1
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Gong J, Or CY, Sze ETP, Man-Ngai Chan S, Wu PL, Poon PMY, Law AKY, Ulrychová L, Hodek J, Weber J, Ouyang H, Yang M, Eilts SM, Torremorell M, Knobloch Y, Hogan CJ, Atallah C, Davies J, Winkler J, Gordon R, Zarghanishiraz R, Zabihi M, Christianson C, Taylor D, Rabinowitz A, Baylis J, Brinkerhoff J, Little JP, Li R, Moldenhauer J, Mansour MK. Effect of multifunctional cationic polymer coatings on mitigation of broad microbial pathogens. Microbiol Spectr 2024; 12:e0409723. [PMID: 39101823 PMCID: PMC11370243 DOI: 10.1128/spectrum.04097-23] [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: 12/12/2023] [Accepted: 05/12/2024] [Indexed: 08/06/2024] Open
Abstract
Infection control measures to prevent viral and bacterial infection spread are critical to maintaining a healthy environment. Pathogens such as viruses and pyogenic bacteria can cause infectious complications. Viruses such as SARS-CoV-2 are known to spread through the aerosol route and on fomite surfaces, lasting for a prolonged time in the environment. Developing technologies to mitigate the spread of pathogens through airborne routes and on surfaces is critical, especially for patients at high risk for infectious complications. Multifunctional coatings with a broad capacity to bind pathogens that result in inactivation can disrupt infectious spread through aerosol and inanimate surface spread. This study uses C-POLAR, a proprietary cationic, polyamine, organic polymer with a charged, dielectric property coated onto air filtration material and textiles. Using both SARS-CoV-2 live viral particles and bovine coronavirus models, C-POLAR-treated material shows a dramatic 2-log reduction in circulating viral inoculum. This reduction is consistent in a static room model, indicating simple airflow through a static C-POLAR hanging can capture significant airborne particles. Finally, Gram-positive and Gram-negative bacteria are applied to C-POLAR textiles using a viability indicator to demonstrate eradication on fomite surfaces. These data suggest that a cationic polymer surface can capture and eradicate human pathogens, potentially interrupting the infectious spread for a more resilient environment. IMPORTANCE Infection control is critical for maintaining a healthy home, work, and hospital environment. We test a cationic polymer capable of capturing and eradicating viral and bacterial pathogens by applying the polymer to the air filtration material and textiles. The data suggest that the simple addition of cationic material can result in the improvement of an infectious resilient environment against viral and bacterial pathogens.
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Affiliation(s)
- Jianliang Gong
- C-POLAR Technologies Inc., West Vancouver, British Columbia, Canada
| | - Chun-Yin Or
- C-POLAR Technologies Inc., West Vancouver, British Columbia, Canada
| | - Eric Tung-Po Sze
- Department of Chemistry, The Chinese University of Hong Kong, Hong Kong, China
| | - Sidney Man-Ngai Chan
- School of Science and Technology, Hong Kong Metropolitan University, Hong Kong, China
| | - Pak-Long Wu
- School of Science and Technology, Hong Kong Metropolitan University, Hong Kong, China
| | - Peggy Miu-Yee Poon
- School of Science and Technology, Hong Kong Metropolitan University, Hong Kong, China
| | - Anthony K. Y. Law
- Department of Mechanical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Lucie Ulrychová
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Prague, Czechia
- Department of Genetics and Microbiology, Charles University, Faculty of Sciences, Prague, Czechia
| | - Jan Hodek
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Prague, Czechia
| | - Jan Weber
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Prague, Czechia
| | - Hui Ouyang
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Mechanical Engineering University of Texas-Dallas, Richardson, Texas, USA
| | - My Yang
- Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Stephanie M. Eilts
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Montserrat Torremorell
- Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Yaakov Knobloch
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christopher J. Hogan
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christine Atallah
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Juliette Davies
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - John Winkler
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Ryan Gordon
- School of Engineering, University of British Columbia, Kelowna, British Columbia, Canada
| | - Reza Zarghanishiraz
- School of Engineering, University of British Columbia, Kelowna, British Columbia, Canada
| | - Mojtaba Zabihi
- School of Engineering, University of British Columbia, Kelowna, British Columbia, Canada
| | - Cole Christianson
- School of Engineering, University of British Columbia, Kelowna, British Columbia, Canada
| | - Deanne Taylor
- School of Nursing, University of British Columbia, Kelowna, British Columbia, Canada
- Interior Health Authority, Kelowna, British Columbia, Canada
- Rural Coordination Center of British Columbia, Vancouver, British Columbia, Canada
| | - Alan Rabinowitz
- Rural Coordination Center of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Jared Baylis
- Interior Health Authority, Kelowna, British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joshua Brinkerhoff
- School of Engineering, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jonathan P. Little
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Ri Li
- School of Engineering, University of British Columbia, Kelowna, British Columbia, Canada
| | | | - Michael K. Mansour
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Rufino de Sousa N, Margerie L, Steponaviciute L, Roux J, Kinahan MW, Olsson D, Ásgeirsson H, Udekwu KI, Rothfuchs AG. Detection of active SARS-CoV-2 in cough aerosols from COVID-19 patients. Infect Dis (Lond) 2024:1-9. [PMID: 38975876 DOI: 10.1080/23744235.2024.2374307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/25/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an airborne pathogen, but detection of infectious SARS-CoV-2 in air and in particular the introduction of the virus into the environment by different human expiratory manoeuvres is not well studied. OBJECTIVES The aim of this study was to investigate the presence of SARS-CoV-2 in cough from coronavirus disease of 2019 (COVID-19) in-patients and to study contamination of the virus in the patient's environment. METHODS Detection of SARS-CoV-2 in cough was analyzed by PCR, culture and imaging. Detection in cough was compared to presence of the virus in air and on surfaces from patient rooms. RESULTS Twenty-five patients in 21 rooms were included in the study. SARS-CoV-2 RNA was found in cough aerosols from 16 out of 22 patients that produced voluntary cough. As demonstrated by plaque-forming unit assays, active virus was isolated from 11 of these 16 patients. Using mainly molecular detection, the virus was also found in air, on high-contact surfaces, and no-touch surfaces from the room of the COVID-19 patients. CONCLUSIONS These results show that infectious SARS-CoV-2 circulating in air can originate from patient cough and should be considered against the risk of acquiring COVID-19 through inhalation.
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Affiliation(s)
- Nuno Rufino de Sousa
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Lucille Margerie
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Laura Steponaviciute
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Julie Roux
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Matthew W Kinahan
- Department of Biological Sciences, University of Idaho, Moscow, ID, USA
| | - David Olsson
- Department of Medicine Huddinge (MedH), Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Hilmir Ásgeirsson
- Department of Medicine Huddinge (MedH), Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Klas I Udekwu
- Department of Biological Sciences, University of Idaho, Moscow, ID, USA
- Department of Aquatic Sciences and Assessment, Swedish Environmental Epidemiology Center, Swedish University of Agricultural Sciences, Uppsala, Sweden
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3
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Zhang Y, Shankar SN, Vass WB, Lednicky JA, Fan ZH, Agdas D, Makuch R, Wu CY. Air Change Rate and SARS-CoV-2 Exposure in Hospitals and Residences: A Meta-Analysis. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2024; 58:217-243. [PMID: 38764553 PMCID: PMC11101186 DOI: 10.1080/02786826.2024.2312178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/16/2024] [Indexed: 05/21/2024]
Abstract
As SARS-CoV-2 swept across the globe, increased ventilation and implementation of air cleaning were emphasized by the US CDC and WHO as important strategies to reduce the risk of inhalation exposure to the virus. To assess whether higher ventilation and air cleaning rates lead to lower exposure risk to SARS-CoV-2, 1274 manuscripts published between April 2020 and September 2022 were screened using key words "airborne SARS-CoV-2 or "SARS-CoV-2 aerosol". Ninety-three studies involved air sampling at locations with known sources (hospitals and residences) were selected and associated data were compiled. Two metrics were used to assess exposure risk: SARS-CoV-2 concentration and SARS-CoV-2 detection rate in air samples. Locations were categorized by type (hospital or residence) and proximity to the sampling location housing the isolated/quarantined patient (primary or secondary). The results showed that hospital wards had lower airborne virus concentrations than residential isolation rooms. A negative correlation was found between airborne virus concentrations in primary-occupancy areas and air changes per hour (ACH). In hospital settings, sample positivity rates were significantly reduced in secondary-occupancy areas compared to primary-occupancy areas, but they were similar across sampling locations in residential settings. ACH and sample positivity rates were negatively correlated, though the effect was diminished when ACH values exceeded 8. While limitations associated with diverse sampling protocols exist, data considered by this meta-analysis support the notion that higher ACH may reduce exposure risks to the virus in ambient air.
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Affiliation(s)
- Yuetong Zhang
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columnia, Canada
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Environmental & Public Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - William B. Vass
- 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
| | - Z. Hugh Fan
- Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | - Duzgun Agdas
- Engineering School of Sustainable Infrastructure & Environment, University of Florida, Gainesville, Florida, USA
| | - Robert Makuch
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, 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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4
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Shankar SN, Vass WB, Lednicky JA, Logan T, Messcher RL, Eiguren-Fernandez A, Amanatidis S, Sabo-Attwood T, Wu CY. The BioCascade-VIVAS system for collection and delivery of virus-laden size-fractionated airborne particles. JOURNAL OF AEROSOL SCIENCE 2024; 175:106263. [PMID: 38680161 PMCID: PMC11044810 DOI: 10.1016/j.jaerosci.2023.106263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
The size of virus-laden particles determines whether aerosol or droplet transmission is dominant in the airborne transmission of pathogens. Determining dominant transmission pathways is critical to implementing effective exposure risk mitigation strategies. The aerobiology discipline greatly needs an air sampling system that can collect virus-laden airborne particles, separate them by particle diameter, and deliver them directly onto host cells without inactivating virus or killing cells. We report the use of a testing system that combines a BioAerosol Nebulizing Generator (BANG) to aerosolize Human coronavirus (HCoV)-OC43 (OC43) and an integrated air sampling system comprised of a BioCascade impactor (BC) and Viable Virus Aerosol Sampler (VIVAS), together referred to as BC-VIVAS, to deliver the aerosolized virus directly onto Vero E6 cells. Particles were collected into four stages according to their aerodynamic diameter (Stage 1: >9.43 μm, Stage 2: 3.81-9.43 μm, Stage 3: 1.41-3.81 μm and Stage 4: <1.41 μm). OC43 was detected by reverse-transcription quantitative polymerase chain reaction (RT-qPCR) analyses of samples from all BC-VIVAS stages. The calculated OC43 genome equivalent counts per cm3 of air ranged from 0.34±0.09 to 70.28±12.56, with the highest concentrations in stage 3 (1.41-3.81 μm) and stage 4 (<1.41 μm). Virus-induced cytopathic effects appeared only in cells exposed to particles collected in stages 3 and 4, demonstrating the presence of viable OC43 in particles <3.81 μm. This study demonstrates the dual utility of the BC-VIVAS as particle size-fractionating air sampler and a direct exposure system for aerosolized viruses. Such utility may help minimize conventional post-collection sample processing time required to assess the viability of airborne viruses and increase the understanding about transmission pathways for airborne pathogens.
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Affiliation(s)
- Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL 32611, USA
| | - William B. Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL 32611, USA
| | - John A. Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Tracey Logan
- Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Rebeccah L. Messcher
- Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | | | | | - Tara Sabo-Attwood
- Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL 32611, USA
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
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5
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Ijaz MK, Sattar SA, Nims RW, Boone SA, McKinney J, Gerba CP. Environmental dissemination of respiratory viruses: dynamic interdependencies of respiratory droplets, aerosols, aerial particulates, environmental surfaces, and contribution of viral re-aerosolization. PeerJ 2023; 11:e16420. [PMID: 38025703 PMCID: PMC10680453 DOI: 10.7717/peerj.16420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
During the recent pandemic of COVID-19 (SARS-CoV-2), influential public health agencies such as the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have favored the view that SARS CoV-2 spreads predominantly via droplets. Many experts in aerobiology have openly opposed that stance, forcing a vigorous debate on the topic. In this review, we discuss the various proposed modes of viral transmission, stressing the interdependencies between droplet, aerosol, and fomite spread. Relative humidity and temperature prevailing determine the rates at which respiratory aerosols and droplets emitted from an expiratory event (sneezing, coughing, etc.) evaporate to form smaller droplets or aerosols, or experience hygroscopic growth. Gravitational settling of droplets may result in contamination of environmental surfaces (fomites). Depending upon human, animal and mechanical activities in the occupied space indoors, viruses deposited on environmental surfaces may be re-aerosolized (re-suspended) to contribute to aerosols, and can be conveyed on aerial particulate matter such as dust and allergens. The transmission of respiratory viruses may then best be viewed as resulting from dynamic virus spread from infected individuals to susceptible individuals by various physical states of active respiratory emissions, instead of the current paradigm that emphasizes separate dissemination by respiratory droplets, aerosols or by contaminated fomites. To achieve the optimum outcome in terms of risk mitigation and infection prevention and control (IPAC) during seasonal infection peaks, outbreaks, and pandemics, this holistic view emphasizes the importance of dealing with all interdependent transmission modalities, rather than focusing on one modality.
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Affiliation(s)
- M. Khalid Ijaz
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, United States of America
| | - Syed A. Sattar
- Department of Biochemistry, Microbiology & Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Stephanie A. Boone
- Water & Energy Sustainable Technology Center, University of Arizona, Tucson, AZ, United States of America
| | - Julie McKinney
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, United States of America
| | - Charles P. Gerba
- Water & Energy Sustainable Technology Center, University of Arizona, Tucson, AZ, United States of America
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6
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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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7
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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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8
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Li H, Nannu Shankar S, Witanachchi CT, Lednicky JA, Loeb JC, Alam MM, Fan ZH, Lauzardo M, Mohamed K, Eiguren-Fernandez A, Wu CY. Lack of SARS-CoV-2 in environmental samples collected from September 2020-February 2021 in a university that followed CDC reopening guidance. HYGIENE AND ENVIRONMENTAL HEALTH ADVANCES 2023; 7:100061. [PMID: 37305381 PMCID: PMC10198740 DOI: 10.1016/j.heha.2023.100061] [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: 07/25/2022] [Revised: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023]
Abstract
This study aimed to provide environmental surveillance data for evaluating the risk of acquiring SARS-CoV-2 in public areas with high foot traffic in a university. Air and surface samples were collected at a university that had the second highest number of COVID-19 cases among public higher education institutions in the U.S. during Fall 2020. A total of 60 samples were collected in 16 sampling events performed during Fall 2020 and Spring 2021. Nearly 9800 students traversed the sites during the study period. SARS-CoV-2 was not detected in any air or surface samples. The university followed CDC guidance, including COVID-19 testing, case investigations, and contact tracing. Students, faculty, and staff were asked to maintain physical distancing and wear face coverings. Although COVID-19 cases were relatively high at the university, the possibility of acquiring SARS-CoV-2 infections at the sites tested was low.
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Affiliation(s)
- Hongwan Li
- Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, USA
- Department of Environmental Engineering Sciences, University of Florida, USA
| | | | | | - John A Lednicky
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Julia C Loeb
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Md Mahbubul Alam
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Z Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | - Michael Lauzardo
- Emerging Pathogens Institute, University of Florida, USA
- Department of Medicine, University of Florida, USA
| | - Karim Mohamed
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, USA
- Department of Chemical, Environmental and Materials Engineering, University of Miami, USA
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9
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Puthussery JV, Ghumra DP, McBrearty KR, Doherty BM, Sumlin BJ, Sarabandi A, Mandal AG, Shetty NJ, Gardiner WD, Magrecki JP, Brody DL, Esparza TJ, Bricker TL, Boon ACM, Yuede CM, Cirrito JR, Chakrabarty RK. Real-time environmental surveillance of SARS-CoV-2 aerosols. Nat Commun 2023; 14:3692. [PMID: 37429842 DOI: 10.1038/s41467-023-39419-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/12/2023] [Indexed: 07/12/2023] Open
Abstract
Real-time surveillance of airborne SARS-CoV-2 virus is a technological gap that has eluded the scientific community since the beginning of the COVID-19 pandemic. Offline air sampling techniques for SARS-CoV-2 detection suffer from longer turnaround times and require skilled labor. Here, we present a proof-of-concept pathogen Air Quality (pAQ) monitor for real-time (5 min time resolution) direct detection of SARS-CoV-2 aerosols. The system synergistically integrates a high flow (~1000 lpm) wet cyclone air sampler and a nanobody-based ultrasensitive micro-immunoelectrode biosensor. The wet cyclone showed comparable or better virus sampling performance than commercially available samplers. Laboratory experiments demonstrate a device sensitivity of 77-83% and a limit of detection of 7-35 viral RNA copies/m3 of air. Our pAQ monitor is suited for point-of-need surveillance of SARS-CoV-2 variants in indoor environments and can be adapted for multiplexed detection of other respiratory pathogens of interest. Widespread adoption of such technology could assist public health officials with implementing rapid disease control measures.
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Affiliation(s)
- Joseph V Puthussery
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Dishit P Ghumra
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Kevin R McBrearty
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA
| | - Brookelyn M Doherty
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA
| | - Benjamin J Sumlin
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Amirhossein Sarabandi
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Anushka Garg Mandal
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
- Department of Chemical Engineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Nishit J Shetty
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
- Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Woodrow D Gardiner
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA
| | - Jordan P Magrecki
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA
| | - David L Brody
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Thomas J Esparza
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Traci L Bricker
- Department of Medicine, Washington University, St. Louis, MO, 63110, USA
| | - Adrianus C M Boon
- Department of Medicine, Washington University, St. Louis, MO, 63110, USA
- Departments Molecular Microbiology, and Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carla M Yuede
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA.
| | - John R Cirrito
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA.
| | - Rajan K Chakrabarty
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA.
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10
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Santarpia JL, Klug E, Ravnholdt A, Kinahan SM. Environmental sampling for disease surveillance: Recent advances and recommendations for best practice. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2023; 73:434-461. [PMID: 37224401 DOI: 10.1080/10962247.2023.2197825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/15/2023] [Accepted: 03/10/2023] [Indexed: 05/26/2023]
Abstract
The study of infectious diseases includes both the progression of the disease in its host and how it transmits between hosts. Understanding disease transmission is important for recommending effective interventions, protecting healthcare workers, and informing an effective public health response. Sampling the environment for infectious diseases is critical to public health since it can provide an understanding of the mechanisms of transmission, characterization of contamination in hospitals and other public areas, and the spread of a disease within a community. Measurements of biological aerosols, particularly those that may cause disease, have been an ongoing topic of research for decades, and so a wide variety of technological solutions exist. This wide field of possibilities can create confusion, particularly when different approaches yield different answers. Therefore, guidelines for best practice in this area are important to allow more effective use of this data in public health decisions. This review examines air, surface and water/wastewater sampling methods, with a focus on aerosol sampling, and a goal of recommending approaches to designing and implementing sampling systems that may incorporate multiple strategies. This is accomplished by developing a framework for designing and evaluating a sampling strategy, reviewing current practices and emerging technologies for sampling and analysis, and recommending guidelines for best practice in the area of aerosol sampling for infectious disease.
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Affiliation(s)
- Joshua L Santarpia
- The Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
- National Strategic Research Institute, Omaha, NE, USA
| | - Elizabeth Klug
- The Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ashley Ravnholdt
- The Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sean M Kinahan
- The Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
- National Strategic Research Institute, Omaha, NE, USA
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11
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Bas M. The impact of the COVID-19 pandemic on the residential real estate market on the example of Szczecin, Poland. PROCEDIA COMPUTER SCIENCE 2022; 207:2048-2058. [PMID: 36275369 PMCID: PMC9578926 DOI: 10.1016/j.procs.2022.09.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this article is to assess the impact of the socio-economic situation caused by the COVID-19 pandemic on the residential property market. Research in this area has been conducted all over the world. The conclusions of these studies are inconclusive. In different countries and different cities, the changes in the property markets observed from 2020 onwards differ. These differences concern both prices and the number of transactions. In this situation, it is important to conduct research in as many markets as possible. Summaries of such research will allow certain patterns to be identified, which will provide a global perspective on how the COVID-19 pandemic has affected the property market. The paper describes the short-term changes that have occurred in the formation of residential property prices and the number of transactions concluded. Separate analyses were conducted for property sales and rental transactions. The research was carried out on the data of over 5000 transactions in one of the biggest Polish cities - Szczecin. The city is divided administratively into four districts, which was also taken into account in the study. This made it possible to assess whether, just as the impact of the pandemic varied between cities and countries, it also varied at district level within one city. Confirming the diversity of impact will allow conclusions to be drawn as to whether the pandemic affects each market equally or whether different property markets are affected differently by restrictions and changes in the decisions of property market participants.
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Affiliation(s)
- Marcin Bas
- University of Szczecin, Institute of Economics and Finance, 71-101 Szczecin, Mickiewicza 64, Poland
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12
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Oksanen LAH, Virtanen J, Sanmark E, Rantanen N, Venkat V, Sofieva S, Aaltonen K, Kivistö I, Svirskaite J, Pérez AD, Kuula J, Levanov L, Hyvärinen A, Maunula L, Atanasova NS, Laitinen S, Anttila V, Lehtonen L, Lappalainen M, Geneid A, Sironen T. SARS-CoV-2 indoor environment contamination with epidemiological and experimental investigations. INDOOR AIR 2022; 32:e13118. [PMID: 36305066 PMCID: PMC9828560 DOI: 10.1111/ina.13118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/25/2022] [Accepted: 09/06/2022] [Indexed: 05/02/2023]
Abstract
SARS-CoV-2 has been detected both in air and on surfaces, but questions remain about the patient-specific and environmental factors affecting virus transmission. Additionally, more detailed information on viral sampling of the air is needed. This prospective cohort study (N = 56) presents results from 258 air and 252 surface samples from the surroundings of 23 hospitalized and eight home-treated COVID-19 index patients between July 2020 and March 2021 and compares the results between the measured environments and patient factors. Additionally, epidemiological and experimental investigations were performed. The proportions of qRT-PCR-positive air (10.7% hospital/17.6% homes) and surface samples (8.8%/12.9%) showed statistical similarity in hospital and homes. Significant SARS-CoV-2 air contamination was observed in a large (655.25 m3 ) mechanically ventilated (1.67 air changes per hour, 32.4-421 L/s/patient) patient hall even with only two patients present. All positive air samples were obtained in the absence of aerosol-generating procedures. In four cases, positive environmental samples were detected after the patients had developed a neutralizing IgG response. SARS-CoV-2 RNA was detected in the following particle sizes: 0.65-4.7 μm, 7.0-12.0 μm, >10 μm, and <100 μm. Appropriate infection control against airborne and surface transmission routes is needed in both environments, even after antibody production has begun.
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Affiliation(s)
- Lotta‐Maria A. H. Oksanen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
| | - Jenni Virtanen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Enni Sanmark
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
| | - Noora Rantanen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
| | - Vinaya Venkat
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Svetlana Sofieva
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
- Finnish Meteorological InstituteHelsinkiFinland
| | - Kirsi Aaltonen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Ilkka Kivistö
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Julija Svirskaite
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | | | - Joel Kuula
- Finnish Meteorological InstituteHelsinkiFinland
| | - Lev Levanov
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | | | - Leena Maunula
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Nina S. Atanasova
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
- Finnish Meteorological InstituteHelsinkiFinland
| | | | - Veli‐Jukka Anttila
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- HUS Inflammation CenterHelsinki University HospitalHelsinkiFinland
| | - Lasse Lehtonen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- HUS Diagnostic Center, HUSLABHelsinki University HospitalHelsinkiFinland
| | - Maija Lappalainen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- HUS Diagnostic Center, HUSLABHelsinki University HospitalHelsinkiFinland
| | - Ahmed Geneid
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
| | - Tarja Sironen
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
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13
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Köberlein M, Hermann L, Gantner S, Tur B, Peters G, Westphalen C, Benthaus T, Döllinger M, Kniesburges S, Echternach M. Impulse dispersion of aerosols during playing the recorder and evaluation of safety measures. PLoS One 2022; 17:e0266991. [PMID: 36156597 PMCID: PMC9512216 DOI: 10.1371/journal.pone.0266991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/09/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Group musical activities using wind instruments have been restricted during the CoVID19 pandemic due to suspected higher risk of virus transmission. It was presumed that the aerosols exhaled through the tubes while playing would be ejected over larger distances and spread into the room due to jet stream effects. In particular, the soprano recorder is widely used as an instrument in school classes, for beginners of all age groups in their musical education, in the context of leisure activities and in professional concert performances. Understanding the aerosol impulse dispersion characteristics of playing the soprano recorder could assist with the establishment of concepts for safe music-making. METHODS Five adult professionally trained soprano recorder players (4 female, 1 male) played four bars of the main theme of L. van Beethoven's "Ode to Joy" in low and in high octaves, as well as with 3 different potential protection devices in the high octave. For comparison they spoke the corresponding text by F. Schiller. Before each task, they inhaled .5 L of vapor from an e-cigarette filled with base liquid. The vapor cloud escaping during speaking or playing was recorded by cameras and its spread was measured as a function of time in the three spatial dimensions. The potential safety devices were rated for practicability with a questionnaire, and their influence on the sound was compared, generating a long-term average spectrum from the audio data. RESULTS When playing in the high octave, at the end of the task the clouds showed a median distance of 1.06 m to the front and .57 m diameter laterally (maxima: x: 1.35 m and y: .97 m). It was found that the clouds' expansion values in playing the recorder with and without safety measures are mostly lower when compared to the ordinary, raised speaking voice of the same subjects. The safety devices which covered the instrument did not show clear advantages and were rated as unpractical by the subjects. The most effective reduction of the cloud was reached when playing into a suction funnel. CONCLUSION The aerosol dispersion characteristics of soprano recorders seem comparable to clarinets. The tested safety devices which covered holes of the instrument did not show clear benefits.
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Affiliation(s)
- Marie Köberlein
- Department of Otorhinolaryngology, Division of Phoniatrics and Pediatric Audiology, University Hospital Ludwig-Maximilians Universität, Munich, Germany
| | - Laila Hermann
- Department of Otorhinolaryngology, Division of Phoniatrics and Pediatric Audiology, University Hospital Ludwig-Maximilians Universität, Munich, Germany
| | - Sophia Gantner
- Department of Otorhinolaryngology, Division of Phoniatrics and Pediatric Audiology, University Hospital Ludwig-Maximilians Universität, Munich, Germany
| | - Bogac Tur
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics and Pediatric Audiology, University Hospital Friedrich-Alexander-Universität, Erlangen, Germany
| | - Gregor Peters
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics and Pediatric Audiology, University Hospital Friedrich-Alexander-Universität, Erlangen, Germany
| | - Caroline Westphalen
- Department of Otorhinolaryngology, Division of Phoniatrics and Pediatric Audiology, University Hospital Ludwig-Maximilians Universität, Munich, Germany
| | - Tobias Benthaus
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital Ludwig-Maximilians-University, Munich, Germany
| | - Michael Döllinger
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics and Pediatric Audiology, University Hospital Friedrich-Alexander-Universität, Erlangen, Germany
| | - Stefan Kniesburges
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics and Pediatric Audiology, University Hospital Friedrich-Alexander-Universität, Erlangen, Germany
| | - Matthias Echternach
- Department of Otorhinolaryngology, Division of Phoniatrics and Pediatric Audiology, University Hospital Ludwig-Maximilians Universität, Munich, Germany
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14
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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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15
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Linde KJ, Wouters IM, Kluytmans JAJW, Kluytmans-van den Bergh MFQ, Pas SD, GeurtsvanKessel CH, Koopmans MPG, Meier M, Meijer P, Raben CR, Spithoven J, Tersteeg-Zijderveld MHG, Heederik DJJ, Dohmen W. Detection of SARS-CoV-2 in Air and on Surfaces in Rooms of Infected Nursing Home Residents. Ann Work Expo Health 2022; 67:129-140. [PMID: 36068657 PMCID: PMC9834894 DOI: 10.1093/annweh/wxac056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/12/2022] [Accepted: 07/29/2022] [Indexed: 01/14/2023] Open
Abstract
There is an ongoing debate on airborne transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as a risk factor for infection. In this study, the level of SARS-CoV-2 in air and on surfaces of SARS-CoV-2 infected nursing home residents was assessed to gain insight in potential transmission routes. During outbreaks, air samples were collected using three different active and one passive air sampling technique in rooms of infected patients. Oropharyngeal swabs (OPS) of the residents and dry surface swabs were collected. Additionally, longitudinal passive air samples were collected during a period of 4 months in common areas of the wards. Presence of SARS-CoV-2 RNA was determined using RT-qPCR, targeting the RdRp- and E-genes. OPS, samples of two active air samplers and surface swabs with Ct-value ≤35 were tested for the presence of infectious virus by cell culture. In total, 360 air and 319 surface samples from patient rooms and common areas were collected. In rooms of 10 residents with detected SARS-CoV-2 RNA in OPS, SARS-CoV-2 RNA was detected in 93 of 184 collected environmental samples (50.5%) (lowest Ct 29.5), substantially more than in the rooms of residents with negative OPS on the day of environmental sampling (n = 2) (3.6%). SARS-CoV-2 RNA was most frequently present in the larger particle size fractions [>4 μm 60% (6/10); 1-4 μm 50% (5/10); <1 μm 20% (2/10)] (Fischer exact test P = 0.076). The highest proportion of RNA-positive air samples on room level was found with a filtration-based sampler 80% (8/10) and the cyclone-based sampler 70% (7/10), and impingement-based sampler 50% (5/10). SARS-CoV-2 RNA was detected in 10 out of 12 (83%) passive air samples in patient rooms. Both high-touch and low-touch surfaces contained SARS-CoV-2 genome in rooms of residents with positive OPS [high 38% (21/55); low 50% (22/44)]. In one active air sample, infectious virus in vitro was detected. In conclusion, SARS-CoV-2 is frequently detected in air and on surfaces in the immediate surroundings of room-isolated COVID-19 patients, providing evidence of environmental contamination. The environmental contamination of SARS-CoV-2 and infectious aerosols confirm the potential for transmission via air up to several meters.
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Affiliation(s)
- Kimberly J Linde
- Author to whom correspondence should be addressed. Tel: +31302535358; e-mail:
| | - Inge M Wouters
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jan A J W Kluytmans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjolein F Q Kluytmans-van den Bergh
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands,Department of Infection Control, Amphia Hospital, Breda, The Netherlands
| | - Suzan D Pas
- Microvida Location Amphia/Bravis, Breda/Roosendaal, The Netherlands
| | | | | | | | - Patrick Meijer
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ceder R Raben
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jack Spithoven
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | | | - Dick J J Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Wietske Dohmen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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16
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Vass WB, Lednicky JA, Shankar SN, Fan ZH, Eiguren-Fernandez A, Wu CY. Viable SARS-CoV-2 Delta variant detected in aerosols in a residential setting with a self-isolating college student with COVID-19. JOURNAL OF AEROSOL SCIENCE 2022; 165:106038. [PMID: 35774447 PMCID: PMC9217630 DOI: 10.1016/j.jaerosci.2022.106038] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 05/08/2023]
Abstract
The B.1.617.2 (Delta) variant of SARS-CoV-2 emerged in India in October of 2020 and spread widely to over 145 countries, comprising over 99% of genome sequence-confirmed virus in COVID-19 cases of the United States (US) by September 2021. The rise in COVID-19 cases due to the Delta variant coincided with a return to in-person school attendance, straining COVID-19 mitigation plans implemented by educational institutions. Some plans required sick students to self-isolate off-campus, resulting in an unintended consequence: exposure of co-inhabitants of dwellings used by the sick person during isolation. We assessed air and surface samples collected from the bedroom of a self-isolating university student with mild COVID-19 for the presence of SARS-CoV-2. That virus' RNA was detected by real-time reverse-transcription quantitative polymerase chain reaction (rRT-qPCR) in air samples from both an isolation bedroom and a distal, non-isolation room of the same dwelling. SARS-CoV-2 was detected and viable virus was isolated in cell cultures from aerosol samples as well as from the surface of a mobile phone. Genomic sequencing revealed that the virus was a Delta variant SARS-CoV-2 strain. Taken together, the results of this work confirm the presence of viable SARS-CoV-2 within a residential living space of a person with COVID-19 and show potential for transportation of virus-laden aerosols beyond a designated isolation suite to other areas of a single-family home.
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Affiliation(s)
- William B Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| | - John A Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| | - Z Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, 32611, USA
- Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
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17
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Snelling WJ, Afkhami A, Turkington HL, Carlisle C, Cosby SL, Hamilton JWJ, Ternan NG, Dunlop PSM. Efficacy of single pass UVC air treatment for the inactivation of coronavirus, MS2 coliphage and Staphylococcus aureus bioaerosols. JOURNAL OF AEROSOL SCIENCE 2022; 164:106003. [PMID: 35496770 PMCID: PMC9040443 DOI: 10.1016/j.jaerosci.2022.106003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/17/2022] [Accepted: 04/20/2022] [Indexed: 05/03/2023]
Abstract
There is strong evidence that SARS-CoV-2 is spread predominantly by airborne transmission, with high viral loads released into the air as respiratory droplets and aerosols from the infected subject. The spread and persistence of SARS-CoV-2 in diverse indoor environments reinforces the urgent need to supplement distancing and PPE based approaches with effective engineering measures for microbial decontamination - thereby addressing the significant risk posed by aerosols. We hypothesized that a portable, single-pass UVC air treatment device (air flow 1254 L/min) could effectively inactivate bioaerosols containing bacterial and viral indicator organisms, and coronavirus without reliance on filtration technology, at reasonable scale. Robust experiments demonstrated UVC dose dependent inactivation of Staphylococcus aureus (UV rate constant (k) = 0.098 m2/J) and bacteriophage MS2, with up to 6-log MS2 reduction achieved in a single pass through the system (k = 0.119 m2/J). The inclusion of a PTFE diffuse reflector increased the effective UVC dose by up to 34% in comparison to a standard Al foil reflector (with identical lamp output), resulting in significant additional pathogen inactivation (1-log S. aureus and MS2, p < 0.001). Complete inactivation of bovine coronavirus bioaerosols was demonstrated through tissue culture infectivity (2.4-log reduction) and RT-qPCR analysis - confirming single pass UVC treatment to effectively deactivate coronavirus to the limit of detection of the culture-based method. Scenario-based modelling was used to investigate the reduction in risk of airborne person-to-person transmission based upon a single infected subject within the small room. Use of the system providing 5 air changes per hour was shown to significantly reduce airborne viral load and maintain low numbers of RNA copies when the infected subject remained in the room, reducing the risk of airborne pathogen transmission to other room users. We conclude that the application of single-pass UVC systems (without reliance on HEPA filtration) could play a critical role in reducing the risk of airborne pathogen transfer, including SARS-CoV2, in locations where adequate fresh air ventilation cannot be implemented.
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Affiliation(s)
- William J Snelling
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Coleraine, Co. Londonderry, Northern Ireland, United Kingdom
| | - Arsalan Afkhami
- Nanotechnology and Integrated BioEngineering Centre (NIBEC), Ulster University, Newtownabbey, Northern Ireland, United Kingdom
| | - Hannah L Turkington
- Veterinary Sciences Division, Agri-Food and Biosciences Institute, Stormont, Belfast, Northern Ireland, United Kingdom
| | - Claire Carlisle
- Veterinary Sciences Division, Agri-Food and Biosciences Institute, Stormont, Belfast, Northern Ireland, United Kingdom
| | - S Louise Cosby
- Veterinary Sciences Division, Agri-Food and Biosciences Institute, Stormont, Belfast, Northern Ireland, United Kingdom
| | - Jeremy W J Hamilton
- Nanotechnology and Integrated BioEngineering Centre (NIBEC), Ulster University, Newtownabbey, Northern Ireland, United Kingdom
| | - Nigel G Ternan
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Coleraine, Co. Londonderry, Northern Ireland, United Kingdom
| | - Patrick S M Dunlop
- Nanotechnology and Integrated BioEngineering Centre (NIBEC), Ulster University, Newtownabbey, Northern Ireland, United Kingdom
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18
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Silva PG, Branco PTBS, Soares RRG, Mesquita JR, Sousa SIV. SARS-CoV-2 air sampling: A systematic review on the methodologies for detection and infectivity. INDOOR AIR 2022; 32:e13083. [PMID: 36040285 PMCID: PMC9538005 DOI: 10.1111/ina.13083] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
This systematic review aims to present an overview of the current aerosol sampling methods (and equipment) being used to investigate the presence of SARS-CoV-2 in the air, along with the main parameters reported in the studies that are essential to analyze the advantages and disadvantages of each method and perspectives for future research regarding this mode of transmission. A systematic literature review was performed on PubMed/MEDLINE, Web of Science, and Scopus to assess the current air sampling methodologies being applied to SARS-CoV-2. Most of the studies took place in indoor environments and healthcare settings and included air and environmental sampling. The collection mechanisms used were impinger, cyclone, impactor, filters, water-based condensation, and passive sampling. Most of the reviewed studies used RT-PCR to test the presence of SARS-CoV-2 RNA in the collected samples. SARS-CoV-2 RNA was detected with all collection mechanisms. From the studies detecting the presence of SARS-CoV-2 RNA, fourteen assessed infectivity. Five studies detected viable viruses using impactor, water-based condensation, and cyclone collection mechanisms. There is a need for a standardized protocol for sampling SARS-CoV-2 in air, which should also account for other influencing parameters, including air exchange ratio in the room sampled, relative humidity, temperature, and lighting conditions.
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Affiliation(s)
- Priscilla G Silva
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Pedro T B S Branco
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Ruben R G Soares
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Solna, Sweden
- Division of Nanobiotechnology, Department of Protein Science, Science for Life Laboratory, KTH Royal Institute of Technology, Solna, Sweden
| | - João R Mesquita
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Sofia I V Sousa
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
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19
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Moharir SC, Thota SC, Goel A, Thakur B, Tandel D, Reddy SM, Vodapalli A, Singh Bhalla G, Kumar D, Singh Naruka D, Kumar A, Tuli A, Suravaram S, Chander Bingi T, Srinivas M, Mesipogu R, Reddy K, Khosla S, Harshan KH, Bharadwaj Tallapaka K, Mishra RK. Detection of SARS-CoV-2 in the air in Indian hospitals and houses of COVID-19 patients. JOURNAL OF AEROSOL SCIENCE 2022; 164:106002. [PMID: 35495416 PMCID: PMC9040488 DOI: 10.1016/j.jaerosci.2022.106002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 05/05/2023]
Abstract
To understand the transmission characteristics of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) through air, samples from different locations occupied by coronavirus disease (COVID-19) patients were analyzed. Three sampling strategies were used to understand the presence of virus in the air in different environmental conditions. In the first strategy, which involved hospital settings, air samples were collected from several areas of hospitals like COVID-intensive-care units (ICUs), nurse-stations, COVID-wards, corridors, non-COVID-wards, personal protective equipment (PPE) doffing areas, COVID rooms, out-patient (OP) corridors, mortuary, COVID casualty areas, non-COVID ICUs and doctors' rooms. Out of the 80 air samples collected from 6 hospitals from two Indian cities- Hyderabad and Mohali, 30 samples showed the presence of SARS-CoV-2 nucleic acids. In the second sampling strategy, that involved indoor settings, one or more COVID-19 patients were asked to spend a short duration of time in a closed room. Out of 17 samples, 5 samples, including 4 samples collected after the departure of three symptomatic patients from the room, showed the presence of SARS-CoV-2 nucleic acids. In the third strategy, involving indoor settings, air samples were collected from rooms of houses of home-quarantined COVID-19 patients and it was observed that SARS-CoV-2 RNA could be detected in the air in the rooms occupied by COVID-19 patients but not in the other rooms of the houses. Taken together, we observed that the air around COVID-19 patients frequently showed the presence of SARS-CoV-2 RNA in both hospital and indoor residential settings and the positivity rate was higher when 2 or more COVID-19 patients occupied the room. In hospitals, SARS-CoV-2 RNA could be detected in ICUs as well as in non-ICUs, suggesting that the viral shedding happened irrespective of the severity of the infection. This study provides evidence for the viability of SARS-CoV-2 and its long-range transport through the air. Thus, airborne transmission could be a major mode of transmission for SARS-CoV-2 and appropriate precautions need to be followed to prevent the spread of infection through the air.
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Affiliation(s)
- Shivranjani C Moharir
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
- The Tata Institute for Genetics and Society, Bangalore, 560065, India
| | - Sharath Chandra Thota
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | - Arushi Goel
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | - Bhuwaneshwar Thakur
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | - Dixit Tandel
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | - S Mahesh Reddy
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | - Amareshwar Vodapalli
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | | | - Dinesh Kumar
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | | | - Ashwani Kumar
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | - Amit Tuli
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | | | | | - M Srinivas
- ESI Hospital and Medical College, Hyderabad, 500018, India
| | | | - Krishna Reddy
- Durgabai Deshmukh Hospital, Hyderabad, 500044, India
| | - Sanjeev Khosla
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | - Krishnan H Harshan
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | | | - Rakesh K Mishra
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
- The Tata Institute for Genetics and Society, Bangalore, 560065, India
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20
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Manibusan S, Mainelis G. Passive Bioaerosol Samplers: A Complementary Tool for Bioaerosol Research. A Review. JOURNAL OF AEROSOL SCIENCE 2022; 163:105992. [PMID: 36386279 PMCID: PMC9648171 DOI: 10.1016/j.jaerosci.2022.105992] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Bioaerosols consist of airborne particles of biological origin. They play an important role in our environment and may cause negative health effects. The presence of biological aerosol is typically determined using active samplers. While passive bioaerosol samplers are used much less frequently in bioaerosol investigations, they offer certain advantages, such as simple design, low cost, and long sampling duration. This review discusses different types of passive bioaerosol samplers, including their collection mechanisms, advantages and disadvantages, applicability in different sampling environments, and available sample elution and analysis methods. Most passive samplers are based on gravitational settling and electrostatic capture mechanism or their combination. We discuss the agar settle plate, dustfall collector, Personal Aeroallergen Sampler (PAAS), and settling filters among the gravity-based samplers. The described electrostatics-based samplers include electrostatic dust cloths (EDC) and Rutgers Electrostatic Passive Sampler (REPS). In addition, the review also discusses passive opportunity samplers using preexisting airflow, such as filters in HVAC systems. Overall, passive bioaerosol sampling technologies are inexpensive, easy to operate, and can continuously sample for days and even weeks which is not easily accomplished by active sampling devices. Although passive sampling devices are usually treated as qualitative tools, they still provide information about bioaerosol presence and diversity, especially over longer time scales. Overall, this review suggests that the use of passive bioaerosol samplers alongside active collection devices can aid researchers in developing a more comprehensive understanding of biological presence and dynamics, especially over extended time scales and multiple locations.
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Affiliation(s)
- Sydonia Manibusan
- Department of Environmental Sciences, Rutgers, The State University of New Jersey, 14 College Farm Road, New Brunswick, New Jersey 08901-8551, USA
| | - Gediminas Mainelis
- Department of Environmental Sciences, Rutgers, The State University of New Jersey, 14 College Farm Road, New Brunswick, New Jersey 08901-8551, USA
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21
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Tao Y, Zhang X, Qiu G, Spillmann M, Ji Z, Wang J. SARS-CoV-2 and other airborne respiratory viruses in outdoor aerosols in three Swiss cities before and during the first wave of the COVID-19 pandemic. ENVIRONMENT INTERNATIONAL 2022; 164:107266. [PMID: 35512527 PMCID: PMC9060371 DOI: 10.1016/j.envint.2022.107266] [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: 02/21/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 05/02/2023]
Abstract
Caused by the SARS-CoV-2 virus, Coronavirus disease 2019 (COVID-19) has been affecting the world since the end of 2019. While virus-laden particles have been commonly detected and studied in the aerosol samples from indoor healthcare settings, studies are scarce on air surveillance of the virus in outdoor non-healthcare environments, including the correlations between SARS-CoV-2 and other respiratory viruses, between viruses and environmental factors, and between viruses and human behavior changes due to the public health measures against COVID-19. Therefore, in this study, we collected airborne particulate matter (PM) samples from November 2019 to April 2020 in Bern, Lugano, and Zurich. Among 14 detected viruses, influenza A, HCoV-NL63, HCoV-HKU1, and HCoV-229E were abundant in air. SARS-CoV-2 and enterovirus were moderately common, while the remaining viruses occurred only in low concentrations. SARS-CoV-2 was detected in PM10 (PM below 10 µm) samples of Bern and Zurich, and PM2.5 (PM below 2.5 µm) samples of Bern which exhibited a concentration positively correlated with the local COVID-19 case number. The concentration was also correlated with the concentration of enterovirus which raised the concern of coinfection. The estimated COVID-19 infection risks of an hour exposure at these two sites were generally low but still cannot be neglected. Our study demonstrated the potential functionality of outdoor air surveillance of airborne respiratory viruses, especially at transportation hubs and traffic arteries.
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Affiliation(s)
- Yile Tao
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Xiaole Zhang
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Guangyu Qiu
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Martin Spillmann
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Zheng Ji
- School of Geography and Tourism, Shaanxi Normal University, Xi'an 710119, China
| | - Jing Wang
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland.
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22
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Firle C, Steinmetz A, Stier O, Stengel D, Ekkernkamp A. Aerosol emission from playing wind instruments and related COVID-19 infection risk during music performance. Sci Rep 2022; 12:8598. [PMID: 35597808 PMCID: PMC9124212 DOI: 10.1038/s41598-022-12529-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 04/29/2022] [Indexed: 12/29/2022] Open
Abstract
The pandemic of COVID-19 led to restrictions in all kinds of music activities. Airborne transmission of SARS-CoV-2 requires risk assessment of wind instrument playing in various situations. Previous studies focused on short-range transmission, whereas long-range transmission risk has not been assessed. The latter requires knowledge of aerosol emission rates from wind instrument playing. We measured aerosol concentrations in a hermetically closed chamber of 20 m3 in an operating theatre as resulting from 20 min standardized wind instrument playing (19 flute, 11 oboe, 1 clarinet, 1 trumpet players). We calculated aerosol emission rates showing uniform distribution for both instrument groups. Aerosol emission from wind instrument playing ranged from 11 ± 288 particles/second (P/s) up to 2535 ± 195 P/s, expectation value ± uncertainty standard deviation. The analysis of aerosol particle size distributions shows that 70-80% of emitted particles had a size of 0.25-0.8 µm and thus are alveolar. Masking the bell with a surgical mask did not reduce aerosol emission. Aerosol emission rates were higher from wind instrument playing than from speaking or breathing. Differences between instrumental groups could not be found but high interindividual variance, as expressed by uniform distribution of aerosol emission rates. Our findings indicate that aerosol emission depends on physiological factors and playing techniques rather than on the type of instrument, in contrast to some previous studies. Based on our results, we present transmission risk calculations for long-range transmission of COVID-19 for three typical woodwind playing situations.
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Affiliation(s)
- Carl Firle
- GP Practice, Dr. Claudia-Isabella Wildfeuer, 10715, Berlin, Germany.
| | - Anke Steinmetz
- Physical and Rehabilitation Medicine, Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Dirk Stengel
- BG Kliniken-Klinikverbund Der Gesetzlichen Unfallversicherung gGmbH, Berlin, Germany
- BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Axel Ekkernkamp
- Physical and Rehabilitation Medicine, Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Trauma, Reconstructive Surgery, and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
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23
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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.
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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
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24
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Rufino de Sousa N, Steponaviciute L, Margerie L, Nissen K, Kjellin M, Reinius B, Salaneck E, Udekwu KI, Rothfuchs AG. Detection and isolation of airborne SARS-CoV-2 in a hospital setting. INDOOR AIR 2022; 32:e13023. [PMID: 35347788 PMCID: PMC9111425 DOI: 10.1111/ina.13023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/21/2022] [Accepted: 03/10/2022] [Indexed: 05/15/2023]
Abstract
Transmission mechanisms for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are incompletely understood. In particular, aerosol transmission remains unclear, with viral detection in air and demonstration of its infection potential being actively investigated. To this end, we employed a novel electrostatic collector to sample air from rooms occupied by COVID-19 patients in a major Swedish hospital. Electrostatic air sampling in conjunction with extraction-free, reverse-transcriptase polymerase chain reaction (hid-RT-PCR) enabled detection of SARS-CoV-2 in air from patient rooms (9/22; 41%) and adjoining anterooms (10/22; 45%). Detection with hid-RT-PCR was concomitant with viral RNA presence on the surface of exhaust ventilation channels in patients and anterooms more than 2 m from the COVID-19 patient. Importantly, it was possible to detect active SARS-CoV-2 particles from room air, with a total of 496 plaque-forming units (PFUs) being isolated, establishing the presence of infectious, airborne SARS-CoV-2 in rooms occupied by COVID-19 patients. Our results support circulation of SARS-CoV-2 via aerosols and urge the revision of existing infection control frameworks to include airborne transmission.
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Affiliation(s)
- Nuno Rufino de Sousa
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Laura Steponaviciute
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Lucille Margerie
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Karolina Nissen
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Midori Kjellin
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Björn Reinius
- Department of Medical Biochemistry and Biophysics (MBB)Karolinska InstitutetStockholmSweden
| | - Erik Salaneck
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Klas I. Udekwu
- Department of Aquatic Sciences and AssessmentSwedish University of Agricultural SciencesUppsalaSweden
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