November is a month that’s synonymous with preparation: for Thanksgiving, Christmas, Hanukkah, New Year’s, and, regrettably, norovirus. The U.S. Centers for Disease Control and Prevention (CDC) states that the peak period for norovirus spans from November to April.
Despite this, many establishments such as schools, hospitals, businesses, restaurants, and even cruise ships continue to rely on alcohol-based hand sanitizer (ABHS) for protection. Unfortunately, scientific evidence shows that ABHS is ineffective against norovirus, and both the CDC and other health agencies caution against relying on it. Before delving into why ABHS falls short against norovirus, let’s first understand what norovirus is and why an outbreak can be so perilous.
A Brief Definition
Norovirus, often referred to as the stomach flu, comprises a group of viruses responsible for acute gastroenteritis and inflammation of the stomach and intestines. Unlike influenza, this highly contagious virus can lead to days of nausea, vomiting, diarrhea, and fever. In the worst cases, norovirus has also led to significant dehydration, diminished nutrient absorption, and tragically, death.
The primary mode of transmission is person-to-person, which is why places with frequent personal contact, such as healthcare facilities, restaurants, schools, daycare centers, and cruise ships, are particularly vulnerable to norovirus outbreaks.
Some Alarming Statistics
As reported by the National Foundation for Infectious Disease (NFID), on an annual basis in the United States, norovirus results in:
- 19 to 21 million cases of vomiting and diarrhea
- Almost 2.3 million outpatient visits
- Over 450,000 emergency department visits
- 109,000 hospitalizations
- 900 deaths
The CDC highlights that norovirus is especially dangerous for young children. Among children under five infected:
- 1 in 40 will require an emergency department visit
- 1 in 160 will be hospitalized
- 1 in 110,000 will succumb to the virus
Furthermore, according to the CDC, half of all cases of foodborne illnesses in the United States are attributed to norovirus. The situation is not limited to the U.S., as the U.K. Health Security Agency reported a significant increase in norovirus cases compared to the five-season average before the COVID-19 pandemic.
The Science Behind Why ABHS Fails
Norovirus, being a nonenveloped virus, exhibits heightened resilience to changes in pH and temperature. Alcohol-based sanitizers, regardless of their strength, cannot penetrate the protective protein shell (capsid) that encases the viral nucleic acid core. In contrast, enveloped viruses like SARS-CoV-2 (the cause of COVID-19) have fragile coverings that alcohol can easily breach.
Expert Opinions
Multiple studies and experts, including Dr. Lee-Ann Jaykus, a professor at North Carolina State University, often referred to as “the norovirus woman,” confirm that ABHS is ineffective against norovirus.
The CDC has reiterated this stance over the years. The CDC has consistently supported this assertion, reiterating it on multiple occasions. Ten years ago, the agency released a study categorizing ABHS and certain disinfectants as “ineffective” in combating norovirus. In 2017, Dr. Aron Hall, the former branch chief for viral gastroenteritis at the CDC, agreed with that, stating to NBC News that ABHS lacks efficacy against the virus and emphasized that “soap and water can rinse it away, but only hot water can effectively eliminate it.”
Even today, the CDC’s website explicitly states that “hand sanitizer does not work well against norovirus” and cannot replace handwashing with warm water and soap.
The Challenge with ABHS
Despite these warnings, the CDC recommended ABHS extensively during the COVID-19 pandemic, conditioning people to rely on it. Adding to the concern, as far back as 2011, research suggested that ABHS not only lacked effectiveness but could potentially elevate the risk of outbreaks involving highly contagious diseases such as norovirus.
People, especially in healthcare settings, are more inclined to use ABHS than to wash their hands. The widespread use of ABHS during and after the COVID-19 pandemic has fostered a false sense of security.
Why Handwashing Falls Short
Killing norovirus requires water at a scalding temperature of 140°Fahrenheit or higher, which is not practical for human hands. Handwashing can effectively remove norovirus, but only if done correctly and thoroughly, a practice that studies show most healthcare workers perform less than 50% of the time.
Moreover, a study conducted by the U.S. Department of Agriculture (USDA) disclosed that individuals in a test kitchen exhibited improper handwashing practices a staggering 97% of the time. Many situations also lack ready access to water for handwashing, which contributed to ABHS becoming the go-to option during the COVID-19 pandemic.
This raises the question: what is the solution to protect against norovirus?
HOCL- The Ultimate Choice
HOCL, or hypochlorous acid, is a natural defense produced by our white blood cells to combat infections. Created through electrolysis of saltwater, HOCL has no alcohol or harmful chemicals. Studies in the U.S. confirm HOCL’s effectiveness against a variety of viruses, including norovirus. Additionally, it’s FDA-approved for non-rinse sanitation in food, wound care, and eye care.
In summary, while ABHS proves effective against COVID-19 and enveloped viruses, it falls short in safeguarding against norovirus. The key to effective norovirus protection lies in adopting a hand hygiene antimicrobial spray with HOCL.
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