Coronavirus disease SARS-CoV-2 : Guidance for environmental cleaning in non-healthcare facilities

0
428

The causative agent involved in the current outbreaks of coronavirus disease 2019 (COVID-19), SARS-CoV-2 (genus: Betacoronavirus), belongs to the family of Coronaviridae, a large family of enveloped, positive-sense single-stranded RNA viruses.

Coronaviruses are transmitted in most instances through large respiratory droplets and contact transmission, but other modes of transmission have also been proposed.

The time of survival and the conditions affecting SARS-CoV-2 viability in the environment are currently unknown.

Persistence of coronavirus on inanimate surfaces

On different types of materials it can remain infectious for from 2 hours up to 9 days. A higher temperature such as 30°C or 40°C reduced the duration of persistence of highly pathogenic MERS-CoV, TGEV and MHV.

However, at 4°C persistence of TGEV and MHV can be increased to ≥ 28 days.

Few comparative data obtained with SARS-CoV indicate that persistence was longer with higher inocula (Table I).

In addition it was shown at room temperature that HCoV-229E persists better at 50% compared to 30% relative humidity  – [Ijaz, M.K., Brunner, A.H., Sattar, S.A., Nair, R.C., and Johnson-Lussenburg, C.M. Survival characteristics of airborne human coronavirus 229E. J Gen Virol. 1985; 66: 2743–2748].

Table I – Persistence of coronaviruses on different types of inanimate surfaces

Type of surface Virus Strain / isolate Inoculum (viral titer) Temp. Persistence Reference
Steel MERS-CoV Isolate HCoV-EMC/2012 105 20°C

30°C
48 h

8–24 h
[21]
TGEV Unknown 106 4°C

20°C

40°C
≥ 28 d

3–28 d

4–96 h
[22]
MHV Unknown 106 4°C

20°C

40°C
≥ 28 d

4–28 d

4–96 h
[22]
HCoV Strain 229E 103 21°C 5 d [23]
Aluminium HCoV Strains 229E and OC43 5 x 103 21°C 2–8 h [24]
Metal SARS-CoV Strain P9 105 RT 5 d [25]
Wood SARS-CoV Strain P9 105 RT 4 d [25]
Paper SARS-CoV Strain P9 105 RT 4–5 d [25]
SARS-CoV Strain GVU6109 106

105

104
RT 24 h

3 h

< 5 min
[26]
Glass SARS-CoV Strain P9 105 RT 4 d [25]
HCoV Strain 229E 103 21°C 5 d [23]
Plastic SARS-CoV Strain HKU39849 105 22°-25°C ≤ 5 d [27]
MERS-CoV Isolate HCoV-EMC/2012 105 20°C

30°C
48 h

8–24 h
[21]
SARS-CoV Strain P9 105 RT 4 d [25]
SARS-CoV Strain FFM1 107 RT 6–9 d [28]
HCoV Strain 229E 107 RT 2–6 d [28]
PVC HCoV Strain 229E 103 21°C 5 d [23]
Silicon rubber HCoV Strain 229E 103 21°C 5 d [23]
Surgical glove (latex) HCoV Strains 229E and OC43 5 x 103 21°C ≤ 8 h [24]
Disposable gown SARS-CoV Strain GVU6109 106

105

104
RT 2 d

24 h

1 h
[26]
Ceramic HCoV Strain 229E 103 21°C 5 d [23]
Teflon HCoV Strain 229E 103 21°C 5 d [23]

MERS = Middle East Respiratory Syndrome; HCoV = human coronavirus; TGEV = transmissible gastroenteritis virus; MHV = mouse hepatitis virus; SARS = Severe Acute Respiratory Syndrome; RT = room temperature.

Environmental cleaning options

Due to the potential survival of the virus in the environment for several days, the premises and areas potentially contaminated with SARS-CoV-2 should be cleaned before their re-use, using products containing antimicrobial agents known to be effective against coronaviruses.

Although there is lack of specific evidence for their effectiveness against SARS-CoV-2, cleaning with water and household detergents and use of common disinfectant products should be sufficient for general precautionary cleaning.

A recent paper which compared different healthcare germicides [4] found that those with 70% concentration ethanol had a stronger effect on two different coronaviruses (mouse hepatitis virus and transmissible gastroenteritis virus) after one minute contact time on hard surfaces when compared with 0.06% sodium hypochlorite.

Tests carried out using SARS-CoV showed that sodium hypochlorite is effective at a concentration of  0.05 and 0.1% after five minutes when it is mixed to a solution containing SARS-CoV [5].

Similar results were obtained using household detergents containing sodium lauryl ether sulphate, alkyl polyglycosides and coco-fatty acid diethanolamide [5].

Table 2. Antimicrobial agents effective against different coronaviruses: human coronavirus 229E (HCoV-229E), mouse hepatitis virus (MHV-2 and MHV-N), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV)1

Antimicrobial agent Concentration Coronaviruses tested References
Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7]
Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV [6] [5]
Povidone-iodine 10% (1% iodine) HCoV-229E [6]
Glutaraldehyde 2% HCoV-229E [6]
Isopropanol 50% MHV-2, MHV-N, CCV [7]
Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7]
Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7]
Formaldehyde 0.7% MHV-2, MHV-N, CCV [7]

Inactivation of coronaviruses by biocidal agents in suspension tests

  • Ethanol (78–95%), 2-propanol (70–100%), the combination of 45% 2-propanol with 30% 1-propanol, glutardialdehyde (0.5–2.5%), formaldehyde (0.7–1%) and povidone iodine (0.23–7.5%) readily inactivated coronavirus infectivity by approximately 4 log10 or more. (Table II).
  • Sodium hypochlorite required a minimal concentration of at least 0.21% to be effective.
  • Hydrogen peroxide was effective with a concentration of 0.5% and an incubation time of 1 min.
  • Data obtained with benzalkonium chloride at reasonable contact times were conflicting. Within 10 min a concentration of 0.2% revealed no efficacy against coronavirus whereas a concentration of 0.05% was quite effective. 0.02% chlorhexidine digluconate was basically ineffective (Table II).

Table II – Inactivation of coronaviruses by different types of biocidal agents in suspension tests

Biocidal agent Concentration Virus Strain / isolate Exposure time Reduction of viral infectivity (log10) Reference
Ethanol 95% SARS-CoV Isolate FFM-1 30 s ≥ 5.5 [29]
85% SARS-CoV Isolate FFM-1 30 s ≥ 5.5 [29]
80% SARS-CoV Isolate FFM-1 30 s ≥ 4.3 [29]
80% MERS-CoV Strain EMC 30 s > 4.0 [14]
78% SARS-CoV Isolate FFM-1 30 s ≥ 5.0 [28]
70% MHV Strains MHV-2 and MHV-N 10 min > 3.9 [30]
70% CCV Strain I-71 10 min > 3.3 [30]
2-Propanol 100% SARS-CoV Isolate FFM-1 30 s ≥ 3.3 [28]
75% SARS-CoV Isolate FFM-1 30 s ≥ 4.0 [14]
75% MERS-CoV Strain EMC 30 s ≥ 4.0 [14]
70% SARS-CoV Isolate FFM-1 30 s ≥ 3.3 [28]
50% MHV Strains MHV-2 and MHV-N 10 min > 3.7 [30]
50% CCV Strain I-71 10 min > 3.7 [30]
2-Propanol and 1-propanol 45% and 30% SARS-CoV Isolate FFM-1 30 s ≥ 4.3 [29]
SARS-CoV Isolate FFM-1 30 s ≥ 2.8 [28]
Benzalkonium chloride 0.2% HCoV ATCC VR-759 (strain OC43) 10 min 0.0 [31]
0.05% MHV Strains MHV-2 and MHV-N 10 min > 3.7 [30]
0.05% CCV Strain I-71 10 min > 3.7 [30]
0.00175% CCV Strain S378 3 d 3.0 [32]
Didecyldimethyl ammonium chloride 0.0025% CCV Strain S378 3 d > 4.0 [32]
Chlorhexidine digluconate 0.02% MHV Strains MHV-2 and MHV-N 10 min 0.7–0.8 [30]
0.02% CCV Strain I-71 10 min 0.3 [30]
Sodium hypochlorite 0.21% MHV Strain MHV-1 30 s ≥ 4.0 [33]
0.01% MHV Strains MHV-2 and MHV-N 10 min 2.3–2.8 [30]
0.01% CCV Strain I-71 10 min 1.1 [30]
0.001% MHV Strains MHV-2 and MHV-N 10 min 0.3–0.6 [30]
0.001% CCV Strain I-71 10 min 0.9 [30]
Hydrogen peroxide 0.5% HCoV Strain 229E 1 min > 4.0 [34]
Formaldehyde 1% SARS-CoV Isolate FFM-1 2 min > 3.0 [28]
0.7% SARS-CoV Isolate FFM-1 2 min > 3.0 [28]
0.7% MHV 10 min > 3.5 [30]
0.7% CCV Strain I-71 10 min > 3.7 [30]
0.009% CCV 24 h > 4.0 [35]
Glutardialdehyde 2.5% SARS-CoV Hanoi strain 5 min > 4.0 [36]
0.5% SARS-CoV Isolate FFM-1 2 min > 4.0 [28]
Povidone iodine 7.5% MERS-CoV Isolate HCoV-EMC/2012 15 s 4.6 [37]
4% MERS-CoV Isolate HCoV-EMC/2012 15 s 5.0 [37]
1% SARS-CoV Hanoi strain 1 min > 4.0 [36]
1% MERS-CoV Isolate HCoV-EMC/2012 15 s 4.3 [37]
0.47% SARS-CoV Hanoi strain 1 min 3.8 [36]
0.25% SARS-CoV Hanoi strain 1 min > 4.0 [36]
0.23% SARS-CoV Hanoi strain 1 min > 4.0 [36]
0.23% SARS-CoV Isolate FFM-1 15 s ≥ 4.4 [38]
0.23% MERS-CoV Isolate HCoV-EMC/2012 15 s ≥ 4.4 [38]

Inactivation of coronaviruses by biocidal agents in carrier tests

Ethanol at concentrations between 62% and 71% reduced coronavirus infectivity within 1 min exposure time by 2.0–4.0 log10.

Concentrations of 0.1–0.5% sodium hypochlorite and 2% glutardialdehyde were also quite effective with > 3.0 log10 reduction in viral titre.

 In contrast, 0.04% benzalkonium chloride, 0.06% sodium hypochlorite and 0.55% ortho-phtalaldehyde were less effective (Table III).

Table III – Inactivation of coronaviruses by different types of biocidal agents in carrier tests

Biocidal agent Concentration Virus Strain / isolate Volume / material Organic load Exposure time Reduction of viral infectivity (log10) Reference
Ethanol 71% TGEV Unknown 50 μl / stainless steel None 1 min 3.5 [39]
71% MHV Unknown 50 μl / stainless steel None 1 min 2.0 [39]
70% TGEV Unknown 50 μl / stainless steel None 1 min 3.2 [39]
70% MHV Unknown 50 μl / stainless steel None 1 min 3.9 [39]
70% HCoV Strain 229E 20 μl / stainless steel 5% serum 1 min > 3.0 [40]
62% TGEV Unknown 50 μl / stainless steel None 1 min 4.0 [39]
62% MHV Unknown 50 μl / stainless steel None 1 min 2.7 [39]
Benzalkoniumchloride 0.04% HCoV Strain 229E 20 μl / stainless steel 5% serum 1 min < 3.0 [40]
Sodium hypochlorite 0.5% HCoV Strain 229E 20 μl / stainless steel 5% serum 1 min > 3.0 [40]
0.1% HCoV Strain 229E 20 μl / stainless steel 5% serum 1 min > 3.0 [40]
0.06% TGEV Unknown 50 μl / stainless steel None 1 min 0.4 [39]
0.06% MHV Unknown 50 μl / stainless steel None 1 min 0.6 [39]
0.01% HCoV Strain 229E 20 μl / stainless steel 5% serum 1 min < 3.0 [40]
Glutardialdehyde 2% HCoV Strain 229E 20 μl / stainless steel 5% serum 1 min > 3.0 [40]
Ortho-phtalaldehyde 0.55% TGEV Unknown 50 μl / stainless steel None 1 min 2.3 [39]
0.55% MHV Unknown 50 μl / stainless steel None 1 min 1.7 [39]
Hydrogen peroxide Vapor of unknown concentration TGEV Purdue strain type 1 20 μl / stainless steel None 2–3 h 4.9–5.3* [41]

TGEV = transmissible gastroenteritis virus; MHV = mouse hepatitis virus; HCoV = human coronavirus; *depending on the volume of injected hydrogen peroxide.

Cleaning approaches

Cleaning should be performed using the proper personal protective equipment (PPE). The correct donning and doffing of PPE should be followed; further information on the donning and doffing procedures can be found in the ECDC Technical Document ‘Safe use of personal protective equipment in the treatment of infectious diseases of high consequence’ [8].

Disposable PPE should be treated as potentially infectious material and disposed in accordance with national rules.

The use of disposable or dedicated cleaning equipment is recommended; non-single use PPE should be decontaminated using the available products (e.g. 0.1% sodium hypochlorite or 70% ethanol).

When other chemical products are used, the manufacturer’s recommendation should be followed and the products prepared and applied according to them.

When using chemical products for cleaning, it is important to keep the facility ventilated (e.g. by opening the windows) in order to protect the health of cleaning personnel.

The following PPE items are suggested for use when cleaning facilities likely to be contaminated by SARS-CoV-2:

  • Filtering face pieces (FFP) respirators class 2 or 3 (FFP2 or FFP3)
  • Goggles or face shield
  • Disposable long-sleeved water-resistant gown
  • Disposable gloves.

All frequently touched areas, such as all accessible surfaces of walls and windows, the toilet bowl and bathroom surfaces, should be also carefully cleaned.

All textiles (e.g. bed linens, curtains, etc.) should be washed using a hot-water cycle (90 °C) and adding laundry detergent.

If a hot-water cycle cannot be used due to the characteristics of the tissues, specific chemicals should be added when washing the textiles (e.g. bleach or laundry products containing sodium hypochlorite, or decontamination products specifically developed for use on textiles).



References

4.            Hulkower RL, Casanova LM, Rutala WA, Weber DJ, Sobsey MD. Inactivation of surrogate coronaviruses on hard surfaces by health care germicides. American journal of infection control. 2011;39(5):401-7.

5.            Lai MYY, Cheng PKC, Lim WWL. Survival of severe acute respiratory syndrome coronavirus. Clinical Infectious Diseases. 2005;41(7):e67-e71.

6.            Sattar SA, Springthorpe VS, Karim Y, Loro P. Chemical disinfection of non-porous inanimate surfaces experimentally contaminated with four human pathogenic viruses. Epidemiology & Infection. 1989;102(3):493- 505.

7.            Saknimit M, Inatsuki I, Sugiyama Y, Yagami K. Virucidal efficacy of physico-chemical treatments against coronaviruses and parvoviruses of laboratory animals. Experimental animals. 1988;37(3):341-5.

8.            European Centre for Disease Prevention and Control (ECDC). Safe use of personal protective equipment in the treatment of infectious diseases of high consequence. Stockholm: ECDC; 2014. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/safe-use-of-ppe.pdf.

21.          van Doremalen, N., Bushmaker, T., and Munster, V.J. Stability of Middle East respiratory syndrome coronavirus (MERS-CoV) under different environmental conditions. Euro Surveill. 2013; 18

22.          Casanova, L.M., Jeon, S., Rutala, W.A., Weber, D.J., and Sobsey, M.D. Effects of air temperature and relative humidity on coronavirus survival on surfaces. Appl Environ Microbiol. 2010; 76: 2712–2717

23.          Warnes, S.L., Little, Z.R., and Keevil, C.W. Human Coronavirus 229E Remains Infectious on Common Touch Surface Materials. mBio. 2015; 6: e01697–15

24.          Sizun, J., Yu, M.W., and Talbot, P.J. Survival of human coronaviruses 229E and OC43 in suspension and after drying on surfaces: a possible source of hospital-acquired infections. J Hosp Infect. 2000; 46: 55–60

25.          Duan, S.M., Zhao, X.S., Wen, R.F., Huang, J.J., Pi, G.H., Zhang, S.X. et al. Stability of SARS coronavirus in human specimens and environment and its sensitivity to heating and UV irradiation. Biomed Environ Sci. 2003; 16: 246–255

26.          Lai, M.Y., Cheng, P.K., and Lim, W.W. Survival of severe acute respiratory syndrome coronavirus. Clin Infect Dis. 2005; 41: e67–e71

27.          Chan, K.H., Peiris, J.S., Lam, S.Y., Poon, L.L., Yuen, K.Y., and Seto, W.H. The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus. Adv Virol. 2011; : 734690

28.          Rabenau, H.F., Cinatl, J., Morgenstern, B., Bauer, G., Preiser, W., and Doerr, H.W. Stability and inactivation of SARS coronavirus. Med Microbiol Immunol. 2005; 194: 1–6

29.          Rabenau, H.F., Kampf, G., Cinatl, J., and Doerr, H.W. Efficacy of various disinfectants against SARS coronavirus. J Hosp Infect. 2005; 61: 107–111

30.          Saknimit, M., Inatsuki, I., Sugiyama, Y., and Yagami, K. Virucidal efficacy of physico-chemical treatments against coronaviruses and parvoviruses of laboratory animals. Jikken Dobutsu Exp Anim. 1988; 37: 341–345

31.          Wood, A. and Payne, D. The action of three antiseptics/disinfectants against enveloped and non-enveloped viruses. J Hosp Infect. 1998; 38: 283-295

32.          Pratelli, A. Action of disinfectants on canine coronavirus replication in vitro. Zoonoses Publ Health. 2007; 54: 383–386

33.          Dellanno, C., Vega, Q., and Boesenberg, D. The antiviral action of common household disinfectants and antiseptics against murine hepatitis virus, a potential surrogate for SARS coronavirus. Am J Infect Control. 2009; 37: 649–652

34.          Omidbakhsh, N. and Sattar, S.A. Broad-spectrum microbicidal activity, toxicologic assessment, and materials compatibility of a new generation of accelerated hydrogen peroxide-based environmental surface disinfectant. Am J Infect Control. 2006; 34: 251–257

35.          Pratelli, A. Canine coronavirus inactivation with physical and chemical agents. Vet J (London, England : 1997). 2008; 177: 71–79  

36.          Kariwa, H., Fujii, N., and Takashima, I. Inactivation of SARS coronavirus by means of povidone-iodine, physical conditions and chemical reagents. Dermatol (Basel, Switzerland). 2006; 212: 119–123 

37.          Eggers, M., Eickmann, M., and Zorn, J. Rapid and Effective Virucidal Activity of Povidone-Iodine Products Against Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and Modified Vaccinia Virus Ankara (MVA). Infect Dis Ther. 2015; 4: 491–501  

38.          Eggers, M., Koburger-Janssen, T., Eickmann, M., and Zorn, J. In Vitro Bactericidal and Virucidal Efficacy of Povidone-Iodine Gargle/Mouthwash Against Respiratory and Oral Tract Pathogens. Infect Dis Ther. 2018; 7: 249–259

39.          Hulkower, R.L., Casanova, L.M., Rutala, W.A., Weber, D.J., and Sobsey, M.D. Inactivation of surrogate coronaviruses on hard surfaces by health care germicides. Am J Infect Control. 2011; 39: 401–407

40.          Sattar, S.A., Springthorpe, V.S., Karim, Y., and Loro, P. Chemical disinfection of non-porous inanimate surfaces experimentally contaminated with four human pathogenic viruses. Epidemiol Infect. 1989; 102: 493–505

41.          Goyal, S.M., Chander, Y., Yezli, S., and Otter, J.A. Evaluating the virucidal efficacy of hydrogen peroxide vapour. J Hosp Infect. 2014; 86: 255–259

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Questo sito usa Akismet per ridurre lo spam. Scopri come i tuoi dati vengono elaborati.