51
|
Rocha-Melogno L, Crank K, Bergin MH, Gray GC, Bibby K, Deshusses MA. Quantitative risk assessment of COVID-19 aerosol transmission indoors: a mechanistic stochastic web application. ENVIRONMENTAL TECHNOLOGY 2023; 44:1201-1212. [PMID: 34726128 DOI: 10.1080/09593330.2021.1998228] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/08/2021] [Indexed: 06/13/2023]
Abstract
An increasing body of literature suggests that aerosol inhalation plays a primary role in COVID-19 transmission, particularly in indoor settings. Mechanistic stochastic models can help public health professionals, engineers, and space planners understand the risk of aerosol transmission of COVID-19 to mitigate it. We developed such model and a user-friendly web application to meet the need of accessible risk assessment tools during the COVID-19 pandemic. We built our model based on the Wells-Riley model of respiratory disease transmission, using quanta emission rates obtained from COVID-19 outbreak investigations. In this report, three modelled scenarios were evaluated and compared to epidemiological studies looking at similar settings: classrooms, weddings, and heavy exercise sessions. We found that the risk of long-range aerosol transmission increased 309-332% when people were not wearing masks, and 424-488% when the room was poorly ventilated in addition to no masks being worn across the scenarios. Also, the risk of transmission could be reduced by ∼40-60% with ventilation rates of 5 ACH for 1-4 h exposure events, and ∼70% with ventilation rates of 10 ACH for 4 h exposure events. Relative humidity reduced the risk of infection (inducing viral inactivation) by a maximum of ∼40% in a 4 h exposure event at 70% RH compared to a dryer indoor environment with 25% RH. Our web application has been used by more than 1000 people in 52 countries as of September 1st, 2021. Future work is needed to obtain SARS-CoV-2 dose-response functions for more accurate risk estimates.
Collapse
Affiliation(s)
- Lucas Rocha-Melogno
- Department of Civil and Environmental Engineering, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
- ICF, Durham, NC, USA
| | - Katherine Crank
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, IN, USA
| | - Michael H Bergin
- Department of Civil and Environmental Engineering, Duke University, Durham, NC, USA
| | - Gregory C Gray
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA
- Global Health Research Center, Duke-Kunshan University, Kunshan, People's Republic of China
- Emerging Infectious Diseases Program, Duke-NUS Medical School, Singapore, Singapore
- Division of Infectious Diseases, University of Texas Medical Branch (UTMB), Galveston, TX, USA
| | - Kyle Bibby
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, IN, USA
| | - Marc A Deshusses
- Department of Civil and Environmental Engineering, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| |
Collapse
|
52
|
Zhang X, Chen Y, Pan Y, Ma X, Hu G, Li S, Deng Y, Chen Z, Chen H, Wu Y, Jiang Z, Li Z. Research progress of severe acute respiratory syndrome coronavirus 2 on aerosol collection and detection. CHINESE CHEM LETT 2023:108378. [PMID: 37362323 PMCID: PMC10039702 DOI: 10.1016/j.cclet.2023.108378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/02/2023] [Accepted: 03/22/2023] [Indexed: 06/28/2023]
Abstract
The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019 has negatively affected people's lives and productivity. Because the mode of transmission of SARS-CoV-2 is of great concern, this review discusses the sources of virus aerosols and possible transmission routes. First, we discuss virus aerosol collection methods, including natural sedimentation, solid impact, liquid impact, centrifugal, cyclone and electrostatic adsorption methods. Then, we review common virus aerosol detection methods, including virus culture, metabolic detection, nucleic acid-based detection and immunology-based detection methods. Finally, possible solutions for the detection of SARS-CoV-2 aerosols are introduced. Point-of-care testing has long been a focus of attention. In the near future, the development of an instrument that integrates sampling and output results will enable the real-time, automatic monitoring of patients.
Collapse
Affiliation(s)
- Xinyu Zhang
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Yuting Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Yueying Pan
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Xinye Ma
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Gui Hu
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Song Li
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Yan Deng
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Zhu Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Hui Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou, 412007, China
| | - Yanqi Wu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, 999078, China
- Shenzhen Lemniscare Med Technol Co. Ltd., Shenzhen, 518000, China
| | - Zhihong Jiang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, 999078, China
| | - Zhiyang Li
- Department of Clinical Laboratory, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China
| |
Collapse
|
53
|
Fortin A, Veillette M, Larrotta A, Longtin Y, Duchaine C, Grandvaux N. Detection of viable SARS-CoV-2 in retrospective analysis of aerosol samples collected from hospital rooms of patients with COVID-19. Clin Microbiol Infect 2023:S1198-743X(23)00135-0. [PMID: 36963565 PMCID: PMC10033144 DOI: 10.1016/j.cmi.2023.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/20/2023] [Accepted: 03/14/2023] [Indexed: 03/24/2023]
Affiliation(s)
- Audray Fortin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Marc Veillette
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Quebec city, QC, Canada
| | | | - Yves Longtin
- Jewish General Hospital & McGill University faculty of medicine, Montreal, QC, Canada
| | - Caroline Duchaine
- Département de biochimie, microbiologie et bioinformatique, Université Laval et Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Quebec city, QC, Canada
| | - Nathalie Grandvaux
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada & Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
| |
Collapse
|
54
|
Cruz JP, Balay-Odao EM, Bajet JB, Mesde J, Alotaibi K, Almogairi A, Alquwez N, Alqahtani M, Almansour AM, Alasiry S, Alotaibi JS. Face Mask Use and Social Distancing Attitude of Healthcare Students: A Multi-Disciplinary Study. Healthcare (Basel) 2023; 11:healthcare11060901. [PMID: 36981558 PMCID: PMC10048679 DOI: 10.3390/healthcare11060901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
This multi-disciplinary, cross-sectional, and descriptive study investigated health care students' face mask use knowledge, attitude, and practices (KAP) and social distancing attitudes. The study was carried out from October to December 2021 and surveyed 543 health care students selected via convenience sampling from the three Shaqra University campuses in Saudi Arabia. Standard multiple linear regressions were conducted on face mask use KAP and social distancing attitude to identify their significant associated factors. The students in this study had poor knowledge and a neutral attitude towards and modest use practices of face masks during the COVID-19 pandemic. Being female, being a nursing student, and having greater self-reported COVID-19-prevention knowledge were related to higher levels of face mask use knowledge. Having higher face mask use knowledge was linked to better attitude and practice. Knowledge of COVID-19 and its prevention and decreased COVID-19 risk perception were associated with better face mask use practices. The students had more positive than negative attitudes toward social distancing. Having known someone who was infected by the virus, lower risk perception, and better face mask use practices were associated with more positive social distancing attitudes. The findings imply the need to ensure that future health care practitioners are knowledgeable, have a positive attitude and good practices concerning face mask use, and have positive attitudes toward social distancing. The study implications are relevant for health care education in Saudi Arabia and elsewhere.
Collapse
Affiliation(s)
- Jonas Preposi Cruz
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
| | - Ejercito Mangawa Balay-Odao
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
- School of Advanced Studies, Saint Louis University, Baguio 2600, Philippines
| | - Junel Bryan Bajet
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Jennifer Mesde
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Khalaf Alotaibi
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Ahmed Almogairi
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Nahed Alquwez
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Mohammed Alqahtani
- College of Applied Medical Sciences, Department of Nursing, King Faisal University, Alahsa 31982, Saudi Arabia
| | - Ahmed Mansour Almansour
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Sharifa Alasiry
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Jazi Shaydied Alotaibi
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| |
Collapse
|
55
|
Raymenants J, Geenen C, Budts L, Thibaut J, Thijssen M, De Mulder H, Gorissen S, Craessaerts B, Laenen L, Beuselinck K, Ombelet S, Keyaerts E, André E. Indoor air surveillance and factors associated with respiratory pathogen detection in community settings in Belgium. Nat Commun 2023; 14:1332. [PMID: 36898982 PMCID: PMC10005919 DOI: 10.1038/s41467-023-36986-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
Currently, the real-life impact of indoor climate, human behaviour, ventilation and air filtration on respiratory pathogen detection and concentration are poorly understood. This hinders the interpretability of bioaerosol quantification in indoor air to surveil respiratory pathogens and transmission risk. We tested 341 indoor air samples from 21 community settings in Belgium for 29 respiratory pathogens using qPCR. On average, 3.9 pathogens were positive per sample and 85.3% of samples tested positive for at least one. Pathogen detection and concentration varied significantly by pathogen, month, and age group in generalised linear (mixed) models and generalised estimating equations. High CO2 and low natural ventilation were independent risk factors for detection. The odds ratio for detection was 1.09 (95% CI 1.03-1.15) per 100 parts per million (ppm) increase in CO2, and 0.88 (95% CI 0.80-0.97) per stepwise increase in natural ventilation (on a Likert scale). CO2 concentration and portable air filtration were independently associated with pathogen concentration. Each 100ppm increase in CO2 was associated with a qPCR Ct value decrease of 0.08 (95% CI -0.12 to -0.04), and portable air filtration with a 0.58 (95% CI 0.25-0.91) increase. The effects of occupancy, sampling duration, mask wearing, vocalisation, temperature, humidity and mechanical ventilation were not significant. Our results support the importance of ventilation and air filtration to reduce transmission.
Collapse
Affiliation(s)
- Joren Raymenants
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Department of General Internal Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Caspar Geenen
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Lore Budts
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Jonathan Thibaut
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Marijn Thijssen
- Laboratory of Clinical and Epidemiological Virology (Rega Institute), KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Hannelore De Mulder
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Sarah Gorissen
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Bastiaan Craessaerts
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Lies Laenen
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Kurt Beuselinck
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Sien Ombelet
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Els Keyaerts
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Emmanuel André
- Laboratory of Clinical Microbiology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Laboratory Medicine, National Reference Center of Respiratory Pathogens, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| |
Collapse
|
56
|
Groma V, Kugler S, Farkas Á, Füri P, Madas B, Nagy A, Erdélyi T, Horváth A, Müller V, Szántó-Egész R, Micsinai A, Gálffy G, Osán J. Size distribution and relationship of airborne SARS-CoV-2 RNA to indoor aerosol in hospital ward environments. Sci Rep 2023; 13:3566. [PMID: 36864124 PMCID: PMC9980870 DOI: 10.1038/s41598-023-30702-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/28/2023] [Indexed: 03/04/2023] Open
Abstract
Aerosol particles proved to play a key role in airborne transmission of SARS-CoV-2 viruses. Therefore, their size-fractionated collection and analysis is invaluable. However, aerosol sampling in COVID departments is not straightforward, especially in the sub-500-nm size range. In this study, particle number concentrations were measured with high temporal resolution using an optical particle counter, and several 8 h daytime sample sets were collected simultaneously on gelatin filters with cascade impactors in two different hospital wards during both alpha and delta variants of concern periods. Due to the large number (152) of size-fractionated samples, SARS-CoV-2 RNA copies could be statistically analyzed over a wide range of aerosol particle diameters (70-10 µm). Our results revealed that SARS-CoV-2 RNA is most likely to exist in particles with 0.5-4 µm aerodynamic diameter, but also in ultrafine particles. Correlation analysis of particulate matter (PM) and RNA copies highlighted the importance of indoor medical activity. It was found that the daily maximum increment of PM mass concentration correlated the most with the number concentration of SARS-CoV-2 RNA in the corresponding size fractions. Our results suggest that particle resuspension from surrounding surfaces is an important source of SARS-CoV-2 RNA present in the air of hospital rooms.
Collapse
Affiliation(s)
- V Groma
- Environmental Physics Department, Centre for Energy Research, Budapest, 1121, Hungary
| | - Sz Kugler
- Environmental Physics Department, Centre for Energy Research, Budapest, 1121, Hungary
| | - Á Farkas
- Environmental Physics Department, Centre for Energy Research, Budapest, 1121, Hungary
| | - P Füri
- Environmental Physics Department, Centre for Energy Research, Budapest, 1121, Hungary
| | - B Madas
- Environmental Physics Department, Centre for Energy Research, Budapest, 1121, Hungary
| | - A Nagy
- Department of Applied and Nonlinear Optics, Wigner Research Centre for Physics, Budapest, 1121, Hungary
| | - T Erdélyi
- Department of Pulmonology, Semmelweis University, Budapest, 1085, Hungary
| | - A Horváth
- Department of Pulmonology, Semmelweis University, Budapest, 1085, Hungary
- Pest County Pulmonology Hospital, Törökbálint, 2045, Hungary
| | - V Müller
- Department of Pulmonology, Semmelweis University, Budapest, 1085, Hungary
| | | | | | - G Gálffy
- Pest County Pulmonology Hospital, Törökbálint, 2045, Hungary
| | - J Osán
- Environmental Physics Department, Centre for Energy Research, Budapest, 1121, Hungary.
| |
Collapse
|
57
|
Yang YF, Lin YJ, You SH, Lu TH, Chen CY, Wang WM, Liao CM. Control measure implications of COVID-19 infection in healthcare facilities reconsidered from human physiological and engineering aspects. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:36228-36243. [PMID: 36547825 PMCID: PMC9772602 DOI: 10.1007/s11356-022-24815-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
The Wells-Riley model invokes human physiological and engineering parameters to successfully treat airborne transmission of infectious diseases. Applications of this model would have high potentiality on evaluating policy actions and interventions intended to improve public safety efforts on preventing the spread of COVID-19 in an enclosed space. Here, we constructed the interaction relationships among basic reproduction number (R0) - exposure time - indoor population number by using the Wells-Riley model to provide a robust means to assist in planning containment efforts. We quantified SARS-CoV-2 changes in a case study of two Wuhan (Fangcang and Renmin) hospitals. We conducted similar approach to develop control measures in various hospital functional units by taking all accountable factors. We showed that inhalation rates of individuals proved crucial for influencing the transmissibility of SARS-CoV-2, followed by air supply rate and exposure time. We suggest a minimum air change per hour (ACH) of 7 h-1 would be at least appropriate with current room volume requirements in healthcare buildings when indoor population number is < 10 and exposure time is < 1 h with one infector and low activity levels being considered. However, higher ACH (> 16 h-1) with optimal arranged-exposure time/people and high-efficiency air filters would be suggested if more infectors or higher activity levels are presented. Our models lay out a practical metric for evaluating the efficacy of control measures on COVID-19 infection in built environments. Our case studies further indicate that the Wells-Riley model provides a predictive and mechanistic basis for empirical COVID-19 impact reduction planning and gives a framework to treat highly transmissible but mechanically heterogeneous airborne SARS-CoV-2.
Collapse
Affiliation(s)
- Ying-Fei Yang
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, 10617, Taiwan
| | - Yi-Jun Lin
- Institute of Food Safety and Health Risk Assessment, National Yang Ming Chia Tung University, Taipei, 11221, Taiwan
| | - Shu-Han You
- Institute of Food Safety and Risk Management, National Taiwan Ocean University, Keelung City, 20224, Taiwan
| | - Tien-Hsuan Lu
- Department of Environmental Engineering, Da-Yeh University, Changhua, 515006, Taiwan
| | - Chi-Yun Chen
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, 10617, Taiwan
| | - Wei-Min Wang
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, 10617, Taiwan
| | - Chung-Min Liao
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, 10617, Taiwan.
| |
Collapse
|
58
|
Inactivation of replication-competent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on common surfaces by disinfectants. Infect Control Hosp Epidemiol 2023; 44:504-506. [PMID: 35078553 PMCID: PMC8828396 DOI: 10.1017/ice.2021.527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This experimental laboratory-based study evaluated two disinfectants' efficacy against replication-competent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) on three surfaces. Disinfectants were effictive at eliminating the presence, viability, and subsequent replication of SARS-CoV-2 on all surfaces. Although SARS-CoV-2 likely spreads primarily via airborne transmission, layered mitigation should include high-touch surface disinfection.
Collapse
|
59
|
Chaussade S, Pellat A, Chamseddine A, Corre F, Coriat R. Airborne transmission of SARS-Cov2: What consequences for digestive endoscopy? United European Gastroenterol J 2023; 11:171-178. [PMID: 36700355 PMCID: PMC10039792 DOI: 10.1002/ueg2.12355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/07/2022] [Indexed: 01/27/2023] Open
Abstract
The SARS-Cov-2 disease disrupted essential hospital procedures, such as gastrointestinal (GI) endoscopy, due to concerns about air transmission and the risk of exposing health care workers. With the spread of the pandemic, air transmission was considered as the main source of SARS-Cov2 transmission. This raised the problem of transmission by aerosolization of viral particles in operating rooms as well as endoscopy units. This is in line with the known airborne transmission of many other respiratory viruses. The risk of SARS-Cov-2 transmission during GI endoscopy was initially reduced by controlled measures, involving personal protections (mask…), restricted access to endoscopy rooms, and detection of infected patients. Gastrointestinal endoscopy generates aerosols, which may carry viruses. In addition, the endoscopy system may facilitate the diffusion of virus particles or fomites considering the forced-air cooling system used to maintain a stable temperature inside the box (25°C). The volume of air that goes through the light source box is high (240-300 m3 for a 1-h period). Moreover, the light system contains an air pump to inflate air inside the gut lumen. In order to isolate people from hazard, different levels of protection and solutions to avoid airborne transmission of microorganisms should be proposed, such as the reinforcement of personal protective equipment, the change in the way people work and engineering control of the risk.
Collapse
Affiliation(s)
- Stanislas Chaussade
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| | - Anna Pellat
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| | - Ali Chamseddine
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| | - Felix Corre
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| | - Romain Coriat
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| |
Collapse
|
60
|
Murga A, Bale R, Li CG, Ito K, Tsubokura M. Large eddy simulation of droplet transport and deposition in the human respiratory tract to evaluate inhalation risk. PLoS Comput Biol 2023; 19:e1010972. [PMID: 36940207 PMCID: PMC10027217 DOI: 10.1371/journal.pcbi.1010972] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/22/2023] [Indexed: 03/21/2023] Open
Abstract
As evidenced by the worldwide pandemic, respiratory infectious diseases and their airborne transmission must be studied to safeguard public health. This study focuses on the emission and transport of speech-generated droplets, which can pose risk of infection depending on the loudness of the speech, its duration and the initial angle of exhalation. We have numerically investigated the transport of these droplets into the human respiratory tract by way of a natural breathing cycle in order to predict the infection probability of three strains of SARS-CoV-2 on a person who is listening at a one-meter distance. Numerical methods were used to set the boundary conditions of the speaking and breathing models and large eddy simulation (LES) was used for the unsteady simulation of approximately 10 breathing cycles. Four different mouth angles when speaking were contrasted to evaluate real conditions of human communication and the possibility of infection. Breathed virions were counted using two different approaches: the breathing zone of influence and direction deposition on the tissue. Our results show that infection probability drastically changes based on the mouth angle and the breathing zone of influence overpredicts the inhalation risk in all cases. We conclude that to portray real conditions, the probability of infection should be based on direct tissue deposition results to avoid overprediction and that several mouth angles must be considered in future analyses.
Collapse
Affiliation(s)
- Alicia Murga
- Kobe University, Graduate School of System Informatics, Japan
| | - Rahul Bale
- Kobe University, Graduate School of System Informatics, Japan
- Riken Center for Computational Sciences, Japan
| | | | - Kazuhide Ito
- Kyushu University, Faculty of Engineering Sciences, Japan
| | - Makoto Tsubokura
- Kobe University, Graduate School of System Informatics, Japan
- Riken Center for Computational Sciences, Japan
| |
Collapse
|
61
|
Otter JA, Zhou J, Price JR, Reeves L, Zhu N, Randell P, Sriskandan S, Barclay WS, Holmes AH. SARS-CoV-2 surface and air contamination in an acute healthcare setting during the first and second pandemic waves. J Hosp Infect 2023; 132:36-45. [PMID: 36435307 PMCID: PMC9683853 DOI: 10.1016/j.jhin.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Surfaces and air in healthcare facilities can be contaminated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Previously, the authors identified SARS-CoV-2 RNA on surfaces and air in their hospital during the first wave of the coronavirus disease 2019 pandemic (April 2020). AIM To explore whether the profile of SARS-CoV-2 surface and air contamination had changed between April 2020 and January 2021. METHODS This was a prospective, cross-sectional, observational study in a multi-site London hospital. In January 2021, surface and air samples were collected from comparable areas to those sampled in April 2020, comprising six clinical areas and a public area. SARS-CoV-2 was detected using reverse transcription polymerase chain reaction and viral culture. Sampling was also undertaken in two wards with natural ventilation alone. The ability of the prevalent variants at the time of the study to survive on dry surfaces was evaluated. FINDINGS No viable virus was recovered from surfaces or air. Five percent (N=14) of 270 surface samples and 4% (N=1) of 27 air samples were positive for SARS-CoV-2, which was significantly lower than in April 2020 [52% (N=114) of 218 surface samples and 48% (N=13) of 27 air samples (P<0.001, Fisher's exact test)]. There was no clear difference in the proportion of surface and air samples positive for SARS-CoV-2 RNA based on the type of ventilation in the ward. All variants tested survived on dry surfaces for >72 h, with a <3-log10 reduction in viable count. CONCLUSION This study suggests that enhanced infection prevention measures have reduced the burden of SARS-CoV-2 RNA on surfaces and air in healthcare facilities.
Collapse
Affiliation(s)
- J A Otter
- National Institute for Healthcare Research Health Protection Research Unit in Healthcare-associated Infection and Antimicrobial Resistance, Imperial College London & Public Health England, Hammersmith Hospital, London, UK; Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - J Zhou
- Department of Infectious Disease, Imperial College London, London, UK
| | - J R Price
- National Institute for Healthcare Research Health Protection Research Unit in Healthcare-associated Infection and Antimicrobial Resistance, Imperial College London & Public Health England, Hammersmith Hospital, London, UK; Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK
| | - L Reeves
- National Institute for Healthcare Research Health Protection Research Unit in Healthcare-associated Infection and Antimicrobial Resistance, Imperial College London & Public Health England, Hammersmith Hospital, London, UK
| | - N Zhu
- National Institute for Healthcare Research Health Protection Research Unit in Healthcare-associated Infection and Antimicrobial Resistance, Imperial College London & Public Health England, Hammersmith Hospital, London, UK
| | - P Randell
- Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK
| | - S Sriskandan
- National Institute for Healthcare Research Health Protection Research Unit in Healthcare-associated Infection and Antimicrobial Resistance, Imperial College London & Public Health England, Hammersmith Hospital, London, UK; Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK
| | - W S Barclay
- Department of Infectious Disease, Imperial College London, London, UK
| | - A H Holmes
- National Institute for Healthcare Research Health Protection Research Unit in Healthcare-associated Infection and Antimicrobial Resistance, Imperial College London & Public Health England, Hammersmith Hospital, London, UK; Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK
| |
Collapse
|
62
|
Silva PGD, Nascimento MSJ, Sousa SIV, Mesquita JR. SARS-CoV-2 in outdoor air following the third wave lockdown release, Portugal, 2021. J Med Microbiol 2023; 72. [PMID: 36763082 DOI: 10.1099/jmm.0.001659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Aiming to contribute with more data on the presence of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in outdoor environments, we performed air sampling in outdoor terraces from restaurants in three major cities of Portugal in April 2021, following the third wave lockdown release in the country. Air samples (n=19) were collected in 19 restaurant terraces during lunch time. Each air sample was collected using a Coriolis Compact air sampler, followed by RNA extraction and real-time quantitative PCR for the detection of viral RNA. Viral viability was also assessed through RNAse pre-treatment of samples. Only one of the 19 air samples was positive for SARS-CoV-2 RNA, with 7337 gene copies m-3 for the genomic region N2, with no viable virus in this sample. The low number of positive samples found in this study is not surprising, as sampling took place in outdoor settings where air circulation is optimal, and aerosols are rapidly dispersed by the air currents. These results are consistent with previous reports stating that transmission of SARS-CoV-2 in outdoor spaces is low, although current evidence shows an association of exposures in settings where drinking and eating is possible on-site with an increased risk in acquiring SARS-CoV-2 infection. Moreover, the minimal infectious dose for SARS-CoV-2 still needs to be determined so that the real risk of infection in different environments can be accurately established.
Collapse
Affiliation(s)
- Priscilla Gomes da Silva
- ICBAS - School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal.,Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal.,ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | | | - Sofia I V Sousa
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal.,ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - João R Mesquita
- ICBAS - School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal.,Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| |
Collapse
|
63
|
Cox J, Christensen B, Burton N, Dunn KH, Finnegan M, Ruess A, Estill C. Transmission of SARS-CoV-2 in the workplace: Key findings from a rapid review of the literature. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2023; 57:233-254. [PMID: 37213938 PMCID: PMC10193509 DOI: 10.1080/02786826.2023.2166394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/27/2022] [Indexed: 05/23/2023]
Abstract
At the beginning of the COVID-19 pandemic, the primary route of transmission of the SARS-CoV-2 virus was not well understood. Research gathered from other respiratory infectious diseases, including other coronaviruses, was the basis for the initial perceptions for transmission of SARS-CoV-2. To better understand transmission of SARS-CoV-2, a rapid literature review was conducted from literature generated March 19, 2020, through September 23, 2021. 18,616 unique results were identified from literature databases and screened. Of these, 279 key articles were reviewed and abstracted covering critical topics such as environmental/workplace monitoring, sampling and analytical method evaluation, and the ability of the virus to remain intact and infectious during sampling. This paper describes the results of the rapid literature review, which evaluated pathways that contribute to transmission as well as the strengths and limitations of current sampling approaches. This review also evaluates how different factors, including environmental conditions and surface characteristics, could impact the transmission potential of SARS-CoV-2. A continual rapid review in the midst of a pandemic proved particularly useful for quickly understanding the transmission parameters of the virus and enabled us to comprehensively assess literature, respond to workplace questions, and evaluate our understanding as the science evolved. Air and surface sampling with the accompanying analytical methods were not generally effective in recovering SARS-CoV-2 viable virus or RNA in many likely contaminated environments. In light of these findings, the development of validated sampling and analysis methods is critical for determining worker exposure to SARS-CoV-2 and to assess the impact of mitigation efforts.
Collapse
Affiliation(s)
- Jennie Cox
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Brian Christensen
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Nancy Burton
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Kevin H. Dunn
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | | | - Ana Ruess
- Gryphon Scientific, Takoma Park, MD, USA
| | - Cherie Estill
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| |
Collapse
|
64
|
Aganovic A, Cao G, Kurnitski J, Wargocki P. New dose-response model and SARS-CoV-2 quanta emission rates for calculating the long-range airborne infection risk. BUILDING AND ENVIRONMENT 2023; 228:109924. [PMID: 36531865 PMCID: PMC9747236 DOI: 10.1016/j.buildenv.2022.109924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Predictive models for airborne infection risk have been extensively used during the pandemic, but there is yet still no consensus on a common approach, which may create misinterpretation of results among public health experts and engineers designing building ventilation. In this study we applied the latest data on viral load, aerosol droplet sizes and removal mechanisms to improve the Wells Riley model by introducing the following novelties i) a new model to calculate the total volume of respiratory fluid exhaled per unit time ii) developing a novel viral dose-based generation rate model for dehydrated droplets after expiration iii) deriving a novel quanta-RNA relationship for various strains of SARS-CoV-2 iv) proposing a method to account for the incomplete mixing conditions. These new approaches considerably changed previous estimates and allowed to determine more accurate average quanta emission rates including omicron variant. These quanta values for the original strain of 0.13 and 3.8 quanta/h for breathing and speaking and the virus variant multipliers may be used for simple hand calculations of probability of infection or with developed model operating with six size ranges of aerosol droplets to calculate the effect of ventilation and other removal mechanisms. The model developed is made available as an open-source tool.
Collapse
Affiliation(s)
- Amar Aganovic
- Department of Automation and Process Engineering, UiT The Arctic University of Norway, Tromsø, Norway
| | - Guangyu Cao
- Department of Energy and Process Engineering, Norwegian University of Science and Technology - NTNU, Trondheim, Norway
| | - Jarek Kurnitski
- REHVA Technology and Research Committee, Tallinn University of Technology, Tallinn, Estonia
| | - Pawel Wargocki
- Department of Civil Engineering, Technical University of Denmark, Copenhagen, Denmark
| |
Collapse
|
65
|
Li X, Sun B, Lyu K, Chen J, Zhang Y, Sun Y, Li C, Sui T, Wang X, Hu Y, Wang Q, Xu D. Research on the relationship between architectural features in northeast China and vertical aerosol transmission of COVID-19. Front Public Health 2023; 10:1052610. [PMID: 36711357 PMCID: PMC9881651 DOI: 10.3389/fpubh.2022.1052610] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
During the COVID-19 pandemic, many buildings in northeast China have had clusters of infected cases in the vertical layout. There is speculation that vertical aerosol transmission occurs. The houses in northeast China are airtight, and range hoods may be used for a long period of time when cooking. The pathway and factors influencing vertical aerosol transmission are worth studying. To elucidate a viral aerosol transmission pathway, we selected a multistory apartment and a high-rise building in Changchun city, Jilin province, China, to conduct an in-depth investigation and on-site simulation experiments. According to epidemiological investigation information on infected cases, building structures, drainage, ventilation, etc., we used fluorescent microspheres to simulate the behaviors of infected people, such as breathing and flushing the toilet after defecation, to discharge simulated viruses and track and monitor them. The field simulation experiment confirmed the transmission of fluorescent microsphere aerosols to other rooms in two types of buildings using a vertical aerosol transmission pathway of toilet flush-sewage pipe-floor drain without a water seal. Our study showed that, in the absence of a U-shaped trap or floor drain water seal whether in a multistory apartment or high-rise residential building, there is a transmission pathway of "excretion of virus through feces-toilet flushing-sewage pipe-floor drain without water seal," which will cause the vertical transmission of viral aerosol across floors during the COVID-19 pandemic. Moreover, the negative pressure generated by turning on the range hood when closing doors and windows increase aerosol transmission. Based on this negative pressure, prevention and control measures for residential buildings in northeast China during the COVID-19 pandemic were proposed.
Collapse
Affiliation(s)
- Xia Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bingxin Sun
- Changchun Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Keyang Lyu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiayu Chen
- Shandong Provincial Third Hospital, Jinan, Shandong, China
| | - Yunjian Zhang
- Changchun Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Yu Sun
- Changchun Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Chenguang Li
- Changchun Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Tianzhuo Sui
- Changchun Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Xinxin Wang
- Changchun Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Yu Hu
- Changchun Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Qin Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China,*Correspondence: Qin Wang ✉
| | - Dongqun Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China,Dongqun Xu ✉
| |
Collapse
|
66
|
Hernaez B, Muñoz-Gómez A, Sanchiz A, Orviz E, Valls-Carbo A, Sagastagoitia I, Ayerdi O, Martín R, Puerta T, Vera M, Cabello N, Vergas J, Prieto C, Pardo-Figuerez M, Negredo A, Lagarón JM, del Romero J, Estrada V, Alcamí A. Monitoring monkeypox virus in saliva and air samples in Spain: a cross-sectional study. THE LANCET. MICROBE 2023; 4:e21-e28. [PMID: 36436538 PMCID: PMC9691259 DOI: 10.1016/s2666-5247(22)00291-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/19/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The transmission of monkeypox virus occurs through direct contact, but transmission through saliva or exhaled droplets and aerosols has not yet been investigated. We aimed to assess the presence of monkeypox virus DNA and infectious virus in saliva samples and droplets and aerosols exhaled from patients infected with monkeypox virus. METHODS We did a cross-sectional study in patients with monkeypox confirmed by PCR who attended two health centres in Madrid, Spain. For each patient, we collected samples of saliva, exhaled droplets within a mask, and aerosols captured by air filtration through newly developed nanofiber filters. We evaluated the presence of monkeypox virus in the samples by viral DNA detection by quantitative PCR (qPCR) and isolation of infectious viruses in cell cultures. FINDINGS Between May 18 and July 15, 2022, 44 patients with symptomatic monkeypox attended two health centres in Madrid and were included in the study. All were cisgender men, with a median age of 35·0 years (IQR 11·3). We identified high loads of monkeypox virus DNA by qPCR in 35 (85%) of 41 saliva samples. Infectious monkeypox virus was recovered from 22 (67%) of 33 saliva samples positive for monkeypox virus DNA. We also found a significant association between the number of affected cutaneous areas or general symptoms and the viral load present in saliva samples. Droplets exhaled from patients with monkeypox, detected inside a mask, contained monkeypox virus DNA in 32 (71%) of 45 samples, with two of the 32 positive samples showing the presence of the infectious virus. Monkeypox virus DNA in aerosols, collected from the medical consultation room, were detected in 27 (64%) of 42 samples, despite patients wearing an FFP2 mask during the visit. Infectious virus was not recovered from aerosol samples. High levels of monkeypox virus DNA were identified in aerosols collected from a hospital isolation room housing a patient with monkeypox. INTERPRETATION The identification of high viable monkeypox virus loads in saliva in most patients with monkeypox and the finding of monkeypox virus DNA in droplets and aerosols warrants further epidemiological studies to evaluate the potential relevance of the respiratory route of infection in the 2022 monkeypox virus outbreak. FUNDING EU, Consejo Superior de Investigaciones Científicas, and Ciberinfec.
Collapse
Affiliation(s)
- Bruno Hernaez
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Ana Muñoz-Gómez
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Africa Sanchiz
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Eva Orviz
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | | | - Iñigo Sagastagoitia
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain,Ciber de Enfermedades Infecciosas, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Rocío Martín
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Teresa Puerta
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Mar Vera
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Noemi Cabello
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain,Ciber de Enfermedades Infecciosas, Madrid, Spain
| | - Jorge Vergas
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Cristina Prieto
- Instituto de Agroquímica y Tecnología de Alimentos, Valencia, Spain
| | | | - Anabel Negredo
- Ciber de Enfermedades Infecciosas, Madrid, Spain,Laboratorio de Arbovirus y Enfermedades Víricas Importadas, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jorge del Romero
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Vicente Estrada
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain; Ciber de Enfermedades Infecciosas, Madrid, Spain.
| | - Antonio Alcamí
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain.
| |
Collapse
|
67
|
Clark JR, Terwilliger A, Avadhanula V, Tisza M, Cormier J, Javornik-Cregeen S, Ross MC, Hoffman KL, Troisi C, Hanson B, Petrosino J, Balliew J, Piedra PA, Rios J, Deegan J, Bauer C, Wu F, Mena KD, Boerwinkle E, Maresso AW. Wastewater pandemic preparedness: Toward an end-to-end pathogen monitoring program. Front Public Health 2023; 11:1137881. [PMID: 37026145 PMCID: PMC10070845 DOI: 10.3389/fpubh.2023.1137881] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/09/2023] [Indexed: 04/08/2023] Open
Abstract
Molecular analysis of public wastewater has great potential as a harbinger for community health and health threats. Long-used to monitor the presence of enteric viruses, in particular polio, recent successes of wastewater as a reliable lead indicator for trends in SARS-CoV-2 levels and hospital admissions has generated optimism and emerging evidence that similar science can be applied to other pathogens of pandemic potential (PPPs), especially respiratory viruses and their variants of concern (VOC). However, there are substantial challenges associated with implementation of this ideal, namely that multiple and distinct fields of inquiry must be bridged and coordinated. These include engineering, molecular sciences, temporal-geospatial analytics, epidemiology and medical, and governmental and public health messaging, all of which present their own caveats. Here, we outline a framework for an integrated, state-wide, end-to-end human pathogen monitoring program using wastewater to track viral PPPs.
Collapse
Affiliation(s)
- Justin R. Clark
- TAILOR Labs, Baylor College of Medicine, Houston, TX, United States
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
| | - Austen Terwilliger
- TAILOR Labs, Baylor College of Medicine, Houston, TX, United States
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
| | - Vasanthi Avadhanula
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
| | - Michael Tisza
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Alkek Center for Metagenomics and Microbiome Research, CMMR, Baylor College of Medicine, Houston, TX, United States
| | - Juwan Cormier
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Alkek Center for Metagenomics and Microbiome Research, CMMR, Baylor College of Medicine, Houston, TX, United States
| | - Sara Javornik-Cregeen
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Alkek Center for Metagenomics and Microbiome Research, CMMR, Baylor College of Medicine, Houston, TX, United States
| | - Matthew Clayton Ross
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Alkek Center for Metagenomics and Microbiome Research, CMMR, Baylor College of Medicine, Houston, TX, United States
| | - Kristi Louise Hoffman
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Alkek Center for Metagenomics and Microbiome Research, CMMR, Baylor College of Medicine, Houston, TX, United States
| | - Catherine Troisi
- UTHealth Houston School of Public Health, Houston, TX, United States
- Texas Epidemic Public Health Institute (TEPHI), UTHealth Houston, Houston, TX, United States
| | - Blake Hanson
- UTHealth Houston School of Public Health, Houston, TX, United States
- Texas Epidemic Public Health Institute (TEPHI), UTHealth Houston, Houston, TX, United States
- Center for Infectious Diseases, Department of Epidemiology, Human Genetics and Environmental Sciences, Houston, TX, United States
| | - Joseph Petrosino
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Alkek Center for Metagenomics and Microbiome Research, CMMR, Baylor College of Medicine, Houston, TX, United States
| | - John Balliew
- El Paso Water Utility, El Paso, TX, United States
| | - Pedro A. Piedra
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Pediatrics Department, Baylor College of Medicine, Houston, TX, United States
| | - Janelle Rios
- UTHealth Houston School of Public Health, Houston, TX, United States
- Texas Epidemic Public Health Institute (TEPHI), UTHealth Houston, Houston, TX, United States
| | - Jennifer Deegan
- Texas Epidemic Public Health Institute (TEPHI), UTHealth Houston, Houston, TX, United States
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Cici Bauer
- UTHealth Houston School of Public Health, Houston, TX, United States
- Texas Epidemic Public Health Institute (TEPHI), UTHealth Houston, Houston, TX, United States
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, TX, United States
| | - Fuqing Wu
- UTHealth Houston School of Public Health, Houston, TX, United States
- Texas Epidemic Public Health Institute (TEPHI), UTHealth Houston, Houston, TX, United States
| | - Kristina D. Mena
- UTHealth Houston School of Public Health, Houston, TX, United States
- Texas Epidemic Public Health Institute (TEPHI), UTHealth Houston, Houston, TX, United States
| | - Eric Boerwinkle
- UTHealth Houston School of Public Health, Houston, TX, United States
- Texas Epidemic Public Health Institute (TEPHI), UTHealth Houston, Houston, TX, United States
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, Houston, TX, United States
| | - Anthony W. Maresso
- TAILOR Labs, Baylor College of Medicine, Houston, TX, United States
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Anthony W. Maresso
| |
Collapse
|
68
|
Millar R, Moorhouse A. Aerosol generation during paediatric procedural sedation with continuous-flow nitrous oxide suggests a low risk of airborne viral transmission to health-care workers. J Paediatr Child Health 2023; 59:123-128. [PMID: 36282176 PMCID: PMC9874389 DOI: 10.1111/jpc.16258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 12/11/2021] [Accepted: 10/08/2022] [Indexed: 01/27/2023]
Abstract
AIM Inhaled nitrous oxide is a common form of procedural sedation in paediatric care. During the COVID-19 pandemic, concerns about potential aerosol generation and associated viral transmission to health-care workers have led to controversy regarding its use. We aimed to measure the degree of aerosol generation during continuous flow nitrous oxide sedation to inform future guidelines. METHODS Aerosol numbers in the respirable range were measured using a particle counter during 30 procedures undertaken in children under nitrous oxide sedation in the Emergency Department. RESULTS Changes from baseline measurements were greatest in particles in the 0.3 μm range. The mean increase from baseline in 0.3 μm particles per cubic metre was 18 022 (95% confidence interval (CI) 5949-30 096) after the child entered the room, and 2931 (95% CI -4407 to 10 269) during nitrous oxide administration. CONCLUSION Variation of respirable particle numbers from baseline levels was no greater during nitrous oxide administration than for breathing and talking asymptomatic children. These results suggest the additional risk of airborne viral transmission to staff during inhaled nitrous oxide sedation is low.
Collapse
Affiliation(s)
- Robert Millar
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.,Austin Health, Melbourne, Victoria, Australia
| | | |
Collapse
|
69
|
Kitagawa H, Nomura T, Kaiki Y, Kakimoto M, Nazmul T, Omori K, Shigemoto N, Sakaguchi T, Ohge H. Viable SARS-CoV-2 detected in the air of hospital rooms of patients with COVID-19 with an early infection. Int J Infect Dis 2023; 126:73-78. [PMID: 36356797 PMCID: PMC9640214 DOI: 10.1016/j.ijid.2022.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study assessed the concentration of SARS-CoV-2 in the air of hospital rooms occupied by patients with COVID-19 who had viable SARS-CoV-2 in nasopharyngeal (NP) samples in early infection. METHODS Between July and October 2021, NP swabs were collected from 20 patients with early SARS-CoV-2 infection admitted to a tertiary hospital in Japan. Air samples were collected from their rooms, tested for SARS-CoV-2 RNA, and cultured to determine potential infectivity. RESULTS The NP swab samples of 18 patients were positive for viable SARS-CoV-2 (median concentration: 4.0 × 105 tissue culture infectious dose 50/ml). In the air samples, viral RNA (median concentration: 1.1 × 105 copies/m3) was detected in 12/18 (67%) patients, and viable virus (median concentration: 8.9 × 102 tissue culture infectious dose 50/m3) was detected in 5/18 (28%) patients. The median time between illness onset and sampling was 3 days. The RNA concentration was significantly higher in samples wherein viable SARS-CoV-2 was detected than in samples in which viable virus was not detected (P-value = 0.027). CONCLUSION Viable SARS-CoV-2 can be detected in the air surrounding patients with early SARS-CoV-2 infection. Health care workers should pay attention to infection control when caring for patients with early SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Hiroki Kitagawa
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan,Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan,Corresponding author: Hiroki Kitagawa, Department of Infectious Diseases, Hiroshima University Hospital, Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Toshihito Nomura
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan,Department of Virology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Kaiki
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masaki Kakimoto
- Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Tanuza Nazmul
- Department of Virology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keitaro Omori
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Norifumi Shigemoto
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan,Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan,Translational Research Center, Hiroshima University, Hiroshima, Japan
| | - Takemasa Sakaguchi
- Department of Virology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| |
Collapse
|
70
|
Tedeschini E, Pasqualini S, Emiliani C, Marini E, Valecchi A, Laoreti C, Ministrini S, Camilloni B, Castronari R, Patoia L, Merante F, Baglioni S, De Robertis E, Pirro M, Mencacci A, Pasqualini L. Monitoring of indoor bioaerosol for the detection of SARS-CoV-2 in different hospital settings. Front Public Health 2023; 11:1169073. [PMID: 37151587 PMCID: PMC10157290 DOI: 10.3389/fpubh.2023.1169073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Background Spore Trap is an environmental detection technology, already used in the field of allergology to monitor the presence and composition of potentially inspirable airborne micronic bioparticulate. This device is potentially suitable for environmental monitoring of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in hospital, as well as in other high-risk closed environments. The aim of the present study is to investigate the accuracy of the Spore Trap system in detecting SARS-CoV-2 in indoor bioaerosol of hospital rooms. Methods The Spore Trap was placed in hospital rooms hosting patients with documented SARS-CoV-2 infection (n = 36) or, as a negative control, in rooms where patients with documented negativity to a Real-Time Polymerase Chain Reaction molecular test for SARS-CoV-2 were admitted (n = 10). The monitoring of the bioaerosol was carried on for 24 h. Collected samples were analyzed by real-time polymerase chain reaction. Results The estimated sensitivity of the Spore Trap device for detecting SARS-CoV-2 in an indoor environment is 69.4% (95% C.I. 54.3-84.4%), with a specificity of 100%. Conclusion The Spore Trap technology is effective in detecting airborne SARS-CoV-2 virus with excellent specificity and high sensitivity, when compared to previous reports. The SARS-CoV-2 pandemic scenario has suggested that indoor air quality control will be a priority in future public health management and will certainly need to include an environmental bio-investigation protocol.
Collapse
Affiliation(s)
- Emma Tedeschini
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università degli Studi di Perugia, Perugia, Italy
| | - Stefania Pasqualini
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Carla Emiliani
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Ettore Marini
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Alessandro Valecchi
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Chiara Laoreti
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Stefano Ministrini
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
- *Correspondence: Stefano Ministrini
| | - Barbara Camilloni
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Roberto Castronari
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Lucio Patoia
- Ospedale S.G. Battista – Azienda Unità Sanitaria Umbria 2, Foligno, Italy
| | - Francesco Merante
- Ospedale S.G. Battista – Azienda Unità Sanitaria Umbria 2, Foligno, Italy
| | - Stefano Baglioni
- S.C. Pneumologia, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Edoardo De Robertis
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Matteo Pirro
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Antonella Mencacci
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Leonella Pasqualini
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| |
Collapse
|
71
|
Ramsey ME, Faugno AJ, Puryear WB, Lee BC, Foss AD, Lambert LH, Nargi FE, Bopp GP, Lee LP, Rudzinski CM, Ervin BL, Runstadler JA, Hill NS. Characterization of SARS-CoV-2 Aerosols Dispersed During Noninvasive Respiratory Support of Patients With COVID-19. Respir Care 2023; 68:8-17. [PMID: 36566031 PMCID: PMC9993517 DOI: 10.4187/respcare.10340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND In the midst of the COVID-19 pandemic, noninvasive respiratory support (NRS) therapies such as high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) were central to respiratory care. The extent to which these treatments increase the generation and dispersion of infectious respiratory aerosols is not fully understood. The objective of this study was to characterize SARS-CoV-2 aerosol dispersion from subjects with COVID-19 undergoing NRS therapy. METHODS Several different aerosol sampling devices were used to collect air samples in the vicinity of 31 subjects with COVID-19, most of whom were receiving NRS therapy, primarily HFNC. Aerosols were collected onto filters and analyzed for the presence of SARS-CoV-2 RNA. Additional measurements were collected in an aerosol chamber with healthy adult subjects using respiratory therapy devices under controlled and reproducible conditions. RESULTS Fifty aerosol samples were collected from subjects receiving HFNC or NIV therapy, whereas 6 samples were collected from subjects not receiving NRS. Only 4 of the 56 aerosol samples were positive for SARS-CoV-2 RNA, and all positive samples were collected using a high air flow scavenger mask collection device placed in close proximity to the subject. The chamber measurements with healthy subjects did not show any significant increase in aerosol dispersion caused by the respiratory therapy devices compared to baseline. CONCLUSIONS Our findings demonstrate very limited detection of SARS-CoV-2-containing aerosols in the vicinity of subjects with COVID-19 receiving NRS therapies in the clinical setting. These results, combined with controlled chamber measurements showing that HFNC and NIV device usage was not associated with increased aerosol dispersion, suggest that NRS therapies do not result in increased dispersal of aerosols in the clinical setting.
Collapse
Affiliation(s)
- Meghan E Ramsey
- Biotechnology and Human Systems Division, Massachusetts Institute of Technology, Lincoln Laboratory, Lexington, Massachusetts
| | - Anthony J Faugno
- Critical Care and Sleep Division, Tufts Medical Center, Boston, Massachusetts
| | - Wendy B Puryear
- Cummings School of Veterinary Medicine, Tufts University, Grafton, Massachusetts
| | - Brian C Lee
- Biotechnology and Human Systems Division, Massachusetts Institute of Technology, Lincoln Laboratory, Lexington, Massachusetts
| | - Alexa D Foss
- Cummings School of Veterinary Medicine, Tufts University, Grafton, Massachusetts
| | - Lester H Lambert
- Critical Care and Sleep Division, Tufts Medical Center, Boston, Massachusetts
| | - Frances E Nargi
- Biotechnology and Human Systems Division, Massachusetts Institute of Technology, Lincoln Laboratory, Lexington, Massachusetts
| | - Gregory P Bopp
- Biotechnology and Human Systems Division, Massachusetts Institute of Technology, Lincoln Laboratory, Lexington, Massachusetts
| | - Lauren P Lee
- Biotechnology and Human Systems Division, Massachusetts Institute of Technology, Lincoln Laboratory, Lexington, Massachusetts
| | - Christina M Rudzinski
- Biotechnology and Human Systems Division, Massachusetts Institute of Technology, Lincoln Laboratory, Lexington, Massachusetts
| | - Benjamin L Ervin
- Biotechnology and Human Systems Division, Massachusetts Institute of Technology, Lincoln Laboratory, Lexington, Massachusetts
| | | | - Nicholas S Hill
- Critical Care and Sleep Division, Tufts Medical Center, Boston, Massachusetts.
| |
Collapse
|
72
|
Cilloniz C, Luna CM, Hurtado JC, Marcos MÁ, Torres A. Respiratory viruses: their importance and lessons learned from COVID-19. Eur Respir Rev 2022; 31:31/166/220051. [PMID: 36261158 DOI: 10.1183/16000617.0051-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/30/2022] [Indexed: 01/08/2023] Open
Abstract
Respiratory virus infection can cause severe illnesses capable of inducing acute respiratory failure that can progress rapidly to acute respiratory distress syndrome (ARDS). ARDS is related to poor outcomes, especially in individuals with a higher risk of infection, such as the elderly and those with comorbidities, i.e. obesity, asthma, diabetes mellitus and chronic respiratory or cardiovascular disease. Despite this, effective antiviral treatments available for severe viral lung infections are scarce. The coronavirus disease 2019 (COVID-19) pandemic demonstrated that there is also a need to understand the role of airborne transmission of respiratory viruses. Robust evidence supporting this exists, but better comprehension could help implement adequate measures to mitigate respiratory viral infections. In severe viral lung infections, early diagnosis, risk stratification and prognosis are essential in managing patients. Biomarkers can provide reliable, timely and accessible information possibly helpful for clinicians in managing severe lung viral infections. Although respiratory viruses highly impact global health, more research is needed to improve care and prognosis of severe lung viral infections. In this review, we discuss the epidemiology, diagnosis, clinical characteristics, management and prognosis of patients with severe infections due to respiratory viruses.
Collapse
Affiliation(s)
- Catia Cilloniz
- Pneumology Dept, Respiratory Institute, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain .,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (Ciberes), Barcelona, Spain.,Faculty of Health Sciences, Continental University, Huancayo, Peru
| | - Carlos M Luna
- Pneumology Division, Hospital of Clínicas, Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Juan Carlos Hurtado
- Dept of Microbiology, Hospital Clinic, Universitat de Barcelona, ISGlobal, Barcelona, Spain
| | - María Ángeles Marcos
- Dept of Microbiology, Hospital Clinic, Universitat de Barcelona, ISGlobal, Barcelona, Spain
| | - Antoni Torres
- Pneumology Dept, Respiratory Institute, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (Ciberes), Barcelona, Spain
| |
Collapse
|
73
|
del Álamo C, Vázquez-Calvo Á, Sanchiz Á, Rodríguez-Caravaca G, Martín R, Hernáez B, Méndez-Vigo-Carranza P, Sánchez García-Casarrubios J, Alcamí A, Pérez-Díaz JL. Fast Air-to-Liquid Sampler Detects Surges in SARS-CoV-2 Aerosol Levels in Hospital Rooms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010576. [PMID: 36612897 PMCID: PMC9819203 DOI: 10.3390/ijerph20010576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 05/14/2023]
Abstract
The COVID-19 pandemic highlighted the dangers of airborne pathogen transmission. SARS-CoV-2 is known to be transmitted through aerosols; however, little is known about the dynamics of these aerosols in real environments, the conditions, and the minimum viral load required for infection. Efficiently measuring and capturing pathogens present in the air would help to understand the infection process. Air samplers usually take several hours to obtain an air sample. In this work a fast (1-2 min) method for capturing bioaerosols into a liquid medium has been tested in hospital rooms with COVID-19 patients. This fast sampling allows detecting transient levels of aerosols in the air. SARS-CoV-2 RNA is detected in aerosols from several hospital rooms at different levels. Interestingly, there are sudden boosts of the SARS-CoV-2 load in the air, suggesting that SARS-CoV-2 could be released abundantly at certain moments. These results show that the distribution of SARS-CoV-2-containing aerosols is not homogeneous in the hospital room. This technology is a fast and effective tool for capturing airborne matter in a very short time, which allows for fast decision-making any kind of hazard in the air is detected. It is also useful for a better understanding of aerosols dynamics.
Collapse
Affiliation(s)
- Cristina del Álamo
- Escuela Politécnica, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
| | - Ángela Vázquez-Calvo
- Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas (CSIC), and Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
| | - África Sanchiz
- Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas (CSIC), and Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
| | - Gil Rodríguez-Caravaca
- Preventive Medicine Service, Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, Madrid, Spain
- Department of Medical Specialities and Public Health, Universidad Rey Juan Carlos, 28922 Alcorcón, Madrid, Spain
| | - Rocío Martín
- Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas (CSIC), and Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
| | - Bruno Hernáez
- Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas (CSIC), and Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
| | | | | | - Antonio Alcamí
- Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas (CSIC), and Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Correspondence: (A.A.); (J.L.P.-D.)
| | - José Luis Pérez-Díaz
- Escuela Politécnica, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Correspondence: (A.A.); (J.L.P.-D.)
| |
Collapse
|
74
|
Nieto-Caballero M, Davis RD, Fuques E, Gomez OM, Huynh E, Handorean A, Ushijima S, Tolbert M, Hernandez M. Carbohydrate vitrification in aerosolized saliva is associated with the humidity-dependent infectious potential of airborne coronavirus. PNAS NEXUS 2022; 2:pgac301. [PMID: 36743472 PMCID: PMC9896139 DOI: 10.1093/pnasnexus/pgac301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 12/22/2022] [Indexed: 12/26/2022]
Abstract
An accepted murine analogue for the environmental behavior of human SARS coronaviruses was aerosolized in microdroplets of its culture media and saliva to observe the decay of its airborne infectious potential under relative humidity (RH) conditions relevant to conditioned indoor air. Contained in a dark, 10 m3 chamber maintained at 22°C, murine hepatitis virus (MHV) was entrained in artificial saliva particles that were aerosolized in size distributions that mimic SARS-CoV-2 virus expelled from infected humans' respiration. As judged by quantitative PCR, more than 95% of the airborne MHV aerosolized was recovered from microdroplets with mean aerodynamic diameters between 0.56 and 5.6 μm. As judged by its half-life, calculated from the median tissue culture infectious dose (TCID50), saliva was protective of airborne murine coronavirus through a RH range recommended for conditioned indoor air (60% < RH < 40%; average half-life = 60 minutes). However, its average half-life doubled to 120 minutes when RH was maintained at 25%. Saliva microaerosol was dominated by carbohydrates, which presented hallmarks of vitrification without efflorescence at low RH. These results suggest that dehydrating carbohydrates can affect the infectious potential coronaviruses exhibit while airborne, significantly extending their persistence under the drier humidity conditions encountered indoors.
Collapse
Affiliation(s)
| | - Ryan D Davis
- Department of Chemistry, Trinity University, San Antonio, TX 78212, USA,Materials Reliability Department, Sandia National Laboratories, Albuquerque, NM 82123, USA
| | - Eddie Fuques
- Department of Microbiology, Oregon State University, Corvallis, OR 97331, USA
| | - Odessa M Gomez
- Environmental Engineering Program, University of Colorado, Boulder, CO 80309, USA
| | - Erik Huynh
- Department of Chemistry, Trinity University, San Antonio, TX 78212, USA
| | - Alina Handorean
- Departments of Engineering Design and Society and Civil and Environmental Engineering, Colorado School of Mines, Golden, CO 80401, USA
| | - Shuichi Ushijima
- Cooperative Institute for Research in Environmental Sciences and Department of Chemistry, University of Colorado, Boulder, CO 80309, USA
| | - Margaret Tolbert
- Cooperative Institute for Research in Environmental Sciences and Department of Chemistry, University of Colorado, Boulder, CO 80309, USA
| | | |
Collapse
|
75
|
Chaussade S, Pellat A, Corre F, Hallit R, Abou Ali E, Belle A, Barret M, Chaussade P, Coriat R. A new system to prevent SARS-CoV-2 and microorganism air transmission through the air circulation system of endoscopes. Endosc Int Open 2022; 10:E1589-E1594. [PMID: 36531679 PMCID: PMC9754862 DOI: 10.1055/a-1907-3939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/18/2022] [Indexed: 12/23/2022] Open
Abstract
Background and study aims Evidence for the modes of transmission of SARS-CoV-2 remains controversial. Recently, the potential for airborne spread of SARS-CoV-2 has been stressed. Air circulation in gastrointestinal light source boxes and endoscopes could be implicated in airborne transmission of microorganisms. Methods The ENDOBOX SC is a 600 × 600 mm cube designed to contain any type of machine used during gastrointestinal endoscopy. It allows for a 100-mm space between a machine and the walls of the ENDOBOX SC. To use the ENDOBOX SC, it is connected to the medical air system and it provides positive flow from the box to the endoscopy room. The ENDOBOX SC uses medical air to inflate the digestive tract and to decrease the temperature induced by the microprocessors or by the lamp. ENDOBOX SC has been investigated in different environments. Results An endoscopic procedure performed without ventilation was interrupted after 40 minutes to prevent computer damage. During the first 30 minutes, the temperature increased from 18 °C to 31 °C with a LED system. The procedure with fans identified variations in temperature inside the ENDOBOX SC from 21 to 26 °C (± 5 °C) 1 hour after the start of the procedure. The temperature was stable for the next 3 hours. Conclusions ENDOBOX SC prevents the increase in temperature induced by lamps and processors, allows access to all necessary connections into the endoscopic columns, and creates a sterile and positive pressure volume, which prevents potential contamination from microorganisms.
Collapse
Affiliation(s)
- Stanislas Chaussade
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Anna Pellat
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Felix Corre
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Rachel Hallit
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Einas Abou Ali
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Arthur Belle
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Maximilien Barret
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Paul Chaussade
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Romain Coriat
- Gastroenterology and Digestive Endoscopy Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| |
Collapse
|
76
|
Aganovic A, Cao G, Kurnitski J, Melikov A, Wargocki P. Zonal modeling of air distribution impact on the long-range airborne transmission risk of SARS-CoV-2. APPLIED MATHEMATICAL MODELLING 2022; 112:800-821. [PMID: 36060304 PMCID: PMC9420246 DOI: 10.1016/j.apm.2022.08.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/15/2022] [Accepted: 08/25/2022] [Indexed: 05/10/2023]
Abstract
A widely used analytical model to quantitatively assess airborne infection risk is the Wells-Riley model which is limited to complete air mixing in a single zone. However, this assumption tends not to be feasible (or reality) for many situations. This study aimed to extend the Wells-Riley model so that the infection risk can be calculated in spaces where complete mixing is not present. Some more advanced ventilation concepts create either two horizontally divided air zones in spaces as displacement ventilation or the space may be divided into two vertical zones by downward plane jet as in protective-zone ventilation systems. This is done by evaluating the time-dependent distribution of infectious quanta in each zone and by solving the coupled system of differential equations based on the zonal quanta concentrations. This model introduces a novel approach by estimating the interzonal mixing factor based on previous experimental data for three types of ventilation systems: incomplete mixing ventilation, displacement ventilation, and protective zone ventilation. The modeling approach is applied to a room with one infected and one susceptible person present. The results show that using the Wells-Riley model based on the assumption of completely air mixing may considerably overestimate or underestimate the long-range airborne infection risk in rooms where air distribution is different than complete mixing, such as displacement ventilation, protected zone ventilation, warm air supplied from the ceiling, etc. Therefore, in spaces with non-uniform air distribution, a zonal modeling approach should be preferred in analytical models compared to the conventional single-zone Wells-Riley models when assessing long-range airborne transmission risk of infectious respiratory diseases.
Collapse
Affiliation(s)
- Amar Aganovic
- Department of Automation and Process Engineering, UiT The Arctic University of Norway, Postboks 6050 Langnes, Tromsø 9037, Norway
| | - Guangyu Cao
- Department of Energy and Process Engineering, Norwegian University of Science and Technology - NTNU, Trondheim, Norway
| | - Jarek Kurnitski
- REHVA Technology and Research Committee, Tallinn University of Technology, Tallinn, Estonia
| | - Arsen Melikov
- Department of Civil Engineering, Technical University of Denmark, Copenhagen, Denmark
| | - Pawel Wargocki
- Department of Civil Engineering, Technical University of Denmark, Copenhagen, Denmark
| |
Collapse
|
77
|
Ziegler MJ, Huang E, Bekele S, Reesey E, Tolomeo P, Loughrey S, David MZ, Lautenbach E, Kelly BJ. Spatial and temporal effects on severe acute respiratory coronavirus virus 2 (SARS-CoV-2) contamination of the healthcare environment. Infect Control Hosp Epidemiol 2022; 43:1773-1778. [PMID: 34955111 PMCID: PMC8755533 DOI: 10.1017/ice.2021.530] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND The spatial and temporal extent of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) environmental contamination has not been precisely defined. We sought to elucidate contamination of different surface types and how contamination changes over time. METHODS We sampled surfaces longitudinally within COVID-19 patient rooms, performed quantitative RT-PCR for the detection of SARS-CoV-2 RNA, and modeled distance, time, and severity of illness on the probability of detecting SARS-CoV-2 using a mixed-effects binomial model. RESULTS The probability of detecting SARS-CoV-2 RNA in a patient room did not vary with distance. However, we found that surface type predicted probability of detection, with floors and high-touch surfaces having the highest probability of detection: floors (odds ratio [OR], 67.8; 95% credible interval [CrI], 36.3-131) and high-touch elevated surfaces (OR, 7.39; 95% CrI, 4.31-13.1). Increased surface contamination was observed in room where patients required high-flow oxygen, positive airway pressure, or mechanical ventilation (OR, 1.6; 95% CrI, 1.03-2.53). The probability of elevated surface contamination decayed with prolonged hospitalization, but the probability of floor detection increased with the duration of the local pandemic wave. CONCLUSIONS Distance from a patient's bed did not predict SARS-CoV-2 RNA deposition in patient rooms, but surface type, severity of illness, and time from local pandemic wave predicted surface deposition.
Collapse
Affiliation(s)
- Matthew J. Ziegler
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elizabeth Huang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Selamawit Bekele
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emily Reesey
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Pam Tolomeo
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sean Loughrey
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael Z. David
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ebbing Lautenbach
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brendan J. Kelly
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | |
Collapse
|
78
|
Zahedi A, Seif F, Golshan M, Khammar A, Rezaei Kahkha MR. Air Surveillance for Viral Contamination with SARS-CoV-2 RNA at a Healthcare Facility. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:374-383. [PMID: 35610444 PMCID: PMC9129059 DOI: 10.1007/s12560-022-09524-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 05/10/2022] [Indexed: 05/13/2023]
Abstract
The transmission pathway of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 also called COVID-19 disease) in indoor environments are the main area of contention between health systems and scientists. In this context, little has been investigated about the collection of airborne viral shedding. Here, we collected air samples from 24 locations inside the sole COVID-19 patient care center in Zabol, Iran, for screening SARS-CoV-2 RNA from March to May 2021. Locations included the ICU, COVID-19 wards (CWs) rooms, corridors, nearby nurses' stations, and toilets. We identified the SARS-CoV-2 RNA in breathing zone of CW, in room air, with the positivity rate of 2.5% at a concentration of 17 × 103 virus genome copies/m3 air. It also investigates the relationship between local climate conditions [i.e., temperature and relative humidity] and COVID-19 transmission with the evolution of daily official data on the number of new cases, hospitalizations, and deaths. Current data explained that the difference of temperature and humidity may affect the behavior of virus along with other factors, i.e., population density, individual viral shedding, and infectious dose of SARS-CoV-2 (both indoor and outdoor). Our data support the potential SARS-CoV-2 airborne transmission indoors suggesting the specific safety assessment of building to improve ventilation solutions besides proper using face masks and extensive public health interventions.
Collapse
Affiliation(s)
- Amir Zahedi
- Department of Environmental Health Engineering, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Faezeh Seif
- Department of Basic Sciences, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Masoumeh Golshan
- Department of Environmental Health Engineering, Faculty of Health, Zabol University of Medical Sciences, Zabol, Iran.
| | - Alireza Khammar
- Department of Occupational Health, Faculty of Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohammad Reza Rezaei Kahkha
- Department of Environmental Health Engineering, Faculty of Health, Zabol University of Medical Sciences, Zabol, Iran
| |
Collapse
|
79
|
Dabisch PA, Sanjak JS, Boydston JA, Yeager J, Herzog A, Biryukov J, Beck K, Do D, Seman BG, Green B, Bohannon JK, Holland B, Miller D, Ammons T, Freeburger D, Miller S, Jenkins T, Rippeon S, Miller J, Clarke D, Manan E, Patty A, Rhodes K, Sweeney T, Winpigler M, Altamura LA, Zimmerman H, Hail AS, Wahl V, Hevey M. Comparison of Dose-Response Relationships for Two Isolates of SARS-CoV-2 in a Nonhuman Primate Model of Inhalational COVID-19. J Aerosol Med Pulm Drug Deliv 2022; 35:296-306. [PMID: 36318785 PMCID: PMC9807281 DOI: 10.1089/jamp.2022.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: As the COVID-19 pandemic has progressed, numerous variants of SARS-CoV-2 have arisen, with several displaying increased transmissibility. Methods: The present study compared dose-response relationships and disease presentation in nonhuman primates infected with aerosols containing an isolate of the Gamma variant of SARS-CoV-2 to the results of our previous study with the earlier WA-1 isolate of SARS-CoV-2. Results: Disease in Gamma-infected animals was mild, characterized by dose-dependent fever and oronasal shedding of virus. Differences were observed in shedding in the upper respiratory tract between Gamma- and WA-1-infected animals that have the potential to influence disease transmission. Specifically, the estimated median doses for shedding of viral RNA or infectious virus in nasal swabs were approximately 10-fold lower for the Gamma variant than the WA-1 isolate. Given that the median doses for fever were similar, this suggests that there is a greater difference between the median doses for viral shedding and fever for Gamma than for WA-1 and potentially an increased range of doses for Gamma over which asymptomatic shedding and disease transmission are possible. Conclusions: These results complement those of previous studies, which suggested that differences in exposure dose may help to explain the range of clinical disease presentations observed in individuals with COVID-19, highlighting the importance of public health measures designed to limit exposure dose, such as masking and social distancing. The dose-response data provided by this study are important to inform disease transmission and hazard modeling, as well as to inform dose selection in future studies examining the efficacy of therapeutics and vaccines in animal models of inhalational COVID-19.
Collapse
Affiliation(s)
- Paul A. Dabisch
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA.,Address correspondence to: Paul A. Dabisch, PhD, National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, for the U.S. Department of Homeland Security, 8300 Research Plaza, Frederick, MD 21701, USA
| | - Jaleal S. Sanjak
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland, USA
| | - Jeremy A. Boydston
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - John Yeager
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | | | - Jennifer Biryukov
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Katie Beck
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Danh Do
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Brittany G. Seman
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Brian Green
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Jordan K. Bohannon
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Brian Holland
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - David Miller
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Taylor Ammons
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Denise Freeburger
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Susan Miller
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Tammy Jenkins
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Sherry Rippeon
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - James Miller
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - David Clarke
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Emmanuel Manan
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Ashley Patty
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Kim Rhodes
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Tina Sweeney
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Michael Winpigler
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Louis A. Altamura
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Heather Zimmerman
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Alec S. Hail
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Victoria Wahl
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| | - Michael Hevey
- National Biodefense Analysis and Countermeasures Center, Operated by Battelle National Biodefense Institute, U.S. Department of Homeland Security, Frederick, Maryland, USA
| |
Collapse
|
80
|
Zhang S, Yun W, Lin Z. Integrated system of exhaust air heat pump and advanced air distribution for energy-efficient provision of outdoor air. APPLIED THERMAL ENGINEERING 2022; 217:119256. [PMID: 36091098 PMCID: PMC9439866 DOI: 10.1016/j.applthermaleng.2022.119256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/30/2022] [Accepted: 08/28/2022] [Indexed: 05/16/2023]
Abstract
A large outdoor air supply is required to control the airborne infection risk of respiratory diseases (e.g., COVID 19) but causes a high energy penalty. This study proposes a novel integrated system of the exhaust air heat pump and advanced air distribution to energy-efficiently provide outdoor air. The system energy performances are evaluated by the experimentally validated thermodynamic model of heat pump and heat removal efficiency model of advanced air distribution. Results show the exhaust air heat pump with advanced air distribution can save energy because of three mechanisms. First, the exhaust air heat pump reuses the exhaust air to reduce the condensation temperature, thereby improving the coefficient of performance. Second, advanced air distribution reduces ventilation load. Third, advanced air distribution reduces the condensation temperature and enhances the evaporation temperature, thereby improving the coefficient of performance. The exhaust air heat pump saves energy by 18%, advanced air distribution saves energy by 36%, and the integrated system of the exhaust air heat pump and advanced air distribution can save energy by 45%. As a specific application, compared with the conventional system (i.e., the outdoor air heat pump with mixing ventilation), the exhaust air heat pump with stratum ventilation saves energy by 21% - 35% under various outdoor air ratios and outdoor air temperatures. The proposed integrated system of the exhaust air heat pump and advanced air distribution contributes to the development of low-carbon and healthy buildings.
Collapse
Affiliation(s)
- Sheng Zhang
- School of Human Settlements and Civil Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Weigeng Yun
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong Special Administrative Region
| | - Zhang Lin
- Division of Building Science and Technology, City University of Hong Kong, Hong Kong Special Administrative Region
| |
Collapse
|
81
|
Valenzuela-Fernández A, Cabrera-Rodriguez R, Ciuffreda L, Perez-Yanes S, Estevez-Herrera J, González-Montelongo R, Alcoba-Florez J, Trujillo-González R, García-Martínez de Artola D, Gil-Campesino H, Díez-Gil O, Lorenzo-Salazar JM, Flores C, Garcia-Luis J. Nanomaterials to combat SARS-CoV-2: Strategies to prevent, diagnose and treat COVID-19. Front Bioeng Biotechnol 2022; 10:1052436. [PMID: 36507266 PMCID: PMC9732709 DOI: 10.3389/fbioe.2022.1052436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the associated coronavirus disease 2019 (COVID-19), which severely affect the respiratory system and several organs and tissues, and may lead to death, have shown how science can respond when challenged by a global emergency, offering as a response a myriad of rapid technological developments. Development of vaccines at lightning speed is one of them. SARS-CoV-2 outbreaks have stressed healthcare systems, questioning patients care by using standard non-adapted therapies and diagnostic tools. In this scenario, nanotechnology has offered new tools, techniques and opportunities for prevention, for rapid, accurate and sensitive diagnosis and treatment of COVID-19. In this review, we focus on the nanotechnological applications and nano-based materials (i.e., personal protective equipment) to combat SARS-CoV-2 transmission, infection, organ damage and for the development of new tools for virosurveillance, diagnose and immune protection by mRNA and other nano-based vaccines. All the nano-based developed tools have allowed a historical, unprecedented, real time epidemiological surveillance and diagnosis of SARS-CoV-2 infection, at community and international levels. The nano-based technology has help to predict and detect how this Sarbecovirus is mutating and the severity of the associated COVID-19 disease, thereby assisting the administration and public health services to make decisions and measures for preparedness against the emerging variants of SARS-CoV-2 and severe or lethal COVID-19.
Collapse
Affiliation(s)
- Agustín Valenzuela-Fernández
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Romina Cabrera-Rodriguez
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Laura Ciuffreda
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Silvia Perez-Yanes
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Judith Estevez-Herrera
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | | | - Julia Alcoba-Florez
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Rodrigo Trujillo-González
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- Departamento de Análisis Matemático, Facultad de Ciencias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Helena Gil-Campesino
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Oscar Díez-Gil
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - José M. Lorenzo-Salazar
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
| | - Carlos Flores
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, University of Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Jonay Garcia-Luis
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| |
Collapse
|
82
|
Ultrafast inactivation of SARS-CoV-2 with 266 nm lasers. Sci Rep 2022; 12:18640. [PMID: 36333440 PMCID: PMC9636154 DOI: 10.1038/s41598-022-23423-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Disinfection eliminates pathogenic microorganisms and ensures a biosafe environment for human beings. The rapid spread of COVID-19 is challenging traditional disinfection methods in terms of reducing harmful side effects and conducting faster processes. Spraying large-scale chemical disinfectants is harmful to individuals and the environment, while UV lamp and light-emitting diode (LED) disinfection still requires a long exposure time due to the low irradiance and highly divergent beam characteristics. Given that a laser maintains a high irradiance over a long distance, we studied the effectiveness of lasers as a new disinfection method, and the results show the capability for ultrafast inactivation of SARS-CoV-2 virus with a 266 nm laser. This work confirms UV lasers as a good candidate for disinfection.
Collapse
|
83
|
Oksanen L, Auvinen M, Kuula J, Malmgren R, Romantschuk M, Hyvärinen A, Laitinen S, Maunula L, Sanmark E, Geneid A, Sofieva S, Salokas J, Veskiväli H, Sironen T, Grönholm T, Hellsten A, Atanasova N. Combining Phi6 as a surrogate virus and computational large-eddy simulations to study airborne transmission of SARS-CoV-2 in a restaurant. INDOOR AIR 2022; 32:e13165. [PMID: 36437671 PMCID: PMC10100099 DOI: 10.1111/ina.13165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 05/18/2023]
Abstract
COVID-19 has highlighted the need for indoor risk-reduction strategies. Our aim is to provide information about the virus dispersion and attempts to reduce the infection risk. Indoor transmission was studied simulating a dining situation in a restaurant. Aerosolized Phi6 viruses were detected with several methods. The aerosol dispersion was modeled by using the Large-Eddy Simulation (LES) technique. Three risk-reduction strategies were studied: (1) augmenting ventilation with air purifiers, (2) spatial partitioning with dividers, and (3) combination of 1 and 2. In all simulations infectious viruses were detected throughout the space proving the existence long-distance aerosol transmission indoors. Experimental cumulative virus numbers and LES dispersion results were qualitatively similar. The LES results were further utilized to derive the evolution of infection probability. Air purifiers augmenting the effective ventilation rate by 65% reduced the spatially averaged infection probability by 30%-32%. This relative reduction manifests with approximately 15 min lag as aerosol dispersion only gradually reaches the purifier units. Both viral findings and LES results confirm that spatial partitioning has a negligible effect on the mean infection-probability indoors, but may affect the local levels adversely. Exploitation of high-resolution LES jointly with microbiological measurements enables an informative interpretation of the experimental results and facilitates a more complete risk assessment.
Collapse
Affiliation(s)
- Lotta Oksanen
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | | | - Joel Kuula
- Finnish Meteorological InstituteHelsinkiFinland
| | - Rasmus Malmgren
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Martin Romantschuk
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiLahtiFinland
| | | | | | - Leena Maunula
- Faculty of Veterinary Medicine, Food Hygiene and Environmental HealthUniversity of HelsinkiHelsinkiFinland
| | - Enni Sanmark
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Ahmed Geneid
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Svetlana Sofieva
- Finnish Meteorological InstituteHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Julija Salokas
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Helin Veskiväli
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Tarja Sironen
- Department of Virology, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Veterinary Biosciences, Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | | | | | - Nina Atanasova
- Finnish Meteorological InstituteHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| |
Collapse
|
84
|
Abkar L, Zimmermann K, Dixit F, Kheyrandish A, Mohseni M. COVID-19 pandemic lesson learned- critical parameters and research needs for UVC inactivation of viral aerosols. JOURNAL OF HAZARDOUS MATERIALS ADVANCES 2022; 8:100183. [PMID: 36619826 PMCID: PMC9553962 DOI: 10.1016/j.hazadv.2022.100183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/28/2022] [Accepted: 10/10/2022] [Indexed: 11/28/2022]
Abstract
The COVID-19 pandemic highlighted public awareness of airborne disease transmission in indoor settings and emphasized the need for reliable air disinfection technologies. This increased awareness will carry in the post-pandemic era along with the ever-emerging SARS-CoV variants, necessitating effective and well-defined protocols, methods, and devices for air disinfection. Ultraviolet (UV)-based air disinfection demonstrated promising results in inactivating viral bioaerosols. However, the reported data diversity on the required UVC doses has hindered determining the best UVC practices and led to confusion among the public and regulators. This article reviews available information on critical parameters influencing the efficacy of a UVC air disinfection system and, consequently, the required dose including the system's components as well as operational and environmental factors. There is a consensus in the literature that the interrelation of humidity and air temperature has a significant impact on the UVC susceptibility, which translate to changing the UVC efficacy of commercialized devices in indoor settings under varying conditions. Sampling and aerosolization techniques reported to have major influence on the result interpretation and it is recommended to use several sampling methods simultaneously to generate comparable and conclusive data. We also considered the safety concerns and the potential safe alternative of UVC, far-UVC. Finally, the gaps in each critical parameter and the future research needs of the field are represented. This paper is the first step to consolidating literature towards developing a standard validation protocol for UVC air disinfection devices which is determined as the one of the research needs.
Collapse
Key Words
- Aerosolization of pathogens
- Air sampling methods
- Airborne transmission
- CDC, centre for disease control and prevention (USA)
- CMD, count median diameter
- DNA, deoxyribonucleic acid
- DSB, double strand break
- Far-UVC
- Far-UVC, ultraviolet irradiation in the ‘far’ range of 200–230 nm
- GTC, growth tube collectors
- LED, light emitting diode
- LPUV, low-pressure ultraviolet lamp
- NIOSH, national institute for occupational safety and health
- PBS, phosphate buffered saline
- PRRS, porcine reproductive and respiratory syndrome
- Particle size distribution
- REL, recommended exposure limit
- RH, relative humidity
- RNA, ribonucleic acid
- ROS, reactive oxygen species
- SARS-CoV-2, severe acute respiratory syndrome coronavirus-2
- SSB, single strand break
- Suspending media
- UV, ultraviolet irradiation
- UV-LED, light emitting diode in the ultraviolet range
- UVC, ultraviolet irradiation in the ‘C’, or germicidal, spectrum from 200 to 290 nm
- UVGI, ultraviolet germicidal irradiation
- Viral UVC susceptibility
- dsDNA, double-stranded deoxyribonucleic acid
- ssRNA, single-stranded ribonucleic acid
Collapse
|
85
|
Assessment of SARS-CoV-2 airborne infection transmission risk in public buses. GEOSCIENCE FRONTIERS 2022; 13. [PMID: 37521135 PMCID: PMC9006420 DOI: 10.1016/j.gsf.2022.101398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Public transport environments are thought to play a key role in the spread of SARS-CoV-2 worldwide. Indeed, high crowding indexes (i.e. high numbers of people relative to the vehicle size), inadequate clean air supply, and frequent extended exposure durations make transport environments potential hotspots for transmission of respiratory infections. During the COVID-19 pandemic, generic mitigation measures (e.g. physical distancing) have been applied without also considering the airborne transmission route. This is due to the lack of quantified data about airborne contagion risk in transport environments. In this study, we apply a novel combination of close proximity and room-scale risk assessment approaches for people sharing public transport environments to predict their contagion risk due to SARS-CoV-2 respiratory infection. In particular, the individual infection risk of susceptible subjects and the transmissibility of SARS-CoV-2 (expressed through the reproduction number) are evaluated for two types of buses, differing in terms of exposure time and crowding index: urban and long-distance buses. Infection risk and reproduction number are calculated for different scenarios as a function of the ventilation rates (both measured and estimated according to standards), crowding indexes, and travel times. The results show that for urban buses, the close proximity contribution significantly affects the maximum occupancy to maintain a reproductive number of <1. In particular, full occupancy of the bus would be permitted only for an infected subject breathing, whereas for an infected subject speaking, masking would be required. For long-distance buses, full occupancy of the bus can be maintained only if specific mitigation solutions are simultaneously applied. For example, for an infected person speaking for 1 h, appropriate filtration of the recirculated air and simultaneous use of FFP2 masks would permit full occupancy of the bus for a period of almost 8 h. Otherwise, a high percentage of immunized persons (>80%) would be needed.
Collapse
|
86
|
Moreno T, Gibbons W. Aerosol transmission of human pathogens: From miasmata to modern viral pandemics and their preservation potential in the Anthropocene record. GEOSCIENCE FRONTIERS 2022; 13:101282. [PMID: 38620922 PMCID: PMC8356732 DOI: 10.1016/j.gsf.2021.101282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/23/2021] [Accepted: 08/08/2021] [Indexed: 05/04/2023]
Abstract
Ongoing uncertainty over the relative importance of aerosol transmission of COVID-19 is in part rooted in the history of medical science and our understanding of how epidemic diseases can spread through human populations. Ancient Greek medical theory held that such illnesses are transmitted by airborne pathogenic emanations containing particulate matter ("miasmata"). Notable Roman and medieval scholars such as Varro, Ibn al-Khatib and Fracastoro developed these ideas, combining them with early germ theory and the concept of contagion. A widely held but vaguely defined belief in toxic miasmatic mists as a dominant causative agent in disease propagation was overtaken by the science of 19th century microbiology and epidemiology, especially in the study of cholera, which was proven to be mainly transmitted by contaminated water. Airborne disease transmission came to be viewed as burdened by a dubious historical reputation and difficult to demonstrate convincingly. A breakthrough came with the classic mid-20th century work of Wells, Riley and Mills who proved how expiratory aerosols (their "droplet nuclei") could transport still-infectious tuberculosis bacteria through ventilation systems. The topic of aerosol transmission of pathogenic respiratory diseases assumed a new dimension with the mid-late 20th century "Great Acceleration" of an increasingly hypermobile human population repeatedly infected by different strains of zoonotic viruses, and has taken centre stage this century in response to outbreaks of new respiratory infections that include coronaviruses. From a geoscience perspective, the consequences of pandemic-status diseases such as COVID-19, produced by viral pathogens utilising aerosols to infect a human population currently approaching 8 billion, are far-reaching and unprecedented. The obvious and sudden impacts on for example waste plastic production, water and air quality and atmospheric chemistry are accelerating human awareness of current environmental challenges. As such, the "anthropause" lockdown enforced by COVID-19 may come to be seen as a harbinger of change great enough to be preserved in the Anthropocene stratal record.
Collapse
Affiliation(s)
- Teresa Moreno
- Institute of Environmental Assessment and Water Research, IDAEA-CSIC, 08034 Barcelona, Spain
| | | |
Collapse
|
87
|
Barbato L, Bernardelli F, Braga G, Clementini M, Di Gioia C, Littarru C, Oreglia F, Raspini M, Brambilla E, Iavicoli I, Pinchi V, Landi L, Sforza NM, Cavalcanti R, Crea A, Cairo F. Surface disinfection and protective masks for SARS-CoV-2 and other respiratory viruses: A review by SIdP COVID-19 task force. Oral Dis 2022; 28 Suppl 2:2317-2325. [PMID: 32946152 PMCID: PMC7646272 DOI: 10.1111/odi.13646] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Primary focused question for this systematic review (SR) was "Which is the evidence about surfaces decontamination and protection masks for SARS-Cov-2 in dental practice?" Secondary question was "Which is the evidence about surfaces decontamination and protection masks against airborne pathogens and directly transmitted viral pathogens causing respiratory infections?" MATERIALS AND METHODS PRISMA guidelines were used. Studies on surface decontamination and protective masks for SARS-CoV-2 in dental practice were considered. Studies on other respiratory viruses were considered for the secondary question. RESULTS No studies are available for SARS-CoV-2. Four studies on surface disinfection against respiratory viruses were included. Ethanol 70% and sodium hypochlorite 0,5% seem to be effective in reducing infectivity by > 3log TCID. Four RCTs compared different types of masks on HCW. The single studies reported no difference for laboratory-diagnosed influenza, laboratory-diagnosed respiratory infection, and influenza-like illness. A meta-analysis was not considered appropriate. CONCLUSIONS There is lack of evidence on the efficacy of surface disinfection and protective masks to reduce the spread of SARS-CoV-2 or other respiratory viruses in dentistry. However, the consistent use of respirator and routine surface disinfection is strongly suggested. There is urgent need of data on the efficacy of specific protection protocols for dental HCW against viral infections.
Collapse
Affiliation(s)
- Luigi Barbato
- Research Unit in Periodontology and Periodontal MedicineDepartment of Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
| | | | | | - Marco Clementini
- Department of PeriodontologyUniversità Vita‐Salute San RaffaeleMilanoItaly
| | | | | | | | | | - Eugenio Brambilla
- Department of BiomedicalSurgical and Dental SciencesUniversity of MilanMilanItaly
| | - Ivo Iavicoli
- Section of Occupational MedicineDepartment of Public HealthUniversity of Naples Federico IINaplesItaly
| | - Vilma Pinchi
- Department of Health SciencesSection of Medical Forensic SciencesUniversity of FlorenceFlorenceItaly
| | - Luca Landi
- Private PracticeRomeItaly
- SIdPFlorenceItaly
| | | | | | | | - Francesco Cairo
- SIdPFlorenceItaly
- Research Unit in Periodontology and Periodontal MedicineDepartment of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
| |
Collapse
|
88
|
Correia G, Rodrigues L, Afonso M, Mota M, Oliveira J, Soares R, Tomás AL, Reichel A, Silva PM, Costa JJ, da Silva MG, Santos NC, Gonçalves T. SARS-CoV-2 air and surface contamination in residential settings. Sci Rep 2022; 12:18058. [PMID: 36302823 PMCID: PMC9610309 DOI: 10.1038/s41598-022-22679-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/18/2022] [Indexed: 01/24/2023] Open
Abstract
SARS-CoV-2 transmission occurs mainly indoors, through virus-laden airborne particles. Although the presence and infectivity of SARS-CoV-2 in aerosol are now acknowledged, the underlying circumstances for its occurrence are still under investigation. The contamination of domiciliary environments during the isolation of SARS-CoV-2-infected patients in their respective rooms in individual houses and in a nursing home was investigated by collecting surface and air samples in these environments. Surface contamination was detected in different contexts, both on high and low-touch surfaces. To determine the presence of virus particles in the air, two sampling methodologies were used: air and deposition sampling. Positive deposition samples were found in sampling locations above the patient's height, and SARS-CoV-2 RNA was detected in impactation air samples within a size fraction below 2.5 μm. Surface samples rendered the highest positivity rate and persistence for a longer period. The presence of aerosolized SARS-CoV-2 RNA occurred mainly in deposition samples and closer to symptom onset. To evaluate the infectivity of selected positive samples, SARS-CoV-2 viability assays were performed, but our study was not able to validate the virus viability. The presented results confirm the presence of aerosolized SARS-CoV-2 RNA in indoor compartments occupied by COVID-19 patients with mild symptoms, in the absence of aerosol-generating clinical procedures.
Collapse
Affiliation(s)
- Gil Correia
- grid.8051.c0000 0000 9511 4342FMUC, Faculty of Medicine, Univ Coimbra, Rua Larga, 3004-504 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Medical Microbiology Research Group, CNC-Center for Neurosciences and Cell Biology, 3004-504 Coimbra, Portugal ,ARS Centro, IP, Alameda Júlio Henriques, 3000-457 Coimbra, Portugal
| | - Luís Rodrigues
- grid.8051.c0000 0000 9511 4342Universitary Clinic of Nephrology, Faculty of Medicine University of Coimbra Nephrology Service, Hospital and University Center of Coimbra, Coimbra, Portugal
| | - Mariana Afonso
- grid.8051.c0000 0000 9511 4342FMUC, Faculty of Medicine, Univ Coimbra, Rua Larga, 3004-504 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Medical Microbiology Research Group, CNC-Center for Neurosciences and Cell Biology, 3004-504 Coimbra, Portugal
| | - Marta Mota
- grid.8051.c0000 0000 9511 4342FMUC, Faculty of Medicine, Univ Coimbra, Rua Larga, 3004-504 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Medical Microbiology Research Group, CNC-Center for Neurosciences and Cell Biology, 3004-504 Coimbra, Portugal
| | - Joana Oliveira
- grid.8051.c0000 0000 9511 4342FMUC, Faculty of Medicine, Univ Coimbra, Rua Larga, 3004-504 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Medical Microbiology Research Group, CNC-Center for Neurosciences and Cell Biology, 3004-504 Coimbra, Portugal
| | - Rui Soares
- grid.8051.c0000 0000 9511 4342FMUC, Faculty of Medicine, Univ Coimbra, Rua Larga, 3004-504 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Medical Microbiology Research Group, CNC-Center for Neurosciences and Cell Biology, 3004-504 Coimbra, Portugal ,grid.418711.a0000 0004 0631 0608Department of Clinical Pathology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, 3000-075 Coimbra, Portugal
| | - Ana Luísa Tomás
- grid.9983.b0000 0001 2181 4263Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Anna Reichel
- grid.9983.b0000 0001 2181 4263Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Patrícia M. Silva
- grid.9983.b0000 0001 2181 4263Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - José J. Costa
- grid.8051.c0000 0000 9511 4342ADAI, Department of Mechanical Engineering, Univ Coimbra, Rua Luís Reis Santos, Pólo II, 3030-788 Coimbra, Portugal
| | - Manuel Gameiro da Silva
- grid.8051.c0000 0000 9511 4342ADAI, Department of Mechanical Engineering, Univ Coimbra, Rua Luís Reis Santos, Pólo II, 3030-788 Coimbra, Portugal
| | - Nuno C. Santos
- grid.9983.b0000 0001 2181 4263Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Teresa Gonçalves
- grid.8051.c0000 0000 9511 4342FMUC, Faculty of Medicine, Univ Coimbra, Rua Larga, 3004-504 Coimbra, Portugal ,grid.8051.c0000 0000 9511 4342Medical Microbiology Research Group, CNC-Center for Neurosciences and Cell Biology, 3004-504 Coimbra, Portugal
| |
Collapse
|
89
|
Hadavi I, Hashemi M, Asadikaram G, Kalantar-Neyestanaki D, Hosseininasab A, Darijani T, Faraji M. Investigation of SARS-CoV-2 Genome in the Indoor Air and High-Touch Surfaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH 2022; 16:103. [PMID: 36267501 PMCID: PMC9568984 DOI: 10.1007/s41742-022-00462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/06/2022] [Accepted: 08/16/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to investigate the presence/absence of SARS-CoV-2 genome in the air and high-touch surfaces. This cross-sectional study was conducted from late-2020 to mid-2021 in the sections of Intensive Care Unit (ICU), emergency, infectious disease ward, and nursing station of the COVID-19 patient reception center in Kerman, Iran. The presence/absence of SARS-CoV-2 genome in the 60 samples of high-touch surfaces and 23 air samples was analyzed by reverse transcription polymerase chain reaction (RT-PCR). Fisher's exact test was used to compare the number of positive samples in different sampling sites. The genome of SARS-CoV-2 was found in the eight samples (13.32%) taken from the high-touch surfaces (two samples in COVID-19 ICU, two samples in general ICU, two samples in emergency ward, and two samples in nursing station) and two air samples (8.70%) (one sample in the general ICU and one sample in the emergency ward). Statistical analysis showed that there was no significant difference between the type of sampling site and the positive cases of SARS-CoV-2 in the surface samples (p value = 0.80) and air samples (p value = 0.22). According to the results, the SARS-CoV-2 can find in the high-touch surfaces and indoor air of the COVID-19 patient reception centers. Therefore, suitable safety and health measures should be taken, including regular and accurate disinfection of surfaces and equipment and proper ventilation to protect healthcare workers and prevent disease transmission. More studies are recommended to investigate the SARS-CoV-2 concentration in the high-touch surfaces and air samples in the similar researches, efficacy of different disinfectants used on the high-touch surfaces and compare the effect of type of ventilation (natural or mechanical) on the viral load.
Collapse
Affiliation(s)
- Iman Hadavi
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Environmental Health Engineering, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Hashemi
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Environmental Health Engineering, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamreza Asadikaram
- Department of Biochemistry, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Davood Kalantar-Neyestanaki
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Medical Microbiology (Bacteriology and Virology), Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Hosseininasab
- Infectious and Tropical Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Tooba Darijani
- Department of Environmental Health Engineering, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Faraji
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Environmental Health Engineering, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
90
|
Genetic Load of SARS-CoV-2 in Aerosols Collected in Operating Theaters. Appl Environ Microbiol 2022; 88:e0129722. [PMID: 36102660 PMCID: PMC9552596 DOI: 10.1128/aem.01297-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
After the outbreak of COVID-19, additional protocols have been established to prevent the transmission of the SARS-CoV-2 from the patient to the health personnel and vice versa in health care settings. However, in the case of emergency surgeries, it is not always possible to ensure that the patient is not infected with SARS-CoV-2, assuming a potential source of transmission of the virus to health personnel. This work aimed to evaluate the presence of the SARS-CoV-2 and quantify the viral load in indoor air samples collected inside operating rooms, where emergency and scheduled operations take place. Samples were collected for 3 weeks inside two operating rooms for 24 h at 38 L/min in quartz filters. RNA was extracted from the filters and analyzed using RT-qPCR targeting SARS-CoV-2 genes E, N1 and N2 regions. SARS-CoV-2 RNA was detected in 11.3% of aerosol samples collected in operating rooms, despite with low concentrations (not detected at 13.5 cg/m3 and 10.5 cg/m3 in the scheduled and emergency operating rooms, respectively). Potential sources of airborne SARS-CoV-2 could be aerosolization of the virus during aerosol-generating procedures and in open surgery from patients that might have been recently infected with the virus, despite presenting a negative COVID-19 test. Another source could be related to health care workers unknowingly infected with the virus and exhaling SARS-CoV-2 virions into the air. These results highlight the importance of reinforcing preventive measures against COVID-19 in operating rooms, such as the correct use of protective equipment, screening programs for health care workers, and information campaigns. IMPORTANCE Operating rooms are critical environments in which asepsis must be ensured. The COVID-19 pandemic entailed the implementation of additional preventative measures in health care settings, including operating theaters. Although one of the measures is to operate only COVID-19 free patients, this measure cannot be always implemented, especially in emergency interventions. Therefore, a surveillance campaign was conducted during 3 weeks in two operating rooms to assess the level of SARS-CoV-2 genetic material detected in operating theaters with the aim to assess the risk of COVID-19 transmission during operating procedures. SARS-CoV-2 genetic material was detected in 11% of aerosol samples collected in operating rooms, despite with low concentrations. Plausible SARS-CoV-2 sources have been discussed, including patients and health care personnel infected with the virus. These results highlight the importance of reinforcing preventive measures against COVID-19 in operating rooms, such as the correct use of protective equipment, screening programs for health care workers and information campaigns.
Collapse
|
91
|
Tang SGH, Hadi MHH, Arsad SR, Ker PJ, Ramanathan S, Afandi NAM, Afzal MM, Yaw MW, Krishnan PS, Chen CP, Tiong SK. Prerequisite for COVID-19 Prediction: A Review on Factors Affecting the Infection Rate. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12997. [PMID: 36293576 PMCID: PMC9602751 DOI: 10.3390/ijerph192012997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/24/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Since the year 2020, coronavirus disease 2019 (COVID-19) has emerged as the dominant topic of discussion in the public and research domains. Intensive research has been carried out on several aspects of COVID-19, including vaccines, its transmission mechanism, detection of COVID-19 infection, and its infection rate and factors. The awareness of the public related to the COVID-19 infection factors enables the public to adhere to the standard operating procedures, while a full elucidation on the correlation of different factors to the infection rate facilitates effective measures to minimize the risk of COVID-19 infection by policy makers and enforcers. Hence, this paper aims to provide a comprehensive and analytical review of different factors affecting the COVID-19 infection rate. Furthermore, this review analyses factors which directly and indirectly affect the COVID-19 infection risk, such as physical distance, ventilation, face masks, meteorological factor, socioeconomic factor, vaccination, host factor, SARS-CoV-2 variants, and the availability of COVID-19 testing. Critical analysis was performed for the different factors by providing quantitative and qualitative studies. Lastly, the challenges of correlating each infection risk factor to the predicted risk of COVID-19 infection are discussed, and recommendations for further research works and interventions are outlined.
Collapse
Affiliation(s)
- Shirley Gee Hoon Tang
- Center for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Muhamad Haziq Hasnul Hadi
- Institute of Sustainable Energy, Department of Electrical & Electronics, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - Siti Rosilah Arsad
- Institute of Sustainable Energy, Department of Electrical & Electronics, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - Pin Jern Ker
- Institute of Sustainable Energy, Department of Electrical & Electronics, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - Santhi Ramanathan
- Faculty of Business, Multimedia University, Jalan Ayer Keroh Lama, Malacca 75450, Malaysia
| | - Nayli Aliah Mohd Afandi
- Institute of Sustainable Energy, Department of Electrical & Electronics, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - Madihah Mohd Afzal
- Center for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Mei Wyin Yaw
- Institute of Sustainable Energy, Department of Electrical & Electronics, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - Prajindra Sankar Krishnan
- Institute of Sustainable Energy, Department of Electrical & Electronics, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - Chai Phing Chen
- Institute of Sustainable Energy, Department of Electrical & Electronics, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - Sieh Kiong Tiong
- Institute of Sustainable Energy, Department of Electrical & Electronics, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| |
Collapse
|
92
|
Sachs JD, Karim SSA, Aknin L, Allen J, Brosbøl K, Colombo F, Barron GC, Espinosa MF, Gaspar V, Gaviria A, Haines A, Hotez PJ, Koundouri P, Bascuñán FL, Lee JK, Pate MA, Ramos G, Reddy KS, Serageldin I, Thwaites J, Vike-Freiberga V, Wang C, Were MK, Xue L, Bahadur C, Bottazzi ME, Bullen C, Laryea-Adjei G, Ben Amor Y, Karadag O, Lafortune G, Torres E, Barredo L, Bartels JGE, Joshi N, Hellard M, Huynh UK, Khandelwal S, Lazarus JV, Michie S. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet 2022; 400:1224-1280. [PMID: 36115368 PMCID: PMC9539542 DOI: 10.1016/s0140-6736(22)01585-9] [Citation(s) in RCA: 239] [Impact Index Per Article: 119.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/01/2022] [Accepted: 08/11/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Jeffrey D Sachs
- Center for Sustainable Development, Columbia University, New York, NY, United States.
| | - Salim S Abdool Karim
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Lara Aknin
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Joseph Allen
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, United States
| | | | - Francesca Colombo
- Health Division, Organisation for Economic Co-operation and Development, Paris, France
| | | | | | - Vitor Gaspar
- Fiscal Affairs Department, International Monetary Fund, Washington, DC, United States
| | | | - Andy Haines
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK; Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter J Hotez
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Phoebe Koundouri
- Department of International and European Economic Studies, Athens University of Economics and Business, Athens, Greece; Department of Technology, Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark; European Association of Environmental and Resource Economists, Athens, Greece
| | - Felipe Larraín Bascuñán
- Department of Economics and Administration, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jong-Koo Lee
- National Academy of Medicine of Korea, Seoul, Republic of Korea
| | - Muhammad Ali Pate
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, United States
| | | | | | | | - John Thwaites
- Monash Sustainable Development Institute, Monash University, Clayton, VIC, Australia
| | | | - Chen Wang
- National Clinical Research Center for Respiratory Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | | | - Lan Xue
- Schwarzman College, Tsinghua University, Beijing, China
| | - Chandrika Bahadur
- The Lancet COVID-19 Commission Regional Task Force: India, New Delhi, India
| | - Maria Elena Bottazzi
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Chris Bullen
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | | | - Yanis Ben Amor
- Center for Sustainable Development, Columbia University, New York, NY, United States
| | - Ozge Karadag
- Center for Sustainable Development, Columbia University, New York, NY, United States
| | | | - Emma Torres
- United Nations Sustainable Development Solutions Network, New York, NY, United States
| | - Lauren Barredo
- United Nations Sustainable Development Solutions Network, New York, NY, United States
| | - Juliana G E Bartels
- Center for Sustainable Development, Columbia University, New York, NY, United States
| | - Neena Joshi
- United Nations Sustainable Development Solutions Network, New York, NY, United States
| | | | | | | | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| |
Collapse
|
93
|
Ramezani Ziarani F, Tahamtan A, Safari H, Tabarraei A, Dadban Shahamat Y. Detection of SARS-CoV-2 genome in the air, surfaces, and wastewater of the referral hospitals, Gorgan, north of Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2022; 14:617-623. [PMID: 36531809 PMCID: PMC9723430 DOI: 10.18502/ijm.v14i5.10954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND AND OBJECTIVES Coronavirus disease 2019 (COVID-19) is a pandemic caused by the novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Knowing the virus's behavior and its persistence in different environments are crucial and will lead to the proper management of the disease. In this study, air, surface, and sewage samples were taken from different parts of referral hospitals for COVID-19. MATERIALS AND METHODS Air samples were taken with impinger, surface samples with swabs, and sewage samples were taken from the hospital wastewater treatment plant. After viral genome extraction, a real-time RT-PCR test was applied to confirm the presence of SARS-CoV-2 RNA in the collected samples. RESULTS The virus genome could be traced in the wards and wastewater related to hospitalized COVID-19 patients. Overally, 29%, 16%, and 37.5% of air, surface, and sewage samples were positive for the SARS-CoV-2 genome, respectively. CONCLUSION Findings of such studies provide valuable results regarding the degree of contamination of hospital environments and the risk of virus transmission in different environments and among hospital staff and patients.
Collapse
Affiliation(s)
- Farzad Ramezani Ziarani
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alireza Tahamtan
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hasan Safari
- Department of Environmental Health Engineering, Faculty of Health, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alijan Tabarraei
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Yousef Dadban Shahamat
- Department of Environmental Health Engineering, Faculty of Health, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| |
Collapse
|
94
|
Oksanen LAH, Virtanen J, Sanmark E, Rantanen N, Venkat V, Sofieva S, Aaltonen K, Kivistö I, Svirskaite J, Pérez AD, Kuula J, Levanov L, Hyvärinen A, Maunula L, Atanasova NS, Laitinen S, Anttila V, Lehtonen L, Lappalainen M, Geneid A, Sironen T. SARS-CoV-2 indoor environment contamination with epidemiological and experimental investigations. INDOOR AIR 2022; 32:e13118. [PMID: 36305066 PMCID: PMC9828560 DOI: 10.1111/ina.13118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/25/2022] [Accepted: 09/06/2022] [Indexed: 05/02/2023]
Abstract
SARS-CoV-2 has been detected both in air and on surfaces, but questions remain about the patient-specific and environmental factors affecting virus transmission. Additionally, more detailed information on viral sampling of the air is needed. This prospective cohort study (N = 56) presents results from 258 air and 252 surface samples from the surroundings of 23 hospitalized and eight home-treated COVID-19 index patients between July 2020 and March 2021 and compares the results between the measured environments and patient factors. Additionally, epidemiological and experimental investigations were performed. The proportions of qRT-PCR-positive air (10.7% hospital/17.6% homes) and surface samples (8.8%/12.9%) showed statistical similarity in hospital and homes. Significant SARS-CoV-2 air contamination was observed in a large (655.25 m3 ) mechanically ventilated (1.67 air changes per hour, 32.4-421 L/s/patient) patient hall even with only two patients present. All positive air samples were obtained in the absence of aerosol-generating procedures. In four cases, positive environmental samples were detected after the patients had developed a neutralizing IgG response. SARS-CoV-2 RNA was detected in the following particle sizes: 0.65-4.7 μm, 7.0-12.0 μm, >10 μm, and <100 μm. Appropriate infection control against airborne and surface transmission routes is needed in both environments, even after antibody production has begun.
Collapse
Affiliation(s)
- Lotta‐Maria A. H. Oksanen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
| | - Jenni Virtanen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Enni Sanmark
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
| | - Noora Rantanen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
| | - Vinaya Venkat
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Svetlana Sofieva
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
- Finnish Meteorological InstituteHelsinkiFinland
| | - Kirsi Aaltonen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Ilkka Kivistö
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Julija Svirskaite
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | | | - Joel Kuula
- Finnish Meteorological InstituteHelsinkiFinland
| | - Lev Levanov
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | | | - Leena Maunula
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Nina S. Atanasova
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
- Finnish Meteorological InstituteHelsinkiFinland
| | | | - Veli‐Jukka Anttila
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- HUS Inflammation CenterHelsinki University HospitalHelsinkiFinland
| | - Lasse Lehtonen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- HUS Diagnostic Center, HUSLABHelsinki University HospitalHelsinkiFinland
| | - Maija Lappalainen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- HUS Diagnostic Center, HUSLABHelsinki University HospitalHelsinkiFinland
| | - Ahmed Geneid
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
| | - Tarja Sironen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| |
Collapse
|
95
|
Abstract
The continued spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in humans necessitates evaluation of variants for enhanced virulence and transmission. We used the ferret model to perform a comparative analysis of four SARS-CoV-2 strains, including an early pandemic isolate from the United States (WA1), and representatives of the Alpha, Beta, and Delta lineages. While Beta virus was not capable of pronounced replication in ferrets, WA1, Alpha, and Delta viruses productively replicated in the ferret upper respiratory tract, despite causing only mild disease with no overt histopathological changes. Strain-specific transmissibility was observed; WA1 and Delta viruses transmitted in a direct contact setting, whereas Delta virus was also capable of limited airborne transmission. Viral RNA was shed in exhaled air particles from all inoculated animals but was highest for Delta virus. Prior infection with SARS-CoV-2 offered varied protection against reinfection with either homologous or heterologous variants. Notable genomic variants in the spike protein were most frequently detected following WA1 and Delta virus infection.
Collapse
|
96
|
SARS-CoV-2 in the Air Surrounding Patients during Nebulizer Therapy. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:9297974. [PMID: 36213437 PMCID: PMC9536972 DOI: 10.1155/2022/9297974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/05/2022] [Accepted: 08/29/2022] [Indexed: 11/19/2022]
Abstract
Nebulizer therapy is commonly used for patients with obstructive pulmonary disease or acute pulmonary infections with signs of obstruction. It is considered a “potential aerosol-generating procedure,” and the risk of disease transmission to health care workers is uncertain. The aim of this pilot study was to assess whether nebulizer therapy in hospitalized COVID-19 patients is associated with increased dispersion of SARS-CoV-2. Air samples collected prior to and during nebulizer therapy were analyzed by RT-PCR and cell culture. Total aerosol particle concentrations were also quantified. Of 13 patients, seven had quantifiable virus in oropharynx samples, and only two had RT-PCR positive air samples. For both these patients, air samples collected during nebulizer therapy had higher SARS-CoV-2 RNA concentrations compared to control air samples. Also, for particle sizes 0.3–5 µm, particle concentrations were significantly higher during nebulizer therapy than in controls. We were unable to cultivate virus from any of the RT-PCR positive air samples, and it is therefore unknown if the detected virus were replication-competent; however, the significant increase in smaller particles, which can remain airborne for extended periods of time, and increased viral RNA concentrations during treatment may indicate that nebulizer therapy is associated with increased risk of SARS-CoV-2 transmission.
Collapse
|
97
|
Genome Sequence of Genotype 1A Hepatovirus A Isolated from Plasma from a Haitian Child. Microbiol Resour Announc 2022; 11:e0044922. [PMID: 35950865 PMCID: PMC9476952 DOI: 10.1128/mra.00449-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Genotype 1A hepatovirus A was identified by quantitative reverse transcription-PCR and isolated from plasma from a Haitian child with acute undifferentiated febrile illness and malaise. The strain was most closely related to Brazilian strains, consistent with recognized patterns of virus movement in the Caribbean region.
Collapse
|
98
|
da Silva SJR, do Nascimento JCF, Germano Mendes RP, Guarines KM, Targino Alves da Silva C, da Silva PG, de Magalhães JJF, Vigar JRJ, Silva-Júnior A, Kohl A, Pardee K, Pena L. Two Years into the COVID-19 Pandemic: Lessons Learned. ACS Infect Dis 2022; 8:1758-1814. [PMID: 35940589 PMCID: PMC9380879 DOI: 10.1021/acsinfecdis.2c00204] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible and virulent human-infecting coronavirus that emerged in late December 2019 in Wuhan, China, causing a respiratory disease called coronavirus disease 2019 (COVID-19), which has massively impacted global public health and caused widespread disruption to daily life. The crisis caused by COVID-19 has mobilized scientists and public health authorities across the world to rapidly improve our knowledge about this devastating disease, shedding light on its management and control, and spawned the development of new countermeasures. Here we provide an overview of the state of the art of knowledge gained in the last 2 years about the virus and COVID-19, including its origin and natural reservoir hosts, viral etiology, epidemiology, modes of transmission, clinical manifestations, pathophysiology, diagnosis, treatment, prevention, emerging variants, and vaccines, highlighting important differences from previously known highly pathogenic coronaviruses. We also discuss selected key discoveries from each topic and underline the gaps of knowledge for future investigations.
Collapse
Affiliation(s)
- Severino Jefferson Ribeiro da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil.,Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
| | - Jessica Catarine Frutuoso do Nascimento
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Renata Pessôa Germano Mendes
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Klarissa Miranda Guarines
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Caroline Targino Alves da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Poliana Gomes da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Jurandy Júnior Ferraz de Magalhães
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil.,Department of Virology, Pernambuco State Central Laboratory (LACEN/PE), 52171-011 Recife, Pernambuco, Brazil.,University of Pernambuco (UPE), Serra Talhada Campus, 56909-335 Serra Talhada, Pernambuco, Brazil.,Public Health Laboratory of the XI Regional Health, 56912-160 Serra Talhada, Pernambuco, Brazil
| | - Justin R J Vigar
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
| | - Abelardo Silva-Júnior
- Institute of Biological and Health Sciences, Federal University of Alagoas (UFAL), 57072-900 Maceió, Alagoas, Brazil
| | - Alain Kohl
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, United Kingdom
| | - Keith Pardee
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada.,Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada
| | - Lindomar Pena
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| |
Collapse
|
99
|
Linde KJ, Wouters IM, Kluytmans JAJW, Kluytmans-van den Bergh MFQ, Pas SD, GeurtsvanKessel CH, Koopmans MPG, Meier M, Meijer P, Raben CR, Spithoven J, Tersteeg-Zijderveld MHG, Heederik DJJ, Dohmen W. Detection of SARS-CoV-2 in Air and on Surfaces in Rooms of Infected Nursing Home Residents. Ann Work Expo Health 2022; 67:129-140. [PMID: 36068657 PMCID: PMC9834894 DOI: 10.1093/annweh/wxac056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/12/2022] [Accepted: 07/29/2022] [Indexed: 01/14/2023] Open
Abstract
There is an ongoing debate on airborne transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as a risk factor for infection. In this study, the level of SARS-CoV-2 in air and on surfaces of SARS-CoV-2 infected nursing home residents was assessed to gain insight in potential transmission routes. During outbreaks, air samples were collected using three different active and one passive air sampling technique in rooms of infected patients. Oropharyngeal swabs (OPS) of the residents and dry surface swabs were collected. Additionally, longitudinal passive air samples were collected during a period of 4 months in common areas of the wards. Presence of SARS-CoV-2 RNA was determined using RT-qPCR, targeting the RdRp- and E-genes. OPS, samples of two active air samplers and surface swabs with Ct-value ≤35 were tested for the presence of infectious virus by cell culture. In total, 360 air and 319 surface samples from patient rooms and common areas were collected. In rooms of 10 residents with detected SARS-CoV-2 RNA in OPS, SARS-CoV-2 RNA was detected in 93 of 184 collected environmental samples (50.5%) (lowest Ct 29.5), substantially more than in the rooms of residents with negative OPS on the day of environmental sampling (n = 2) (3.6%). SARS-CoV-2 RNA was most frequently present in the larger particle size fractions [>4 μm 60% (6/10); 1-4 μm 50% (5/10); <1 μm 20% (2/10)] (Fischer exact test P = 0.076). The highest proportion of RNA-positive air samples on room level was found with a filtration-based sampler 80% (8/10) and the cyclone-based sampler 70% (7/10), and impingement-based sampler 50% (5/10). SARS-CoV-2 RNA was detected in 10 out of 12 (83%) passive air samples in patient rooms. Both high-touch and low-touch surfaces contained SARS-CoV-2 genome in rooms of residents with positive OPS [high 38% (21/55); low 50% (22/44)]. In one active air sample, infectious virus in vitro was detected. In conclusion, SARS-CoV-2 is frequently detected in air and on surfaces in the immediate surroundings of room-isolated COVID-19 patients, providing evidence of environmental contamination. The environmental contamination of SARS-CoV-2 and infectious aerosols confirm the potential for transmission via air up to several meters.
Collapse
Affiliation(s)
- Kimberly J Linde
- Author to whom correspondence should be addressed. Tel: +31302535358; e-mail:
| | - Inge M Wouters
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jan A J W Kluytmans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjolein F Q Kluytmans-van den Bergh
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands,Department of Infection Control, Amphia Hospital, Breda, The Netherlands
| | - Suzan D Pas
- Microvida Location Amphia/Bravis, Breda/Roosendaal, The Netherlands
| | | | | | | | - Patrick Meijer
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ceder R Raben
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jack Spithoven
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | | | - Dick J J Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Wietske Dohmen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | | |
Collapse
|
100
|
Vass WB, Lednicky JA, Shankar SN, Fan ZH, Eiguren-Fernandez A, Wu CY. Viable SARS-CoV-2 Delta variant detected in aerosols in a residential setting with a self-isolating college student with COVID-19. JOURNAL OF AEROSOL SCIENCE 2022; 165:106038. [PMID: 35774447 PMCID: PMC9217630 DOI: 10.1016/j.jaerosci.2022.106038] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 05/08/2023]
Abstract
The B.1.617.2 (Delta) variant of SARS-CoV-2 emerged in India in October of 2020 and spread widely to over 145 countries, comprising over 99% of genome sequence-confirmed virus in COVID-19 cases of the United States (US) by September 2021. The rise in COVID-19 cases due to the Delta variant coincided with a return to in-person school attendance, straining COVID-19 mitigation plans implemented by educational institutions. Some plans required sick students to self-isolate off-campus, resulting in an unintended consequence: exposure of co-inhabitants of dwellings used by the sick person during isolation. We assessed air and surface samples collected from the bedroom of a self-isolating university student with mild COVID-19 for the presence of SARS-CoV-2. That virus' RNA was detected by real-time reverse-transcription quantitative polymerase chain reaction (rRT-qPCR) in air samples from both an isolation bedroom and a distal, non-isolation room of the same dwelling. SARS-CoV-2 was detected and viable virus was isolated in cell cultures from aerosol samples as well as from the surface of a mobile phone. Genomic sequencing revealed that the virus was a Delta variant SARS-CoV-2 strain. Taken together, the results of this work confirm the presence of viable SARS-CoV-2 within a residential living space of a person with COVID-19 and show potential for transportation of virus-laden aerosols beyond a designated isolation suite to other areas of a single-family home.
Collapse
Affiliation(s)
- William B Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| | - John A Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| | - Z Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, 32611, USA
- Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| |
Collapse
|