Abstract
The scale of the 2014–2017 West African Ebola Virus Disease outbreak overwhelmed the international response capacity. This has led to inconsistencies in international guidance documents, particularly around chlorine disinfection of surfaces and hands to prevent transmission. To provide evidence for the disinfection recommendations, three research strands were conducted: (1) impacts of chlorine chemistry; (2) efficacy of surface cleaning recommendations; and (3) safety and efficacy of handwashing recommendations. Strand 1 research found that the compound chemistry of the chlorine source has an impact on the chlorine solution shelf-life (<1 day–30 days), with testing of chlorine solutions recommended to ensure accuracy. Strand 2 research found that surface cleaning with 0.5% chlorine solutions with a 15-min exposure time is efficacious in reducing transmission risk. Strand 3 research found that community handwashing with chlorine solutions is as safe and efficacious as handwashing with soap and water or sanitizer, which offers a benefit of reducing pathogens in the rinsing water. Using calcium hypochlorite as the chlorine source compound provided a particularly good performance in chemistry and handwashing studies. The research was successful at providing information to align with the inconsistent international guidelines. Further research is needed to proactively establish the efficacy, safety and suitability of disinfection for the seven viral pathogens that are considered likely to cause severe outbreaks with few/no medical countermeasures.
Highlights
During the 2014–2017 West African Ebola Virus Disease (EVD) outbreak, 493 of 500 healthcare providers (99%) and 550 of 550 patients (100%) who were surveyed reported that their body had been deliberately sprayed with 0.5% chlorine solution [1]
Summary of Research Thread #1: Each chlorine source compound has benefits and drawbacks and it is recommended that responders choose the appropriate compound for their context, while ensuring chlorine solutions made from these source compounds are stored appropriately, used within their shelf-life, periodically tested by trained personnel using titration methods and tested daily with pH-resistant test strips
As all handwashing methods have benefits and drawbacks (Table 2), it is recommended that EVD responders and communities use whichever handwashing method(s) are most acceptable, available and feasible for handwashing, considering that chlorine solutions may offer a benefit in reducing transmission risk from rinsing water
Summary
During the 2014–2017 West African Ebola Virus Disease (EVD) outbreak, 493 of 500 healthcare providers (99%) and 550 of 550 patients (100%) who were surveyed reported that their body had been deliberately sprayed with 0.5% chlorine solution [1]. This is a denigrating, non-evidence based disinfection intervention that damages eyes, skin and lungs. Disinfectants are critical for cleaning living and non-living surfaces and preventing the transmission of infectious diseases. Framework for preventing infectious disease transmission includes three elements: (1) public health fundamentals, including surveillance, laboratory detection and epidemiologic investigation;. (2) high-impact interventions, including new vaccines, strategies and tools for infection control and treatment and other interventions to reduce zoonotic transmission; and (3) policies to prevent, detect and control infectious diseases [2].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
