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Effective Hand Hygiene in the Presence of Norovirus

Patrick Boshell
January 30, 2013

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.



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