Solar/ClO2 system inactivates fungal spores in drinking water: Synergy, efficiency and mechanisms.

The risk of fungal pollution in drinking water has been paid attention. Solar/chlorine dioxide (ClO2) combined system is an environment-friendly, economical and efficient disinfection method, especially for countries and regions that are economically backward and still exposed to unsafe drinking water. In this paper, the kinetics, influencing factors, mechanism and regrowth potential of inactivated Aspergillus niger (A. niger) spores by solar/ClO2 were reported for the first time. The inactivation curve can be divided into three stages: instant inactivation within 1-2 min, slow linear inactivation and finally a tail. The synergistic factors produced by solar/ClO2 in terms of log reduction and maximum inactivation rate were 1.194 and 1.112, respectively. The inhibitory effect on the regrowth of A. niger spores inactivated by solar/ClO2 was also stronger than that by ClO2 alone. Strongly oxidizing reactive species produced by solar/ClO2 accelerated the accumulation of endogenic reactive oxygen species (ROS) caused by oxidation stress of A. niger spores, improving the inactivation ability of the system. The inactivation order of A. niger spores was: loss of culturability, accumulation of intracellular ROS, loss of membrane integrity, leakage of intracellular species and change of morphology. The inactivation performance of solar/ClO2 was better than solar/chlor(am)ine according to the comparison of inactivation efficiency and regrowth potential. Results also suggested that solar/ClO2 process was more suitable for the treatment of ground water sources.

Exploring the Antimicrobial Efficacy of Low-Cost Commercial Disinfectants Utilized in the Agro-Food Industry Wash Tanks: Towards Enhanced Hygiene Practices.

The increase in vegetable consumption has underlined the importance of minimizing the risks associated with microbiological contamination of fresh produce. The critical stage of the vegetable washing process has proven to be a key point for cross-contamination and the persistence of pathogens. In this context, the agri-food industry has widely adopted the use of disinfectants to reduce the bacterial load in the wash water. Therefore, we conducted laboratory-scale experiments in order to demonstrate the antimicrobial activity of disinfectants used in the wash tank of agro-food industries. Different wash water matrices of shredded lettuce, shredded cabbage, diced onion, and baby spinach were treated with sodium hypochlorite (NaClO), chlorine dioxide (ClO2), and per-oxyacetic acid (PAA) at recommended concentrations. To simulate the presence of pathogenic bacteria, a cocktail of E. coli O157:H7 was inoculated into the process water samples (PWW) to determine whether concentrations of disinfectants inhibit the pathogen or bring it to a viable non-culturable state (VBNC). Hereby, we used quantitative qPCR combined with different photo-reactive dyes such as ethidium monoazide (EMA) and propidium monoazide (PMA). The results indicated that concentrations superior to 20 ppm NaClO inhibit the pathogen E. coli O157:H7 artificially inoculated in the process water. Concentrations between 10-20 ppm ClO2 fail to induce the pathogen to the VBNC state. At concentrations of 80 ppm PAA, levels of culturable bacteria and VBNC of E. coli O157:H7 were detected in all PWWs regardless of the matrix. Subsequently, this indicates that the recommended concentrations of ClO2 and PAA for use in the fresh produce industry wash tank do not inhibit the levels of E. coli O157:H7 present in the wash water.

Efficacy of Chlorine Dioxide as an Endodontic Irrigant for Pulp Dissolution in vitro

Determine the efficacy of 5 % chlorine dioxide as an endodontic irrigant for pulp dissolution. Thirty five samples of human dental pulp were obtained, previously weighed and immersed in three solutions= 5 % ClO 2, 5.25 % NaOCl and saline (control group), for 10 minutes at 32 ºC; they were dried and reweighed. Then the weight loss was compared to the original weight and analyzed statistically. 5.25 % NaOCl and 5 % ClO 2 dissolved the dental pulp samples more effectively than saline (p> 0.001). No statistically significant difference was found between the tissue dissolving proper ties of 5.25 % NaOCl and 5 % ClO2 (p=0.893). 5 % ClO2 is effective in dissolving human dental pulp tissue.

El objetivo de este estudio fue determinar la eficacia del dióxido de cloro al 5 % como irrigante endodóntico para la disolución pulpar. Se obtuvieron 35 muestras de pulpa dental humana, se pesaron previamente y se sumergieron en tres soluciones= 5 % ClO2, 5.25 % NaOCl y suero fisiológico (grupo control), durante 10 minutos a 32ºC; se secaron y se pesaron de nuevo. Luego se comparó la pérdida de peso del peso original y se analizó estadísticamente. NaOCl al 5.25 % y ClO2 al 5 % disolvieron las muestras de pulpa dental con más eficacia que el suero fisiológico (p> 0.001). No se encontró diferencias estadísticamente significativas entre las propiedades de disolución de tejido de NaOCl al 5.25 % y ClO2 al 5 % (p=0.893) ClO2 al 5 % es eficaz para disolver tejido de pulpa dental humana.

Use of Ivermectin and Chlorine Dioxide for COVID-19 Treatment and Prophylaxis in Peru: A Narrative Review.

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, created a rapidly unfolding health crisis, especially in the initial phases of the pandemic. In the early stages of the pandemic, various strategies were proposed for COVID-19 prophylaxis and treatment with very little scientific evidence available. Among these proposed treatments were ivermectin and chlorine dioxide, which were both used widely in Peru for both disease prevention and treatment without considering their problematic side effects. For instance, ivermectin was part of an approved therapeutic scheme based on in vitro data, although its efficacy in humans was not demonstrated. In addition, chlorine dioxide was never shown to be effective but causes threatening side effects. In this article, we discuss current information regarding chlorine dioxide and ivermectin in the context of the COVID-19 pandemic, with a focus on experiences in Peru.

Dióxido de cloro: la verdad toxicológica y el riesgo de las noticias falsas / Chlorine dioxide: the toxicological truth and the risk of fake news

El dióxido de cloro es una sustancia que se ha usado como desinfectante para tratar el agua de consumo humano. A las dosis usadas en este escenario no se han asociado compromisos toxicológicos para el ser humano. Químicamente, el dióxido de cloro se caracteriza por reaccionar con diversas moléculas y generar estrés oxidativo en los microorganismos y en las células. A pesar de no ser un medicamento ni estar aprobado por las agencias reguladoras, se ha promovido su uso como una solución milagrosa; sin embargo, no hay ninguna evidencia científica que lo respalde. De otro lado, sí hay evidencia de que puede generar toxicidad aguda, y posiblemente crónica, para el ser humano.

Summary Chlorine dioxide has been used as a disinfectant to treat water for human consumption, at the doses used in this scenario, human poisoning has not been described. Chemically, chlorine dioxide is characterized by reacting with various molecules, and generating oxidative stress in microorganisms, and in human cells. Chlorine dioxide is not a medicine, and it is not approved by regulatory agencies. Chlorine dioxide has been promoted as a miracle solution, yet there is no scientific evidence to back it up. On the other hand, there is evidence, that it can generate acute poisoning and possibly chronic poisoning in humans.

Misinformation About and Interest in Chlorine Dioxide During the COVID-19 Pandemic in Mexico Identified Using Google Trends Data: Infodemiology Study.

BACKGROUND: The COVID-19 pandemic has prompted the increasing popularity of several emerging therapies or preventives that lack scientific evidence or go against medical directives. One such therapy involves the consumption of chlorine dioxide, which is commonly used in the cleaning industry and is available commercially as a mineral solution. This substance has been promoted as a preventive or treatment agent for several diseases, including SARS-CoV-2 infection. As interest in chlorine dioxide has grown since the start of the pandemic, health agencies, institutions, and organizations worldwide have tried to discourage and restrict the consumption of this substance. OBJECTIVE: The aim of this study is to analyze search engine trends in Mexico to evaluate changes in public interest in chlorine dioxide since the beginning of the COVID-19 pandemic. METHODS: We retrieved public query data for the Spanish equivalent of the term "chlorine dioxide" from the Google Trends platform. The location was set to Mexico, and the time frame was from March 3, 2019, to February 21, 2021. A descriptive analysis was performed. The Kruskal-Wallis and Dunn tests were used to identify significant changes in search volumes for this term between four consecutive time periods, each of 13 weeks, from March 1, 2020, to February 27, 2021. RESULTS: From the start of the pandemic in Mexico (February 2020), an upward trend was observed in the number of searches compared with that in 2019. Maximum volume trends were recorded during the week of July 19-25, 2020. The search volumes declined between September and November 2020, but another peak was registered in December 2020 through February 2021, which reached a maximum value on January 10. Percentage change from the first to the fourth time periods was +312.85, -71.35, and +228.18, respectively. Pairwise comparisons using the Kruskal-Wallis and Dunn tests showed significant differences between the four periods (P<.001). CONCLUSIONS: Misinformation is a public health risk because it can lower compliance with the recommended measures and encourage the use of therapies that have not been proven safe. The ingestion of chlorine dioxide presents a danger to the population, and several adverse reactions have been reported. Programs should be implemented to direct those interested in this substance to accurate medical information.

Could polyhexanide and chlorine dioxide be used as an alternative to chlorhexidine? A systematic review

ABSTRACT BACKGROUND: Maintenance of oral microbiota balance is the simplest way to prevent infectious oral diseases, through controlling dental biofilm. Combined use of mouthwash and mechanical removal has been shown to be a very effective way for this. OBJECTIVES: To identify clinical studies comparing the antimicrobial effect and possible adverse effects and/or side effects of chlorhexidine-based mouthwashes with those of mouthwashes containing chlorine dioxide and/or polyhexanide, for controlling oral microbiota. DESIGN AND SETTING: Systematic review designed by the stomatology sector of postgraduation in applied dental sciences of Bauru Dentistry School, University of São Paulo, Brazil. METHODS: A systematic review was conducted using online databases (PubMed, Embase, Web of Science and Science Direct) up to April 8, 2020. The search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The studies included comprised eight articles published between 2001 and 2017. A total of 295 young adults, adults and elderly people were evaluated (males 44.75% and females 55.25%). Three articles compared polyhexanide with chlorhexidine and five articles compared chlorine dioxide with chlorhexidine. No studies comparing all three mouthwashes were found. The concentrations of the study solutions were quite varied, and all rinses had an antimicrobial effect. In four studies, it was stated that no side effects or adverse effects had been found. Three studies did not address these results and only one study addressed side effects and/or adverse effects. CONCLUSION: Mouthwashes containing chlorine dioxide and polyhexanide are viable alternatives to chlorhexidine, since they reduce oral biofilm and have little or no reported side or adverse effects.

Tendencias de búsqueda en Internet sobre dióxido de cloro en ocho países de Latinoamérica durante la pandemia por COVID-19 / Trends of Internet search about chlorine dioxide in eight Latin American countries during the COVID-19 pandemic

La infodemiología e infovigilancia son métodos informáticos para el análisis y seguimiento de los datos de Internet, y permiten tomar conciencia de las situaciones y crear políticas sanitarias. Este estudio se propuso analizar las tendencias de búsqueda de dióxido de cloro y términos equivalentes en Internet (chlorine dioxide solution, CDS; miracle mineral solution, MMS), en relación con la morbilidad y mortalidad por COVID-19 en ocho países de Latinoamérica. Para ello se utilizó Google Trends; el período examinado fue del 1ro de marzo al 25 de noviembre de 2020. Se calculó la media móvil por 7 días para el volumen relativo de búsqueda (VRB), la tasa de morbilidad y mortalidad. Para la asociación de las variables cuantitativas, se utilizó el coeficiente de correlación de Spearman con un nivel de significancia p < 0,05. El país con mayor interés de búsqueda fue Bolivia; el de menor interés, Brasil. El análisis del VRB con la tasa de morbilidad y mortalidad fue diferente entre países. Los picos máximos de VRB de Colombia y Chile, en abril, y de México, Ecuador y Bolivia, en julio, coincidieron con la emisión de alertas sanitarias sobre dióxido de cloro. La mayoría mostró una correlación significativa moderada y baja entre el VRB y el número de casos confirmados y muertes diarias por COVID-19. El comportamiento de las búsquedas, diferenciado entre países, podría indicar mayor interés por el tema dióxido de cloro en pandemia; lo cual se explicaría por la difusión de alertas sanitarias de organismos de salud internacionales, regionales y locales(AU)

Infodemiology and infovigilance are computer methods for the analysis and monitoring of Internet data, and allow awareness of situations and creation of health policies. This study aimed to analyze the search trends for chlorine dioxide and equivalent terms on the Internet (chlorine dioxide solution, CDS; miracle mineral solution, MMS), in relation to COVID-19 morbidity and mortality in eight Latin American countries. Google Trends was used for this purpose; the period reviewed was from March 1st to November 25th 2020. The 7-day moving average for relative search volume (VRB), morbidity and mortality rate were calculated. For the association of quantitative variables, the Spearman correlation coefficient was used with a significance level p < 0.05. The country with the highest search interest was Bolivia; the one with the least interest, Brazil. The analysis of the VRB with the morbidity and mortality rate was different between countries. The maximum VRB peaks of Colombia and Chile, in April, and of Mexico, Ecuador and Bolivia, in July, coincided with the issuance of health alerts on chlorine dioxide. Most showed a moderate and low significant correlation between VRB and the number of confirmed cases and daily deaths from COVID-19. The behavior of the searches, differentiated between countries, could indicate greater interest in the topic of chlorine dioxide during the pandemic; this would be explained by the dissemination of health alerts from international, regional and local health agencies(AU)

Guía de actuación y abordaje frente a intoxicación por dióxido de cloro/clorito de sodio, a partir de la experiencia de los CIAT de América Latina / Guidelines for action and approach to chlorine dioxide/sodium chlorite poisoning based on the experience of the CIATs in Latin America

Resumen El 11 de marzo de 2020, la Organización Mundial de la Salud, declaró la pandemia a nivel mundial por la COVID-19. Ante este escenario, los centros de información y asesoramiento toxicológico (CIAT) de América Latina comenzaron a recibir consultas por exposición/intoxicación a dióxido de cloro/clorito de sodio y sus compuestos relacionados, por desvío de uso, destinado a la prevención y/o tratamiento de la COVID-19 sin aval científico alguno ni contar con registro sanitario para ese fin. A través de la Red de Toxicología de América Latina y el Caribe (RETOXLAC), se comprobó que no eran hechos aislados, sino que se estaba produ ciendo el mismo fenómeno en toda la región y que existían antecedentes de intoxicaciones con dichos productos y alertas desde hace más de una década, con indicaciones no aprobadas, para el tratamiento de distintas patologías como SIDA, cáncer, esclerosis lateral amiotrófica ELA, malaria, autismo, entre otras, sin evidencia. Ante esta realidad, los CIAT presentan una revisión de los signos y síntomas observados según la vía de ingreso, basados en la comunicación de riesgo en salud; proponiéndose pruebas de apoyo al diagnóstico, algoritmo de tratamiento para las intoxicaciones y modelo de ficha clínica para la vigilancia epidemiológica de los casos atendidos. Recomendamos a las autoridades y organismos responsables, reforzar las acciones tendientes a la vigilancia, control y prevención de este tipo de intoxicaciones, producto del mal uso de un desinfectante no autorizado para fines terapéuticos/médicos.

Abstract On March 11th, 2020, the World Health Organization declared a global pandemic due to COVID-19. Faced with this sce- nario, the Poison Control Centers (CIATs for its initials in spanish) in Latin America began to receive consultations for exposure/poi- soning to chlorine dioxide/sodium chlorite and its related compounds for their use aimed to prevent or treat COVID-19 without any scientific endorsement or having a sanitary registry for that purpose. It was found through the Toxicology Network of Latin America and the Caribbean (RETOXLAC) that they were not isolated events but rather that the same phenomenon was occurring throughout the region and that there has been a history of poisoning and alerts with these products for more than a decade with unapproved indications for the treatment of different pathologies such as AIDS, cancer, amyotrophic lateral sclerosis (ALS), malaria, autism, among others, without evidence. In the light of this situation, the CIATs present a review of the signs and symptoms observed ac- cording to the route of exposure based on health risk communication; proposing tests to support the diagnosis, an algorithm for poisoning treatment, and a model of a clinical record for the epidemiological surveillance of the assisted cases. We recommend to the authorities and responsible organisms reinforce the actions aimed at surveillance, control, and prevention of this type of poisoning due to the misuse of an unauthorized disinfectant for therapeutic or medical purposes.

Factors associated with the consumption of chlorine dioxide to prevent and treat COVID-19 in the Peruvian population: a cross-sectional study.

BACKGROUND: Chlorine dioxide has been promoted as an alternative for the prevention and treatment of COVID-19, especially in Peru, despite the lack of evidence to support its efficacy. This study aimed to evaluate the factors associated with chlorine dioxide consumption in the Peruvian population. METHODS: Analytical cross-sectional study. An adult Peruvian population was evaluated where chlorine dioxide consumption was divided into two groups according to the purpose of use: as prevention (individuals without COVID-19 history) and as treatment (individuals with COVID-19 history). The associated factors in each group were evaluated using Poisson regressions with the bootstrapping resampling method. RESULTS: Of 3610 participants included, 3213 reported no history of COVID-19, and 397 had been infected. The prevalence of chlorine dioxide consumption to prevent or treat COVID-19 was 8 and 16%, respectively. Factors either positively or negatively associated with chlorine dioxide consumption for prevention were male sex (aPR: 1.36; 95% CI: 1.09-1.71), being an adult or older adult (aPR: 0.54; 95% CI: 0.35-0.82), having a health sciences student within the family unit (aPR: 1.38; 95% CI: 1.02-1.87), using medical information as the main source of information of COVID-19 (aPR: 0.57; 95% CI: 0.40-0.80), having comorbidities for COVID-19 (aPR: 1.36; 95% CI: 1.01-1.82), considering COVID-19 dangerous and deadly (aPR: 0.57; 95% CI: 0.45-0.74), using medications (aPR: 1.59; 95% CI: 1.25-2.06) and plants to prevent COVID-19 (aPR: 1.69; 95% CI: 1.21-2.36), considering chlorine dioxide ineffective (aPR: 0.18; 95% CI: 0.18-0.24), and being uninformed of its efficacy (aPR: 0.21; 95% CI: 0.16-0.28). In addition, factors associated with chlorine dioxide consumption for treatment were considering COVID-19 dangerous and deadly (aPR: 0.56; 95% CI: 0.33-0.96), considering chlorine dioxide ineffective (aPR: 0.22; 95% CI: 0.12-0.42), and being uninformed of its efficacy (aPR: 0.15; 95% CI: 0.07-0.32). CONCLUSIONS: The prevalence of chlorine dioxide consumption to treat COVID-19 was higher than prevent. It is important to apply information strategies, prioritizing population groups with certain characteristics that are associated with a higher consumption pattern.

Enfoque de tratamiento integral del paciente intoxicado por dióxido de cloro y derivados del cloro / Comprehensive therapy approach for patients affected by chloride dioxide and chlorine derivative poisoning

RESUMEN Durante la emergencia sanitaria debida al SARS-CoV-2 y ante la ausencia de una terapéutica específica surgieron tratamientos sin evidencia científica, conllevando a un contexto de infodemia sobre el uso de dióxido de cloro y derivados del cloro, cuyas medidas de elaboración, distribución y administración no son reguladas, exponiendo a un gran número de personas a dicho producto pudiendo llevar a contextos de intoxicación y muerte. En este escenario el artículo presentado tiene el objetivo de brindar al personal de salud, un enfoque de tratamiento integral del paciente intoxicado por estos productos a nivel prehospitalario, que consiste en realizar un protocolo donde se valore el escenario de la exposición del paciente (uso de equipo de protección personal, triaje, descontaminación, entre otros), se realice la evaluación primaria y una evaluación secundaria (revaloración continua del paciente) y a nivel hospitalario (evaluación sistemática del paciente, identificación de la vía de exposición y aplicación de uso de antídoto en escenarios específicos); así como medidas de prevención tanto para el personal de salud como para la población general.

ABSTRACT During the sanitary emergency due to SARS-CoV-2, and considering the absence of specific therapy against this condition, many therapy approaches with no underlying scientific evidence appeared, leading to infodemics with many publications about the use of chloride dioxide and chlorine derivatives, without any regulation on manufacturing, distribution, and administration of such products; and so many people developed multiple symptoms, leading to intoxication and death. In this context, this paper aims to offer healthcare personnel, a comprehensive pre-hospital therapy approach for patients affected by the aforementioned compounds. The idea is to perform a protocol where the scenario for patients' exposure is determined (use of personal protective equipment, triage, decontamination, and the like), primary and secondary assessments are to be performed (continuously reassessing the affected patient). Later, hospital management is to be performed (systematic patient's assessment, identifying the exposure route and use of an antidote when necessary for specific cases); and establishing prevention measures for both healthcare personnel and the general population.

Acute kidney injury secondary to chlorine dioxide use for COVID-19 prevention.

Chlorine dioxide has been historically used as a disinfecting agent for drinking water supplies and surfaces. Widespread use as an alternative option for prevention and treatment of COVID-19 has emerged due to a lack of specific treatment. We present the case of a 55-year-old male who developed acute kidney injury and disseminated intravascular coagulation after chlorine dioxide prophylactic ingestion, with regression after therapy with hemodialysis.

Dióxido de cloro y su repercusión en las tendencias de búsquedas en internet durante la pandemia por la COVID-19 / Chlorine dioxide: its impact on internet search trends in times of COVID-19 / Dióxido de cloro e seu impacto nas tendências de pesquisa da Internet durante a pandemia de COVID-19

RESUMEN Introducción: El creciente número de casos de COVID-19 a nivel mundial han dado paso al deterioro de la de salud mental y la investigación de nuevos tratamientos; esto ha dado lugar a una explosión de búsquedas en internet de palabras clave. Objetivo: En esta investigación se ha descrito el uso de Google Trends para medir las búsquedas en internet de términos asociados a la pandemia por COVID-19 en distintas regiones de Perú y su potencial para realizar investigaciones en salud. Método: Se midió la tendencia de búsquedas en internet del término "dioxido de cloro" en el período entre el 3 de junio al 3 de septiembre de 2020. Se utilizaron los datos de Google Trends sobre una fracción de las búsquedas de las palabras clave, y se analizaron los resultados de acuerdo con una ubicación geográfica dada y un período definido. Resultados: Se encontró que los países que presentaron mayor nivel de búsqueda para dicho término fueron Bolivia, Perú, Ecuador, Argentina y México. Se encontró correlación positiva alta entre el nivel de búsqueda en Argentina y el número de casos en este país, a comparación de Perú, Ecuador y México, donde la correlación fue positiva muy baja. En el caso de Bolivia, se presentó una correlación negativa muy baja. Google Trends podría, además, definir potencialmente el momento y la ubicación adecuada para practicar estrategias de comunicación de riesgos a las poblaciones afectadas. Conclusiones: Existe correlación entre en número de casos y las búsquedas de dióxido de cloro como medida médica contra la COVID-19.

ABSTRACT Introduction: The increasing worldwide number of cases of COVID-19 has led to the deterioration of mental health and researches of new treatments; this has resulted in an explosion of keyword searches on Internet. Objective: This research has described the use of Google Trends to measure the search queries in internet for terms associated with the COVID-19 pandemic in different regions of Peru as well as its potential to conduct research on health aspects. Method: It was measured the search trends in internet for the term "chlorine dioxide" in the period from June 3 to September 3, 2020. Google trends data were used on a fraction of the keyword searches, and the outcomes were analyzed according to the geographic location and defined period. Results: It was found a higher tendency of searching related terms in Bolivia, Perú, Ecuador, Argentina, and México. A high positive correlation was found between the level of search in Argentina and the number of COVID-19 cases in this country, unlike Peru, Ecuador and Mexico, where the correlation was very low. Instead, in Bolivia there was a very low negative correlation. Google Trends could also potentially define the appropriate time and location to practice risk communication strategies to affected populations. Conclusions: An appropriate risk communication could help to prevent the excessive information intakes, which often causes concern or panic in different populations.

RESUMO Introdução: O crescente número de casos de COVID-19 em todo o mundo tem dado lugar à deterioração da saúde mental e à investigação de novos tratamentos; Isso levou a uma explosão de pesquisas de palavras-chave na Internet. Objetivo: Esta pesquisa descreveu o uso do Google Trends para medir buscas na internet por termos associados à pandemia COVID-19 em diferentes regiões do Peru e seu potencial para a realização de pesquisas em saúde. Método: A tendência das pesquisas na internet do termo "dióxido de cloro" foi medida no período entre 3 de junho e 3 de setembro de 2020. Os dados do Google Trends foram usados ​​em uma fração das pesquisas pelas palavras-chave, e os resultados foram analisados ​​de acordo com uma determinada localização geográfica e um período definido. Resultados: Constatou-se que os países com maior nível de busca por esse termo foram Bolívia, Peru, Equador, Argentina e México. Foi encontrada uma alta correlação positiva entre o nível de pesquisa na Argentina e o número de casos neste país, em comparação com Peru, Equador e México, onde a correlação foi muito baixa positiva. No caso da Bolívia, houve uma correlação negativa muito baixa. O Google Trends também pode definir o momento e o local certos para praticar estratégias de comunicação de risco para as populações afetadas. Conclusões: Há correlação entre o número de casos e as pesquisas de dióxido de cloro como medida médica contra o COVID-19.

Chlorine dioxide: an evaluation based on a microbial decay approach during mango packing process.

Mango is highly consumed worldwide; nonetheless, its consumption has been related to foodborne outbreaks. This study was performed to evaluate bacterial transference during mango postharvest management and the feasibility of adopting chlorine dioxide as first choice disinfectant in mango packinghouse. Chlorine dioxide (3 and 5 ppm) and sodium hypochlorite (100 and 200 ppm) were evaluated at different turbidity and times against Salmonella Choleraesuis and Listeria monocytogenes. Bacterial transference was higher from water to fruit than vice-versa (49.17%). Chlorine dioxide (5 ppm) achieved the highest Salmonella reductions at low turbidity reaching 2.13 Log10 at 10 min; meanwhile, Listeria was totally reduced in all conditions. Bacterial decay kinetic showed that chlorine dioxide 5 ppm was 34-fold faster than sodium hypochlorite at 200 ppm in reducing 1 Log10 of Salmonella. Chlorine dioxide reached faster bacterial inactivation decay over sodium hypochlorite; its usage is safe and meets the regulatory standards set for mango processing.

Dióxido de cloro y derivados del cloro para prevenir o tratar la COVID-19: revisión sistemática / Chlorine dioxide and chlorine derivatives for the prevention or treatment of COVID-19: a systematic review

RESUMEN Objetivos: Realizar una revisión sistemática acerca de la efectividad y seguridad del uso de dióxido de cloro y derivados del cloro, en la prevención o el tratamiento de la COVID-19. Materiales y métodos: Se siguieron las pautas internacionales de elaboración de revisiones sistemáticas de PRISMA y el Manual Cochrane para revisiones sistemáticas de intervenciones. La estrategia de búsqueda la desarrolló un bibliotecario y la revisaron dos de los autores. Se complementó la búsqueda electrónica con una búsqueda manual. Se incluyeron ensayos clínicos aleatorizados, estudios cuasiexperimentales, estudios de cohorte, estudios de casos y controles, estudios de corte transversal y reportes de casos; y se excluyeron estudios in vitro o realizados en animales. Dos revisores, de forma independiente, seleccionaron los estudios según los criterios de elegibilidad definidos, usando el aplicativo web Rayyan, en caso de discordancia se hizo partícipe a un tercer revisor. El protocolo de la revisión sistemática se registró en PROSPERO (CRD42020200641). Resultados: No se identificó ningún estudio publicado ni en proceso de publicación que haya evaluado el uso del dióxido de cloro o derivados del cloro, administrado por vía inhalatoria, oral o parenteral en humanos, como agente preventivo o terapéutico de la COVID-19 o en infecciones por otros coronavirus. Solo se identificó el registro de un único estudio catalogado como observacional que hasta ahora no tiene resultados. Conclusiones: A la fecha, no existe evidencia científica que apoye el uso del dióxido de cloro o derivados del cloro para prevenir o tratar la COVID-19.

ABSTRACT Objectives: To systematically review the effectiveness and safety of chlorine dioxide solution and chlorine derivatives used in the prevention or treatment of COVID-19. Methods: This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and follows the guidelines provided in the Cochrane Handbook for Systematic Reviews of Interventions. A librarian developed and executed the search strategy; it was further reviewed by two of the authors and complemented by manual search. Randomized clinical trials, quasi-experimental studies, cohort studies, case-control studies, cross-sectional studies, and case reports were included; in vitro or animal studies were excluded. Abstract and full-text screening according to pre-defined eligibility criteria were performed by two reviewers independently using web application Rayyan QCRI. Disagreements on study selection were resolved by a third reviewer. The systematic review protocol was registered in PROSPERO (CRD42020200641). Results: Neither published nor pre-print studies evaluating the use of chlorine dioxide or derivatives on SARS-CoV-2 infection were identified. The only finding was an unpublished observational study registry which has no results released yet. Conclusions: To date, there are no scientific evidence to uphold the use of chlorine dioxide or derivatives as preventive or therapeutic agents against COVID-19.

Caracterización epidemiológica de las exposiciones a dióxido de cloro/clorito de sodio en el contexto de la pandemia COVID-19: Reporte de los centros toxicológicos de América Latina / Epidemiological characterization of exposures to chlorine dioxide/ sodium chlorite in the context of the COVID-19 pandemic: Report of Poison Control Centers in Latin America

Resumen Los centros de información y asesoramiento toxicológico CIATs de América Latina, en el contexto de la pandemia de COVID-19, recibieron una serie de llamadas para consultas y asesoramientos relacionados con el uso de dióxido de cloro/clorito de sodio, que se estaban empleando en el tratamiento o prevención de dicha enfermedad. Dentro de la legislación vigente en los países de América Latina, no se contemplan productos farmacéuticos registrados para uso en humanos, ni se tiene evidencia de registros sanitarios en Europa, Canadá o Estados Unidos para tal fin, que contengan dióxido de cloro o clorito de sodio. Esta publicación, compila la información registrada como parte de la estadística del trabajo de ocho CIATs correspondientes a igual número de países de América Latina. Se identificó sexo, edad, sintomatología, circunstancia y grado de severidad de los 56 casos de pacientes intoxicados con dióxido de cloro/clorito de sodio registrados en el período del 15 de marzo al 30 de septiembre de 2020 en estos ocho países. Los resultados obtenidos confirman que la causa más común fue por mal uso, y el lugar de ocurrencia fue el hogar o sus alrededores, siendo el mayor porcentaje adultos jóvenes comprendidos entre 30 y 49 años. Los síntomas de intoxicación más frecuentemente encontrados fueron gastrointestinales, seguidos de cardiovasculares y respiratorios. La vía de ingreso al organismo en la mayoría de los casos fue por vía oral, reportándose algunos casos por vía inhalatoria, y en el 50% de los casos se constituyeron casos de severidad moderada, severa o fatal (3 fallecimientos). Este estudio contribuye a generar información relevante para las diferentes autoridades sanitarias, los ministerios de salud, las entidades encargadas de inspección, vigilancia y control de los países en los que se comercializan estos productos de manera ilegal por medio de redes sociales y promoviéndolos para uso en humanos para prevenir o curar COVID-19.

Abstract The Poison Control Centers in Latin America, in the context of COVID-19 pandemic, received a series of calls for consultations and recommendations related to the use of chlorine dioxide/sodium chlorite, in the treatment or prevention of CO-VID-19. Under current legislation in Latin America, no pharmaceutical products are registered for use in humans that contain chlorine dioxide or sodium chlorite, nor is there evidence of sanitary registries in Europe, Canada, or the United States for this purpose. This publication compiles the information registered by eight Poison Control Centers that correspond to the same number of Latin American countries. Sex, age, symptoms, circumstance, and degree of severity of the 56 cases of patients poisoned with chlorine dioxide/ sodium chlorite registered in the period from March 15th to September 30th, 2020 were identified. The results obtained confirm that the most common cause of poisoning was unintentional misuse, all of which occurred at home or its surroundings, with the highest percentage of registered cases being young adults between 30 and 49 years old. The most frequent symptoms of intoxication were gastrointestinal, followed by cardiovascular and respiratory. The route of exposure in most cases was oral, with some cases reported by inhalation; 48.2% of the cases were of moderate, severe, or fatal (3 deaths). This study contributes to the generation of relevant information for different health authorities, ministries of health, entities in charge of inspection, surveillance, and control in countries where these products are illegally marketed through social networks and promoted for use in humans to prevent or cure COVID-19.

Evaluation of Hot Water, Gaseous Chlorine Dioxide, and Chlorine Treatments in Combination with an Edible Coating for Enhancing Safety, Quality, and Shelf Life of Fresh-Cut Cantaloupes.

Fresh-cut cantaloupes have been implicated in numerous foodborne outbreaks of salmonellosis. Commercial aqueous wash treatments are limited in their ability to inactivate Salmonella enterica. Our objective was to evaluate the efficacy of hot water, gaseous chlorine dioxide, and chlorine on enhancing microbial safety and sensory qualities of fresh-cut cantaloupes. Cantaloupes were inoculated with an S. enterica cocktail (serovars Michigan, Mbandaka, and Poona) and treated with chlorine (200 ppm of free chlorine) for 40 min, 5 mg/L gaseous chlorine dioxide for 4.5 h, and hot water (76.1°C) for 3 min. Fresh-cut cantaloupes were prepared from treated whole cantaloupes and divided into two sets; one set of samples was treated with NatureSeal to evaluate its effect on shelf life and sensory quality and the second set (control) was packed without further treatment. Fresh-cut samples were stored at 4°C for up to 21 days. For the sensory quality parameters analyzed (color, water loss, and texture), the samples treated with NatureSeal had significantly better quality ( P < 0.05) than did the control samples. All treatments significantly reduced ( P < 0.05) the pathogen populations on the rind of the whole melons and on the fresh-cut samples prepared from the treated melons. All fresh-cut samples prepared from melons treated with hot water were negative for Salmonella throughout the storage period except for the samples treated with hot water and NatureSeal and evaluated on day 7. The fresh-cut samples prepared from melons treated with chlorine dioxide and chlorine were negative for Salmonella after 21 days of storage. These results provide a framework to producers of fresh-cut cantaloupes for the potential use of hot water as an intervention treatment in combination with NatureSeal for enhancing the microbiological safety and quality of this commodity.

Survival of Salmonella Typhimurium on soybean sprouts following treatments with gaseous chlorine dioxide and biocontrol Pseudomonas bacteria.

Control of Salmonella Typhimurium on sprouts is crucial for food and consumer safety. In this study, natural microflora on soybean seed was assessed and effects of gaseous chlorine dioxide (ClO2) and biocontrol Pseudomonas on the survival of S. Typhimurium on soybean sprouts were evaluated. Sprouts were dip-inoculated with S. Typhimurium prior to the application of the biocontrol (P. chlororaphis and P. fluorescens). After inoculation with S. Typhimurium, the sprouts were treated with ClO2 at 0.4 mg/L for 1 h (90% R.H., 13°C). Pseudomonas strains and Salmonella were recovered on Pseudomonas Agar F (PAF) and xylose lysine tergitol-4 (XLT-4) media, respectively. Pseudomonas strains reduced Salmonella by <1 log colony forming units (CFU)/g of sprouts, whereas S. Typhimurium on soybean sprouts was reduced from 2.55 to 5.35 logs CFU/g by ClO2. Gaseous ClO2 treatment reduced S. Typhimurium by 3.90 (0 h), 4.47 (24 h), and 3.61 log CFU/g (168 h). It was concluded that ClO2 and biocontrol treatment can enhance sprout safety.

Esterilização química para o cultivo in vitro de porta-enxerto de pessegueiro / Chemical sterilization of in vitro culture for peach rootstook

A esterilização dos meios de cultura é normalmente realizada por autoclavagem. Decorre que, este processo pode degradar ou reduzir a ação de compostos com efeito fisiológico desejável, como vitaminas e fitorreguladores. Objetivou-se avaliar a ação de agentes esterilizantes adicionados ao meio de cultura para o estabelecimento in vitro de umezeiro ‘Rigitano’. Para tanto, segmentos nodais foram inoculados em meio de cultura MS, preparado considerando os seguintes tratamentos: adição de hipoclorito de sódio (0,01 e 0,05% v/v); de dióxido de cloro (0,1; 0,5 e 1,0 % v/v); e de peróxido de hidrogênio (0,3; 0,7 e 1,5% v/v). O tratamento controle constou da ausência de agente esterilizante, autoclavado e não autoclavado. Em períodos variáveis de avaliação (7, 14 e 21 dias), foram determinadas sobrevivência dos explantes, contaminação total, contaminação por bactéria, contaminação por fungos e oxidação. Constatou-se a ocorrência de fungos dos gêneros Alternaria, Cladosporium, Penicillium, Trichoderma e Criptococcus. Podese concluir que o uso de peróxido de hidrogênio ou dióxido de cloro é eficiente para a esterilização química de meios de cultivo.

The culture media sterilization is typically performed by autoclaving. However, this process may degrade or reduce the action of compounds with desired physiological effect, such as vitamins and growth regulators. This study aimed to evaluate the effect of sterilizing agents added to the culture medium in vitro mume 'Rigitano' establishment. For this purpose, nodal segments were inoculated into culture medium prepared considering the following treatments: addition of sodium hypochlorite (0.01 and 0.05 % v/v), chlorine dioxide (0.1, 0.5 and 1% v/v) or hydrogen peroxide (0.3, 0.7 and 1.5 %, v/v). The control treatment consisted of the absence of sterilizing, autoclaved and non-autoclaved. In different periods (7, 14 and 21 days), it was determined survival explants, whole contamination, contamination by bacteria, fungi contamination and oxidation. It was found ocurrence of Alternaria, Cladosporim, Penicillium, Trichoderma and Cryptococcus fungal genera. It was conclude that the use of hydrogen peroxide or chlorine dioxide is effective for the chemical sterilization of culture media.

Esterilização química para o cultivo in vitro de porta-enxerto de pessegueiro / Chemical sterilization of in vitro culture for peach rootstook

A esterilização dos meios de cultura é normalmente realizada por autoclavagem. Decorre que, este processo pode degradar ou reduzir a ação de compostos com efeito fisiológico desejável, como vitaminas e fitorreguladores. Objetivou-se avaliar a ação de agentes esterilizantes adicionados ao meio de cultura para o estabelecimento in vitro de umezeiro ‘Rigitano. Para tanto, segmentos nodais foram inoculados em meio de cultura MS, preparado considerando os seguintes tratamentos: adição de hipoclorito de sódio (0,01 e 0,05% v/v); de dióxido de cloro (0,1; 0,5 e 1,0 % v/v); e de peróxido de hidrogênio (0,3; 0,7 e 1,5% v/v). O tratamento controle constou da ausência de agente esterilizante, autoclavado e não autoclavado. Em períodos variáveis de avaliação (7, 14 e 21 dias), foram determinadas sobrevivência dos explantes, contaminação total, contaminação por bactéria, contaminação por fungos e oxidação. Constatou-se a ocorrência de fungos dos gêneros Alternaria, Cladosporium, Penicillium, Trichoderma e Criptococcus. Podese concluir que o uso de peróxido de hidrogênio ou dióxido de cloro é eficiente para a esterilização química de meios de cultivo.(AU)

The culture media sterilization is typically performed by autoclaving. However, this process may degrade or reduce the action of compounds with desired physiological effect, such as vitamins and growth regulators. This study aimed to evaluate the effect of sterilizing agents added to the culture medium in vitro mume 'Rigitano' establishment. For this purpose, nodal segments were inoculated into culture medium prepared considering the following treatments: addition of sodium hypochlorite (0.01 and 0.05 % v/v), chlorine dioxide (0.1, 0.5 and 1% v/v) or hydrogen peroxide (0.3, 0.7 and 1.5 %, v/v). The control treatment consisted of the absence of sterilizing, autoclaved and non-autoclaved. In different periods (7, 14 and 21 days), it was determined survival explants, whole contamination, contamination by bacteria, fungi contamination and oxidation. It was found ocurrence of Alternaria, Cladosporim, Penicillium, Trichoderma and Cryptococcus fungal genera. It was conclude that the use of hydrogen peroxide or chlorine dioxide is effective for the chemical sterilization of culture media.(AU)