4.7 Article

Survival of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Influenza Virus on Human Skin: Importance of Hand Hygiene in Coronavirus Disease 2019 (COVID-19)

Journal

CLINICAL INFECTIOUS DISEASES
Volume 73, Issue 11, Pages E4329-E4335

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa1517

Keywords

SARS-CoV-2; human skin; stability; influenza A virus; hand hygiene

Funding

  1. Japan Agency for Medical Research and Development (AMED) [JP20fk0108077, JP20fk0108270]
  2. JSPS KAKENHI [JP18K16183, JP18H03040]
  3. Mochida Memorial Foundation for Medical and Pharmaceutical Research
  4. Uehara Memorial Foundation
  5. Ichiro Kanehara Foundation
  6. Takeda Science Foundation
  7. Daiwa Securities Health Foundation

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The study found that SARS-CoV-2 survives longer on human skin compared to influenza A virus, increasing the risk of contact transmission and accelerating the pandemic. Proper hand hygiene is crucial in preventing the spread of the virus. Ethanol can completely inactivate both viruses within 15 seconds on human skin.
Background. The stability of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on human skin remains unknown, considering the hazards of viral exposure to humans. We generated a model that allows the safe reproduction of clinical studies on the application of pathogens to human skin and elucidated the stability of SARS-CoV-2 on human skin. Methods. We evaluated the stability of SARS-CoV-2 and influenza A virus (IAV), mixed with culture medium or upper respiratory mucus, on human skin surfaces and the dermal disinfection effectiveness of 80% (weight/weight) ethanol against SARS-CoV-2 and IAV. Results. SARS-CoV-2 and IAV were inactivated more rapidly on skin surfaces than on other surfaces (stainless steel/glass/plastic); the survival time was significantly longer for SARS-CoV-2 than for IAV (9.04 hours [95% confidence interval, 7.96-10.2 hours] vs 1.82 hours [1.65-2.00 hours]). IAV on other surfaces was inactivated faster in mucus versus medium conditions, while SARS-CoV-2 showed similar stability in the mucus and medium; the survival time was significantly longer for SARS-CoV-2 than for IAV (11.09 hours [10.22-12.00 hours] vs 1.69 hours [1.57-1.81 hours]). Moreover, both SARS-CoV-2 and IAV in the mucus/medium on human skin were completely inactivated within 15 seconds by ethanol treatment. Conclusions. The 9-hour survival of SARS-CoV-2 on human skin may increase the risk of contact transmission in comparison with IAV, thus accelerating the pandemic. Proper hand hygiene is important to prevent the spread of SARS-CoV-2 infections.

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