A fascinating new study in AJIC suggests that adding a disinfectant to the toilet bowl before flushing results in a significant reduction in viral contamination of a bathroom. Does this mean we should disinfect the loo before flushing it?
The study used MS2 coliphage as a proxy marker of pathogenic virus contamination. The degree of surface contamination of the bathroom was assessed with and without adding the phage to the toilet bowl (at a high concentration of 10^12) before flushing. The bathroom was heavily contaminated with the phage when it was added to the toilet bowl; surfaces were contaminated up to a concentration of 10^6 per 100cm2. Then, the experiments were repeated but this time disinfectants were added to the bowl before flushing: 5-10% hypochlorite, 0.5-2% hydrogen peroxide, QAC, or 0.23% peracetic acid. Perhaps surprisingly, the hypochlorite had limited impact on the concentration of phage in the toilet bowl until a contact time of 30 minutes, whereas both QAC and peracetic acid resulted in a ~2-log reduction with only a 1 minute contact time. The hydrogen peroxide made a limited impact on the concentration of phage at any concentration or contact time.
So does this mean we should disinfect the toilet bowl before flushing? The major problem with this is that the toilet bowl will be full of bodily fluids and organic matter (well, it's what the toilet is for), so there's a big risk that any attempt to disinfect the toilet bowl immediately before flushing are unlikely to reduce contamination of the bathroom. The author did attempt to simulate waste in the bowl using a microbiological culture broth - but I suspect the real thing would be a tougher challenge! However, this study does illustrate the risk of contaminating the bathroom with viral aerosol through toilet flushing, and argues for regular (perhaps more regular) disinfection of the toilet bowl!