Environmental Health & Safety I. Environmental Management II. Cleaning and Disinfection III. Cleaning Confirmed Cases of Flu IV. Use of Bleach V. Cleaning Public Areas VI. Clean-up for Blood and Body Fluids VII.Contacts Influenza viruses can persist on both nonporous and porous surfaces for several hours The secondary spread of infectious virus from an environmental surface to other people is accomplished primarily via hand transfer ◦ (i.e. hand contact with contaminated surfaces and then touching the eyes, nose, and mouth) Proper hand washing, respiratory hygiene, and cough etiquette are the principal means of interrupting transfer of flu virus. Influenza viruses are transmitted primarily by exposure to infectious respiratory secretions. These large droplets can transmit influenza virus to other people within 6 feet from the source individual. These large droplets tend to settle out of the air in a relatively short period and eventually rest on a variety of environmental surfaces: ◦ Large housekeeping surfaces Floors, walls, windows, tables and countertops ◦ Equipment and appliances ◦ Surfaces frequently touched by hand Door handles, light switches, bathroom and kitchen surfaces, phones, computers Cleaning: ◦ Removing dirt or other contamination Disinfection: ◦ Cleaning a surface or object to eliminate nearly all recognized pathogenic organisms that may cause infection Cleaning and disinfection can reduce the numbers of viruses present on environmental surfaces, which can help to minimize hand transfer of virus. Although pandemic influenza viruses may cause severe disease, these viruses are among the least resistant to chemical disinfection. Therefore, routine cleaning and disinfection strategies used during influenza season could be applied for the management of pandemic influenza. Cleaning with soap or detergent in water is the first step in surface treatment. Cleaning will remove debris, such as dust or dirt, that could reduce the effectiveness of disinfection step that follows. There is no indication for cleaning procedures that differ from what is done routinely. Use any commercially available soap or detergent. Water can be cold or warm, or as recommended on the label of the cleaning product used. 1. Cleaning with soap or detergent is the first step in cleaning a surface and MUST be performed before disinfection. 2. The flu virus is inactivated by a number of disinfectants. 3. Follow manufacturer’s recommendations for the use/dilution, contact time, and handling of disinfectants. 4. Patient rooms/areas should be cleaned at least daily. 5. ◦ Special attention should be given to cleaning frequently touched surfaces (e.g. television controls, doorknobs, microwaves, gaming controls, commodes, closets, desks). 5. Common areas should be cleaned using standard facility cleaning procedure. ◦ Surfaces frequently touched with hands such as sinks, flush handles, doorknobs, railings, counters, and vending machines should be added to cleaning schedule in all areas. 6. Clean and disinfect bathroom surfaces on a daily or more regular basis. 7. Bleach may be substituted if disinfectants are not available (¼ cup of bleach to a gallon of clean water). ◦ Apply to a cleaned surface, preferably with a cloth moistened with the bleach solution, and allow the surface to remain wet for at least 3-5 minutes. ◦ Diluted bleach solutions must be prepared fresh before each use. 8. Wash linens (such as bed sheets and towels) by using laundry soap/detergent in hot water and tumble dry on a hot setting. ◦ Avoid “hugging”, shaking or fluffing laundry before washing it to prevent contaminating yourself. 9. Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first. 10.During wet cleaning, cleaning solutions and equipment become contaminated. ◦ ◦ ◦ Clean less contaminated areas first Change cleaning solutions, cleaning cloths, and mop heads frequently (e.g. do not clean sinks & toilets with same cloth) 11.Recommend using one bucket for cleaning solution and a separate bucket for rinsing. 12.Equipment used for cleaning and disinfecting must be cleaned and dried after each use. ◦ Mop heads should be laundered in hot water daily and dried thoroughly before storage or reuse. 13.In carpeted areas it is best to use a vacuum cleaner with HEPA filtration if available. 14.Keep areas around sick individuals free of unnecessary supplies and equipment. 15.Do not spray rooms with disinfectant. This is potentially dangerous (health risk) Has no proven disease control benefit Bleach, also known as sodium hypochlorite, is an effective disinfectant against the flu virus. Starting solution: Most household bleach solutions contain 5% sodium hypochlorite Recommended dilution: Use 1 part bleach to 9 parts water for disinfection of surfaces Contact time: When wiping surfaces with bleach, allow a contact time of 3-5 minutes before wiping again with a clean wet cloth NOTE: Surfaces must be cleaned before disinfection Routine use of bleach should be avoided because it is corrosive to metals, damaging to environmental surfaces, is inactivated by organic matter (e.g. dust or dirt), has no detergent (cleaning) benefit and is toxic. After metal is cleaned with bleach it is necessary to wipe surface with clean wet cloth to avoid corrosion. If bleach gets into the eyes, immediately rinse with water for at least 15 minutes and seek medical care or consult a doctor. Bleach should NOT be used or mixed with other detergents as this reduces its effectiveness and can cause chemical reactions. Personal protective equipment should be worn when applying cleaning products. This should include gloves as well as safety goggles if splashes or spraying is possible. 1. Hand hygiene is most important method to prevent transmission of influenza virus. ◦ ◦ Distribute hand washing and personal hygiene educational materials. If possible distribute hand sanitizer. 2. Normal facility cleaning procedures should be followed using standard cleaning products. 3. Surfaces that are frequently touched with hands (e.g. sinks, flush handles, doorknobs, railings and counters) should be added to cleaning schedule in all areas. 4. Student Resident Halls (Dorm Rooms): In addition to cleaning floors and other surfaces, special attention should be given to frequently touched surfaces. ◦ e.g. television controls, doorknobs, microwaves, commodes, closets, desks, vending machines, laundry machines 5. Laundry: Use detergents, laundry additives, and appropriate water temperature (routine procedures). ◦ Follow manufacturer’s instructions for detergent and bleach use. 6. Individual employees and students may want to consider regular cleaning of their phones and keyboards, particularly if shared with others or used by the public. ◦ In addition, routine use of hand sanitizer and good hand washing techniques are recommended. 7. Gloves should be worn when handling waste or waste containers at all times. 8. Floors should be mopped routinely. ◦ Mop heads should be laundered in hot water daily and dried thoroughly before storage and reuse. Clean and disinfect spills of blood and body fluids in accordance with Universal Precautions and the OSHA Bloodborne Pathogens Standard. Treat all spills containing blood and body fluids as if the spilled material is infectious (using appropriate disinfectant and gloves). Alert people in immediate area Don appropriate protective equipment Cover spill with absorbent material Carefully pour fresh 10% bleach solution around edges & work inward Allow 20 min. disinfectant contact time Use absorbent material to wipe up spill Clean area again with fresh absorbent and disinfectant Place clean-up materials inside a leakproof biohazard bags for disposal Contact Environmental Health and Safety for guidance before using disinfectants in large quantities or in enclosed areas. ◦ Phone: 777-5269 ◦ Website: http://ehs.sc.edu Contact Thomson Student Health Center for more information regarding cleaning and disinfection for pandemic influenza. http://www.sa.sc.edu/shs/tshc/ I. Maintain good personal hygiene. II. Cover your mouth and nose when sneezing and coughing. III. Hand hygiene is the most important method to prevent the transmission of influenza virus. IV. Routine cleaning of surfaces frequently touched by hand can minimize spread of flu.