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May 7, 2009

Does hand sanitizer kill bacteria and viruses?

Posted: 11:39 AM ET

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

From CNN.com blogger, Dick:

"Hand sanitizer has been recommended but the bottles say, "Effective against bacteria," with no mention of viruses. What gives?"

Answer:

That is a good question. There are not a lot of data actually on how effective those sanitizers are against viruses. There have been some studies done over the years and the conclusion is washing your hands with soap and water is still probably the best idea. If you are having a busy day and it is hard to get to a sink, then carrying a bottle of hand sanitizer would be a good idea.

In essence, it makes your hands very inhospitable to viruses. You put it on your hands and viruses simply don't want to cling to it. So it does reduce the amount of a virus that can cling to your hand but it does not kill it. Alternatively, it also can’t harm you in any way. We get a lot of questions from concerned viewers asking if sanitizers could actually cause antibiotic resistance down the road. Many studies have looked into the issue and all evidence points to the answer being no.

At the end of the day, basic principles apply to avoid getting a virus. Avoid touching your mouth, eyes and nose as much as possible. If you cough or sneeze, cover your mouth and nose with a tissue or your sleeve. If you're sick, stay home and avoid close contact with others. Some viruses can live for hours on surfaces such as ATMs, doorknobs, even money.

So be methodical about good hygiene, all year long! Remember that the number of 2009 H1N1 cases will most likely decrease over the summer months because viruses just don't transmit that well in the heat. But in the fall and winter, we're all going to have to remember what the new H1N1 strain was like and be extra vigilant so this doesn't get out of control.

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Filed under: Dr. Gupta • Expert Q&A • Flu • Germs • Virus


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Ursula Haubrick   May 14th, 2009 10:15 am ET

Hand sanitizers should come with a warning.
Since the concerns over the Swine flu outbreak, the use of these sanitizers have been on the increase.
It has also been recommended that they contain at least 60% alcohol.
There have now been cases where people (mostly smokers) have sustained serious burns to the hands because they have foolishly lit up while their hands have been wet with hand sanitizer.
Our work sites have been instructed to post a flamible warning along side these bottles.
Perhaps more mention of this side effect when promoting the use of these sanitizers
Thankyou

Sandra Smith   May 14th, 2009 8:20 pm ET

I learned in microbiology back in the60's whatever kills most organisms makes survivors stronger. How can sanitizers not do same? Bacteria & viruses mutate & adapt.

Mario Guerrero   May 21st, 2009 1:23 pm ET

In high quantities, alcohol is cytotoxic to all organisms, however it does not necessarily affect dormant organisms or viruses which have special protective barriers. The action of alcohol as a disinfectant occurs by disrupting the cellular membrane, essentially inactivating the pathogen by destroying its capacity to infect cells. Dormant organisms may have layers of protein, which act as a shell, protecting the internal components of the pathogen from chemical attack. A good example are the spores generated by anthrax, which are resistant to alcohol. Organisms will never adapt to alcohol treatment, because it is a purely chemical process, much like acid treatment. They do adapt to anti-bacterial compounds which target specific biochemical processes, which are easily altered to circumvent such sensitivities.

nelson   May 21st, 2009 10:13 pm ET

the dental profession has been dealing with this question since the beginning of the aids back in the early 80's. the main problem with hand sanitizers is that they are almost exclusively made with isopropyl alcohol. we have tested many products through the years and isopropyl will not kill viruses. our profession needed something to combat them that was economical and somewhat safe. the best defense for viruses is straight bleach. it is harmful to tissue and a lot of delicate surfaces. what we found was ethanol would kill viruses if the concentration was adequate. isopropyl alcohol is completely different and is quite useless to us. but ethanol at 79% by weight achieves what we call high level hospital disinfection. the short of it is the companies that make these products are short cutting us with an inferior product. lysol used to be 79% ethanol and we used it all the time. they found out we bought it over the counter, changed it to 59% and can out with lysol professional at 79% and charge us double. i make my own hand sanitizer with straight up pure grain alcohol diluted slightly with water to achieve 79% and add some fragrance. i feel confident anywhere i go with this.

Jenny Lynn   May 22nd, 2009 9:27 am ET

Sandra, it says right in the article that sanitizer DOES NOT KILL the virus. It just makes your skin inhospitable to carrying them. Hello, read the article before you ask a question.

Ken   May 27th, 2009 1:02 pm ET

There are a couple of very important things about viruses that people seem to forget (or never learn). First, a virus is NOT a living thing... at least not in the traditional sense. It is rather a mass of protein and DNA that is pretty much inert until it can find itself a host cell to use for reproductive purposes. Thus, it cannot be expected to respond like a living thing to medications and/or disinfectants.

Also, antibiotics are effective against bacteria only. They have no effect on viruses! ...none!... zero! ...nada! ...bupkis! Therefore, unless your personal case of the flu or a cold also leaves you with a bacterial infection (like an ear infection or pneunmonia), there no reason whatsoever for you to take antibiotics.

In fact, individuals who insist on taking antibiotics everytime they have a cold (and the doctors who are dumb enough to prescribe them to "shut their patients up") are a large part of the reason there so many bacterial illnesses that are resistant to antibiotics. It isn't rocket science. Darwin's laws work for bacteria just like they do for large creatures and, because the life and reproductive cycle of a bacteria is a heck of lot shorter than it is for most living things, a bacteria can evolve a heck of lot quicker. It goes without saying that the same goes for use of disinfectants. If you continuously expose bacteria to disinfectants, they WILL evolve to be tolerant to it. There have allegedly been studies that "prove" (and I use quotes because I can't seem to find details online to link to, but they are out there) that, in homes where parents use large amounts of disinfectants to constantly clean surfaces, kids tend to be more susceptible to colds and flu because their home becomes such a bacteria-free zone that kids are unable to build up their immunities, which would happen a matter of course, in a "dirtier" home.

chris   June 4th, 2009 11:20 am ET

I use hand sanitizer all the time at work as I work at school with over 2,000 students,I think its more a mind over matter thing,you use it therefore you think you wont get sick,so it makes me feel better.well I wash my hands to and never touch my face unless my hands are clean and I still get sick once in a while.vitamins help too

Rob   July 12th, 2009 6:57 pm ET

I use a product called Microdine, I put a dime spot in my palm and rub it all over my hands, it leaves a film of spent iodine upon drying that can rinced off and then it has a persistance of about 5 hours. Microdine containes no alcohol and it is a class 1 FDA approved hand sanitizer and sugical scrub. Check out all the test data at http://www.microdine.com for youself

Ivan   July 21st, 2009 8:19 am ET

Jenny Lynn, Sandra still has a point. Viruses may mutate in order to adapt to that place where they are "not allowed", even though they do not achieve success in this adaptation.

Kevin   August 15th, 2009 9:42 pm ET

Some basic biology for you...ALL living cells are surrounded by a fat-based plasma membrane. Alcohol disrupts the plasma membrane, as fats are soluable in alcohol. Viruses are NOT cells, and are NOT alive. Many viruses, including influenza, have a fatty envelope surrounding them that facilitate their attachment to target host cells. Alcohol breaks down the envelope IF in high enough concentration and IF used for appropriate time of exposure (15-20 seconds minimum).

Over-the-counter sanitizer gels are almost always 62%-63% ethyl alcohol, NOT isopropyl alcohol as suggested by Ken above. They are NOT as substitute for handwashing, but are MUCH better than nothing if soap and water are not available.

While Sandra Smith said in her comment above, bacteria and viruses can mutate if exposed to drugs. Alcohol is not a drug, so resistance via mutation cannot happen with alcohols. This is a basic chemical reaction, not a targeted attack that occurs when using antimicrobial or antiviral drugs...totally different thing.

Kevin
Microbiology Instructor

Hand_Sanitizer   August 26th, 2009 8:51 pm ET

My company gives all employees in our office hand sanitizer pumps bottles for desks (Purell) and a delivery service company (UniFirst.com) comes and refills the "touchless" dispensers in our restrooms and in our cafeteria. I imagine it is cheaper than paying for lots of sick time.

HCG   August 27th, 2009 12:30 pm ET

Kevin states: " Over-the-counter sanitizer gels are almost always 62%-63% ethyl alcohol, NOT isopropyl alcohol as suggested by Ken above. "

Looking at the bottle of Putrell Hand Santizer on my desk, first two ingredients are water and isopropyl alcohol.

Kevin   August 28th, 2009 9:40 am ET

HCG – Did you mean "Purell?" I've never heard of Putrell and couldn't find it with a Google search. It could be a specialty product, I suppose. It could be that a formulation has changed, but this is what I found on the net. Most over the counter preps are very similar. I cannot speak for all of them.

From: http://www.raytechcatalog.com/product_info/purell-hand-sanitizer-376.html

Purell Ingredients:

Active Ingredients: Contains: Ethyl Alcohol (62%)

Inactive Ingredients: Water, Glycerin, Isopropyl Myristate, Propylene Glycol, Tocopheryl Acetate, Aminomethyl Propanol, Carbomer, Fragrance (parfum)

From http://www.brands2liveby.com/purell/content/faq.htm

1. What is the active ingredient?
Ethyl alcohol, 62% – "mother nature's disinfectant." According to the American Journal of Infection Control, Aug. 1995, "Alcohols applied to the skin are among the safest known antiseptics."

2. What are the inactive ingredients used in Purell® products?
Denaturant/bittering agent – small amount of Isopropyl Alcohol, Moisturizers derived from plant materials, Propylene Glycol, Isopropyl Myristate, Thickener – Carbomer Fragrance

veronica s.   November 9th, 2009 11:06 am ET

my science partner and i are 14 and we neeeded to find information and yours was the right blog to read =]

Alysia   November 10th, 2009 11:51 am ET

What I found to be funny was the tangents people strayed off to when the topic is about hand sanitizer.

Robert, you just attacked Sandra in regards to talking on the phone while driving. lol

One should not throw stones unless one is 100% pure and we all know that isn't possible or realistic.

Back to hand sanitizer. We're required to use it when coming in or leaving the office. I see it as a precautionary, but also pretty pointless.

No one enjoys using this stuff. Granted, it smells like alcohol...however, I guess anything helps...

Dasharath Desai   November 16th, 2009 12:46 pm ET

Sir,
Can you send me the list of pathogens which can be killed by Alcohol Hand Sanitizer?

Thanks.

Desai

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