title: Rapid and Effective Virucidal Activity of Povidone-Iodine Products Against Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and Modified Vaccinia Virus Ankara (MVA).
abstract: BACKGROUND
  Since the first case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection was reported in 2012, the virus has infected more than 1300 individuals in 26 countries, and caused more than 480 deaths. Human-to-human transmission requires close contact, and has typically occurred in the healthcare setting. Improved global awareness, together with improved hygiene practices in healthcare facilities, has been highlighted as key strategies in controlling the spread of MERS-CoV. This study tested the in vitro efficacy of three formulations of povidone iodine (PVP-I: 4% PVP-I skin cleanser, 7.5% PVP-I surgical scrub, and 1% PVP-I gargle/mouthwash) against a reference virus (Modified vaccinia virus Ankara, MVA) and MERS-CoV.
  
  
  METHODS
  According to EN14476, a standard suspension test was used to assess virucidal activity against MVA and large volume plating was used for MERS-CoV. All products were tested under clean (0.3 g/L bovine serum albumin, BSA) and dirty conditions (3.0 g/L BSA + 3.0 mL/L erythrocytes), with application times of 15, 30, and 60 s for MVA, and 15 s for MERS-CoV. The products were tested undiluted, 1:10 and 1:100 diluted against MVA, and undiluted against MERS-CoV.
  
  
  RESULTS
  A reduction in virus titer of ≥4 log10 (corresponding to an inactivation of ≥99.99%) was regarded as evidence of virucidal activity. This was achieved versus MVA and MERS-CoV, under both clean and dirty conditions, within 15 s of application of each undiluted PVP-I product.
  
  
  CONCLUSIONS
  These data indicate that PVP-I-based hand wash products for potentially contaminated skin, and PVP-I gargle/mouthwash for reduction of viral load in the oral cavity and the oropharynx, may help to support hygiene measures to prevent transmission of MERS-CoV.
  
  
  BACKGROUND
  Mundipharma Research GmbH & Co.
authors.affiliation: Labor Prof. Gisela Enders MVZ GbR and the Institute of Virology, Infectious Diseases and Epidemiology e.V., Stuttgart, Germany.
authors.forename: Maren
authors.initials: M
authors.lastname: Eggers
authors.affiliation: Institute for Virology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Eickmann
authors.affiliation: Mundipharma Research GmbH & Co.KG, Limburg, Germany. Juergen.zorn@mundipharma-rd.eu.
authors.forename: Juergen
authors.initials: J
authors.lastname: Zorn
keywords: Enveloped virus; Gargle; Hand hygiene; MERS-CoV; MVA; Middle East respiratory syndrome coronavirus; Modified vaccinia virus Ankara; Mouthwash; Povidone iodine; Virucidal