Povidone-iodine is also efficient against fungi and viruses (including HIV and "Herpes simplex"). It is used in pleurodesis (fusion of the pleura because of incessant pleural effusions). For this purpose, povidone-iodine is equally effective and safe as talc, and may be preferred because of easy availability and low cost. There is tentative evidence that chlorhexidine and denatured alcohol used to clean skin prior to surgery is better than povidone-iodine with alcohol; however, the evidence is not strong enough as of 2015 to determine routine practice. PVP-I is contraindicated in patients with hyperthyroidism (overactive thyroid gland) and other diseases of the thyroid,
Iodine east of Tokyo and the American Anadarko Basin gas field in northwest Oklahoma are the two largest such sources. The brine is hotter than 60 °C from the depth of the source. The brine is first purified and acidified using sulfuric acid, then the iodide present is oxidised to iodine with chlorine. An iodine solution is produced, but is dilute and must be concentrated. Air is blown into the solution to evaporate the iodine, which is passed into an absorbing tower where sulfur dioxide reduces the iodine. The hydrogen iodide (HI) is reacted with chlorine to precipitate the iodine. After