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Study shows how diligent we have to be to keep surfaces germ-free

Only half of surfaces in animal hospital disinfected

March 25, 2020

Science Daily/Ohio State University

During the COVID-19 pandemic, every frequently touched surface outside our home seems as dangerous as a hot pot right out of the oven. We won't get burned if we touch it, but we might get infected with a potentially dangerous virus.

A recent study suggests that even organized efforts to clean surfaces can fall short, a reminder for us all that keeping our surroundings clean may require some additional work.

For 5 ½ weeks, researchers tagged surfaces of a small-animal veterinary practice daily with a fluorescent dye visible only under black light. They checked tagged surfaces 24 hours later to see if the marks were showing. Surfaces were considered cleaned if the dye was completely removed.

Results showed that overall, only half of all surfaces were adequately cleaned during the study period. Human-touch surfaces -- such as medical instruments, dog run handles, and computer mice and keyboards -- were cleaned less frequently than areas touched primarily by animals. The results were similar to studies from other veterinary clinics.

The researchers recommended creating checklists of surfaces that need to be regularly cleaned and educating all staff on the importance of proper cleaning to protect animal and human health.

"The concept of infectious diseases is around us all the time, but now it's more important than ever to take steps to protect ourselves," said senior study author Jason Stull, assistant professor of veterinary preventive medicine at The Ohio State University.

"A recent study concluded the coronavirus causing COVID-19 has the ability to survive on certain types of surfaces for hours to a few days. At veterinary practices, other businesses and certainly human hospitals, surface cleaning and disinfection is extremely important. People come in and may contaminate an area and that area potentially can serve as a source of infection for other people."

The study is published in the February issue of the Journal of Small Animal Practice.

Stull specializes in veterinary infection control, including prevention of diseases that animals can share with each other or pass to humans -- such as Salmonella, E. coli and parasites.

For the current work, Stull and colleagues assessed almost 5,000 surfaces over the course of the study. On average, 50 percent of surfaces were cleaned, with broad variations by type of surface and hospital location. The human-touch surfaces were the least likely to be cleaned.

The study assessed everyday cleaning practices in a place where people spend lots of time with different animals and different people. It's not too much of a stretch to apply some lessons to what we're experiencing now with COVID-19, Stull said.

"Plenty of industries and groups outside of human health care have ramped up their efforts to clean and disinfect common-touch surfaces. The take-home messages from our study can have important parallels for others, such as other veterinary clinics, but also groups such as grocery stores.

"Our study also highlights that, despite our best efforts, 100 percent cleaning and disinfection is unlikely to occur. This is important to remember, as regardless of where you visit, it's also best to assume surfaces may be contaminated -- and before you come back into your home, you should follow the recommendations to clean your hands and clean items you've handled."

At home, Stull said, it makes sense to concentrate on cleaning common-touch surfaces like doorknobs and countertops.

"For the average person, it's thinking about your list of things in your own home and ensuring that in some way that you're actually hitting those pieces with reasonable effort," he said.

On a normal day, people who have touched commonly shared surfaces should wash their hands before eating or scratching their noses. But will we remain diligent about this level of personal cleanliness -- and community health -- once the worst of the coronavirus threat is behind us?

"People have a tendency to swing from extremes," Stull said. "Changing the innate behaviors of people is always difficult, and we've struggled in human and veterinary health care to change these everyday practices.

"The hard part is continuing these efforts. When we get to the end of this, and at some point that will happen, you will likely see people revert back to their norm. What we need is a culture shift, so people recognize that infection control through hand-washing and thorough cleaning of shared surfaces is a critically important thing we can all do all the time, and it has measurable impact."

Armando Hoet of Ohio State's College of Veterinary Medicine and Gregory Langdon of the College of Public Health also worked on the study.

https://www.sciencedaily.com/releases/2020/03/200325120849.htm

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Risk of coronavirus importation in Africa

February 20, 2020

Science Daily/INSERM (Institut national de la santé et de la recherche médicale)

Egypt, Algeria and Republic of South Africa are the African countries most at risk for coronavirus COVID-19 importation in the continent, due to high air traffic with the contaminated Chinese provinces. But these countries are also among the best equipped on the continent to quickly detect and deal with new cases. In other African countries, the risk of importation is lower, but health organization deficiencies raise concerns about rapid spread.

The COVID-19 coronavirus continues to spread in China and cases have been reported in more than 25 countries. The African continent was spared for a long time until a first case was recently reported in Egypt. Vittoria Colizza, research director at Inserm (French Institute for Health and Medical Research), and her team from Unit 1136 Pierre Louis Institute of Epidemiology and Public Health (Inserm / Sorbonne University), in collaboration with the Université libre de Bruxelles, the Oxford Martin Programme on Pandemic Genomics and the University of California Los Angeles, assessed the risk of importing the virus into Africa, country by country, and the capacities of each of them to detect and deal with it.

The researchers evaluated the risk of the virus importation according to the number of cases declared by each chinese province and according to air traffic between the three main airports of each of these provinces (except Hubei due to flights suspension) and each African country. Moreover, they analyzed the potential of each country to face the risk of the spread of a contagious disease using WHO data and official data.

Each country makes a mandatory annual declaration to the WHO of its resources to deal with an epidemic (State Parties self-assessment Annual Reporting SPAR). It includes twenty-four items weighted into an overall score between 0 and 100, 100 showing a strong preparedness to face an epidemic.

These indicators are legislation, adherence to WHO standards, laboratory skills, medical staff, emergency organization, food safety, level of equipment in healthcare centers and public communication.

The researchers also took into account the IDVI score (for Infectious Disease Vulnerability Index), also noted out of 100, 0 corresponding to an extreme vulnerability and 100 to the lowest vulnerability. The IDVI takes into account factors not directly linked to the health system but which can influence the response to an epidemic: the size of the population, the socio-economic level or even political stability. Thus, high IDVI and SPAR scores are predictive to an efficient response in case of virus importation.

The results show that Egypt, Algeria and Republic of South Africa are the countries most at risk of importing the virus to Africa due to high trade exchanges with China. On the other hand, their SPAR and IDVI scores are among the best on the continent, letting expect effective detection and containment of the virus. Other countries as Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana and Kenya, are at lower risk of virus importation but their SPAR and IDVI scores are lower, raising fears of the nondetection of possible imported cases and of local or even national spread.

Finally, the researchers clustered the African countries at risk into three groups according to the influence of the Chinese provinces in these countries. Thus, a first group including 18 countries will be more vulnerable in the event of a major epidemic in the province of Beijing, a second comprising 7 countries will be more exposed in the event of a strong growth of the epidemic in the province of Guangdong and a third group of two countries is risking virus importation only from Fujian province.

"This work will allow the international community to make projections and plans according to the evolution in China. It also alerts the countries most exposed to the need of being prepared for the possible introduction of the virus. We can see how hard it is to quickly detect imported cases, as even well prepared developed countries missed some of them. For several poorly equipped African countries, the risks are significant of not having sufficient organization and infrastructure for detection, containment and urgent care, raising fears of a risk of epidemic on the continent," concludes Vittoria Colizza.

https://www.sciencedaily.com/releases/2020/02/200220104049.htm

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