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The German Society of Hospital Hygiene develops guidelines, recommendations and standard operation procedures on a voluntary basis, published on the DGKH-website ().The original German version of this recommendation was published in April 2022 and has now been made available to the international professional public in English. Evaluating the current data on the efficacy of virucidal gargle/mouthwash solutions and nasal sprays against SARS-CoV-2 and in clinical trials, conducted with preventive or therapeutic objectives, recommendations are given for the prevention of COVID-19. The following areas are considered:

Aim: Glutaraldehyde (GDA) is an active ingredient in many instrument disinfectants and is effective against a broad spectrum of microorganisms. In the past, the virus-inactivating properties of these products were mainly claimed based on quantitative suspension tests with different test viruses. Recently, however, a European Norm EN 17111:2018 has been published which allows examination of instrument disinfectants in a surface carrier test, simulating practical conditions. Therefore, it is of interest to evaluate GDA for the ability to inactivate the viruses used in this European Norm as test viruses. Methods: The virucidal efficacy of GDA as the active ingredient in instrument disinfectants was evaluated with 4 different test viruses in a method simulating practical conditions (EN 17111:2018).Results: With a fixed exposure time of five minutes at 20°C, 100 ppm GDA were necessary to inactivate vaccinia virus, classifying it as a limited spectrum virucidal activity for pre-cleaning products. For adenovirus, 125 ppm GDA were required, whereas for murine norovirus as a surrogate for human norovirus, 4,000 ppm GDA were required for a significant reduction of viral titres. Both non-enveloped viruses must be tested to prove virucidal activity in EN 17111:2018. But even 4,000 ppm were not enough to yield a 4 log reduction of the murine parvovirus at 20°C. This virus is only required as a test virus using this method if temperatures ≥40°C are used. Conclusion: GDA, as the active ingredient of many instrument disinfectants, shows virucidal efficacy at 20°C. The necessary concentrations are strongly dependent on the stability of the test viruses. Due to the high stability of murine norovirus, GDA levels of 4,000 ppm were required to inactivate this virus within the 5-minute exposure time.

Hepatitis E virus (HEV; family Hepeviridae), is a single-stranded positive-sense RNA virus with 3 open reading frames (1). Members of the HEV species Paslahepevirus balayani have been assigned to 8 [...]

Aim: The virucidal efficacy of an automated ultrasound probe disinfector (trophon EPR) was evaluated in a three step procedure according to European and German test methods. This system uses sonicated hydrogen peroxide mist (35%) at elevated temperature (50°C) in a closed chamber with control of all parameters within a 7 minute cycle. Methods: In the first step of examination, the peroxide solution was tested in a quantitative suspension assay according to the Guideline of Deutsche Vereinigung zur Bekämpfung der Viruskrankheiten (DVV) e.V. and Robert Koch-Institute (RKI) and in parallel with the European Norm EN 14476 with all test viruses creating a virucidal claim. In the second step, the virucidal efficacy of the hydrogen peroxide solution was evaluated in a hard surface carrier test according to the Guideline of DVV with adenovirus, murine norovirus and parvovirus simulating practical conditions. Finally, the efficacy was evaluated by the automated system using stainless steel carriers inoculated with test virus and positioned at different levels inside the chamber. Results: A ≥4 log reduction of virus titre was demonstrated with all methods including carrier tests with murine norovirus, adenovirus, and parvovirus using the automated device. Conclusion: The automated device is able to inactivate test viruses of German and European norms and can therefore claim efficacy against human pathogenic enveloped and non-enveloped viruses. This includes human papillomaviruses which form part of the complete virucidal claim.

Horses and other equids can be infected with several viruses of the family Flaviviridae, belonging to the genus Flavivirus and Hepacivirus. This consensus statement focuses on viruses with known occurrence in Europe, with the objective to summarize the current literature and formulate clinically relevant evidence-based recommendations regarding clinical disease, diagnosis, treatment, and prevention. The viruses circulating in Europe include West Nile virus, tick-borne encephalitis virus, Usutu virus, Louping ill virus and the equine hepacivirus. West Nile virus and Usutu virus are mosquito-borne, while tick-borne encephalitis virus and Louping ill virus are tick-borne. The natural route of transmission for equine hepacivirus remains speculative. West Nile virus and tick-borne encephalitis virus can induce encephalitis in infected horses. In the British Isle, rare equine cases of encephalitis associated with Louping ill virus are reported. In contrast, equine hepacivirus infections are associated with mild acute hepatitis and possibly chronic hepatitis. Diagnosis of flavivirus infections is made primarily by serology, although cross-reactivity occurs. Virus neutralization testing is considered the gold standard to differentiate between flavivirus infections in horses. Hepacivirus infection is detected by serum or liver RT-PCR. No direct antiviral treatment against flavi- or hepacivirus infections in horses is currently available and thus, treatment is supportive. Three vaccines against West Nile virus are licensed in the European Union. Geographic expansion of flaviviruses pathogenic for equids should always be considered a realistic threat, and it would be beneficial if their detection was included in surveillance programs.

The global spread of human monkeypox virus (MPXV) has activated the highest alert level of the World Health Organization (WHO), which declared the virus a public health emergency of international [...]

Background and Aims: Severe acute respiratory syndrome coronavirus (SARS‐CoV‐2) preferentially infects the respiratory tract; however, several studies have implicated a multi‐organ involvement. Hepatic dysfunctions caused by SARS‐CoV‐2 infection have been increasingly recognized and described to correlate with disease severity. To elucidate molecular factors that could contribute towards hepatic infection, we concentrated on microRNAs (miRNAs), a class of small non‐coding RNAs that modulate various cellular processes and which are reported to be differentially regulated during liver injury. We aimed to study the infection of primary human hepatocytes (PHH) with SARS‐CoV‐2 and to evaluate the potential of miRNAs for modulating viral infection. Methods: We analysed liver autopsies from a coronavirus disease 19 (COVID‐19)‐positive cohort for the presence of viral RNA using Nanopore sequencing. PHH were used for the infection with SARS‐CoV‐2. The candidate miRNAs targeting angiotensin converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) were identified using in silico approaches. To discover the potential regulatory mechanism, transfection experiments, qRT‐PCRs, western blots and luciferase reporter assays were performed. Results: We could detect SARS‐CoV‐2 RNA in COVID‐19‐positive liver autopsies. We show that PHH express ACE2 and TMPRSS2 and can be readily infected with SARS‐CoV‐2, resulting in robust replication. Transfection of selected miRNA mimics reduced SARS‐CoV‐2 receptor expression and SARS‐CoV‐2 burden in PHH. In silico and biochemical analyses supported a potential direct binding of miR‐141‐3p to the SARS‐CoV‐2 genome. Conclusion: We confirm that PHH are susceptible to SARS‐CoV‐2 infection and demonstrate selected miRNAs targeting SARS‐CoV‐2 entry factors and/or the viral genome reduce viral loads. These data provide novel insights into hepatic susceptibility to SARS‐CoV‐2 and associated dysfunctions in COVID‐19. [ABSTRACT FROM AUTHOR]

Studies have pointed to a decisive role of autoantibodies in the context of sepsis and severe Coronavirus disease 2019 (COVID‐19), which itself often fulfills the criteria for sepsis, including dysregulated immune responses and organ dysfunction. To directly compare and further analyze the autoantibody profiles of sepsis patients with and without COVID‐19, the luciferase immunoprecipitation systems (LIPS) assay was used to measure the levels of autoantibodies against a variety of clinically relevant cytokines, lung‐associated proteins, other autoantigens, and antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). In addition, cytokine titers were measured with the LEGENDplex™ Human Antivirus Response Panel. We observed significantly increased levels of autoantibodies in 59% of the COVID‐19‐Sepsis group compared to 48% of the Sepsis group. Significant differences were identified between the groups for the levels of autoantibodies against gATPase. The cytokine levels of interferon (IFN)‐λ1 and IP‐10 were higher in the COVID‐19‐Sepsis group compared to the Sepsis group. Additional correlations between autoantibodies, cytokines and 30‐day survival could be demonstrated, suggesting varied underlying pathological mechanisms. Elevated levels of cytokines and autoantibodies may serve as prognostic indicators for the survival probability of sepsis patients, highlighting the intricate relationship between immune responses and patient outcomes in the context of both sepsis and COVID‐19. Summary: COVID‐19 sepsis patients exhibited a higher number of significantly increased autoantibody levels than sepsis patients without COVID‐19. For both groups, effects of specific autoantibody and cytokine profiles on survival could be shown, which may be relevant in clinical terms. [ABSTRACT FROM AUTHOR]

The replication organelle of hepatitis C virus (HCV), called membranous web, is derived from the endoplasmic reticulum (ER) and mainly comprises double membrane vesicles (DMVs) that concentrate the viral replication complexes. It also tightly associates with lipid droplets (LDs), which are essential for virion morphogenesis. In particular acyl-CoA:diacylglycerol acyltransferase 1 (DGAT1), a rate-limiting enzyme in triglyceride synthesis, promotes early steps of virus assembly. The close proximity between ER membranes, DMVs and LDs therefore permits the efficient coordination of the HCV replication cycle. Here, we demonstrate that exaggerated LD accumulation due to the excessive expression of the DGAT1 isozyme, DGAT2, dramatically impairs the formation of the HCV membranous web. This effect depended on the enzymatic activity and ER association of DGAT2, whereas the mere LD accumulation was not sufficient to hamper HCV RNA replication. Our lipidomics data indicate that both HCV infection and DGAT2 overexpression induced membrane lipid biogenesis and markedly increased phospholipids with long chain polyunsaturated fatty acids, suggesting a dual use of these lipids and their possible competition for LD and DMV biogenesis. On the other hand, overexpression of DGAT2 depleted specific phospholipids, particularly oleyl fatty acyl chain-containing phosphatidylcholines, which, in contrast, are increased in HCV-infected cells and likely essential for viral infection. In conclusion, our results indicate that lipid exchanges occurring during LD biogenesis regulate the composition of intracellular membranes and thereby affect the formation of the HCV replication organelle. The potent antiviral effect observed in our DGAT2 overexpression system unveils lipid flux that may be relevant in the context of steatohepatitis, a hallmark of HCV infection, but also in physiological conditions, locally in specific subdomains of the ER membrane. Thus, LD formation mediated by DGAT1 and DGAT2 might participate in the spatial compartmentalization of HCV replication and assembly factories within the membranous web. Author summary: Lipid droplets are fat storage organelles with an increasingly recognized importance for the infectious cycle of multiple pathogens. In particular, they support hepatitis C virion morphogenesis and the formation of the picornaviral replication organelle. Unexpectedly, we observed that exaggerated lipid droplet biogenesis, due to an excessive expression of the triglyceride forming enzyme DGAT2, is deleterious to hepatitis C virus replication. More precisely, the formation and maintenance of the viral replication organelle was impeded. Exaggerated lipid droplet biogenesis induced by DGAT2 also profoundly altered the cell lipidome, with strong accumulation of neutral lipids and changes in the membrane lipid composition. Our results support a model where lipid flux occurring during lipid droplet biogenesis regulates the composition of the endoplasmic reticulum membranes, where lipid droplets are formed, and thereby affect the capacity of hepatitis C virus to remodel these membranes into its replication organelle. Since DGAT1 and its triglyceride synthesis were previously reported to contribute to virus assembly, this also implies that lipid droplet biogenesis driven by DGAT1 and DGAT2 but also membrane contact sites between endoplasmic reticulum and lipid droplets might locally restrict and determine the formation of hepatitis C virus replication and assembly factories. [ABSTRACT FROM AUTHOR]

Background: Equine parvovirus hepatitis (EqPV‐H) can cause Theiler's disease and subclinical hepatitis in horses. Objectives: Assess the frequency of subclinical EqPV‐H infection in hospitalized horses and to study viral transmission by investigating potential shedding routes. Animals: One hundred sixteen equids, that presented to the University Equine Hospital of the University of Veterinary Medicine Vienna between February 2021 and March 2022, for causes other than hepatopathy. Methods: In this cross‐sectional study, samples (serum, feces, nasal, and buccal swabs) of hospitalized horses were collected. Sera were screened for the presence of anti‐EqPV‐H antibodies by a luciferase immunoprecipitation system assay. Quantitative PCR was used for the detection of EqPV‐H DNA in the samples and a nested PCR was used for further validation. Results: Seroprevalence was 10.3% (12/116) and viremia occurred in 12.9% (15/116) of the serologically positive horses. The detected viral load in serum varied from non‐quantifiable amount to 1.3 × 106 genome equivalents per milliliter of serum. A low viral load of EqPV‐H DNA was detected in 2 nasal swabs and 1 fecal sample. Conclusion and Clinical Importance: EqPV‐H DNA was detected in nasal secretions and feces of viremic horses, which could pose a risk to naive hospitalized horses. It is advisable to screen hospitalized horses that are potential donors of blood or plasma to reduce the risk of iatrogenic EqPV‐H transmission. [ABSTRACT FROM AUTHOR]

Despite continued outbreaks of yellow fever virus (YFV) in endemic regions, data on its environmental stability or guidelines for its effective inactivation is limited. Here, we evaluated the susceptibility of the YFV 17D vaccine strain to inactivation by ethanol, 2-propanal, World Health Organization (WHO)-recommended hand rub formulations I and II, as well as surface disinfectants. In addition, two pathogenic strains were tested to compare inactivation kinetics by WHO-recommended hand rub formulations I and II. Furthermore, environmental stability of the vaccine strain was assessed. YFV 17D particles displayed infectivity half-life decay profiles of ~13 days at room temperature. Despite this extended environmental stability, YFV was efficiently inactivated by alcohols, WHO-recommended hand formulations, and four out of five tested surface disinfectants. These results are useful in defining disinfection protocols to prevent non-vector borne YFV transmission. Author summary: Yellow fever virus (YFV) outbreaks persist in certain regions, emphasizing the need for effective inactivation methods. Our study focused on the YFV 17D vaccine strain, evaluating its susceptibility to commonly used disinfectants. Surprisingly, despite a prolonged half-life of ~13 days at room temperature, YFV proved susceptible to alcohols, WHO-recommended hand rubs, and most surface disinfectants tested. Consistent with these findings, WHO-recommended hand rubs effectively inactivated two pathogenic strains of YFV. This is essential information for establishing protocols to curb YFV transmission beyond vector-related scenarios. Our findings contribute to the broader understanding of YFV control, offering practical insights that can inform public health measures. [ABSTRACT FROM AUTHOR]

Recently, hepatitis E virus (HEV, Paslahepevirus balayani) particles were detected for the first time in the ejaculate of two chronically infected patients. Since then, we have been able to detect HEV in ejaculate in five further patients, and thus in a total of seven out of nine (78%) chronically infected men (age 36–67 years, median 56 years). In five patients, the HEV RNA concentration was more than 100‐fold higher compared to the serum, while in two patients, the viral load was more than 10‐fold lower. However, it has remained unclear whether viral particles shed in the ejaculate were infectious, as a previous cell culture model had failed to demonstrate the infectivity. In the current study, we employed an optimized HEV cell culture system based on overconfluent PLC/PRF/5 cells to investigate the infectivity of HEV particles from ejaculate and other body fluids. With this approach, we were able to show for the first time that HEV particles in the ejaculate from several patients were infectious. HEV replicated to high viral loads of 1e9 HEV RNA copies per ml. This indicates that HEV‐positive ejaculate could bear a risk of infection for sexual partners. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third highly pathogenic human coronavirus to cross the species barrier into the human population during the past 20 years (2-3). SARS-CoV-2 [...]