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Importance of Fomites in the Transmission of Infectious Disease
  • Charles P. Gerba
  • Department of Soil, Water and Environmental Science
  • And
  • Epidemiology and Biostatistics


  • University of Arizona
  • Tucson, AZ
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"80%"
  • 80% of all pathogens in the hospital and home environment are spread through hand contact
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Most Diseases Spread Through Hand Contact
  • Every three minutes, a child brings his/ her hand to nose or mouth
  • Every 60 seconds, a working adult touches as many as 30 objects
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Occurrence of fecal bacteria on the hand (United States)
  • Preparing a meal             Greatest
  • Children after playing


  • Doing the laundry     Least
  • Person exiting a toilet
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Detection of Pathogens on Fomites
  • Hard surfaces
    • Phones, tap handles, desk tops, door knobs, cutting boards, table tops
    • E. coli, influenza, parainfluenza, norovirus
  • Clothing
    • Laundry, towels, bed sheets
    • Salmonella, hepatitis A virus, norovirus, E. coli
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Detection of Pathogens on Fomites
  • Bathroom
    • Sinks, taps, bottom of the toilet seat
    • Norovirus, Giardia, Cryptosporidium, Shigella
  • Kitchen
    • Sponge, sink, cutting board
    • Salmonella, Campylobacter, E. coli
  • Schools
    • Norovirus, rhinovirus, Salmonella, influenza


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Sites by Coliform Bacterial Densities in the Home
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Fomite Cleaning is not enough to Prevent Exposure to Pathogens
  • % of norovirus detected on surfaces
    • during outbreak at a college campus: 18%
    • after cleaning with soap and water: 48%
  • % of surfaces on which E. coli detected:
    • in restroom: 8%
    • after cleaning with soap and water: 21%
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Conclusions
  • Hand contact plays a significant role in transmission of common infections
  • Fomite contamination by pathogens is a common event in home and work environments
  • Washing fomite with soap and water is not enough to prevent the spread of pathogens
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Overall Summary
  • Targeted hygiene is needed for “home” infection control
  • The benefit is prophylactic but real
  • Topical antiseptic wash products do not contribute to decreased antimicrobial susceptibility
  • Extensive data indicate environmental risks from individual active ingredients are unlikely
  • The data clearly support the current proposed labeling indication (i.e., “ to decrease bacteria on skin”)
  • The 1994 TFM log reductions after a single wash (i.e., 2 log10 ) are appropriate, as long as standardized ASTM methods are employed