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Haowei Y, Mahyuddin N, Bin Nik Ghazali NN, Wang Z, Liu Y, Pan S, Badruddin IA. A critical review of research methodologies for COVID-19 transmission in indoor built environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-65. [PMID: 38385569 DOI: 10.1080/09603123.2024.2308731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/17/2024] [Indexed: 02/23/2024]
Abstract
The Coronavirus Disease 2019 (COVID-19) has caused massive losses for the global economy. Scholars have used different methods to study the transmission mode and influencing factors of the virus to find effective methods to provide people with a healthy built environment. However, these studies arrived at different or even contradictory conclusions. This review presents the main research methodologies utilized in this field, summarizes the main investigation methods, and critically discusses their related conclusions. Data statistical analysis, sample collection, simulation models, and replication transmission scenarios are the main research methods. The summarized conclusion for prevention from all reviewed papers are: adequate ventilation and proper location of return air vents, proper use of personal protective equipment, as well as the reasonable and strict enforcement of policies are the main methods for reducing the transmission. Recommendations including standardized databases, causation clarification, rigorous experiment design, improved simulation accuracy and verification are provided.
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Affiliation(s)
- Yu Haowei
- Centre for Building, Construction & Tropical Architecture (BuCTA), Faculty of Built Environment, University of Malaya, Kuala Lumpur, Malaysia
| | - Norhayati Mahyuddin
- Centre for Building, Construction & Tropical Architecture (BuCTA), Faculty of Built Environment, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Nazri Bin Nik Ghazali
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Zeyu Wang
- China Nuclear Power Engineering Co. Ltd, Beijing Institute of Nuclear Engineering, Beijing, China
| | - Yiqiao Liu
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Song Pan
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
- Key Laboratory for Comprehensive Energy Saving of Cold Regions Architecture of Ministry of Education, Jilin Jianzhu University, Changchun, PR China
| | - Irfan Anjum Badruddin
- Mechanical Engineering Department, College of Engineering, King Khalid University, Abha, Saudi Arabia
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Ge J, Zhang C, Peng Z, Chu M, Chen W, Li Z, Liu S, Yang Y, Chu M. Environmental Contamination of SARS-CoV-2 Delta VOC by COVID-19 Patients Staying in the Hospital for More Than Two Weeks. Risk Manag Healthc Policy 2023; 16:2163-2170. [PMID: 37868023 PMCID: PMC10590072 DOI: 10.2147/rmhp.s413639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023] Open
Abstract
Background Patients infected with SARS-CoV-2 Delta VOC have a longer course of disease. We detected the air, surfaces, and patient's personal items in the wards of the second hospital of Nanjing during the outbreak of the COVID-19 Delta Variant to identify the environmental contamination, which provides a theoretical basis for the prevention and control of COVID-19 variation beads in the future. Methods In the cross-sectional study, we collected and analyzed clinical features, demographic and epidemiological data, laboratory and swab test results, and surface and air samples of 144 COVID-19 cases. Results The time from symptom onset to surface sampling was 25 days (IQR, 21 to 33 days). Positive throat swabs were detected in 52(36.1%) patients, of which only 8(5.6%) patients had N or ORF1a/b genes Ct value <35 on the surface sampling day. Among the 692 environmental surface and air specimens collected from 144 COVID-19 cases, 3 specimens (3/692, 0.4%) related to 5 cases (3.5%, 5/144) were detected positive on RT-PCR. Overall, bedside tables (2/144, 1.4%) were most likely to be contaminated, followed by toilet seats (1/81, 1.2%). Conclusion The environmental contamination by SARS-CoV-2 Delta VOC-infected cases with disease duration of more than two weeks is limited.
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Affiliation(s)
- Jingwu Ge
- Department of Infection Management, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210009, People’s Republic of China
| | - Chuanmeng Zhang
- The Center for Translational Medicine, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, 225300, People’s Republic of China
| | - Zhihang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People’s Republic of China
| | - Minjuan Chu
- Department of Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210009, People’s Republic of China
| | - Wensen Chen
- Department of Infection Management, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210009, People’s Republic of China
| | - Zhanjie Li
- Department of Infection Management, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210009, People’s Republic of China
| | - Shuangyuan Liu
- Department of Infection Management, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210009, People’s Republic of China
| | - Yongfeng Yang
- Center of Infectious Diseases, Affiliated Nanjing Hospital of Nanjing University of Chinese Medicine (The No. 2 Hospital of Nanjing), Nanjing, 211113, People’s Republic of China
| | - Ming Chu
- Department of Infection Management, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, 225300, People’s Republic of China
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Nicholls I, Spencer A, Chen Y, Bennett A, Atkinson B. Surface sampling for SARS-CoV-2 RNA in workplace outbreak settings in the UK, 2021-22. J Appl Microbiol 2023; 134:lxad216. [PMID: 37742225 DOI: 10.1093/jambio/lxad216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/14/2023] [Accepted: 09/19/2023] [Indexed: 09/26/2023]
Abstract
AIMS To utilize environmental surface sampling to evaluate areas of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contamination within workplaces to identify trends and improve local coronavirus disease 2019 (COVID-19) control measures. METHODS AND RESULTS Surface sampling was undertaken at 12 workplaces that experienced a cluster of COVID-19 cases in the workforce between March 2021 and March 2022. A total of 7.4% (61/829) samples collected were positive for SARS-CoV-2 RNA by the quantitative PCR (qPCR) with only 1.8% (15/829) of samples identified with crossing threshold (Ct) values <35.0. No sample returned whole-genome sequence inferring RNA detected was degraded. CONCLUSIONS Few workplace surface samples were positive for SARS-CoV-2 RNA and positive samples typically contained low levels of nucleic acid. Although these data may infer a low probability of fomite transmission within the workplace, Ct values may have been lower at the time of contamination. Workplace environmental sampling identified lapses in COVID-19 control measures within individual sites and showed trends throughout the pandemic.
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Affiliation(s)
- Ian Nicholls
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - Antony Spencer
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - Yiqun Chen
- Science Division, Health and Safety Executive, Buxton, SK17 9JN, United Kingdom
| | - Allan Bennett
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - Barry Atkinson
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, United Kingdom
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Zambrana W, Boehm AB. Occurrence of Human Viruses on Fomites in the Environment: A Systematic Review and Meta-analysis. ACS ENVIRONMENTAL AU 2023; 3:277-294. [PMID: 37743950 PMCID: PMC10515712 DOI: 10.1021/acsenvironau.3c00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 09/26/2023]
Abstract
Documenting the occurrence of viruses on fomites is crucial in determining the significance of fomite-mediated transmission and the potential use of fomites for environmental disease surveillance. We conducted a systematic review and meta-analysis to compile information on the occurrence of human viruses on fomites in the environment; we identified 134 peer-reviewed papers. We compiled sampling and measurement methods, results, quality control information, and whether virus data were compared with community health data from the papers. We conducted univariate and multivariate analyses to investigate if presence of virus on fomites was associated with virus type (enveloped, nonenveloped), sampling location (healthcare setting, nonhealthcare temporary setting, nonhealthcare nontemporary setting), and area of fomite swabbed (<50, 50-100, >100 cm2). Across 275 data sets from the 134 papers, there was the most data available for Coronaviridae and from fomites at hospitals. Positivity rates, defined as the percent positive fomite samples, were low (median = 6%). Data were available on viruses from 16 different viral families, but data on viruses from 9 families had few (n < 5) data sets. Many human virus families were not identified in this review (11 families). Less than 15% of the data sets reported virus concentrations in externally valid units (viruses per area of surface), and 16% provided a quantitative comparison between virus and health data. Virus type and area swabbed were significant predictors of virus presence on fomites, and the positivity rate of data sets collected from healthcare settings and nonhealthcare nontemporary settings (e.g., individual housing) were significantly higher than those collected in nonhealthcare temporary settings (e.g., restaurants). Data from this review indicates that viruses may be present on fomites, that fomite-mediated virus transmission may occur, and that fomites may provide information on circulation of infectious diseases in the community. However, more quantitative data on diverse viruses are needed, and method reporting needs significant improvements.
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Affiliation(s)
- Winnie Zambrana
- Department
of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Alexandria B. Boehm
- Department
of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
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Vass WB, Shankar SN, Lednicky JA, Yang Y, Manzanas C, Zhang Y, Boyette J, Chen J, Chen Y, Shirkhani A, Washeem M, Fan ZH, Eiguren-Fernandez A, Jutla A, Wu CY. Detection and isolation of infectious SARS-CoV-2 omicron subvariants collected from residential settings. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2023; 57:1142-1153. [PMID: 38143528 PMCID: PMC10735208 DOI: 10.1080/02786826.2023.2251537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/17/2023] [Indexed: 12/26/2023]
Abstract
Airborne transmission of infectious (viable) SARS-CoV-2 is increasingly accepted as the primary manner by which the virus is spread from person to person. Risk of exposure to airborne virus is higher in enclosed and poorly ventilated spaces. We present a study focused on air sampling within residences occupied by individuals with COVID-19. Air samplers (BioSpot-VIVAS, VIVAS, and BC-251) were positioned in primary- and secondary-occupancy regions in seven homes. Swab samples were collected from high-touch surfaces. Isolation of SARS-CoV-2 was attempted for samples with virus detectable by RT-qPCR. Viable virus was quantified by plaque assay, and complete virus genome sequences were obtained for selected samples from each sampling day. SARS-CoV-2 was detected in 24 of 125 samples (19.2%) by RT-qPCR and isolated from 14 (11.2%) in cell cultures. It was detected in 80.9% (17/21) and cultured from 61.9% (13/21) of air samples collected using water condensation samplers, compared to swab samples which had a RT-qPCR detection rate of 10.5% (4/38) and virus isolation rate of 2.63% (1/38). No statistically significant differences existed in the likelihood of virus detection by RT-qPCR or amount of infectious virus in the air between areas of primary and secondary occupancy within residences. Our work provides information about the presence of SARS-CoV-2 in the air within homes of individuals with COVID-19. Information herein can help individuals make informed decisions about personal exposure risks when sharing indoor spaces with infected individuals isolating at home and further inform health departments and the public about SARS-CoV-2 exposure risks within residences.
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Affiliation(s)
- William B. Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - John A. Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Yang Yang
- Department of Statistics, University of Georgia, Athens, Georgia, USA
| | - Carlos Manzanas
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, Florida, USA
| | - Yuetong Zhang
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Jessica Boyette
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Jiayi Chen
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Yuqiao Chen
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Amin Shirkhani
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Mo Washeem
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Z. Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, Florida, USA
- Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | | | - Antarpreet Jutla
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, Florida, USA
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Pilipenco A, Forinová M, Mašková H, Hönig V, Palus M, Lynn Jr. NS, Víšová I, Vrabcová M, Houska M, Anthi J, Spasovová M, Mustacová J, Štěrba J, Dostálek J, Tung CP, Yang AS, Jack R, Dejneka A, Hajdu J, Vaisocherová-Lísalová H. Negligible risk of surface transmission of SARS-CoV-2 in public transportation. J Travel Med 2023; 30:taad065. [PMID: 37133444 PMCID: PMC10481417 DOI: 10.1093/jtm/taad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/14/2023] [Accepted: 04/22/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Exposure to pathogens in public transport systems is a common means of spreading infection, mainly by inhaling aerosol or droplets from infected individuals. Such particles also contaminate surfaces, creating a potential surface-transmission pathway. METHODS A fast acoustic biosensor with an antifouling nano-coating was introduced to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on exposed surfaces in the Prague Public Transport System. Samples were measured directly without pre-treatment. Results with the sensor gave excellent agreement with parallel quantitative reverse-transcription polymerase chain reaction (qRT-PCR) measurements on 482 surface samples taken from actively used trams, buses, metro trains and platforms between 7 and 9 April 2021, in the middle of the lineage Alpha SARS-CoV-2 epidemic wave when 1 in 240 people were COVID-19 positive in Prague. RESULTS Only ten of the 482 surface swabs produced positive results and none of them contained virus particles capable of replication, indicating that positive samples contained inactive virus particles and/or fragments. Measurements of the rate of decay of SARS-CoV-2 on frequently touched surface materials showed that the virus did not remain viable longer than 1-4 h. The rate of inactivation was the fastest on rubber handrails in metro escalators and the slowest on hard-plastic seats, window glasses and stainless-steel grab rails. As a result of this study, Prague Public Transport Systems revised their cleaning protocols and the lengths of parking times during the pandemic. CONCLUSIONS Our findings suggest that surface transmission played no or negligible role in spreading SARS-CoV-2 in Prague. The results also demonstrate the potential of the new biosensor to serve as a complementary screening tool in epidemic monitoring and prognosis.
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Affiliation(s)
- Alina Pilipenco
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Michala Forinová
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Hana Mašková
- Faculty of Science, University of South Bohemia, Branišovská 1645/31a, 370 05 České Budějovice, Czech Republic
| | - Václav Hönig
- Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Branišovská 31, 370 05 České Budějovice, Czech Republic
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, Hudcova 70, 621 00 Brno, Czech Republic
| | - Martin Palus
- Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Branišovská 31, 370 05 České Budějovice, Czech Republic
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, Hudcova 70, 621 00 Brno, Czech Republic
| | - Nicholas Scott Lynn Jr.
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Ivana Víšová
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Markéta Vrabcová
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Milan Houska
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Judita Anthi
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Monika Spasovová
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Johana Mustacová
- Faculty of Science, University of South Bohemia, Branišovská 1645/31a, 370 05 České Budějovice, Czech Republic
| | - Ján Štěrba
- Faculty of Science, University of South Bohemia, Branišovská 1645/31a, 370 05 České Budějovice, Czech Republic
| | - Jakub Dostálek
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Chao-Ping Tung
- Genomics Research Center, Academia Sinica, 128 Academia Rd., Sec.2, Nankang Dist., Taipei 115, Taiwan
| | - An-Suei Yang
- Genomics Research Center, Academia Sinica, 128 Academia Rd., Sec.2, Nankang Dist., Taipei 115, Taiwan
| | - Rachael Jack
- The European Extreme Light Infrastructure, ERIC, Za Radnici 835, 25241 Dolní Břežany, Czech Republic
| | - Alexandr Dejneka
- Institute of Physics of the Czech Academy of Sciences, Na Slovance 2, 182 00 Prague, Czech Republic
| | - Janos Hajdu
- The European Extreme Light Infrastructure, ERIC, Za Radnici 835, 25241 Dolní Břežany, Czech Republic
- Department of Cell and Molecular Biology, Uppsala University, Box 596, 751 24 Uppsala, Sweden
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Viral Cultures for Assessing Fomite Transmission of SARS-CoV-2: a Systematic Review and Meta-Analysis. J Hosp Infect 2022; 130:63-94. [PMID: 36115620 PMCID: PMC9473144 DOI: 10.1016/j.jhin.2022.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/28/2022] [Accepted: 09/02/2022] [Indexed: 01/01/2023]
Abstract
Background The role of fomites in the transmission of SARS-CoV-2 is unclear. Aim To assess whether SARS-CoV-2 can be transmitted through fomites, using evidence from viral culture studies. Methods Searches were conducted in the World Health Organization COVID-19 Database, PubMed, LitCovid, medRxiv, and Google Scholar to December 31st, 2021. Studies that investigated fomite transmission and performed viral culture to assess the cytopathic effect (CPE) of positive fomite samples and confirmation of SARS-CoV-2 as the cause of the CPE were included. The risk of bias using a checklist modified from the modified Quality Assessment of Diagnostic Accuracy Studies – 2 (QUADAS-2) criteria was assessed. Findings Twenty-three studies were included. The overall risk of bias was moderate. Five studies demonstrated replication-competent virus from fomite cultures and three used genome sequencing to match fomite samples with human clinical specimens. The mean cycle threshold (CT) of samples with positive viral culture was significantly lower compared with cultured samples that returned negative results (standardized mean difference: –1.45; 95% confidence interval (CI): –2.00 to –0.90; I2 = 0%; P < 0.00001). The likelihood of isolating replication-competent virus was significantly greater when CT was <30 (relative risk: 3.10; 95% CI: 1.32 to 7.31; I2 = 71%; P = 0.01). Infectious specimens were mostly detected within seven days of symptom onset. One study showed possible transmission of SARS-CoV-2 from fomites to humans. Conclusion The evidence from published studies suggests that replication-competent SARS-CoV-2 is present on fomites. Replication-competent SARS-CoV-2 is significantly more likely when the PCR CT for clinical specimens and fomite samples is <30. Further studies should investigate the duration of infectiousness of SARS-CoV-2 and the frequency of transmission from fomites.
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Geng Y, Wang Y. Stability and transmissibility of SARS-CoV-2 in the environment. J Med Virol 2022; 95:e28103. [PMID: 36039831 PMCID: PMC9537778 DOI: 10.1002/jmv.28103] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 01/11/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing the ongoing global coronavirus disease 2019 (COVID-19) pandemic, is believed to be transmitted primarily through respiratory droplets and aerosols. However, reports are increasing regarding the contamination of environmental surfaces, shared objects, and cold-chain foods with SARS-CoV-2 RNA and the possibility of environmental fomite transmission of the virus raises much concern and debate. This study summarizes the current knowledge regarding potential mechanisms of environmental transmission of SARS-CoV-2, including the prevalence of surface contamination in various settings, the viability and stability of the virus on surfaces or fomites, as well as environmental factors affecting virus viability and survival such as temperature and relative humidity. Instances of fomite transmission, including cold-chain food transmission, and the importance of fomite transmission in epidemics, are discussed. The knowledge gaps regarding fomite transmission of SARS-CoV-2 are also briefly analyzed.
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Affiliation(s)
- Yansheng Geng
- Key Laboratory of Public Health Safety of Hebei Province, School of Public HealthHebei UniversityBaodingChina
| | - Youchun Wang
- Division of HIV/AIDS and Sex‐Transmitted Virus VaccinesNational Institutes for Food and Drug ControlBeijingChina
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9
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Diagnostic Laboratory Characteristics of COVID-19 Patients Infected by Fomites: COVID-19 Outbreak in a South Korean Public Administrative Facility. Pathogens 2022; 11:pathogens11060700. [PMID: 35745554 PMCID: PMC9228738 DOI: 10.3390/pathogens11060700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/10/2022] Open
Abstract
There is a paucity of data regarding the differentiating characteristics of patients who were infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by fomites around the world. We conducted an event-based outbreak investigation, involving 795 public officers and 277 assistant staff, in the Ministry of Oceans and Fisheries (MOF) or the same building from March 2 to March 18, 2020. The SARS-CoV-2 patients were found to have more frequently touched fomites and used public toilets than those who were tested negative for the virus (cOR, 24.38; 95% CI, 4.95-120.01). Symptoms such as coughing and loss of taste and smell were more frequently found in the office-cleaner group than in the public-officer group. The SARS-CoV-2 office-cleaner patients were more likely to have a high RdRp(Ct) value of PCR (median: 34.17 vs. 24.99; p = 0.035) and E(Ct) value of PCR (median: 32.30 vs. 24.74; p = 0.045). All office cleaner patients (100%) had a ground glass opacity in both lobes. Regarding segmental lung involvement of CT, two patients (100%) had a lesion in the right middle lobe, which invaded the whole lobe later. This implies that the fomite might be a selective risk factor of SARS-CoV-2 infection.
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10
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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.
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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
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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.
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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
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12
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Bastola A, Dhital R, Shah R, Subedi M, Hamal PK, Shrestha C, Chalise BS, Maharjan K, Nepal R, Rajbhandari S. Experiences of COVID-19 patients admitted in a government infectious disease hospital in Nepal and its implications for health system strengthening: A qualitative study. PLoS One 2021; 16:e0261524. [PMID: 34969043 PMCID: PMC8718006 DOI: 10.1371/journal.pone.0261524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 12/05/2021] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has affected the health systems in many ways. It has put unprecedented strain on health systems worldwide and exposed gaps in public health infrastructure. A health system comprises all institutions and resources working towards improving and maintaining health. Among the different aspects of health system strengthening, a patient's experiences and expectations play a crucial role in determining how well the health facilities function. This study aims to explore health system strengthening's implications based on experiences and feedback provided by COVID-19 patients admitted to a government tropical and infectious disease hospital in Nepal. METHODS In this qualitative study, we collected the voluntary handwritten feedback by the admitted COVID-19 patients to document the feedback and experiences from a book, maintained by the hospital. We performed thematic content analysis using the World Health Organization's six building blocks of health system as a theoretical framework which included service delivery, health workforce, information, leadership and governance, financing, and access to medicines. RESULTS Most patients in this study had positive experiences on service delivery and health workforce. Some also highlighted the gaps in infrastructure, cleanliness, and hygiene. Many suggested positive experiences on other dimensions of the health system such as financing, governance and leadership, and access to medicines reflected upon by the patients' thankfulness to the hospital and the government for the treatment they received. The responses also reflected the inter-connectedness between the different building blocks of health system. CONCLUSION This study approached a unique way to strengthen the health system by exploring patients' feedback, which suggested an overall positive impression on most building blocks of health system. However, it also highlighted certain gaps in infrastructure, cleanliness, and hygiene. It reinforces the hospital management and government's role to continue its efforts to strengthen the health system.
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Affiliation(s)
- Anup Bastola
- Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
| | - Rolina Dhital
- Health Action and Research, Kathmandu, Nepal
- * E-mail:
| | - Richa Shah
- Health Action and Research, Kathmandu, Nepal
| | | | | | | | | | - Kijan Maharjan
- Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
| | - Richa Nepal
- Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
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13
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Wong SC, Au AKW, Chen H, Yuen LLH, Li X, Lung DC, Chu AWH, Ip JD, Chan WM, Tsoi HW, To KKW, Yuen KY, Cheng VCC. Transmission of Omicron (B.1.1.529) - SARS-CoV-2 Variant of Concern in a designated quarantine hotel for travelers: a challenge of elimination strategy of COVID-19. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 18:100360. [PMID: 34961854 PMCID: PMC8696199 DOI: 10.1016/j.lanwpc.2021.100360] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Shuk-Ching Wong
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Albert Ka-Wing Au
- Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Hong Chen
- Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Lithia Lai-Ha Yuen
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Xin Li
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - David Christopher Lung
- Department of Pathology, Hong Kong Children's Hospital / Queen Elizabeth Hospital, Hong Kong Special Administrative Region, China
| | - Allen Wing-Ho Chu
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jonathan Daniel Ip
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wan-Mui Chan
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hoi-Wah Tsoi
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kelvin Kai-Wang To
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kwok-Yung Yuen
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Vincent Chi-Chung Cheng
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.,Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
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Salvatori P. The rationale of ethanol inhalation for disinfection of the respiratory tract in SARS-CoV-2-positive asymptomatic subjects. Pan Afr Med J 2021; 40:201. [PMID: 35136464 PMCID: PMC8783302 DOI: 10.11604/pamj.2021.40.201.31211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/01/2021] [Indexed: 12/20/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic is a major health concern and is affecting the socio-economic lives. As other highly contagious diseases, it is of outmost importance to early identify and treat the healthy carriers or positive asymptomatic subjects (PAS). SARS-CoV-2 entry points are mainly in the respiratory tract. No specific virucidal treatments against SARS-CoV-2 are currently available. Monoclonal antibodies are under evaluation, but high cost and possible ineffectiveness against virus variants could limit its use. Resorting nonspecific drugs is an alternative approach. Among them, ethanol (EtOH) is known to be a powerful, cost-effective and abundant virucidal agent, now advised for surgical hand and surfaces disinfection. The paper aims to determine the potential role of inhaled ethanol to disinfect SARS-CoV-2 PAS, taking into account the dimension of the problem, ethanol efficiency and other beneficial effects on the respiratory tract, ethanol local and general toxicity and ethanol therapeutic window; consequently, to propose a study in order to verify this hypothesis. Together with the consolidated knowledge, an extensive review of the medical literature has been carried out looking for sound data able to support (or discard) the rationale on which a study could be built up. Evident data supporting the inhaled ethanol potential role on SARS-CoV-2 PAS disinfection have been found and discussed. A clinical trial to test the hypothesis that inhaled ethanol could be rapidly efficient in lowering or eradicating SARS-CoV-2 from the respiratory tract in PAS is advisable. Individual and public health benefits are stressed, together with socio-economic positive fallouts.
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Affiliation(s)
- Pietro Salvatori
- Retired Head & Neck Surgeon, Former Head of Ear, Nose and Throat (ENT) Department at the Humanitas San Pio X Hospital, Milan, Italy
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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.
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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
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Haji Ali B, Shahin MS, Masoumi Sangani MM, Faghihinezhad M, Baghdadi M. Wastewater aerosols produced during flushing toilets, WWTPs, and irrigation with reclaimed municipal wastewater as indirect exposure to SARS-CoV-2. JOURNAL OF ENVIRONMENTAL CHEMICAL ENGINEERING 2021; 9:106201. [PMID: 34405082 PMCID: PMC8361049 DOI: 10.1016/j.jece.2021.106201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 05/07/2023]
Abstract
The detection of SARS-CoV-2 RNA in raw and treated wastewater can open up a fresh perspective to waterborne and aerosolized wastewater as a new transmission route of SARS-CoV-2 RNA during the current pandemic. The aim of this paper is to discuss the potential transmission of SARS-CoV-2 RNA from wastewater aerosols formed during toilet flushing, plumbing failure, wastewater treatment plants, and municipal wastewater reuse for irrigation. Moreover, how these aerosols might increase the risk of exposure to this novel coronavirus (SARS-CoV-2 RNA). This article supplies a review of the literature on the presence of SARS-CoV-2 RNA in untreated wastewater, as well as the fate and stability of SARS-CoV-2 RNA in wastewater. We also reviewed the existing literatures on generation and transmission of aerosolized wastewater through flush a toilet, house's plumbing networks, WWTPs, wastewater reuse for irrigation of agricultural areas. Finally, the article briefly studies the potential risk of infection with exposure to the fecal bioaerosols of SARS-CoV-2 RNA for the people who might be exposed through flushing toilets or faulty building plumbing systems, operators/workers in wastewater treatment plants, and workers of fields irrigated with treated wastewater - based on current knowledge. Although this review highlights the indirect transmission of SARS-CoV-2 RNA through wastewater aerosols, no research has yet clearly demonstrated the role of aerosolized wastewater in disease transmission regarding the continuation of this pandemic. Therefore, there is a need for additional studies on wastewater aerosols in transmission of COVID-19.
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Affiliation(s)
- Banafsheh Haji Ali
- School of Environment, College of Engineering, University of Tehran, Tehran, Iran
| | | | | | - Mohsen Faghihinezhad
- School of Environment, College of Engineering, University of Tehran, Tehran, Iran
| | - Majid Baghdadi
- School of Environment, College of Engineering, University of Tehran, Tehran, Iran
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