Mouthwashes, Oral Rinses May Inactivate Human Coronaviruses

Certain oral antiseptics and mouthwashes may have the ability to inactivate human coronaviruses, according to a Penn State College of Medicine research study. The results indicate that some of these products might be useful for reducing the viral load, or amount of virus, in the mouth after infection and may help to reduce the spread of SARS-CoV-2, the coronavirus that causes COVID-19.

Craig Meyers, distinguished professor of microbiology and immunology and obstetrics and gynecology, led a group of physicians and scientists who tested several oral and nasopharyngeal rinses in a laboratory setting for their ability to inactivate human coronaviruses, which are similar in structure to SARS-CoV-2. The products evaluated include a 1% solution of baby shampoo, a neti pot, peroxide sore-mouth cleansers and mouthwashes.

The researchers found that several of the nasal and oral rinses had a strong ability to neutralize human coronavirus, which suggests that these products may have the potential to reduce the amount of virus spread by people who are COVID-19 positive.

“While we wait for a vaccine to be developed, methods to reduce transmission are needed,” Meyers said. “The products we tested are readily available and often already part of people’s daily routines.”

Meyers and colleagues used a test to replicate the interaction of the virus in the nasal and oral cavities with the rinses and mouthwashes. Nasal and oral cavities are major points of entry and transmission for human coronaviruses. They treated solutions containing a strain of human coronavirus, which served as a readily available and genetically similar alternative for SARS-CoV-2, with the baby shampoo solutions, various peroxide antiseptic rinses and various brands of mouthwash. They allowed the solutions to interact with the virus for 30 seconds, one minute and two minutes, before diluting the solutions to prevent further virus inactivation. According to Meyers, the outer envelopes of the human coronavirus tested and SARS-CoV-2 are genetically similar so the research team hypothesizes that a similar amount of SARS-CoV-2 may be inactivated upon exposure to the solution.

To measure how much virus was inactivated, the researchers placed the diluted solutions in contact with cultured human cells. They counted how many cells remained alive after a few days of exposure to the viral solution and used that number to calculate the amount of human coronavirus that was inactivated as a result of exposure to the mouthwash or oral rinse that was tested. The results were published in the Journal of Medical Virology.

The 1% baby shampoo solution, which is often used by head and neck doctors to rinse the sinuses, inactivated greater than 99.9% of human coronavirus after a two-minute contact time. Several of the mouthwash and gargle products also were effective at inactivating the infectious virus. Many inactivated greater than 99.9% of virus after only 30 seconds of contact time and some inactivated 99.99% of the virus after 30 seconds.   

According to Meyers, the results with mouthwashes are promising and add to the findings of a study showing that certain types of oral rinses could inactivate SARS-CoV-2 in similar experimental conditions. In addition to evaluating the solutions at longer contact times, they studied over-the-counter products and nasal rinses that were not evaluated in the other study. Meyers said the next step to expand upon these results is to design and conduct clinical trials that evaluate whether products like mouthwashes can effectively reduce viral load in COVID-19 positive patients.

“People who test positive for COVID-19 and return home to quarantine may possibly transmit the virus to those they live with,” said Meyers, a researcher at Penn State Cancer Institute. “Certain professions including dentists and other health care workers are at a constant risk of exposure. Clinical trials are needed to determine if these products can reduce the amount of virus COVID-positive patients or those with high-risk occupations may spread while talking, coughing or sneezing. Even if the use of these solutions could reduce transmission by 50%, it would have a major impact.”

Future studies may include a continued investigation of products that inactive human coronaviruses and what specific ingredients in the solutions tested inactivate the virus.

Janice Milici, Samina Alam, David Quillen, David Goldenberg and Rena Kass of Penn State College of Medicine and Richard Robison of Brigham Young University also contributed to this research.

The research was supported by funds from Penn State Huck Institutes for the Life Sciences. The researchers declare no conflict of interest.

About Penn State College of Medicine Located on the campus of Penn State Health Milton S. Hershey Medical Center in Hershey, Pa., Penn State College of Medicine boasts a portfolio of nearly $100 million in funded research. Projects range from development of artificial organs and advanced diagnostics to groundbreaking cancer treatments and understanding the fundamental causes of disease. Enrolling its first students in 1967, the College of Medicine has more than 1,700 students and trainees in medicine, nursing, the health professions and biomedical research on its two campuses.

Are climate scientists being too cautious when linking extreme weather to climate change?

In this year of extreme weather events — from devastating West Coast wildfires to tropical Atlantic storms that have exhausted the alphabet — scientists and members of the public are asking when these extreme events can be scientifically linked to climate change.

Dale Durran, a professor of atmospheric sciences at the University of Washington, argues that climate science need to approach this question in a way similar to how weather forecasters issue warnings for hazardous weather.

In a new paper, published in the October issue of the Bulletin of the American Meteorological Society, he draws on the weather forecasting community’s experience in predicting extreme weather events such as tornadoes, flash floods, high winds and winter storms. If forecasters send out a mistaken alert too often, people will start to ignore them. If they don’t alert for severe events, people will get hurt. How can the atmospheric sciences community find the right balance?

Most current approaches to attributing extreme weather events to global warming, he says, such as the conditions leading to the ongoing Western wildfires, focus on the likelihood of raising a false alarm. Scientists do this by using statistics to estimate the increase in the probability of that event that is attributable to climate change.  Those statistical measures are closely related to the “false alarm ratio,” an important metric used to assess the quality of hazardous weather warnings.

But there is a second key metric used to assess the performance of weather forecasters, he argues: The probably that the forecast will correctly warn of events that actually occur, known as  the “probability of detection.” The ideal probability of detection score is 100%, while the ideal false-alarm rate would be zero.

Probability of detection has mostly been ignored when it comes to linking extreme events to climate change, he says. Yet both weather forecasting and climate change attribution face a tradeoff between the two. In both weather forecasting and climate-change attribution, calculations in the paper show that raising the thresholds to reduce false alarms produces a much greater drop in the probability of detection.

Drawing on a hypothetical example of a tornado forecaster whose false alarm ratio is zero, but is accompanied by a low probability of detection, he writes that such an “overly cautious tornado forecasting strategy might be argued by some to be smart politics in the context of attributing extreme events to global warming, but it is inconsistent with the way meteorologists warn for a wide range of hazardous weather, and arguably with the way society expects to be warned about threats to property and human life.”

Why does this matter? The paper concludes by noting: “If a forecaster fails to warn for a tornado there may be serious consequences and loss of life, but missing the forecast does not make next year’s tornadoes more severe. On the other hand, every failure to alert the public about those extreme events actually influenced by global warming facilitates the illusion that mankind has time to delay the actions required to address the source of that warming. Because the residence time of CO2 in the atmosphere is many hundreds to thousands of years the cumulative consequences of such errors can have a very long lifetime.”

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