Study reveals Hepatitis E resistant to common hand disinfectants

Many common hand disinfectants do not inactivate the Hepatitis E virus (HEV), according to a study.

Researchers found HEV has strong stability against alcohols and alcohol-based hand disinfectants but did identify one substance that worked.

HEV can be found in pigs and infect humans who eat undercooked pork or raw meat products. It is also a major cause of waterborne outbreaks in low and middle-income countries.

The World Health Organization (WHO) has recommendations for disinfectants that can be easily prepared and are available in rural areas. However, scientists found these formulations were not able to disrupt the viral infectivity of HEV.

Different Hepatitis E types
Professor Eike Steinmann, from Ruhr Universität Bochum (RUB), said: “We tested the effect of the alcohols ethanol and propanol, both individually and in the mixing ratios recommended by the WHO, and also commercial hand disinfectants. However, only one product that contained another component was effective.”

Usually, HEV occurs non-enveloped and is very resistant to chemical influences. However, virus particles in the blood of patients are surrounded by a lipid envelope. Scientists looked at both forms of the virus in their tests.

They used a recently developed HEV cell culture system to evaluate commonly used hand disinfectants and their principal components (e.g. alcohols) against the different forms of HEV.

Although some tested disinfectants were certified to inactivate both enveloped and non-enveloped viruses, they were not effective against HEV, according to the study published in the Journal of Hepatology.

Hepatitis E has four different types. Genotypes 1 and 2 have been found only in humans while 3 and 4 circulate in animals including pigs, wild boars, and deer without causing disease but can infect humans.

Phosphoric acid finding
Researchers said they expect that the combination of different prevention measures like a vaccine, food safety, hygiene, and hand disinfectants will all contribute to a reduction of secondary infections regardless of HEV genotype.

Of the five tested commercial hand disinfectants only one, that contained phosphoric acid as well as alcohol, neutralized all virus particles sufficiently. Ethanol disrupted the envelope of HEV but it left the infectious virus intact.

Dr. Patrick Behrendt said the team showed that HEV can resist the most common hand disinfectants.

“The alcoholic components dissolve the lipid envelope, but the resulting naked viruses are still infectious. We hope that these findings will be taken into consideration in the future when hygiene measures are recommended for handling contaminated meat products and in HEV outbreak situations.”