{"id":4624,"date":"2023-09-07T10:56:57","date_gmt":"2023-09-07T08:56:57","guid":{"rendered":"https:\/\/magazine.zhermack.com\/?p=4624"},"modified":"2023-09-07T11:55:31","modified_gmt":"2023-09-07T09:55:31","slug":"virucidal-activity-and-effectiveness-levels","status":"publish","type":"post","link":"https:\/\/magazine.zhermack.com\/en\/hygiene-en\/virucidal-activity-and-effectiveness-levels\/","title":{"rendered":"The disinfection hierarchy: virucidal activity and its different efficacy levels"},"content":{"rendered":"\n<p>The main purpose of infection control can be briefly summarised as <strong>blocking the transmission of microorganisms or pathogens<\/strong>.&nbsp;<\/p>\n\n\n\n<p>This block must be applied in two directions.&nbsp;The first is the <strong>prevention of vertical transmission<\/strong> and the second is the <strong>prevention of horizontal or lateral transmission<\/strong>.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Prevention of vertical and lateral transmission<\/h2>\n\n\n\n<p>Vertical transmission is the <strong>propagation of pathogens from one generation to another<\/strong>.&nbsp;Proper use and regulation of antibiotics are essential for preventing vertical transmission, calling for appropriate antibiotic management.<\/p>\n\n\n\n<p>Lateral transmission is the <strong>transfer of the resistance of a pathogen to others of the same generation<\/strong>, or the <strong>propagation and expansion of the pathogen in the surrounding environment<\/strong>.&nbsp;<\/p>\n\n\n\n<p>Preventing this lateral transmission to the greatest possible extent is a practical point in terms of infection control.&nbsp;<\/p>\n\n\n\n<p>The methods for blocking lateral transmission include the <strong>management of healthcare professional hygiene<\/strong>, with procedures such as hand hygiene, and environmental infection control, with cleaning and disinfection protocols.&nbsp;<\/p>\n\n\n\n<p>These measures require knowledge of <a href=\"https:\/\/www.zhermack.com\/en\/product_category\/dental\/dental-practice\/hygiene\/instruments-burs\/\" target=\"_blank\" rel=\"noopener\" title=\"\">disinfection or antisepsis and sterilisation<\/a>[1].<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Spaulding classification<\/h3>\n\n\n\n<p>The Spaulding classification, which was first proposed in 1957, can be used for this purpose.<\/p>\n\n\n\n<p>This <strong>system is commonly used to pair the disinfection and sterilisation of surfaces<\/strong>, particularly those of reusable medical\/surgical devices, with the processes available.&nbsp;<\/p>\n\n\n\n<p>It provides a classification, <strong>from simple disinfection through to sterilisation<\/strong>, that should be taken into consideration when <strong>reconditioning devices<\/strong> based on the risk associated with their use. It starts from \u201ccritical\u201d (presenting a high risk), then proceeds to \u201csemi-critical\u201d, and finally \u201cnon-critical\u201d (presenting a low risk).&nbsp;<\/p>\n\n\n\n<p>The different disinfection levels are based on the demonstration of the antimicrobial activity towards established marker organisms, which represent a range of pathogens [2].<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">The microbiological disinfectant hierarchy<\/h4>\n\n\n\n<p>There is a microbiological disinfectant hierarchy. Indeed, microorganisms have a <strong>variable intrinsic resistance to disinfectants<\/strong>, which can be shown in this list, from the most resistant (A) to the most susceptible (F):<\/p>\n\n\n\n<ol class=\"wp-block-list\" type=\"A\">\n<li>Spores (C. difficile)<\/li>\n\n\n\n<li>Mycobacteria (M. tuberculosis)<\/li>\n\n\n\n<li>Non-enveloped viruses (norovirus, HAV, polio)<\/li>\n\n\n\n<li>Fungi (Candida, Trichophyton)<\/li>\n\n\n\n<li>Bacteria (MRSA, VRE, Acinetobacter)<\/li>\n\n\n\n<li>Enveloped viruses (HIV, HSV, influenza)<\/li>\n<\/ol>\n\n\n\n<p>The Spaulding classification provides a strategy for the sterilisation or disinfection of objects and surfaces depending on the degree of risk associated with their use.<\/p>\n\n\n\n<p>Three types of device are considered:<\/p>\n\n\n\n<ol class=\"wp-block-list\" type=\"1\">\n<li><strong>Critical<\/strong>: equipment that is introduced directly into the human body, blood or areas of the body that are usually sterile.<\/li>\n\n\n\n<li><strong>Semi-critical<\/strong>: surfaces and equipment that come into contact with intact mucosae and non-intact skin.<\/li>\n\n\n\n<li><strong>Non-critical<\/strong>: surfaces and equipment that only come into contact with intact skin[3].<\/li>\n<\/ol>\n\n\n\n<p>This article will focus on virucidal activity and its different efficacy levels.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Virucidal activity: definitions and the European approach<\/h2>\n\n\n\n<p>In a narrow definition, virucidal activity, represents the <strong>activity by which to interact with and physically disrupt viral particles<\/strong>.&nbsp;<\/p>\n\n\n\n<p>In a broader definition it includes the activity by which to functionally inhibit (neutralise) viral infectivity without apparent morphological alterations of the viral particles, as in the case of antibody-mediated neutralisation[4].<\/p>\n\n\n\n<p>We will now focus on the European virucidal activity levels.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">European virucidal activity levels<\/h3>\n\n\n\n<p>\u2022&nbsp;<strong>Virucidal activity against enveloped viruses:<\/strong>&nbsp;activity against enveloped viruses, such as influenza, including avarian influenza A (H7N9), herpes virus, HIV, HBV, HCV, Zika virus, Ebola virus, corona viruses (including SARS-CoV-2 and MERS- CoV) and flavivirus.&nbsp;<\/p>\n\n\n\n<p>This statement applies to <a href=\"https:\/\/www.zhermack.com\/en\/product_category\/dental\/dental-practice\/hygiene\/hands\/\" target=\"_blank\" rel=\"noopener\" title=\"\">hand disinfection<\/a>, the disinfection of surfaces and products for preliminary instrument cleaning, which involve a combination of cleaning agents and disinfectants.<\/p>\n\n\n\n<p>\u2022&nbsp;<strong>Limited spectrum of virucidal activity:<\/strong>&nbsp;activity against non-enveloped norovirus, rotavirus, adenovirus and enveloped viruses.&nbsp;<\/p>\n\n\n\n<p>This statement applies to hand disinfection and the disinfection of surfaces.<\/p>\n\n\n\n<p>\u2022&nbsp;<strong>Virucidal activity:<\/strong>&nbsp;activity against viruses, including non-enveloped viruses (e.g. poliovirus and enteroviruses, such as enterovirus 71 and enterovirus D68) and enveloped viruses.&nbsp;<\/p>\n\n\n\n<p>This statement applies to hand disinfection, the disinfection of surfaces, the disinfection of instruments and the disinfection of tissues[5].<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">The necessary prevention measures<\/h4>\n\n\n\n<p><strong>Disinfectants<\/strong> and <strong>antiseptics<\/strong> are part of the package of measures required to obtain the prevention and control of infection in healthcare facilities and the community.&nbsp;<\/p>\n\n\n\n<p>The European tiered approach to classifying virucidal efficacy as \u201cvirucidal activity against enveloped viruses&#8221;, \u201climited spectrum of virucidal activity&#8221; and \u201cvirucidal activity&#8221; helps in <strong>choosing the most appropriate indication for emerging or re-emerging virus outbreaks<\/strong>, with a tested concentration and contact time.&nbsp;<\/p>\n\n\n\n<p>This results in the <strong>correct choice of test method<\/strong> for determining the appropriate use, concentration and contact time of antiseptics and disinfectants [6].<\/p>\n\n\n\n<p>All the products in the <a href=\"https:\/\/www.zhermack.com\/en\/product_category\/dental\/dental-practice\/hygiene\/\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>Zeta Hygiene range<\/strong><\/a>, which are specifically intended for a given application (instruments, surfaces, suction units, hands and impressions), are effective against the main types of microorganism, in accordance with the most recent European standards.&nbsp;&nbsp;<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>References<\/strong><strong><\/strong><\/p>\n\n\n\n<p>[1]<sup> <\/sup><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6031597\/\" target=\"_blank\" rel=\"noopener\" title=\"\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6031597\/<\/a><br>[2] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0195670111001988#preview-section-abstract\" target=\"_blank\" rel=\"noopener\" title=\"\">https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0195670111001988#preview-section-abstract<\/a><br>[3] <a href=\"https:\/\/www.epa.gov\/sites\/default\/files\/2015-10\/documents\/rutala_overview_of_current_disinfection_hierarchy_models_final.pdf\" target=\"_blank\" rel=\"noopener\" title=\"\">https:\/\/www.epa.gov\/sites\/default\/files\/2015-10\/documents\/rutala_overview_of_current_disinfection_hierarchy_models_final.pdf<\/a><br>[4] <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8275317\" target=\"_blank\" rel=\"noopener\" title=\"\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8275317<\/a><br>[5] <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7848678\/\" target=\"_blank\" rel=\"noopener\" title=\"\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7848678\/<\/a><br>[6] <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7848678\/\" target=\"_blank\" rel=\"noopener\" title=\"\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7848678\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The main purpose of infection control can be briefly summarised as blocking the transmission of microorganisms or pathogens.&nbsp; This block must be applied in two directions.&nbsp;The first is the prevention of vertical transmission and the second is the prevention of horizontal or lateral transmission.&nbsp; Prevention of vertical and lateral transmission Vertical transmission is the propagation [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4546,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"rs_blank_template":"","rs_page_bg_color":"","slide_template_v7":"","footnotes":""},"categories":[37],"tags":[],"class_list":["post-4624","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hygiene-en"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/posts\/4624","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/comments?post=4624"}],"version-history":[{"count":0,"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/posts\/4624\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/media\/4546"}],"wp:attachment":[{"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/media?parent=4624"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/categories?post=4624"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/magazine.zhermack.com\/en\/wp-json\/wp\/v2\/tags?post=4624"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}