title: Control of the spread of viruses in a long-term care facility using hygiene protocols.
abstract: BACKGROUND
  Approximately 50% of norovirus cases in the United States occur in long-term care facilities; many incidences of rotavirus, sapovirus, and adenovirus also occur. The primary objectives of this study were to demonstrate movement of pathogenic viruses through a long-term care facility and to determine the impact of a hygiene intervention on viral transmission.
  
  
  METHODS
  The coliphage MS-2 was seeded onto a staff member's hands, and samples were collected after 4 hours from fomites and hands. After 3 consecutive days of sample collection, a 14-day hygiene intervention was implemented. Hand sanitizers, hand and face wipes, antiviral tissues, and a disinfectant spray were distributed to employees and residents. Seeding and sampling were repeated postintervention.
  
  
  RESULTS
  Analysis of the pre- and postintervention data was performed using a Wilcoxon signed-rank test. Significant reductions in the spread of MS-2 on hands (P = .0002) and fomites (P = .04) were observed postintervention, with a >99% average reduction of virus recovered from both hands and fomites.
  
  
  CONCLUSIONS
  Although MS-2 spread readily from hands to fomites and vice versa, the intervention reduced average MS-2 concentrations recovered from hands and fomites by up to 4 logs and also reduced the incidence of MS-2 recovery.
authors.affiliation: Department of Soil, Water, and Environmental Science, The University of Arizona, Tucson, AZ.
authors.forename: Hannah P
authors.initials: HP
authors.lastname: Sassi
authors.affiliation: Department of Soil, Water, and Environmental Science, The University of Arizona, Tucson, AZ. Electronic address: lys@email.arizona.edu.
authors.forename: Laura Y
authors.initials: LY
authors.lastname: Sifuentes
authors.affiliation: Corporate Research and Engineering, Kimberly-Clark Corp, Neenah, WI.
authors.forename: David W
authors.initials: DW
authors.lastname: Koenig
authors.affiliation: Global Clinical Affairs, Kimberly-Clark Corp, Neenah, WI.
authors.forename: Emmalee
authors.initials: E
authors.lastname: Nichols
authors.affiliation: Global Clinical Affairs, Kimberly-Clark Corp, Neenah, WI.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Clark-Greuel
authors.affiliation: Kimberly-Clark Corp, Roswell, GA.
authors.forename: Lung Fai
authors.initials: LF
authors.lastname: Wong
authors.affiliation: Kimberly-Clark Corp, Roswell, GA.
authors.forename: Kevin
authors.initials: K
authors.lastname: McGrath
authors.affiliation: Department of Soil, Water, and Environmental Science, The University of Arizona, Tucson, AZ.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Gerba
authors.affiliation: Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Reynolds
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D050456:Fomites / Q000821:virology; D006225:Hand / Q000821:virology; D063373:Hand Hygiene / Q000379:methods*; D006268:Health Facilities; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017909:Levivirus / Q000302:isolation & purification; D008134:Long-Term Care; D008962:Models, Theoretical; D014481:United States; D014777:Virus Diseases / Q000517:prevention & control*
keywords: Hygiene protocol; Long-term care; Virus spread