Wednesday, April 25, 2012

Alcohol hand rub prevents rhinovirus infection (despite the authors’ claims) and it can get you really pissed!

This morning, two kind folks independently pointed me to new reports on the efficacy of alcohol hand rub.  The first report in CID by Ronald Turner et al. describes a randomized trial of the efficacy of 62% ethanol hand rub for the prevention of rhinovirus infection.  In the study, 116 volunteers were randomized to the active hand rub group and asked to apply the hand rub after each hand washing episode and also every three hours for 9 weeks. Apparently, there is data showing ethanol hand rub prevents rhinovirus for up to 4 hours. The 96 unblinded controls were asked to practice their usual hand hygiene routine. All enrolled kept a diary of symptoms, had weekly nasal lavage for PCR and two additional nasal lavages if they developed cold symptoms.

The results of the study were somewhat surprising, especially if you just read the abstract and focus on the highlighted p-values.  The authors conclude that "hand disinfection did not reduce rhinovirus infection or rhinovirus-related common cold illnesses."  When you look more closely, only 39% of treated subject developed a confirmed infection versus 49% of untreated. Sure, the p=0.3, but this is just because the study is underpowered. Oh, and reported common cold illnesses were lower in the hand disinfection arm (56% vs 72%, p=0.01). And then read their conclusion - a bit of an over-reach: "the results of our study call into question commonly held assumptions about the route of spread of rhinovirus infection..."  Wow. Do one underpowered study - not blinded, cherry pick the results and then claim rhinovirus might not be spread via hands?

h/t Charlesnika Evans 

The second report highlights the efficacy of hand rub in getting kids wasted.  The report by Jane Weaver (with Today Show video) describes how 16 LA teens have been treated for intoxication after guzzling 120-proof alcohol hand rub.  Some might even be distilling it first.  Very ingenious.

h/t Mark Vander Weg

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