Interim Guidance for Cleaning Transit Stations During an Influenza Pandemic

Following are general guidelines for cleaning a transit station during an influenza pandemic. 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 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 United States 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 transit station with special attention in certain areas as specified below:

1. Wear non-sterile, disposable gloves that are recommended by the manufacturer of the detergent/disinfectant when preparing disinfectant and cleaning solutions and when performing cleaning tasks. Dispose of gloves if they become damaged or soiled and when cleaning is completed. Never wash or reuse the gloves. Eye protection, such as a faceshield 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.
2. 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 label requirements (e.g., allowing adequate ventilation in confined areas such as lavatories and proper disposal of unused product or used containers).
3. Keep housekeeping surfaces and countertops clean of visible soil with detergents and water or proprietary cleaners, followed by rinsing with water. Repeated application of disinfectants to table- and desktop surfaces is unnecessary. Use of room air deodorizers to disinfect the air is not recommended.
4. Clean and disinfect bathroom surfaces regularly using EPA-registered detergent/disinfectants. Alternatively, clean surfaces first with detergent and water and then disinfect with an EPA-registered disinfectant in accordance with manufacturer instructions.
   • If EPA-registered disinfectants are not available, use a dilute solution (1:100 volume/volume, approximately 600 parts per million [ppm]) of household chlorine bleach (5.25% or 6.00% sodium hypochlorite) to disinfect bathroom surfaces. To prepare this solution, add ¼ cup of bleach to a gallon of clean water, or 2 teaspoons of bleach to a quart of clean water. Apply to a cleaned surface, preferably with a cloth moistened with the bleach solution, and allow the surface to remain wet for at least 3 – 5 minutes. Use gloves that protect the hands when preparing the bleach solution and pour bleach carefully.
5. Clean and disinfect commonly touched surfaces in the facility with a detergent/disinfectant in accordance with label instructions (e.g., turnstiles, door handles, handrails).
6. Wipe frequently touched electronic items (e.g., ticket vending machines) with hard surface disinfectant wipes.
7. After cleaning, remove and dispose of gloves. 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.
8. 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. Avoid touching the face with gloved or unwashed hands³.
9. Cleaning procedures such as pressure-washing, blow-downs, or the use of high-capacity vacuums to clean platforms, parking areas, access walkways, rights-of-way, etc. should be restricted to hours when no passengers are present and used only after proper disinfection has taken place. Workers should not direct debris toward other workers. Workers should stay upwind when using these procedures outdoors or in strongly-ventilated areas to avoid blow back. Eye protection is recommended.

Additional Information

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 hand 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).