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Coronavirus : précautions pour le contrôle des infections au COVID-19 en milieu sanitaire

Ecolab Healthcare Infection Control Precautions for 2019-nCoV

Human coronaviruses1 are common throughout the world. Human coronaviruses commonly cause mild to moderate illness. Deux coronavirus humains plus récents, le MERS-CoV et le SARS-CoV, ont provoqué des cas de maladie grave. A novel coronavirus, SARS-CoV-2, which causes a respiratory infection called COVID-19, emerged in 2019.  Chinese authorities identified the new coronavirus originating in Wuhan, China.  Since its emergence, this virus has resulted in hundreds of thousands of confirmed cases globally.  On March 11, 2020, the World Health Organization declared the situation a pandemic because the disease has spread over many countries and continents and affects a large percent of the population.  In the United States, the Centers for Disease Control and Prevention (CDC) is working closely with state health departments and healthcare facilities on disease testing, surveillance, contact tracing, and interim guidance for clinicians on identifying, containing and treating COVID-19 infections.

What is COVID-19?2

  • Les signes et symptômes cliniques incluent de la fièvre et des symptômes d'une maladie des voies respiratoires inférieures (par exemple, la toux, l'essoufflement).
  • Au départ, lors de l'épidémie à Wuhan, en Chine, une grande partie des patients semblaient plus ou moins liés à un vaste marché de fruits de mer et animaux, ce qui suggérait une transmission d'animal à humain. However, as the outbreak has evolved, community person-to-person spread is occurring. The situation with COVID-19 is evolving rapidly. While severe illness has been reported globally, other patients have had milder illness requiring no medical care. Person-to-person transmission has been reported in healthcare workers.
  • People of all ages can be infected by COVID-19. Older people, and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus.

What are the healthcare infection control precautions for COVID-19 as it relates to hand hygiene and environmental hygiene?3

Although the transmission dynamics have yet to be fully determined, CDC currently recommends a cautious approach to patients under investigation for COVID-19:

  • Une hygiène des mains et une hygiène environnementale méticuleuse jouent un rôle essentiel dans ces précautions d'isolement.
  • Les professionnels de la santé doivent s'assurer de l'hygiène de leurs mains avant et après tout contact avec les patients, tout contact avec du matériel potentiellement infectieux, et avant d'enfiler leur EPI, y compris les gants, et après l'avoir enlevé. Si les mains sont visiblement sales, utilisez du savon et de l'eau avant de vous tourner vers un désinfectant pour les mains à base d'alcool.
  • Les installations de soins de santé doivent s'assurer que les fournitures pour l'hygiène des mains sont faciles d'accès dans chaque lieu de soin.
  • Healthcare professionals must be cleared, trained and fit tested for respiratory protection device use, and educated, trained and have practiced appropriate PPE use including correct use to prevent contamination of skin, clothing or the environment, prior to caring for a patient with known or suspected cases of COVID-19.
  • Les professionnels de la santé entrant dans la chambre d'un patient devront appliquer les précautions d'usage, des précautions de contact, des précautions concernant les infections aéroportées et des protections occulaires (comme des lunettes ou un masque facial). In situations where N95 respirators are in short supply, healthcare professionals may wear surgical masks for patient contact except in instances where aerosol-generating procedures are being performed, where an N95 must be worn.
  • The EPA and the CDC recognize environmental surfaces as a vector for transmission of coronaviruses. The CDC has developed a hospital preparedness checklist4 which recommends that hospitals assess the effectiveness of environmental cleaning and consider providing refresher training on environmental hygiene best practices as outlined in the CDC Toolkit: Options for Evaluating Environmental Cleaning.5
  • Le CDC indique que les professionnels de la santé doivent recevoir une formation propre à leur poste ou à leurs tâches sur la transmission des agents infectueux, y compris des formations de rappel.
  • Le nettoyage et la désinfection de routine sont adaptés contre le COVID-19 dans les établissements de santé, y compris dans les espaces d'attention aux patients dans lesquels des procédures génératrices d'aérosols sont réalisées.

What hand hygiene products are effective against COVID-19?

Se laver les mains fréquemment avec du savon et de l'eau est une des meilleures façons d'éviter la transmission de pathogènes émergents. The World Health Organization recommends performing hand hygiene with soap and water or alcohol-based hand rub if soap and water are not available. The US Food and Drug Administration regulates claims on both medicated, antimicrobial soaps and on alcohol-based hand sanitizers. Claims related to efficacy against viruses are not allowed on any medicated, antimicrobial soaps nor on any alcohol-based hand sanitizers in the United States.

DOMAINE D'APPLICATION PRODUIT ECOLAB
Solution hydroalcoolique pour les mains AniosGel 800
Solution hydroalcoolique pour les mains AniosRub 800
Solution hydroalcoolique pour les mains AniosGel 85 NPC
Solution hydroalcoolique pour les mains AniosRub 85 NPC
Solution hydroalcoolique pour les mains Mousse Skinman
Solution hydroalcoolique pour les mains Skinman Soft Plus
Solution hydroalcoolique pour les mains Skinman Soft Protect
Solution hydroalcoolique pour les mains Spirigel Complete

What disinfectants are effective against COVID-19?

COVID-19 is caused by SARS-CoV-2. The EPA has developed the “Guidance to Registrants: Process for making claims against emerging viral pathogens not on EPA-registered disinfectant labels”.6 This document provides general guidance to disinfectant manufacturers and addresses public concerns on a process that can be used to identify effective disinfectants for use against emerging viral pathogens. It permits manufacturers to make limited claims about their product’s efficacy against such pathogens once the EPA confirms the product meets the eligibility criteria outlined in the guidance.  In addition, the EPA has published List N: Disinfectants for Use Against SARS-CoV-2.7  See graphic below which shows how to know if a product is approved for use against COVID-19.

In addition, the table below lists Ecolab products that meet the criteria for claims against emerging viral pathogens and therefore can be used against COVID-19 when used in accordance with the directions for use against the listed supporting virus on hard, non-porous surfaces. Contactez votre chargé de clientèle Ecolab pour plus d'informartions sur ces produits.

DAZO™ fluorescent marker is an objective method to evaluate the thoroughness of the cleaning process, rather than the presence of organic material or pathogens.5 Other environmental monitoring methods intended to measure organic load (e.g. ATP)6 or bacterial burden (e.g. bacterial cultures) do not detect viruses. Even with the best EVS staff in the world, without an effective environmental hygiene monitoring tool such as DAZO fluorescent marker, there is no way to determine the effectiveness of their cleaning practices.

HOW TO KNOW IF PRODUCTS ARE APPROVED FOR USE AGAINST CORONAVIRUS

for healthcare COVID article
ECOLAB PRODUCT NAME ITEM NUMBER (Package Size) DILUTION RATE TEMPS DE CONTACT EPA REG. # SUPPORTING VIRUS
A-456 II™ DISINFECTANT CLEANER 6166931 (2x1.3L)
0.5-1 oz/gal 10 minutes 6836-78-1677 Norovirus (Feline calicivirus surrogate)

ASEPTI-HBTM 

6064202 (12x32oz) Prêt à l'emploi 10 minutes 61178-2-1677 Feline calicivirus
ASEPTICARETM TB+II 6021521 (12x32oz) Prêt à l'emploi 3 minutes 1130-15-1677 Rotavirus
NETTOYANT DÉSINFECTANT NEUTRE 6027314 (4x1gal)
6101205 (1x2.5gal)
6114541 (2x1.3L)
6100836 (50x1oz Pour Pak)
0.5-1 oz/gal 10 minutes 47371-129-1677 Adenovirus
NETTOYANT DÉSINFECTANT QUOTIDIEN OXYCIDE™ 6000189 (2x96oz)
3 oz/gal 3 minutes 1677-237 Norovirus (Feline calicivirus surrogate)
NETTOYANT DÉSINFECTANT QUATERNAIRE 6063304 (4x1gal)
0.5-1 oz/gal
10 minutes
6836-78-1677 Norovirus (Feline calicivirus surrogate)
QUATERNARY DISINFECTANT WIPES

6000166 (12x220ct)

6000169 (12x85ct)

Prêt à l'emploi 2 minutes 6836-372-1677 Human Coronavirus
NETTOYANT DÉSINFECTANT TB PRÊT À L'EMPLOI 6143556 (12x32oz)
Prêt à l'emploi
3 minutes
1839-83-1677 Poliovirus
VIRASEPT™ 6002314 (12x32oz)
Prêt à l'emploi
4 minutes
1677-226 Rhinovirus

Pour plus d'informations :


Références :
1. Centers for Disease Control and Prevention, Coronavirus Summary. www.cdc.gov/coronavirus/index.html 
2. Centers for Disease Control and Prevention, 2019 Novel Coronavirus.  www.cdc.gov/coronavirus/2019-nCoV/summary.html 
3. Centers for Disease Control and Prevention, Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus. www.cdc.gov/coronavirus/2019-nCoV/infection-control.html 
4. Centers for Disease Control and Prevention, Hospital Preparedness Checklist for Suspected or Confirmed 2019-nCoV Patients. www.cdc.gov/coronavirus/2019-ncov/hcp/hcp-hospital-checklist.html
5. Centers for Disease Control and Prevention, Options for Evaluating Environmental Cleaning. www.cdc.gov/HAI/toolkits/Evaluating-Environmental-Cleaning.html
6. Environmental Protection Agency, Emerging Viral Pathogen Guidance for Antimicrobial Pesticides. www.epa.gov/pesticide-registration/emerging-viral-pathogen-guidance-antimicrobial-pesticides
7. Environmental Protection Agency, List N: Disinfectants for Use Against SARS-CoV-2.  https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2-covid-19

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