In 2002 the U.S. Environmental Protection Agency (EPA) was searching for a way to stop the spread of deadly diseases in hospitals. They knew that disease germs are spread mainly by touch.
EPA Administrator
January 26, 2005 –
January 20, 2009
A patient with an infectious disease, for example, touches bed rails, tray tables, chair arms, faucets and other surfaces, contaminating the surfaces with disease germs from their fingers. A nurse or visitor who later touches those surfaces spreads the germs to other surfaces with their own fingers. The germs soon reach the rooms of other patients, infecting them with an illness they didn’t have when they came to the hospital.
Such illnesses are called “hospital-acquired infections.” They have become more widespread and dangerous because many germs have become resistance to antibiotics.
Earlier university research had suggested that germs could not survive on copper surfaces. EPA sponsored tests confirmed this. Under Administrator Stephen L. Johnson, the EPA approved the registration of copper as antimicrobial, officially stating that copper is capable of killing harmful, potentially deadly microbes. Copper is the first solid surface material to receive this type of EPA registration.
Since then a huge outpouring of research from universities, hospitals, and labs around the world proves that copper kills viruses and bacteria rapidly just by touch.
These are some of the scientists whose research results, along with others, helped inspire the idea for CopperZap.
Professor C W Keevil, Director of the Environmental Healthcare Unit in the School of Biological Sciences, and his team at the University of Southampton, examine survival rates of deposits of pathogens (including MRSA, E Coli, Listeria monocytogenes, Influenza A (H1N1), Aspergillus niger, Clostridium difficile) on stainless steel (the metal most commonly used in healthcare and food processing institutions) and on a range of copper alloys.
Dr. Christopher Rensing. While at the University of Arizona, Dr. Rensing demonstrated that copper starts killing microbes in less that a minute after direct contact with a copper surface. He coined the term “contact killing” for the effect of copper on microbes.
Dr. Gregor Grass, Institut für Mikrobiologie der Bundeswehr. General research interests are in microbe-metal interactions. One focus of his research is concerned with the mode-of-antimicrobial action exerted by metallic copper surfaces.
Dr. Patrick Pina, Hôpital de Rambouillet. Assessment of copper as an adjunct to standard infection control practices in the intensive care and paediatric units. The Centre hospitalier de Rambouillet fitted bed rails, trolleys, taps, handrails, door handles and push plates made of copper and copper alloys.
Dr. Takeshi Sasahara, Kitasato University. Dr. Takeshi Sasahara is an Assistant Professor at the Kitasato University School of Medicine. He belongs to the Department of Microbiology and Parasitology. His speciality is Environmental Microbiology and Infection Immunology.
Professor Shaheen Mehtar, University of Stellenbosch. In the preliminary phase of the African Health Care Initiative, a team of specialist scientists from the University of Stellenbosch, led by internationally renowned Infection Control Specialist, Professor Shaheen Mehtar, proved for the first time internationally via in vitro testing of clinical strains that copper touch surfaces are effective in killing multi-drug resistant bacteria including tuberculosis.
In the Resource Links are research by universities, hospitals, and government showing solid copper kills bacteria and viruses on contact in minutes and suggesting how to stop a cold and other illnesses.
Researchers have identified over 100 microbial pathogens that are killed by copper, including cold and flu viruses, MRSA, E.coli, C.diff, VRE, and Krebsiella. The CDA said so far no micro-organisms have been found that are not killed or inactivated by copper.
Copper’s effect on cold viruses in particular suggests a new way to stop colds, by rubbing solid copper briefly and gently in the inner nostril where cold viruses tend to multiply before producing full-blown symptoms. Anecdotal evidence from CopperZap users indicates this is a safe and effective way to stop or prevent a cold.
Copper has been used for thousands of years for purifying water and disinfecting wounds, but only recently have scientists figured out ways it may work. A leading theory is that when copper touches a microbe, the high electrical conductance of the copper pops tiny holes in the outer membrane of the microbe cell and kills it quickly.
Many hospitals have tested solid copper as a replacement for touch-surfaces such as patient bed rails, tray tables, chair arms, doorknobs, faucets, etc. In the wards tested, hospital-acquired infections have dropped dramatically.
CopperZap™ extends the application with a handheld personal implement for touching copper to the inside of your nose and to your fingers and hands. CopperZap is solid copper, 99.9% pure for maximum effect, with a comfortable nasal wand for safe use in your nose, where many disease germs multiply before they make you sick.
Use before, after, and during time in a hospital, whether as a patient, visitor, or healthcare worker. Rub your hands on the copper to kill germs on your skin and reduce the chance you will transfer disease to yourself or others. Gently rub the smooth tip in your nostril to get rid of staph germs, cold viruses, and other microbes growing there.
If you touch your face, rub the tip just inside your nostril and rub the handle around your nose and on your cheeks. By intercepting microbes on their way to your nose or mouth you may avoid illness.
Research suggests that staph germs are already present in many people’s noses. These germs may include antibiotic resistant strains such as MRSA, which can become dangerous or deadly if transferred by touch to an open cut, wound, or surgical site. EPA studies show that solid copper kills MRSA swiftly.
Copper is a powerful new ally in the fight to reduce the spread of infectious illness in hospitals, schools, daycare, at work, on airplanes, and even at home.
Use all standard infection control practices, and add copper to protect yourself and those you love. Use CopperZap. If you don’t think it works, return it within 90 days for a full refund including shipping both ways.
Science confirms, copper zaps germs. The science behind CopperZap™ is strong.
Copper Kills Viruses and Bacteria
Decades of scientific research have demonstrated over and over that copper kills germs on contact.[A22][W1] (A list of micro-organisms found to be killed, inactivated, or inhibited by copper appears in the Appendix at the bottom of this article.)
“The antimicrobial activity of copper and copper alloys is now well established, and copper has recently been registered at the U.S. Environmental Protection Agency (EPA) as the first solid antimicrobial material.”[B2]
“Science supporting the EPA registration … has sparked a global campaign advocating the use of these materials to improve infection control in healthcare facilities, mass transit, educational institutions and beyond. … The only solid antimicrobial touch surface approved by the EPA. Never wears out. … Natural tarnishing does not impair efficacy. Safe to use. Not harmful to people or the environment. … Completely recyclable.”[3]
“Antimicrobial Copper surfaces in hospital rooms can reduce the number of healthcare-acquired infections by 58 percent.”[4] (“Antimicrobial Copper” is a trademark of the Copper Development Association.)
“The surfaces of copper and its alloys, such as brass and bronze, are antimicrobial. They have an inherent ability to kill a wide range of harmful microbes relatively rapidly with a high degree of efficacy. These antimicrobial properties have been demonstrated by an extensive body of research.”[W5]
“Metallic copper surfaces kill microbes on contact, decimating their populations, according to a paper in the February 2011 issue of the journal Applied and Environmental Microbiology. They do so literally in minutes, by causing massive membrane damage after about a minute’s exposure, says the study’s corresponding author, Gregor Grass of the University of Nebraska, Lincoln.
“When microbes were exposed to copper surfaces, we observed contact killing to take place at the rate of tens to hundreds of millions of bacterial cells within minutes, says Grass. This means that usually no live micro-organisms can be recovered from copper surfaces after exposure.”
“The healing power of copper has been recognized for thousands of years. More than 4,000 years ago, the Egyptians used it to sterilize wounds and drinking water and the Aztecs treated skin conditions with the metal. The ancient Greeks also knew of its benefits. Hippocrates, sometimes called ‘the father of medicine’, noted that it could be used to treat leg ulcers. Today, copper is a common constituent in medicines including antiseptic and antifungal creams.”
“Copper is considered safe to humans, as demonstrated by the widespread and prolonged use of copper intrauterine devices (IUDs) by women. In contrast to the low sensitivity of human tissue (skin or other) to copper, microorganisms are extremely susceptible to copper.”
Copper Kills Cold and Flu Viruses and Many Others
Copper inactivates Rhinovirus 2, which causes colds, and Influenza A, which causes flu.[10] Copper kills coronaviruses, which are a cause of the common cold and pneumonia.[1a] Copper is used in advanced surgical masks as part of a defense against cold and flu viruses and other pathogens.[9] Copper can help prevent colds and flu.[11] Copper has potent virucidal properties.[A19]
Copper kills many other pathogens (harmful viruses and bacteria), including ones that are highly resistant to antibiotics. Studies show copper kills MRSA, C.Diff, E.Coli, Fungi, and even Adenovirus, which is said to be one of the most difficult viruses to inactivate and is a cause of pneumonia and bronchitis.[W1] Studies show copper also kills MTB, which is considered extremely multi-drug resistant, as well as pathogens responsible for Staph infections[5], Salmonella, Klebsiella, and others.[B2]
In March 2013 a representative of the Copper Development Association, which has coordinated much of the recent research as steward of the EPA registration activities, told us researchers have yet to find any type of germ that is not killed by physical contact with bare copper. By contrast, a number of the studies cited note that on stainless steel and other surfaces harmful microorganisms can live for weeks or even months.
No germs are believed to have developed resistance to copper, even though humans have used copper for over 4000 years. Copper is even effective against newly evolved antibiotic-resistant strains of old public health enemies.[12]
“Natural tarnishing does not impair the bacteria killing power of Antimicrobial Copper. EPA registrations 85012, 1-6.”[13] (“Antimicrobial Copper” is a trademark of the Copper Development Association.)
Copper Reduces Germs Transferred by Touch
Scientists are actively demonstrating the intrinsic efficacies of copper alloy “touch surfaces” to destroy a wide range of micro-organisms that threaten public health.[W1]
Scientists have accumulated substantial knowledge regarding the antimicrobial properties of copper alloy touch surfaces, including results of clinical trials conducted at hospitals around the world, resulting in registration by the U.S. Environmental Protection Agency of various different copper alloys as “antimicrobial materials” with public health benefits.[W5]
“Copper eliminates bacteria from skin.”[14]
“Copper has potent biocidal properties. Copper ions, either alone or in copper complexes, have been used for centuries to disinfect liquids, solids and human tissue.”[10]
“Once surfaces are contaminated with virus particles, fingers can transfer particles to up to seven other clean surfaces…. Because of copper’s ability to destroy influenza A (flu) virus particles, copper can help to prevent cross-contamination of this viral pathogen.”[W1]
“Antimicrobial copper surfaces can reduce the number of hospital-acquired infections (HAIs) by 58% as compared with touch surfaces that do not use copper, according to a new study.”[15] (“Antimicrobial Copper” is a trademark of the Copper Development Association.)][10], Yellow Fever[A19]
Pure Copper Works Better Than Copper Alloys
The germ-killing power of copper alloys is correlated with the percent of copper in the alloy.[W1] The higher the copper content the better. Some of the EPA-registered alloys are as low as 60% copper. CopperZap™ is made from 99.9% pure solid copper, which is indicated to have the greatest power to kill bacteria and viruses.
Such pure copper is harder to machine and harder on tooling than copper mixed with other metals. We put in a lot of effort to overcome these problems, however, so we could use the most potent form of copper in CopperZap™.
How Copper Works
Scientists have identified a number of ways copper can destroy bacteria and viruses. One is electrical.
Copper is highly conductive to electricity. “Every cell’s outer membrane, including that of a single cell organism like a bacterium, is characterized by a stable electrical micro-current. This is often called ‘transmembrane potential’, and is, literally, a voltage difference between the inside and the outside of a cell. It is strongly suspected that when a bacterium comes in contact with a copper surface, a short circuiting of the current in the cell membrane can occur. This weakens the membrane and creates holes.”[16]
In other words, copper zaps the cell.
Copper is the second most conductive metal after silver. Silver also kills microbes on contact, but silver is highly toxic and too dangerous to use on mucous membranes. (Zinc, the third most conductive metal, is also known to kill germs but is also potentially toxic. The FDA has warned that zinc can damage the sense of smell. Some people say it has also affected their sense of taste and can cause nausea.)
Copper alloys with even a very small amounts of other metals mixed in are not as conductive as pure copper. The fact that pure copper works better than other copper alloys supports the idea that electrical conductivity is a source of the power of copper to reduce the spread of infectious illness.
Other ways copper affects germs involve oxides, enzymes, proteins, and copper ions, which are released from the copper and suffuse into the fluid around the germs.
“Another way to make a hole in a membrane is by localized oxidation or ‘rusting.’ This happens when a single copper molecule, or copper ion, is released from the copper surface and hits a building block of the cell membrane (either a protein or a fatty acid). If the ‘hit’ occurs in the presence of oxygen, we speak of ‘oxidative damage,’ or ‘rust.’ An analogy is rust weakening and making holes in a piece of metal.
“After punching holes, how do copper ions further damage the cell?
“Now that the cell’s main defense (its outer envelope) has been breached, there is an unopposed stream of copper ions entering the cell. This puts several vital processes inside the cell in danger. Copper literally overwhelms the inside of the cell and obstructs cell metabolism (i.e., the biochemical reactions needed for life). These reactions are accomplished and catalyzed by enzymes. When excess copper binds to these enzymes, their activity grinds to a halt. The bacterium can no longer ‘breathe’, ‘eat’, ‘digest’ or ‘create energy’.
“How can copper’s effect be so fast, and affect such a wide range of micro-organisms?
“Experts explain the speed with which bacteria perish on copper surfaces by the multi-targeted nature of copper’s effects. After membrane perforation, copper can inhibit any given enzyme that ‘stands in its way,’ and stop the cell from transporting or digesting nutrients, from repairing its damaged membrane, from breathing or multiplying. It is also thought that this is why such a wide range of micro-organisms are susceptible to contact action by copper.”[16]
According to Guillermo Figueroa of the nutrition and food technology department of the University of Chile in Santiago, it’s the ions, or atoms, released by the copper that kill bacteria. “Copper ions separate on contact with bacteria and cause irreversible damage to the bacteria’s cells,” Figueroa said. “It is a very swift, physical chemical process. They die quickly.”[17]
“At the current state of knowledge, it appears that contact killing proceeds by successive membrane damage, copper influx into the cells, oxidative damage, cell death, and DNA degradation.”[B2]
The Idea for CopperZap™
The science above has led to rising use of solid copper touch surfaces in healthcare facilities such as hospitals. These are “community” touch surfaces, meaning surfaces that are touched by numerous people. If patients or healthcare workers have pathogens on their fingers and touch a copper surface, they leave some of the pathogens on the copper. The copper kills the pathogens rapidly, which helps protect the next person who touches that surface and helps reduce the spread of the pathogen.
But the person who left some pathogens on the surface still has some on their fingers. People naturally touch their faces many times a day, so the person may deposit some of the pathogens near their nose before they next wash their hands. From there the pathogens have a short trip to the nose, their “happy valley” where they can accumulate and multiply, make the person ill, and cause the person to later spread pathogens to others, including their families.
So the idea came up that a “personal” copper touch surface might increase protection both in and out of healthcare settings by attacking pathogens directly on the skin. When a person touches a community touch surface, the contact is usually quite brief and only reaches a small portion of the fingertips. With a personal copper touch surface, on the other hand, carried on the person or available close by, a person could rub their fingers on it for 60 seconds and touch the copper to the entire area of the fingertips.
Also, pathogens deposited on a community touch surface are usually in a gob or film of moisture or mucous, saliva or other medium. The copper is only in direct contact with the first layer of pathogens. It takes time for the other pathogens to come in direct contact or to be reached by copper ions diffusing through the medium. By rubbing fingers on a personal touch surface, on the other hand, the medium gets spread around and the copper can directly contact many more of the pathogens, so destruction of pathogens should be more complete in a shorter time.
In community touch surfaces, solid copper reduces germs on the surface. But in a personal touch surface, solid copper may help reduce germs on the skin, not just on the surface. Preliminary research described below gives support to this idea.
The idea for CopperZap™ first arose, however, as a way to apply a virus-killing metal by touch in the nose to stop colds, without the side effects of nasal gels or sprays. Colds generally occur after cold viruses incubate for a time in the inner cavity of the nostril. During the incubation period, some people begin to feel a tickle in their nose that feels different from allergies and warns that a cold is about to start. It makes logical sense that applying solid copper, which is known to kill viruses, should beat back the cold virus and allow the immune system to quickly gain the upper hand.
The logic led to the idea of a solid copper nasal wand with a tip that can be rubbed gently along the valley in the bottom of the inner cavity of the nostril. That’s where the cold virus first collects, replicates, and multiplies before the cold starts. By rubbing for 60 seconds, the copper tip touches a large number of the viruses. Some of the studies cited above noted that copper kills viruses faster at warmer temperatures. The inside of the nostril is warmer than the temperatures at which most of the studies were conducted, so the virus-killing should be even faster. Preliminary research cited below supports the idea that a solid copper nasal wand can prevent a cold if applied at the first warning tickle.
Some people, however, do not notice a tickle in the nose and don’t realize a cold is coming on until a later sign appears, like a scratchy throat or congestion. These are believed to happen as the viruses start to spread out from the valley of the nostril. The logic suggests that you can still stop the cold if you apply copper right away. You can still destroy a large portion of the virus population, especially if you repeat the application several times, even though you many not reach the virues that have spread into the throat or the upper portion of the nose. By greatly reducing the number of viruses where they incubate, our preliminary research suggests, you may give the immune system a better chance to get ahead of the cold and stop it before major symptoms appear.
Once full-blown symptoms appear, the viruses have spread out so much that it is probably too late to completely stop the cold. Copper can still destroy a large number of viruses in the nostril, which may allow the immune system to get ahead of the rest of the viruses sooner and thereby mitigate the severity and/or reduce the duration of the cold. Preliminary research cited below supports this idea.
If a solid copper nasal wand is combined with a solid copper handle, a person trying to prevent a cold also naturally touches their fingers and thumb to the handle, which should reduce the chance they could recontaminate themselves with their fingers or spread any infectious illness to others.
CopperZap™ combines a solid copper nasal wand with a solid copper touch surface handle to create a single low-cost device for personal use.
Preliminary Research
A number of people have tried solid copper when they felt they were getting a cold. They gently rubbed a solid copper wand for about 60 seconds in each nostril. The ones who did so early, before significant cold symptoms developed, all reported they did not get the cold. It appears copper killed enough cold viruses to stop the cold completely, or to help the immune system to do so.
Some other people who tried it already had significant cold symptoms by the time they applied copper. Of those, all said they believed the cold was less severe or did not last as long as they expected based on their past experience with colds. More research is needed, but it seems in those cases the cold viruses had already spread out from the nostrils into the throat, up to higher portions of the nose, or to the sinuses. Yet by zapping a number of viruses in the nostrils, the copper may have allowed the immune system to gain the upper hand more quickly.
Solid copper seemed to work in a similar manner against flu if the flu starts in the nose, though flu takes more applications over a longer period than colds do. A small number of people reported signs more consistent with oncoming flu than cold. Those who applied copper frequently over 2-3 days reported the flu never fully developed and all signs were gone by day 3 or 4. As with colds, however, it was important to start using copper as early as possible after noticing the first signs. Cases of apparent flu that start in the throat, rather than the nose, did not seem responsive to copper in the nose, although persistent application of solid copper in the nose may have reduced the congestion that sometimes develops later during a flu that started in the throat.
In a small preliminary test, we found that a residue of copper remained in the nostrils and also on the fingers and thumb after rubbing with copper for about 60 seconds. We expected the residue to be absorbed over time. We found that on the fingers and thumb, the residue declined by about 40% in the first 20 minutes. In the nostril, the residue declined by about 60% in the first 20 minutes, presumably because mucous membranes absorb faster than skin.
In a small preliminary lab test, participants who rubbed their fingers and thumbs on clean solid copper for 60 seconds showed a significant reduction in bacteria on fingers and thumbs 15 minutes later, compared with participants who rubbed their fingers and thumbs on stainless steel.
More research is needed, so we plan to provide free CopperZaps™ for testing by qualified researchers upon approval of research protocols. Contact us: info@CopperZap.com.
Ergonomic Shape
The tip of CopperZap is smooth and comfortable to apply gently in the inner cavity of the nostril. It is shaped to reach easily into the valley in the bottom of the nostril, where viruses collect and replicate.
The handle of CopperZap is smooth and contoured to achieve maximize contact with the fingers and thumb and to be easy and comfortable to rub while holding in one hand. A solid copper personal touch surface may protect against pathogens received on the hands, especially in hospitals, doctor’s offices, day care, or after handling money. It may also reduce the chance of spreading infectious illness to family members, friends, co-workers, and others.
The handle is also comfortable to rub on the face around the nose and mouth where airborn germs may land or where people may touch their faces, which people do much more often than most of us realize. The touch of solid copper on the face may reduce the number of pathogens reaching the nose.
All surfaces of CopperZap have a fine microscopic texture to increase the surface area contact with microbes for faster and more thorough effect. The texture is so fine the surfaces still feel smooth on the skin and in the nose.
We Want User Feedback
If you try CopperZap™, please tell us about your experience on our research form, or contact us directly, or call or write to us as follows:
CopperZap LLC
5151 E Broadway Blvd Suite 1600
Tucson AZ 85711-3777 USA
520-512-5474, fax 520512-5401
info@copperzap.com
Appendix: Partial List of Micro-organisms Found To Be Killed, Inactivated, or Inhibited by Solid Copper or Copper Compounds, Solutions or Filters.
Achromobacter fischeri[W1], Acinetobacter baumanii[B2][W5][10], Acinetobacter johnsonii[B2], Actinomucor elegans[W1], Adenovirus Type 1[W1][W5][A19], Aspergillus carbonarius[10], Aspergillus flavus[B2], Aspergillus fumigatus[B2][10], Aspergillus niger[W1][B2][10], Aspergillus oryzae[10], Aspergillus spp.[W1][A8][10][20], Bacillus macerans[10], Bacillus megaterium[W1], Bacillus subtilis[W1][10], Bacterium linens[W1], Brachybacterium conglomeratum[B2], Brevibacterium erythrogenes[W1], C. difficile (Clostridium difficile)[W1][B2][W5][10], Campylobacter jejuni[B2][A8][10], Candida albicans[W1][B2][W5][10], Candida utilis[W1], Citrobacter[10], Coxsackie virus types B2 & B4[A8][10], CRS (Ciprofloxacin-resistant Staphylococcus)[B2], Cryptococcus neoformans[10], Cytomegalovirus[A19], D. radiodurans (Deinococcus radiodurans)[B2][6], E. coli (Escherichia coli, including E. coli O157:H7)[W1][B2][W5][A8][10][20], EMRSA[B2], Echovirus 4[A8][10], Enterobacter aurogenes[W5], Enterococci[10], Enterococcus faecalis[A8]Enterococcus hirae[B2], Enterococcus spp.[B2][W5], Epidermophyton floccusum[10], Fusarium culmonium[B2], Fusarium oxysporum[B2], Fusarium solani[B2], Fusarium spp.[W1], Hartmannella vermiformis[A8], HIV-1 (Human Immunodeficiency Virus Type 1)[A8][10][A19], HSV (herpes simplex virus)[A8][10], Infectious Bronchitis Virus[10], Influenza A[W1][B2][W5][A19], Junin Virus[10], Klebsiella pneumoniae[B2][W5][A8][10], Legionella pneumophila[A8][10][20], Listeria monocytogenes[B2][10][20], Measles[A19], Microsporum canis[10], MRSA (Methicillin-resistant Staphylococcus aureus)[W1][B2][W5][A8][15][20], MSSA (Methicillin-sensitive Staphylococcus aureus)[B2], MTB (Mycobacterium tuberculosis)[B2][10], Myrothecium verrucaria[10], Naegleria fowleria[A8], Pantoea stewartii[B2], Parainfluenza 3[A19], Paramecium caudatum[W1], Penicillium chrysogenum[W1][B2], Photobacterium phosphoreum[W1], Pichinde[19], Poliovirus[W1][A8][10][20], Pseudomonas aeruginosa[B2][W5][A8][10], Pseudomonas flouorescens[10], Pseudomonas oleovorans[B2], Pseudomonas striata[10], Punta Toro[A19], Respiratory Syncytial Virus[A19], Rhinovirus 2[A19], Rhizopus niveus[W1], Rothecium verrucaria[10], Saccharomyces cerevisiae[W1][B2][10], Saccharomyces mandshuricus[W1], Salmonella enterica[B2][A8], Salmonella sp. [10], Salmonella typhimurium[10], Shewanella putrefaciens[10], Shigella flexnerii[10], Simian rotavirus SA11[A8][10], Staphylococcus aureus[W5][A8][10][20], Staphylococcus epidermidis[10], Staphylococcus spp.[W5], Staphylococcus warnerii[B2], Streptococcus[W5][10], Streptococcus group D[A8][20], Streptococcus sanguis[A8][10], Tetrahymena pyriformis[A8], Torulopsis pintolopesii[10], Torulopsis utilis[W1], Trichoderma viride[10], Trichophyton mentagrophytes[10], Trichophyton rubrum[10], Tubercle bacillus[W1], Vaccinia[A19], VRE (Vancomycin-resistant enterococci)[B2][W5][15], West Nile Virus[A8][10], Yellow Fever[A19]
