Reducing viral contamination from finger pads: handwashing is more effective than alcohol-based hand disinfectants.
BACKGROUND
Hand hygiene is important for interrupting transmission of viruses through hands. Effectiveness of alcohol-based hand disinfectant has been shown for bacteria but their effectiveness in reducing transmission of viruses is ambiguous.


OBJECTIVE
To test efficacy of alcohol hand disinfectant against human enteric and respiratory viruses and to compare efficacy of an alcohol-based hand disinfectant and handwashing with soap and water against norovirus.


METHODS
Efficacies of a propanol and an ethanol-based hand disinfectant against human enteric and respiratory viruses were tested in carrier tests. Efficacy of an alcohol-based hand disinfectant and handwashing with soap and water against noroviruses GI.4, GII.4, and MNV1 were tested using finger pad tests.


RESULTS
The alcohol-based hand disinfectant reduced the infectivity of rotavirus and influenza A virus completely within 30s whereas poliovirus Sabin 1, adenovirus type 5, parechovirus 1, and MNV1 infectivity were reduced <3 log10 within 3 min. MNV1 infectivity reduction by washing hands with soap and water for 30s (>3.0 ± 0.4 log10) was significantly higher than treating hands with alcohol (2.8 ± 1.5 log10). Washing with soap and water for 30s removed genomic copies of MNV1 (>5 log10), noroviruses GI.4 (>6 log10), and GII.4 (4 log10) completely from all finger pads. Treating hands with propanol-based hand disinfectant showed little or no reduction to complete reduction with mean genomic copy reduction of noroviruses GI.4, GII.4, and MNV1 being >2.6, >3.3, and >1.2 log10 polymerase chain reaction units respectively.


CONCLUSIONS
Washing hands with soap and water is better than using alcohol-based hand disinfectants in removing noroviruses from hands.
Laboratory of Food Microbiology, Wageningen University, Wageningen, The Netherlands; Laboratory for Infectious Diseases and Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
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Tuladhar
Laboratory of Food Microbiology, Wageningen University, Wageningen, The Netherlands. Electronic address: Wilma.Hazeleger@wur.nl.
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Hazeleger
Laboratory for Infectious Diseases and Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Virology, Erasmus Medical Centre, Rotterdam, The Netherlands.
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Koopmans
Laboratory of Food Microbiology, Wageningen University, Wageningen, The Netherlands.
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Zwietering
Laboratory for Infectious Diseases and Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
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Duizer
Laboratory of Food Microbiology, Wageningen University, Wageningen, The Netherlands.
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Beumer
D000438:Alcohols; D017250:Caliciviridae Infections / Q000635:transmission; D017927:Calicivirus, Feline; D004202:Disinfectants / Q000592:standards*; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D005385:Fingers / Q000821:virology*; D006225:Hand / Q000821:virology*; D006235:Hand Disinfection / Q000379:methods* / Q000592:standards*; D063373:Hand Hygiene / Q000379:methods* / Q000592:standards; D064548:Hand Sanitizers / Q000592:standards; D006801:Humans; D008297:Male; D029322:Norovirus; D012401:Rotavirus; D012915:Soaps; D014780:Viruses / Q000235:genetics / Q000302:isolation & purification*
D000438:Alcohols; D004202:Disinfectants; D064548:Hand Sanitizers; D012915:Soaps
Carrier test; Enteric virus; Finger pad test; Foodborne viruses; Hand disinfection; Norovirus; Respiratory viruses