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What are the recommended hand-washing practices in Ebola settings?

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Correct hand-washing is best achieved by washing with adequate quantities of water and soap or an alcohol-based solution and rubbing hands thoroughly for at least 20 to 30 seconds in order to cover all surfaces (WHO, 2014). Hand washing with chlorinated water is not considered ideal since this may lead to skin lesions which would increase risk of infection.

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After having worked in an Ebola treatment centre for 2 months, it is clear that 0,05% chlorine is the most convenient solution for hand washing. It is the solution recommended - and implemented - by MSF in all the Ebola Treatment centre.

0,05% is easy to produced from the 0,5% solution (used for every disinfection in the centre) by a 1/10 dilution, easy to implement and to explain to staff in charge of hand-washing stations refilling.

Soap is effective but it is more likely to be "taken home", letting HWS without soap.

For alcohol-based solution, you better have a good supply chain to exclude the possibility of a shortage.

And about skin lesions, if 0,5% burns your hands, 0,05% is ok. My skin has no problem after 8 weeks of constant hand washing...

Laurent LeHot gravatar imageLaurent LeHot ( 2014-10-31 19:42:16 +0000 )edit

As I expected the cited WHO guideline warns against relying too much on hand-disinfection rather than soap:

"Alcohol-based hand rubs should be made available at every point of care (at the entrance and within the isolation rooms and areas); running water, soap, and single use towels should also be always available. Soap and running water should always be used when hands are visibly soiled. - See more at: use"

"Chlorine should NOT be used as a replacement for soap or alcohol-based hand rub. Chlorine needs to be in contact with your hands for a prolonged period to have an effect on Ebola virus, typically much longer than it takes to wash your hands, so the added benefit in handwashing is not clear. - See more at: use"

A locally used solution to supplying soap if soap bars is removed is supplying washing powder like OMO. At the Q and A on WHO guidelines, I discuss uses of ash for soap substitute and disinfectant if needed, eg. outside health centers: It is based on 6 pp referenced text I compiled I link to here as well. Ash as a neglected low-cost alternative for soap for hand washing (and disinfectant) relevant for Ebola prevention -- and some more suggestions.docx

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Abir gravatar imageAbir ( 2018-01-19 10:16:23 +0000 )edit
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