Norovirus: why frantic $40K cleanup could still come unstuck

Anxious businesswoman
It’s not just the cost, norovirus can kill a business reputation stone-cold dead

You don’t take chances with norovirus.

Very unpleasant – and very bad for business – it has a boomerang property that keeps it coming back and back, whatever anyone does.

Boomerang in Kansas?

Which may soon be the experience of the popular New Theatre Restaurant in Kansas City. With 400 people down with norovirus last week, but determined to stay open, they’ve had hit-teams spray the place with a “Lysol-like” disinfectant – the same kind of stuff used on cruise liners – and boldly kept on going. Comedy performances of Out of Order starring Gary Sandy of WKRP in Cincinnati fame are to continue uninterrupted.

Let’s hope they’re not too hasty.

Norovirus is a nasty not to be wished on anyone. Cramps, vomiting and diarrhoea – up to four days and more, feeling like the end of the world.

Violent and explosive vomiting is one reason why a Lysol-type spray (similar to Dettol aerosol) may not be enough. It’s one of the ways the virus ensures it spreads as wide as possible. You’re not just being sick, you’re rocketing out your guts further and farther than with any other upchuck.

So if that spray doesn’t reach into every little nook and cranny, norovirus can be back in full raging force just hours later.

Virulent and vindictive

Norovirus is more contagious than other viruses too – 1,000 times more potent than everyday winter flu. All it takes is 10 tiny particles (around 2 microns in size) to become infected – and one particle can contain 100,000,000,000 particles.

But that’s not the only reason New Theatre Restaurant might still be in trouble. The spray they’ve used is water-based, hose-piping around trying to cover all areas. It’s potency is 99.9% effective – a Sterility Assurance Level of Log 3.

Not really good enough.

Water-based vapour starts falling to the floor as soon as it’s dispersed. It never reaches ceilings or walls, the water drops are too heavy. And with a potency of just 10 particles needed to start an infection, 99.9% efficiency might work for an hour or two – then it’s back to square one.

Meanwhile, the super-light particles of norovirus float easily around on the smallest wafts of air – smaller and lighter than the molecules around them – lighter than nitrogen and hydrogen (once used to lift airships), tinier than dust, wispier than smoke, so almost nothing they may never fall to the floor, ever.

Yeah, it infects on contact – but how do you think it spreads?

Plus, there’s the boomerang effect.

Repeat performances

Get rid of norovirus – or think you do – and it’s back, with interest in days. Again and again and again.

Check out the sad story of Fred Olsen Line’s cruise liner Amsterdam in 2002.

FOUR times the ship sailed from Port Canaveral, Florida, with a load of happy, expectant holiday passengers. FOUR times, the ship had to put back with outbreaks of norovirus. It got so bad that passengers on the later voyages were even warned before embarking!

Only when the ship was pulled from service and 600 workers took TEN DAYS to disinfect the ship under supervision of the CDC, was the boomerang cycle broken.

Imagine the cost – FOUR fully-loaded voyages with 1,300 passengers paying upwards of $1,200 each – TEN days of docking fees and port costs – plus labour for 600 workers, cleaning down to detail fomite objects like poker chips and bedside bibles – not much change out of 10 million.

Alongside that kind of money, New Theatre Restaurant’s 40 grand begins to look like chicken feed.

And was it the same Lysol-type spray that was so ineffective on Amsterdam? In which case look out future audiences of Out of Order – you may not be as safe as you think you are.

No more norovirus

It doesn’t have to be this way.

Norovirus might be potent – out of reach in the air, or hiding in cracks and crevices. But there IS a way to clobber it good – along with all other viruses and bacteria too – just by pressing a button.

The trick is to use a Hypersteriliser or a number of them. Called the Halo in the States, this minor miracle is a nifty portable machine about the size of a small wheelie-bin that sprays the air with hydrogen peroxide.

Not just any hydrogen peroxide either. It’s a 6% solution – the same strength you might use in a mouthwash/teeth whitener from the chemist – boosted with silver, the proven antiseptic treatment doctors used for burns and wounds before antibiotics were discovered.

It’s also ionised, so that as it mists the room or auditorium, the particles of hydrogen peroxide become charged, pushing dynamically to disperse away from each other. Spreading everywhere – hard up against walls and ceilings, deep into cracks and crevices – over, under and behind things where most clean-ups never even get considered.

Ionising actually changes the state of the hydrogen peroxide too. Already smaller and finer than water droplets – lighter than air like the viruses it preys on – the mist changes from a gas to a plasma, an electrostatically-charged cloud reaching out and grabbing at live bacteria and viruses, oxidising them to nothing.

A whole kit of extra antimicrobials help it do this – because ionising releases further hydroxyl radicals, reactive oxygen species, reactive nitrogen species, ozone (a more voracious oxidiser than hydrogen peroxide), and ultraviolet. Look carefully in a darkened room, and you may even see a faint purple glow.

Safe and sterile

An hour or so later and it’s all over. 99.9999% of germs are gone – a Sterility Assurance Level of Log 6 – and the hydrogen peroxide reverts back to just oxygen and water, in such small quantities that it evaporates to nothing.

Ain’t no norovirus boomeranging back after that treatment. Theatre-goers can enjoy their dinner and the show without a care in the world.

But let’s hope they’ve fixed it already.

Picture Copyright: natulrich / 123RF Stock Photo

What to do now the Doc can’t prescribe antibiotics

Pondering doctor
Life after antibiotics? Yes – if we hike up our hygiene!

It’s over – or almost.

The wonder-drugs of the Twentieth Century don’t work any more.

We are at hazard

Fifty years of pumping antibiotics into everything that moves have caused them to run out of fizz. Bacteria have learnt how to survive them – they have become resistant. Swallow a bunch of antibiotics right now and chances are they won’t do anything.

Not against the kind of infection we’re seeing today – the superbugs that medicine can’t clobber.

With rogue illnesses like MRSA, salmonella, streptococcus, c.difficile, TB, gonorrhoea and e.coli flying around, routine surgery is already an iffy issue. Soon it won’t be possible at all. The bugs will develop similar immunity to the few remaining effective drugs – and last failsafe will have gone for good.

Yes there are still a few antibiotics of last resort – the carbapenems, used in the treatment of the already-resistant MRSA.

But the bad guys are already at the door. Newest kid on the block is CRE – carbapenem-resistant enterobacteriaceae – a resistant strain that includes klebsiella species and escherichia coli (e. coli), both of which are normal gut bacteria but can go hostile.

OK, the guns don’t work, so it’s down to bare hands. Not as impossible as it seems – and we’re not dead yet.

Our hands have it

Since we use our hands for everything, they are pretty much our most major source of infection. Every touch brings a transfer of dirt and germs, microscopic so they still LOOK clean – but potentially deadly if they get into our bodies.

But wash hands, and most of the time, the problem goes away.

A good proper session with soap and hot water will get rid of 99.9% of the germs we all carry. It works for doctors and nurses – and it’s the major reason why every visit to hospital doesn’t land us at death’s door.

But it has to be a genuine wash – not hands under the tap for a few seconds, which is all most of us attempt. We don’t know the dangers, so we’re playing with our lives. There is no failsafe. We can’t rely on antibiotics to rescue us any more.

The other thing we need to do is sterilise the spaces around us. It’s not just our hands that are covered in germs – 10 million on each in the average office – it’s every single thing in our lives, including the air around us.

Yes, the air full of germs all of the time, but not always in concentrated clouds – and yes, day-to-day our immune systems can normally cope with it.

Except we spend most of our time indoors, particularly in winter – sharing the same space, breathing the same atmosphere. Which means the smallest thing about us can easily influence everyone else.

Interacting with each other

And it does. Every one of us trails around a personal germ cloud – billions and billions bacteria, viruses, smells, dead skin cells and other body detritus – everywhere we go.

We may not pass anything on to each other – that usually requires physical contact or breathing something in. But every day our clouds mingle and influence each other, creating a germ threshold that lingers behind us after we’re gone – and is there waiting for us again in the morning.

If any one of us has a weakness or underlying condition, we are at risk. Harmless to ourselves, but a possible threat to others. But not if the place is sterile. No germs, no risk – everybody’s safe.

And we need to be.

Our bodies are more sensitive than in years gone by – prone to allergies, vulnerable to even the tiniest of germ threats. Plus living and working on top of each other as our modern lifestyles demand, we’re much more contagious – if one of us catches something , we all do.

Which is why regular sessions with a Hypersteriliser are becoming essential after we go home at night.

A nifty gadget like a sort of posh wheelie-bin, it creates a super-fine dry mist of ionised hydrogen peroxide that spreads everywhere – actively pushing into remote spaces, cracks, crevices, all the places that never usually get cleaned.

As it does so, its electrically-charged particles reach out and grab viruses and bacteria, attracted exactly like magnets. The germs die, oxidised by oxygen atoms that rip their cell structure to shreds.

Forty minutes and the place is sterile – the mild, non-toxic 6% mist leaving only oxygen and water, which evaporates before it touches anything. Oh, and a microscopically thin layer of antimicrobial silver on everything – a sterile barrier that lasts up to a week or more.

Rediscover hygiene

How does this help the Doc?

Well if we make a habit of deliberately avoiding germs, half her problem has gone away. Prevention is better than cure – fewer patients means more time for care, more effort available for saving lives.

Yes, it’s a challenge without antibiotics. But keeping clean – sterile clean – is the one sure way of avoiding infection. If we rediscover hygiene, we’ll make it.

Easy, huh?

Just clean up our act and we’re there.

How purified office air could still be full of germs

Unwell at work
You’re only as safe as the air you breathe – and everybody else breathes it too

You should be OK with purified air. But every system has its drawbacks.

Which means you may not be as safe as you think you are – even with the latest triple-whammy set up.

One reason is how most purifying systems work.

Passive instead of active.

A great big fan system sits in one place, sucking air through it. Filters next to the fan sift out contaminants – and the air goes round again, circulating for reuse. Purified.

HEPA efficiency

That’s usually pretty good with High Efficiency Particulate Air (HEPA) systems, which filter out particles down to a very small 0.03 microns.  Fine for fumes and exhaust sucked from outside, as well as smoke, dust, emissions from from building materials, furnishings, cleaning products, electronic equipment, toiletries, people and pets.

Not so fine for harmful viruses, bacteria, protozoa and fungi – which are often very much smaller. A typical cough-sniffle cold bug like rhinovirus might be as small as 0.002 microns. Too small to be filtered out, too light for gravity to affect it. So it rides the air, round and round – waiting for us to breathe it in. Not purified.

An efficient alternative is to use ultraviolet light. A fan draws air in through a long exposure tube – the “killing zone”. Ultraviolet attacks the microorganism’s DNA, rendering it unable to reproduce. If contact is long enough, it becomes neutral and effectively dead.

But how long is long enough? To make sure of a kill, the air has to move fairly slowly. It can’t recirculate fast like the HEPA filter – unless it has a whacking great bulb. And if the bulb is too big, it produces too much ozone – an effective antimicrobial, yes, but hazardous to humans.

Those are the passive systems. Air goes to the germ-killer, not the other way around. It works only where there’s airflow. In quiet corners and along walls, the air is still and unmoving. Particulates and microbes are there for keeps. Not purified.

Active – go get ’em

More effective is to be active – to take the germ-killer to the air. To force it out positively, driving it to disperse in all directions pro-actively. To invade the air totally.

The vehicle is a dry ultra-fine hydrogen peroxide mist, which kills germs by oxidising them. The mist is ionised to become a plasma, forcing itself away in all directions, penetrating everywhere.

The actual solution is mild, only 6%. But ionising transforms it, producing further antimicrobials – hydroxyl radicals, reactive oxygen species, reactive nitrogen species, ozone and ultraviolet. From eco-friendly 6%, to turbo-charged 600%.

Electrostatic attraction causes oxygen atoms to grab oppositely charged viruses and bacteria. They are physically ripped apart – and the mist safely reverts to oxygen and water, which evaporates. Sterilised, purified, safe and secure.

OK, there is a downside.

Hydrogen peroxide won’t take out non-biological contaminants with anything like the same efficiency. Pollutants like volatile organic chemicals (VOCs), gases such as nitrogen dioxide, ozone and carbon monoxide, particulate matter and fibres are better removed by the regular HEPA filters.

But work the two together…

Picture Copyright: pressmaster / 123RF Stock Photo