Analysis of alcohol-based hand sanitizer delivery systems: efficacy of foam, gel, and wipes against influenza A (H1N1) virus on hands

Background Minimal research has been published evaluating the effectiveness of hand hygiene delivery systems (i.e., rubs, foams, or wipes) at removing viruses from hands. The purposes of this study were to determine the effect of several alcohol-based hand sanitisers in removing influenza A (H1N1) virus, and to compare the effectiveness of foam, gel, and hand wipe products. Methods Hands of 30 volunteers were inoculated with H1N1 and randomised to treatment with foam, gel, or hand wipe applied to half of each volunteer’s finger pads. The log10 count of each subject’s treated and untreated finger pads were averaged. Log10 reductions were calculated from these differences and averaged within treatment group. Between-treatment analysis compared changes from the untreated finger pads using analysis of covariance with treatment as a factor and the average log10 untreated finger pads as the covariate. Results Log10 counts on control finger pads were 2.7-5.3 log10 of the 50% infectious dose for tissue culture (TCID50/0.1 mL) (mean, 3.8  0.5 log10 TCID50/0.1 mL), and treated finger pad counts for all test products were 0.5-1.9 log10 TCID50/0.1 mL (mean, 0.53  0.17 log10 TCID50/0.1 mL). Treatments with all products resulted in a significant reduction in viral titres (>3 logs) at their respective exposure times that were statistically comparable. Conclusions All 3 delivery systems (foam, gel, and wipe) produced significantly reduced viral counts on hands.