It may seem odd, at this stage in the Flu season to write
yet another blog on Influenza, particularly when reports in Flu activity in North America are starting to decline. Rest assured, this blog is not going to focus on how to prevent transmission of the flu through cleaning and disinfection, what the symptoms of
flu are or a reminder that it's not too late to get vaccinated.
Instead I want to focus on the question that inevitably
comes up when a new strain of influenza comes knocking on our door. That question is:
"Do you have efficacy against the H(insert
number)N(insert number) strain of Influenza?"
As most would attest, in accordance to EPA criteria, if
you do not see the "bug" you are concerned with on the label then the
disinfectant cannot makes claims against it. To some aspects I can agree, however, if we look at the plethora of data
investigating disinfectant efficacy we know that from an efficacy perspective
there are not any differences in a disinfectant product's ability to kill K.
pneumonia, K. pneumonia ESBL, K. pneumonia MDRO or K. pneumonia CRE. From a purely scientific perspective, if a
disinfectant can kill K. pneumonia for example, it does not matter whether you
are dealing with the ESBL, the MDRO or the CRE strain. Unfortunately, the EPA has been slow to adopt
this stance which has lead disinfectant manufacturers into the "claims
race" for bragging rights on who has the greatest number of claims on
their label. The truth is when it comes
to efficacy claims, strength is not always found in numbers.
For Influenza however; for once, I can say the EPA has
finally got it right! In 2009, when the
Pandemic H1N1 strain hit and panic over how facilities were to develop cleaning
and disinfection protocols when disinfectant products available on the market
did not have efficacy testing against the specific H1N1 strain, the EPA
determined that since there were over 500 disinfectant products registered for
use on hard, non-porous surfaces against influenza A viruses that based on
available scientific information, the currently registered influenza A virus products will be effective against the 2009-H1N1 flu strain and other influenza
A virus strains on hard, non-porous surfaces. Of course, for safe and effective use of these products, the EPA
reminded users to always follow label instructions and to pay special attention
to the product’s dilution rate (if applicable) and contact time. Fancy that, if you kill 1 strain you kill
them all.
In health care, where we talk about evidence based practices,
why then do we not use the science, the evidence and the experts who generate
the science and evidence to develop evidence based practices around efficacy
claims? The EPA has shown it can work
for Influenza perhaps we should consider using the same rational for antibiotic
resistant bacteria?
In the meantime, the rates of H7N9 cases and deaths
continue to increase and a new strain, H10N8 has caused the death of two people
with genetic testing showing it appears to be more virulent to mammals. Is this concerning from an infection
prevention perspective? Yes. Are we concerned from an environmental
hygiene perspective? NO. If you kill 1 strain you kill them all.
Bugging Off!
Nicole
