New research calls into question current CDC and WHO guidelines for hand hygiene to prevent the flu.
According to a recent study published in mSphere, a journal from the American Society of Microbiology, 30 seconds of hand-rubbing with an ethanol-based disinfectant won’t deactivate the influenza A virus (IAV) when mucus is carrying it. Hand-washing, in contrast, does the trick — and faster.
What the study found
To come to this conclusion, researchers took 19 sputum samples from individuals (greater than 20 years old) diagnosed with an acute, upper-respiratory infection, whose mucus also tested positive for IAV. Researchers used this material to create infectious mucus and then applied it to human fingers. During in situ tests, the researchers attempted to recreate the way patients’ infectious mucus adheres to medical staff’s fingers. For comparison, they performed with same test with IAV-infected saline.
The study found hand-rubbing with disinfectant was much more effective at inactivating IAV in saline than it was in mucus. More than two minutes of hand-rubbing did not inactivate the mucus, but for the saline, less than 30 seconds did.
Because current hand hygiene guidelines from CDC and WHO suggest 15 to 30 seconds of hand-rubbing with ethanol-based sanitizer is adequate, the study “suggests … current contact infection prevention and AHR regimens using EBDs are not sufficient to prevent IAV outbreaks,” the authors explain.
The researchers also tested hand-rubbing with ethanol-based disinfectant on dried mucus, which worked within 30 seconds because its gel-like properties were gone. Similarly, actual hand-washing completely inactivated the virus in the wet mucus within 30 seconds.
What the study means for clinicians
As a result, the study authors make the most logical recommendation: Wash your hands after coming in contact with flu patients instead of just hitting the hand-sanitizer station. Follow the same protocol that you would with a non-enveloped virus, they add.
Another take away? Practices for evaluating the effectiveness of disinfection methods could use some revision. According to the authors, such tests usually include liquids with low viscosity, which means they don’t accurately simulate the physical properties of infectious body fluids. So, disinfectants (and disinfection methods) approved with currently recommended processes might be ineffective on mucus and other, more viscous bodily fluids.