Paper Money and Coins as Potential Vectors of Transmissible Disease

Emmanouil Angelakis; Esam I Azhar; Fehmida Bibi; Muhammad Yasir; Ahmed K Al-Ghamdi; Ahmad M Ashshi; Adel G Elshemi; Didier Raoult


Future Microbiol. 2014;9(2):249-261. 

In This Article


Money can provide an indirect route for hand-to-hand contamination, and hand washing is critical after handling money if a clinical or food preparation procedure is to be performed. Many pathogenic or antibiotic-resistant bacteria have been isolated from various coins and paper money collected from medical staff and food handlers.[2] Moreover, the possibility that terrorists could contaminate banknotes with pathogens and then put those notes back into circulation has been proposed.[67] As a result, microbial testing of banknotes and replacement of contaminated notes, and the regular withdrawal of damaged notes by federal authorities is recommended. Antimicrobial polymer materials can also be used in the manufacture of banknotes and banknote paper can be treated with antimicrobial-active compounds, which prevent the growth of microorganisms on banknotes and consequently limit risks of contamination during handling.[68] In addition, the banknote paper can be treated with metallic ions, which are known to have a wide range of antibacterial properties.

Hands are the most important fomites for the spread of nosocomial infection. Alcohol-based hand rubs can improve compliance with hand hygiene and reduce the transmission of pathogenic agents.[69] In addition, routine surface disinfection is crucial to control the spread of nosocomial pathogens. However, the disinfection and hygiene intervention studies conducted so far could not determine a definitive causal relationship due to the lack of statistical significance, presence of confounding factors or absence of randomization.[1,70]

An essential measure for preventing food-borne outbreak is hygiene training for food handlers. Many food outlets heavily rely on the exchange of money for food. The possibility that the handling of money might result in food contamination should bring about changes regarding how foods are handled and traded. Appropriate and regular hand hygiene, particularly after toilet visits and handling money, is critical. In addition, food-handling tools can help prevent cross-contamination occurring between money and food through contact with the hands if workers cannot or will not wash hands between tasks. Routine vaccination of food handlers for HAV infection can reduce the foodborne transmission of HAV.