title: Surface Cleaning and Disinfection: Efficacy Assessment of Four Chlorine Types Using Escherichia coli and the Ebola Surrogate Phi6.
abstract: In the 2014 West African Ebola outbreak, international organizations provided conflicting recommendations for disinfecting surfaces contaminated by uncontrolled patient spills. We compared the efficacy of four chlorine solutions (sodium hypochlorite, sodium dichloroisocyanurate, high-test hypochlorite, and generated hypochlorite) for disinfection of three surface types (stainless steel, heavy-duty tarp, and nitrile) with and without pre-cleaning practices (prewiping, covering, or both) and soil load. The test organisms were Escherichia coli and the Ebola surrogate Phi6. All tests achieved a minimum of 5.9 and 3.1 log removal in E. coli and Phi6, respectively. A 15 min exposure to 0.5% chlorine was sufficient to ensure <8 Phi6 plaque-forming unit (PFU)/cm2in all tests. While chlorine types were equally efficacious with and without soil load, variation was seen by surface type. Wiping did not increase disinfection efficacy and is not recommended because it generates infectious waste. Covering spills decreased disinfection efficacy against E. coli on heavy-duty tarp but does prevent splashing, which is critical in Ebola contexts. Our results support the recommendation of a 15 min exposure to 0.5% chlorine, independently of chlorine type, surface, pre-cleaning practices, and organic matter, as an efficacious measure to interrupt disease transmission from uncontrolled spills in Ebola outbreaks.
authors.affiliation: Department of Civil and Environmental Engineering, Tufts University , Medford, Massachusetts 02155, United States.
authors.forename: Karin
authors.identifier: 0000-0001-6412-1483
authors.initials: K
authors.lastname: Gallandat
authors.affiliation: Department of Civil and Environmental Engineering, Tufts University , Medford, Massachusetts 02155, United States.
authors.forename: Marlene K
authors.initials: MK
authors.lastname: Wolfe
authors.affiliation: Department of Civil and Environmental Engineering, Tufts University , Medford, Massachusetts 02155, United States.
authors.forename: Daniele
authors.initials: D
authors.lastname: Lantagne
mesh_terms: D002713:Chlorine; D004202:Disinfectants; D004203:Disinfection; D004926:Escherichia coli; D019142:Hemorrhagic Fever, Ebola; D006801:Humans; D012973:Sodium Hypochlorite
chemical_list: D004202:Disinfectants; D002713:Chlorine; D012973:Sodium Hypochlorite