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Interim guidance for environmental cleaning in non-healthcare facilities exposed to SARS-CoV-2

Flag for EU European Centre for Disease Prevention and Control on February 19th 2020
This document aims to provide guidance about the environmental cleaning in non-healthcare facilities (e.g. rooms, public offices, transports, schools, etc.) where confirmed COVID-19 cases have been before being admitted to hospital. This guidance is based on the current knowledge about SARS-CoV-2 and evidence originating from studies on other coronaviruses.

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Safe use of personal protective equipment in the treatment of infectious diseases of high consequence
European Centre for Disease Prevention and Control
Cleaning should be performed using the proper personal protective equipment (PPE). The correct donning and doffing of PPE should be followed; further information on the donning and doffing procedures can be found in the ECDC Technical Document ‘Safe use of personal protective equipment in the treatment of infectious diseases of high consequence’ [8]. https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/safe-use-of-ppe.pdf
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The correct donning and doffing of PPE should be followed; further information on the donning and doffing procedures can be found in the ECDC Technical Document ‘Safe use of personal protective equipment in the treatment of infectious diseases of high consequence’ [8].
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8. European Centre for Disease Prevention and Control (ECDC). Safe use of personal protective equipment in the treatment of infectious diseases of high consequence. Stockholm: ECDC; 2014. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/safe-use-of-ppe.pdf.
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Stability of Middle East respiratory syndrome coronavirus (MERS-CoV) under different environmental conditions
Eurosurveillance (European Centre for Disease Control and Prevention (ECDC))
N van Doremalen et al. 2013
Antimicrobial agents effective against different coronaviruses: human coronavirus 229E (HCoV-229E), mouse hepatitis virus (MHV-2 and MHV-N), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1
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According to studies assessing the environmental stability of other coronaviruses, the severe acute respiratory syndrome coronavirus (SARS-CoV) is estimated to survive several days in the environment, and the Middle East respiratory syndrome-related coronavirus (MERS-CoV) can withstand more than 48 hours at average room temperature (20 °C) on different surfaces [1-3].
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1. van Doremalen N, Bushmaker T, Munster VJ. Stability of Middle East respiratory syndrome coronavirus (MERS- CoV) under different environmental conditions. Eurosurv. 2013 Sep 19;18(38).
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Transmission of SARS and MERS coronaviruses and influenza virus in healthcare settings: the possible role of dry surface contamination
Journal of Hospital Infection (Elsevier BV)
J.A. Otter et al. 2016
According to studies assessing the environmental stability of other coronaviruses, the severe acute respiratory syndrome coronavirus (SARS-CoV) is estimated to survive several days in the environment, and the Middle East respiratory syndrome-related coronavirus (MERS-CoV) can withstand more than 48 hours at average room temperature (20 °C) on different surfaces [1-3].
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2. Otter JA, Donskey C, Yezli S, Douthwaite S, Goldenberg SD, Weber DJ. Transmission of SARS and MERS coronaviruses and influenza virus in healthcare settings: the possible role of dry surface contamination. The Journal of hospital infection. 2016 Mar;92(3):235-50.
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Survival of Severe Acute Respiratory Syndrome Coronavirus
Clinical Infectious Diseases (Oxford University Press (OUP))
M. Y. Y. Lai et al. 2005
According to studies assessing the environmental stability of other coronaviruses, the severe acute respiratory syndrome coronavirus (SARS-CoV) is estimated to survive several days in the environment, and the Middle East respiratory syndrome-related coronavirus (MERS-CoV) can withstand more than 48 hours at average room temperature (20 °C) on different surfaces [1-3].
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3. Lai MY, Cheng PK, Lim WW. Survival of severe acute respiratory syndrome coronavirus. Clinical infectious diseases. 2005 Oct 1;41(7):e67-71.
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Tests carried out using SARS-CoV showed that sodium hypochlorite is effective at a concentration of 0.05 and 0.1% after five minutes when it is mixed to a solution containing SARS-CoV [5].
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Similar results were obtained using household detergents containing sodium lauryl ether sulphate, alkyl polyglycosides and coco-fatty acid diethanolamide [5].
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Contributing ECDC experts In alphabetical order: Agoritsa Baka, Orlando Cenciarelli [6] [5] 1 This list is based on antimicrobial agents that are mentioned in analysed peer-reviewed scientific literature reported in the references.
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5. Lai MYY, Cheng PKC, Lim WWL. Survival of severe acute respiratory syndrome coronavirus. Clinical Infectious Diseases. 2005;41(7):e67-e71.
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Inactivation of surrogate coronaviruses on hard surfaces by health care germicides
American Journal of Infection Control (Elsevier BV)
Rachel L. Hulkower et al. 2011
ECDC TECHNICAL REPORT Interim guidance for environmental cleaning in non-healthcare facilities exposed to SARS-CoV-2 A recent paper which compared different healthcare germicides [4] found that those with 70% concentration ethanol had a stronger effect on two different coronaviruses (mouse hepatitis virus and transmissible gastroenteritis virus) after one minute contact time on hard surfaces when compared with 0.06% sodium hypochlorite.
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Antimicrobial agents effective against different coronaviruses: human coronavirus 229E (HCoV-229E), mouse hepatitis virus (MHV-2 and MHV-N), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning
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4. Hulkower RL, Casanova LM, Rutala WA, Weber DJ, Sobsey MD. Inactivation of surrogate coronaviruses on hard surfaces by health care germicides. American journal of infection control. 2011;39(5):401-7.
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Chemical disinfection of non-porous inanimate surfaces experimentally contaminated with four human pathogenic viruses
Epidemiology and Infection (Cambridge University Press (CUP))
S. A. Sattar et al. 1989
Antimicrobial agents effective against different coronaviruses: human coronavirus 229E (HCoV-229E), mouse hepatitis virus (MHV-2 and MHV-N), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning
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effective against different coronaviruses: human coronavirus 229E (HCoV-229E), mouse hepatitis virus (MHV-2 and MHV-N), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning with a neutral detergent is suggested for decontamination purposes, although no data on the effectiveness against the SARS-CoV-2 are
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viruses: human coronavirus 229E (HCoV-229E), mouse hepatitis virus (MHV-2 and MHV-N), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning with a neutral detergent is suggested for decontamination purposes, although no data on the effectiveness against the SARS-CoV-2 are available.
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Contributing ECDC experts In alphabetical order: Agoritsa Baka, Orlando Cenciarelli [6] [5] 1 This list is based on antimicrobial agents that are mentioned in analysed peer-reviewed scientific literature reported in the references.
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6. Sattar SA, Springthorpe VS, Karim Y, Loro P. Chemical disinfection of non-porous inanimate surfaces experimentally contaminated with four human pathogenic viruses. Epidemiology & Infection. 1989;102(3):493- 505.
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Virucidal Efficacy of Physico-chemical Treatments Against Coronaviruses and Parvoviruses of Laboratory Animals
Experimental Animals (Japanese Association for Laboratory Animal Science)
Morakot SAKNIMIT et al. 1988
Antimicrobial agents effective against different coronaviruses: human coronavirus 229E (HCoV-229E), mouse hepatitis virus (MHV-2 and MHV-N), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning
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E), mouse hepatitis virus (MHV-2 and MHV-N), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning with a neutral detergent is suggested for decontamination purposes, although no data on the effectiveness against the SARS-CoV-2 are available.
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coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning with a neutral detergent is suggested for decontamination purposes, although no data on the effectiveness against the SARS-CoV-2 are available.
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tis virus (TGEV), and severe acute respiratory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning with a neutral detergent is suggested for decontamination purposes, although no data on the effectiveness against the SARS-CoV-2 are available.
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tory syndrome coronavirus (SARS-CoV) 1 Antimicrobial agent Concentration Coronaviruses tested References Ethanol 70% HCoV-229E, MHV-2, MHV-N, CCV, TGEV [4,6,7] Sodium hypochlorite 0.1–0.5% 0.05–0.1% HCoV-229E SARS-CoV Povidone-iodine 10% (1% iodine) HCoV-229E [6] Glutaraldehyde 2% HCoV-229E [6] Isopropanol 50% MHV-2, MHV-N, CCV [7] Benzalkonium chloride 0.05% MHV-2, MHV-N, CCV [7] Sodium chlorite 0.23% MHV-2, MHV-N, CCV [7] Formaldehyde 0.7% MHV-2, MHV-N, CCV [7] Cleaning approaches The use of 0.1% sodium hypochlorite (dilution 1:50 if household bleach at an initial concentration of 5% is used) after cleaning with a neutral detergent is suggested for decontamination purposes, although no data on the effectiveness against the SARS-CoV-2 are available.
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7. Saknimit M, Inatsuki I, Sugiyama Y, Yagami K. Virucidal efficacy of physico-chemical treatments against coronaviruses and parvoviruses of laboratory animals. Experimental animals. 1988;37(3):341-5.
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