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Sharma S, Mohindra R, Rana K, Suri V, Bhalla A, Biswal M, Singh MP, Goyal K, Lakshmi PVM. Assessment of Potential Risk Factors for 2019-Novel Coronavirus (2019-nCov) Infection among Health Care Workers in a Tertiary Care Hospital, North India. J Prim Care Community Health 2021; 12:21501327211002099. [PMID: 33719717 PMCID: PMC7968012 DOI: 10.1177/21501327211002099] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Health care workers (HCWs) are at the forefront to fight against COVID-19 pandemic. They are at more risk of contracting the infection. This study was planned to assess potential risk factors of 2019-novel coronavirus infection among HCWs working in a health facility and to evaluate the effectiveness of infection prevention and control measures among them. METHODS A study was conducted in a tertiary care hospital among HCWs who were directly or indirectly involved in the management of a confirmed or suspected case of COVID-19. The socio-demographic characteristics, history of exposure, IPC measures followed and clinical symptoms were compared between health care workers in COVID and non-COVID areas. RESULTS Majority (45%) of HCWs were nurses, followed by hospital/sanitary/technical attendants (30%) and doctors (24%). Out of a total of 256 HCWs, 2% tested positive. Around 80% of HCWs had ever attended any IPC training. A statistically significant association was found between posting area of HCWs and their exposure to COVID patients (duration of exposure, PPE has worn by HCWs, direct contact of HCWs with the patient's material) and COVID positivity (P value <.001). CONCLUSION If health care workers were trained and take adequate precautions then the risk of getting an infection is minimized.
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Belluco S, Mancin M, Marzoli F, Bortolami A, Mazzetto E, Pezzuto A, Favretti M, Terregino C, Bonfante F, Piro R. Prevalence of SARS-CoV-2 RNA on inanimate surfaces: a systematic review and meta-analysis. Eur J Epidemiol 2021; 36:685-707. [PMID: 34313896 PMCID: PMC8313411 DOI: 10.1007/s10654-021-00784-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease (COVID-19) is a respiratory disease affecting many people and able to be transmitted through direct and perhaps indirect contact. Direct contact transmission, mediated by aerosols or droplets, is widely demonstrated, whereas indirect transmission is only supported by collateral evidence such as virus persistence on inanimate surfaces and data from other similar viruses. The present systematic review aims to estimate SARS-CoV-2 prevalence on inanimate surfaces, identifying risk levels according to surface characteristics. Data were obtained from studies in published papers collected from two databases (PubMed and Embase) with the last search on 1 September 2020. Included studies had to be papers in English, had to deal with coronavirus and had to consider inanimate surfaces in real settings. Studies were coded according to our assessment of the risk that the investigated surfaces could be contaminated by SARS-CoV-2. A meta-analysis and a metaregression were carried out to quantify virus RNA prevalence and to identify important factors driving differences among studies. Thirty-nine out of forty retrieved paper reported studies carried out in healthcare settings on the prevalence of virus RNA, five studies carry out also analyses through cell culture and six tested the viability of isolated viruses. Overall prevalences of SARS-CoV-2 RNA on high-, medium- and low-risk surfaces were 0.22 (CI95 [0.152-0.296]), 0.04 (CI95 [0.007-0.090]), and 0.00 (CI95 [0.00-0.019]), respectively. The duration surfaces were exposed to virus sources (patients) was the main factor explaining differences in prevalence.
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Affiliation(s)
- Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy.
| | - Marzia Mancin
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Filippo Marzoli
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Alessio Bortolami
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Eva Mazzetto
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Alessandra Pezzuto
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Michela Favretti
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Calogero Terregino
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Francesco Bonfante
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Roberto Piro
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
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Neale RE, Barnes PW, Robson TM, Neale PJ, Williamson CE, Zepp RG, Wilson SR, Madronich S, Andrady AL, Heikkilä AM, Bernhard GH, Bais AF, Aucamp PJ, Banaszak AT, Bornman JF, Bruckman LS, Byrne SN, Foereid B, Häder DP, Hollestein LM, Hou WC, Hylander S, Jansen MAK, Klekociuk AR, Liley JB, Longstreth J, Lucas RM, Martinez-Abaigar J, McNeill K, Olsen CM, Pandey KK, Rhodes LE, Robinson SA, Rose KC, Schikowski T, Solomon KR, Sulzberger B, Ukpebor JE, Wang QW, Wängberg SÅ, White CC, Yazar S, Young AR, Young PJ, Zhu L, Zhu M. Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2020. Photochem Photobiol Sci 2021; 20:1-67. [PMID: 33721243 PMCID: PMC7816068 DOI: 10.1007/s43630-020-00001-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 01/31/2023]
Abstract
This assessment by the Environmental Effects Assessment Panel (EEAP) of the United Nations Environment Programme (UNEP) provides the latest scientific update since our most recent comprehensive assessment (Photochemical and Photobiological Sciences, 2019, 18, 595-828). The interactive effects between the stratospheric ozone layer, solar ultraviolet (UV) radiation, and climate change are presented within the framework of the Montreal Protocol and the United Nations Sustainable Development Goals. We address how these global environmental changes affect the atmosphere and air quality; human health; terrestrial and aquatic ecosystems; biogeochemical cycles; and materials used in outdoor construction, solar energy technologies, and fabrics. In many cases, there is a growing influence from changes in seasonality and extreme events due to climate change. Additionally, we assess the transmission and environmental effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the COVID-19 pandemic, in the context of linkages with solar UV radiation and the Montreal Protocol.
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Affiliation(s)
- R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - P W Barnes
- Biological Sciences and Environmental Program, Loyola University New Orleans, New Orleans, LA, USA
| | - T M Robson
- Organismal and Evolutionary Biology (OEB), Viikki Plant Sciences Centre (ViPS), University of Helsinki, Helsinki, Finland
| | - P J Neale
- Smithsonian Environmental Research Center, Maryland, USA
| | - C E Williamson
- Department of Biology, Miami University, Oxford, OH, USA
| | - R G Zepp
- ORD/CEMM, US Environmental Protection Agency, Athens, GA, USA
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - S Madronich
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - A L Andrady
- Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC, USA
| | - A M Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | - G H Bernhard
- Biospherical Instruments Inc, San Diego, CA, USA
| | - A F Bais
- Department of Physics, Laboratory of Atmospheric Physics, Aristotle University, Thessaloniki, Greece
| | - P J Aucamp
- Ptersa Environmental Consultants, Pretoria, South Africa
| | - A T Banaszak
- Unidad Académica de Sistemas Arrecifales, Universidad Nacional Autónoma de México, Puerto Morelos, México
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia.
| | - L S Bruckman
- Department of Materials Science and Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - S N Byrne
- The University of Sydney, School of Medical Sciences, Discipline of Applied Medical Science, Sydney, Australia
| | - B Foereid
- Environment and Natural Resources, Norwegian Institute of Bioeconomy Research, Ås, Norway
| | - D-P Häder
- Department of Biology, Friedrich-Alexander University, Möhrendorf, Germany
| | - L M Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - W-C Hou
- Department of Environmental Engineering, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - S Hylander
- Centre for Ecology and Evolution in Microbial model Systems-EEMiS, Linnaeus University, Kalmar, Sweden.
| | - M A K Jansen
- School of BEES, Environmental Research Institute, University College Cork, Cork, Ireland
| | - A R Klekociuk
- Antarctic Climate Program, Australian Antarctic Division, Kingston, Australia
| | - J B Liley
- National Institute of Water and Atmospheric Research, Lauder, New Zealand
| | - J Longstreth
- The Institute for Global Risk Research, LLC, Bethesda, MD, USA
| | - R M Lucas
- National Centre of Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - J Martinez-Abaigar
- Faculty of Science and Technology, University of La Rioja, Logroño, Spain
| | | | - C M Olsen
- Cancer Control Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - K K Pandey
- Department of Wood Properties and Uses, Institute of Wood Science and Technology, Bangalore, India
| | - L E Rhodes
- Photobiology Unit, Dermatology Research Centre, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - S A Robinson
- Securing Antarctica's Environmental Future, Global Challenges Program and School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - K C Rose
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - T Schikowski
- IUF-Leibniz Institute of Environmental Medicine, Dusseldorf, Germany
| | - K R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - B Sulzberger
- Academic Guest Eawag: Swiss Federal Institute of Aquatic Science and Technology, Duebendorf, Switzerland
| | - J E Ukpebor
- Chemistry Department, Faculty of Physical Sciences, University of Benin, Benin City, Nigeria
| | - Q-W Wang
- Institute of Applied Ecology, Chinese Academy of Sciences (CAS), Shenyang, China
| | - S-Å Wängberg
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - C C White
- Bee America, 5409 Mohican Rd, Bethesda, MD, USA
| | - S Yazar
- Garvan Institute of Medical Research, Sydney, Australia
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, UK
| | - P J Young
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - L Zhu
- Center for Advanced Low-Dimension Materials, Donghua University, Shanghai, China
| | - M Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, China
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Aydogdu MO, Altun E, Chung E, Ren G, Homer-Vanniasinkam S, Chen B, Edirisinghe M. Surface interactions and viability of coronaviruses. J R Soc Interface 2021; 18:20200798. [PMID: 33402019 PMCID: PMC7879773 DOI: 10.1098/rsif.2020.0798] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022] Open
Abstract
The recently emerged coronavirus pandemic (COVID-19) has become a worldwide threat affecting millions of people, causing respiratory system related problems that can end up with extremely serious consequences. As the infection rate rises significantly and this is followed by a dramatic increase in mortality, the whole world is struggling to accommodate change and is trying to adapt to new conditions. While a significant amount of effort is focused on developing a vaccine in order to make a game-changing anti-COVID-19 breakthrough, novel coronavirus (SARS-CoV-2) is also developing mutations rapidly as it transmits just like any other virus and there is always a substantial chance of the invented antibodies becoming ineffective as a function of time, thus failing to inhibit virus-to-cell binding efficiency as the spiked protein keeps evolving. Hence, controlling the transmission of the virus is crucial. Therefore, this review summarizes the viability of coronaviruses on inanimate surfaces under different conditions while addressing the current state of known chemical disinfectants for deactivation of the coronaviruses. The review attempts to bring together a wide spectrum of surface-virus-cleaning agent interactions to help identify material selection for inanimate surfaces that have frequent human contact and cleaning procedures for effective prevention of COVID-19 transmission.
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Affiliation(s)
- Mehmet Onur Aydogdu
- Department of Mechanical Engineering, University College London (UCL), Torrington Place, London WC1E 7JE, UK
| | - Esra Altun
- Department of Mechanical Engineering, University College London (UCL), Torrington Place, London WC1E 7JE, UK
| | - Etelka Chung
- Science and Technology Research Institute, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Guogang Ren
- Science and Technology Research Institute, University of Hertfordshire, Hatfield AL10 9AB, UK
| | | | - Biqiong Chen
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Belfast BT7 1NN, UK
| | - Mohan Edirisinghe
- Department of Mechanical Engineering, University College London (UCL), Torrington Place, London WC1E 7JE, UK
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55
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Ravi K, Pushpa NB. Mask – A Ubiquitous Symbol of COVID-19 Scuffle. NATIONAL JOURNAL OF CLINICAL ANATOMY 2021. [DOI: 10.4103/njca.njca_9_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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56
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Wong JCC, Hapuarachchi HC, Arivalan S, Tien WP, Koo C, Mailepessov D, Kong M, Nazeem M, Lim M, Ng LC. Environmental Contamination of SARS-CoV-2 in a Non-Healthcare Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E117. [PMID: 33375308 PMCID: PMC7797951 DOI: 10.3390/ijerph18010117] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/18/2022]
Abstract
Fomite-mediated transmission has been identified as a possible route for the spread of COVID-19 disease caused by SARS-CoV-2. In healthcare settings, environmental contamination by SARS-CoV-2 has been found in patients' rooms and toilets. Here, we investigated environmental presence of SARS-CoV-2 in non-healthcare settings and assessed the efficacy of cleaning and disinfection in removing virus contamination. A total of 428 environmental swabs and six air samples was taken from accommodation rooms, toilets and elevators that have been used by COVID-19 cases. By using a reverse transcription polymerase chain reaction assay, we detected two SARS-CoV-2 RNA positive samples in a room where a COVID-19 patient stayed prior to diagnosis. The present study highlights the risk of fomite-mediated transmission in non-healthcare settings and the importance of surface disinfection in spaces occupied by cases. Of note, neither air-borne transmission nor surface contamination of elevators, which were transiently exposed to infected individuals, was evident among samples analyzed.
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Affiliation(s)
- Judith Chui Ching Wong
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Hapuarachchige Chanditha Hapuarachchi
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Sathish Arivalan
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Wei Ping Tien
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Carmen Koo
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Diyar Mailepessov
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Marcella Kong
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Mohammad Nazeem
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Merrill Lim
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
| | - Lee Ching Ng
- Environmental Health Institute, National Environmental Agency, 11, Biopolis Way, Helios Block, #06-05/08, Singapore 138667, Singapore; (J.C.C.W.); (H.C.H.); (S.A.); (W.P.T.); (C.K.); (D.M.); (M.K.); (M.N.); (M.L.)
- School of Biological Sciences, Nanyang Technological University, 60, Nanyang Drive, Singapore 637551, Singapore
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Gholipour S, Nikaeen M, Mohammadi Manesh R, Aboutalebian S, Shamsizadeh Z, Nasri E, Mirhendi H. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Contamination of High-touch Surfaces in Field Settings. BIOMEDICAL AND ENVIRONMENTAL SCIENCES : BES 2020; 33:925-929. [PMID: 33472732 PMCID: PMC7817469 DOI: 10.3967/bes2020.126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/30/2020] [Indexed: 05/11/2023]
Affiliation(s)
- Sahar Gholipour
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran;Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahnaz Nikaeen
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran;Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, University of Medical Sciences, Isfahan, Iran
| | - Reza Mohammadi Manesh
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shima Aboutalebian
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Shamsizadeh
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elahe Nasri
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mirhendi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Ben-Shmuel A, Brosh-Nissimov T, Glinert I, Bar-David E, Sittner A, Poni R, Cohen R, Achdout H, Tamir H, Yahalom-Ronen Y, Politi B, Melamed S, Vitner E, Cherry L, Israeli O, Beth-Din A, Paran N, Israely T, Yitzhaki S, Levy H, Weiss S. Detection and infectivity potential of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination in isolation units and quarantine facilities. Clin Microbiol Infect 2020; 26:1658-1662. [PMID: 32919072 PMCID: PMC7481174 DOI: 10.1016/j.cmi.2020.09.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Environmental surfaces have been suggested as likely contributors in the transmission of COVID-19. This study assessed the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contaminating surfaces and objects in two hospital isolation units and a quarantine hotel. METHODS SARS-CoV-2 virus stability and infectivity on non-porous surfaces was tested under controlled laboratory conditions. Surface and air sampling were conducted at two COVID-19 isolation units and in a quarantine hotel. Viral RNA was detected by RT-PCR and infectivity was assessed by VERO E6 CPE test. RESULTS In laboratory-controlled conditions, SARS-CoV-2 gradually lost its infectivity completely by day 4 at ambient temperature, and the decay rate of viral viability on surfaces directly correlated with increase in temperature. Viral RNA was detected in 29/55 surface samples (52.7%) and 16/42 surface samples (38%) from the surroundings of symptomatic COVID-19 patients in isolation units of two hospitals and in a quarantine hotel for asymptomatic and very mild COVID-19 patients. None of the surface and air samples from the three sites (0/97) were found to contain infectious titres of SARS-Cov-2 on tissue culture assay. CONCLUSIONS Despite prolonged viability of SARS-CoV-2 under laboratory-controlled conditions, uncultivable viral contamination of inanimate surfaces might suggest low feasibility for indirect fomite transmission.
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Affiliation(s)
- Amir Ben-Shmuel
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Tal Brosh-Nissimov
- Infectious Diseases Unit, Assuta Ashdod University Hospital, Ashdod, Israel; Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheba, Israel
| | - Itai Glinert
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Elad Bar-David
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Assa Sittner
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Reut Poni
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Regev Cohen
- Infectious Diseases Unit, Laniado Hospital, Netanya, Israel
| | - Hagit Achdout
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Hadas Tamir
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Yfat Yahalom-Ronen
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Boaz Politi
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Sharon Melamed
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Einat Vitner
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Lilach Cherry
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Ofir Israeli
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Adi Beth-Din
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Nir Paran
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Tomer Israely
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Shmuel Yitzhaki
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Haim Levy
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Shay Weiss
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel.
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Kampf G, Brüggemann Y, Kaba H, Steinmann J, Pfaender S, Scheithauer S, Steinmann E. Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2. J Hosp Infect 2020; 106:678-697. [PMID: 32956786 PMCID: PMC7500278 DOI: 10.1016/j.jhin.2020.09.022] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 12/19/2022]
Abstract
During the current SARS-CoV-2 pandemic new studies are emerging daily providing novel information about sources, transmission risks and possible prevention measures. In this review, we aimed to comprehensively summarize the current evidence on possible sources for SARS-CoV-2, including evaluation of transmission risks and effectiveness of applied prevention measures. Next to symptomatic patients, asymptomatic or pre-symptomatic carriers are a possible source with respiratory secretions as the most likely cause for viral transmission. Air and inanimate surfaces may be sources; however, viral RNA has been inconsistently detected. Similarly, even though SARS-CoV-2 RNA has been detected on or in personal protective equipment (PPE), blood, urine, eyes, the gastrointestinal tract and pets, these sources are currently thought to play a negligible role for transmission. Finally, various prevention measures such as handwashing, hand disinfection, face masks, gloves, surface disinfection or physical distancing for the healthcare setting and in public are analysed for their expected protective effect.
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Affiliation(s)
- G. Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany,Corresponding author. Address: University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Ferdinand-Sauerbruch-Strasse, 17475 Greifswald, Germany
| | - Y. Brüggemann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - H.E.J. Kaba
- Institute of Infection Control and Infectious Diseases, University Medical Center, Georg August University, Göttingen, Germany
| | - J. Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | - S. Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - S. Scheithauer
- Institute of Infection Control and Infectious Diseases, University Medical Center, Georg August University, Göttingen, Germany
| | - E. Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
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Dansana D, Kumar R, Das Adhikari J, Mohapatra M, Sharma R, Priyadarshini I, Le DN. Global Forecasting Confirmed and Fatal Cases of COVID-19 Outbreak Using Autoregressive Integrated Moving Average Model. Front Public Health 2020; 8:580327. [PMID: 33194982 PMCID: PMC7658382 DOI: 10.3389/fpubh.2020.580327] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/31/2020] [Indexed: 12/21/2022] Open
Abstract
The world health organization (WHO) formally proclaimed the novel coronavirus, called COVID-19, a worldwide pandemic on March 11 2020. In December 2019, COVID-19 was first identified in Wuhan city, China, and now coronavirus has spread across various nations infecting more than 198 countries. As the cities around China started getting contaminated, the number of cases increased exponentially. As of March 18 2020, the number of confirmed cases worldwide was more than 250,000, and Asia alone had more than 81,000 cases. The proposed model uses time series analysis to forecast the outbreak of COVID-19 around the world in the upcoming days by using an autoregressive integrated moving average (ARIMA). We analyze data from February 1 2020 to April 1 2020. The result shows that 120,000 confirmed fatal cases are forecasted using ARIMA by April 1 2020. Moreover, we have also evaluated the total confirmed cases, the total fatal cases, autocorrelation function, and white noise time-series for both confirmed cases and fatalities in the COVID-19 outbreak.
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Affiliation(s)
- Debabrata Dansana
- Department of Computer Science and Engineering, GIET University, Gunupur, India
| | - Raghvendra Kumar
- Department of Computer Science and Engineering, GIET University, Gunupur, India
| | | | - Mans Mohapatra
- Department of Computer Science and Engineering, GIET University, Gunupur, India
| | - Rohit Sharma
- Department of Electronics & Communication Engineering, SRM Institute of Science and Technology, Ghaziabad, India
| | - Ishaani Priyadarshini
- Department of Electrical and Computer Engineering, University of Delaware, Newark, DE, United States
| | - Dac-Nhuong Le
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam.,Faculty of Information Technology, Duy Tan University, Da Nang, Vietnam
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Datta S, Dexter F, Ledolter J, Wall RT, Loftus RW. Sample times for surveillance of S. aureus transmission to monitor effectiveness and provide feedback on intraoperative infection control. ACTA ACUST UNITED AC 2020; 21:100137. [PMID: 33072894 PMCID: PMC7547614 DOI: 10.1016/j.pcorm.2020.100137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/04/2020] [Accepted: 10/08/2020] [Indexed: 01/17/2023]
Abstract
Background Reductions in perioperative surgical site infections are obtained by a multifaceted approach including patient decolonization, vascular care, hand hygiene, and environmental cleaning. Associated surveillance of S. aureus transmission quantifies the effectiveness of these basic measures to prevent transmission of pathogenic bacteria and viruses to patients and clinicians, including Coronavirus Disease 2019 (COVID-19). To measure transmission, the observational units are pairs of successive surgical cases in the same operating room on the same day. In this prospective cohort study, we measured sampling times for inexperienced and experienced personnel. Methods OR PathTrac kits included 6 samples collected before the start of surgery and 7 after surgery. The time for consent also was recorded. We obtained 1677 measurements of time among 132 cases. Results Sampling times were not significantly affected by technician's experience, type of anesthetic, or patient's American Society of Anesthesiologists’ Physical Status. Sampling times before the start of surgery averaged less than 5 min (3.39 min [SE 0.23], P < 0.0001). Sampling times after surgery took approximately 5 min (4.39 [SE 0.25], P = 0.015). Total sampling times averaged less than 10 min without consent (7.79 [SE 0.50], P < 0.0001), and approximately 10 min with consent (10.22 [0.56], P = 0.70). Conclusions For routine use of monitoring S. aureus transmission, when done by personnel already present in the operating rooms of the cases, the personnel time budget can be 10 min per case.
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Affiliation(s)
- Subhradeep Datta
- Medical student 2022 class, Georgetown University, United States
| | - Franklin Dexter
- Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6-JCP, Iowa City, IA, 52242, United States
| | | | | | - Randy W Loftus
- Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6-JCP, Iowa City, IA, 52242, United States
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62
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Brown E, Nelson N, Gubbins S, Colenutt C. Environmental and air sampling are efficient methods for the detection and quantification of foot-and-mouth disease virus. J Virol Methods 2020; 287:113988. [PMID: 33038353 PMCID: PMC7539831 DOI: 10.1016/j.jviromet.2020.113988] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022]
Abstract
Foot-and-mouth disease virus (FMDV) can be found in all secretions and excretions and the breath of acutely infected animals. FMDV can survive in the environment, providing an opportunity for surveillance. The objective of this study was to assess the efficiency of sampling methods for the recovery and quantification of FMDV from a range of environmental surfaces and in aerosols. Selected surfaces, based on those likely to be found on farms, were spiked with a range of concentrations of FMDV, left to dry and then the surface was swabbed with an electrostatic dust cloth. For aerosol sampling, FMDV was nebulised at different concentrations and distances from the sampler. Recovery of viral RNA and infectious virus was measured by RT-qPCR and virus isolation respectively. FMDV RNA was detected from all surfaces at all concentrations except from glass. Infectious virus was recovered from all surfaces but only at higher concentrations. The higher the starting concentration of virus the more efficient the recovery was from surfaces and recovery was more consistent from non-porous surfaces than porous surfaces. FMDV was detected in aerosol samples and the amount of virus recovered decreased as the distance between the nebuliser and sampler increased. The higher the starting concentration of virus the more efficient the recovery was from sampled aerosols. The information provided in this study could be used to direct environmental and aerosol sampling approaches in the field and improve the detection efficiency of FMDV from an environment, thus extending the toolbox available for diagnosis and surveillance of this pathogen.
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Affiliation(s)
- Emma Brown
- The Pirbright Institute, Ash Road, Pirbright, Surrey, GU24 0NF, United Kingdom.
| | - Noel Nelson
- The Pirbright Institute, Ash Road, Pirbright, Surrey, GU24 0NF, United Kingdom; The Met Office, FitzRoy Road, Exeter, Devon, EX1 3PB, United Kingdom
| | - Simon Gubbins
- The Pirbright Institute, Ash Road, Pirbright, Surrey, GU24 0NF, United Kingdom
| | - Claire Colenutt
- The Pirbright Institute, Ash Road, Pirbright, Surrey, GU24 0NF, United Kingdom
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63
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Vardoulakis S, Sheel M, Lal A, Gray D. COVID-19 environmental transmission and preventive public health measures. Aust N Z J Public Health 2020; 44:333-335. [PMID: 32833313 PMCID: PMC7461436 DOI: 10.1111/1753-6405.13033] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory,Correspondence to: Sotiris Vardoulakis, National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory
| | - Aparna Lal
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory
| | - Darren Gray
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory
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Abo-Zeid Y, Ismail NSM, McLean GR, Hamdy NM. A molecular docking study repurposes FDA approved iron oxide nanoparticles to treat and control COVID-19 infection. Eur J Pharm Sci 2020; 153:105465. [PMID: 32668312 PMCID: PMC7354764 DOI: 10.1016/j.ejps.2020.105465] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 12/27/2022]
Abstract
COVID-19, is a disease resulting from the SARS-CoV-2 global pandemic. Due to the current global emergency and the length of time required to develop specific antiviral agent(s) and a vaccine for SARS-CoV-2, the world health organization (WHO) adopted the strategy of repurposing existing medications to treat COVID-19. Iron oxide nanoparticles (IONPs) were previously approved by the US food and drug administration (FDA) for anemia treatment and studies have also demonstrated its antiviral activity in vitro. Therefore, we performed a docking study to explore the interaction of IONPs (Fe2O3 and Fe3O4) with the spike protein receptor binding domain (S1-RBD) of SARS-CoV-2 that is required for virus attachment to the host cell receptors. A similar docking analysis was also performed with hepatitis C virus (HCV) glycoproteins E1 and E2. These studies revealed that both Fe2O3 and Fe3O4 interacted efficiently with the SARS-CoV-2 S1-RBD and to HCV glycoproteins, E1 and E2. Fe3O4 formed a more stable complex with S1-RBD whereas Fe2O3 favored HCV E1 and E2. These interactions of IONPs are expected to be associated with viral proteins conformational changes and hence, viral inactivation. Therefore, we recommend FDA-approved-IONPs to proceed for COVID-19 treatment clinical trials.
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Affiliation(s)
- Yasmin Abo-Zeid
- Pharmaceutics Dept., Faculty of Pharmacy, Helwan University, Cairo, Egypt.
| | - Nasser S M Ismail
- Pharmaceutical Chemistry Dept., Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo 12311, Egypt.
| | - Gary R McLean
- Cellular and Molecular Immunology Research Centre, London Metropolitan University, 166-220 Holloway Road, London, N7 8DB, UK; National Heart and Lung Institute, Imperial College London, Norfolk Place, London W2 1PG UK.
| | - Nadia M Hamdy
- Biochemistry Dept., Faculty of Pharmacy, Ain shams University, Cairo, 11566, Egypt.
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Mayurnikova L, Koksharov A, Krapiva T. Food safety practices in catering during the coronavirus COVID-19 pandemic. FOODS AND RAW MATERIALS 2020. [DOI: 10.21603/2308-4057-2020-2-197-203] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
On January 30, 2020, the Director-General of the World Health Organization declared the outbreak of COVID-19 a Public Health Emergency of International Concern. There is hardly a country in the world that is not currently facing this problem. The number of cases is constantly growing, patients and carriers being the main mode of transmission. The economies of all countries are at stake. However, people need essential goods and food, regardless of the situation. In this respect, agriculture, food industry, food market, and catering have become priority industries. A continuous operation of food service enterprises (FSE) is crucial for the uninterrupted food supply in the period of preventive measures. The paper describes how pathogen makes its way into FSEs, spreads, and infects people. This information makes it possible to assess the probability of coronavirus infection and to reduce its spread, thus ensuring the safe operation of the enterprise. There are three transmission routes the coronavirus can take at a FSE: (1) aerial transmission by droplets and aerosols during the main and secondary technological production processes, (2) person-to-person transmission from clients to staff or from employee to employee via direct or indirect contact, (3) transmission via contaminated surfaces, e.g. packaging, furniture, equipment, etc. FSEs have to follow the recommendations published by the federal and/or local authorities, which may vary depending on the COVID-19 incidence rate in the area. These recommendations are based on the probability of the public health risk associated with person-to-person transmission, rather than on food safety.
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Gaudou B, Huynh NQ, Philippon D, Brugière A, Chapuis K, Taillandier P, Larmande P, Drogoul A. COMOKIT: A Modeling Kit to Understand, Analyze, and Compare the Impacts of Mitigation Policies Against the COVID-19 Epidemic at the Scale of a City. Front Public Health 2020; 8:563247. [PMID: 33072700 PMCID: PMC7542232 DOI: 10.3389/fpubh.2020.563247] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022] Open
Abstract
Since its emergence in China, the COVID-19 pandemic has spread rapidly around the world. Faced with this unknown disease, public health authorities were forced to experiment, in a short period of time, with various combinations of interventions at different scales. However, as the pandemic progresses, there is an urgent need for tools and methodologies to quickly analyze the effectiveness of responses against COVID-19 in different communities and contexts. In this perspective, computer modeling appears to be an invaluable lever as it allows for the in silico exploration of a range of intervention strategies prior to the potential field implementation phase. More specifically, we argue that, in order to take into account important dimensions of policy actions, such as the heterogeneity of the individual response or the spatial aspect of containment strategies, the branch of computer modeling known as agent-based modeling is of immense interest. We present in this paper an agent-based modeling framework called COVID-19 Modeling Kit (COMOKIT), designed to be generic, scalable and thus portable in a variety of social and geographical contexts. COMOKIT combines models of person-to-person and environmental transmission, a model of individual epidemiological status evolution, an agenda-based 1-h time step model of human mobility, and an intervention model. It is designed to be modular and flexible enough to allow modelers and users to represent different strategies and study their impacts in multiple social, epidemiological or economic scenarios. Several large-scale experiments are analyzed in this paper and allow us to show the potentialities of COMOKIT in terms of analysis and comparison of the impacts of public health policies in a realistic case study.
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Affiliation(s)
- Benoit Gaudou
- UMI 209, UMMISCO, IRD, Sorbonne Université, Bondy, France
- UMR 5505, IRIT, Université Toulouse 1 Capitole, Toulouse, France
- ICTLab, University of Science and Technology of Hanoi (USTH), Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Nghi Quang Huynh
- UMI 209, UMMISCO, IRD, Sorbonne Université, Bondy, France
- College of Information & Communication Technology (CICT), Can Tho University, Can Tho, Vietnam
| | - Damien Philippon
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Arthur Brugière
- UMI 209, UMMISCO, IRD, Sorbonne Université, Bondy, France
- ICTLab, University of Science and Technology of Hanoi (USTH), Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Kevin Chapuis
- UMI 209, UMMISCO, IRD, Sorbonne Université, Bondy, France
- UMR 228, ESPACE-DEV, IRD, Montpellier, France
| | | | - Pierre Larmande
- ICTLab, University of Science and Technology of Hanoi (USTH), Vietnam Academy of Science and Technology, Hanoi, Vietnam
- UMR 232, DIADE, IRD, University of Montpellier, Montpellier, France
| | - Alexis Drogoul
- UMI 209, UMMISCO, IRD, Sorbonne Université, Bondy, France
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Environmental Disinfection Strategies to Prevent Indirect Transmission of SARS-CoV2 in Healthcare Settings. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10186291] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
(1) Introduction: The novel respiratory syndrome coronavirus 2 (SARS-CoV-2), also called coronavirus disease 2019 (COVID-19), is rapidly spreading in many countries and represents a public health emergency of international concern. The SARS-CoV-2 transmission mainly occurs from person-to-person via respiratory droplets (direct transmission route), leading to the onset of mild or severe symptoms or even causing death. Since COVID-19 is able to survive also on inanimate surfaces for extended periods, constituting an indirect transmission route, healthcare settings contaminated surfaces should be submitted to specific disinfection protocols. Our review aimed to investigate the existing disinfection measures of healthcare settings surfaces, preventing the nosocomial transmission of SARS-CoV-2. (2) Materials and Methods: We conducted electronic research on PubMed, Scopus, Science Direct, and Cochrane Library, and 120 items were screened for eligibility. Only 11 articles were included in the review and selected for data extraction. (3) Results: All the included studies proposed the use of ethanol at different concentrations (70% or 75%) as a biocidal agent against SARS-CoV-2, which has the capacity to reduce the viral activity by 3 log10 or more after 1 min of exposure. Other disinfection protocols involved the use of chlorine-containing disinfectant, 0.1% and 0.5% sodium hypochlorite, quaternary ammonium in combination with 75% ethanol, isopropyl alcohol 70%, glutardialdehyde 2%, ultraviolet light (UV-C) technology, and many others. Two studies suggested to use the Environmental Protection Agency (EPA)-registered disinfectants, while one article chooses to follow the WST-512-2016 Guidance of Environmental and Surfaces Cleaning, Disinfection and Infection Control in Hospitals. (4) Conclusion: Different surface disinfection methods proved to reduce the viral activity of SARS-CoV-2, preventing its indirect nosocomial transmission. However, more specific cleaning measures, ad hoc for the different settings of the healthcare sector, need to be formulated.
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Mukhra R, Krishan K, Kanchan T. Possible modes of transmission of Novel coronavirus SARS-CoV-2: a review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020036. [PMID: 32921730 PMCID: PMC7716952 DOI: 10.23750/abm.v91i3.10039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 07/25/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The widespread outbreak of the novel SARS-CoV-2 has raised numerous questions about the origin and transmission of the virus. Knowledge about the mode of transmission as well as assessing the effectiveness of the preventive measures would aid in containing the outbreak of the coronavirus. Presently, respiratory droplets, physical contact and aerosols/air-borne have been reported as the modes of SARS-CoV-2 transmission of the virus. Besides, some of the other possible modes of transmission are being explored by the researchers, with some studies suggesting the viral spread through fecal-oral, conjunctival secretions, flatulence (farts), sexual and vertical transmission from mother to the fetus, and through asymptomatic carriers, etc. Aim: The primary objective was to review the present understanding and knowledge about the transmission of SARS-CoV-2 and also to suggest recommendations in containing and preventing the novel coronavirus. METHODS A review of possible modes of transmission of the novel SARS-CoV-2 was conducted based on the reports and articles available in PubMed and ScienceDirect.com that were searched using keywords, 'transmission', 'modes of transmission', 'SARS-CoV-2', 'novel coronavirus', and 'COVID-19'. Articles referring to air-borne, conjunctiva, fecal-oral, maternal-fetal, flatulence (farts), and breast milk transmission were included, while the remaining were excluded. RESULT AND CONCLUSION The modes of transmission linked to SARS-CoV-2 were identified and the available literature on each of these is described in detail in view of the possibilities of viral transmission through various modes of transmission. The review provides updated and necessary information on the possible modes of transmission for the health care workers and the lay public under one umbrella that can also be considered during framing guidelines in order to prevent and control the viral spread.
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Affiliation(s)
- Richa Mukhra
- Department of Anthropology (UGC Centre of Advanced Study), Panjab University, Sector-14, Chandigarh, India.
| | - Kewal Krishan
- Department of Anthropology (UGC Centre of Advanced Study), Panjab University, Sector-14, Chandigarh, India.
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences Jodhpur, India.
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Dhama K, Patel SK, Sharun K, Pathak M, Tiwari R, Yatoo MI, Malik YS, Sah R, Rabaan AA, Panwar PK, Singh KP, Michalak I, Chaicumpa W, Martinez-Pulgarin DF, Bonilla-Aldana DK, Rodriguez-Morales AJ. SARS-CoV-2 jumping the species barrier: Zoonotic lessons from SARS, MERS and recent advances to combat this pandemic virus. Travel Med Infect Dis 2020; 37:101830. [PMID: 32755673 PMCID: PMC7396141 DOI: 10.1016/j.tmaid.2020.101830] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022]
Abstract
Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome - Coronavirus-2) of the family Coronaviridae, appeared in China in December 2019. This disease was declared as posing Public Health International Emergency by World Health Organization on January 30, 2020, attained the status of a very high-risk category on February 29, and now having a pandemic status (March 11). COVID-19 has presently spread to more than 215 countries/territories while killing nearly 0.75 million humans out of cumulative confirmed infected asymptomatic or symptomatic cases accounting to almost 20.5 million as of August 12, 2020, within a short period of just a few months. Researchers worldwide are pacing with high efforts to counter the spread of this virus and to design effective vaccines and therapeutics/drugs. Few of the studies have shown the potential of the animal-human interface and zoonotic links in the origin of SARS-CoV-2. Exploring the possible zoonosis and revealing the factors responsible for its initial transmission from animals to humans will pave ways to design and implement effective preventive and control strategies to counter the COVID-19. The present review presents a comprehensive overview of COVID-19 and SARS-CoV-2, with emphasis on the role of animals and their jumping the cross-species barriers, experiences learned from SARS- and MERS-CoVs, zoonotic links, and spillover events, transmission to humans and rapid spread, and highlights the new advances in diagnosis, vaccine and therapies, preventive and control measures, one health concept along with recent research developments to counter this pandemic disease.
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Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, 243 122, Bareilly, Uttar Pradesh, India.
| | - Shailesh Kumar Patel
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, 243 122, Bareilly, Uttar Pradesh, India
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, 243 122, Uttar Pradesh, India
| | - Mamta Pathak
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, 243 122, Bareilly, Uttar Pradesh, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, UP Pandit Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan (DUVASU), Mathura, India
| | - Mohd Iqbal Yatoo
- Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, 190025, Srinagar, Jammu and Kashmir, India
| | - Yashpal Singh Malik
- Division of Biological Standardization, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, 243 122, Uttar Pradesh, India
| | - Ranjit Sah
- Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | | | - Karam Pal Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, 243 122, Bareilly, Uttar Pradesh, India
| | - Izabela Michalak
- Faculty of Chemistry, Department of Advanced Material Technologies, Wrocław University of Science and Technology, Wrocław, 50-370, Poland
| | - Wanpen Chaicumpa
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Dayron F Martinez-Pulgarin
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Colombia
| | - D Katterine Bonilla-Aldana
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Colombia; Semillero de Investigación en Zoonosis (SIZOO), Grupo de Investigación BIOECOS, Fundación Universitaria Autónoma de Las Américas, Sede Pereira, Pereira, Risaralda, Colombia
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Colombia; Grupo de Investigacion Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de Las Americas, Pereira, Risaralda, Colombia; School of Medicine, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia.
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Sharma AR, Batra G, Kumar M, Mishra A, Singla R, Singh A, Singh RS, Medhi B. BCG as a game-changer to prevent the infection and severity of COVID-19 pandemic? Allergol Immunopathol (Madr) 2020; 48:507-517. [PMID: 32653224 PMCID: PMC7332934 DOI: 10.1016/j.aller.2020.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/24/2020] [Accepted: 05/28/2020] [Indexed: 02/05/2023]
Abstract
The impact of COVID-19 is changing with country wise and depend on universal immunization policies. COVID-19 badly affects countries that did not have universal immunization policies or having them only for the selective population of countries (highly prominent population) like Italy, USA, UK, Netherland, etc. Universal immunization of BCG can provide great protection against the COVID-19 infection because the BCG vaccine gives broad protection against respiratory infections. BCG vaccine induces expressions of the gene that are involved in the antiviral innate immune response against viral infections with long-term maintenance of BCG vaccine-induced cellular immunity. COVID-19 cases are reported very much less in the countries with universal BCG vaccination policies such as India, Afghanistan, Nepal, Bhutan, Bangladesh, Israel, Japan, etc. as compared to without BCG implemented countries such as the USA, Italy, Spain, Canada, UK, etc. BCG vaccine provides protection for 50–60 years of immunization, so the elderly population needs to be revaccinated with BCG. Several countries started clinical trials of the BCG vaccine for health care workers and elderly people. BCG can be uses as a prophylactic treatment until the availability of the COVID-19 vaccine.
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Affiliation(s)
- A R Sharma
- Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh, India; Department of Neurology, India
| | - G Batra
- Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh, India; Department of Neurology, India
| | - M Kumar
- Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh, India; Department of Pharmacology, India
| | - A Mishra
- Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh, India; Department of Pharmacology, India
| | - R Singla
- Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh, India; Department of Pharmacology, India
| | - A Singh
- Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh, India; Department of Pharmacology, India
| | - R S Singh
- Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh, India; Department of Pharmacology, India
| | - B Medhi
- Post Graduate Institute for Medical Education and Research (PGIMER), Chandigarh, India; Department of Pharmacology, India.
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Whitworth C, Mu Y, Houston H, Martinez-Smith M, Noble-Wang J, Coulliette-Salmond A, Rose L. Persistence of Bacteriophage Phi 6 on Porous and Nonporous Surfaces and the Potential for Its Use as an Ebola Virus or Coronavirus Surrogate. Appl Environ Microbiol 2020; 86:e01482-20. [PMID: 32591388 PMCID: PMC7440805 DOI: 10.1128/aem.01482-20] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/03/2022] Open
Abstract
The infection of health care workers during the 2013 to 2016 Ebola outbreak raised concerns about fomite transmission. In the wake of the coronavirus disease 2019 (COVID-19) pandemic, investigations are ongoing to determine the role of fomites in coronavirus transmission as well. The bacteriophage phi 6 has a phospholipid envelope and is commonly used in environmental studies as a surrogate for human enveloped viruses. The persistence of phi 6 was evaluated as a surrogate for Ebola virus (EBOV) and coronaviruses on porous and nonporous hospital surfaces. Phi 6 was suspended in a body fluid simulant and inoculated onto 1-cm2 coupons of steel, plastic, and two fabric curtain types. The coupons were placed at two controlled absolute humidity (AH) levels: a low AH of 3.0 g/m3 and a high AH of 14.4 g/m3 Phi 6 declined at a lower rate on all materials under low-AH conditions, with a decay rate of 0.06-log10 PFU/day to 0.11-log10 PFU/day, than under the higher AH conditions, with a decay rate of 0.65-log10 PFU/h to 1.42-log10 PFU/day. There was a significant difference in decay rates between porous and nonporous surfaces at both low AH (P < 0.0001) and high AH (P < 0.0001). Under these laboratory-simulated conditions, phi 6 was found to be a conservative surrogate for EBOV under low-AH conditions in that it persisted longer than Ebola virus in similar AH conditions. Additionally, some coronaviruses persist longer than phi 6 under similar conditions; therefore, phi 6 may not be a suitable surrogate for coronaviruses.IMPORTANCE Understanding the persistence of enveloped viruses helps inform infection control practices and procedures in health care facilities and community settings. These data convey to public health investigators that enveloped viruses can persist and remain infective on surfaces, thus demonstrating a potential risk for transmission. Under these laboratory-simulated Western indoor hospital conditions, we assessed the suitability of phi 6 as a surrogate for environmental persistence research related to enveloped viruses, including EBOV and coronaviruses.
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Affiliation(s)
- Carrie Whitworth
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yi Mu
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hollis Houston
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marla Martinez-Smith
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Judith Noble-Wang
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Angela Coulliette-Salmond
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Laura Rose
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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72
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Deactivation of SARS-CoV-2 with pulsed-xenon ultraviolet light: Implications for environmental COVID-19 control. Infect Control Hosp Epidemiol 2020; 42:127-130. [PMID: 32741425 PMCID: PMC7443558 DOI: 10.1017/ice.2020.399] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives: Prolonged survival of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on environmental surfaces and personal protective equipment may lead to these surfaces transmitting this pathogen to others. We sought to determine the effectiveness of a pulsed-xenon ultraviolet (PX-UV) disinfection system in reducing the load of SARS-CoV-2 on hard surfaces and N95 respirators. Methods: Chamber slides and N95 respirator material were directly inoculated with SARS-CoV-2 and were exposed to different durations of PX-UV. Results: For hard surfaces, disinfection for 1, 2, and 5 minutes resulted in 3.53 log10, >4.54 log10, and >4.12 log10 reductions in viral load, respectively. For N95 respirators, disinfection for 5 minutes resulted in >4.79 log10 reduction in viral load. PX-UV significantly reduced SARS-CoV-2 on hard surfaces and N95 respirators. Conclusion: With the potential to rapidly disinfectant environmental surfaces and N95 respirators, PX-UV devices are a promising technology to reduce environmental and personal protective equipment bioburden and to enhance both healthcare worker and patient safety by reducing the risk of exposure to SARS-CoV-2.
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73
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Goldman E. Exaggerated risk of transmission of COVID-19 by fomites. THE LANCET. INFECTIOUS DISEASES 2020; 20:892-893. [PMID: 32628907 PMCID: PMC7333993 DOI: 10.1016/s1473-3099(20)30561-2] [Citation(s) in RCA: 243] [Impact Index Per Article: 60.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Emanuel Goldman
- Professor of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School - Rutgers University, Newark, NJ 07103, USA.
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74
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Bae S, Asojo AO. Nurses' Perception of Safety on Hospital Interior Environments and Infectious Diseases: An Exploratory Study. GLOBAL JOURNAL ON QUALITY AND SAFETY IN HEALTHCARE 2020; 3:89-97. [PMID: 37275601 PMCID: PMC10234088 DOI: 10.36401/jqsh-19-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/03/2020] [Indexed: 06/07/2023]
Abstract
Introduction Healthcare environments consist of a variety of different fomites containing infectious agents. From the 2003 outbreaks of Severe Acute Respiratory Syndrome to the recent concerns about the Ebola and Zika viruses, interest in the role of healthcare environment fomites in spreading infectious diseases has increased. Because of a high risk of being exposed to infections, the goal of this study was to learn how hospital interior environments impact nurses' perceptions of safety about infectious diseases. Methods Semistructured, in-depth interviews were conducted with six nurses at a public hospital. Results The following three themes were identified: (1) perceptions of safety from infectious diseases were diverse among the participants; (2) various interior environments in hospital settings can prevent as well as promote the spreading of infectious diseases; and (3) the different perceptions influenced the ways participants developed their contrasting behaviors of treating interior environments to cope with their fears (e.g., how they open doors). Conclusion The findings from this study contribute to the existing body of knowledge on designing hospital interior environments to better understand nurses' perception of infectious diseases.
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Affiliation(s)
- Suyeon Bae
- Department of Architectural Studies, University of Missouri, Columbia, MO, USA
| | - Abimbola O. Asojo
- Interior Design, Department of Design, Housing, and Apparel, University of Minnesota, St. Paul, MN, USA
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75
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Cai Y, Huang T, Liu X, Xu G. The effects of "Fangcang, Huoshenshan, and Leishenshan" hospitals and environmental factors on the mortality of COVID-19. PeerJ 2020; 8:e9578. [PMID: 32742816 PMCID: PMC7380280 DOI: 10.7717/peerj.9578] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/30/2020] [Indexed: 12/17/2022] Open
Abstract
Background In December 2019, a novel coronavirus disease (COVID-19) broke out in Wuhan, China; however, the factors affecting the mortality of COVID-19 remain unclear. Methods Thirty-two days of data (the growth rate/mortality of COVID-19 cases) that were shared by Chinese National Health Commission and Chinese Weather Net were collected by two authors independently. Student’s t-test or Mann-Whitney U test was used to test the difference in the mortality of confirmed/severe cases before and after the use of “Fangcang, Huoshenshan, and Leishenshan” makeshift hospitals (MSHs). We also studied whether the above outcomes of COVID-19 cases were related to air temperature (AT), relative humidity (RH), or air quality index (AQI) by performing Pearson’s analysis or Spearman’s analysis. Results Eight days after the use of MSHs, the mortality of confirmed cases was significantly decreased both in Wuhan (t = 4.5, P < 0.001) and Hubei (U = 0, P < 0.001), (t and U are the test statistic used to test the significance of the difference). In contrast, the mortality of confirmed cases remained unchanged in non-Hubei regions (U = 76, P = 0.106). While on day 12 and day 16 after the use of MSHs, the reduce in mortality was still significant both in Wuhan and Hubei; but in non-Hubei regions, the reduce also became significant this time (U = 123, P = 0.036; U = 171, P = 0.015, respectively). Mortality of confirmed cases was found to be negatively correlated with AT both in Wuhan (r = − 0.441, P = 0.012) and Hubei (r = − 0.440, P = 0.012). Also, both the growth rate and the mortality of COVID-19 cases were found to be significantly correlated with AQI in Wuhan and Hubei. However, no significant correlation between RH and the growth rate/mortality of COVID-19 cases was found in our study. Conclusions Our findings indicated that both the use of MSHs, the rise of AT, and the improvement of air quality were beneficial to the survival of COVID-19 patients.
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Affiliation(s)
- Yuwen Cai
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China.,Second Clinical Medical College of Nanchang University, Nanchang, China
| | - Tianlun Huang
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
| | - Xin Liu
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
| | - Gaosi Xu
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
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76
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Deyab MA. Coronaviruses widespread on nonliving surfaces: important questions and promising answers. ACTA ACUST UNITED AC 2020; 75:363-367. [DOI: 10.1515/znc-2020-0105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/16/2020] [Indexed: 11/15/2022]
Abstract
Abstract
The world is facing, while writing this review, a global pandemic due to one of the types of the coronaviruses (i.e., COVID-19), which is a new virus. Among the most important reasons for the transmission of infection between humans is the presence of this virus active on the surfaces and materials. Here, we addressed important questions such as do coronaviruses remain active on the inanimate surfaces? Do the types of inanimate surfaces affect the activity of coronaviruses? What are the most suitable ingredients that used to inactivate viruses? This review article addressed many of the works that were done in the previous periods on the survival of many viruses from the coronaviruses family on various surfaces such as steel, glass, plastic, Teflon, ceramic tiles, silicon rubber and stainless steel copper alloys, Al surface, sterile sponges, surgical gloves and sterile latex. The impacts of environmental conditions such as temperature and humidity were presented and discussed. The most important active ingredients that can deactivate viruses on the surfaces were reported here. We hope that these active ingredients will have the same effect on COVID-19.
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Affiliation(s)
- Mohamed A. Deyab
- Egyptian Petroleum Research Institute (EPRI) , PO Box 11727 , Nasr City , Cairo , Egypt
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77
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Cimolai N. Environmental and decontamination issues for human coronaviruses and their potential surrogates. J Med Virol 2020; 92:2498-2510. [PMID: 32530505 PMCID: PMC7307025 DOI: 10.1002/jmv.26170] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/10/2020] [Indexed: 01/19/2023]
Abstract
Pandemic coronavirus disease‐2019 (COVID‐19) gives ample reason to generally review coronavirus (CoV) containment. For establishing some preliminary views on decontamination and disinfection, surrogate CoVs have commonly been assessed. This review serves to examine the existing science in regard to CoV containment generically and then to translate these findings into timely applications for COVID‐19. There is widespread dissemination of CoVs in the immediate patient environment, and CoVs can potentially be spread via respiratory secretions, urine, and stool. Interpretations of the spread however must consider whether studies examine for viral RNA, virus viability by culture, or both. Presymptomatic, asymptomatic, and post‐14 day virus excretion from patients may complicate the epidemiology. Whereas droplet spread is accepted, there continues to be controversy over the extent of possible airborne spread and especially now for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). CoVs are stable in body secretions and sewage at reduced temperatures. In addition to temperature, dryness or relative humidity, initial viral burden, concomitant presence of bioburden, and the type of surface can all affect stability. Generalizing, CoVs can be susceptible to radiation, temperature extremes, pH extremes, peroxides, halogens, aldehydes, many solvents, and several alcohols. Whereas detergent surfactants can have some direct activity, these agents are better used as complements to a complex disinfectant solution. Disinfectants with multiple agents and adverse pH are more likely to be best active at higher water temperatures. Real‐life assessments should be encouraged with working dilutions. The use of decontamination and disinfection should be balanced with considerations of patient and caregiver safety. Processes should also be balanced with considerations for other potential pathogens that must be targeted. Given some CoV differences and given that surrogate testing provides experimental correlates at best, direct assessments with SARS‐CoV, Middle East respiratory syndrome‐related coronavirus (MERS‐CoV), and SARS‐CoV‐2 are required. Environmental spread in the immediate context of infected hosts is common for coronaviruses. The epidemiology of coronavirus infections is complicated by presymptomatic, asymptomatic, and post‐fourteen day infection spread. Mechanical removal of associated organic debris is vital to effective coronavirus decontamination. Proper exposure times for disinfection are vital to effective coronavirus inactivation. Temperature of disinfectant working dilutions and pH can have impact on antiviral activity. The immediate patient environment should be simplified for necessary and reusable items. Coronavirus inactivation should be considered in the context of other pathogens that need to be inactivated simultaneously.
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Affiliation(s)
- Nevio Cimolai
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada
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78
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Dev Kumar G, Mishra A, Dunn L, Townsend A, Oguadinma IC, Bright KR, Gerba CP. Biocides and Novel Antimicrobial Agents for the Mitigation of Coronaviruses. Front Microbiol 2020; 11:1351. [PMID: 32655532 PMCID: PMC7324725 DOI: 10.3389/fmicb.2020.01351] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/26/2020] [Indexed: 12/18/2022] Open
Abstract
In December, 2019, a highly infectious and rapidly spreading new pneumonia of unknown cause was reported to the Chinese WHO Country Office. A cluster of these cases had appeared in Wuhan, a city in the Hubei Province of China. These infections were found to be caused by a new coronavirus which was given the name "2019 novel coronavirus" (2019-nCoV). It was later renamed "severe acute respiratory syndrome coronavirus 2," or SARS-CoV-2 by the International Committee on Taxonomy of Viruses on February 11, 2020. It was named SARS-CoV-2 due to its close genetic similarity to the coronavirus which caused the SARS outbreak in 2002 (SARS-CoV-1). The aim of this review is to provide information, primarily to the food industry, regarding a range of biocides effective in eliminating or reducing the presence of coronaviruses from fomites, skin, oral/nasal mucosa, air, and food contact surfaces. As several EPA approved sanitizers against SARS-CoV-2 are commonly used by food processors, these compounds are primarily discussed as much of the industry already has them on site and is familiar with their application and use. Specifically, we focused on the effects of alcohols, povidone iodine, quaternary ammonium compounds, hydrogen peroxide, sodium hypochlorite (NaOCl), peroxyacetic acid (PAA), chlorine dioxide, ozone, ultraviolet light, metals, and plant-based antimicrobials. This review highlights the differences in the resistance or susceptibility of different strains of coronaviruses, or similar viruses, to these antimicrobial agents.
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Affiliation(s)
| | - Abhinav Mishra
- Department of Food Science and Technology, The University of Georgia, Athens, GA, United States
| | - Laurel Dunn
- Department of Food Science and Technology, The University of Georgia, Athens, GA, United States
| | - Anna Townsend
- Department of Food Science and Technology, The University of Georgia, Athens, GA, United States
| | | | - Kelly R. Bright
- Department of Soil, Water and Environmental Science, University of Arizona, Tucson, AZ, United States
| | - Charles P. Gerba
- Department of Soil, Water and Environmental Science, University of Arizona, Tucson, AZ, United States
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79
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Kampf G, Todt D, Pfaender S, Steinmann E. Corrigendum to "Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents" [J Hosp Infect 104 (2020) 246-251]. J Hosp Infect 2020; 104:246-251. [PMID: 32035997 PMCID: PMC7132493 DOI: 10.1016/j.jhin.2020.01.022] [Citation(s) in RCA: 1915] [Impact Index Per Article: 478.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 01/31/2020] [Indexed: 12/11/2022]
Affiliation(s)
- G Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany.
| | - D Todt
- Department of Molecular and Medical Virology, Ruhr University Bochum, Universitätsstrasse 50, 44801 Bochum, Germany
| | - S Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Universitätsstrasse 50, 44801 Bochum, Germany
| | - E Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Universitätsstrasse 50, 44801 Bochum, Germany
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80
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Cimolai N. Features of enteric disease from human coronaviruses: Implications for COVID-19. J Med Virol 2020; 92:1834-1844. [PMID: 32462689 PMCID: PMC7283829 DOI: 10.1002/jmv.26066] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/25/2020] [Indexed: 01/19/2023]
Abstract
Coronaviruses have long been studied in both human and veterinary fields. Whereas the initial detection of endemic human respiratory coronaviruses was problematic, detection of these and newly discovered human coronaviruses has been greatly facilitated with major advances in the laboratory. Nevertheless, technological factors can affect the accuracy and timeliness of virus detection. Many human coronaviruses can be variably found in stool samples. All human coronaviruses have been variably associated with symptoms of gastroenteritis. Coronaviruses can occasionally be cultured from enteric specimens, but most detection is accomplished with genetic amplification technologies. Excretion of viral RNA in stool can extend for a prolonged period. Culture‐positive stool samples have been found to exceed a fourteen day period after onset of infection for some coronaviruses. Virus can also sometimes be cultured from patients' respiratory samples during the late incubation period. Relatively asymptomatic patients may excrete virus. Both viable and nonviable virus can be found in the immediate environment of the patient, the health care worker, and less often the public. These lessons from the past study of animal and human coronaviruses can be extended to presumptions for severe acute respiratory syndrome coronavirus 2. Already, the early reports from the coronavirus disease‐2019 pandemic are confirming some concerns. These data have the cumulative potential to cause us to rethink some current and common public health and infection control strategies. coronaviruses are variably found in human enteric samples during the course of infection. abdominal and intestinal illnesses are associated with coronavirus infections. enteric excretion of live virus and viral RNA have been confirmed. occasionally, live virus can be found in stool samples to exceed a fourteen day period after disease onset, and virus can also be cultured from these samples during the late incubation period or from asymptomatic individuals.
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Affiliation(s)
- Nevio Cimolai
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, Children's and Women's Health Centre of British Columbia, The University of British Columbia, Vancouver, British Columbia, Canada
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81
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Fineschi V, Aprile A, Aquila I, Arcangeli M, Asmundo A, Bacci M, Cingolani M, Cipolloni L, D’Errico S, De Casamassimi I, Di Mizio G, Di Paolo M, Focardi M, Frati P, Gabbrielli M, La Russa R, Maiese A, Manetti F, Martelloni M, Mazzeo E, Montana A, Neri M, Padovano M, Pinchi V, Pomara C, Ricci P, Salerno M, Santurro A, Scopetti M, Testi R, Turillazzi E, Vacchiano G, Crivelli F, Bonoldi E, Facchetti F, Nebuloni M, Sapino A. Management of the corpse with suspect, probable or confirmed COVID-19 respiratory infection - Italian interim recommendations for personnel potentially exposed to material from corpses, including body fluids, in morgue structures and during autopsy practice. Pathologica 2020; 112:64-77. [PMID: 32324727 PMCID: PMC7931563 DOI: 10.32074/1591-951x-13-20] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Anna Aprile
- Department of Molecular Medicine, Legal Medicine, University of Padua, Italy
| | - Isabella Aquila
- Institute of Legal Medicine, University “Magna Graecia” of Catanzaro, Italy
| | - Mauro Arcangeli
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, Italy
| | - Alessio Asmundo
- Departmental section of Legal Medicine “G. Martino”, University of Messina, Italy
| | - Mauro Bacci
- Forensic and Sports Medicine Section, Department of Surgery and Biomedical Science, University of Perugia, Italy
| | | | - Luigi Cipolloni
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D’Avanzo, Foggia, Italy
| | | | - Ilaria De Casamassimi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Giulio Di Mizio
- Institute of Legal Medicine, University “Magna Graecia” of Catanzaro, Italy
| | - Marco Di Paolo
- Department of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, Italy
| | - Martina Focardi
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Mario Gabbrielli
- Department of Medicine, Surgery and Neuroscience, Santa Maria alle Scotte University Hospital of Siena, Italy
| | - Raffaele La Russa
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Aniello Maiese
- Department of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, Italy
| | - Federico Manetti
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Massimo Martelloni
- Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy
| | - Elena Mazzeo
- Department of Biomedical Sciences, Legal Medicine, University of Sassari, Italy
| | - Angelo Montana
- Department of Medical Science, Surgical Science and advanced Technologies “G.F, Ingrassia”, University of Catania, Italy
| | - Margherita Neri
- Department of Morphology, Surgery and Experimental Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Italy
| | - Martina Padovano
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Vilma Pinchi
- Department of Health Sciences, University of Florence, Italy
| | - Cristoforo Pomara
- Department of Medical Science, Surgical Science and advanced Technologies “G.F, Ingrassia”, University of Catania, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, University “Magna Graecia” of Catanzaro, Italy
| | - Monica Salerno
- Department of Medical Science, Surgical Science and advanced Technologies “G.F, Ingrassia”, University of Catania, Italy
| | - Alessandro Santurro
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Matteo Scopetti
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Roberto Testi
- ASL “Città di Torino”, Regional Center for Prion Diseases (DOMP), Turin, Italy
| | - Emanuela Turillazzi
- Department of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, Italy
| | - Giuseppe Vacchiano
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy
| | | | - Emanuela Bonoldi
- SC Anatomia Istologia Patologica e Citogenetica, Grande Ospedale Metropolitano Niguarda Milan, Italy
| | - Fabio Facchetti
- UOC di Anatomia Patologica, ASST Spedali Civili di Brescia, Italy
| | | | - Anna Sapino
- SC Anatomia Patologica FPO-IRCCS, Candiolo (Turin), Italy
- Department of Medical Sciences, University of Turin, Italy
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82
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Kampf G. Potential role of inanimate surfaces for the spread of coronaviruses and their inactivation with disinfectant agents. Infect Prev Pract 2020; 2:100044. [PMID: 34316556 PMCID: PMC7148653 DOI: 10.1016/j.infpip.2020.100044] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 12/24/2022] Open
Abstract
The novel human coronavirus SARS-CoV-2 has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described, probably via droplets but possibly also via contaminated hands or surfaces. In a recent review on the persistence of human and veterinary coronaviruses on inanimate surfaces it was shown that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days. Some disinfectant agents effectively reduce coronavirus infectivity within 1 minute such 62%-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite. Other compounds such as 0.05%-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. An effective surface disinfection may help to ensure an early containment and prevention of further viral spread.
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Affiliation(s)
- Günter Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
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83
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Akram MZ. Inanimate surfaces as potential source of 2019-nCoV spread and their disinfection with biocidal agents. Virusdisease 2020; 31:94-96. [PMID: 32656305 PMCID: PMC7274069 DOI: 10.1007/s13337-020-00603-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022] Open
Abstract
The WHO has declared COVID-19 illness a global health concern which is caused by 2019-nCoV, causing severe respiratory tract infections in humans. Transmissibility among individual to individual have been reported through droplets and probably also via contaminated surfaces and hands. Human coronaviruses can persist on inanimate surfaces such as plastic, glass, fibers and metals up to nine days. 2019-nCoV remains infectious in air for 3 h and on inanimate surfaces such as cardboard, copper, plastic and steel up to 24, 4, 72 and 48 h respectively. Disinfectant activity of various biocidal agents against coronaviruses like ethanol (62-71%), sodium hypochlorite (0.1%) and hydrogen peroxide (0.5%) can be regarded effective against 2019-nCoV as well. As no vaccine and antiviral therapies have been discovered for 2019-nCoV, prevention of further spread will viable option to control the ongoing and future outbreaks.
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Affiliation(s)
- Muhammad Zeeshan Akram
- Animal Production and Technologies Department, Faculty of Agricultural Sciences and Technologies, Niğde Ömer Halisdemir University, 51240 Niğde, Turkey
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SARS-CoV-2 / COVID-19 and its Transmission, Prevention, Treatment and Control - An Update. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.spl1.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Virus-2 (SARS-CoV-2), pandemic has caused huge panic, havoc and global threats worldwide. The origin of this virus has been linked to animals, intermediate host is still to be identified, and studies are being carried out that how it got transmitted to humans and acquired rapid human-to-human transmission. Within a short time period of only 05 months, SARS-CoV-2 has spread to 213 countries, and till 28th May, 2020, nearly 5.8 million confirmed cases have been reported while taking lives of 0.36 million persons. Seeing the current situation of rapid increase in COVID-19 cases daily in many countries, this seems to be the deadliest pandemic after the 1918 Spanish Flu. There is currently no specific effective treatment for COVID-19 and also in absence of vaccine the radical cure of the disease is far away. Researchers are pacing high to design and develop effective vaccines, drugs and therapeutics to counter COVID-19, however such efforts, clinical trials, necessary approvals and then to reach the level of bulk production of many millions of doses may still take much time. Prevention and control of COVID-19 outbreaks requires an evidence-based, multi-factorial and effective mitigation strategy to be adopted. The current review discusses on the research advancements, challenges and opportunities in COVID 19 management with a focus on its transmission, prevention, treatment and control.
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Dexter F, Ledolter J, Wall RT, Datta S, Loftus RW. Sample sizes for surveillance of S. aureus transmission to monitor effectiveness and provide feedback on intraoperative infection control including for COVID-19. ACTA ACUST UNITED AC 2020; 20:100115. [PMID: 32501426 PMCID: PMC7240254 DOI: 10.1016/j.pcorm.2020.100115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/12/2020] [Accepted: 05/17/2020] [Indexed: 12/19/2022]
Abstract
Reductions in perioperative surgical site infections are obtained by a multifaceted approach including patient decolonization, hand hygiene, and hub disinfection, and environmental cleaning. Associated surveillance of S. aureus transmission quantifies the effectiveness of the basic measures to prevent the transmission to patients and clinicians of pathogenic bacteria and viruses, including Coronavirus Disease 2019 (COVID-19). To measure transmission, the observational units are pairs of successive surgical cases in the same operating room on the same day. We evaluated appropriate sample sizes and strategies for measuring transmission. There was absence of serial correlation among observed counts of transmitted isolates within each of several periods (all P ≥.18). Similarly, observing transmission within or between cases of a pair did not increase the probability that the next sampled pair of cases also had observed transmission (all P ≥.23). Most pairs of cases had no detected transmitted isolates. Also, although transmission (yes/no) was associated with surgical site infection (P =.004), among cases with transmission, there was no detected dose response between counts of transmitted isolates and probability of infection (P =.25). The first of a fixed series of tests is to use the binomial test to compare the proportion of pairs of cases with S. aureus transmission to an acceptable threshold. An appropriate sample size for this screening is N =25 pairs. If significant, more samples are obtained while additional measures are implemented to reduce transmission and infections. Subsequent sampling is done to evaluate effectiveness. The two independent binomial proportions are compared using Boschloo's exact test. The total sample size for the 1st and 2nd stage is N =100 pairs. Because S. aureus transmission is invisible without testing, when choosing what population(s) to screen for surveillance, another endpoint needs to be used (e.g., infections). Only 10/298 combinations of specialty and operating room were relatively common (≥1.0% of cases) and had expected incidence ≥0.20 infections per 8 hours of sampled cases. The 10 combinations encompassed ≅17% of cases, showing the value of targeting surveillance of transmission to a few combinations of specialties and rooms. In conclusion, we created a sampling protocol and appropriate sample sizes for using S. aureus transmission within and between pairs of successive cases in the same operating room, the purpose being to monitor the quality of prevention of intraoperative spread of pathogenic bacteria and viruses.
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Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J 2020. [PMID: 32310621 DOI: 10.1097/inf.0000000000002660)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Coronaviruses (CoVs) are a large family of enveloped, single-stranded, zoonotic RNA viruses. Four CoVs commonly circulate among humans: HCoV2-229E, -HKU1, -NL63 and -OC43. However, CoVs can rapidly mutate and recombine leading to novel CoVs that can spread from animals to humans. The novel CoVs severe acute respiratory syndrome coronavirus (SARS-CoV) emerged in 2002 and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012. The 2019 novel coronavirus (SARS-CoV-2) is currently causing a severe outbreak of disease (termed COVID-19) in China and multiple other countries, threatening to cause a global pandemic. In humans, CoVs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. SARS-CoV, MERS-CoV and SARS-CoV-2 seem to less commonly affect children and to cause fewer symptoms and less severe disease in this age group compared with adults, and are associated with much lower case-fatality rates. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. However, the importance of children in transmitting the virus remains uncertain. Children more often have gastrointestinal symptoms compared with adults. Most children with SARS-CoV present with fever, but this is not the case for the other novel CoVs. Many children affected by MERS-CoV are asymptomatic. The majority of children infected by novel CoVs have a documented household contact, often showing symptoms before them. In contrast, adults more often have a nosocomial exposure. In this review, we summarize epidemiologic, clinical and diagnostic findings, as well as treatment and prevention options for common circulating and novel CoVs infections in humans with a focus on infections in children.
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Zimmermann P, Curtis N. Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J 2020; 39:355-368. [PMID: 32310621 PMCID: PMC7158880 DOI: 10.1097/inf.0000000000002660] [Citation(s) in RCA: 662] [Impact Index Per Article: 165.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2020] [Indexed: 02/06/2023]
Abstract
Coronaviruses (CoVs) are a large family of enveloped, single-stranded, zoonotic RNA viruses. Four CoVs commonly circulate among humans: HCoV2-229E, -HKU1, -NL63 and -OC43. However, CoVs can rapidly mutate and recombine leading to novel CoVs that can spread from animals to humans. The novel CoVs severe acute respiratory syndrome coronavirus (SARS-CoV) emerged in 2002 and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012. The 2019 novel coronavirus (SARS-CoV-2) is currently causing a severe outbreak of disease (termed COVID-19) in China and multiple other countries, threatening to cause a global pandemic. In humans, CoVs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. SARS-CoV, MERS-CoV and SARS-CoV-2 seem to less commonly affect children and to cause fewer symptoms and less severe disease in this age group compared with adults, and are associated with much lower case-fatality rates. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. However, the importance of children in transmitting the virus remains uncertain. Children more often have gastrointestinal symptoms compared with adults. Most children with SARS-CoV present with fever, but this is not the case for the other novel CoVs. Many children affected by MERS-CoV are asymptomatic. The majority of children infected by novel CoVs have a documented household contact, often showing symptoms before them. In contrast, adults more often have a nosocomial exposure. In this review, we summarize epidemiologic, clinical and diagnostic findings, as well as treatment and prevention options for common circulating and novel CoVs infections in humans with a focus on infections in children.
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Affiliation(s)
- Petra Zimmermann
- From the Department of Paediatrics, Fribourg Hospital HFR and Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Paediatrics, The University of Melbourne
- Infectious Diseases Research Group, Murdoch Children’s Research Institute
| | - Nigel Curtis
- Department of Paediatrics, The University of Melbourne
- Infectious Diseases Research Group, Murdoch Children’s Research Institute
- Infectious Diseases Unit, The Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
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Sportelli MC, Izzi M, Kukushkina EA, Hossain SI, Picca RA, Ditaranto N, Cioffi N. Can Nanotechnology and Materials Science Help the Fight against SARS-CoV-2? NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E802. [PMID: 32326343 PMCID: PMC7221591 DOI: 10.3390/nano10040802] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 12/17/2022]
Abstract
Since 2004, we have been developing nanomaterials with antimicrobial properties, the so-called nanoantimicrobials. When the coronavirus disease 2019 (COVID-19) emerged, we started investigating new and challenging routes to nanoantivirals. The two fields have some important points of contact. We would like to share with the readership our vision of the role a (nano)materials scientist can play in the fight against the COVID-19 pandemic. As researchers specifically working on surfaces and nanomaterials, in this letter we underline the importance of nanomaterial-based technological solutions in several aspects of the fight against the virus. While great resources are understandably being dedicated to treatment and diagnosis, more efforts could be dedicated to limit the virus spread. Increasing the efficacy of personal protection equipment, developing synergistic antiviral coatings, are only two of the cases discussed. This is not the first nor the last pandemic: our nanomaterials community may offer several technological solutions to challenge the ongoing and future global health emergencies. Readers' feedback and suggestions are warmly encouraged.
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Affiliation(s)
- Maria Chiara Sportelli
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
- IFN-CNR, Physics Department “M. Merlin”, Bari, Italy, via Amendola 173, 70126 Bari, Italy
- CSGI (Center for Colloid and Surface Science) c/o Dept. Chemistry, via Orabona 4, 70125 Bari, Italy
| | - Margherita Izzi
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
| | - Ekaterina A. Kukushkina
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
| | - Syed Imdadul Hossain
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
| | - Rosaria Anna Picca
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
- CSGI (Center for Colloid and Surface Science) c/o Dept. Chemistry, via Orabona 4, 70125 Bari, Italy
| | - Nicoletta Ditaranto
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
- CSGI (Center for Colloid and Surface Science) c/o Dept. Chemistry, via Orabona 4, 70125 Bari, Italy
| | - Nicola Cioffi
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
- CSGI (Center for Colloid and Surface Science) c/o Dept. Chemistry, via Orabona 4, 70125 Bari, Italy
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MUSTAFA N, ZAHOOR H, MAJOO FM. İnsan-COVID-19'da Pandemik SARS Coronavirus-2 Enfeksiyonları. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2020. [DOI: 10.38079/igusabder.695778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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90
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Shidham VB, Frisch NK, Layfield LJ. Severe acute respiratory syndrome coronavirus 2 (the cause of COVID 19) in different types of clinical specimens and implications for cytopathology specimen: An editorial review with recommendations. Cytojournal 2020; 17:7. [PMID: 32395151 PMCID: PMC7210469 DOI: 10.25259/cytojournal_24_2020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 01/25/2023] Open
Affiliation(s)
- Vinod B. Shidham
- Department of Pathology, Karmanos Cancer Center and Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Nora K. Frisch
- Department of Pathology, The University of Vermont Medical Center, Burlington, Vermont, United States
| | - Lester J. Layfield
- Department of Pathology, University of Missouri, Columbia, Missouri, United States
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91
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Abstract
In December 2019, health authorities in Wuhan, China, identified a cluster of pneumonia cases of unknown aetiology linked to the city's South China Seafood Market. Subsequent investigations revealed a novel coronavirus, SARS-CoV-2, as the causative agent now at the heart of a major outbreak. The rising case numbers have been accompanied by unprecedented public health action, including the wholesale isolation of Wuhan. Alongside this has been a robust scientific response, including early publication of the pathogen genome, and rapid development of highly specific diagnostics. This article will review the new knowledge of SARS-CoV-2 COVID-19 acute respiratory disease, and summarise its clinical features.
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92
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Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect 2020. [PMID: 32035997 DOI: 10.1016/jjhin202001022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Currently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.
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Affiliation(s)
- G Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany.
| | - D Todt
- Department of Molecular and Medical Virology, Ruhr University Bochum, Universitätsstrasse 50, 44801 Bochum, Germany
| | - S Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Universitätsstrasse 50, 44801 Bochum, Germany
| | - E Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Universitätsstrasse 50, 44801 Bochum, Germany
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93
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Abstract
In December 2019, health authorities in Wuhan, China, identified a cluster of pneumonia cases of unknown aetiology linked to the city's South China Seafood Market. Subsequent investigations revealed a novel coronavirus, SARS-CoV-2, as the causative agent now at the heart of a major outbreak. The rising case numbers have been accompanied by unprecedented public health action, including the wholesale isolation of Wuhan. Alongside this has been a robust scientific response, including early publication of the pathogen genome, and rapid development of highly specific diagnostics. This article will review the new knowledge of SARS-CoV-2 COVID-19 acute respiratory disease, and summarise its clinical features.
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94
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Environmental investigation of respiratory pathogens during the Hajj 2016 and 2018. Travel Med Infect Dis 2019; 33:101500. [PMID: 31600567 PMCID: PMC7110696 DOI: 10.1016/j.tmaid.2019.101500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Respiratory tract infections are common in the context of the Hajj pilgrimage and respiratory pathogens can be transmitted via contact with contaminated surfaces. We sampled surfaces during the Hajj to detect the presence of respiratory bacteria and viruses. METHODS Frequently touched surfaces at Mecca, Mina, Arafat and Medina were sampled. The common respiratory pathogens were tested by qPCR. RESULTS 70/142 (49.3%) environmental samples collected were positive for at least one respiratory pathogen. Among the positive samples, Klebsiella pneumoniae was the bacterium most frequently tested positive (57.1%), followed by Streptococcus pneumoniae (12.9%), Staphylococcus aureus (10.0%) and Haemophilus influenzae (7.1%). 32.9% positive samples tested positive for rhinovirus and 1.4% for coronavirus. Surfaces with the highest rates of positive samples were kitchen tables (100%), water fountain faucet (73.3%) and edge of water coolers lid (84.6%). Samples collected in Mina were the most frequently contaminated with 68.8% being positive for at least one pathogen and 18.8% positive for a combination of multiple pathogens. CONCLUSION These preliminary results indicate that respiratory pathogens are common in environmental surfaces from areas frequented by Hajj pilgrims. Further larger-scale studies are needed to better assess the possible role of environmental respiratory pathogens in respiratory infections in Hajj pilgrims.
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95
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Phan LT, Maita D, Mortiz DC, Bleasdale SC, Jones RM. Environmental Contact and Self-contact Patterns of Healthcare Workers: Implications for Infection Prevention and Control. Clin Infect Dis 2019; 69:S178-S184. [PMID: 31517975 PMCID: PMC6761362 DOI: 10.1093/cid/ciz558] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Respiratory viruses on fomites can be transferred to sites susceptible to infection via contact by hands or other fomites. METHODS Care for hospitalized patients with viral respiratory infections was observed in the patient room for 3-hour periods at an acute care academic medical center for over a 2 year period. One trained observer recorded the healthcare activities performed, contacts with fomites, and self-contacts made by healthcare workers (HCWs), while another observer recorded fomite contacts of patients during the encounter using predefined checklists. RESULTS The surface contacted by HCWs during the majority of visits was the patient (90%). Environmental surfaces contacted by HCWs frequently during healthcare activities included the tray table (48%), bed surface (41%), bed rail (41%), computer station (37%), and intravenous pole (32%). HCWs touched their own torso and mask in 32% and 29% of the visits, respectively. HCWs' self-contacts differed significantly among HCW job roles, with providers and respiratory therapists contacting themselves significantly more times than nurses and nurse technicians (P < .05). When HCWs performed only 1 care activity, there were significant differences in the number of patient contacts and self-contacts that HCWs made during performance of multiple care activities (P < .05). CONCLUSIONS HCWs regularly contact environmental surfaces, patients, and themselves while providing care to patients with infectious diseases, varying among care activities and HCW job roles. These contacts may facilitate the transmission of infection to HCWs and susceptible patients.
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Affiliation(s)
- Linh T Phan
- School of Public Health, University of Illinois at Chicago
| | - Dayana Maita
- College of Medicine, University of Illinois at Chicago
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Querido MM, Aguiar L, Neves P, Pereira CC, Teixeira JP. Self-disinfecting surfaces and infection control. Colloids Surf B Biointerfaces 2019; 178:8-21. [PMID: 30822681 PMCID: PMC7127218 DOI: 10.1016/j.colsurfb.2019.02.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 12/27/2022]
Abstract
According to World Health Organization, every year in the European Union, 4 million patients acquire a healthcare associated infection. Even though some microorganisms represent no threat to healthy people, hospitals harbor different levels of immunocompetent individuals, namely patients receiving immunosuppressors, with previous infections, or those with extremes of age (young children and elderly), requiring the implementation of effective control measures. Public spaces have also been found an important source of infectious disease outbreaks due to poor or none infection control measures applied. In both places, surfaces play a major role on microorganisms' propagation, yet they are very often neglected, with very few guidelines about efficient cleaning measures and microbiological assessment available. To overcome surface contamination problems, new strategies are being designed to limit the microorganisms' ability to survive over surfaces and materials. Surface modification and/or functionalization to prevent contamination is a hot-topic of research and several different approaches have been developed lately. Surfaces with anti-adhesive properties, with incorporated antimicrobial substances or modified with biological active metals are some of the strategies recently proposed. This review intends to summarize the problems associated with contaminated surfaces and their importance on infection spreading, and to present some of the strategies developed to prevent this public health problem, namely some already being commercialized.
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Affiliation(s)
- Micaela Machado Querido
- National Institute of Health, Environmental Health Department, Porto, Portugal; EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - Lívia Aguiar
- National Institute of Health, Environmental Health Department, Porto, Portugal
| | - Paula Neves
- National Institute of Health, Environmental Health Department, Porto, Portugal
| | - Cristiana Costa Pereira
- National Institute of Health, Environmental Health Department, Porto, Portugal; EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
| | - João Paulo Teixeira
- National Institute of Health, Environmental Health Department, Porto, Portugal; EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
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Stephens B, Azimi P, Thoemmes MS, Heidarinejad M, Allen JG, Gilbert JA. Microbial Exchange via Fomites and Implications for Human Health. CURRENT POLLUTION REPORTS 2019; 5:198-213. [PMID: 34171005 PMCID: PMC7149182 DOI: 10.1007/s40726-019-00123-6] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PURPOSE OF REVIEW Fomites are inanimate objects that become colonized with microbes and serve as potential intermediaries for transmission to/from humans. This review summarizes recent literature on fomite contamination and microbial survival in the built environment, transmission between fomites and humans, and implications for human health. RECENT FINDINGS Applications of molecular sequencing techniques to analyze microbial samples have increased our understanding of the microbial diversity that exists in the built environment. This growing body of research has established that microbial communities on surfaces include substantial diversity, with considerable dynamics. While many microbial taxa likely die or lay dormant, some organisms survive, including those that are potentially beneficial, benign, or pathogenic. Surface characteristics also influence microbial survival and rates of transfer to and from humans. Recent research has combined experimental data, mechanistic modeling, and epidemiological approaches to shed light on the likely contributors to microbial exchange between fomites and humans and their contributions to adverse (and even potentially beneficial) human health outcomes. SUMMARY In addition to concerns for fomite transmission of potential pathogens, new analytical tools have uncovered other microbial matters that can be transmitted indirectly via fomites, including entire microbial communities and antibiotic-resistant bacteria. Mathematical models and epidemiological approaches can provide insight on human health implications. However, both are subject to limitations associated with study design, and there is a need to better understand appropriate input model parameters. Fomites remain an important mechanism of transmission of many microbes, along with direct contact and short- and long-range aerosols.
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Affiliation(s)
- Brent Stephens
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Alumni Memorial Hall 228E, 3201 South Dearborn Street, Chicago, IL 60616 USA
| | - Parham Azimi
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Megan S. Thoemmes
- Department of Pediatrics, University of California San Diego School of Medicine, San Diego, CA USA
| | - Mohammad Heidarinejad
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Alumni Memorial Hall 228E, 3201 South Dearborn Street, Chicago, IL 60616 USA
| | - Joseph G. Allen
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Jack A. Gilbert
- Department of Pediatrics, University of California San Diego School of Medicine, San Diego, CA USA
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Ikonen N, Savolainen-Kopra C, Enstone JE, Kulmala I, Pasanen P, Salmela A, Salo S, Nguyen-Van-Tam JS, Ruutu P. Deposition of respiratory virus pathogens on frequently touched surfaces at airports. BMC Infect Dis 2018; 18:437. [PMID: 30157776 PMCID: PMC6116441 DOI: 10.1186/s12879-018-3150-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/15/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND International and national travelling has made the rapid spread of infectious diseases possible. Little information is available on the role of major traffic hubs, such as airports, in the transmission of respiratory infections, including seasonal influenza and a pandemic threat. We investigated the presence of respiratory viruses in the passenger environment of a major airport in order to identify risk points and guide measures to minimize transmission. METHODS Surface and air samples were collected weekly at three different time points during the peak period of seasonal influenza in 2015-16 in Finland. Swabs from surface samples, and air samples were tested by real-time PCR for influenza A and B viruses, respiratory syncytial virus, adenovirus, rhinovirus and coronaviruses (229E, HKU1, NL63 and OC43). RESULTS Nucleic acid of at least one respiratory virus was detected in 9 out of 90 (10%) surface samples, including: a plastic toy dog in the children's playground (2/3 swabs, 67%); hand-carried luggage trays at the security check area (4/8, 50%); the buttons of the payment terminal at the pharmacy (1/2, 50%); the handrails of stairs (1/7, 14%); and the passenger side desk and divider glass at a passport control point (1/3, 33%). Among the 10 respiratory virus findings at various sites, the viruses identified were: rhinovirus (4/10, 40%, from surfaces); coronavirus (3/10, 30%, from surfaces); adenovirus (2/10, 20%, 1 air sample, 1 surface sample); influenza A (1/10, 10%, surface sample). CONCLUSIONS Detection of pathogen viral nucleic acids indicates respiratory viral surface contamination at multiple sites associated with high touch rates, and suggests a potential risk in the identified airport sites. Of the surfaces tested, plastic security screening trays appeared to pose the highest potential risk, and handling these is almost inevitable for all embarking passengers.
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Affiliation(s)
- Niina Ikonen
- Department of Health Security, National Institute for Health and Welfare, P.O.Box 30, 00271 Helsinki, Finland
| | - Carita Savolainen-Kopra
- Department of Health Security, National Institute for Health and Welfare, P.O.Box 30, 00271 Helsinki, Finland
| | - Joanne E. Enstone
- School of Medicine, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Ilpo Kulmala
- VTT Technical Research Centre of Finland Ltd, Espoo and Tampere, Finland
| | - Pertti Pasanen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anniina Salmela
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Satu Salo
- VTT Technical Research Centre of Finland Ltd, Espoo and Tampere, Finland
| | - Jonathan S. Nguyen-Van-Tam
- School of Medicine, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Petri Ruutu
- Department of Health Security, National Institute for Health and Welfare, P.O.Box 30, 00271 Helsinki, Finland
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99
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Majumder MS, Brownstein JS, Finkelstein SN, Larson RC, Bourouiba L. Nosocomial amplification of MERS-coronavirus in South Korea, 2015. Trans R Soc Trop Med Hyg 2018; 111:261-269. [PMID: 29044371 PMCID: PMC6257029 DOI: 10.1093/trstmh/trx046] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/03/2017] [Indexed: 01/25/2023] Open
Abstract
Background Nosocomial amplification resulted in nearly 200 cases of Middle East respiratory syndrome (MERS) during the 2015 South Korean MERS-coronavirus outbreak. It remains unclear whether certain types of cases were more likely to cause secondary infections than others, and if so, why. Methods Publicly available demographic and transmission network data for all cases were collected from the Ministry of Health and Welfare. Statistical analyses were conducted to determine the relationship between demographic characteristics and the likelihood of human-to-human transmission. Findings from the statistical analyses were used to inform a hypothesis-directed literature review, through which mechanistic explanations for nosocomial amplification were developed. Results Cases that failed to recover from MERS were more likely to cause secondary infections than those that did. Increased probability of direct, human-to-human transmission due to clinical manifestations associated with death, as well as indirect transmission via environmental contamination (e.g., fomites and indoor ventilation systems), may serve as mechanistic explanations for nosocomial amplification of MERS-coronavirus in South Korea. Conclusions In addition to closely monitoring contacts of MERS cases that fail to recover during future nosocomial outbreaks, potential fomites with which they may have had contact should be sanitized. Furthermore, indoor ventilation systems that minimize recirculation of pathogen-bearing droplets should be implemented whenever possible.
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Affiliation(s)
- Maimuna S Majumder
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA.,Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA
| | - John S Brownstein
- Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Stan N Finkelstein
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Richard C Larson
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Lydia Bourouiba
- The Fluid Dynamics of Disease Transmission Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
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100
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Lei H, Li Y, Xiao S, Lin C, Norris SL, Wei D, Hu Z, Ji S. Routes of transmission of influenza A H1N1, SARS CoV, and norovirus in air cabin: Comparative analyses. INDOOR AIR 2018; 28:394-403. [PMID: 29244221 PMCID: PMC7165818 DOI: 10.1111/ina.12445] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 12/06/2017] [Indexed: 05/05/2023]
Abstract
Identifying the exact transmission route(s) of infectious diseases in indoor environments is a crucial step in developing effective intervention strategies. In this study, we proposed a comparative analysis approach and built a model to simulate outbreaks of 3 different in-flight infections in a similar cabin environment, that is, influenza A H1N1, severe acute respiratory syndrome (SARS) coronavirus (CoV), and norovirus. The simulation results seemed to suggest that the close contact route was probably the most significant route (contributes 70%, 95% confidence interval [CI]: 67%-72%) in the in-flight transmission of influenza A H1N1 transmission; as a result, passengers within 2 rows of the index case had a significantly higher infection risk than others in the outbreak (relative risk [RR]: 13.4, 95% CI: 1.5-121.2, P = .019). For SARS CoV, the airborne, close contact, and fomite routes contributed 21% (95% CI: 19%-23%), 29% (95% CI: 27%-31%), and 50% (95% CI: 48%-53%), respectively. For norovirus, the simulation results suggested that the fomite route played the dominant role (contributes 85%, 95% CI: 83%-87%) in most cases; as a result, passengers in aisle seats had a significantly higher infection risk than others (RR: 9.5, 95% CI: 1.2-77.4, P = .022). This work highlighted a method for using observed outbreak data to analyze the roles of different infection transmission routes.
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Affiliation(s)
- H. Lei
- Department of Mechanical EngineeringThe University of Hong KongPokfulamHong KongChina
| | - Y. Li
- Department of Mechanical EngineeringThe University of Hong KongPokfulamHong KongChina
| | - S. Xiao
- Department of Mechanical EngineeringThe University of Hong KongPokfulamHong KongChina
| | - C.‐H. Lin
- Environmental Control SystemsBoeing Commercial AirplanesEverettWAUSA
| | - S. L. Norris
- Environmental Control SystemsBoeing Commercial AirplanesEverettWAUSA
| | - D. Wei
- Boeing (China) Co. Ltd.BeijingChina
| | - Z. Hu
- Beijing Aeronautical Science & Technology Research Institute of COMACBeijingChina
| | - S. Ji
- Beijing Aeronautical Science & Technology Research Institute of COMACBeijingChina
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