title: The effect of blood on the antiviral activity of sodium hypochlorite, a phenolic, and a quaternary ammonium compound.
abstract: OBJECTIVE
  To assess the virucidal activity of three disinfectants (sodium hypochlorite, a phenolic, and a quaternary ammonium compound) in the presence and absence of blood.
  
  
  METHODS
  Disinfectants at varying concentrations (hypochlorite: 5,000, 500, or 50 ppm; phenolic: 1:10 or 1:128 dilution; quaternary ammonium compound: 1:10 or 1:128 dilution) were added to either saline or whole blood (final concentration, 80% or 20% blood) and mixed. Test organisms included an attenuated vaccine strain of poliovirus type 1 (prototype for relatively resistant hydrophilic viruses) and herpes simplex virus (HSV) type 1 (prototype for relatively susceptible lipophilic viruses). Virus was added to create a viral-blood suspension. Viral survival was tested at room temperature at the following times: 0, 15 seconds, 30 seconds, 1 minute, 2 minutes, 5 minutes, and 10 minutes. A neutralizer stopped the reaction, and virus was assayed using a plaque technique.
  
  
  RESULTS
  In the absence of blood, complete inactivation of HSV was achieved within 30 seconds with 5,000 (1:10 dilution of bleach) and 500 (1:100 dilution of bleach) ppm chlorine, 1:10 and 1:128 diluted phenolic (use dilution), and 1:10 and 1:128 diluted quaternary ammonium compound (use dilution). In the presence of 80% blood, only 5,000 ppm hypochlorite, 1:10 phenolic, and 1:10 or 1:128 quaternary ammonium compound were effective. In the absence of blood, complete inactivation of polio was achieved within 30 seconds by 5,000 and 500 ppm chlorine and 1:10 quaternary ammonium compound. In the presence of 80% blood, no solution tested was capable of completely inactivating poliovirus within 10 minutes.
  
  
  CONCLUSIONS
  Our data suggest that, in the absence of visible blood, environmental surfaces may be disinfected with a diluted hypochlorite solution (1:10 or 1:100), a phenolic, or a quaternary ammonium compound. Based on our studies using HSV, which has similar susceptibilities to disinfectants as human immunodeficiency virus (HIV), phenolics at their use dilution and 1:100 diluted hypochlorite are unlikely to inactivate HIV or hepatitis B virus reliably in the presence of blood. Hypochlorite at a final concentration of 5,000 ppm (1:10 dilution) should be used to decontaminate blood spills, but, even after decontamination, care should be used to avoid sharps injuries.
authors.affiliation: Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill 27599-7030, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Weber
authors.forename: S L
authors.initials: SL
authors.lastname: Barbee
authors.forename: M D
authors.initials: MD
authors.lastname: Sobsey
authors.forename: W A
authors.initials: WA
authors.lastname: Rutala
mesh_terms: D001769:Blood; D004202:Disinfectants / Q000494:pharmacology*; D018259:Herpesvirus 1, Human / Q000187:drug effects*; D006801:Humans; D019800:Phenol / Q000494:pharmacology*; D017955:Poliovirus / Q000187:drug effects*; D000644:Quaternary Ammonium Compounds / Q000494:pharmacology*; D012973:Sodium Hypochlorite / Q000494:pharmacology*
chemical_list: D004202:Disinfectants; D000644:Quaternary Ammonium Compounds; D019800:Phenol; D012973:Sodium Hypochlorite