How to disinfect offices and businesses during flu season

Although influenza can strike any time of year, the flu season typically occurs in the fall and winter months. The influenza A and B viruses that routinely spread among people (human influenza viruses) are responsible for these seasonal epidemics, however, influenza A viruses are the only influenza viruses known to cause flu pandemics, i.e., global epidemics of flu disease.¹ 

During an influenza outbreak, cleaning and disinfection plans are an important consideration for offices and business facilities to help prevent flu germs from spreading. The influenza virus can live as long as eight hours on some surfaces. Proper cleaning and disinfection can help minimize the spread of the virus through surface contact.

Whether you have in-house janitorial staff or a contract cleaning service, it is important to implement a comprehensive cleaning plan to help ensure all parties understand their responsibilities.

4 key components to a disinfection plan

Planning is a critical component to a cleaning and disinfection program. The plan should address four important components:

• Areas to be cleaned/disinfected
• Frequency of cleaning
• Cleaning/disinfection materials that will be used
• Material-specific cleaning procedures and techniques

Each cleaning/disinfection material has specific procedures for use that can enhance its effectiveness. These materials’ specific procedures should be integrated into your routine cleaning and disinfection plan. Finally, the cleaning and disinfection plan should be clearly documented in writing and communicated to all interested parties.

Implementing the plan

Areas to be cleaned: Guidance from the U.S. Centers for Disease Control and Prevention (CDC) indicates that routine cleaning should be appropriate for most areas. Certain high traffic areas such as the ones listed below may need additional cleaning (as often as several times daily):²

• Door knobs
• Elevator buttons
• Light switches
• Faucet handles
• Publicly used telephones
• Computer monitors, mice and keyboards
• Countertops and conference tables
• Cafeteria tables, coffee pots and vending equipment

Cleaning frequency: The use of regular cleaning and disinfection materials should be sufficient in many instances. The cleaning frequency for each area should be covered specifically in the plan and should match the significance of the cleaning and disinfection task. For example, the cleaning plan for a hospital emergency room would be different from that for an office or retail occupancy. For more frequent cleaning, you may also wish to provide disinfecting wipes for employees and have them available at high traffic areas such as conference rooms, shared workspaces and in the cafeteria. In office spaces such as desks and cubicles, disinfectant wipes and sprays may be used on surfaces.³

Cleaning procedures: For personal safety, it is important that all janitorial staff or cleaning service providers receive training on all items in the plan, including the use of appropriate personal protective equipment (PPE) such as gloves and goggles per manufacturer's recommendations. This training should also include specific processes, requirements for each area cleaned and how they will address the increased cleaning needed during an influenza outbreak. The following cleaning guidance is provided by the Washington State Department of Health.⁴

Cleaning during a flu outbreak consists of normal cleaning procedures with the use of detergent cleaners followed by disinfection with U.S. Environmental Protection Agency (EPA)-registered products that are effective at disinfecting type A influenza virus (see below). Follow cleaning directions on the label – generally clean surfaces first with soap or detergent followed by disinfection.

For cleaning of critical areas in regulated facilities such as hospital and food processing facilities, inquire about the need for validation of cleaning protocols for effectiveness.

Cleaning chemicals and disinfectants: Influenza viruses can be inactivated by many low- or intermediate-level disinfectants. Use of disinfectants registered by the EPA is recommended whenever these are available. Lists of registered disinfectants can be found on the EPA website. Many, if not all, of these products indicate potency for several target pathogens on the label. There are approximately over 400 registered disinfectants with human influenza A and/or B listed on the product label, and all should inactivate influenza viruses when used according to manufacturer instructions.

Contracted services: Service level agreements are important for both the facility owner-operator and the cleaning service. This helps avoid any potential misunderstanding and disputes about responsibilities and expectations for each party. A service level agreement should be in writing and should include, as a minimum, the four key areas described earlier. They include areas to be cleaned/disinfected, frequency of cleaning, materials that will be used and material-specific cleaning procedures and techniques. Additional items should be added to the contract to address any specific situations as they apply to your facility. A competent legal counsel should review the terms and conditions of any service level agreement.

Other considerations: The adherence to good personal hygiene, proper hand hygiene, respiratory hygiene, and cough etiquette is especially important for helping prevent the spread of influenza in the workplace and non-healthcare settings in the community. As part of influenza control strategy during early stages of a moderate or severe influenza outbreak, schools may dismiss classes, and businesses may consider implementing social distancing, such as spacing employees out as much as possible while at work (using empty desks or spaces) or by implementing a remote working plan that allows employees who are able to work from home rather than in the workplace. Regular cleaning for non-healthcare settings focuses on most surfaces and targeted use of disinfection for surfaces touched frequently by hand:

• Keep housekeeping surfaces and countertops clean of visible soil by cleaning with detergents and water or proprietary cleaners, followed by rinsing with water.
• Follow label instructions carefully when using disinfectants and cleaners, noting any hazard advisories and indications for using PPE (such as household gloves). Do not mix disinfectants and cleaners unless the labels indicate it is safe to do so. Combining certain products (such as chlorine bleach and ammonia cleaners) can be harmful, potentially resulting in serious injury or even death.
• Clean and disinfect bathroom surfaces on a regular basis 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, the CDC suggests using a dilute solution (1:100 volume/volume, approximately 600 parts per million [ppm]) of household chlorine bleach (sodium hypochlorite) to disinfect bathroom surfaces. To prepare this solution, add ¼ cup of bleach to a gallon of clean water, or 1 tablespoon 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 minimally 3 to 5 minutes.²
• Wipe frequently touched electronic items (e.g., remote controls, handheld gaming devices) with hand sanitizer cloths.

Cleaning and disinfection plans can be a critical part of minimizing the spread of the influenza virus during an outbreak. A plan should outline what will be cleaned, the frequency of cleaning, the materials/techniques to be used and the manner in which janitorial staff or outside cleaning providers will be trained. These cleaning procedures/requirements should be clearly outlined and understood in any agreements developed. The use of proper materials, techniques and clear cleaning plans can support a facility's influenza outbreak-response efforts. Additional information can be found in the resources and references noted below.

Additional resources
”Flu Resources for Businesses.” Centers for Disease Control and Prevention. 16 October 2019.
“Workplace Administrators: Flu Prevention at Work.” Centers for Disease Control and Prevention. 26 August 2019.
“Guidance on Preparing Workplaces for an Influenza Pandemic.”U.S. Department of Labor/Occupational Safety & Health Administration. 1 July 2009.
Ridgely, Lisa. "H1N1 Fact Sheet for Cleaning Professionals." CleanLink. 8 May 2009.
“Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers.” Occupational Safety & Health Administration, U.S. Department of Labor. 2009.