COVE R S TORY
computers. Both general wards and intensive care units (ICU) showed contamination, with a significant risk of contamination in ICU.12,13
Although the survival of the virus depends on a number of environmental factors, the underlying risk of exposure presented to healthcare workers, patients and the public through contaminated surfaces should not be underestimated. An efficient disinfection process should always include a precleaning step to remove soil and organic contamination from a surface using the physical action of scrubbing and the chemical action of a detergent. This process is designed to physically remove organisms rather than kill them, and in the process prepare the surface for the subsequent disinfection step. The principle that only clean things can be efficiently disinfected is valuable.14 A virucidal, ethanol-based disinfectant or cleaner such as mikrozid® liquid could play a useful role in the cleaning and disinfection of hard surfaces, particularly as it is effective against enveloped viruses within one minute (EN14476).
The second stage of disinfection aims to reduce the number of microorganisms present to a level that is unlikely to cause infection. Before considering the most appropriate
surface disinfectants for managing COVID-19, it is worth noting that coronaviruses are classified as ‘enveloped’ viruses, compared to other viruses, such as rotavirus, or poliovirus which are termed non-enveloped. Enveloped viruses possess an envelope or outer coating that is composed of a lipid layer (fat-like substance that is water insoluble). The envelope is needed to help the virus attach to the host cell and the loss of this envelope results in loss of infectivity. Public Health England states that: ‘as coronaviruses have a lipid envelope, a wide range of disinfectants are effective,’.8
To
ensure the efficacy of a disinfectant against viruses, there is a recognised microbiological test against enveloped viruses, according to the European Norm (EN) standard named EN14476. A positive result means that the solution within the wipes/tissue is efficacious against enveloped viruses. Choosing a wipe with ‘virucidal efficacy against enveloped viruses’ combined with mention of EN14476 is a useful indicator for the selection of the disinfection wipe. Passing the EN14476 test means that the disinfectant solution can inactivate enveloped viruses (e.g. COVID-19 virus) but what really influences the practical application of the wipe is the contact time. This is the time required for the solution to be in contact with pathogens in order to eliminate or inactivate them. A disinfectant wipe could be EN14476 certified, but may require a contact time of 5 minutes
OCTOBER 2020
COVID-19. J Korean Med Sci. 2020;35(13): e142.
3 Jayaweera M et al. “Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy.” Environmental research vol. 188 (2020): 109819. doi:10.1016/j. envres.2020.109819
4 Morawska L. and Cao J. Airborne transmission of SARS-CoV-2: The world should face the reality. Environ. Int. 2020;139:105730.
5 van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020 Apr 16;382(16):1564-7
6 Zhang W, Du RH, Li B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect. 2020 Dec;9(1):386-9.
compared to another which requires only 30 seconds. A shorter contact time will save time and help simplify the cleaning/ disinfection process.
Besides the disinfectant content, consideration should also be given to the material of which the wipe is composed, as it is also key to achieving effective disinfection. The composition of the wipe needs to be capable of both containing and transferring the optimum amount of disinfectant onto the surface to achieve the antimicrobial effect. Of particular importance is the ability of the wipe to mop up and hold pathogens rather than just spreading them over the wiped area. The EN16615 test is the highest level of testing for antimicrobial wipes under the recognition of the European Standards committee. The test examines the efficacy of the wipe as a whole i.e. the wipe plus the disinfectant component.
When selecting a wipe for the clinical setting, it cannot be assumed that all wipes will have the ‘gold standard’ of EN16615 certification. In general, most wipes will have EN14476 certification for the disinfectant liquid contained within but not necessarily EN16615, which raises the critical question of whether the wipes are really fit for purpose. A wipe like mikrozid®
has both
EN14476 and EN16615 certification. With no cure or imminent vaccination available, stringent infection control measures including the highest standards of environmental cleaning are a key measure to help contain the immediate threat from COVID-19.
References 1 Rickman HM, Rampling T, Shaw K, et al. Nosocomial transmission of COVID-19: a retrospective study of 66 hospital-acquired cases in a London teaching hospital. Clin Infect Dis. 2020 Jun 20
2 Chin BS, et al. Clinical course and outcomes of patients with severe acute respiratory syndrome coronavirus 2 infection: a preliminary report of the first 28 patients from the Korean cohort study on
7 van Doorn AS, Meijer B, Frampton CMA, et al. Systematic review with meta-analysis: SARS- CoV-2 stool testing and the potential for faecal-oral transmission. Aliment Pharmacol Ther. 2020 Aug 27
8 Public Health England, August 2020, COVID-19: Guidance for the remobilisation of services within health and care settings Infection prevention and control recommendations
9 Moriarty LF et al, Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020, MMWR / March 27, 2020 / Vol. 69 / No. 12 US Department of Health and Human Services/Centers for Disease Control and Prevention
10 Kraay ANM, Hayashi MAL et al, Fomite-mediated transmission as a sufficient pathway: a comparative analysis across three viral pathogens BMC Infect Dis. 2018 Oct 29;18(1):540.
11 Kampf G, Todt D et al, Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents J Hosp Infect. 2020 Mar;104(3):246-251
12 Guo ZD, Wang ZY, Zhang SF, et al. Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020. Emerg Infect Dis. 2020 Apr 10;26(7)]
13 Zhou J, Otter JA, Price JR, et al. Investigating SARS- CoV-2 surface and air contamination in an acute healthcare setting during the peak of the COVID-19 pandemic in London. Clin Infect Dis. 2020 Jul 8
14 Geller, C., Varbanov M., Duval, R.E. Human Coronaviruses: Insights into Environmental Resistance and Its Influence on the Development of New Antiseptic Strategies; Viruses 2012, 4, 3044- 3068
Schülke & Mayr UK Ltd. Sheffield S9 1AT United Kingdom
www.schuelke.com
Email:
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