Are routine healthcare worker hand hygiene protocols (soap/water, alcohol-based handrub) effective against influenza? [ 2006 - 2007 ]

Research Grant

Researchers: Prof Michael Lindsay Grayson (Principal investigator) ,  Dr Christopher Birch ,  Julian Druce ,  Prof Paul Johnson

Brief description Although influenza is mainly spread from person-to-person by aerosol transmission (coughing, sneezing etc), there is growing evidence that spread also occurs on the hands of infected patients and their carers (non-aerosol transmission). Because of this, health authorities now recommend the use of careful hand hygiene (HH: hand washing with soap-water or use of alcohol-based hand rub solutions [ABHRS]) by healthcare workers (HCWs) and patients. However, despite these recommendations, there are no data that demonstrate the effectiveness of such HH protocols. This project aims to assess the clinical effectiveness of four HH protocols (handwashing with soap-water, alcohol-only ABHRS, two alcohol-chlorhexidine ABHRS) in common use in Australian hospitals to see which protocol is best for killing influenza virus. We also plan to assess how long influenza virus remains infectious on HCWs hands if they fail to use appropriate HH. Since it could be dangerous to use live avian influenza virus in this study, we plan to use the H1N1 influenza A strain that was a component of the influenza vaccine administered to most HCWs in 2005. Thus, only HCWs with protective immunity to H1N1 will participate in a series of tests in which they will have their hands artificially contaminated with a known concentration of live H1N1 before using either no HH, or one of the four HH protocols, followed by an assessment (virus culture and molecular tests) or the amount of H1N1 surviving on their hands after each protocol. Some selected HCWs will also have the amount of surviving virus assessed 30 and 60 minutes after contamination to identify how long H1N1 survives on HCWs hands should they not use appropriate HH. Following all protocols, all HCWs will perform a detailed surgical scrub (similar to surgeons before an operation) to make certain that all H1N1 is killed to avoid any infection of themselves or their contacts. The study will be undertaken in special, secure, negative-pressure rooms at Austin Hospital away from patient care areas to provide maximum safety conditions. All virus culture and molecular tests will be performed in the virus Identification Laboratory at the Victorian Infectious Disease Reference Laboratory (VIDRL), Melbourne. Results of the study should help identify which HH protocol provides the most protection against influenza.

Funding Amount $AUD 99,950.00

Funding Scheme NHMRC Strategic Awards

Notes Urgent Research - Pandemic Influenza - H5N1