51
|
Cantú VJ, Salido RA, Huang S, Rahman G, Tsai R, Valentine H, Magallanes CG, Aigner S, Baer NA, Barber T, Belda-Ferre P, Betty M, Bryant M, Casas Maya M, Castro-Martínez A, Chacón M, Cheung W, Crescini ES, De Hoff P, Eisner E, Farmer S, Hakim A, Kohn L, Lastrella AL, Lawrence ES, Morgan SC, Ngo TT, Nouri A, Plascencia A, Ruiz CA, Sathe S, Seaver P, Shwartz T, Smoot EW, Ostrander RT, Valles T, Yeo GW, Laurent LC, Fielding-Miller R, Knight R. SARS-CoV-2 Distribution in Residential Housing Suggests Contact Deposition and Correlates with Rothia sp. mSystems 2022; 7:e0141121. [PMID: 35575492 PMCID: PMC9239251 DOI: 10.1128/msystems.01411-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/20/2022] [Indexed: 11/20/2022] Open
Abstract
Monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on surfaces is emerging as an important tool for identifying past exposure to individuals shedding viral RNA. Our past work demonstrated that SARS-CoV-2 reverse transcription-quantitative PCR (RT-qPCR) signals from surfaces can identify when infected individuals have touched surfaces and when they have been present in hospital rooms or schools. However, the sensitivity and specificity of surface sampling as a method for detecting the presence of a SARS-CoV-2 positive individual, as well as guidance about where to sample, has not been established. To address these questions and to test whether our past observations linking SARS-CoV-2 abundance to Rothia sp. in hospitals also hold in a residential setting, we performed a detailed spatial sampling of three isolation housing units, assessing each sample for SARS-CoV-2 abundance by RT-qPCR, linking the results to 16S rRNA gene amplicon sequences (to assess the bacterial community at each location), and to the Cq value of the contemporaneous clinical test. Our results showed that the highest SARS-CoV-2 load in this setting is on touched surfaces, such as light switches and faucets, but a detectable signal was present in many untouched surfaces (e.g., floors) that may be more relevant in settings, such as schools where mask-wearing is enforced. As in past studies, the bacterial community predicts which samples are positive for SARS-CoV-2, with Rothia sp. showing a positive association. IMPORTANCE Surface sampling for detecting SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is increasingly being used to locate infected individuals. We tested which indoor surfaces had high versus low viral loads by collecting 381 samples from three residential units where infected individuals resided, and interpreted the results in terms of whether SARS-CoV-2 was likely transmitted directly (e.g., touching a light switch) or indirectly (e.g., by droplets or aerosols settling). We found the highest loads where the subject touched the surface directly, although enough virus was detected on indirectly contacted surfaces to make such locations useful for sampling (e.g., in schools, where students did not touch the light switches and also wore masks such that they had no opportunity to touch their face and then the object). We also documented links between the bacteria present in a sample and the SARS-CoV-2 virus, consistent with earlier studies.
Collapse
Affiliation(s)
- Victor J Cantú
- Department of Bioengineering, University of California San Diegogrid.266100.3, La Jolla, CA, USA
| | - Rodolfo A Salido
- Department of Bioengineering, University of California San Diegogrid.266100.3, La Jolla, CA, USA
| | - Shi Huang
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Gibraan Rahman
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, La Jolla, CA, USA
| | - Rebecca Tsai
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Holly Valentine
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Celestine G Magallanes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Stefan Aigner
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA, USA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Nathan A Baer
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Tom Barber
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Pedro Belda-Ferre
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Maryann Betty
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Rady Children's Hospital, San Diego, CA, USA
| | - MacKenzie Bryant
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Martín Casas Maya
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Anelizze Castro-Martínez
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Marisol Chacón
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Willi Cheung
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA, USA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- San Diego State University, San Diego, CA, USA
| | - Evelyn S Crescini
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Peter De Hoff
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA, USA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Emily Eisner
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Sawyer Farmer
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Abbas Hakim
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Laura Kohn
- Herbert Wertheim School of Public Health, University of California San Diegogrid.266100.3, La Jolla, CA, USA
| | - Alma L Lastrella
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Elijah S Lawrence
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Sydney C Morgan
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA, USA
| | - Toan T Ngo
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Alhakam Nouri
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Ashley Plascencia
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Christopher A Ruiz
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Shashank Sathe
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA, USA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Phoebe Seaver
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Tara Shwartz
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Elizabeth W Smoot
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - R Tyler Ostrander
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Thomas Valles
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Gene W Yeo
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Louise C Laurent
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Rebecca Fielding-Miller
- Herbert Wertheim School of Public Health, University of California San Diegogrid.266100.3, La Jolla, CA, USA
| | - Rob Knight
- Department of Bioengineering, University of California San Diegogrid.266100.3, La Jolla, CA, USA
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
52
|
Definition of an Indoor Air Sampling Strategy for SARS-CoV-2 Detection and Risk Management: Case Study in Kindergartens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127406. [PMID: 35742654 PMCID: PMC9224333 DOI: 10.3390/ijerph19127406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022]
Abstract
In the last two years, the world has been overwhelmed by SARS-CoV-2. One of the most important ways to prevent the spread of the virus is the control of indoor conditions: from surface hygiene to ventilation. Regarding the indoor environments, monitoring the presence of the virus in the indoor air seems to be promising, since there is strong evidence that airborne transmission through infected droplets and aerosols is its dominant transmission route. So far, few studies report the successful detection of SARS-CoV-2 in the air; moreover, the lack of a standard guideline for air monitoring reduces the uniformity of the results and their usefulness in the management of the risk of virus transmission. In this work, starting from a critical analysis of the existing standards and guidelines for indoor air quality, we define a strategy to set-up indoor air sampling plans for the detection of SARS-CoV-2. The strategy is then tested through a case study conducted in two kindergartens in the metropolitan city of Milan, in Italy, involving a total of 290 children and 47 teachers from 19 classrooms. The results proved its completeness, effectiveness, and suitability as a key tool in the airborne SARS-CoV-2 infection risk management process. Future research directions are then identified and discussed.
Collapse
|
53
|
Asif Z, Chen Z, Stranges S, Zhao X, Sadiq R, Olea-Popelka F, Peng C, Haghighat F, Yu T. Dynamics of SARS-CoV-2 spreading under the influence of environmental factors and strategies to tackle the pandemic: A systematic review. SUSTAINABLE CITIES AND SOCIETY 2022; 81:103840. [PMID: 35317188 PMCID: PMC8925199 DOI: 10.1016/j.scs.2022.103840] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 05/05/2023]
Abstract
COVID-19 is deemed as the most critical world health calamity of the 21st century, leading to dramatic life loss. There is a pressing need to understand the multi-stage dynamics, including transmission routes of the virus and environmental conditions due to the possibility of multiple waves of COVID-19 in the future. In this paper, a systematic examination of the literature is conducted associating the virus-laden-aerosol and transmission of these microparticles into the multimedia environment, including built environments. Particularly, this paper provides a critical review of state-of-the-art modelling tools apt for COVID-19 spread and transmission pathways. GIS-based, risk-based, and artificial intelligence-based tools are discussed for their application in the surveillance and forecasting of COVID-19. Primary environmental factors that act as simulators for the spread of the virus include meteorological variation, low air quality, pollen abundance, and spatial-temporal variation. However, the influence of these environmental factors on COVID-19 spread is still equivocal because of other non-pharmaceutical factors. The limitations of different modelling methods suggest the need for a multidisciplinary approach, including the 'One-Health' concept. Extended One-Health-based decision tools would assist policymakers in making informed decisions such as social gatherings, indoor environment improvement, and COVID-19 risk mitigation by adapting the control measurements.
Collapse
Affiliation(s)
- Zunaira Asif
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Canada
| | - Zhi Chen
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Western University, Ontario, Canada
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Xin Zhao
- Department of Animal Science, McGill University, Montreal, Canada
| | - Rehan Sadiq
- School of Engineering (Okanagan Campus), University of British Columbia, Kelowna, BC, Canada
| | | | - Changhui Peng
- Department of Biological Sciences, University of Quebec in Montreal, Canada
| | - Fariborz Haghighat
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Canada
| | - Tong Yu
- Department of Civil and Environmental Engineering, University of Alberta, Canada
| |
Collapse
|
54
|
Kweon OJ, Lee JH, Choi YS, Kim BS, Lim YK, Lee MK, Park JH, Park JY, Kim SH. Positivity of Rapid Antigen Testing for SARS-CoV-2 With Serial Followed-up Nasopharyngeal Swabs in Hospitalized Patients due to COVID-19. J Korean Med Sci 2022; 37:e168. [PMID: 35638195 PMCID: PMC9151995 DOI: 10.3346/jkms.2022.37.e168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/05/2022] [Indexed: 11/20/2022] Open
Abstract
Despite the accuracy of nucleic acid amplification tests (NAATs), rapid antigen tests (RATs) for severe acute respiratory syndrome coronavirus-2 are widely used as point-of-care tests. A total of 282 pairs of reverse transcription-polymerase chain reaction and Standard Q COVID-19 Ag tests were serially conducted for 68 patients every 3-4 days until their discharge. Through a field evaluation of RATs using direct nasopharyngeal swabs, the sensitivities were 84.6% and 87.3% for E and RNA-dependent RNA polymerase (RdRp) genes, respectively, for specimens with cycle thresholds (Cts) < 25. The Ct values of E and RdRp genes for 95% detection rates by RATs were 16.9 and 18.1, respectively. The sensitivity of RAT was 48.4% after the onset of symptoms, which was not sufficient. RAT positivity gradually decreased with increased time after symptom onset and had continuously lower sensitivity than NAATs.
Collapse
Affiliation(s)
- Oh Joo Kweon
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Joo Hee Lee
- Department of Pulmonary Medicine, Hyundae General Hospital, Chung-Ang University, Namyangju, Korea
| | - Yang-Seon Choi
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Seoul, Korea
| | - Boo-Seop Kim
- Department of Orthopaedic Surgery, Hyundae General Hospital, Chung-Ang University, Namyangju, Korea
| | - Yong Kwan Lim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mi-Kyung Lee
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Joung Ha Park
- Department of Internal Medicine, Hyundae General Hospital, Chung-Ang University, Namyangju, Korea
| | - Ji Young Park
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea.
| | - Seong Hwan Kim
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Seoul, Korea.
| |
Collapse
|
55
|
Raja AI, van Veldhoven K, Ewuzie A, Frost G, Sandys V, Atkinson B, Nicholls I, Graham A, Higgins H, Coldwell M, Simpson A, Cooke J, Bennett A, Barber C, Morgan D, Atchison C, Keen C, Fletcher T, Pearce N, Brickley EB, Chen Y. Investigation of a SARS-CoV-2 Outbreak at an Automotive Manufacturing Site in England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116400. [PMID: 35681985 DOI: 10.1101/2022.01.31.22269194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 05/25/2023]
Abstract
Workplace-related outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to occur globally. The manufacturing sector presents a particular concern for outbreaks, and a better understanding of transmission risks are needed. Between 9 March and 24 April 2021, the COVID-19 (coronavirus disease 2019) Outbreak Investigation to Understand Transmission (COVID-OUT) study undertook a comprehensive investigation of a SARS-CoV-2 outbreak at an automotive manufacturing site in England. The site had a total of 266 workers, and 51 SARS-CoV-2 infections. Overall, ventilation, humidity, and temperature at the site were assessed to be appropriate for the number of workers and the work being conducted. The company had implemented a number of infection control procedures, including provision of face coverings, spacing in the work, and welfare areas to allow for social distancing. However, observations of worker practices identified lapses in social distancing, although all were wearing face coverings. A total of 38 workers, including four confirmed cases, participated in the COVID-OUT study. The majority of participants received COVID-19 prevention training, though 42.9% also reported that their work required close physical contact with co-workers. Additionally, 73.7% and 34.2% had concerns regarding reductions in future income and future unemployment, respectively, due to self-isolation. This investigation adds to the growing body of evidence of SARS-CoV-2 outbreaks from the manufacturing sector. Despite a layered COVID-19 control strategy at this site, cases clustered in areas of high occupancy and close worker proximity.
Collapse
Affiliation(s)
- Amber I Raja
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Karin van Veldhoven
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Adanna Ewuzie
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Gillian Frost
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| | - Vince Sandys
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| | - Barry Atkinson
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Ian Nicholls
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Alice Graham
- Rapid Investigation Team, Field Services, UK Health Security Agency, Wellington House, London SE1 8UG, UK
| | - Hannah Higgins
- Rapid Investigation Team, Field Services, UK Health Security Agency, Wellington House, London SE1 8UG, UK
| | - Matthew Coldwell
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| | - Andrew Simpson
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| | - Joan Cooke
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| | - Allan Bennett
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Chris Barber
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| | - Derek Morgan
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| | - Christina Atchison
- Rapid Investigation Team, Field Services, UK Health Security Agency, Wellington House, London SE1 8UG, UK
| | - Chris Keen
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| | - Tony Fletcher
- Chemical and Environmental Effects Department, UK Health Security Agency, Chilton OX11 0RQ, UK
| | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Elizabeth B Brickley
- Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Yiqun Chen
- Science Division, Health and Safety Executive, Buxton SK17 9JN, UK
| |
Collapse
|
56
|
Döhla M, Schulte B, Wilbring G, Kümmerer BM, Döhla C, Sib E, Richter E, Ottensmeyer PF, Haag A, Engelhart S, Eis-Hübinger AM, Exner M, Mutters NT, Schmithausen RM, Streeck H. SARS-CoV-2 in Environmental Samples of Quarantined Households. Viruses 2022; 14:1075. [PMID: 35632816 PMCID: PMC9147922 DOI: 10.3390/v14051075] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/12/2022] [Accepted: 05/12/2022] [Indexed: 02/01/2023] Open
Abstract
The role of environmental transmission of SARS-CoV-2 remains unclear. Thus, the aim of this study was to investigate whether viral contamination of air, wastewater, and surfaces in quarantined households result in a higher risk for exposed persons. For this study, a source population of 21 households under quarantine conditions with at least one person who tested positive for SARS-CoV-2 RNA were randomly selected from a community in North Rhine-Westphalia in March 2020. All individuals living in these households participated in this study and provided throat swabs for analysis. Air and wastewater samples and surface swabs were obtained from each household and analysed using qRT-PCR. Positive swabs were further cultured to analyse for viral infectivity. Out of all the 43 tested adults, 26 (60.47%) tested positive using qRT-PCR. All 15 air samples were qRT-PCR-negative. In total, 10 out of 66 wastewater samples were positive for SARS-CoV-2 (15.15%) and 4 out of 119 surface samples (3.36%). No statistically significant correlation between qRT-PCR-positive environmental samples and the extent of the spread of infection between household members was observed. No infectious virus could be propagated under cell culture conditions. Taken together, our study demonstrates a low likelihood of transmission via surfaces. However, to definitively assess the importance of hygienic behavioural measures in the reduction of SARS-CoV-2 transmission, larger studies should be designed to determine the proportionate contribution of smear vs. droplet transmission.
Collapse
Affiliation(s)
- Manuel Döhla
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
- Department of Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Bianca Schulte
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Gero Wilbring
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Beate Mareike Kümmerer
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Christin Döhla
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Esther Sib
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Enrico Richter
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Patrick Frank Ottensmeyer
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Alexandra Haag
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Steffen Engelhart
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Anna Maria Eis-Hübinger
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| | - Martin Exner
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Nico Tom Mutters
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Ricarda Maria Schmithausen
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (M.D.); (G.W.); (C.D.); (E.S.); (A.H.); (S.E.); (M.E.); (N.T.M.); (R.M.S.)
| | - Hendrik Streeck
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (B.S.); (B.M.K.); (E.R.); (P.F.O.); (A.M.E.-H.)
| |
Collapse
|
57
|
Döhla M, Schulte B, Wilbring G, Kümmerer BM, Döhla C, Sib E, Richter E, Ottensmeyer PF, Haag A, Engelhart S, Eis-Hübinger AM, Exner M, Mutters NT, Schmithausen RM, Streeck H. SARS-CoV-2 in Environmental Samples of Quarantined Households. Viruses 2022. [PMID: 35632816 DOI: 10.1101/2020.05.28.20114041] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
The role of environmental transmission of SARS-CoV-2 remains unclear. Thus, the aim of this study was to investigate whether viral contamination of air, wastewater, and surfaces in quarantined households result in a higher risk for exposed persons. For this study, a source population of 21 households under quarantine conditions with at least one person who tested positive for SARS-CoV-2 RNA were randomly selected from a community in North Rhine-Westphalia in March 2020. All individuals living in these households participated in this study and provided throat swabs for analysis. Air and wastewater samples and surface swabs were obtained from each household and analysed using qRT-PCR. Positive swabs were further cultured to analyse for viral infectivity. Out of all the 43 tested adults, 26 (60.47%) tested positive using qRT-PCR. All 15 air samples were qRT-PCR-negative. In total, 10 out of 66 wastewater samples were positive for SARS-CoV-2 (15.15%) and 4 out of 119 surface samples (3.36%). No statistically significant correlation between qRT-PCR-positive environmental samples and the extent of the spread of infection between household members was observed. No infectious virus could be propagated under cell culture conditions. Taken together, our study demonstrates a low likelihood of transmission via surfaces. However, to definitively assess the importance of hygienic behavioural measures in the reduction of SARS-CoV-2 transmission, larger studies should be designed to determine the proportionate contribution of smear vs. droplet transmission.
Collapse
Affiliation(s)
- Manuel Döhla
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
- Department of Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Bianca Schulte
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Gero Wilbring
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Beate Mareike Kümmerer
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Christin Döhla
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Esther Sib
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Enrico Richter
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | | | - Alexandra Haag
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Steffen Engelhart
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Anna Maria Eis-Hübinger
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Martin Exner
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Nico Tom Mutters
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Ricarda Maria Schmithausen
- Institute for Hygiene and Public Health, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Hendrik Streeck
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| |
Collapse
|
58
|
Legeay C, Peron W, Le Bihan C, Pivert A, Lefeuvre C. SARS-CoV-2 detection on healthcare workers' hands caring for COVID-19 patients. J Hosp Infect 2022; 126:78-80. [PMID: 35594984 PMCID: PMC9112601 DOI: 10.1016/j.jhin.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Clément Legeay
- Infection Control and Prevention Unit, CHU Angers, F-49000 Angers, France
| | - William Peron
- Infection Control and Prevention Unit, CHU Angers, F-49000 Angers, France
| | - Clément Le Bihan
- Laboratoire de virologie, Département de Biologie des Agents Infectieux, CHU Angers, F-49000 Angers, France
| | - Adeline Pivert
- Laboratoire de virologie, Département de Biologie des Agents Infectieux, CHU Angers, F-49000 Angers, France; Univ Angers, HIFIH, SFR ICAT, F-49000 Angers, France
| | - Caroline Lefeuvre
- Laboratoire de virologie, Département de Biologie des Agents Infectieux, CHU Angers, F-49000 Angers, France; Univ Angers, HIFIH, SFR ICAT, F-49000 Angers, France.
| |
Collapse
|
59
|
Nagle S, Tandjaoui-Lambiotte Y, Boubaya M, Gerber A, Alloui C, Bloch-Queyrat C, Carbonnelle E, Brichler S, Cohen Y, Zahar JR, Delagrèverie H. Environmental SARS-CoV-2 contamination in hospital rooms of patients with acute COVID-19. J Hosp Infect 2022; 126:116-122. [PMID: 35569577 PMCID: PMC9098885 DOI: 10.1016/j.jhin.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 12/19/2022]
Abstract
Objective Data on the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) remain conflicting. Airborne transmission is still debated. However, hospital risk control requires better understanding of the different modes of transmission. This study aimed to evaluate the frequency of, and factors associated with, environmental air and surface contamination in the rooms of patients with coronavirus disease 2019 in the acute phase of the disease. Methods Sixty-five consecutive patients were included in this study. For each patient, seven room surfaces, air 1 m and 3 m from the patient's head, the inner surface of the patient's mask, and the outer surface of healthcare workers' (HCW) masks were sampled. Environmental contamination was assessed by quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA on surfaces, air and masks. A viral isolation test was performed on Vero cells for samples with an RT-qPCR cycle threshold (Ct) ≤37. Results SARS-CoV-2 RNA was detected by RT-qPCR in 34%, 12%, 50% and 10% of surface, air, patient mask and HCW mask samples, respectively. Infectious virus was isolated in culture from two samples among the 85 positive samples with Ct ≤37. On multi-variate analysis, only a positive result for SARS-CoV-2 RT-qPCR for patients' face masks was found to be significantly associated with surface contamination (odds ratio 5.79, 95% confidence interval 1.31–25.67; P=0.025). Conclusion This study found that surface contamination by SARS-CoV-2 was more common than air and mask contamination. However, viable virus was rare. The inner surface of a patient's mask could be used as a marker to identify those at higher risk of contamination.
Collapse
|
60
|
Stettler MEJ, Nishida RT, de Oliveira PM, Mesquita LCC, Johnson TJ, Galea ER, Grandison A, Ewer J, Carruthers D, Sykes D, Kumar P, Avital E, Obeysekara AIB, Doorly D, Hardalupas Y, Green DC, Coldrick S, Parker S, Boies AM. Source terms for benchmarking models of SARS-CoV-2 transmission via aerosols and droplets. ROYAL SOCIETY OPEN SCIENCE 2022. [PMID: 35592762 DOI: 10.6084/m9.figshare.c.5958950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
There is ongoing and rapid advancement in approaches to modelling the fate of exhaled particles in different environments relevant to disease transmission. It is important that models are verified by comparison with each other using a common set of input parameters to ensure that model differences can be interpreted in terms of model physics rather than unspecified differences in model input parameters. In this paper, we define parameters necessary for such benchmarking of models of airborne particles exhaled by humans and transported in the environment during breathing and speaking.
Collapse
Affiliation(s)
- Marc E J Stettler
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
| | - Robert T Nishida
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada T6G 2G8
| | | | - Léo C C Mesquita
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| | - Tyler J Johnson
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| | - Edwin R Galea
- Fire Safety Engineering Group, University of Greenwich, London SE10 9LS, UK
| | - Angus Grandison
- Fire Safety Engineering Group, University of Greenwich, London SE10 9LS, UK
| | - John Ewer
- Fire Safety Engineering Group, University of Greenwich, London SE10 9LS, UK
| | - David Carruthers
- Cambridge Environmental Research Consultants Ltd, 3 Kings Parade, Cambridge CB2 1SJ, UK
| | | | - Prashant Kumar
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Eldad Avital
- School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, UK
| | - Asiri I B Obeysekara
- Applied Modelling and Computation Group, Department of Earth Science and Engineering, Imperial College London, London SW7 2AZ, UK
| | - Denis Doorly
- Department of Aeronautics, Imperial College London, London SW7 2AZ, UK
| | - Yannis Hardalupas
- Department of Mechanical Engineering, Imperial College London, London SW7 2AZ, UK
| | - David C Green
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College London, Michael Uren Biomedical Engineering Hub, London, W12 OBZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College London, Michael Uren Biomedical Engineering Hub, London, W12 OBZ, UK
| | - Simon Coldrick
- Health and Safety Executive, Harpur Hill, Buxton, Derbyshire SK17 9JN UK
| | - Simon Parker
- Defence Science and Technology Laboratory, Porton Down, Salisbury SP4 0JQ, UK
| | - Adam M Boies
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| |
Collapse
|
61
|
Stettler MEJ, Nishida RT, de Oliveira PM, Mesquita LCC, Johnson TJ, Galea ER, Grandison A, Ewer J, Carruthers D, Sykes D, Kumar P, Avital E, Obeysekara AIB, Doorly D, Hardalupas Y, Green DC, Coldrick S, Parker S, Boies AM. Source terms for benchmarking models of SARS-CoV-2 transmission via aerosols and droplets. ROYAL SOCIETY OPEN SCIENCE 2022; 9:212022. [PMID: 35592762 PMCID: PMC9066307 DOI: 10.1098/rsos.212022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/13/2022] [Indexed: 05/03/2023]
Abstract
There is ongoing and rapid advancement in approaches to modelling the fate of exhaled particles in different environments relevant to disease transmission. It is important that models are verified by comparison with each other using a common set of input parameters to ensure that model differences can be interpreted in terms of model physics rather than unspecified differences in model input parameters. In this paper, we define parameters necessary for such benchmarking of models of airborne particles exhaled by humans and transported in the environment during breathing and speaking.
Collapse
Affiliation(s)
- Marc E. J. Stettler
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
| | - Robert T. Nishida
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada T6G 2G8
| | | | - Léo C. C. Mesquita
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| | - Tyler J. Johnson
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| | - Edwin R. Galea
- Fire Safety Engineering Group, University of Greenwich, London SE10 9LS, UK
| | - Angus Grandison
- Fire Safety Engineering Group, University of Greenwich, London SE10 9LS, UK
| | - John Ewer
- Fire Safety Engineering Group, University of Greenwich, London SE10 9LS, UK
| | - David Carruthers
- Cambridge Environmental Research Consultants Ltd, 3 Kings Parade, Cambridge CB2 1SJ, UK
| | | | - Prashant Kumar
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Eldad Avital
- School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, UK
| | - Asiri I. B. Obeysekara
- Applied Modelling and Computation Group, Department of Earth Science and Engineering, Imperial College London, London SW7 2AZ, UK
| | - Denis Doorly
- Department of Aeronautics, Imperial College London, London SW7 2AZ, UK
| | - Yannis Hardalupas
- Department of Mechanical Engineering, Imperial College London, London SW7 2AZ, UK
| | - David C. Green
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College London, Michael Uren Biomedical Engineering Hub, London, W12 OBZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College London, Michael Uren Biomedical Engineering Hub, London, W12 OBZ, UK
| | - Simon Coldrick
- Health and Safety Executive, Harpur Hill, Buxton, Derbyshire SK17 9JN UK
| | - Simon Parker
- Defence Science and Technology Laboratory, Porton Down, Salisbury SP4 0JQ, UK
| | - Adam M. Boies
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| |
Collapse
|
62
|
Zuniga-Montanez R, Coil DA, Eisen JA, Pechacek R, Guerrero RG, Kim M, Shapiro K, Bischel HN. The challenge of SARS-CoV-2 environmental monitoring in schools using floors and portable HEPA filtration units: Fresh or relic RNA? PLoS One 2022; 17:e0267212. [PMID: 35452479 PMCID: PMC9032406 DOI: 10.1371/journal.pone.0267212] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/04/2022] [Indexed: 11/25/2022] Open
Abstract
Testing surfaces in school classrooms for the presence of SARS-CoV-2, the virus that causes COVID-19, can provide public-health information that complements clinical testing. We monitored the presence of SARS-CoV-2 RNA in five schools (96 classrooms) in Davis, California (USA) by collecting weekly surface-swab samples from classroom floors and/or portable high-efficiency particulate air (HEPA) units (n = 2,341 swabs). Twenty-two surfaces tested positive, with qPCR cycle threshold (Ct) values ranging from 36.07-38.01. Intermittent repeated positives in a single room were observed for both floor and HEPA filter samples for up to 52 days, even following regular cleaning and HEPA filter replacement after a positive result. We compared the two environmental sampling strategies by testing one floor and two HEPA filter samples in 57 classrooms at Schools D and E. HEPA filter sampling yielded 3.02% and 0.41% positivity rates per filter sample collected for Schools D and E, respectively, while floor sampling yielded 0.48% and 0% positivity rates. Our results indicate that HEPA filter swabs are more sensitive than floor swabs at detecting SARS-CoV-2 RNA in interior spaces. During the study, all schools were offered weekly free COVID-19 clinical testing through Healthy Davis Together (HDT). HDT also offered on-site clinical testing in Schools D and E, and upticks in testing participation were observed following a confirmed positive environmental sample. However, no confirmed COVID-19 cases were identified among students associated with classrooms yielding positive environmental samples. The positive samples detected in this study appeared to contain relic viral RNA from individuals infected before the monitoring program started and/or RNA transported into classrooms via fomites. High-Ct positive results from environmental swabs detected in the absence of known active infections supports this conclusion. Additional research is needed to differentiate between fresh and relic SARS-CoV-2 RNA in environmental samples and to determine what types of results should trigger interventions.
Collapse
Affiliation(s)
- Rogelio Zuniga-Montanez
- Department of Civil and Environmental Engineering, One Shields Avenue, University of California, Davis, California, United States of America
| | - David A. Coil
- Genome Center, University of California, Davis, California, United States of America
| | - Jonathan A. Eisen
- Genome Center, University of California, Davis, California, United States of America
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, California, United States of America
- Department of Evolution and Ecology, University of California, Davis, California, United States of America
| | - Randi Pechacek
- Department of Civil and Environmental Engineering, One Shields Avenue, University of California, Davis, California, United States of America
| | - Roque G. Guerrero
- Department of Civil and Environmental Engineering, One Shields Avenue, University of California, Davis, California, United States of America
| | - Minji Kim
- Department of Civil and Environmental Engineering, One Shields Avenue, University of California, Davis, California, United States of America
| | - Karen Shapiro
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Heather N. Bischel
- Department of Civil and Environmental Engineering, One Shields Avenue, University of California, Davis, California, United States of America
| |
Collapse
|
63
|
Li M, Li J, Yang Y, Liu W, Liang Z, Ding G, Chen X, Song Q, Xue C, Sun B. Investigation of mouse hepatitis virus strain A59 inactivation under both ambient and cold environments reveals the mechanisms of infectivity reduction following UVC exposure. JOURNAL OF ENVIRONMENTAL CHEMICAL ENGINEERING 2022; 10:107206. [PMID: 35043085 PMCID: PMC8757640 DOI: 10.1016/j.jece.2022.107206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/04/2022] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
The surface contamination of SARS-CoV-2 is becoming a potential source of virus transmission during the pandemic of COVID-19. Under the cold environment, the infection incidents would be more severe with the increase of virus survival time. Thus, the disinfection of contaminated surfaces in both ambient and cold environments is a critical measure to restrain the spread of the virus. In our study, it was demonstrated that the 254 nm ultraviolet-C (UVC) is an efficient method to inactivate a coronavirus, mouse hepatitis virus strain A59 (MHV-A59). The inactivation rate to MHV-A59 coronavirus was up to 99.99% when UVC doses were 2.90 and 14.0 mJ/cm2 at room temperature (23 °C) and in cold environment (-20 °C), respectively. Further mechanistic study demonstrated that UVC could induce spike protein damage to partly impede virus attachment and genome penetration processes, which contributes to 12% loss of viral infectivity. Additionally, it can induce genome damage to significantly interrupt genome replication, protein synthesis, virus assembly and release processes, which takes up 88% contribution to viral inactivation. With these mechanistic understandings, it will greatly contribute to the prevention and control of the current SARS-CoV-2 transmissions in cold chains (low temperature-controlled product supply chains), public area such as airport, school, and warehouse.
Collapse
Affiliation(s)
- Min Li
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, 116024 Dalian, China
- School of Chemical Engineering, Dalian University of Technology, 116024 Dalian, China
| | - Jiahuan Li
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, 116024 Dalian, China
- School of Chemical Engineering, Dalian University of Technology, 116024 Dalian, China
| | - Yunlong Yang
- School of Bioengineering, Dalian University of Technology, 116024 Dalian, China
| | - Wenhui Liu
- School of Bioengineering, Dalian University of Technology, 116024 Dalian, China
| | - Zhihui Liang
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, 116024 Dalian, China
- School of Chemical Engineering, Dalian University of Technology, 116024 Dalian, China
| | - Guanyu Ding
- Soleilware Photonics Co.,LTD, Suzhou, Jiangsu 215000, China
| | - Xiaohe Chen
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu 215163, China
| | - Qi Song
- Soleilware Photonics Co.,LTD, Suzhou, Jiangsu 215000, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu 215163, China
| | - Changying Xue
- School of Bioengineering, Dalian University of Technology, 116024 Dalian, China
| | - Bingbing Sun
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, 116024 Dalian, China
- School of Chemical Engineering, Dalian University of Technology, 116024 Dalian, China
| |
Collapse
|
64
|
Barrios Andrés JL, Carriba Rodriguez MJ, Aranzamendi Zaldumbide M, Hernández JM, Viciola García M. Evaluation of cleaning and disinfection protocols for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) on different hospital surfaces. Infect Control Hosp Epidemiol 2022; 43:544-545. [PMID: 33487202 PMCID: PMC7870904 DOI: 10.1017/ice.2021.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 11/09/2022]
Affiliation(s)
- José Luis Barrios Andrés
- Hospital Infection Control Division, Microbiology Service, Hospital Universitario Cruces, Barakaldo (Bizkaia), Basque Country, Spain
| | | | | | - Jose María Hernández
- Commission on Infections and Antibiotic Policy, Department of Preventive Medicine, Hospital Universitario Cruces, Barakaldo (Bizkaia), Basque Country, Spain
| | - Margarita Viciola García
- Preventive Medicine Service, Hospital Universitario Cruces, Barakaldo (Bizkaia), Basque Country, Spain
| |
Collapse
|
65
|
Myers NT, Laumbach RJ, Black KG, Ohman‐Strickland P, Alimokhtari S, Legard A, De Resende A, Calderón L, Lu FT, Mainelis G, Kipen HM. Portable air cleaners and residential exposure to SARS-CoV-2 aerosols: A real-world study. INDOOR AIR 2022; 32:e13029. [PMID: 35481935 PMCID: PMC9111720 DOI: 10.1111/ina.13029] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 05/04/2023]
Abstract
Individuals with COVID-19 who do not require hospitalization are instructed to self-isolate in their residences. Due to high secondary infection rates in household members, there is a need to understand airborne transmission of SARS-CoV-2 within residences. We report the first naturalistic intervention study suggesting a reduction of such transmission risk using portable air cleaners (PACs) with HEPA filters. Seventeen individuals with newly diagnosed COVID-19 infection completed this single-blind, crossover, randomized study. Total and size-fractionated aerosol samples were collected simultaneously in the self-isolation room with the PAC (primary) and another room (secondary) for two consecutive 24-h periods, one period with HEPA filtration and the other with the filter removed (sham). Seven out of sixteen (44%) air samples in primary rooms were positive for SARS-CoV-2 RNA during the sham period. With the PAC operated at its lowest setting (clean air delivery rate [CADR] = 263 cfm) to minimize noise, positive aerosol samples decreased to four out of sixteen residences (25%; p = 0.229). A slight decrease in positive aerosol samples was also observed in the secondary room. As the world confronts both new variants and limited vaccination rates, our study supports this practical intervention to reduce the presence of viral aerosols in a real-world setting.
Collapse
Affiliation(s)
- Nirmala T. Myers
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Robert J. Laumbach
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Environmental and Occupational Health and JusticeRutgers UniversityPiscatawayNew JerseyUSA
| | - Kathleen G. Black
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Pamela Ohman‐Strickland
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Biostatistics and EpidemiologyRutgers School of Public HealthRutgers UniversityPiscatawayNew JerseyUSA
| | - Shahnaz Alimokhtari
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Alicia Legard
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Adriana De Resende
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Leonardo Calderón
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Frederic T. Lu
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Gediminas Mainelis
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Howard M. Kipen
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Environmental and Occupational Health and JusticeRutgers UniversityPiscatawayNew JerseyUSA
| |
Collapse
|
66
|
Detection and quantification of infectious severe acute respiratory coronavirus-2 in diverse clinical and environmental samples. Sci Rep 2022; 12:5418. [PMID: 35354854 PMCID: PMC8967087 DOI: 10.1038/s41598-022-09218-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/14/2022] [Indexed: 12/19/2022] Open
Abstract
To explore the potential modes of Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) transmission, we collected 535 diverse clinical and environmental samples from 75 infected hospitalized and community patients. Infectious SARS-CoV-2 with quantitative burdens varying from 5 plaque-forming units/mL (PFU/mL) up to 1.0 × 106 PFU/mL was detected in 151/459 (33%) of the specimens assayed and up to 1.3 × 106 PFU/mL on fomites with confirmation by plaque morphology, PCR, immunohistochemistry, and/or sequencing. Infectious virus in clinical and associated environmental samples correlated with time since symptom onset with no detection after 7–8 days in immunocompetent hosts and with N-gene based Ct values ≤ 25 significantly predictive of yielding plaques in culture. SARS-CoV-2 isolated from patient respiratory tract samples caused illness in a hamster model with a minimum infectious dose of ≤ 14 PFU. Together, our findings offer compelling evidence that large respiratory droplet and contact (direct and indirect i.e., fomites) are important modes of SARS-CoV-2 transmission.
Collapse
|
67
|
Lin YC, Malott RJ, Ward L, Kiplagat L, Pabbaraju K, Gill K, Berenger BM, Hu J, Fonseca K, Noyce RS, Louie T, Evans DH, Conly JM. Detection and quantification of infectious severe acute respiratory coronavirus-2 in diverse clinical and environmental samples. Sci Rep 2022. [PMID: 35354854 DOI: 10.1101/2021.07.08.21259744] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
To explore the potential modes of Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) transmission, we collected 535 diverse clinical and environmental samples from 75 infected hospitalized and community patients. Infectious SARS-CoV-2 with quantitative burdens varying from 5 plaque-forming units/mL (PFU/mL) up to 1.0 × 106 PFU/mL was detected in 151/459 (33%) of the specimens assayed and up to 1.3 × 106 PFU/mL on fomites with confirmation by plaque morphology, PCR, immunohistochemistry, and/or sequencing. Infectious virus in clinical and associated environmental samples correlated with time since symptom onset with no detection after 7-8 days in immunocompetent hosts and with N-gene based Ct values ≤ 25 significantly predictive of yielding plaques in culture. SARS-CoV-2 isolated from patient respiratory tract samples caused illness in a hamster model with a minimum infectious dose of ≤ 14 PFU. Together, our findings offer compelling evidence that large respiratory droplet and contact (direct and indirect i.e., fomites) are important modes of SARS-CoV-2 transmission.
Collapse
Affiliation(s)
- Yi-Chan Lin
- Department of Medical Microbiology and Immunology, University of Alberta, 6-142L Katz Group Centre, Edmonton, AB, T6G 2J7, Canada
| | - Rebecca J Malott
- Cumming School of Medicine, University of Calgary, 3030 Hospital Dr NW, Calgary, AB, T2N 4W4, Canada
| | - Linda Ward
- Cumming School of Medicine, University of Calgary, 3030 Hospital Dr NW, Calgary, AB, T2N 4W4, Canada
- Foothills Medical Centre, Alberta Health Services, 1403 29 Street NW, Calgary, AB, 2TN 2T9, Canada
| | - Linet Kiplagat
- Cumming School of Medicine, University of Calgary, 3030 Hospital Dr NW, Calgary, AB, T2N 4W4, Canada
| | - Kanti Pabbaraju
- Alberta Public Health Laboratory, Alberta Precision Laboratories, Calgary, AB, Canada
| | - Kara Gill
- Alberta Public Health Laboratory, Alberta Precision Laboratories, Calgary, AB, Canada
| | - Byron M Berenger
- Cumming School of Medicine, University of Calgary, 3030 Hospital Dr NW, Calgary, AB, T2N 4W4, Canada
- Alberta Public Health Laboratory, Alberta Precision Laboratories, Calgary, AB, Canada
| | - Jia Hu
- Cumming School of Medicine, University of Calgary, 3030 Hospital Dr NW, Calgary, AB, T2N 4W4, Canada
| | - Kevin Fonseca
- Cumming School of Medicine, University of Calgary, 3030 Hospital Dr NW, Calgary, AB, T2N 4W4, Canada
- Foothills Medical Centre, Alberta Health Services, 1403 29 Street NW, Calgary, AB, 2TN 2T9, Canada
- Alberta Public Health Laboratory, Alberta Precision Laboratories, Calgary, AB, Canada
| | - Ryan S Noyce
- Department of Medical Microbiology and Immunology, University of Alberta, 6-142L Katz Group Centre, Edmonton, AB, T6G 2J7, Canada
| | - Thomas Louie
- Cumming School of Medicine, University of Calgary, 3030 Hospital Dr NW, Calgary, AB, T2N 4W4, Canada
- Foothills Medical Centre, Alberta Health Services, 1403 29 Street NW, Calgary, AB, 2TN 2T9, Canada
| | - David H Evans
- Department of Medical Microbiology and Immunology, University of Alberta, 6-142L Katz Group Centre, Edmonton, AB, T6G 2J7, Canada.
| | - John M Conly
- Cumming School of Medicine, University of Calgary, 3030 Hospital Dr NW, Calgary, AB, T2N 4W4, Canada
- Foothills Medical Centre, Alberta Health Services, 1403 29 Street NW, Calgary, AB, 2TN 2T9, Canada
| |
Collapse
|
68
|
Sloan A, Kasloff SB, Cutts T. Mechanical Wiping Increases the Efficacy of Liquid Disinfectants on SARS-CoV-2. Front Microbiol 2022; 13:847313. [PMID: 35391722 PMCID: PMC8981239 DOI: 10.3389/fmicb.2022.847313] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 02/03/2022] [Indexed: 12/24/2022] Open
Abstract
High-touch environmental surfaces are acknowledged as potential sources of pathogen transmission, particularly in health care settings where infectious agents may be readily abundant. Methods of disinfecting these surfaces often include direct application of a chemical disinfectant or simply wiping the surface with a disinfectant pre-soaked wipe (DPW). In this study, we examine the ability of four disinfectants, ethanol (EtOH), sodium hypochlorite (NaOCl), chlorine dioxide (ClO2), and potassium monopersulfate (KMPS), to inactivate SARS-CoV-2 on a hard, non-porous surface, assessing the effects of concentration and contact time. The efficacy of DPWs to decontaminate carriers spiked with SARS-CoV-2, as well as the transferability of the virus from used DPWs to clean surfaces, is also assessed. Stainless steel carriers inoculated with approximately 6 logs of SARS-CoV-2 prepared in a soil load were disinfected within 5 min through exposure to 66.5% EtOH, 0.5% NaOCl, and 1% KMPS. The addition of mechanical wiping using DPWs impregnated with these biocides rendered the virus inactive almost immediately, with no viral transfer from the used DPW to adjacent surfaces. Carriers treated with 100 ppm of ClO2 showed a significant amount of viable virus remaining after 10 min of biocide exposure, while the virus was only completely inactivated after 10 min of treatment with 500 ppm of ClO2. Wiping SARS-CoV-2-spiked carriers with DPWs containing either concentration of ClO2 for 5 s left significant amounts of viable virus on the carriers. Furthermore, higher titers of infectious virus retained on the ClO2-infused DPWs were transferred to uninoculated carriers immediately after wiping. Overall, 66.5% EtOH, 0.5% NaOCl, and 1% KMPS appear to be highly effective biocidal agents against SARS-CoV-2, while ClO2 formulations are much less efficacious.
Collapse
Affiliation(s)
| | | | - Todd Cutts
- National Microbiology Laboratory, Applied Biosafety Research Program, Safety and Environmental Services, Public Health Agency of Canada, Winnipeg, MB, Canada
| |
Collapse
|
69
|
Data on Transfer of Human Coronavirus SARS-CoV-2 from Foods and Packaging Materials to Gloves Indicate That Fomite Transmission Is of Minor Importance. Appl Environ Microbiol 2022; 88:e0233821. [PMID: 35285254 PMCID: PMC9004375 DOI: 10.1128/aem.02338-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is mainly transmitted via droplets and aerosols. To evaluate the role of transmission by fomites, SARS-CoV-2-specific data on transfer rates from surfaces to hands and from hands to face are lacking. Here, we generated quantitatively controlled transfer rates for SARS-CoV-2 from food items (lettuce, ham, and vegetarian meat alternative [VMA]) and packaging materials (cardboard and plastic) to gloves using a wet, dry, and frozen viral inoculum and from glove to glove using a wet viral inoculum. For biosafety reasons, the transfer from surfaces to hands and hands to face was simulated by using gloves. The cumulative transfer rate was calculated by using the data from the first transfer experiment, food or packaging material to glove, and combined with the transfer rate obtained from the second transfer experiment from glove to glove. The cumulative transfer rates from lettuce (4.7%) and ham (3.4%) were not significantly different (P > 0.05) but were significantly higher (P < 0.05) than that from VMA (“wet” or “frozen”). The wet cumulative transfer rate from VMA (1.3%) was significantly higher than the cumulative transfer rate from frozen VMA (0.0011%). No transfer from plastic or cardboard was observed with a dry inoculum. The plastic packaging under wet conditions provided the highest cumulative transfer rate (3.0%), while the cumulative transfer from frozen cardboard was very small (0.035%). Overall, the transfer rates determined in this study suggest a minor role of foods or food packaging materials in infection transmission. IMPORTANCE The observation of SARS-CoV-2 RNA in swab samples from frozen fish packages in China, confirmed only once by cell culture, led to the hypothesis that food contaminated with SARS-CoV-2 virus particles could be the source of an outbreak. Epidemiological evidence for fomites as infection source is scarce, but it is important for the food industry to evaluate this infection path with quantitative microbial risk assessment (QMRA), using measured viral transfer rates from surfaces to hands and face. The present study provides transfer data for SARS-CoV-2 from various types of foods and packaging materials using quantitative methods that take uncertainties related to the virus recovery from the different surfaces into consideration. The transfer data from this model system provide important input parameters for QMRA models to assess the risk of SARS-CoV-2 transmission from contaminated food items.
Collapse
|
70
|
Viral load of SARS-CoV-2 in droplets and bioaerosols directly captured during breathing, speaking and coughing. Sci Rep 2022; 12:3484. [PMID: 35241703 PMCID: PMC8894466 DOI: 10.1038/s41598-022-07301-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/16/2022] [Indexed: 02/08/2023] Open
Abstract
Determining the viral load and infectivity of SARS-CoV-2 in macroscopic respiratory droplets, bioaerosols, and other bodily fluids and secretions is important for identifying transmission modes, assessing risks and informing public health guidelines. Here we show that viral load of SARS-CoV-2 Ribonucleic Acid (RNA) in participants’ naso-pharyngeal (NP) swabs positively correlated with RNA viral load they emitted in both droplets >10 \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\upmu \hbox {m}$$\end{document}μm and bioaerosols <10 \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\upmu \hbox {m}$$\end{document}μm directly captured during the combined expiratory activities of breathing, speaking and coughing using a standardized protocol, although the NP swabs had \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\approx$$\end{document}≈ 10\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$^3\times$$\end{document}3× more RNA on average. By identifying highly-infectious individuals (maximum of 18,000 PFU/mL in NP), we retrieved higher numbers of SARS-CoV-2 RNA gene copies in bioaerosol samples (maximum of 4.8\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$${\times }10^{5}$$\end{document}×105 gene copies/mL and minimum cycle threshold of 26.2) relative to other studies. However, all attempts to identify infectious virus in size-segregated droplets and bioaerosols were negative by plaque assay (0 of 58). This outcome is partly attributed to the insufficient amount of viral material in each sample (as indicated by SARS-CoV-2 gene copies) or may indicate no infectious virus was present in such samples, although other possible factors are identified.
Collapse
|
71
|
Kotwa JD, Jamal AJ, Mbareche H, Yip L, Aftanas P, Barati S, Bell NG, Bryce E, Coomes E, Crowl G, Duchaine C, Faheem A, Farooqi L, Hiebert R, Katz K, Khan S, Kozak R, Li AX, Mistry HP, Mozafarihashjin M, Nasir JA, Nirmalarajah K, Panousis EM, Paterson A, Plenderleith S, Powis J, Prost K, Schryer R, Taylor M, Veillette M, Wong T, Zoe Zhong X, McArthur AG, McGeer AJ, Mubareka S. Surface and Air Contamination With Severe Acute Respiratory Syndrome Coronavirus 2 From Hospitalized Coronavirus Disease 2019 Patients in Toronto, Canada, March-May 2020. J Infect Dis 2022; 225:768-776. [PMID: 34850051 DOI: 10.1101/2021.05.17.21257122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/24/2021] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND We determined the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in air and on surfaces in rooms of patients hospitalized with coronavirus disease 2019 (COVID-19) and investigated patient characteristics associated with SARS-CoV-2 environmental contamination. METHODS Nasopharyngeal swabs, surface, and air samples were collected from the rooms of 78 inpatients with COVID-19 at 6 acute care hospitals in Toronto from March to May 2020. Samples were tested for SARS-CoV-2 ribonucleic acid (RNA), cultured to determine potential infectivity, and whole viral genomes were sequenced. Association between patient factors and detection of SARS-CoV-2 RNA in surface samples were investigated. RESULTS Severe acute respiratory syndrome coronavirus 2 RNA was detected from surfaces (125 of 474 samples; 42 of 78 patients) and air (3 of 146 samples; 3 of 45 patients); 17% (6 of 36) of surface samples from 3 patients yielded viable virus. Viral sequences from nasopharyngeal and surface samples clustered by patient. Multivariable analysis indicated hypoxia at admission, polymerase chain reaction-positive nasopharyngeal swab (cycle threshold of ≤30) on or after surface sampling date, higher Charlson comorbidity score, and shorter time from onset of illness to sampling date were significantly associated with detection of SARS-CoV-2 RNA in surface samples. CONCLUSIONS The infrequent recovery of infectious SARS-CoV-2 virus from the environment suggests that the risk to healthcare workers from air and near-patient surfaces in acute care hospital wards is likely limited.
Collapse
Affiliation(s)
| | | | | | - Lily Yip
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | | | | | | | - Elizabeth Bryce
- Division of Medical Microbiology and Infection Prevention, Vancouver Coastal Health, Vancouver, British Colombia, Canada
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Colombia, Canada
| | - Eric Coomes
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Caroline Duchaine
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université de Laval, Québec City, Québec, Canada
- Départment de Biochimie, de Microbiologie et de Bio-Informatique, Faculté des Sciences et de Génie, Université de Laval, Québec City, Québec, Canada
| | - Amna Faheem
- Sinai Health System, Toronto, Ontario, Canada
| | | | - Ryan Hiebert
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Kevin Katz
- North York General Hospital, Toronto, Ontario, Canada
| | - Saman Khan
- Sinai Health System, Toronto, Ontario, Canada
| | - Robert Kozak
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Angel X Li
- Sinai Health System, Toronto, Ontario, Canada
| | | | | | - Jalees A Nasir
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Science, McMaster University, Hamilton, Ontario, Canada
| | | | - Emily M Panousis
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Science, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Jeff Powis
- Michael Garron Hospital, Toronto, Ontario, Canada
| | - Karren Prost
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Renée Schryer
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | | | - Marc Veillette
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université de Laval, Québec City, Québec, Canada
| | - Titus Wong
- Division of Medical Microbiology and Infection Prevention, Vancouver Coastal Health, Vancouver, British Colombia, Canada
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Colombia, Canada
| | | | - Andrew G McArthur
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Science, McMaster University, Hamilton, Ontario, Canada
| | - Allison J McGeer
- Sinai Health System, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Samira Mubareka
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
72
|
Grimalt JO, Vílchez H, Fraile-Ribot PA, Marco E, Campins A, Orfila J, van Drooge BL, Fanjul F. Spread of SARS-CoV-2 in hospital areas. ENVIRONMENTAL RESEARCH 2022; 204:112074. [PMID: 34547251 PMCID: PMC8450143 DOI: 10.1016/j.envres.2021.112074] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/30/2021] [Accepted: 09/11/2021] [Indexed: 05/05/2023]
Abstract
We performed a systematic sampling and analysis of airborne SARS-CoV-2 RNA in different hospital areas to assess viral spread. Systematic air filtration was performed in rooms with COVID-19 infected patients, in corridors adjacent to these rooms, to rooms of intensive care units, and to rooms with infected and uninfected patients, and in open spaces. RNA was extracted from the filters and real-time reverse transcription polymerase chain reaction was performed using the LightMix Modular SARS-CoV-2 E-gene. The highest occurrence of RNA was found in the rooms with COVID-19 patients (mean 2600 c/m3) and the adjacent corridor (mean 4000 c/m3) which was statistically significant more exposed (p < 0.01). This difference was related to the ventilation systems. As is commonly found in many hospitals, each of the rooms had an individual air inlet and outlet, while in the corridors these devices were located at the distance of every four rooms. There was a significant transfer of viruses from the COVID-19 patients' rooms to the corridors. The airborne SARS-CoV-2 RNA in the corridors of ICUs with COVID-19 patients or care rooms of uninfected patients were ten times lower, averages 190 c/m3 and 180 c/m3, respectively, without presenting significant differences. In all COVID-19 ICU rooms, patients were intubated and connected to respirators that filtered all exhaled air and prevented virus release, resulting in significantly lower viral concentrations in adjacent corridors. The results show that the greatest risk of nosocomial infection may also occur in hospital areas not directly exposed to the exhaled breath of infected patients. Hospitals should evaluate the ventilation systems of all units to minimize possible contagion and, most importantly, direct monitoring of SARS-CoV-2 in the air should be carried out to prevent unexpected viral exposures.
Collapse
Affiliation(s)
| | - Helem Vílchez
- Infectious Diseases Unit, Son Espases University Hospital, Palma, Mallorca, Spain; Balearic Islands Health Research Institute (IdISBa), Son Espases University Hospital, Palma, Mallorca, Spain
| | - Pablo A Fraile-Ribot
- Balearic Islands Health Research Institute (IdISBa), Son Espases University Hospital, Palma, Mallorca, Spain; Microbiology Department, Son Espases University Hospital, Palma, Mallorca, Spain
| | | | - Antoni Campins
- Infectious Diseases Unit, Son Espases University Hospital, Palma, Mallorca, Spain; Balearic Islands Health Research Institute (IdISBa), Son Espases University Hospital, Palma, Mallorca, Spain
| | - Jaime Orfila
- Internal Medicine Department, Son Espases University Hospital, Palma, Mallorca, Spain
| | | | - Francisco Fanjul
- Infectious Diseases Unit, Son Espases University Hospital, Palma, Mallorca, Spain; Balearic Islands Health Research Institute (IdISBa), Son Espases University Hospital, Palma, Mallorca, Spain.
| |
Collapse
|
73
|
Risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA environmental contamination in rooms of patients with coronavirus disease 2019 (COVID-19). Infect Control Hosp Epidemiol 2022; 44:827-829. [PMID: 35225184 PMCID: PMC8914131 DOI: 10.1017/ice.2022.44] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The risk factors of environmental contamination by SARS-CoV-2 are largely unknown. We analyzed 1,320 environmental samples obtained from COVID-19 patients over 1 year. The risk factors for contamination of COVID-19 patients’ surrounding environment were higher viral load in the respiratory tract and shorter duration from symptom onset to sample collection.
Collapse
|
74
|
Thuresson S, Fraenkel CJ, Sasinovich S, Soldemyr J, Widell A, Medstrand P, Alsved M, Löndahl J. Airborne SARS-CoV-2 in hospitals - effects of aerosol-generating procedures, HEPA-filtration units, patient viral load and physical distance. Clin Infect Dis 2022; 75:e89-e96. [PMID: 35226740 PMCID: PMC9383519 DOI: 10.1093/cid/ciac161] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Transmission of covid-19 can occur through inhalation of fine droplets or aerosols containing infectious virus. The objective of this study was to identify situations, patient characteristics, environmental parameters and aerosol-generating procedures (AGPs) associated with airborne SARS-CoV-2 virus. METHODS Air samples were collected near hospitalised covid-19 patients and analysed by RT-qPCR. Results were related to distance to the patient, most recent patient diagnostic PCR Ct-value, room ventilation and ongoing potential AGP. RESULTS In total 310 air samples were collected, and of these 26 (8%) were positive. Of the 231 samples from patient rooms, 22 (10%) were positive for SARS-CoV-2. Positive air samples were associated with a low patient Ct-value (OR 5.0 for a Ct-value <25 vs >25, p=0.01, 95% confidence interval 1.18 to 29.5) and a shorter physical distance to the patient (OR 2.0 for every meter closer to the patient, p=0.05, CI 1.0 to 3.8). A mobile HEPA-filtration unit in the room decreased the proportion of positive samples (OR 0.3, p=0.02, CI 0.12 to 0.98). No association was observed between SARS-CoV-2 positive air samples and mechanical ventilation, high flow nasal cannula, nebulizer treatment or non-invasive ventilation. An association was found with positive expiratory pressure (PEP) training (p<0.01) and a trend towards association for airway manipulation, including bronchoscopies and in- and extubations. CONCLUSIONS Our results show that major risk factors for airborne SARS-CoV-2 include short physical distance, high patient viral load and poor room ventilation. AGPs, as traditionally defined, seem to be of secondary importance.
Collapse
Affiliation(s)
- Sara Thuresson
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Carl-Johan Fraenkel
- Department of Infection Control, Region Skåne, Lund, Sweden.,Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | | | - Jonathan Soldemyr
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Anders Widell
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Patrik Medstrand
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Malin Alsved
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Jakob Löndahl
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| |
Collapse
|
75
|
Dinoi A, Feltracco M, Chirizzi D, Trabucco S, Conte M, Gregoris E, Barbaro E, La Bella G, Ciccarese G, Belosi F, La Salandra G, Gambaro A, Contini D. A review on measurements of SARS-CoV-2 genetic material in air in outdoor and indoor environments: Implication for airborne transmission. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 809:151137. [PMID: 34699823 PMCID: PMC8539199 DOI: 10.1016/j.scitotenv.2021.151137] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 05/03/2023]
Abstract
Airborne transmission of SARS-CoV-2 has been object of debate in the scientific community since the beginning of COVID-19 pandemic. This mechanism of transmission could arise from virus-laden aerosol released by infected individuals and it is influenced by several factors. Among these, the concentration and size distribution of virus-laden particles play an important role. The knowledge regarding aerosol transmission increases as new evidence is collected in different studies, even if it is not yet available a standard protocol regarding air sampling and analysis, which can create difficulties in the interpretation and application of results. This work reports a systematic review of current knowledge gained by 73 published papers on experimental determination of SARS-CoV-2 RNA in air comparing different environments: outdoors, indoor hospitals and healthcare settings, and public community indoors. Selected papers furnished 77 datasets: outdoor studies (9/77, 11.7%) and indoor studies (68/77. 88.3%). The indoor datasets in hospitals were the vast majority (58/68, 85.3%), and the remaining (10/68, 14.7%) were classified as community indoors. The fraction of studies having positive samples, as well as positivity rates (i.e. ratios between positive and total samples) are significantly larger in hospitals compared to the other typologies of sites. Contamination of surfaces was more frequent (in indoor datasets) compared to contamination of air samples; however, the average positivity rate was lower compared to that of air. Concentrations of SARS-CoV-2 RNA in air were highly variables and, on average, lower in outdoors compared to indoors. Among indoors, concentrations in community indoors appear to be lower than those in hospitals and healthcare settings.
Collapse
Affiliation(s)
- Adelaide Dinoi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy
| | - Matteo Feltracco
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniela Chirizzi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Sara Trabucco
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Marianna Conte
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy; Laboratory for Observations and Analyses of Earth and Climate, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy
| | - Elena Gregoris
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Elena Barbaro
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Giuseppina Ciccarese
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Franco Belosi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Andrea Gambaro
- Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniele Contini
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy.
| |
Collapse
|
76
|
Zhou J, Peacock TP, Brown JC, Goldhill DH, Elrefaey AME, Penrice-Randal R, Cowton VM, De Lorenzo G, Furnon W, Harvey WT, Kugathasan R, Frise R, Baillon L, Lassaunière R, Thakur N, Gallo G, Goldswain H, Donovan-Banfield I, Dong X, Randle NP, Sweeney F, Glynn MC, Quantrill JL, McKay PF, Patel AH, Palmarini M, Hiscox JA, Bailey D, Barclay WS. Mutations that adapt SARS-CoV-2 to mink or ferret do not increase fitness in the human airway. Cell Rep 2022; 38:110344. [PMID: 35093235 PMCID: PMC8768428 DOI: 10.1016/j.celrep.2022.110344] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/11/2021] [Accepted: 01/14/2022] [Indexed: 12/18/2022] Open
Abstract
SARS-CoV-2 has a broad mammalian species tropism infecting humans, cats, dogs, and farmed mink. Since the start of the 2019 pandemic, several reverse zoonotic outbreaks of SARS-CoV-2 have occurred in mink, one of which reinfected humans and caused a cluster of infections in Denmark. Here we investigate the molecular basis of mink and ferret adaptation and demonstrate the spike mutations Y453F, F486L, and N501T all specifically adapt SARS-CoV-2 to use mustelid ACE2. Furthermore, we risk assess these mutations and conclude mink-adapted viruses are unlikely to pose an increased threat to humans, as Y453F attenuates the virus replication in human cells and all three mink adaptations have minimal antigenic impact. Finally, we show that certain SARS-CoV-2 variants emerging from circulation in humans may naturally have a greater propensity to infect mustelid hosts and therefore these species should continue to be surveyed for reverse zoonotic infections.
Collapse
Affiliation(s)
- Jie Zhou
- Department of Infectious Disease, Imperial College London, London, UK
| | - Thomas P Peacock
- Department of Infectious Disease, Imperial College London, London, UK
| | - Jonathan C Brown
- Department of Infectious Disease, Imperial College London, London, UK
| | - Daniel H Goldhill
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Rebekah Penrice-Randal
- Institute of Infection, Veterinary and Ecology Sciences, University of Liverpool, Liverpool, UK
| | - Vanessa M Cowton
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | | | - Wilhelm Furnon
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - William T Harvey
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | | | - Rebecca Frise
- Department of Infectious Disease, Imperial College London, London, UK
| | - Laury Baillon
- Department of Infectious Disease, Imperial College London, London, UK
| | - Ria Lassaunière
- Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Nazia Thakur
- The Pirbright Institute, Woking, Surrey, UK; The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Hannah Goldswain
- Institute of Infection, Veterinary and Ecology Sciences, University of Liverpool, Liverpool, UK
| | - I'ah Donovan-Banfield
- Institute of Infection, Veterinary and Ecology Sciences, University of Liverpool, Liverpool, UK
| | - Xiaofeng Dong
- Institute of Infection, Veterinary and Ecology Sciences, University of Liverpool, Liverpool, UK
| | - Nadine P Randle
- Institute of Infection, Veterinary and Ecology Sciences, University of Liverpool, Liverpool, UK
| | - Fiachra Sweeney
- Department of Infectious Disease, Imperial College London, London, UK
| | - Martha C Glynn
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Paul F McKay
- Department of Infectious Disease, Imperial College London, London, UK
| | - Arvind H Patel
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | | | - Julian A Hiscox
- Institute of Infection, Veterinary and Ecology Sciences, University of Liverpool, Liverpool, UK; Infectious Diseases Horizontal Technology Centre (ID HTC), A(∗)STAR, Singapore, Singapore
| | | | - Wendy S Barclay
- Department of Infectious Disease, Imperial College London, London, UK.
| |
Collapse
|
77
|
Owen L, Shivkumar M, Cross RBM, Laird K. Porous surfaces: stability and recovery of coronaviruses. Interface Focus 2022; 12:20210039. [PMID: 34956608 PMCID: PMC8662390 DOI: 10.1098/rsfs.2021.0039] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/03/2021] [Indexed: 12/12/2022] Open
Abstract
The role of indirect contact in the transmission of SARS-CoV-2 is not clear. SARS-CoV-2 persists on dry surfaces for hours to days; published studies have largely focused on hard surfaces with less research being conducted on different porous surfaces, such as textiles. Understanding the potential risks of indirect transmission of COVID-19 is useful for settings where there is close contact with textiles, including healthcare, manufacturing and retail environments. This article aims to review current research on porous surfaces in relation to their potential as fomites of coronaviruses compared to non-porous surfaces. Current methodologies for assessing the stability and recovery of coronaviruses from surfaces are also explored. Coronaviruses are often less stable on porous surfaces than non-porous surfaces, for example, SARS-CoV-2 persists for 0.5 h-5 days on paper and 3-21 days on plastic; however, stability is dependent on the type of surface. In particular, the surface properties of textiles differ widely depending on their construction, leading to variation in the stability of coronaviruses, with longer persistence on more hydrophobic materials such as polyester (1-3 days) compared to highly absorbent cotton (2 h-4 days). These findings should be considered where there is close contact with potentially contaminated textiles.
Collapse
Affiliation(s)
- Lucy Owen
- Infectious Disease Research Group, The Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK
| | - Maitreyi Shivkumar
- Infectious Disease Research Group, The Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK
| | - Richard B. M. Cross
- Emerging Technologies Research Centre, School of Engineering and Sustainable Development, De Montfort University, Leicester LE1 9BH, UK
| | - Katie Laird
- Infectious Disease Research Group, The Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK
| |
Collapse
|
78
|
Liu J, Zheng T, Xia W, Xu S, Li Y. Cold chain and severe acute respiratory syndrome coronavirus 2 transmission: a review for challenges and coping strategies. MEDICAL REVIEW (BERLIN, GERMANY) 2022; 2:50-65. [PMID: 35658108 PMCID: PMC9047647 DOI: 10.1515/mr-2021-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/13/2021] [Indexed: 06/15/2023]
Abstract
Since June 2020, the re-emergence of coronavirus disease 2019 (COVID-19) epidemics in parts of China was linked to the cold chain, which attracted extensive attention and heated discussions from the public. According to the typical characteristics of these epidemics, we speculated a possible route of transmission from cold chain to human. A series of factors in the supply chain contributed to the epidemics if the cold chain were contaminated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), such as temperature, humidity, personal hygiene/protection, and disinfection. The workers who worked in the cold chain at the receiving end faced a higher risk of being infected when they were not well protected. Facing the difficult situation, China put forward targeted and powerful countermeasures to block the cold chain-related risk. However, in the context of the unstable pandemic situation globally, the risk of the cold chain needs to be recognized and evaluated seriously. Hence, in this review, we reviewed the cold chain-related epidemics in China, analyzed the possible mechanisms, introduced the Chinese experience, and suggested coping strategies for the global epidemic prevention and control.
Collapse
Affiliation(s)
- Jiangtao Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, United States
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
79
|
Mody L, Akinboyo IC, Babcock HM, Bischoff WE, Cheng VCC, Chiotos K, Claeys KC, Coffey KC, Diekema DJ, Donskey CJ, Ellingson KD, Gilmartin HM, Gohil SK, Harris AD, Keller SC, Klein EY, Krein SL, Kwon JH, Lauring AS, Livorsi DJ, Lofgren ET, Merrill K, Milstone AM, Monsees EA, Morgan DJ, Perri LP, Pfeiffer CD, Rock C, Saint S, Sickbert-Bennett E, Skelton F, Suda KJ, Talbot TR, Vaughn VM, Weber DJ, Wiemken TL, Yassin MH, Ziegler MJ, Anderson DJ. Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology. Infect Control Hosp Epidemiol 2022; 43:156-166. [PMID: 33487199 PMCID: PMC8160487 DOI: 10.1017/ice.2021.25] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 02/07/2023]
Abstract
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.
Collapse
Affiliation(s)
- Lona Mody
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
- Geriatrics Research Education and Clinical Center, Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Ibukunoluwa C. Akinboyo
- Division of Infectious Diseases, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, United States
| | - Hilary M. Babcock
- Washington University School of Medicine, St. Louis, Missouri, United States
| | - Werner E. Bischoff
- Wake Forest School of Medicine, Winston Salem, North Carolina, United States
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Kathleen Chiotos
- Division of Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - Kimberly C. Claeys
- University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - K. C. Coffey
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Daniel J. Diekema
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Curtis J. Donskey
- Infectious Diseases Section, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio, United States
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Katherine D. Ellingson
- Department of Epidemiology and Biostatistics, College of Public Health, University of Arizona, Tucson, Arizona, United States
| | - Heather M. Gilmartin
- Veterans’ Affairs Eastern Colorado Healthcare System, Aurora, Colorado, United States
- Colorado School of Public Health, University of Colorado, Aurora, Colorado, United States
| | - Shruti K. Gohil
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California, United States
- Epidemiology and Infection Prevention, UC Irvine Health, Irvine, California, United States
| | - Anthony D. Harris
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Sara C. Keller
- Division of Infectious Diseases, John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Eili Y. Klein
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, Unites States
| | - Sarah L. Krein
- Veterans’ Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, United States
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Jennie H Kwon
- Washington University School of Medicine, St. Louis, Missouri, United States
| | - Adam S. Lauring
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Daniel J. Livorsi
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Eric T. Lofgren
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States
| | | | - Aaron M. Milstone
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Elizabeth A. Monsees
- Children’s Mercy Kansas City, Kansas City, Missouri, United States
- University of Missouri–Kansas City School of Medicine, Kansas City, Missouri, United States
| | - Daniel J. Morgan
- University of Maryland School of Medicine, Baltimore, Maryland, United States
- Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland, United States
| | - Luci P. Perri
- Infection Control Results, Wingate, North Carolina, United States
| | - Christopher D. Pfeiffer
- Veterans’ Affairs Portland Health Care System, Portland, Oregon, United States
- Oregon Health & Science University, Portland, Oregon, United States
| | - Clare Rock
- Division of Infectious Diseases, John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Sanjay Saint
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
- Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Emily Sickbert-Bennett
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina, United States
| | - Felicia Skelton
- Michael E. DeBakey Veterans’ Affairs Medical Center, Houston, Texas, United States
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, United States
| | - Katie J. Suda
- Center for Health Equity Research and Promotion, Veterans’ Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Thomas R. Talbot
- Vanderbilt University School of Medicine, Nashville, Tennessee, United States
| | - Valerie M. Vaughn
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - David J. Weber
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Timothy L. Wiemken
- Division of Infectious Diseases, Allergy, and Immunology, Department of Medicine, Saint Louis University School of Medicine, St Louis, Missouri, United States
| | - Mohamed H. Yassin
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Matthew J. Ziegler
- Infectious Diseases Division, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Deverick J. Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, North Carolina, United States
| |
Collapse
|
80
|
Newey CR, Olausson AT, Applegate A, Reid AA, Robison RA, Grose JH. Presence and stability of SARS-CoV-2 on environmental currency and money cards in Utah reveals a lack of live virus. PLoS One 2022; 17:e0263025. [PMID: 35077511 PMCID: PMC8789161 DOI: 10.1371/journal.pone.0263025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/10/2022] [Indexed: 01/22/2023] Open
Abstract
The highly contagious nature of SARS-CoV-2 has led to several studies on the transmission of the virus. A little studied potential fomite of great concern in the community is currency, which has been shown to harbor microbial pathogens in several studies. Since the onset of the COVID-19 pandemic, many businesses in the United States have limited the use of banknotes in favor of credit cards. However, SARS-CoV-2 has shown greater stability on plastic in several studies. Herein, the stability of SARS-CoV-2 at room temperature on banknotes, money cards and coins was investigated. In vitro studies with live virus suggested SARS-CoV-2 was highly unstable on banknotes, showing an initial rapid reduction in viable virus and no viral detection by 24 hours. In contrast, SARS-CoV-2 displayed increased stability on money cards with live virus detected after 48 hours. Environmental swabbing of currency and money cards on and near the campus of Brigham Young University supported these results, with no detection of SARS-CoV-2 RNA on banknotes, and a low level on money cards. However, no viable virus was detected on either. These preliminary results suggest that the use of money cards over banknotes in order to slow the spread of this virus may be ill-advised. These findings should be investigated further through larger environmental studies involving more locations.
Collapse
Affiliation(s)
- Colleen R. Newey
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Abigail T. Olausson
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Alyssa Applegate
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Ann-Aubrey Reid
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Richard A. Robison
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Julianne H. Grose
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| |
Collapse
|
81
|
Yu J, Zhang W, Huo W, Meng X, Zhong T, Su Y, Liu Y, Liu J, Wang Z, Song F, Zhang S, Li Z, Yu X, Yu X, Hua S. Regulation of host factor γ-H2AX level and location by enterovirus A71 for viral replication. Virulence 2022; 13:241-257. [PMID: 35067196 PMCID: PMC8786350 DOI: 10.1080/21505594.2022.2028482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Numerous viruses manipulate host factors for viral production. We demonstrated that human enterovirus A71 (EVA71), a primary causative agent for hand, foot, and mouth disease (HFMD), increased the level of the DNA damage response (DDR) marker γ-H2AX. DDR is primarily mediated by the ataxia telangiectasia mutated (ATM), ATM and Rad3-related (ATR), or DNA-dependent protein kinase (DNA-PK) pathways. Upregulation of γ-H2AX by EVA71 was dependent on the ATR but not the ATM or DNA-PK pathway. As a nuclear factor, there is no previous evidence of cytoplasmic distribution of γ-H2AX. However, the present findings demonstrated that EVA71 encouraged the localization of γ-H2AX to the cytoplasm. Of note, γ-H2AX formed a complex with structural protein VP3, non-structural protein 3D, and the viral genome. Treatment with an inhibitor or CRISPR/Cas9 technology to decrease or silence the expression of γ-H2AX decreased viral genome replication in host cells; this effect was accompanied by decreased viral protein expression and virions. In animal experiments, caffeine was used to inhibit DDR; the results revealed that caffeine protected neonatal mice from death after infection with EVA71, laying the foundation for new therapeutic applications of caffeine. More importantly, in children with HFMD, γ-H2AX was upregulated in peripheral blood lymphocytes. The consistent in vitro and in vivo data on γ-H2AX from this study suggested that caffeine or other inhibitors of DDR might be novel therapeutic agents for HFMD.
Collapse
Affiliation(s)
- Jinghua Yu
- Institute of Virology and AIDS Research, the First Hospital of Jilin University, Jilin University, Changchun, China
| | - Wenyan Zhang
- Institute of Virology and AIDS Research, the First Hospital of Jilin University, Jilin University, Changchun, China
| | - Wenbo Huo
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin University, Changchun, China
| | - Xiangling Meng
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin University, Changchun, China
| | - Ting Zhong
- Medicinal Chemistry, College of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
| | - Ying Su
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin University, Changchun, China
| | - Yumeng Liu
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin University, Changchun, China
| | - Jinming Liu
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin University, Changchun, China
| | - Zengyan Wang
- Department of Internal Medicine, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Fengmei Song
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin University, Changchun, China
| | - Shuxia Zhang
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin University, Changchun, China
| | - Zhaolong Li
- Institute of Virology and AIDS Research, the First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiaoyan Yu
- Department of Experimental Pharmacology and Toxicology, School of Pharmacy, Jilin University, Changchun, China
| | - Xiaofang Yu
- Institute of Virology and AIDS Research, the First Hospital of Jilin University, Jilin University, Changchun, China
| | - Shucheng Hua
- Department of Internal Medicine, The First Hospital of Jilin University, Jilin University, Changchun, China
| |
Collapse
|
82
|
Ghosh S, Chakraborty A, Bhattacharya S. How surface and fomite infection affect contagion dynamics: a study with self-propelled particles. THE EUROPEAN PHYSICAL JOURNAL. SPECIAL TOPICS 2022; 231:3439-3452. [PMID: 35035779 PMCID: PMC8752393 DOI: 10.1140/epjs/s11734-022-00431-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
Self-propelled particles have been a tool of choice for many studies for understanding spatial interaction of people and propagation of infectious diseases. Other than the direct contagion process through face-to-face contacts with an infected agent, in some diseases, like COVID-19, the disease can spread by indirect ways, through contaminated object surfaces and puff-clouds created by the infected individual. However, this dual spreading process and the impact of these indirect infections in the entire dynamics are not properly explored. In this work, we consider epidemic spreading in an artificial society, with realistic parameters and movements of people, along with the possibilities of indirect exposure through contaminated surfaces and puff-clouds. This particular simulation based infectious disease dynamics is associated with the movements of some self-propelled free agents executing random motion which is investigated in conjunction with the rules of a realistic contagion process. With mathematical formulation and extensive computational studies, we have accommodated the indirect infection possibilities into the dynamics by incorporating an infectious 'tail' with the infected individuals. Analytical expressions of survival distance and infection probability of individuals have been explicitly calculated and reported. Results of precise and comparative simulation study have revealed the seriousness of indirect infections in connection with several dynamical parameters. Using this framework, interpretation of multiple waves in local as well as global scenarios have been established for COVID-19 infection statistics. Furthermore, the importance of indirect infections are also pointed out through data fitting, showing that ignoring this component might cause a misinterpretation of the dynamical parameters, like, imposed restrictions.
Collapse
Affiliation(s)
- Sayantari Ghosh
- Department of Physics, National Institute of Technology, Durgapur, India
| | - Arijit Chakraborty
- Department of Physics, National Institute of Technology, Durgapur, India
| | | |
Collapse
|
83
|
Warren BG, Nelson A, Barrett A, Addison B, Graves A, Binder R, Gray G, Lewis S, Smith BA, Weber DJ, Sickbert-Bennett EE, Anderson DJ. SARS-CoV-2 Environmental contamination in hospital rooms is uncommon using viral culture techniques. Clin Infect Dis 2022; 75:e307-e309. [PMID: 35023553 PMCID: PMC8807208 DOI: 10.1093/cid/ciac023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Indexed: 01/04/2023] Open
Abstract
We assessed environmental contamination of inpatient rooms housing COVID-19 patients in a dedicated COVID-19 unit. Contamination with SARS-CoV-2 was found on 5.5% (19/347) of surfaces via RT-PCR and 0.3% (1/347) of surfaces via cell culture. Environmental contamination is uncommon in hospitals rooms; RNA presence is not a specific indicator of infectious virus.
Collapse
Affiliation(s)
- Bobby G Warren
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.,Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Alicia Nelson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.,Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Aaron Barrett
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.,Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Bechtler Addison
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA
| | - Amanda Graves
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA
| | - Raquel Binder
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Gregory Gray
- Division of Infectious Disease, University of Texas Medical Branch, Galveston, TX, USA
| | - Sarah Lewis
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.,Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Becky A Smith
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.,Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - David J Weber
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Emily E Sickbert-Bennett
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.,Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | | |
Collapse
|
84
|
An evaluation of critical knowledge areas for managing the COVID-19 pandemic. JOURNAL OF KNOWLEDGE MANAGEMENT 2022. [DOI: 10.1108/jkm-01-2021-0083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose
The ability to manage the COVID-19 pandemic is contingent upon the ability to effectively manage its heterogeneous knowledge resources. Knowledge mapping represents a great opportunity to create value by bringing stakeholders together, facilitating comprehensive collaboration and facilitating broader in-depth knowledge sharing and transfer. However, identifying and analysing critical knowledge areas is one of the most important steps when creating a knowledge map. Therefore, the purpose of this paper is to appraise the critical knowledge areas for managing COVID-19, and thereby enhance decision-making in tackling the consequences of the pandemic.
Design/methodology/approach
The methodological approach for this study is a critical literature review, covering publications on knowledge management, knowledge mapping and COVID-19. EBSCOhost, PubMed, Scopus, Science Direct, TRID, Web of Science and Wiley Online Library were searched for full text, peer-reviewed articles written in English that investigated on critical knowledge areas for managing the spread of COVID-19. After full screening, 21 articles met the criteria for inclusion and were analysed and reported.
Findings
The study revealed seven critical knowledge areas for managing the COVID-19 pandemic. These are cleaning and disinfection; training, education and communication; reporting guidance and updates; testing; infection control measures, personal protective equipment; and potential COVID-19 transmission in health and other care settings. The study developed a concept knowledge map illustrating areas of critical knowledge which decision-makers need to be aware of.
Practical implications
Providing decision-makers with access to key knowledge during the COVID-19 pandemic seems to be crucial for effective decision-making. This study has provided insights for the professionals and decision-makers identifying the critical knowledge areas for managing the COVID-19 pandemic.
Social implications
The study advances the literature on knowledge management and builds a theoretical link with the management of public health emergencies. Additionally, the findings support the theoretical position that knowledge maps facilitate decision-making and help users to identify critical knowledge areas easily and effectively.
Originality/value
This study fills gaps in the existing literature by providing an explicit representation of know-how for managing the COVID-19 pandemic. This paper uses an objective and qualitative approach by reviewing related publications, reports and guidelines in the analysis. The concept map illustrates the critical knowledge areas for managing the COVID-19 pandemic.
Collapse
|
85
|
Wilson AM, Sleeth DK, Schaefer C, Jones RM. Transmission of Respiratory Viral Diseases to Health Care Workers: COVID-19 as an Example. Annu Rev Public Health 2022; 43:311-330. [DOI: 10.1146/annurev-publhealth-052120-110009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Health care workers (HCWs) can acquire infectious diseases, including coronavirus disease 2019 (COVID-19), from patients. Herein, COVID-19 is used with the source–pathway–receptor framework as an example to assess evidence for the role of aerosol transmission and indirect contact transmission of viral respiratory infectious diseases. Evidence for both routes is strong for COVID-19 and other respiratory viruses, but aerosol transmission is likely dominant for COVID-19. Key knowledge gaps about transmission processes and control strategies include the distribution of viable virus among respiratory aerosols of different sizes, the mechanisms and efficiency by which virus deposited on the facial mucous membrane moves to infection sites inside the body, and the performance of source controls such as face coverings and aerosol containment devices. To ensure that HCWs are adequately protected from infection, guidelines and regulations must be updated to reflect the evidence that respiratory viruses are transmitted via aerosols. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- Amanda M. Wilson
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA
| | - Darrah K. Sleeth
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
| | - Camie Schaefer
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
| | - Rachael M. Jones
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
| |
Collapse
|
86
|
Detection of SARS-CoV-2 genome on inanimate surfaces in COVID-19 intensive care units and emergency care cohort. Braz J Microbiol 2022; 53:213-220. [PMID: 34993920 PMCID: PMC8735889 DOI: 10.1007/s42770-021-00674-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/24/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction Understanding the different transmission routes of SARS-CoV-2 is crucial in planning effective interventions in healthcare institutions. This study aimed to evaluate the presence of SARS-Cov-2 genome on inanimate surfaces in COVID-19 intensive care unit and emergency care cohorts. Methods This is a prospective cross-sectional study. Samples of the environmental surface of objects and furniture were collected between July 15 and October 15, 2020, at COVID-19 intensive and emergency care units. The presence of SARS-CoV-2 genome was determined by quantitative RT-qPCR. The positivity rate for SARS-Cov-2 genome is presented as the arithmetic mean of the sum of the values obtained in each collection. Values of 1.0, 0.5, and 0.0 were assigned for positive, indeterminate, and negative events, respectively. Results In the intensive care unit, 86% of samples collected at the stethoscope and bed rail surfaces were positive. In the emergency care unit, 43% of bathroom tap, bed rails, and bedside table samples were positive. SARS-CoV-2 genome was not detected at the computer mouse and keyboard. At the emergency care unit, 14.3% of the samples from the collection room armchair were positive. Conclusions SARS-CoV-2 genome can be found at the environmental surface of objects and furniture at COVID-19 care units. They can represent a potential source of indirect transmission pathway for COVID-19, especially within health service institutions.
Collapse
|
87
|
King M, Wilson AM, Weir MH, López‐García M, Proctor J, Hiwar W, Khan A, Fletcher LA, Sleigh PA, Clifton I, Dancer SJ, Wilcox M, Reynolds KA, Noakes CJ. Modeling fomite-mediated SARS-CoV-2 exposure through personal protective equipment doffing in a hospital environment. INDOOR AIR 2022; 32:e12938. [PMID: 34693567 PMCID: PMC8653260 DOI: 10.1111/ina.12938] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/20/2021] [Accepted: 09/18/2021] [Indexed: 06/08/2023]
Abstract
Self-contamination during doffing of personal protective equipment (PPE) is a concern for healthcare workers (HCW) following SARS-CoV-2-positive patient care. Staff may subconsciously become contaminated through improper glove removal; so, quantifying this exposure is critical for safe working procedures. HCW surface contact sequences on a respiratory ward were modeled using a discrete-time Markov chain for: IV-drip care, blood pressure monitoring, and doctors' rounds. Accretion of viral RNA on gloves during care was modeled using a stochastic recurrence relation. In the simulation, the HCW then doffed PPE and contaminated themselves in a fraction of cases based on increasing caseload. A parametric study was conducted to analyze the effect of: (1a) increasing patient numbers on the ward, (1b) the proportion of COVID-19 cases, (2) the length of a shift, and (3) the probability of touching contaminated PPE. The driving factors for the exposure were surface contamination and the number of surface contacts. The results simulate generally low viral exposures in most of the scenarios considered including on 100% COVID-19 positive wards, although this is where the highest self-inoculated dose is likely to occur with median 0.0305 viruses (95% CI =0-0.6 viruses). Dose correlates highly with surface contamination showing that this can be a determining factor for the exposure. The infection risk resulting from the exposure is challenging to estimate, as it will be influenced by the factors such as virus variant and vaccination rates.
Collapse
Affiliation(s)
| | - Amanda M. Wilson
- Department of Community, Environment, and PolicyMel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
| | - Mark H. Weir
- Division of Environmental Health SciencesThe Ohio State UniversityColumbusOhioUSA
| | | | | | - Waseem Hiwar
- School of Civil EngineeringUniversity of LeedsLeedsUK
| | - Amirul Khan
- School of Civil EngineeringUniversity of LeedsLeedsUK
| | | | | | - Ian Clifton
- Department of Respiratory MedicineSt. James's HospitalUniversity of LeedsLeedsUK
| | - Stephanie J. Dancer
- School of Applied SciencesEdinburgh Napier UniversityEdinburghUK
- Department of MicrobiologyHairmyres HospitalNHS LanarkshireGlasgowG75 8RGUK
| | - Mark Wilcox
- Healthcare Associated Infections Research GroupLeeds Teaching Hospitals NHS Trust and University of LeedsLeedsUK
| | - Kelly A. Reynolds
- Department of Community, Environment, and PolicyMel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
| | | |
Collapse
|
88
|
Ribaric NL, Vincent C, Jonitz G, Hellinger A, Ribaric G. Hidden hazards of SARS-CoV-2 transmission in hospitals: A systematic review. INDOOR AIR 2022; 32:e12968. [PMID: 34862811 DOI: 10.1111/ina.12968] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/17/2021] [Accepted: 11/19/2021] [Indexed: 05/04/2023]
Abstract
Despite their considerable prevalence, dynamics of hospital-associated COVID-19 are still not well understood. We assessed the nature and extent of air- and surface-borne SARS-CoV-2 contamination in hospitals to identify hazards of viral dispersal and enable more precise targeting of infection prevention and control. PubMed, ScienceDirect, Web of Science, Medrxiv, and Biorxiv were searched for relevant articles until June 1, 2021. In total, 51 observational cross-sectional studies comprising 6258 samples were included. SARS-CoV-2 RNA was detected in one in six air and surface samples throughout the hospital and up to 7.62 m away from the nearest patients. The highest detection rates and viral concentrations were reported from patient areas. The most frequently and heavily contaminated types of surfaces comprised air outlets and hospital floors. Viable virus was recovered from the air and fomites. Among size-fractionated air samples, only fine aerosols contained viable virus. Aerosol-generating procedures significantly increased (ORair = 2.56 (1.46-4.51); ORsurface = 1.95 (1.27-2.99)), whereas patient masking significantly decreased air- and surface-borne SARS-CoV-2 contamination (ORair = 0.41 (0.25-0.70); ORsurface = 0.45 (0.34-0.61)). The nature and extent of hospital contamination indicate that SARS-CoV-2 is likely dispersed conjointly through several transmission routes, including short- and long-range aerosol, droplet, and fomite transmission.
Collapse
Affiliation(s)
- Noach Leon Ribaric
- Faculty of Medicine, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Charles Vincent
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Günther Jonitz
- German Medical Association, Berlin, Germany
- State Chamber of Physicians Berlin, Berlin, Germany
| | - Achim Hellinger
- Department of General, Visceral, Endocrine and Oncologic Surgery, Fulda Hospital, University Medicine Marburg Campus Fulda, Fulda, Germany
| | - Goran Ribaric
- Johnson & Johnson Institute, Norderstedt, Germany
- MedTech Europe, Antimicrobial Resistance (AMR) and Healthcare Associated Infections (HAI) Sector Group, Brussels, Belgium
| |
Collapse
|
89
|
Eggers M, Baumann A, Lilienthal N, Steinmann E, Steinmann J, Hübner NO, Rabenau HF, Weinheimer V, Schwebke I. [Disinfectants during the COVID-19 pandemic: a challenge]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:86-95. [PMID: 34878564 PMCID: PMC8652094 DOI: 10.1007/s00103-021-03457-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/03/2021] [Indexed: 12/31/2022]
Abstract
Disinfection measures have become more important as a result of the COVID-19 pandemic in Germany. The increased need for disinfectants at the beginning of the pandemic required temporary legal regulations in order to provide a sufficient quantity of products for the necessary disinfection in the medical sector on the one hand and for the additional demand in the population on the other. For this purpose, the Federal Institute for Drugs and Medical Devices (BfArM) and the Federal Institute for Occupational Safety and Health (BAuA) issued a general ruling, which is explained in more detail in this article. The focus was on measures for hygienic hand disinfection. However, other applications such as surface disinfection in relation to pandemic respiratory diseases are also addressed. The experience gained in ensuring the supply of disinfectants that are effective and safe to use should be used to prepare for further pandemics.
Collapse
Affiliation(s)
- Maren Eggers
- Kommission für Virusdesinfektion, Deutsche Vereinigung zur Bekämpfung der Viruskrankheiten (DVV) e. V., Geschäftsstelle Kiel, Kiel, Deutschland.
- Gesellschaft für Virologie (GfV) e. V., Geschäftsstelle Heidelberg, Heidelberg, Deutschland.
- Labor Prof. G. Enders MVZ GbR, Rosenbergstraße 85, 70193, Stuttgart, Deutschland.
| | - Anna Baumann
- Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Bonn, Deutschland
| | - Nils Lilienthal
- Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Bonn, Deutschland
| | - Eike Steinmann
- Abteilung für Molekulare & Medizinische Virologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Jochen Steinmann
- Dr. Brill + Partner GmbH Institut für Hygiene und Mikrobiologie, Bremen, Deutschland
| | - Nils-Olaf Hübner
- Institut für Hygiene und Umweltmedizin, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Holger F Rabenau
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Viola Weinheimer
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA), Dortmund, Deutschland
| | - Ingeborg Schwebke
- Kommission für Virusdesinfektion, Deutsche Vereinigung zur Bekämpfung der Viruskrankheiten (DVV) e. V., Geschäftsstelle Kiel, Kiel, Deutschland
- Gesellschaft für Virologie (GfV) e. V., Geschäftsstelle Heidelberg, Heidelberg, Deutschland
| |
Collapse
|
90
|
Orenes-Piñero E, Navas-Carrillo D, Moreno-Docón A, Ortega-García JA, Torres-Cantero AM, García-Vázquez E, Ramírez P. Confirmation of SARS-CoV-2 airborne dissemination indoors using "COVID-19 traps". J Infect 2021; 84:343-350. [PMID: 34953900 PMCID: PMC8694655 DOI: 10.1016/j.jinf.2021.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/21/2021] [Accepted: 12/15/2021] [Indexed: 01/02/2023]
Affiliation(s)
- Esteban Orenes-Piñero
- Proteomic Unit, Instituto Murciano de Investigaciones Biosanitarias (IMIB-Arrixaca), Murcia, Spain.
| | - Diana Navas-Carrillo
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Murcia, Spain
| | | | - Juan A Ortega-García
- Environment and Human Health (EH2) Lab IMIB-Arrixaca, Pediatric Environmental Health, HCUVA, Murcia, Spain
| | | | | | - Pablo Ramírez
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Murcia, Spain
| |
Collapse
|
91
|
Klaczko ME, Lucas K, Salminen AT, McCloskey MC, Ozgurun B, Ward BM, Flax J, McGrath JL. Rapid and specific detection of intact viral particles using functionalized microslit silicon membranes as a fouling-based sensor. Analyst 2021; 147:213-222. [PMID: 34933322 DOI: 10.1039/d1an01504d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic demonstrated the public health benefits of reliable and accessible point-of-care (POC) diagnostic tests for viral infections. Despite the rapid development of gold-standard reverse transcription polymerase chain reaction (RT-PCR) assays for SARS-CoV-2 only weeks into the pandemic, global demand created logistical challenges that delayed access to testing for months and helped fuel the spread of COVID-19. Additionally, the extreme sensitivity of RT-PCR had a costly downside as the tests could not differentiate between patients with active infection and those who were no longer infectious but still shedding viral genomes. To address these issues for the future, we propose a novel membrane-based sensor that only detects intact virions. The sensor combines affinity and size based detection on a membrane-based sensor and does not require external power to operate or read. Specifically, the presence of intact virions, but not viral debris, fouls the membrane and triggers a macroscopically visible hydraulic switch after injection of a 40 μL sample with a pipette. The device, which we call the μSiM-DX (microfluidic device featuring a silicon membrane for diagnostics), features a biotin-coated microslit membrane with pores ∼2-3× larger than the intact virus. Streptavidin-conjugated antibody recognizing viral surface proteins are incubated with the sample for ∼1 hour prior to injection into the device, and positive/negative results are obtained within ten seconds of sample injection. Proof-of-principle tests have been performed using preparations of vaccinia virus. After optimizing slit pore sizes and porous membrane area, the fouling-based sensor exhibits 100% specificity and 97% sensitivity for vaccinia virus (n = 62). Moreover, the dynamic range of the sensor extends at least from 105.9 virions per mL to 1010.4 virions per mL covering the range of mean viral loads in symptomatic COVID-19 patients (105.6-107 RNA copies per mL). Forthcoming work will test the ability of our sensor to perform similarly in biological fluids and with SARS-CoV-2, to fully test the potential of a membrane fouling-based sensor to serve as a PCR-free alternative for POC containment efforts in the spread of infectious disease.
Collapse
Affiliation(s)
- Michael E Klaczko
- Department of Chemistry, University of Rochester, Rochester, NY, 14627 USA
| | - Kilean Lucas
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| | - Alec T Salminen
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| | - Molly C McCloskey
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| | - Baturay Ozgurun
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| | - Brian M Ward
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY, 14642 USA
| | - Jonathan Flax
- Department of Urology, University of Rochester Medical Center, Rochester, NY, 14642 USA
| | - James L McGrath
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| |
Collapse
|
92
|
Cantú VJ, Salido RA, Huang S, Rahman G, Tsai R, Valentine H, Magallanes CG, Aigner S, Baer NA, Barber T, Belda-Ferre P, Betty M, Bryant M, Maya MC, Castro-Martínez A, Chacón M, Cheung W, Crescini ES, De Hoff P, Eisner E, Farmer S, Hakim A, Kohn L, Lastrella AL, Lawrence ES, Morgan SC, Ngo TT, Nouri A, Ostrander RT, Plascencia A, Ruiz CA, Sathe S, Seaver P, Shwartz T, Smoot EW, Valles T, Yeo GW, Laurent LC, Fielding-Miller R, Knight R. SARS-CoV-2 Distribution in Residential Housing Suggests Contact Deposition and Correlates with Rothia sp. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 34909793 DOI: 10.1101/2021.03.16.21253743v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
UNLABELLED Monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on surfaces is emerging as an important tool for identifying past exposure to individuals shedding viral RNA. Our past work has demonstrated that SARS-CoV-2 reverse transcription-quantitative PCR (RT-qPCR) signals from surfaces can identify when infected individuals have touched surfaces such as Halloween candy, and when they have been present in hospital rooms or schools. However, the sensitivity and specificity of surface sampling as a method for detecting the presence of a SARS-CoV-2 positive individual, as well as guidance about where to sample, has not been established. To address these questions, and to test whether our past observations linking SARS-CoV-2 abundance to Rothia spp. in hospitals also hold in a residential setting, we performed detailed spatial sampling of three isolation housing units, assessing each sample for SARS-CoV-2 abundance by RT-qPCR, linking the results to 16S rRNA gene amplicon sequences to assess the bacterial community at each location and to the Cq value of the contemporaneous clinical test. Our results show that the highest SARS-CoV-2 load in this setting is on touched surfaces such as light switches and faucets, but detectable signal is present in many non-touched surfaces that may be more relevant in settings such as schools where mask wearing is enforced. As in past studies, the bacterial community predicts which samples are positive for SARS-CoV-2, with Rothia sp. showing a positive association. IMPORTANCE Surface sampling for detecting SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is increasingly being used to locate infected individuals. We tested which indoor surfaces had high versus low viral loads by collecting 381 samples from three residential units where infected individuals resided, and interpreted the results in terms of whether SARS-CoV-2 was likely transmitted directly (e.g. touching a light switch) or indirectly (e.g. by droplets or aerosols settling). We found highest loads where the subject touched the surface directly, although enough virus was detected on indirectly contacted surfaces to make such locations useful for sampling (e.g. in schools, where students do not touch the light switches and also wear masks so they have no opportunity to touch their face and then the object). We also documented links between the bacteria present in a sample and the SARS-CoV-2 virus, consistent with earlier studies.
Collapse
Affiliation(s)
- Victor J Cantú
- These authors contributed equally.,Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Rodolfo A Salido
- These authors contributed equally.,Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Shi Huang
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Gibraan Rahman
- Department of Pediatrics, University of California San Diego, La Jolla, CA.,Bioinformatics and Systems Biology Graduate Program, University of California San Diego, La Jolla, CA
| | - Rebecca Tsai
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Holly Valentine
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, USA.,Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
| | - Celestine G Magallanes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, USA.,Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
| | - Stefan Aigner
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA.,Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA.,Dept of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA
| | - Nathan A Baer
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Tom Barber
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Pedro Belda-Ferre
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Maryann Betty
- Department of Pediatrics, University of California San Diego, La Jolla, CA.,Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA.,Rady Children's Hospital, San Diego, CA
| | - MacKenzie Bryant
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Martin Casas Maya
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Anelizze Castro-Martínez
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Marisol Chacón
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Willi Cheung
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA.,Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA.,San Diego State University, San Diego, CA
| | - Evelyn S Crescini
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Peter De Hoff
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA.,Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, USA
| | - Emily Eisner
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Sawyer Farmer
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Abbas Hakim
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Laura Kohn
- Herbert Wertheim School of Public Health, University of California, San Diego 9500 Gilman Drive, La Jolla, CA 92093
| | - Alma L Lastrella
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Elijah S Lawrence
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Sydney C Morgan
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
| | - Toan T Ngo
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Alhakam Nouri
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - R Tyler Ostrander
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Ashley Plascencia
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA.,Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA.,Dept of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA
| | - Christopher A Ruiz
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Shashank Sathe
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA.,Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA.,Dept of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA
| | - Phoebe Seaver
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Tara Shwartz
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Elizabeth W Smoot
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Thomas Valles
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Gene W Yeo
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA.,Dept of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA
| | - Louise C Laurent
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, USA
| | - Rebecca Fielding-Miller
- Herbert Wertheim School of Public Health, University of California, San Diego 9500 Gilman Drive, La Jolla, CA 92093
| | - Rob Knight
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA.,Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA.,Center for Microbiome Innovation, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
93
|
Cantú VJ, Salido RA, Huang S, Rahman G, Tsai R, Valentine H, Magallanes CG, Aigner S, Baer NA, Barber T, Belda-Ferre P, Betty M, Bryant M, Maya MC, Castro-Martínez A, Chacón M, Cheung W, Crescini ES, De Hoff P, Eisner E, Farmer S, Hakim A, Kohn L, Lastrella AL, Lawrence ES, Morgan SC, Ngo TT, Nouri A, Ostrander RT, Plascencia A, Ruiz CA, Sathe S, Seaver P, Shwartz T, Smoot EW, Valles T, Yeo GW, Laurent LC, Fielding-Miller R, Knight R. SARS-CoV-2 Distribution in Residential Housing Suggests Contact Deposition and Correlates with Rothia sp. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.12.06.21267101. [PMID: 34909793 PMCID: PMC8669860 DOI: 10.1101/2021.12.06.21267101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on surfaces is emerging as an important tool for identifying past exposure to individuals shedding viral RNA. Our past work has demonstrated that SARS-CoV-2 reverse transcription-quantitative PCR (RT-qPCR) signals from surfaces can identify when infected individuals have touched surfaces such as Halloween candy, and when they have been present in hospital rooms or schools. However, the sensitivity and specificity of surface sampling as a method for detecting the presence of a SARS-CoV-2 positive individual, as well as guidance about where to sample, has not been established. To address these questions, and to test whether our past observations linking SARS-CoV-2 abundance to Rothia spp. in hospitals also hold in a residential setting, we performed detailed spatial sampling of three isolation housing units, assessing each sample for SARS-CoV-2 abundance by RT-qPCR, linking the results to 16S rRNA gene amplicon sequences to assess the bacterial community at each location and to the Cq value of the contemporaneous clinical test. Our results show that the highest SARS-CoV-2 load in this setting is on touched surfaces such as light switches and faucets, but detectable signal is present in many non-touched surfaces that may be more relevant in settings such as schools where mask wearing is enforced. As in past studies, the bacterial community predicts which samples are positive for SARS-CoV-2, with Rothia sp. showing a positive association. IMPORTANCE Surface sampling for detecting SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is increasingly being used to locate infected individuals. We tested which indoor surfaces had high versus low viral loads by collecting 381 samples from three residential units where infected individuals resided, and interpreted the results in terms of whether SARS-CoV-2 was likely transmitted directly (e.g. touching a light switch) or indirectly (e.g. by droplets or aerosols settling). We found highest loads where the subject touched the surface directly, although enough virus was detected on indirectly contacted surfaces to make such locations useful for sampling (e.g. in schools, where students do not touch the light switches and also wear masks so they have no opportunity to touch their face and then the object). We also documented links between the bacteria present in a sample and the SARS-CoV-2 virus, consistent with earlier studies.
Collapse
Affiliation(s)
- Victor J Cantú
- These authors contributed equally
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Rodolfo A Salido
- These authors contributed equally
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Shi Huang
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Gibraan Rahman
- Department of Pediatrics, University of California San Diego, La Jolla, CA
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, La Jolla, CA
| | - Rebecca Tsai
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Holly Valentine
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, USA
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
| | - Celestine G Magallanes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, USA
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
| | - Stefan Aigner
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
- Dept of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA
| | - Nathan A Baer
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Tom Barber
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Pedro Belda-Ferre
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Maryann Betty
- Department of Pediatrics, University of California San Diego, La Jolla, CA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
- Rady Children's Hospital, San Diego, CA
| | - MacKenzie Bryant
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Martin Casas Maya
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Anelizze Castro-Martínez
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Marisol Chacón
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Willi Cheung
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
- San Diego State University, San Diego, CA
| | - Evelyn S Crescini
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Peter De Hoff
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, USA
| | - Emily Eisner
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Sawyer Farmer
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Abbas Hakim
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Laura Kohn
- Herbert Wertheim School of Public Health, University of California, San Diego 9500 Gilman Drive, La Jolla, CA 92093
| | - Alma L Lastrella
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Elijah S Lawrence
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Sydney C Morgan
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
| | - Toan T Ngo
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Alhakam Nouri
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - R Tyler Ostrander
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Ashley Plascencia
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
- Dept of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA
| | - Christopher A Ruiz
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Shashank Sathe
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
- Dept of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA
| | - Phoebe Seaver
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Tara Shwartz
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Elizabeth W Smoot
- Expedited COVID Identification Environment (EXCITE) Laboratory, Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Thomas Valles
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Gene W Yeo
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
- Dept of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA
| | - Louise C Laurent
- Sanford Consortium of Regenerative Medicine, University of California San Diego, La Jolla, CA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, USA
| | - Rebecca Fielding-Miller
- Herbert Wertheim School of Public Health, University of California, San Diego 9500 Gilman Drive, La Jolla, CA 92093
| | - Rob Knight
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
94
|
da Silva SJR, do Nascimento JCF, Dos Santos Reis WPM, da Silva CTA, da Silva PG, Mendes RPG, Mendonça AA, Santos BNR, de Magalhães JJF, Kohl A, Pena L. Widespread Contamination of SARS-CoV-2 on Highly Touched Surfaces in Brazil During the Second Wave of the COVID-19 Pandemic. Environ Microbiol 2021; 23:7382-7395. [PMID: 34863010 PMCID: PMC9303906 DOI: 10.1111/1462-2920.15855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/18/2021] [Indexed: 12/04/2022]
Abstract
Although SARS‐CoV‐2 surface contamination has been investigated in health care settings, little is known about the SARS‐CoV‐2 surface contamination in public urban areas, particularly in tropical countries. Here, we investigated the presence of SARS‐CoV‐2 on high‐touch surfaces in a large city in Brazil, one of the most affected countries by the COVID‐19 pandemic in the world. A total of 400 surface samples were collected in February 2021 in the City of Recife, Northeastern Brazil. A total of 97 samples (24.2%) tested positive for SARS‐CoV‐2 by RT‐qPCR using the CDC‐USA protocol. All the collection sites, except one (18/19, 94.7%) had at least one environmental surface sample contaminated. SARS‐CoV‐2 positivity was higher in public transport terminals (47/84, 55.9%), followed by health care units (26/84, 30.9%), beach areas (4/21, 19.0%), public parks (14/105, 13.3%), supply centre (2/21, 9.5%), and public markets (4/85, 4.7%). Toilets, ATMs, handrails, playgrounds and outdoor gyms were identified as fomites with the highest rates of SARS‐CoV‐2 detection. Taken together, our data provide a real‐world picture of SARS‐CoV‐2 dispersion in highly populated tropical areas and identify critical control points that need to be targeted to break SARS‐CoV‐2 transmission chains.
Collapse
Affiliation(s)
- Severino Jefferson Ribeiro da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| | - Jéssica Catarine Frutuoso do Nascimento
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| | - Wendell Palôma Maria Dos Santos Reis
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| | - Caroline Targino Alves da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| | - Poliana Gomes da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| | - Renata Pessôa Germano Mendes
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| | - Allyson Andrade Mendonça
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| | - Bárbara Nazly Rodrigues Santos
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| | - Jurandy Júnior Ferraz de Magalhães
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil.,Department of Virology, Pernambuco State Central Laboratory (LACEN/PE), Recife, Pernambuco, Brazil.,Serra Talhada Campus, University of Pernambuco (UPE), Serra Talhada, Pernambuco, Brazil
| | - Alain Kohl
- MRC-University of Glasgow Centre for Virus Research, Glasgow, G61 1QH,, UK
| | - Lindomar Pena
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM) , Oswaldo Cruz Foundation (Fiocruz), 50670-420, Recife, Pernambuco, Brazil
| |
Collapse
|
95
|
Kotwa JD, Jamal AJ, Mbareche H, Yip L, Aftanas P, Barati S, Bell NG, Bryce E, Coomes E, Crowl G, Duchaine C, Faheem A, Farooqi L, Hiebert R, Katz K, Khan S, Kozak R, Li AX, Mistry HP, Mozafarihashjin M, Nasir JA, Nirmalarajah K, Panousis EM, Paterson A, Plenderleith S, Powis J, Prost K, Schryer R, Taylor M, Veillette M, Wong T, Zhong XZ, Mc Arthur AG, Mc Geer AJ, Mubareka S. Surface and air contamination with SARS-CoV-2 from hospitalized COVID-19 patients in Toronto, Canada, March-May 2020. J Infect Dis 2021; 225:768-776. [PMID: 34850051 PMCID: PMC8767887 DOI: 10.1093/infdis/jiab578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/24/2021] [Indexed: 01/12/2023] Open
Abstract
Background We determined the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in air and on surfaces in rooms of patients hospitalized with coronavirus disease 2019 (COVID-19) and investigated patient characteristics associated with SARS-CoV-2 environmental contamination. Methods Nasopharyngeal swabs, surface, and air samples were collected from the rooms of 78 inpatients with COVID-19 at 6 acute care hospitals in Toronto from March to May 2020. Samples were tested for SARS-CoV-2 ribonucleic acid (RNA), cultured to determine potential infectivity, and whole viral genomes were sequenced. Association between patient factors and detection of SARS-CoV-2 RNA in surface samples were investigated. Results Severe acute respiratory syndrome coronavirus 2 RNA was detected from surfaces (125 of 474 samples; 42 of 78 patients) and air (3 of 146 samples; 3 of 45 patients); 17% (6 of 36) of surface samples from 3 patients yielded viable virus. Viral sequences from nasopharyngeal and surface samples clustered by patient. Multivariable analysis indicated hypoxia at admission, polymerase chain reaction-positive nasopharyngeal swab (cycle threshold of ≤30) on or after surface sampling date, higher Charlson comorbidity score, and shorter time from onset of illness to sampling date were significantly associated with detection of SARS-CoV-2 RNA in surface samples. Conclusions The infrequent recovery of infectious SARS-CoV-2 virus from the environment suggests that the risk to healthcare workers from air and near-patient surfaces in acute care hospital wards is likely limited.
Collapse
Affiliation(s)
| | | | | | - Lily Yip
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | | | | | | | - Elizabeth Bryce
- Division of Medical Microbiology and Infection Prevention, Vancouver Coastal Health, Vancouver, British Colombia, Canada.,Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Colombia, Canada
| | - Eric Coomes
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Caroline Duchaine
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université de Laval, Québec City, Québec, Canada.,Départment de Biochimie, de Microbiologie et de Bio-Informatique, Faculté des Sciences et de Génie, Université de Laval, Québec City, Québec, Canada
| | - Amna Faheem
- Sinai Health System, Toronto, Ontario, Canada
| | | | - Ryan Hiebert
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Kevin Katz
- North York General Hospital, Toronto, Ontario, Canada
| | - Saman Khan
- Sinai Health System, Toronto, Ontario, Canada
| | - Robert Kozak
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Angel X Li
- Sinai Health System, Toronto, Ontario, Canada
| | | | | | - Jalees A Nasir
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Science, McMaster University, Hamilton, Ontario, Canada
| | | | - Emily M Panousis
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Science, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Jeff Powis
- Michael Garron Hospital, Toronto, Ontario, Canada
| | - Karren Prost
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Renée Schryer
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | | | - Marc Veillette
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université de Laval, Québec City, Québec, Canada
| | - Titus Wong
- Division of Medical Microbiology and Infection Prevention, Vancouver Coastal Health, Vancouver, British Colombia, Canada.,Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Colombia, Canada
| | | | - Andrew G Mc Arthur
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Science, McMaster University, Hamilton, Ontario, Canada
| | - Allison J Mc Geer
- Sinai Health System, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Samira Mubareka
- Sunnybrook Research Institute, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
96
|
Routsias JG, Mavrouli M, Tsoplou P, Dioikitopoulou K, Tsakris A. Diagnostic performance of rapid antigen tests (RATs) for SARS-CoV-2 and their efficacy in monitoring the infectiousness of COVID-19 patients. Sci Rep 2021; 11:22863. [PMID: 34819567 PMCID: PMC8613285 DOI: 10.1038/s41598-021-02197-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 11/01/2021] [Indexed: 12/23/2022] Open
Abstract
The most widely used test for the diagnosis of SARS-CoV-2 infection is a PCR test. PCR has very high sensitivity and is able to detect very low amounts of RNA. However, many individuals receiving a positive test result in a context of a PCR-based surveillance might be infected with SARS-CoV-2, but they are not contagious at the time of the test. The question arises regards if the cost effective, portable rapid antigen tests (RATs) have a better performance than PCR in identification of infectious individuals. In this direction, we examined the diagnostic performance of RATs from 14 different manufacturers in 400 clinical samples with known rRT-PCR cycles threshold (cT) and 50 control samples. Substantial variability was observed in the limit of detection (LOD) of different RATs (cT = 26.8-34.7). The fluorescence-based RAT exhibited a LOD of cT = 34.7. The use of the most effective RATs leads to true positive rates (sensitivities) of 99.1% and 90.9% for samples with cT ≤ 30 and cT ≤ 33, respectively, percentages that can guarantee a sensitivity high enough to identify contagious patients. RAT testing may also substantially reduce the quarantine period for infected individuals without compromising personal or public safety.
Collapse
Affiliation(s)
- John G Routsias
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiota Tsoplou
- GeneDiagnosis, Private Molecular Genetics Laboratory, Mihali Moraiti 93 & Andersen, Neo Psichiko, Athens, Greece
| | - Kyriaki Dioikitopoulou
- GeneDiagnosis, Private Molecular Genetics Laboratory, Mihali Moraiti 93 & Andersen, Neo Psichiko, Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
97
|
Winslow RL, Zhou J, Windle EF, Nur I, Lall R, Ji C, Millar JE, Dark PM, Naisbitt J, Simonds A, Dunning J, Barclay W, Baillie JK, Perkins GD, Semple MG, McAuley DF, Green CA. SARS-CoV-2 environmental contamination from hospitalised patients with COVID-19 receiving aerosol-generating procedures. Thorax 2021; 77:259-267. [PMID: 34737194 PMCID: PMC8646974 DOI: 10.1136/thoraxjnl-2021-218035] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Continuous positive airways pressure (CPAP) and high-flow nasal oxygen (HFNO) are considered 'aerosol-generating procedures' in the treatment of COVID-19. OBJECTIVE To measure air and surface environmental contamination with SARS-CoV-2 virus when CPAP and HFNO are used, compared with supplemental oxygen, to investigate the potential risks of viral transmission to healthcare workers and patients. METHODS 30 hospitalised patients with COVID-19 requiring supplemental oxygen, with a fraction of inspired oxygen ≥0.4 to maintain oxygen saturation ≥94%, were prospectively enrolled into an observational environmental sampling study. Participants received either supplemental oxygen, CPAP or HFNO (n=10 in each group). A nasopharyngeal swab, three air and three surface samples were collected from each participant and the clinical environment. Real-time quantitative polymerase chain reaction analyses were performed for viral and human RNA, and positive/suspected-positive samples were cultured for the presence of biologically viable virus. RESULTS Overall 21/30 (70%) participants tested positive for SARS-CoV-2 RNA in the nasopharynx. In contrast, only 4/90 (4%) and 6/90 (7%) of all air and surface samples tested positive (positive for E and ORF1a) for viral RNA respectively, although there were an additional 10 suspected-positive samples in both air and surfaces samples (positive for E or ORF1a). CPAP/HFNO use or coughing was not associated with significantly more environmental contamination than supplemental oxygen use. Only one nasopharyngeal sample was culture positive. CONCLUSIONS The use of CPAP and HFNO to treat moderate/severe COVID-19 did not appear to be associated with substantially higher levels of air or surface viral contamination in the immediate care environment, compared with the use of supplemental oxygen.
Collapse
Affiliation(s)
- Rebecca L Winslow
- Department of Infectious Diseases and Tropical Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,The Epidemiology and Public Health Group (EPHG), Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Jie Zhou
- Department of Infectious Diseases, Imperial College London, London, UK
| | - Ella F Windle
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Intesar Nur
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Ranjit Lall
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Chen Ji
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Paul M Dark
- NIHR Manchester Biomedical Research Centre, Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Critical Care Unit, Northern Care Alliance NHS Group, Salford Royal Hospital, Greater Manchester, UK
| | - Jay Naisbitt
- Critical Care Unit, Northern Care Alliance NHS Group, Salford Royal Hospital, Greater Manchester, UK
| | - Anita Simonds
- Lung Division, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Jake Dunning
- Faculty of Medicine, Imperial College London, London, UK
| | - Wendy Barclay
- Department of Infectious Diseases, Imperial College London, London, UK
| | | | - Gavin D Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.,Department of Critical Care Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, UK
| | - Malcolm Gracie Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.,Department of Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, UK
| | - Daniel Francis McAuley
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland .,Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland
| | - Christopher A Green
- Department of Infectious Diseases and Tropical Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| |
Collapse
|
98
|
Lu Y, Li Y, Zhou H, Lin J, Zheng Z, Xu H, Lin B, Lin M, Liu L. Affordable measures to monitor and alarm nosocomial SARS-CoV-2 infection due to poor ventilation. INDOOR AIR 2021; 31:1833-1842. [PMID: 34181766 PMCID: PMC8447035 DOI: 10.1111/ina.12899] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/20/2021] [Accepted: 06/12/2021] [Indexed: 05/09/2023]
Abstract
Since the coronavirus disease 2019 (COVID-19) outbreak, the nosocomial infection rate worldwide has been reported high. It is urgent to figure out an affordable way to monitor and alarm nosocomial infection. Carbon dioxide (CO2 ) concentration can reflect the ventilation performance and crowdedness, so CO2 sensors were placed in Beijing Tsinghua Changgung Hospital's fever clinic and emergency department where the nosocomial infection risk was high. Patients' medical records were extracted to figure out their timelines and whereabouts. Based on these, site-specific CO2 concentration thresholds were calculated by the dilution equation and sites' risk ratios were determined to evaluate ventilation performance. CO2 concentration successfully revealed that the expiratory tracer was poorly diluted in the mechanically ventilated inner spaces, compared to naturally ventilated outer spaces, among all of the monitoring sites that COVID-19 patients visited. Sufficient ventilation, personal protection, and disinfection measures led to no nosocomial infection in this hospital. The actual outdoor airflow rate per person (Qc ) during the COVID-19 patients' presence was estimated for reference using equilibrium analysis. During the stay of single COVID-19 patient wearing a mask, the minimum Qc value was 15-18 L/(s·person). When the patient was given throat swab sampling, the minimum Qc value was 21 L/(s·person). The Qc value reached 36-42 L/(s·person) thanks to window-inducted natural ventilation, when two COVID-19 patients wearing masks shared the same space with other patients or healthcare workers. The CO2 concentration monitoring system proved to be effective in assessing nosocomial infection risk by reflecting real-time dilution of patients' exhalation.
Collapse
Affiliation(s)
- Yiran Lu
- Department of Building ScienceTsinghua UniversityBeijingChina
- Key Laboratory of Eco‐Planning & Green BuildingMinistry of EducationTsinghua UniversityBeijingChina
| | - Yifan Li
- Department of Building ScienceTsinghua UniversityBeijingChina
- Key Laboratory of Eco‐Planning & Green BuildingMinistry of EducationTsinghua UniversityBeijingChina
| | - Hao Zhou
- Department of Building ScienceTsinghua UniversityBeijingChina
- Key Laboratory of Eco‐Planning & Green BuildingMinistry of EducationTsinghua UniversityBeijingChina
| | - Jinlan Lin
- Department of Disease & Nosocomial infection controlBeijing Tsinghua Changgung HospitalBeijingChina
- School of Clinical MedicineTsinghua UniversityBeijingChina
| | - Zhuozhao Zheng
- School of Clinical MedicineTsinghua UniversityBeijingChina
- Department of radiologyBeijing Tsinghua Changgung HospitalBeijingChina
| | - Huji Xu
- School of Clinical MedicineTsinghua UniversityBeijingChina
- Peking‐Tsinghua Center for Life SciencesTsinghua UniversityBeijingChina
| | - Borong Lin
- Department of Building ScienceTsinghua UniversityBeijingChina
- Key Laboratory of Eco‐Planning & Green BuildingMinistry of EducationTsinghua UniversityBeijingChina
| | - Minggui Lin
- School of Clinical MedicineTsinghua UniversityBeijingChina
- Department of InfectionBeijing Tsinghua Changgung HospitalBeijingChina
| | - Li Liu
- Department of Building ScienceTsinghua UniversityBeijingChina
- Key Laboratory of Eco‐Planning & Green BuildingMinistry of EducationTsinghua UniversityBeijingChina
| |
Collapse
|
99
|
Liu H, Fei C, Chen Y, Luo S, Yang T, Yang L, Liu J, Ji X, Wu W, Song J. Investigating SARS-CoV-2 persistent contamination in different indoor environments. ENVIRONMENTAL RESEARCH 2021; 202:111763. [PMID: 34329634 PMCID: PMC8316642 DOI: 10.1016/j.envres.2021.111763] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/16/2021] [Accepted: 07/23/2021] [Indexed: 05/12/2023]
Abstract
Environmental contamination caused by COVID-19 patients could be a medium of transmission. Previous reports of SARS-CoV-2 in environmental surfaces were about short-term contamination. This study investigated SARS-CoV-2 RNA existence in room-temperature and low-temperature environments long after exposure (>28 days). A department store, where a COVID-19 outbreak was occurred in January 2020 (the epicenter of 43 COVID-19 patients), and a patient's apartment were included as room-temperature environments after being blocked for 57 days and 48 days, respectively. Seven cold storages and imported frozen foods inside were included as low-temperature environments (under -18 °C). Twenty food markets with potential contamination of imported frozen foods were also included to study the consecutive contamination. Information about temperature, relative humidity, and the number of days of environmental samples since the last exposure was collected and analyzed. In sum, 11,808 swab samples were collected before disinfection, of which 35 samples were positive. Persistent contamination of SARS-CoV-2 RNA was identified in the apartment (6/19), the department store (3/50), food packages in cold storages (23/1360), environmental surfaces of cold storages (2/345), and a package in the food market (1/10,034). Two positive samples were isolated from the bathroom of the apartment (66.7 %, 2/3), and doorknobs were proved with contamination in the apartment (40 %, 2/5) and cold storage (33.3 %, 1/3). The epidemiology information and environmental contamination results of an imported frozen food related COVID-19 case (138th COVID-19 patient in Tianjin) were analyzed. Based on the Ct values, the number of copies of two target genes was calculated by standard curves and linear regressions. In conclusion, SARS-CoV-2 RNA can be detected in room-temperature environments at least 57 days after the last exposure, much longer than previous reports. Based on the results of this study and previous studies, infectious SARS-CoV-2 could exist for at least 60 days on the surface of cold-chain food packages. Doorknobs and toilets (bathrooms) were important positions in COVID-19 control. High-risk populations of cold-chain-related logistic operations, such as porters, require strict prevention and high-level personal protection.
Collapse
Affiliation(s)
- He Liu
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, PR China.
| | - Chunnan Fei
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, PR China.
| | - Yinglei Chen
- Baodi District Centers for Disease Control and Prevention, Tianjin, 301800, PR China
| | - Shengmao Luo
- Wuqing District Centers for Disease Control and Prevention, Tianjin, 301738, PR China
| | - Tao Yang
- Binhai New Area Centers for Disease Control and Prevention, Tianjin, 300454, PR China
| | - Lei Yang
- Tianjin Medical University Second Hospital, Tianjin, 300211, PR China
| | - Jun Liu
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, PR China
| | - Xueyue Ji
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, PR China
| | - Weishen Wu
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, PR China
| | - Jia Song
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, PR China
| |
Collapse
|
100
|
Maltezou HC, Tseroni M, Daflos C, Anastassopoulou C, Vasilogiannakopoulos A, Daligarou O, Panagiotou M, Botsa E, Spanakis N, Lourida A, Tsakris A. Environmental testing for SARS-CoV-2 in three tertiary-care hospitals during the peak of the third COVID-19 wave. Am J Infect Control 2021; 49:1435-1437. [PMID: 34455029 PMCID: PMC8388137 DOI: 10.1016/j.ajic.2021.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 11/21/2022]
Abstract
Contamination of surfaces has been implicated in transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We tested by real-time PCR for SARS-CoV-2 contamination environmental samples from three hospitals during the peak of the third pandemic wave. Overall, 19 of 463 (4.1%) samples tested positive: 12 of 173 (6.9%) samples from a COVID-19 hospital, 3 of 177 (1.7%) samples from a non-COVID-19 hospital, and 4 of 113 (3.5%) samples from a pediatric hospital with dedicated COVID-19 clinics. Most positive samples originated from emergency departments (EDs) (47.3%) and the intensive care units (ICUs) (26.3%) of the COVID-19 hospital. Positive samples belonged almost exclusively (18/19) to the highly transmissible B.1.1.7 cluster, that might explain environmental contamination at this stage of the pandemic. The frequency and efficiency of disinfection in high-risk patient areas, such as EDs and ICUs, should be reinforced, especially during this period where highly transmissible variants of concern are widespread.
Collapse
|