Use of Chlorhexidine mouthwash in preventingspread of COVID-19 in hospital & community setting
One rinse will reduce the virus load in the mouth for 2 hours
A new study published by Korea University College of Medicine, Seoul, Korea on 25th May 2020 in the Journal of Korean Medical Science has concluded that Chlorhexidine (CHX) mouthwash was effective in reducing the SARS-CoV-2 viral load in the saliva for a short-term period (2 hours).
Since the risk of virus spread via droplet transmission is very high, this finding holds great significance in the middle of the current COVID-19 pandemic.
The authors state the key finding “the viral load in the saliva decreased transiently for 2 hours after using the chlorhexidine mouthwash, but it increased again at 2–4 hours post-mouthwash” (Fig. 2 and Supplementary Table 3).
The authors suggest that chlorhexidine mouthwash might be beneficial for the control of SARS-CoV-2 transmission in both the community and hospital setting.
Quoting another important finding of this study, the authors state “we have shown that the SARS-CoV-2 viral load is consistently high in the saliva… Owing to its high viral load in the saliva, SARS-CoV-2 might be transmitted to other people during a conversation”
These findings make the use of Chlorhexidine mouthwash very critical. Based on this study we can recommend the use of 10 ml of 0.2% Chlorhexidine mouthwash for 30 seconds to reduce the viral load in the saliva for 2 hours, thereby reducing the risk of COVID-19 transmission.
Eight key areas where this study can have significant application:
- Outpatient care: like Dermatology, ENT, Ophthalmology, General Practice, Dental clinics and many more can ask their patients to gargle with Chlorhexidine mouthwash before entering the clinics that will give them a safety period of 2 hours in which they can complete their appointments. Dentists being the highest risk group may use the mouthwash even more frequently (every 15 -30 min) to keep the risk consistently low.
- In-patient care hospitals: Many patients admitted in the hospitals may be asymptomatic SARS-CoV-2 carriers. To prevent the disease transmission within the hospitals, Chlorhexidine mouthwash at every 2-hour interval may be needed.
- COVID-facilities: A lot of healthcare workers (HCW) are getting infected in the COVID wards. Chlorhexidine mouthwash given every 2 hourly, to the admitted patients and the HCW may minimize the virus transmission within COVID wards.
- Suspected individuals / travelers coming from red zones and containment zones and put in quarantine facilities can be given CHX mouthwash at every 2 hours.
- Home quarantine individuals: to prevent spread to their family members.
- Working people from the family going out every day to work: They cannot wear masks at home. These people need to prevent their family members from getting affected. They can use the mouthwash every 2 hourly or at least as soon as they come home.
- People going out for events and gatherings: It should be mandated that the events should get over in 1 – 2 hours maximum and every person has to use the mouthwash before the event starts.
- Domestic flights of up to 2 hr duration: Passengers can rinse and gargle before getting into the flight. Since flights are closed environments, this additional measure can be of great help.
Hexidine is Chlorhexidine gluconate solution I.P. diluted to chlorhexidine gluconate 0.2% w/v
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