In Vitro Efficacy of Foam Hand Sanitizers Against Enveloped and Non-Enveloped Viruses.

Enveloped and non-enveloped virus transmission can occur via person-to-person contact and potentially through contaminated surfaces with human hands. Establishing the efficacy of hand sanitizers, including gel and foam formats, is crucial in reducing the transmission of viruses of human health concern, yet foam hand sanitizers are generally underexplored despite being widely used. Following American Society for Testing and Materials (ASTM) E1052-20, the efficacy of foam-based hand sanitizers-one non-alcohol-based hand sanitizer and four alcohol-based hand sanitizers with benzalkonium chloride and ethanol as active ingredients, respectively-were explored using bacteriophage phi6 (Φ6) as a surrogate for enveloped viruses and bacteriophage MS2 (Emesvirus zinderi) and Tulane virus (TuV) as surrogates for non-enveloped viruses. Significant differences in log reduction were observed among viruses (P ≤ 0.05). After a 10 s exposure, a 5.23 ± 1.64 log reduction was observed for Φ6 while MS2 remained resistant (0.04 ± 0.08 log10 reduction). Conversely, significant log reductions (P ≤ 0.05) were observed for TuV across all foam-based hand sanitizer products ranging from 0.07 ± 0.1 to 1.09 ± 0.22. An exposure time of 10 s (i.e., the typical rubbing time in real-world scenarios following hand sanitizer application) is likely sufficient for enveloped virus inactivation based on the inactivation of bacteriophage Φ6 by the tested commercially available products. However, longer exposure times or different hand sanitizer formulations may be required to achieve similar log reductions against non-enveloped viruses such as human norovirus based on the surrogates (MS2, TuV) tested.