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Effective Hand Hygiene in the Presence of Norovirus


The winter vomiting bug Norovirus, continues to wreak havoc around the globe and may be coming soon to an intestine near you . The Sydney 2012 strain for example was first seen in Australia, where the Norovirus season is lasting longer than usual as outbreaks continue into their summer. It's now spread to the UK and has also been reported in France, New Zealand and Japan. 


The flu season in North America is from November to April and similar to this year’s seasonal influenza virus, Norovirus is causing more illnesses than normal in 2013.  The Centers for Disease Control and Prevention has officially reported that this new strain of vomiting disease has now reached the USA from Australia.  Scientists are watching this global trend closely but cannot be sure what will happen next.



The question of hand hygiene effectiveness against Norovirus was explored briefly last week and expanded on with some additional comments.   "Effective hand hygiene in the presence of non-enveloped viruses such as Norovirus, and also other highly robust pathogens such as C difficile spores, is a hot topic and sometime is made unnecessarily complex by well meaning advice. Alcohol sanitizers are known to be relatively less effective against these organisms, thus hand washing with soap and water (either antimicrobial or not) is widely recommended. Soap and water provides a physical removal mechanism in addition to antimicrobial action. Robost pathogens are 'removed' rather than killed, effectively serving the purpose of hand hygiene," said Dr. John Hines, R&D Director for Deb Group.


"Sadly many interpret this advice as meaning 'do not use alcohol sanitizer'. This is not the intent! A better and simpler approach is to advise that healthcare workers should assess risk according to WHO 5 moments and act accordingly. Even in environments where Norovirus is present, many moments remain best dealt with through sanitizing - ensuring that the vast majority of other potential infections are properly eliminated. Where exposure to body fluid is a risk (moment 3), hand washing with soap and water should be done. In a complex environment with risk of highly robust pathogens, proper use of both regular sanitization combined with appropriate hand washing with soap and water when indicated according to WHO 5 moments, is the simplest and best approach," Dr. Hines adds.


Hand Hygiene and NorovirusPaul Blount, European Marketing Director for Deb Group commented. "I really do think the issue with Norovirus emphasizes again the need to approach hand hygiene holistically i.e. it is a combination of complementary activities which makes for effective hand hygiene, not a 'one size fits all' approach. In other words, it's about regular good quality hand washing, complemented by hand sanitizers; but also, it is about using the mildest formulations possible, complemented with restorative hand creams to keep the skin healthy and encourage hand hygiene compliance."


"Whilst regular hand hygiene can be great to kill/remove physical and microbial contamination, their very use can induce skin health issues (e.g. sore and chapped hands and occupational skin disease - nurses are in one of the highest 'at risk' categories for this) that eventually discourage compliance. Our experience as experts in hand hygiene is that very few workers routinely adopt a full hand hygiene AND skin care regime, with the subsequent risk of sub-optimal compliance. Of course, all this needs to be assessed against the back-drop of 'time' i.e. having the time to do the right thing. Therefore, it is incumbent on manufacturers and those responsible on-site for the prevention of the spread of infections to implement practices and facilities that encourage a complete hand hygiene and skin approach and respect the pressures of time," Mr. Blount concludes.





I've noticed over the past few months that there has indeed been a bit of a focus shift towards the prevention of infection spread - closer to the source. In a recent "deb" posting their Vomiting Larry graphically displays what many of us have known, droplet and fomite contamination spreads far and wide, the microscopic particles getting around your face shield with every breath you take. Not to mention landing everywhere else that your hand touches in the extended path of the "cone of death" projected by the infective coughing, vomiting gagging patient. 
Viral load relates to the concentration of virus particles within given volume of 'carrier' or vector - the nares and nasal discharge having one of the highest viral loads of MRSA yet determined. Vomit from those infected with Australia 2012 noro-virus also carries both a high viral load and as well a most virulent pathogen. At Prodaptive we have recorded stills and videos of our own version of deb's Vomiting Larry with quite amazing results shortly to be posted on www; The new photo on the homepage is untouched other than to intensify the lightness of the photo. Nothing other than text was added or taken from the picture. Only one pin-head sized droplet was found beyond the STAL. This reduces accidental cross contamination and inhaled viral load immeasurably . Glo-germ was used to clearly define the expectorant and the STAL's effects. It just works - on Yankauers, scalpels in I & D's, saline bottles for wound care irrigation and more. 
Yes, handvwashing and other PPE are all part of the plan but a new and very affordable tool is at hand - the STAL Shield and Stand - the only 'at source' contamination protection available. have a look or e-mail me directly at Save time, Save money, Reduce Employee Sick-leave. Practice Safe Suction!
Posted @ Thursday, January 31, 2013 11:48 AM by Al Wickheim
Let's hope not...or we'll all have to move our Flat screen TV's into the bathroom! LOL 
If you are 100% SURE you or your associates wash your hands thoroughly for 30 seconds in warm water for most of the day...don't read on. 
If you are not 100% sure - examine the use of Sterile Doctor, it is NOT a water-based or diluted anti-microbial and NOT a chemical treatment, but an anti-microbial utilizing the physical puncture of the cell wall, therefore the likes of Norovirus strains and CKRP which can build resistance to chemicals are not able to build a resistance to a physical eradication. Sterile Doctor's dwell time is 3-4 seconds and 99.99% >4 log kill in third-party lab 
Give you and your employees and patients' intestines a vacation this winter :)
Posted @ Thursday, January 31, 2013 12:01 PM by Gus Shimrak
Norovirus is designed to spread easily; it is non-enveloped (capside made of proteins, without any extra lipid envelop), it resists many biocides (alcohols, cationics, phenolics), it is highly infectious (less than 20 viral particles are sufficient) and its mutation rate may be considered as very high (about 1.3 x 10−2 mutations per site and per year). The current increase of cases described in this paper proves this statement. Therefore, as recommended by many patricians and hygienists, the prevention of cross-infections must be based on a combination of means; the most important one being frequent hand washes (reduces mechanically about 100 times the number of skin transiant micro-organisms such as bacteria, spores, fungi and viruses), followed by the use of an alcohol-based hand sanitizer (very effective on most Gram positive and Gram negative bacteria, yeasts, molds and enveloped viruses) to reduce the risk of transmitting other pathogens too.
Posted @ Monday, February 04, 2013 8:17 AM by Dr Pierre GRASCHA
Hand hygiene is always the top way to prevent the spread of germs, but there are other cleaning techniques that you can perform to lessen the presence of Norovirus (or flu) germs:
Posted @ Wednesday, February 06, 2013 11:57 AM by Sarah Lanse
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