Rapid and Effective Virucidal Activity of Povidone-Iodine Products Against Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and Modified Vaccinia Virus Ankara (MVA)

Maren Eggers, Markus Eickmann, Juergen Zorn, Maren Eggers, Markus Eickmann, Juergen Zorn

Abstract

Introduction: Since the first case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection was reported in 2012, the virus has infected more than 1300 individuals in 26 countries, and caused more than 480 deaths. Human-to-human transmission requires close contact, and has typically occurred in the healthcare setting. Improved global awareness, together with improved hygiene practices in healthcare facilities, has been highlighted as key strategies in controlling the spread of MERS-CoV. This study tested the in vitro efficacy of three formulations of povidone iodine (PVP-I: 4% PVP-I skin cleanser, 7.5% PVP-I surgical scrub, and 1% PVP-I gargle/mouthwash) against a reference virus (Modified vaccinia virus Ankara, MVA) and MERS-CoV.

Methods: According to EN14476, a standard suspension test was used to assess virucidal activity against MVA and large volume plating was used for MERS-CoV. All products were tested under clean (0.3 g/L bovine serum albumin, BSA) and dirty conditions (3.0 g/L BSA + 3.0 mL/L erythrocytes), with application times of 15, 30, and 60 s for MVA, and 15 s for MERS-CoV. The products were tested undiluted, 1:10 and 1:100 diluted against MVA, and undiluted against MERS-CoV.

Results: A reduction in virus titer of ≥4 log10 (corresponding to an inactivation of ≥99.99%) was regarded as evidence of virucidal activity. This was achieved versus MVA and MERS-CoV, under both clean and dirty conditions, within 15 s of application of each undiluted PVP-I product.

Conclusion: These data indicate that PVP-I-based hand wash products for potentially contaminated skin, and PVP-I gargle/mouthwash for reduction of viral load in the oral cavity and the oropharynx, may help to support hygiene measures to prevent transmission of MERS-CoV.

Funding: Mundipharma Research GmbH & Co.

Keywords: Enveloped virus; Gargle; Hand hygiene; MERS-CoV; MVA; Middle East respiratory syndrome coronavirus; Modified vaccinia virus Ankara; Mouthwash; Povidone iodine; Virucidal.

References

    1. Berry M, Gamieldien J, Fielding BC. Identification of new respiratory viruses in the new millennium. Viruses. 2015;7(3):996–1019. doi: 10.3390/v7030996.
    1. Centers for Disease Control and Prevention. Frequently Asked Questions about SARS. . Accessed July 2015.
    1. Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012;367(19):1814–1820. doi: 10.1056/NEJMoa1211721.
    1. World Health Organization (WHO). Middle East respiratory syndrome coronavirus (MERS-CoV) Summary of Current Situation, Literature Update and Risk Assessment. 2015. . Accessed July 2015.
    1. World Health Organization (WHO). Emergencies preparedness, response. Summary and risk assessment of current situation in Republic of Korea and China. . Accessed July 2015.
    1. World Health Organization (WHO). WHO Statement on the 9th Meeting of the IHR Emergency Committee Regarding MERS-CoV. . Accessed July 2015.
    1. World Health Organization (WHO). Frequently Asked Questions on Middle East Respiratory Syndrome cornonavirus (MERS-CoV). . Accessed July 2015.
    1. Eggers M, Eickmann M, Kowalski K, Zorn J, Reimer K. Povidone-iodine hand wash and hand rub products demonstrated excellent in vitro virucidal efficacy against Ebola virus and Modified vaccinia virus Ankara, the new European test virus for enveloped viruses. BMC Infect Dis. 2015;15:375. doi: 10.1186/s12879-015-1111-9.
    1. Al-Saeed MY, Babay N. The use of povidone-iodine and hydrogen peroxide mixture as an adjunct to non-surgical treatment of slight to moderate chronic periodontitis. Saudi Dent J. 2009;21(3):127–133. doi: 10.1016/j.sdentj.2009.10.004.
    1. EN14476:2013/FprA1:2015: Chemical disinfectants and antiseptics. Quantitative suspension test for the evaluation of virucidal activity in the medical area. Test method and requirements (Phase 2/Step 1). 2015.
    1. Spearman C. The method of ‘right and wrong cases’ (‘constant stimuli’) without Gauss’s formulae. Br J Psychol. 1908;2:227–242.
    1. Kärber G. Beitrag zur Kollektiven Behandlung Pharmakologischer Reihenversuche [article in German] Arch Exp Path Pharma. 1931;162:480–487. doi: 10.1007/BF01863914.
    1. World Health Organization (WHO). Essential Medicines and Health Products: Ebola vaccines, therapies, and diagnostics. . Accessed July 2015.
    1. Centers for Disease Control and Prevention. Middle East Respiratory Syndrome (MERS): Prevention and Treatment. . Accessed July 2015.
    1. WHO MERS-CoV Research Group. State of knowledge and data gaps of Middle East respiratory syndrome coronavirus (MERS-CoV) in humans. PLoS Curr. 2013;5. doi:10.1371/currents.outbreaks.0bf719e352e7478f8ad85fa30127ddb8.
    1. World Health Organization (WHO). Infection prevention and control during health care for probable or confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Interim guidance; updated 4 June 2015. . Accessed July 2015.
    1. Sharma VS, Dutta S, Taneja N, Narang A. Comparing hand hygiene measures in a neonatal ICU: a randomized crossover trial. Indian Pediatr. 2013;50(10):917–921. doi: 10.1007/s13312-013-0261-3.
    1. Steinmann J, Paulmann D, Becker B, Bischoff B, Steinmann E, Steinmann J. Comparison of virucidal activity of alcohol-based hand sanitizers versus antimicrobial hand soaps in vitro and in vivo. J Hosp Infect. 2012;82(4):277–280. doi: 10.1016/j.jhin.2012.08.005.
    1. Lages SL, Ramakrishnan MA, Goyal SM. In-vivo efficacy of hand sanitisers against feline calicivirus: a surrogate for norovirus. J Hosp Infect. 2008;68(2):159–163. doi: 10.1016/j.jhin.2007.11.018.
    1. Kariwa H, Fujii N, Takashima I. Inactivation of SARS coronavirus by means of povidone-iodine, physical conditions and chemical reagents. Dermatology. 2006;212(Suppl 1):119–123. doi: 10.1159/000089211.
    1. Gralton J, Tovey ER, McLaws ML, Rawlinson WD. Respiratory virus RNA is detectable in airborne and droplet particles. J Med Virol. 2013;85(12):2151–2159. doi: 10.1002/jmv.23698.
    1. Yung D, Tang M. Press release: 10 years after SARS—improper hand washing in the majority of HK people coupled with a 25% drop in cold & flu sick leave for reducing risk of spreading of germs doctor urges to regain strict personal hygiene habits. 2013. . Accessed July 2015.
    1. Stittelaar KJ, Kuiken T, de Swart RL, van Amerongen G, Vos HW, Niesters HG, et al. Safety of modified vaccinia virus Ankara (MVA) in immune-suppressed macaques. Vaccine. 2001;19:3700–3709. doi: 10.1016/S0264-410X(01)00075-5.
    1. Richmond JY, McKinney RW, editors. Biosafety in microbiological and biomedical laboratories. 4th ed. Washington: CDC-NIH; 1999.
    1. Sparkes JD, Fenje P. The effect of residual moisture in lyophilized smallpox vaccine on its stability at different temperatures. Bull World Health Organ. 1972;46:729–734.
    1. Rabenau HF, Schwebke I, Blümel J, Eggers M, Glebe D, Rapp I, et al. Leitlinie der Deutschen Vereinigung zur Bekämpfung der Viruskrankheiten (DVV) e.V. und des Robert Koch-Instituts (RKI) zur Prüfung von chemischen Desinfektionsmitteln auf Wirksamkeit gegen Viren in der Humanmedizin [article in German].
    1. Ruppach H. Log10 reduction factors in viral clearance studies. Bioprocess J. 2014;12(4):24–30. doi: 10.12665/J124.Ruppach.

Source: PubMed

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