Virucide

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A virucide (alternatively spelled viricide [1] or named biocidal agent [2] or known as microbicides [3] or biocides [4] ) is any physical or chemical agent that deactivates or destroys viruses. [5] The substances are not only virucidal but can be also bactericidal, fungicidal, sporicidal or tuberculocidal. [6]

Contents

Virucides are to be used outside the human body, and as such fall into the category of disinfectants (applied not to the human body) and antiseptics (applied to the surface of skin) for those safe enough. Overall, the notion of virucide differs from an antiviral drug such as Aciclovir, which inhibits the proliferation of the virus inside the body. [7] [8] [9]

CDC's Disinfection and Sterilization list of Chemical Disinfectants mentions and discusses substances such as: alcohol, chlorine and chlorine compounds, formaldehyde, glutaraldehyde, hydrogen peroxide, iodophors, ortho-phthalaldehyde (OPA), peracetic acid, peracetic acid and hydrogen peroxide, phenolics, quaternary ammonium compounds, with different, but usually potent microbicidal activity. [10] [11] Other inactivating agents such as UV light, metals, and ozone exist. [12] [13] [14] [11]

Definitions

According to the Centers for Disease Control and Prevention (CDC), a virucide is "An agent that kills viruses to make them noninfective." [15]

According to a definition by Robert Koch Institute Germany and further institutions, [16] virucide means effective against enveloped and non-enveloped viruses. [17] [18] [12]

Due to the complexity of the subject, in Germany, Robert-Koch-Institute introduced sub-definitions such as "limited virucidal" or "limited virucidal plus" (translated from German) to differentiate its meaning further. [19] [20]

Note that the meaning of virus inactivation or viral clearance is specific for the medical process industry, i.e., to remove HIV from blood.

Functioning

Different substances have interactions between microbicides and viruses such as: [3]

The exact mechanisms, for example of iodine (PVP-I), are still not clear, but it is targeting the bacterial protein synthesis due to disruption of electron transport, DNA denaturation or disruptive effects on the virus membrane. [21]

Registration

The U.S. Centers for Disease Control and Prevention administers a regulatory framework for disinfectants and sterilants. [22] To earn virucidal registration, extensive data on harder-to-kill viruses demonstrating long-lasting virucidal efficacy need to be provided. [23] [24] [25]

Regulations

Testing

A specific protocol for hand-hygiene testing has been researched and established by microbiologist Prof. Graham Ayliffe. [34]

Safety

Virucides are not intended for use inside the body, [35] [36] and most are disinfectants that are not intended for use on the surface of the body. [37] Most substances are toxic. [6] None of the listed substances replaces vaccination [38] [39] [40] or antiviral drugs, if available. [41] [42] [43] Virucides are usually labeled with instructions for safe, effective use. [44] [37] [45] [46] The correct use and scope of disinfectants is very important. [47] [48] [49]

Potential serious side-effects with using "quats" (Quaternary ammonium compounds) exist, and over-use "can have a negative impact on your customers' septic systems." [50]

Mouth-rinsing or gargling can reduce virus load, [51] however experts warn that "Viruses in the nose, lungs or trachea that are released when speaking, sneezing and coughing are unlikely to be reached because the effect is based on physical accessibility of the surface mucous membrane". [52]

According to Deutsche Dermatologische Gesellschaft, medical practitioners recommend that disinfectants are gentler on the skin compared to soap-washing. The disinfected hands should then also be creamed to support the regeneration of the skin barrier. Skin care does not reduce the antiseptic effect of the alcoholic disinfectants. [53] [54]

The "explosive" use of antibacterial cleansers has led the CDC to monitor substances in adults. [55]

On April 5, 2021, a Press Briefing by White House COVID-19 Response Team and Public Health Officials mentions that "Cleaning with household cleaners containing soap or detergent will physically remove germs from surfaces.  This process does not necessarily kill germs, but reduces the risk of infection by removing them. Disinfecting uses a chemical product, which is a process that kills the germs on the surfaces. In most situations, regular cleaning of surfaces with soap and detergent, not necessarily disinfecting those surfaces, is enough to reduce the risk of COVID-19 spread. Disinfection is only recommended in indoor settings — schools and homes — where there has been a suspected or confirmed case of COVID-19 within the last 24 hours. In most situations, regular cleaning of surfaces with soap and detergent, not necessarily disinfecting those surfaces, is enough to reduce the risk of COVID-19 spread." [56] [57]

The CDC issued a special report "Knowledge and Practices Regarding Safe Household Cleaning and Disinfection for COVID-19 Prevention" due to the increased number of calls to poison centers regarding exposures to cleaners and disinfectants since the onset of the COVID-19 pandemic, concluding that "Public messaging should continue to emphasize evidence-based, safe cleaning and disinfection practices to prevent SARS-CoV-2 transmission in households, including hand hygiene and cleaning and disinfection of high-touch surfaces." [58] [59]

CDC provides a Guideline for Disinfection and Sterilization in Healthcare Facilities. [60]

Microbicidal activity

Each mentioned item in the list has different microbicidal activity, i.e. some viruses can be more or less resistant. For example, Poliovirus is resistant to a solution of 3% H2O2 even after a contact time of 10 minutes, [61] however 7.5% H2O2 takes 30 minutes to inactivate over 99.9% of Poliovirus. [10] Generally, hydrogen peroxide is considered as a potent virucide in appropriate concentrations, specifically in other forms such as gaseous. [3]

Another example is povidone-iodine (PVP-I), which is found to be effective against herpes simplex virus [62] or SARS-CoV-2, [63] and other viruses, [64] but coxsackievirus and polio was rather resistant or less sensitive to inactivation. [65] [64]

SARS-CoV-2 (COVID-19)

In the beginning of the COVID-19 pandemic, former US President Donald Trump delivered a very dangerous message to the public on the use of disinfectants, which was immediately rejected and refuted by health professionals. [66] In essence, and as mentioned above, virucides are usually toxic depending on concentrations, mixture, etc., and can be deadly not just to viruses, but also if inside a human or animal body [67] or on surface of body. [68]

With regards to the COVID-19 pandemic, some of the mentioned agents are still under research about their microbicidal activity and effectivity against SARS-CoV-2, e.g., on surfaces, [69] [70] as mouth-washes, [71] hand-washing, [72] etc.

A mixture of 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite is found to be able to deactivate the novel Coronavirus on surfaces within 1 minute. [2]

A 2020 systematic review on hydrogen peroxide (H2O2) mouth-washes concludes, that they don't have an effect on virucidal activity, recommending that "dental care protocols during the COVID-19 pandemic should be revised." [73] Additional research with relation to the Coronavirus virucidal efficacy is on-going. [74] [71] [75]

Various information and overview of light-based strategies (UV-C and other types of light sources; see also Ultraviolet germicidal irradiation) to combat the COVID-19 pandemic are available. [76] [77] [78] [79]

As systematic review of 16 studies by Cochrane on Antimicrobial mouthwashes (gargling) and nasal sprays concludes that "there is currently no evidence relating to the benefits and risks of patients with COVID‐19 using antimicrobial mouthwashes or nasal sprays." [80]

SARS-CoV

Treatment of SARS-CoV for 2 min with Isodine (PVP-I) is found to strongly reduce the virus infectivity. [81]

Research

The International Society of Antimicrobial Chemotherapy (ISAC) is one of the major umbrella organizations for education, research and development in the area of therapy of infections. Its members are national organizations, currently 86 and over 50,000 individual members. [82]

List of virucides

Note that many of the substances, if sold commercially, are usually combinations and mixtures with varying molecular contents. Also note that most products have a limited viricide efficacy. [83] A specific test-protocol is applied. [84] The lists' scope is limited. For further products refer to other lists. [85] [86] [6] Other factors such as stability of the concentrate, application concentration, exposure time, timing of the solution, hydrogen ion concentration (pH value), temperature, etc. play an certain role for the effectivity of a virucide. [11]

EPA is providing a public listing called "List N" [87] [88]

General substance listing of active component or compound

Example products

Other substances, drugs, proteins, therapeutics, research-level topics

Agricultural, veterinary

See also

Related Research Articles

An antiseptic is an antimicrobial substance or compound that is applied to living tissue to reduce the possibility of sepsis, infection or putrefaction. Antiseptics are generally distinguished from antibiotics by the latter's ability to safely destroy bacteria within the body, and from disinfectants, which destroy microorganisms found on non-living objects.

<span class="mw-page-title-main">Hygiene</span> Practices performed to preserve health

Hygiene is a set of practices performed to preserve health. According to the World Health Organization (WHO), "Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases." Personal hygiene refers to maintaining the body's cleanliness. Hygiene activities can be grouped into the following: home and everyday hygiene, personal hygiene, medical hygiene, sleep hygiene, and food hygiene. Home and every day hygiene includes hand washing, respiratory hygiene, food hygiene at home, hygiene in the kitchen, hygiene in the bathroom, laundry hygiene, and medical hygiene at home.

Virkon is a multi-purpose disinfectant. It contains potassium peroxymonosulfate, sodium dodecylbenzenesulfonate, sulfamic acid, and inorganic buffers. It is typically used for cleaning up hazardous spills, disinfecting surfaces and soaking equipment. The solution is used in many areas, including hospitals, laboratories, nursing homes, funeral homes, dental and veterinary facilities, and anywhere else where control of pathogens is required.

<span class="mw-page-title-main">Hand washing</span> Act of cleaning ones hands

Hand washing, also known as hand hygiene, is the act of cleaning one's hands with soap or handwash and water to remove viruses/bacteria/microorganisms, dirt, grease, or other harmful and unwanted substances stuck to the hands. Drying of the washed hands is part of the process as wet and moist hands are more easily recontaminated. If soap and water are unavailable, hand sanitizer that is at least 60% (v/v) alcohol in water can be used as long as hands are not visibly excessively dirty or greasy. Hand hygiene is central to preventing the spread of infectious diseases in home and everyday life settings.

<span class="mw-page-title-main">Tincture of iodine</span> Antiseptic solution rubbed on skin before surgical operations

Tincture of iodine, iodine tincture, or weak iodine solution is an antiseptic. It is usually 2 to 3% elemental iodine, along with potassium iodide or sodium iodide, dissolved in a mixture of ethanol and water. Tincture solutions are characterized by the presence of alcohol. It was used from 1908 in pre-operative skin preparation by Italian surgeon Antonio Grossich.

<span class="mw-page-title-main">Disinfectant</span> Antimicrobial agent that inactivates or destroys microbes

A disinfectant is a chemical substance or compound used to inactivate or destroy microorganisms on inert surfaces. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than sterilization, which is an extreme physical or chemical process that kills all types of life. Disinfectants are generally distinguished from other antimicrobial agents such as antibiotics, which destroy microorganisms within the body, and antiseptics, which destroy microorganisms on living tissue. Disinfectants are also different from biocides—the latter are intended to destroy all forms of life, not just microorganisms. Disinfectants work by destroying the cell wall of microbes or interfering with their metabolism. It is also a form of decontamination, and can be defined as the process whereby physical or chemical methods are used to reduce the amount of pathogenic microorganisms on a surface.

<span class="mw-page-title-main">Benzalkonium chloride</span> Surfactant and antiseptic agent

Benzalkonium chloride, also known as alkyldimethylbenzylammonium chloride (ADBAC) and by the trade name Zephiran, is a type of cationic surfactant. It is an organic salt classified as a quaternary ammonium compound. ADBACs have three main categories of use: as a biocide, a cationic surfactant, and a phase transfer agent. ADBACs are a mixture of alkylbenzyldimethylammonium chlorides, in which the alkyl group has various even-numbered alkyl chain lengths.

<span class="mw-page-title-main">Chlorhexidine</span> Disinfectant and antiseptic

Chlorhexidine is a disinfectant and antiseptic with the molecular formula C22H30Cl2N10, which is used for skin disinfection before surgery and to sterilize surgical instruments. It is also used for cleaning wounds, preventing dental plaque, treating yeast infections of the mouth, and to keep urinary catheters from blocking. It is used as a liquid or a powder. It is commonly used in salt form, either the gluconate or the acetate.

An antimicrobial is an agent that kills microorganisms (microbicide) or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals are used against fungi. They can also be classified according to their function. The use of antimicrobial medicines to treat infection is known as antimicrobial chemotherapy, while the use of antimicrobial medicines to prevent infection is known as antimicrobial prophylaxis.

<span class="mw-page-title-main">Povidone-iodine</span> Antiseptic solution

Povidone-iodine (PVP-I), also known as iodopovidone, is an antiseptic used for skin disinfection before and after surgery. It may be used both to disinfect the hands of healthcare providers and the skin of the person they are caring for. It may also be used for minor wounds. It may be applied to the skin as a liquid or a powder.

<span class="mw-page-title-main">Bedpan</span> Toilet device for someone confined to bed

A bedpan or bed pan is a device used as a receptacle for the urine and/or feces of a person who is confined to a bed and therefore not able to use a toilet or chamber pot.

Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe, infection prevention and control is expanded from healthcare into a component in public health, known as "infection protection". It is an essential part of the infrastructure of health care. Infection control and hospital epidemiology are akin to public health practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.

<span class="mw-page-title-main">Hand sanitizer</span> Alternative to hand washing

Hand sanitizer is a liquid, gel or foam generally used to kill many viruses/bacteria/microorganisms on the hands. It can also come in the form of a cream, spray, or wipe. In most settings, hand washing with soap and water is generally preferred. Hand sanitizer is less effective at killing certain kinds of germs, such as norovirus and Clostridium difficile, and unlike hand washing, it cannot physically remove harmful chemicals. People may incorrectly wipe off hand sanitizer before it has dried, and some are less effective because their alcohol concentrations are too low.

<span class="mw-page-title-main">Isolation (health care)</span> Measure taken to prevent contagious diseases from being spread

In health care facilities, isolation represents one of several measures that can be taken to implement in infection control: the prevention of communicable diseases from being transmitted from a patient to other patients, health care workers, and visitors, or from outsiders to a particular patient. Various forms of isolation exist, in some of which contact procedures are modified, and others in which the patient is kept away from all other people. In a system devised, and periodically revised, by the U.S. Centers for Disease Control and Prevention (CDC), various levels of patient isolation comprise application of one or more formally described "precaution".

<span class="mw-page-title-main">Airborne transmission</span> Disease transmission by airborne particles

Airborne transmission or aerosol transmission is transmission of an infectious disease through small particles suspended in the air. Infectious diseases capable of airborne transmission include many of considerable importance both in human and veterinary medicine. The relevant infectious agent may be viruses, bacteria, or fungi, and they may be spread through breathing, talking, coughing, sneezing, raising of dust, spraying of liquids, flushing toilets, or any activities which generate aerosol particles or droplets. This is the transmission of diseases via transmission of an infectious agent, and does not include diseases caused by air pollution.

Decolonization, also bacterial decolonization, is a medical intervention that attempts to rid a patient of an antimicrobial resistant pathogen, such as methicillin-resistant Staphylococcus aureus (MRSA) or antifungal-resistant Candida.

<span class="mw-page-title-main">COVID-19</span> Contagious disease caused by SARS-CoV-2

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the virus SARS-CoV-2. The first known case was identified in Wuhan, China, in December 2019. The disease quickly spread worldwide, resulting in the COVID-19 pandemic.

In epidemiology, a non-pharmaceutical intervention (NPI) is any method used to reduce the spread of an epidemic disease without requiring pharmaceutical drug treatments. Examples of non-pharmaceutical interventions that reduce the spread of infectious diseases include wearing a face mask and staying away from sick people.

<span class="mw-page-title-main">Transmission of COVID-19</span> Mechanisms that spread coronavirus disease 2019

The transmission of COVID-19 is the passing of coronavirus disease 2019 from person to person. COVID-19 is mainly transmitted when people breathe in air contaminated by droplets/aerosols and small airborne particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the closer people are. However, infection can occur over longer distances, particularly indoors.

Accelerated hydrogen peroxide (AHP) is a trademark for solution of hydrogen peroxide whose antibacterial efficacy is enhanced by a surfactant and an organic acid. It is also a disinfectant/cleaning agent that stabilizes hydrogen peroxide so that it can be used for extended periods of time.

References

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