Sattar Syed A, Springthorpe V Susan, Tetro Jason, Vashon Robert, Keswick Bruce
Centre for Research on Environmental Microbiology, Faculty of Medicine, University of Ottawa, and the Procter & Gamble Co, Cincinnati and Mason, Ohio, USA.
Am J Infect Control. 2002 Oct;30(6):355-72. doi: 10.1067/mic.2002.124532.
Enteric and respiratory viruses are among the most frequent causes of human infections, and hands play an important role in the spread of these and many other viral diseases. Regular and proper hand hygiene by caregivers and food handlers in particular is essential to decontaminate hands and potentially interrupt such spread. What would be considered a proper decontamination of hands? Handwashing with regular soap and water is often considered sufficient, but what of hygienic handwash and handrub antiseptic products? Are they more effective? The evidence suggests that some clearly are. Activity against bacteria may not reflect the ability of hygienic hand antiseptics to deal with viruses, especially those that are nonenveloped. In spite of the acknowledged importance of hands as vehicles for viruses, there is a lack of suitable regulatory mechanism for handwash or handrub products to make claims of efficacy against viruses. This is in contrast with the ability of general-purpose disinfectants to make antiviral claims, although transmission of viruses from surfaces other than those of reusable medical devices may play only a minor role in virus transmission. This review discusses the (1). recent information on the relative importance of viruses as human pathogens, particularly those causing enteric and respiratory infections; (2). the survival of relevant viruses on human hands in comparison with common gram-negative and gram-positive bacteria; (3). the potential of hands to transfer or receive such contamination on casual contact; (4). role of hands in the spread of viruses; (5). the potential of hygienic measures to eliminate viruses from contaminated hands; (6). relative merits of available protocols to assess the activity of hygienic hand antiseptics against viruses; and (7). factors considered crucial in any tests to assess the activity of hygienic hand antiseptics against viruses. In addition, this review proposes surrogate viruses in such testing and discusses issues for additional consideration by researchers, manufacturers, end-users, and regulators.
肠道病毒和呼吸道病毒是人类感染最常见的病因之一，手在这些病毒以及许多其他病毒性疾病的传播中起着重要作用。尤其是护理人员和食品处理人员经常且正确地进行手部卫生，对于手部去污并潜在地阻断此类传播至关重要。怎样才算是对手部进行了恰当的去污呢？用普通肥皂和水洗手通常被认为就足够了，但是卫生洗手液和手部擦拭消毒产品又如何呢？它们更有效吗？证据表明有些产品显然更有效。针对细菌的活性可能无法反映卫生手部消毒剂对付病毒的能力，尤其是那些无包膜的病毒。尽管人们公认手作为病毒载体的重要性，但对于洗手液或手部擦拭产品宣称具有抗病毒功效，却缺乏合适的监管机制。这与通用消毒剂能够宣称具有抗病毒功效形成对比，尽管除了可重复使用的医疗设备表面之外，病毒从其他表面传播在病毒传播中可能只起次要作用。本综述讨论了：（1）关于病毒作为人类病原体，特别是那些引起肠道和呼吸道感染的病毒的相对重要性的最新信息；（2）与常见革兰氏阴性菌和革兰氏阳性菌相比，相关病毒在人手上的存活情况；（3）手在偶然接触中转移或沾染此类污染物的可能性；（4）手在病毒传播中的作用；（5）卫生措施从被污染的手上清除病毒的潜力；（6）评估卫生手部消毒剂抗病毒活性的现有方案的相对优点；以及（7）在评估卫生手部消毒剂抗病毒活性的任何测试中被认为至关重要的因素。此外，本综述提出了此类测试中的替代病毒，并讨论了研究人员、制造商、终端用户和监管机构需要进一步考虑的问题。
