Room or area cleaning during suspected or confirmed cases of Group A streptococcus (GAS) in schools and other general facilities

Room or area cleaning during suspected or confirmed cases of Group A streptococcus (GAS) in schools and other general facilities

Background

Group A streptococcus (GAS) is a very common bacteria that most people carry in throats and on their skin, and largely results in very minor symptoms like a sore throat. However, in recent weeks there has been an increase in invasive group A strep (iGAS) infections among children which has resulted in very serious and, sadly, a small number of deaths.

Transmission

Group A strep bacteria are very contagious. The mode of transmission for Group A strep bacteria are predominantly direct person to person contact in droplets expelled through coughing and sneezing. However, like many respiratory diseases, some infected people may not have symptoms or appear sick, or they may ignore very mild symptoms.

Other means of transmission include touching objects and items with unwashed contaminated hands, typical after coughing, touching nose and mouth.

Cleaning and Disinfecting Surfaces

From a cleaning and disinfection perspective, there are a number of points to cover which gives us insight into the nature of the problem: spread, dispersion and biocide.

Spread and Dispersion

The first point to cover is how Strep bacteria spread around a room or area and from person to person. As you go through this step and visualise the spread, you’ll notice patterns linked to human behaviour. If an infected person enters a room, he or she will touch and handle (interact with) a number of different surfaces, it could be a door, door handle, hand rail, chair or table.

This person could have a bout of coughing or sneezing, and with now contaminated hands, touch these surfaces. We can’t stop other people breathing in droplets contaminated with bacteria, but we can remove or reduce the number of bacteria on surfaces. Have a think about all the common surfaces that a person could touch. Now, imagine healthy people in the same room and assuming that they are not breathing in the droplets from the infected person, those healthy people are touching and handling those same surfaces.

These common surfaces where infected and healthy (in fact everyone) interact with are called Hi-touch surfaces. These can be visualised as hot spots in a room or particular surfaces areas of high probability of contamination.

Now, broaden and expand those hi-touch surfaces to include potential surfaces that could have been contaminated by droplets from coughing or sneezing. For example, the edges of tables are hi-touch surfaces, but with respiratory infections the act of sneezing can disperse droplets into the air which then settle on horizontal surfaces like tables.

Disinfectants

The next point to cover is the use of a disinfectant. You must use a biocide in order to provide disinfection but opting for any biocide is wholly inadequate. The biocide used must be specifically designed and certified to be at least 99.99% effective against bacteria. 99% or 99.9% is not adequate, 99.999% is recommended.

In order to tell the difference, look for disinfectants that are independently tested and marked with BS EN 1276. If the product container, label or information sheet is not marked with this standard – avoid!

Cleaning and disinfection guidelines for routine or suspected cases

    1. Cleaning and disinfection starts with the biocide. Make sure that it is certified and follow all the usage recommendations, particularly the recommended contact time. Use a cleaner/sanitiser combination product if certified
    2. When cleaning and disinfecting always pay very close attention to detail on all hi-touch surfaces and horizontal surfaces.
    3. Ventilate the room before starting. This will reduce any airborne droplets
    4. Wear new disposable gloves as a minimum

 

Cleaning and disinfection guidelines for urgent or extreme outbreaks

    1. Cleaning and disinfection starts with the biocide. Make sure that it is certified and follow all the usage recommendations, particularly the recommended contact time.
    2. When cleaning and disinfecting always pay very close attention to detail on all hi-touch surfaces and horizontal surfaces
    3. Ventilate the room before starting. This will reduce any airborne droplets
    4. With respiratory diseases like these that are transmitted in droplets carried in the air, pay very close attention to ventilation and A/C systems. Filters and covers could collect bacteria.
    5. Fabrics and porous surfaces can act to protect bacteria from routine cleaning. These will need to be deep cleaned and disinfected. It follows that the biocide chosen should not damage the materials.
    6. Isolate and seal room off to all people
    7. Wear full disposable PPE. Face masks are only needed if there is a risk of droplets or contaminated dust being dispersed into the air
    8. Work methodically from the highest point in the room to the lowest, and then from the furthest point to the exit.
    9. Thoroughly clean and disinfect all equipment after use and perform thorough hand hygiene

References:

  • CDC – https://www.cdc.gov/groupastrep/diseases-public/index.html
  • UKHSA – https://ukhsa.blog.gov.uk/2022/12/05/group-a-strep-what-you-need-to-know
  • Sepsis Alliance – https://www.sepsis.org/sepsisand/group-a-streptococcus

How can we help you?

We can provide:

    • Onsite training in cleaning and disinfection practices
    • Onsite cleaning and hygiene audits 
    • Written guidance including cleaning and disinfection procedures and checklists 

Contact us today



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