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Interim Guidance for Passenger Railcar (Transit Vehicle) Cleaning When a Passenger or Crewmember is Visibly Ill During an Influenza Pandemic
Following are general guidelines for cleaning a passenger railcar that has carried a traveler suspected to have pandemic influenza. These guidelines provide a basic framework of response. This guidance may be modified or additional procedures may be recommended by the Centers for Disease Control and Prevention (CDC) as part of the evaluation of an ill traveler, when an influenza pandemic becomes widespread in the United States, or as new information about a pandemic strain becomes available.
Influenza viruses can persist on nonporous surfaces for 24 hours or more, but quantities of the virus sufficient for human infection are likely to persist for shorter periods. Although the relative importance of virus transfer from inanimate objects to humans in spreading influenza is not known, hand transfer of the virus to the mucous membranes of the eyes, nose, and mouth resulting in infection is likely to occur. Hand hygiene1, cough etiquette and respiratory hygiene2 are the principal means of interrupting this type of transmission. Routine cleaning and disinfection practices may play a role in minimizing the spread of influenza.
Routine cleaning with soap or detergent in water to remove soil and organic matter, followed by the proper use of disinfectants are the basic components of effective environmental management of influenza. Reducing the number of influenza virus particles on a surface through those steps can reduce the chances of hand transfer of the virus. Influenza viruses are susceptible to inactivation by a number of chemical disinfectants readily available from consumer and commercial sources. All disinfectants marketed in the U.S. are registered with the U.S. Environmental Protection Agency (EPA). These products must be used in accordance with their label instructions; following label instructions is necessary to achieve adequate efficacy and to avoid unreasonable adverse effects
Routine cleaning methods should be employed throughout the railcar with special attention in certain areas as specified below:
- Wear non-sterile, disposable gloves that are recommended by the manufacturer of the detergent/disinfectant while cleaning the seating area and lavatories or handling cleaning and disinfecting solutions. Dispose of gloves if they become damaged or soiled and when cleaning is completed in a sturdy leakproof (e.g., plastic) bag that is tied shut and not reopened. Never wash or reuse the gloves. Eye protection, such as a face shield or goggles, may be required if splashing is expected. Avoid activities where infectious aerosols are generated. Cleaning activities should be supervised and inspected periodically to ensure correct procedures are followed.
- Clean surfaces first with detergent and water and then disinfect with an EPA-registered disinfectant in accordance with the manufacturer’s instructions. Use only disinfectants that are registered by the EPA for use against influenza viruses. Apply the disinfectant as instructed on the disinfectant manufacturer’s label, adhering to any safety precautions or other recommendations as directed (e.g. allowing adequate ventilation in confined areas such as lavatories, and proper disposal of unused product or used containers). Ensure that there is sufficient contact time between the disinfectant and the surface.
- The following surfaces should be cleaned at the seat of the ill passenger or crew and at adjacent seats in the same row, the backs of the seats in the row in front of the sick passenger’s row, and other areas as noted below to include sleeping cars, lounge cars, diner cars or areas that the traveler frequented:
- Seatbacks (the plastic and/or metal part)
- Tray tables
- Light and air controls, cabin crew call button
- Adjacent walls and windows
- Individual video monitor
- Lavatory(ies) used by the sick traveler: door handle, locking device,
toilet seat, faucet, washbasin, adjacent walls and counter
- Luggage compartments
- Tables and chairs in dining, lounge or café cars
- Door handles and countertops
- Grab handles, rails, straps and similar fixtures used by passengers in transit
A change tan increased frequency of routine cleaning and disinfection practices may be considered based upon the circumstances of the pandemic.
- Dispose of soiled material and gloves in a sturdy, leak-proof (e.g., plastic) bag that is tied shut and not reopened. State and local governments should be consulted for appropriate disposal decisions. Barring specific state solid or medical waste regulations to the contrary, these wastes are considered routine solid wastes that can be sent to municipal solid waste landfills without treatment.
- When cleaning is completed and gloves have been removed, immediately clean hands with soap and water or an alcohol-based hand gel if no soap and water are available. Wash hands with soap and water as soon as they become available. Avoid touching the face with gloved or unwashed hands3.
- Do not use compressed air and/or water under pressure for cleaning. It might re-aerosolize infectious material. Vacuum cleaners should be used only after proper disinfection has taken place. Vacuum cleaners should be maintained to minimize dust dispersal in general and equipped with High Efficiency Particulate Air (HEPA) filters.
For the most current information about pandemic influenza, including up-to-date guidance documents and related materials, visit www.flu.gov.
For more information about environmental management of pandemic influenza virus, go to http://flu.gov/planning-preparedness/hospital/influenzaguidance.html.
Lists of EPA-registered disinfectants can be found at http://www.epa.gov/oppad001/chemregindex.htm.
1 When washing hands with soap and water: Wet your hands with clean running water and apply soap. Use warm water if it is available. Rub hands together to make a lather and scrub all surfaces. Continue rubbing hands for 20 seconds. Rinse hands well under running water. Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet. Remember: If soap and water are not available, use alcohol-based gel to clean hands. When using an alcohol-based hand gel: Apply product to the palm of one hand. Rub hands together. Rub the product over all surfaces of hands and fingers until hands are dry. (http://www.cdc.gov/flu/protect/habits/)
2 The following measures to contain respiratory secretions are recommended for all individuals with signs and symptoms of a respiratory infection: Cover the nose/mouth when coughing or sneezing; use tissues to contain respiratory secretions and dispose of them in the nearest covered waste receptacle after use; if you don't have a tissue, cough or sneeze into your upper sleeve, not your hands; perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand gel, or antiseptic handwash) after having contact with respiratory secretions and contaminated objects/materials (http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm and http://www.cdc.gov/flu/protect/covercough.htm )
3 Employees should be trained to remove personal protective equipment to prevent self-inoculation (e.g., touching a contaminated glove and then touching one’s eyes, nose, or mouth).