Alcohol-based hand sanitizer gel significantly reduces spread of gastrointestinal illnesses

Sep 30 2004

Stomach bug going around your home? You might want to reach for hand sanitizer, suggests research being presented at the 42nd Annual Meeting of the Infectious Diseases Society of America (IDSA).

• Families that used hand sanitizer had a 59 percent reduction in the spread of gastrointestinal illnesses in the home compared with those who did not use hand sanitizer.
• Hand sanitizer likely reduces the spread of colds and respiratory illnesses as well, investigators say.
• The Centers for Disease Control and Prevention (CDC) recommends health care workers use hand sanitizer.
• Soap and water are necessary to remove dirt from skin.

Families that used alcohol-based hand sanitizer gel had a 59 percent reduction in the spread of gastrointestinal illnesses compared with families that didn't use sanitizer, according to a Harvard Medical School study.

"This is the first randomized trial to show that hand sanitizer reduces the spread of germs in the home," said Thomas J. Sandora, MD, MPH, an assistant in medicine in the Division of Infectious Diseases at Children's Hospital Boston and instructor of pediatrics at Harvard Medical School. "Using hand sanitizers is an excellent method for hand hygiene and can be an alternative to soap and water, particularly when a sink isn't convenient."

Hand sanitizers are used without water. They are not cleaning agents, and don't remove surface dirt. Washing with soap and water is necessary to remove visible soil, said Dr. Sandora. The Centers for Disease Control and Prevention (CDC) recommends routine use of alcohol-based sanitizers by healthcare workers, noting that, compared to soap and water, alcohol-based sanitizers are easier and quicker to use, and cause less skin irritation. The sanitizers also are very effective at reducing germs on the skin, according to CDC.

The Healthy Hands, Healthy Families study included 292 families with at least one child in day care who were tracked for five months: 155 were provided with hand sanitizer and hand hygiene educational materials, and 137 were not given sanitizer and were provided only with materials about basic nutrition. Those provided sanitizer were told to place bottles of it around the house including in the bathroom, kitchen and baby's room and to apply it to their hands after using the toilet, before preparing food, after diaper changes and at other appropriate times. Investigators called the families every other week to record how much of the sanitizer they had used.

Investigators also recorded reports of a gastrointestinal and respiratory illness in the families. When a family member came home with a gastrointestinal bug, families that used the sanitizer had a 59 percent decrease in the illnesses spreading to others in the home. Although there was no significant decrease in the spreading of respiratory illnesses among the families that used sanitizer, researchers found families that used greater amounts of the sanitizer were less likely to pass around those types of illnesses.

"We believe hand sanitizer reduces the transmission of the cold and other respiratory illnesses in the home, too, although the evidence wasn't as strong as it was for stopping the spread of gastrointestinal illnesses," said Dr. Sandora. "We think that's probably because people were more diligent about using the sanitizer after a gastrointestinal-related incident, such as using the bathroom or vomiting, than after a respiratory incident, such as nose-wiping or sneezing.

"The families seemed very willing to use the sanitizer," he said. "It's widely available in stores, but is not being used in most homes."

Available in a squeeze bottle or pump, sanitizer gel is alcohol-based and is used without water. A dime-sized amount of hand sanitizer should be poured on the hands and rubbed over all surfaces until dry. Effective hand-washing with soap and water involves scrubbing the fronts and backs of the hands and between the fingers for about 10 to 15 seconds.

Hand sanitizer differs from antibacterial soap. Antibacterial soap must be used with water, and is marketed as having the ability to kill bacteria. However, research has shown that while antibacterial soap does reduce bacteria and other microbes, it is no more effective at doing so than non-antibacterial soap.

Co-authors of a paper on the topic being presented by Dr. Sandora are: Elsie M. Taveras, Mei-Chiung Shih, Elissa A. Resnick, Grace M. Lee, Dennis Ross-Degnan and Donald A. Goldmann.

IDSA is an organization of physicians, scientists and other health care professionals dedicated to promoting human health through excellence in infectious diseases research, education, prevention and patient care. Major programs of IDSA include publication of two journals, The Journal of Infectious Diseases and Clinical Infectious Diseases, an Annual Meeting, awards and fellowships, public policy and advocacy, practice guidelines and other membership services. The Society, which has 7,500 members, was founded in 1963 and is headquartered in Alexandria, Va.