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      Impact of the use of an alcohol-based hand sanitizer in the home on reduction in probability of infection by respiratory and enteric viruses

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          SUMMARY

          The goal of this study was to determine the reduction in risk of infection by viruses with the use of an alcohol-based hand sanitizer, used in addition to routine hand washing, in family members in households. A quantitative microbial risk model was used to determine the probability of infection from the concentration of virus on the hands. The model incorporated variation in hand size, frequency of touching orifices (nose, mouth, eyes), and percent transfer to the site of infection, as well as, dose-response for each virus. Data on the occurrence of virus on household members' hands from an intervention study using MS-2 coliphage was used to determine the reduction of viruses on the hands pre- and post-intervention. It was found that the risk of rhinovirus, rotavirus or norovirus infection after the intervention was reduced by 47–98% depending upon the initial concentration of virus on the hands.

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          Most cited references15

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          A Study Quantifying the Hand-to-Face Contact Rate and Its Potential Application to Predicting Respiratory Tract Infection

          A substantial portion of human respiratory tract infection is thought to be transmitted via contaminated hand contact with the mouth, eyes, and/or nostrils. Thus, a key risk factor for infection transmission should be the rate of hand contact with these areas termed target facial membranes. A study was conducted in which 10 subjects were each videotaped for 3 hr while performing office-type work in isolation from other persons. The number of contacts to the eyes, nostrils, and lips was scored during subsequent viewing of the tapes. The total contacts per subject had sample mean x = 47 and sample standard deviation s = 34. The average total contact rate per hour was 15.7. The authors developed a relatively simple algebraic model for estimating the dose of pathogens transferred to target facial membranes during a defined exposure period. The model considers the rate of pathogen transfer to the hands via contact with contaminated environmental surfaces, and the rate of pathogen loss from the hands due to pathogen die-off and transfer from the hands to environmental surfaces and to target facial membranes during touching. The estimation of infection risk due to this dose also is discussed. A hypothetical but plausible example involving influenza A virus transmission is presented to illustrate the model.
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            Human rotavirus studies in volunteers: determination of infectious dose and serological response to infection.

            An unpassaged, safety-tested strain (CJN) of human rotavirus from a stool specimen of a hospitalized child was administered orally to 62 adult volunteers for determination of the dose required to produce infection with or without illness. Subjects ingested doses ranging from 9 X 10(-3) to 9 X 10(4) focus-forming units in buffered salt solution after consumption of 50 ml of 4% NaHCO3. The amount of virus in the inoculum required to cause infection (shedding of virus, seroconversion, or both) in study subjects was comparable to the minimum detectable in cultures of primary monkey kidney cells. Seventeen of 30 infected subjects became ill with doses equivalent to that required for infection. Although the preinoculation titers of serum neutralizing antibody to the challenge virus in study subjects ranged from less than 1:2 to 1:1,600, the concentration of serum antibody could not be correlated with protection from infection or illness in subjects given an infectious dose of virus.
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              Transmission of experimental rhinovirus infection by contaminated surfaces.

              Transfer of experimental rhinovirus infection by an intermediary environmental surface was examined in healthy young adults, in four studies done in 1980--1981, by having recipients handle surfaces previously contaminated by infected donors. Recipients touched their nasal and conjunctival mucosa after touching the surfaces. Five (50%) of 10 recipients developed infection after exposure to virus-contaminated coffee cup handles and nine (56%) of 16 became infected after exposure to contaminated plastic tiles. Spraying of contaminated tiles with a commercially available phenol/alcohol disinfectant reduced (p = 0.003) the rate of recovery of virus from the tiles from 42% (20/47) to 8% (2/26). Similarly, the rate of detection of virus on fingers touching the tiles was reduced (p = 0.001) from 61% (28/46) with unsprayed tiles to 21% (11/53) with sprayed tiles. Fifty-six per cent (9/16) of the recipients exposed on three consecutive days to untreated tiles became infected while 35% (7/20) touching only sprayed tiles became infected with rhinovirus (p = 0.3). These studies indicate that experimental rhinovirus colds can be spread by way of contaminated environmental surfaces and suggest that disinfectant treatment of such surfaces may reduce risk of viral transmission by this route.
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                Author and article information

                Journal
                Epidemiology and Infection
                Epidemiol. Infect.
                Cambridge University Press (CUP)
                0950-2688
                1469-4409
                November 2015
                March 31 2015
                November 2015
                : 143
                : 15
                : 3335-3341
                Article
                10.1017/S0950268815000035
                25825988
                433f65b9-4bf1-4d4a-8cb8-dbc1229e8050
                © 2015

                https://www.cambridge.org/core/terms

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