A review of scientific evidence convened by WHO in November 2014 confirms existing WHO recommendations for hand hygiene already promoted in the context of this outbreak. The recommendations are published as rapid advice in:
Standard of care
Alcohol-based handrubs are the standard of care for hand hygiene of health workers caring for Ebola patients.
If alcohol-based handrubs are unavailable or when hands are visibly soiled, hands should be cleaned with soap and running water and dried with disposable towels.
Bleach/chlorine solutions currently in use for hand hygiene and glove disinfection may be used in the interim period in emergency situations until alcohol-based handrubs or soap and water become available.
There is limited evidence to evaluate the efficacy of bleach/chlorine solutions in preventing transmission of Ebola virus between patients and health workers or in reducing viral load on hands.
However, experts agree that use of a 0.05% chlorine solution applied for a minimum time of 40 to 60 seconds until hands are dried is appropriate and likely to be efficacious.
Chlorine solutions are suitable for environmental cleaning, decontamination of personal protective equipment and soiled linen. However solutions should be carefully prepared in order to obtain the correct concentration; they also need to be freshly prepared and frequently changed, especially if exposed to sunlight or high temperature.