A straight-forward approach to hygiene in the event of an outbreak

Introduction

In response to the ongoing global spread of the new influenza A (H1N1) virus, on June 11^th, 2009 the World Health Organisation (WHO) raised the worldwide alert to Phase 6. This is the highest alert level and is signified by community level outbreaks in countries in different geographic regions and indicates that a global pandemic is underway.

The spread of the virus is undoubtedly a serious development, but the decision to raise the pandemic alert to Phase 6 by WHO is indicative of the spread of the virus and not the severity of illness caused.

Until more is known, it is clearly sensible to raise awareness of the novel H1N1 virus and to take sensible pre-cautionary steps to prevent unnecessary spread of the virus, create a safe working environment and to protect the well being of customers, guests and all stakeholders in your business and the wider community.

The UK Government has embarked on a publicity campaign to inform the public about sensible steps that can be taken to minimise the spread of the virus through personal hygiene and cleaning regimes and the aim of this document is to build on this advice, suggesting how sanitisers and disinfectants supplied by RP Adam Ltd can help to create a safer workplace and reduce the risk of cross-contamination to protect customers and staff.

Current Status of the Virus in the United Kingdom

The nature of viral spread means that the picture throughout the country changes by the hour, however by June 17^th official figures for the UK indicated 1544 confirmed cases. It is likely that all regions will be affected, with the West Midlands perhaps suffering worst in England and in the Glasgow area where 351 possible cases had been detected by GPs.

H1N1 Virus

Information from the Centers for Disease Control and Prevention (CDC) indicates that the virus is a mutated or novel form of the influenza A (H1N1) virus of swine origin that first caused illness in Mexico and the United States in March and April, 2009.

The virus spreads in a similar way to regular seasonal flu, mainly air borne through the coughs and sneezes of people who have contracted the virus, but it may also be spread by touching contaminated objects and then touching your nose or mouth. Symptoms of H1N1 infection has been reported to be similar to regular flu symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue.

Although it is difficult to avoid air borne spread between people, other than through good personal hygiene, a thorough cleaning and surface disinfection routine can help prevent viral spread from contaminated surfaces in food preparation and bar areas, washrooms and toilets, guest rooms and public areas.

Housekeeping - General Hygiene of Public Areas

The normal regime of hygiene in public areas should be maintained, however in the event of an outbreak of H1N1 virus, the frequency of cleaning in public areas should be increased paying particular attention to "high traffic" areas, particularly surfaces that are likely to be touched by the hands. Products with anti-viral disinfection such as Magic Safeguard or Spectrum should be used and adequate contact time allowed for disinfection to be effective.

Magic Safeguard - Directions for Use

1. If the surface is soiled, pre-clean by spraying and wiping the surface using Magic Safeguard or other sanitiser to remove any visible gross soiling.
2. Spray the clean surface evenly with Magic Safeguard and leave for 15 minutes. Use a clean cloth to wipe to ensure all surfaces are wetted.

Spectrum - Directions for Use

1. Remove any gross soiling from the surface.
2. For general disinfection, we recommend that Spectrum is used at a dilution of 50:1, however where the presence of influenza virus is suspected a much stronger solution of 10:1 dilution should be used and allowing a contact time of 15 minutes.
3. Apply Spectrum solution by spray to the surface and allow to air dry or wipe dry with a paper towel after contact time.

Typical surfaces where hand contact is likely to be high include door handles, desks, counter tops, telephones, lift control panels, tables, chairs etc.

Floor Cleaning - adopt standard hygiene protocols for carpets and hard floor areas, although in the event of a viral outbreak, frequency may be increased where practicable.

Washrooms and Toilets

Must be cleaned thoroughly using standard techniques and cleaning frequency should be increased. Magic Safeguard or Spectrum solution is ideal for use on sinks, taps, soap and towel dispensers and other surfaces likely to have had frequent hand contact.

Cloths, Mops, Overalls, Gloves

Protective gloves should be worn when cleaning. It is important to replace gloves regularly and to thoroughly wash hands afterwards (see Hand Hygiene).

Cloths and Mops should be disinfected after use and Overalls should be laundered daily. Colour coded cloths and cleaning equipment can be helpful in minimising cross-contamination.

Food Area Disinfection

Where possible use a dishwashing or ware-washing machine to clean all crockery, cutlery and cooking utensils. Ensure that the machine is well maintained and can achieve a rinse temperature of 80⁰C or above to provide thermal disinfection, in conjunction with good quality detergent such as Adamatic or Adamax and rinse additive such as Rinsal or Rinse Plus. These chemicals should be auto-dosed at the optimum concentration to provide good cleaning action.

Where there are problems achieving or maintaining high temperatures, chlorine based detergents, such as Adamatic Dishwash Powder, will help.

For general surface disinfection in the kitchen, food preparation area and bar a number of products are suitable for use in the event of a viral outbreak.

A solution of Spectrum diluted as described earlier is ideal for disinfecting most washable surfaces. However where there is likely to be residues of food, fat or grease present, a two-stage approach will give optimum results. It is important to remove soiling from the surface to improve the effectiveness of the disinfection process.

1. Initial cleaning should be carried out using Arpax A7. Arpax A7 is dispensed via an Arpax dispenser and will remove soiling effectively. Arpax A7 also contains an active anti-viral ingredient.

2. After cleaning, disinfect using a solution of Spectrum, as previously described, and allow 15 minutes contact time before rinsing the food preparation surface with potable water.

Chlorine based products are known to have virucidal properties and are widely used in food prep areas where the bleaching effect is not problematic. Where the H1N1 virus is suspected to be present, a relatively high concentration of available chlorine is recommended (1000ppm available chlorine with a contact time of at least 5 minutes). Santab solutions can be created in spray bottles, buckets or sinks to create a soak solution. Suitable products for use include Santabs and Adamatic Sanitizer.

Santabs - Directions for Use

Dissolve 1 tablet per litre of potable water to create a 1000ppm solution. This can be used to soak utensils or can be transferred to a spray bottle to treat worktops and other surfaces. Allow a 5 minute contact time.

Where manual dishwashing is used, because of the high dilution of washing up liquid used, it is unlikely that efficient virucidal action will occur when washing as normal. In the event of a H1N1 viral outbreak, where an automatic dishwasher cannot be used, a double-sink process is recommended. A chlorine solution can be created in the second sink using Santabs, as directed above, and used to soak crockery and other items after washing with a neutral detergent with anti-bacterial properties, such as Crystal or BD77.

Adamatic Sanitizer is a detergent powder containing chlorine. It is packed in a 10kg tub with scoop measure or 500gram shaker pack, which is ideal for sprinkling neat onto a wet work top. Leave in contact for 5 minutes before wiping clean.

Restaurant/Public Areas

Wipe tables using a solution of Arpax A7, Spectrum or Magic Safeguard between customers following the directions given earlier.

Hand Hygiene

As the virus is primarily spread by secretions from the mouth and nose and these in turn are transferred to or picked up from surfaces, it is important that the frequency and thoroughness of hand washing is increased if an outbreak is suspected.

• Wash the hands thoroughly with a good quality soap, such as Centenary Biocidal Handsoap. Rinse the hands thoroughly with water and dry with paper towels or a hand dryer.
• Where there no access to clean water or efficient hand drying, an alcohol based hand sanitiser such as Centenary Alcohol Gel will disinfect the skin and dry quickly.
• In the event of a viral outbreak, it is important to remember to routinely disinfect the exterior of the soap dispenser itself, using a product such as Magic Safeguard or Spectrum. In staff facilities and public areas this is a high risk area for contamination because of the high number of people using this facility.