP-I: 4.09–5.27; CHG: 4.12–5.22; soap: 2.75–3.11). The experimental design using EN1499 was applicable to testing with MNV as discriminatory and reproducible results were generated. Mean log10 RFs of MNV were statistically significantly greater for PVP-I (1.57–2.57) compared with soft soap (1.24–1.62), while mean log10 RFs with CHG (0.90–1.34) were lower than for soft soap across all tests.ConclusionPVP-I 7.5% cleanser showed superior efficacy against MNV compared to soft soap and CHG 4% cleanser, while both PVP-I and CHG were superior to soft soap against E. coli. The experimental set-up may be applicable to future testing for antiviral hand washes.FundingMundipharma Manufacturing Pte Ltd.Plain Language SummaryPlain language summary available for this article.

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“…Ethanol (60%-85%) appears to be the most effective against viruses compared to isopropanol (60%-80%) and n-propanol (60%-80%) [23]. The study conducted with WHO-recommended alcohol-based formulations demonstrated a strong virucidal effect against emerging pathogens, including ZIKV, EBOV, SARS-CoV, and MERS-CoV [73]. Another study conducted in Germany found that the ethanol in the concentration of 42.6% (w/w) was able to destroy SARS coronavirus and MERS coronavirus within 30 s [74].…”

Section: Efficacy Of Alcohol-based Hand Sanitizer Against the Coronavmentioning

confidence: 99%

Hand Sanitizers: A Review on Formulation Aspects, Adverse Effects, and Regulations

Jing

Bose

et al. 2020

IJERPH

245

200

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Hand hygiene is of utmost importance as it may be contaminated easily from direct contact with airborne microorganism droplets from coughs and sneezes. Particularly in situations like pandemic outbreak, it is crucial to interrupt the transmission chain of the virus by the practice of proper hand sanitization. It can be achieved with contact isolation and strict infection control tool like maintaining good hand hygiene in hospital settings and in public. The success of the hand sanitization solely depends on the use of effective hand disinfecting agents formulated in various types and forms such as antimicrobial soaps, water-based or alcohol-based hand sanitizer, with the latter being widely used in hospital settings. To date, most of the effective hand sanitizer products are alcohol-based formulations containing 62%-95% of alcohol as it can denature the proteins of microbes and the ability to inactivate viruses. This systematic review correlated with the data available in Pubmed, and it will investigate the range of available hand sanitizers and their effectiveness as well as the formulation aspects, adverse effects, and recommendations to enhance the formulation efficiency and safety. Further, this article highlights the efficacy of alcohol-based hand sanitizer against the coronavirus.

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Virucidal Activity of World Health Organization–Recommended Formulations Against Enveloped Viruses, Including Zika, Ebola, and Emerging Coronaviruses

Cited by 185 publications

References 12 publications

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

Bactericidal and Virucidal Activity of Povidone-Iodine and Chlorhexidine Gluconate Cleansers in an In Vivo Hand Hygiene Clinical Simulation Study

Hand Sanitizers: A Review on Formulation Aspects, Adverse Effects, and Regulations

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