You’ve probably spotted antiviral tissues in the paper goods aisle at your local grocery store. And if you’ve got any kind of science-focused Spidey sense it’s entirely possible they’ve set off pseudoscience alarm bells.
After all, antivirals are usually reserved for prescription-only medications that are used to treat the only most dire cases of flu. And, while you’re right to be skeptical (because honestly we should all always be skeptical of everything), digging into the science reveals antiviral tissues actually do what they claim and inactivate viruses.
Manufactured by Kleenex, and on store shelves since 2004, antiviral tissues are actually patented and approved by the EPA. While their ingredients do not include prescription antiviral medications, the active substances inside the tissues are citric acid and sodium lauryl sulfate, a chemical found in many soaps.
Though the packaging claims to “kill” viruses, what these substances actually do is inactivate them because viruses aren’t alive—they just hijack our cells for their own purposes. In fact, according to Vincent Racaniello, a microbiologist and virus expert at the Mt. Sinai School of Medicine of CUNY, has personally seen citric acid actually “exploding” viruses upon contact in his lab.
But there are a few caveats here. First, these tissues do not inactivate all cold and flu viruses; they are only effective against Rhinoviruses Type 1A and 2 (a few varieties of the cold), Influenza A and B (aka some flu), and respiratory syncytial virus (RSV, which causes respiratory infection in children and babies).
Second, according to David Koenig, a microbiologist and the research technical lead in the Life Sciences group at Kimberly-Clark, which manufactures Kleenex, the antiviral tissues are actually made up of three layers, with the active ingredients only present on the middle layer.
“What this is actually for is when the viruses of interest get into that ply,” he says. “The action is in the center layer and that’s where it occurs.” So the tissues are not going to be effective at killing viruses if you, say, use them to wipe off a surface or accidentally get some snot on your hands.
Koenig says the tissues were inspired by the fact that in Kimberly-Clark’s research, 74 percent of their customers found themselves in a situation where they couldn’t throw their tissue out right away. “I’ve been there,” he says, describing a situation where you have to blow your nose but can’t find a trash can. “Guess where you put that? In your purse, in your pocket, on a surface. This is making sure the stuff in the tissue is inactivated.”
But Racaniello and Koenig stress the fact that these tissues are only going to prevent the spread of disease from contact with the actual tissue itself. Both microbiologists say even after using the tissue you should still wash your hands and, Koenig adds, dry them thoroughly. “You should make sure your hands are really dry. If they’re wet you greatly increase the ability to transfer organisms back and forth. Drying your hands is the best way to reduce the fact that when you touch something you don’t pick up things on a surface or deposit things,” he says.
Racaniello, who admits he thought the antiviral tissues are “silly,” points out that the vast majority of viruses are passed between people through the air. “The majority of transmission is by aerosol and this is not going to help with that. The simple act of breathing generates huge aerosols,” he said.
And there’s the big point: If you already have a cold or flu, these tissues aren’t going to cure you. Even if you eat them (which really you should not do). “Rhinoviruses don’t go to your stomach,” he says.
Despite the caveats, there’s a reasonable argument to made for using these tissues if you regularly find yourself picking up other people’s snotty leftovers. Nurses, caregivers, teachers, and parents, for example, would likely protect themselves a bit from the transmission of cold and flu by having these around. All you really have to do is briefly imagine a toddler, who probably isn’t great at hygiene and throwing away garbage, handing you over a used snotty tissue to see that these are going to make a difference.