MERS-CoV: Practical Tips for Disinfection
The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is slowly spreading through the Middle East and Asia. Transmission, so far, seems to happen when a close contact with an infected individual occurs. This type of transmission has led to many healthcare associated infections to this day. As an example, a patient that waited for 2.5 days in a Seoul emergency department, end up transmitting the disease to 55 persons.
So far, the case-fatality rate is around 36 %, which is very high. However, this number may not be representative of a normal population and its kill rate is likely to be overestimated. A bias might exist when looking at the population who acquired the virus in Korea. Of the 171 cases, many had underlying medical conditions and have a median age of 55.
CDC and Health Canada issued a few recommendations on infection control and prevention so far, and more is likely to be available soon. Regardless of their recommendations few data are available on environmental hygiene and disinfection practice regarding MERS-CoV in healthcare settings. Also, the transmission through the environment is not well known for this virus.
How to disinfect?
Regarding disinfection few information are available. Coronaviruses are non-enveloped virus which makes them more resistant to certain disinfectant. As an example, it is known that a 400 ppm solution of quaternary ammonium compounds is ineffective against those viruses. Sodium hypochlorite at a minimum of 1,000 ppm seems to be sufficient, however a higher concentration would be optimal in healthcare settings. Very few data exist regarding other disinfectant technology.
At this moment, isolation with contact-droplets precaution is advised. In spite of the fact that it was suggested during the SARS outbreak that this type isolation might not be sufficient. Even though these two viruses are similar, we must remember that many differences exist. Thus we must be careful with extrapolation of data.
It was a pleasure to chat with some of you about current practice in environmental hygiene regarding infection control.
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We look forward to hearing from you, but in the meantime, with best regards we remain.
The Ali-Flex Team (Manon, John and Remi)
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Stopping it from Getting Viral
One disinfecting has to keep in mind what he is trying to get rid of. Disinfectant choice should always consider the microorganism to be eliminated in the environment. Let’s remember what we need to consider when disinfecting a virus contaminated environment.
First, let’s do a quick recap of what is a virus. A virus is a small infectious agent that can only replicate in another organism. This notion is important, it means that a human virus cannot replicate in food or soil. It is specific to its host. Another important notion about viruses is that they can be either enveloped or not enveloped. The envelope is made of a lipidic barrier originating from the cell the virus replicates in. Regardless of the lipidic membrane virus are made of a protein capsid and genetic material which can either be DNA or RNA.
Resistance to disinfectant
Basically, viruses can be divided in two groups regarding their resistance to disinfectant, those are the enveloped and non-enveloped virus. Non-enveloped virus are less susceptible to disinfectant. For example, norovirus or hepatitis A agent are small non-enveloped viruses. They are known to be resistant to environmental stress, such as temperature, UV, low or high humidity levels and disinfectant.
How to disinfect for virus contamination ?
First thing first, if your disinfectant has a virucidal claim on the bottle you are fine. You can also look for specific claims, however the general claim is sufficient has it was proven to be effective on multiple virus. Usually, a minimum of 1,000 ppm of stabilized sodium hypochlorite or 5,000-10,000 ppm of fast acting hydrogen peroxide is good way to make sure virus in the environment are no more of a threat.