Reduced norovirus epidemic follows increased sales of hand hygiene products in Japan, 2020–2021

Abstract

During the recent emergence of COVID-19, an increased practice of hand hygiene coincided with the reduced incidence of the norovirus epidemic in Japan, which is similar to experience with the pandemic flu in 2009. We investigated the relationship between the sales of hand hygiene products, including liquid hand soap and alcohol-based hand sanitizer, and the trend of norovirus epidemic. We used national gastroenteritis surveillance data across Japan in 2020 and 2021 and compared the base statistics of incidence of these two years with the average of the previous 10 years (2010-2019). We calculated the correlations (Spearman's Rho) between monthly sales of hand hygiene products and monthly norovirus cases and fitted them to a regression model. In 2020, there was no epidemic, and the incidence peak was the lowest in recent norovirus epidemics. In 2021, the incidence peak was delayed for five weeks to the usual epidemic seasons. Correlation coefficients between monthly sales of liquid hand soap and skin antiseptics and norovirus incidence showed a significantly negative correlation (Spearman's Rho = -0.88 and p = 0.002 for liquid hand soap; Spearman's Rho = -0.81 and p = 0.007 for skin antiseptics). Exponential regression models were fitted between the sales of each hand hygiene product and norovirus cases, respectively. The results suggest hand hygiene using these products is a potentially useful prevention method against norovirus epidemics. Effective ways of hand hygiene for increasing the prevention of norovirus should therefore be studied.