Virucidal gargling and virucidal nasal spray.

Abstract

To prevent COVID-19, all available hygienic measures must be implemented, especially to protect the medical staff, but also the community. Since a large proportion of those infected release the virus before initial symptoms appear, protective measures that reduce the viral load at the entry points are useful, since the probability of infection increases with exposure, and the initial viral load influences the severity of the infection [1], [2]. Antiseptic gargling and nasal antiseptics are simple preventive measures that have needlessly been forgotten. Gargling has long been used to reduce upper respiratory tract infections and to treat bacterial/viral infections (e.g. sore throats, colds), but it has gone out of fashion. Washing hands with soap and water and gargling with saline solution was already recommended as a preventive measure by the German Health Council during the Spanish flu epidemic in 1918 [3]. In the former GDR, school children were advised to gargle with diluted potassium permanganate solution (pale pink) when entering summer holiday camp (author’s experience). Potassium permanganate solution is hardly used any more today, although it is available as a 1% mouth rinse solution. Unlike in Europe, daily gargling has a long tradition in Japan for the prevention of respiratory infections, and was strongly promoted by the Japanese Ministry of Health, Labour and Welfare during the H1N1 swine flu pandemic in 2009. It has now been explicitly recommended again to the population for daily use in the COVID-19 pandemic. It has been known for centuries that salty air has a beneficial, soothing effect on the respiratory tract. It stimulates the natural self-cleaning of the respiratory tract and prevents the mucous membranes from drying out. In addition, moistening the mucous membranes of the mouth and nose reduces the adhesion of viruses and therefore has a preventive effect even without the use of solutions or sprays with a virucidal effect [4], [5]. To use gargling and nasal rinsing as easily implementable measures for the prevention and control of COVID-19 in Germany, a short summary of previous knowledge on the virucidal effect and the preventive uses of gargling solutions and nasal sprays is given to exploit a further reserve of prevention and promote the public-health discussion process. The advent of the COVID-19 pandemic has made social distancing, mouth and nose protection, hand disinfection and ventilation of indoor spaces vitally important for prevention within the population. Similarly, these easy preventive measures should also be used more intensively.