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Moura CRF, Garcia BCC, de Oliveira Ottone V, Brito PL, Silva TJ, Cantuária VL, de Oliveira DB, Rocha-Vieira E. SARS-CoV-2 genome incidence on the inanimate surface of the material used in the flow of biological samples from the collection point to the testing unit. Ir J Med Sci 2024; 193:1369-1375. [PMID: 37882949 DOI: 10.1007/s11845-023-03554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
Despite the undeniable effect of vaccination against COVID-19 in reducing disease severity, there is still a need to monitor and limit SARS-CoV-2 circulation and transmission. Thus, this study evaluated the presence of the SARS-CoV-2 genome on the surfaces of highly touched objects manipulated in the biological sample collection point and at the reception unit of the diagnostic laboratory. Surfaces were sampled once a week, for 6 weeks, between September 18th and October 23rd, 2020. RT-qPCR was used for SARS-CoV-2 detection. The coolers for biological sample transportation and the envelope containing the patient form were the objects with the highest occurrence of viral genome detection, although it was detected in each object in only two of the 6 evaluations. And the SARS-CoV-2 genome was detected just once on the vehicle steering wheel, computer keyboard, bathroom door handle and disinfection bench. The virus genome was not detected in any object on three of the six evaluations. And eight was the largest number of surfaces contaminated by the virus genome on one occasion. The reduced incidence of object contamination by the SARS-CoV-2 genome can be explained by the exposure of the objects to environmental conditions and the adoption of virus-spread containment measures. It can also reflect the low incidence of SARS-CoV-2 during the study's development period. Despite the low frequency of SARS-CoV-2 genome detection, our findings show that the virus was present in the environment at some point. This highlights the importance of adopting personal preventive measures to reduce respiratory virus spread, especially during epidemics and outbreaks.
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Affiliation(s)
- Cristiane Rocha Fagundes Moura
- Department of Basic Sciences, Faculty of Basic and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Bruna Caroline Chaves Garcia
- Multicentric Graduate Program on Physiological Sciences, Faculty of Basic and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Vinicius de Oliveira Ottone
- Multicentric Graduate Program on Physiological Sciences, Faculty of Basic and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
- Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Philipe Luan Brito
- Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Thyago José Silva
- Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
- Graduate Program on Health Sciences, Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Vinicius Lopes Cantuária
- Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
- Graduate Program on Health Sciences, Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Danilo Bretas de Oliveira
- Multicentric Graduate Program on Physiological Sciences, Faculty of Basic and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
- Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
- Graduate Program on Health Sciences, Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Etel Rocha-Vieira
- Multicentric Graduate Program on Physiological Sciences, Faculty of Basic and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
- Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
- Graduate Program on Health Sciences, Faculty of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
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Aranega-Bou P, Pottage T, Fenwick A, D'Costa W, Brown NF, Yaxley N, King MF, Parker ST, Miller D, López-García M, Noakes CJ, Moore G, Bennett A. A 17-month longitudinal surface sampling study carried out on public transport vehicles operating in England during the COVID-19 pandemic identified low levels of SARS-CoV-2 RNA contamination. J Appl Microbiol 2024; 135:lxae095. [PMID: 38637309 DOI: 10.1093/jambio/lxae095] [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: 12/20/2023] [Revised: 03/28/2024] [Accepted: 04/17/2024] [Indexed: 04/20/2024]
Abstract
AIMS To monitor severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA contamination in vehicles operating in England during the pandemic, to better understand transmission risk of SARS-CoV-2 on public transport. METHODS AND RESULTS We collected 1314 surface samples between December 2020 and April 2022 on trains and buses managed by five different transport operators. The presence of SARS-CoV-2 RNA was investigated through reverse transcription polymerase chain reaction (RT-PCR). SARS-CoV-2 RNA was found on 197 (15%) of the 1314 surfaces sampled, including seat head rests, handholds, and air extract grilles, but the levels of RNA recovered on those samples (median value of 23.4, interquartile range: 14.3-35.4, N gene copies per extraction) made the presence of infectious virus at the time of sampling extremely unlikely. However, detection rates varied over time with peaks broadly coinciding with times of high community transmission, when it was more likely that people infected with SARS-CoV-2 were travelling on public transport. CONCLUSION During the pandemic, and as in other public spaces, low levels of SARS-CoV-2 RNA were found on surfaces associated with public transport.
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Affiliation(s)
- Paz Aranega-Bou
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Thomas Pottage
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Abigail Fenwick
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Wilhemina D'Costa
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Natalie F Brown
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Nicola Yaxley
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Marco-Felipe King
- School of Civil Engineering, University of Leeds, Woodhouse Lane, LS29JT Leeds, United Kingdom
| | - Simon T Parker
- Defence Science and Technology Laboratory, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Daniel Miller
- Defence Science and Technology Laboratory, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Martín López-García
- School of Mathematics, University of Leeds, Woodhouse Lane, LS2 9JT Leeds , United Kingdom
| | - Catherine J Noakes
- School of Civil Engineering, University of Leeds, Woodhouse Lane, LS29JT Leeds, United Kingdom
| | - Ginny Moore
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
| | - Allan Bennett
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, SP4 0JG Salisbury, United Kingdom
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Lam T, Saso A, Torres Ortiz A, Hatcher J, Woodman M, Chandran S, Thistlethwayte R, Best T, Johnson M, Wagstaffe H, Mai A, Buckland M, Gilmour K, Goldblatt D, Grandjean L. Socioeconomic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study. Clin Infect Dis 2024; 78:594-602. [PMID: 37647517 PMCID: PMC10954340 DOI: 10.1093/cid/ciad522] [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: 05/08/2023] [Revised: 07/26/2023] [Accepted: 08/29/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND To protect healthcare workers (HCWs) from the consequences of disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is necessary to understand the risk factors that drive exposure and infection within hospitals. Insufficient consideration of key socioeconomic variables is a limitation of existing studies that can lead to bias and residual confounding of proposed risk factors for infection. METHODS The Co-STARs study prospectively enrolled 3679 HCWs between April 2020 and September 2020. We used multivariate logistic regression to comprehensively characterize the demographic, occupational, socioeconomic, and environmental risk factors for SARS-CoV-2 seropositivity. RESULTS After adjusting for key confounders, relative household overcrowding (odds ratio [OR], 1.4 [95% confidence interval {CI}, 1.1-1.9]; P = .006), Black, Black British, Caribbean, or African ethnicity (OR, 1.7 [95% CI, 1.2-2.3]; P = .003), increasing age (ages 50-60 years: OR, 1.8 [95% CI, 1.3-2.4]; P < .001), lack of access to sick pay (OR, 1.8 [95% CI, 1.3-2.4]; P < .001). CONCLUSIONS Socioeconomic and demographic factors outside the hospital were the main drivers of infection and exposure to SARS-CoV-2 during the first wave of the pandemic in an urban pediatric referral hospital. Overcrowding and out-of-hospital SARS-CoV-2 contact are less amenable to intervention. However, lack of access to sick pay among externally contracted staff is more easily rectifiable. Our findings suggest that providing easier access to sick pay would lead to a decrease in SARS-CoV-2 transmission and potentially that of other infectious diseases in hospital settings. CLINICAL TRIALS REGISTRATION NCT04380896.
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Affiliation(s)
- Tanya Lam
- Department of Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
| | - Anja Saso
- Department of Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
- Department of Tropical and Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Medical Research Council Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Arturo Torres Ortiz
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - James Hatcher
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - Marc Woodman
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Shruthi Chandran
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | | | - Timothy Best
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - Marina Johnson
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Helen Wagstaffe
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Annabelle Mai
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - Matthew Buckland
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - Kimberly Gilmour
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - David Goldblatt
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Louis Grandjean
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
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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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Barberá-Riera M, Barneo-Muñoz M, Gascó-Laborda JC, Bellido Blasco J, Porru S, Alfaro C, Esteve Cano V, Carrasco P, Rebagliato M, de Llanos R, Delgado-Saborit JM. Detection of SARS-CoV-2 in aerosols in long term care facilities and other indoor spaces with known COVID-19 outbreaks. ENVIRONMENTAL RESEARCH 2024; 242:117730. [PMID: 38000631 DOI: 10.1016/j.envres.2023.117730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Coronavirus outbreaks are likely to occur in crowded and congregate indoor spaces, and their effects are most severe in vulnerable long term care facilities (LTCFs) residents. Public health officers benefit from tools that allow them to control COVID-19 outbreaks in vulnerable settings such as LTCFs, but which could be translated in the future to control other known and future virus outbreaks. This study aims to develop and test a methodology based on detection of SARS-CoV-2 in aerosol samples collected with personal pumps that could be easily implemented by public health officers. The proposed methodology was used to investigate the levels of SARS-CoV-2 in aerosol in indoor settings, mainly focusing on LTCFs, suffering COVID-19 outbreaks, or in the presence of known COVID-19 cases, and targeting the initial days after diagnosis. Aerosol samples (N = 18) were collected between November 2020 and March 2022 in Castelló (Spain) from LTCFs, merchant ships and a private home with recently infected COVID-19 cases. Sampling was performed for 24-h, onto 47 mm polytetrafluoroethylene (PTFE) and quartz filters, connected to personal pumps at 2 and 4 L/min respectively. RNA from filters was extracted and SARS-CoV-2 was determined by detection of regions N1 and N2 of the nucleocapsid gene alongside the E gene using RT-PCR technique. SARS-CoV-2 genetic material was detected in 87.5% samples. Concentrations ranged ND-19,525 gc/m3 (gene E). No genetic traces were detected in rooms from contacts that were isolated as a preventative measure. Very high levels were also measured at locations with poor ventilation. Aerosol measurement conducted with the proposed methodology provided useful information to public health officers and contributed to manage and control 12 different COVID-19 outbreaks. SARS-CoV-2 was detected in aerosol samples collected during outbreaks in congregate spaces. Indoor aerosol sampling is a useful tool in the early detection and management of COVID-19 outbreaks and supports epidemiological investigations.
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Affiliation(s)
- M Barberá-Riera
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - M Barneo-Muñoz
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - J C Gascó-Laborda
- Epidemiology Division, Public Health Center, Castelló de la Plana, Spain
| | - J Bellido Blasco
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology Division, Public Health Center, Castelló de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - S Porru
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - C Alfaro
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - V Esteve Cano
- Department of Inorganic and Organic Chemistry, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - P Carrasco
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain
| | - M Rebagliato
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - R de Llanos
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain.
| | - J M Delgado-Saborit
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain.
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Reissner J, Siller P, Bartel A, Roesler U, Friese A. Stability of Feline Coronavirus in aerosols and dried in organic matrices on surfaces at various environmental conditions. Sci Rep 2023; 13:22012. [PMID: 38086913 PMCID: PMC10716419 DOI: 10.1038/s41598-023-49361-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
Enveloped respiratory viruses, including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can be transmitted through aerosols and contact with contaminated surfaces. The stability of these viruses outside the host significantly impacts their transmission dynamics and the spread of diseases. In this study, we investigated the tenacity of Feline Coronavirus (FCoV) in aerosols and on surfaces under varying environmental conditions. We found that airborne FCoV showed different stability depending on relative humidity (RH), with higher stability observed at low and high RH. Medium RH conditions (50-60%) were associated with increased loss of infectivity. Furthermore, FCoV remained infectious in the airborne state over 7 h. On stainless-steel surfaces, FCoV remained infectious for several months, with stability influenced by organic material and temperature. The presence of yeast extract and a temperature of 4 °C resulted in the longest maintenance of infectivity, with a 5 log10 reduction of the initial concentration after 167 days. At 20 °C, this reduction was achieved after 19 days. These findings highlight the potential risk of aerosol and contact transmission of respiratory viruses, especially in enclosed environments, over extended periods. Studying surrogate viruses like FCoV provides important insights into the behavior of zoonotic viruses like SARS-CoV-2 in the environment.
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Affiliation(s)
- Janina Reissner
- Institute of Animal Hygiene and Environmental Health, Veterinary Centre for Resistance Research-TZR, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany.
| | - Paul Siller
- Institute of Animal Hygiene and Environmental Health, Veterinary Centre for Resistance Research-TZR, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
- Federal Office of Consumer Protection and Food Safety, Department Veterinary Drugs, Mittelstraße 51-54, 10117, Berlin, Germany
| | - Alexander Bartel
- Institute of Veterinary Epidemiology and Biostatistics, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
| | - Uwe Roesler
- Institute of Animal Hygiene and Environmental Health, Veterinary Centre for Resistance Research-TZR, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
| | - Anika Friese
- Institute of Animal Hygiene and Environmental Health, Veterinary Centre for Resistance Research-TZR, School of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
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Xia T, Shi S, Yang J, Sun D, Suo J, Kuang H, Sun N, Hu H, Xiao J, Yan Z. Contamination dynamics of personal protective equipment (PPE) by SARS-CoV-2 RNA in a makeshift hospital with COVID-19 positive occupants. Infect Prev Pract 2023; 5:100309. [PMID: 37744681 PMCID: PMC10514403 DOI: 10.1016/j.infpip.2023.100309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Background Personal protective equipment (PPE) helps protect healthcare workers (HCWs) from infection and prevents cross-contamination. Knowledge of the contamination dynamics of PPE during the management of COVID-19 patients in a makeshift hospital is limited. Aim To describe the rate of SARS-CoV-2 contamination in PPE and to assess the change of contamination at different time points. Methods HCWs were followed up for up to 4 hours with hourly collection of swab samples from PPE surfaces in a makeshift COVID-19 hospital setting. Swabs were tested using quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA. Results SARS-CoV-2 was detected on 50.9% of the 1620 swabbed samples from 9 different sites of full-body PPE worn by HCWs. The proportion of sites contaminated with SARS-CoV-2 RNA varied from 10.6% to 95.6%. Viral RNA was most frequently detected from the sole of the outer foot cover (95.6%) and least frequently on the face shield (10.6%). The median Ct values among positive samples were 34.20 (IQR, 32.61-35.22) and 34.05 (IQR, 32.20-35.39) for ORF1ab and N genes, respectively. The highest rate of contamination with SARS-CoV-2 RNA for the PPE swab samples was found after 3 hours of use. The positive rate of outer surface of HEPA filters from air supply device was 82.1% during the full capacity period of the makeshift hospital. Conclusion A higher rate of contamination was identified at 3 hours after the entrance to the COVID-19 patient care area. Virus-containing aerosols were trapped in the HEPA filter of air supply equipment, representing a potential protective factor against infection to HCWs.
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Affiliation(s)
- Tingting Xia
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Shi Shi
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Jinyan Yang
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Dan Sun
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Jijiang Suo
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Huihui Kuang
- Department of Laboratory Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Nana Sun
- Department of Laboratory Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Hongyan Hu
- Department of Laboratory Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Jinhan Xiao
- Department of Rehabilitation Physiotherapy, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Zhongqiang Yan
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
- Department of Disease Prevention and Control, The Second Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
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8
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Pitol AK, Venkatesan S, Hoptroff M, Hughes GL. Persistence of SARS-CoV-2 and its surrogate, bacteriophage Phi6, on surfaces and in water. Appl Environ Microbiol 2023; 89:e0121923. [PMID: 37902315 PMCID: PMC10686083 DOI: 10.1128/aem.01219-23] [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: 07/17/2023] [Accepted: 09/13/2023] [Indexed: 10/31/2023] Open
Abstract
IMPORTANCE The COVID-19 pandemic spurred research on the persistence of SARS-CoV-2 and its surrogates. Here we highlight the importance of evaluating viral surrogates and experimental methodologies when studying pathogen survival in the environment.
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Affiliation(s)
- Ana K. Pitol
- Departments of Vector Biology and Tropical Disease Biology, Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Samiksha Venkatesan
- Departments of Vector Biology and Tropical Disease Biology, Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Michael Hoptroff
- Unilever Research and Development, Port Sunlight, United Kingdom
| | - Grant L. Hughes
- Departments of Vector Biology and Tropical Disease Biology, Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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9
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Nilsson PH, Al-Majdoub M, Ibrahim A, Aseel O, Suriyanarayanan S, Andersson L, Fostock S, Aastrup T, Tjernberg I, Rydén I, Nicholls IA. Quartz Crystal Microbalance Platform for SARS-CoV-2 Immuno-Diagnostics. Int J Mol Sci 2023; 24:16705. [PMID: 38069027 PMCID: PMC10705953 DOI: 10.3390/ijms242316705] [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: 08/31/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
Rapid and accurate serological analysis of SARS-CoV-2 antibodies is important for assessing immune protection from vaccination or infection of individuals and for projecting virus spread within a population. The quartz crystal microbalance (QCM) is a label-free flow-based sensor platform that offers an opportunity to detect the binding of a fluid-phase ligand to an immobilized target molecule in real time. A QCM-based assay was developed for the detection of SARS-CoV-2 antibody binding and evaluated for assay reproducibility. The assay was cross-compared to the Roche electrochemiluminescence assay (ECLIA) Elecsys® Anti-SARS-CoV-2 serology test kit and YHLO's chemiluminescence immunoassay (CLIA). The day-to-day reproducibility of the assay had a correlation of r2 = 0.99, p < 0.001. The assay linearity was r2 = 0.96, p < 0.001, for dilution in both serum and buffer. In the cross-comparison analysis of 119 human serum samples, 59 were positive in the Roche, 52 in the YHLO, and 48 in the QCM immunoassay. Despite differences in the detection method and antigen used for antibody capture, there was good coherence between the assays, 80-100% for positive and 96-100% for negative test results. In summation, the QCM-based SARS-CoV-2 IgG immunoassay showed high reproducibility and linearity, along with good coherence with the ELISA-based assays. Still, factors including antibody titer and antigen-binding affinity may differentially affect the various assays' responses.
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Affiliation(s)
- Per H. Nilsson
- Linnaeus University Centre for Biomaterials Chemistry, Department of Chemistry and Biomedical Sciences, Linnaeus University, SE-39182 Kalmar, Sweden; (P.H.N.); (S.S.); (L.A.)
- Department of Immunology, University of Oslo and Oslo University Hospital Rikshospitalet, Sognsvannsveien 20, NO-0372 Oslo, Norway
| | - Mahmoud Al-Majdoub
- Attana AB, Greta Arwidssons Väg 21, SE-11419 Stockholm, Sweden; (M.A.-M.); (A.I.); (S.F.); (T.A.)
| | - Ahmed Ibrahim
- Attana AB, Greta Arwidssons Väg 21, SE-11419 Stockholm, Sweden; (M.A.-M.); (A.I.); (S.F.); (T.A.)
| | - Obaidullah Aseel
- Medical Programme, Faculty of Medicine and Health Sciences, Linköping University, SE-58225 Linköping, Sweden;
| | - Subramanian Suriyanarayanan
- Linnaeus University Centre for Biomaterials Chemistry, Department of Chemistry and Biomedical Sciences, Linnaeus University, SE-39182 Kalmar, Sweden; (P.H.N.); (S.S.); (L.A.)
| | - Linnea Andersson
- Linnaeus University Centre for Biomaterials Chemistry, Department of Chemistry and Biomedical Sciences, Linnaeus University, SE-39182 Kalmar, Sweden; (P.H.N.); (S.S.); (L.A.)
| | - Samir Fostock
- Attana AB, Greta Arwidssons Väg 21, SE-11419 Stockholm, Sweden; (M.A.-M.); (A.I.); (S.F.); (T.A.)
| | - Teodor Aastrup
- Attana AB, Greta Arwidssons Väg 21, SE-11419 Stockholm, Sweden; (M.A.-M.); (A.I.); (S.F.); (T.A.)
| | - Ivar Tjernberg
- Department of Clinical Chemistry and Transfusion Medicine, Region Kalmar County, SE-39185 Kalmar, Sweden;
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linköping University, SE-58183 Linköping, Sweden
| | - Ingvar Rydén
- Department of Research, Region Kalmar County, SE-39185 Kalmar, Sweden;
- Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology, Linköping University, SE-58183 Linköping, Sweden
| | - Ian A. Nicholls
- Linnaeus University Centre for Biomaterials Chemistry, Department of Chemistry and Biomedical Sciences, Linnaeus University, SE-39182 Kalmar, Sweden; (P.H.N.); (S.S.); (L.A.)
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10
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Hardison RL, Lee SD, Limmer R, Marx J, Taylor BM, Barriga D, Nelson SW, Feliciano-Ruiz N, Stewart MJ, Calfee MW, James RR, Ryan SP, Howard MW. Sampling and recovery of infectious SARS-CoV-2 from high-touch surfaces by sponge stick and macrofoam swab. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:506-519. [PMID: 37382490 DOI: 10.1080/15459624.2023.2231516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Effective sampling for severe acute respiratory syndrome 2 (SARS-CoV-2) is a common approach for monitoring disinfection efficacy and effective environmental surveillance. This study evaluated sampling efficiency and limits of detection (LODs) of macrofoam swab and sponge stick sampling methods for recovering infectious SARS-CoV-2 and viral RNA (vRNA) from surfaces. Macrofoam swab and sponge stick methods were evaluated for collection of SARS-CoV-2 suspended in a soil load from 6-in2 coupons composed of four materials: stainless steel (SS), acrylonitrile butadiene styrene (ABS) plastic, bus seat fabric, and Formica. Recovery of infectious SARS-CoV-2 was more efficient than vRNA recovery on all materials except Formica (macrofoam swab sampling) and ABS (sponge stick sampling). Macrofoam swab sampling recovered significantly more vRNA from Formica than ABS and SS, and sponge stick sampling recovered significantly more vRNA from ABS than Formica and SS, suggesting that material and sampling method choice can affect surveillance results. Time since initial contamination significantly affected infectious virus recovery from all materials, with vRNA recovery showing limited to no difference, suggesting that SARS-CoV-2 vRNA can remain detectable after viral infectivity has dissipated. This study showed that a complex relationship exists between sampling method, material, time from contamination to sampling, and recovery of SARS-CoV-2. In conclusion, data show that careful consideration be used when selecting surface types for sampling and interpreting SARS-CoV-2 vRNA recovery with respect to presence of infectious virus.
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Affiliation(s)
| | - Sang Don Lee
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina
| | | | - Joel Marx
- Battelle Memorial Institute, Columbus, Ohio
| | | | | | | | | | - Michael J Stewart
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina
| | - M Worth Calfee
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina
| | | | - Shawn P Ryan
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina
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11
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Rashid SA, Nazakat R, Muhamad Robat R, Ismail R, Suppiah J, Rajendran K, Raj Louis Masalamany ASS, Muhamad Hendri NA, Mohamad N, Khairul Hasni NA, Suib FA, Nik Hassan NMN, Pahrol MA, Shaharudin R. Droplet digital PCR application for the detection of SARS-CoV-2 in air sample. Front Public Health 2023; 11:1208348. [PMID: 37965510 PMCID: PMC10641526 DOI: 10.3389/fpubh.2023.1208348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) may transmit through airborne route particularly when the aerosol particles remain in enclosed spaces with inadequate ventilation. There has been no standard recommended method of determining the virus in air due to limitations in pre-analytical and technical aspects. Furthermore, the presence of low virus loads in air samples could result in false negatives. Our study aims to explore the feasibility of detecting SARS-CoV-2 ribonucleic acid (RNA) in air samples using droplet digital polymerase chain reaction (ddPCR). Active and passive air sampling was conducted between December 2021 and February 2022 with the presence of COVID-19 confirmed cases in two hospitals and a quarantine center in Klang Valley, Malaysia. SARS-CoV-2 RNA in air was detected and quantified using ddPCR and real-time reverse transcriptase-polymerase chain reaction (RT-PCR). The comparability of two different digital PCR platforms (QX200 and QIAcuity) to RT-PCR were also investigated. Additionally negative staining transmission electron microscopy was performed to visualize virus ultrastructure. Detection rates of SARS-CoV-2 in air samples using ddPCR were higher compared to RT-PCR, which were 15.2% (22/145) and 3.4% (5/145), respectively. The sensitivity and specificity of ddPCR was 100 and 87%, respectively. After excluding 17 negative samples (50%) by both QX200 and QIAcuity, 15% samples (5/34) were found to be positive both ddPCR and dPCR. There were 23.5% (8/34) samples that were detected positive by ddPCR but negative by dPCR. In contrast, there were 11.7% (4/34) samples that were detected positive by dPCR but negative by ddPCR. The SARS-CoV-2 detection method by ddPCR is precise and has a high sensitivity for viral RNA detection. It could provide advances in determining low viral titter in air samples to reduce false negative reports, which could complement detection by RT-PCR.
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Affiliation(s)
- Siti Aishah Rashid
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Raheel Nazakat
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Rosnawati Muhamad Robat
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Jeyanthi Suppiah
- Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Kamesh Rajendran
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - A. S. Santhana Raj Louis Masalamany
- Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Nur Afrina Muhamad Hendri
- Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Nadia Mohamad
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Nurul Amalina Khairul Hasni
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Fatin Amirah Suib
- Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Nik Muhamad Nizam Nik Hassan
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Muhammad Alfatih Pahrol
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Rafiza Shaharudin
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
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12
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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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13
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Chen XE, Zhao C, Luo Y, Tang T, Chen W. Contamination of SARS-CoV-2 RNA on personal protective equipment and environmental surfaces in nonpatient entry area of a Fangcang shelter hospital. Am J Ind Med 2023; 66:805-812. [PMID: 37394558 DOI: 10.1002/ajim.23513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES To determine the extent of contamination of personal protective equipment (PPE) and surfaces by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the nonpatient entry area of a Fangcang shelter hospital, the medical staff accommodation area, and the staff transport bus. METHODS We collected 816 samples from the nonpatient entry area and floors in a Fangcang shelter hospital, medical staff accommodation area, and scheduled bus, and the five major types of PPE used from April 13 to May 18, 2022. SARS-CoV-2 ribonucleic acid (RNA) was detected by reverse transcription-polymerase chain reaction. RESULTS Overall, 22.2% of PPE samples were positive for SARS-CoV-2 RNA. Boot covers and gowns were the most contaminated types of PPE. The positive PPE contamination rate of staff collecting respiratory specimens was significantly higher than that of the general-treatment staff group (35.8% vs. 12.2%) and cleaner group (35.8% vs. 26.4%), p < 0.01. In total, 27 of 265 (10.2%) environmental surface samples were positive for SARS-CoV-2 RNA. The contamination-positive rates were 26.8% (22/82), 5.4% (4/74), and 0.9% (1/109) for contaminated, potentially contaminated, and clean zones, respectively. SARS-CoV-2 RNA was frequently detected on objects such as mobile phones, tables, computer keyboards and mice, and door handles. CONCLUSIONS SARS-CoV-2 RNA was widely distributed on high-touch surfaces and on PPE in the contaminated zone of the Fangcang shelter hospital, implying a potentially high infection risk for healthcare workers. Our findings emphasize the need to ensure adequate environmental cleaning, improve hand hygiene, and reduce the risk of infection. Additionally, prevention of self-contamination during PPE donning and doffing is complex and needs more research.
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Affiliation(s)
- Xue-E Chen
- Department of Nosocomial Infection Control, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - ChenHao Zhao
- Department of Neurology, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - YeTao Luo
- Department of Nosocomial Infection Control, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Tang Tang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Wei Chen
- Department of Nosocomial Infection Control, The Second Affiliated Hospital, Army Medical University, Chongqing, China
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14
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Olsen M, Goldsworthy A, Nassar R, Senok A, Albastaki A, Lee ZZ, Abraham S, Alghafri R, Tajouri L, McKirdy S. Ultraviolet-C-Based Mobile Phone Sanitisation for Global Public Health and Infection Control. Microorganisms 2023; 11:1876. [PMID: 37630437 PMCID: PMC10456618 DOI: 10.3390/microorganisms11081876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION Mobile phones act as fomites that pose a global public health risk of disseminating microorganisms, including highly pathogenic strains possessing antimicrobial resistances. The use of ultraviolet-C (UV-C) to sanitise mobile phones presents an alternative means to complement basic hand hygiene to prevent the cross-contamination and dissemination of microorganisms between hands and mobile phones. AIM This study aimed to evaluate the germicidal efficacy of the Glissner CleanPhone UV-C phone sanitiser (Glissner) device. METHODS Two experimental trials were performed for the evaluation of the CleanPhone (Glissner). The first was a controlled trial, where the germicidal efficacy of the CleanPhone was evaluated against six different microorganism species that were inoculated onto mobile phones. The second was a field trial evaluating the germicidal efficacy of the CleanPhone on 100 volunteer mobile phones. Efficacy was determined based on colony counts of microorganisms on Columbia sheep blood agar before and after UV-C treatment. RESULTS In the controlled trial, reduction in growth was observed for all microorganisms after UV-C treatment with ST131 Escherichia coli showing the highest growth reduction at 4 log10 CFU/mL followed by C. albicans and ATCC E. coli at 3 log10 CFU/mL. An overall reduction in microorganism growth after UV-C treatment was also observed for the field trial, with an average growth reduction of 84.4% and 93.6% in colony counts at 24 h and 48 h post-incubation, respectively. CONCLUSION The findings demonstrated the capability of the CleanPhone (Glissner) to rapidly sanitise mobile phones, thereby providing a means to reduce the potential dissemination of microorganisms, including highly pathogenic strains with antimicrobial resistance.
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Affiliation(s)
- Matthew Olsen
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia
| | - Adrian Goldsworthy
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia
| | - Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff CF10 3AT, UK
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
| | - Abdullah Albastaki
- Dubai Police Scientists Council, Dubai Police, Dubai P.O. Box 1493, United Arab Emirates
- General Department of Forensic Sciences and Criminology, Dubai Police, Dubai P.O. Box 1493, United Arab Emirates
| | - Zheng Z. Lee
- Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Sam Abraham
- Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Rashed Alghafri
- General Department of Forensic Sciences and Criminology, Dubai Police, Dubai P.O. Box 1493, United Arab Emirates
- Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Lotti Tajouri
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia
- Dubai Police Scientists Council, Dubai Police, Dubai P.O. Box 1493, United Arab Emirates
- Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Simon McKirdy
- Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
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15
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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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16
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Martínez-Espinosa E, Carvajal-Mariscal I. Virus-laden droplet nuclei in vortical structures associated with recirculation zones in indoor environments: A possible airborne transmission of SARS-CoV-2. ENVIRONMENTAL ADVANCES 2023; 12:100376. [PMID: 37193349 PMCID: PMC10163794 DOI: 10.1016/j.envadv.2023.100376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023]
Abstract
Droplet nuclei dispersion patterns in indoor environments are reviewed from a physics view to explore the possibility of airborne transmission of SARS-CoV-2. This review analyzes works on particle dispersion patterns and their concentration in vortical structures in different indoor environments. Numerical simulations and experiments reveal the formation of the buildings' recirculation zones and vortex flow regions by flow separation, airflow interaction around objects, internal dispersion of airflow, or thermal plume. These vortical structures showed high particle concentration because particles are trapped for long periods. Then a hypothesis is proposed to explain why some medical studies detect the presence of SARS-CoV-2 and others do not detect the virus. The hypothesis proposes that airborne transmission is possible if virus-laden droplet nuclei are trapped in vortical structures associated with recirculation zones. This hypothesis is reinforced by a numerical study in a restaurant that presented possible evidence of airborne transmission by a large recirculating air zone. Furthermore, a medical study in a hospital is discussed from a physical view for identifying the formation of recirculation zones and their relation with positive tests for viruses. The observations show air sampling site located in this vortical structure is positive for the SARS-CoV-2 RNA. Therefore, the formation of vortical structures associated with recirculation zones should be avoided to minimize the possibility of airborne transmission. This work tries to understand the complex phenomenon of airborne transmission as a way in the prevention of transmission of infectious diseases.
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Affiliation(s)
- E Martínez-Espinosa
- Industrial and Environmental Processes Department, Instituto de Ingeniería, UNAM, Ciudad Universitaria, Mexico City 04510, México
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17
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Kwiatkowska R, Yaxley N, Moore G, Bennett A, Donati M, Love N, Vivancos R, Hickman M, Ready DR. Environmental sampling for SARS-CoV-2 in long term care facilities: lessons from a pilot study. Wellcome Open Res 2023; 6:235. [PMID: 38406228 PMCID: PMC10891430 DOI: 10.12688/wellcomeopenres.17047.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 02/27/2024] Open
Abstract
Background: The SARS-CoV-2 pandemic has highlighted the risk of infection in long-term care facilities (LTCF) and the vulnerability of residents to severe outcomes. Environmental surveillance may help detect pathogens early and inform Infection Prevention and Control (IPC) measures in these settings. Methods: Upon notification of SARS-CoV-2 outbreaks, LTCF within a local authority in South West England were approached to take part in this pilot study. Investigators visited to swab common touch-points and elevated 'non-touch' surfaces (>1.5m above ground level) and samples were analysed for presence of SARS-CoV-2 genetic material (RNA). Data were collected regarding LTCF infrastructure, staff behaviours, clinical and epidemiological risk factors for infection (staff and residents), and IPC measures. Criteria for success were: recruitment of three LTCF; detection of SARS-COV-2 RNA; variation in proportion of SARS-CoV-2 positive surfaces by sampling zone; and collection of clinical and epidemiological data for context. Results: Three LTCFs were recruited, ranging in size and resident demographics. Outbreaks lasted 63, 50 and 30 days with resident attack rates of 53%, 40% and 8%, respectively. The proportion of sample sites on which SARS-CoV-2 was detected was highest in rooms occupied by infected residents and varied elsewhere in the LTCF, with low levels in a facility implementing enhanced IPC measures. The heterogeneity of settings and difficulty obtaining data made it unfeasible to assess association between environmental contamination and infection. A greater proportion of elevated surfaces tested positive for SARS-CoV-2 RNA than common touch-points. Conclusions: SARS-CoV-2 RNA can be detected in a variety of LTCF outbreak settings, both on common-touch items and in elevated sites out of reach. This suggests that further work is justified, to assess feasibility and utility of environmental sampling for infection surveillance in LTCF.
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Affiliation(s)
- Rachel Kwiatkowska
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- Field Service, Health Protection Operations, UKHSA, Bristol, UK
| | - Nicola Yaxley
- Biosafety, Air and Water Microbiology Group, UKHSA, Porton Down, Salisbury, UK
| | - Ginny Moore
- Biosafety, Air and Water Microbiology Group, UKHSA, Porton Down, Salisbury, UK
| | - Allan Bennett
- Biosafety, Air and Water Microbiology Group, UKHSA, Porton Down, Salisbury, UK
| | - Matthew Donati
- Severn Infection Sciences, North Bristol NHS Trust, Bristol, UK
- UKHSA Specialised Microbiology and Laboratories,, South West Regional Laboratory, Bristol, UK
| | - Nicola Love
- Field Service, Health Protection Operations, UKHSA, Newcastle, UK
| | - Roberto Vivancos
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Field Service, Health Protection Operations, UKHSA, Liverpool, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | - Derren R Ready
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- Field Service, Health Protection Operations, UKHSA, Bristol, UK
- Eastman Dental Institute, University College London, London, UK
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18
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Yung L, Leung LY, Lee KH, Morrell S, Fong MW, Yan Fung NH, Cheng KL, Kaewpreedee P, Li Y, Cowling BJ, Lau EH, Hui DS, Graham CA, Yen HL. A longitudinal environmental surveillance study for SARS-CoV-2 from the emergency department of a teaching hospital in Hong Kong. J Hosp Infect 2023:S0195-6701(23)00181-0. [PMID: 37315806 PMCID: PMC10259104 DOI: 10.1016/j.jhin.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Understanding factors associated with SARS-CoV-2 exposure risk in the hospital setting may help improve infection control measures for prevention. AIM To monitor SARS-CoV-2 exposure risk among healthcare workers and to identify risk factors associated with SARS-CoV-2 detection. METHODS Surface and air samples were collected longitudinally over 14 months spanning 2020-2022 at the Emergency Department (ED) of a teaching hospital in Hong Kong. SARS-CoV-2 viral RNA was detected by real-time reverse-transcription polymerase chain reaction. Ecological factors associated with SARS-CoV-2 detection were analysed by logistic regression. A sero-epidemiological study was conducted in January to April 2021 to monitor SARS-CoV-2 seroprevalence. A questionnaire was used to collect information on job nature and use of personal protective equipment (PPE) of the participants. FINDINGS SARS-CoV-2 RNA was detected at low frequencies from surfaces (0.7%, n=2562) and air samples (1.6%, n=128). Crowding was identified as the main risk factor, as weekly ED attendance (OR=1.002, p=0.04) and sampling after peak-hours of ED attendance (OR=5.216, p=0.03) were associated with the detection of SARS-CoV-2 viral RNA from surfaces. The low exposure risk was corroborated by the zero seropositive rate among 281 participants by April 2021. CONCLUSION Crowding may introduce SARS-CoV-2 into ED through increased attendances. Multiple factors may have contributed to the low contamination of SARS-CoV-2 at the ED, including hospital infection control measures for screening ED attendees, high PPE compliance among healthcare workers, and various public health and social measures implemented to reduce community transmission in Hong Kong where a dynamic zero COVID-19 policy was adopted.
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Affiliation(s)
- Louise Yung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ling Yan Leung
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Kwok Hung Lee
- Accident and Emergency Department, Prince of Wales Hospital, Hospital Authority, Hong Kong Special Administrative Region, China
| | - Steven Morrell
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Min Whui Fong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Nikki Ho Yan Fung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kit Ling Cheng
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Prathanporn Kaewpreedee
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Benjamin J Cowling
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric Hy Lau
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - David Sc Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Colin A Graham
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China; Accident and Emergency Department, Prince of Wales Hospital, Hospital Authority, Hong Kong Special Administrative Region, China.
| | - Hui-Ling Yen
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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19
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Selam MN, Tegegne AM, Ababu A, Matsabisa M, Birhanu G. Surface Disinfection Practice in Public Hospitals in the Era of COVID-19: Assessment of Disinfectant Solution Preparation and Use in Addis Ababa, Ethiopia. Infect Drug Resist 2023; 16:3213-3224. [PMID: 37249961 PMCID: PMC10224688 DOI: 10.2147/idr.s411835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Background Surface disinfection of healthcare facilities with appropriate disinfectants is among the infection control strategies against the spread of coronavirus disease 2019 (COVID-19). As sodium hypochlorite solution (SHS) is a commonly used surface disinfectant, its preparation and proper use should be given a due attention. The current study aimed at assessing the practice of Addis Ababa public hospitals in the preparation and use of SHS. Methods A cross-sectional observational study was employed to assess the adequacy of disinfectant solution preparation and use. Checklists were used for data collection. Descriptive statistics were used for data analyses, and categorical variables were described by frequencies and percentages. Results Out of the twelve public hospitals included in the study; only three hospitals checked the potency of the working SHS. Majority of the hospitals (8 hospitals) stored the concentrated SHS products in cool, dry, and direct sunlight protected places. It was only in one hospital where appropriate personal protective equipment was used during the preparation and quality control activities. Surfaces were not cleaned in all hospitals before disinfection; and the rooms were ventilated only in 2 hospitals during the application of the disinfectant solution. Conclusion The study revealed that the preparations of SHS in the public hospitals did not comply with most of the requirements of good compounding practice. Moreover, standard practices were not maintained in majority hospitals during the use of SHS for surface disinfection. As a control strategy in the spread of COVID-19 and other infections, appropriate corrective actions shall be implemented in the studied hospitals to mitigate the limitations observed in the preparation and use of SHS.
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Affiliation(s)
- Muluken Nigatu Selam
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aychew Mekuriaw Tegegne
- Department of Pharmacy, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Andualem Ababu
- Pharmaceutical and Medical Equipment Lead Executive Office, Ministry of Health, Addis Ababa, Ethiopia
| | - Motlalepula Matsabisa
- Department of Pharmacology, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa
| | - Gebremariam Birhanu
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacology, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa
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20
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Banholzer N, Zürcher K, Jent P, Bittel P, Furrer L, Egger M, Hascher T, Fenner L. SARS-CoV-2 transmission with and without mask wearing or air cleaners in schools in Switzerland: A modeling study of epidemiological, environmental, and molecular data. PLoS Med 2023; 20:e1004226. [PMID: 37200241 PMCID: PMC10194935 DOI: 10.1371/journal.pmed.1004226] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/28/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Growing evidence suggests an important contribution of airborne transmission to the overall spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), in particular via smaller particles called aerosols. However, the contribution of school children to SARS-CoV-2 transmission remains uncertain. The aim of this study was to assess transmission of airborne respiratory infections and the association with infection control measures in schools using a multiple-measurement approach. METHODS AND FINDINGS We collected epidemiological (cases of Coronavirus Disease 2019 (COVID-19)), environmental (CO2, aerosol and particle concentrations), and molecular data (bioaerosol and saliva samples) over 7 weeks from January to March 2022 (Omicron wave) in 2 secondary schools (n = 90, average 18 students/classroom) in Switzerland. We analyzed changes in environmental and molecular characteristics between different study conditions (no intervention, mask wearing, air cleaners). Analyses of environmental changes were adjusted for different ventilation, the number of students in class, school and weekday effects. We modeled disease transmission using a semi-mechanistic Bayesian hierarchical model, adjusting for absent students and community transmission. Molecular analysis of saliva (21/262 positive) and airborne samples (10/130) detected SARS-CoV-2 throughout the study (weekly average viral concentration 0.6 copies/L) and occasionally other respiratory viruses. Overall daily average CO2 levels were 1,064 ± 232 ppm (± standard deviation). Daily average aerosol number concentrations without interventions were 177 ± 109 1/cm3 and decreased by 69% (95% CrI 42% to 86%) with mask mandates and 39% (95% CrI 4% to 69%) with air cleaners. Compared to no intervention, the transmission risk was lower with mask mandates (adjusted odds ratio 0.19, 95% CrI 0.09 to 0.38) and comparable with air cleaners (1.00, 95% CrI 0.15 to 6.51). Study limitations include possible confounding by period as the number of susceptible students declined over time. Furthermore, airborne detection of pathogens document exposure but not necessarily transmission. CONCLUSIONS Molecular detection of airborne and human SARS-CoV-2 indicated sustained transmission in schools. Mask mandates were associated with greater reductions in aerosol concentrations than air cleaners and with lower transmission. Our multiple-measurement approach could be used to continuously monitor transmission risk of respiratory infections and the effectiveness of infection control measures in schools and other congregate settings.
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Affiliation(s)
- Nicolas Banholzer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Kathrin Zürcher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Philipp Jent
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pascal Bittel
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Lavinia Furrer
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tina Hascher
- Institute of Educational Science, University of Bern, Bern, Switzerland
| | - Lukas Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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21
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Maltezou HC, Papamichalopoulos N, Horefti E, Tseroni M, Karapanou A, Gamaletsou MN, Veneti L, Ioannidis A, Panagiotou M, Dimitroulia E, Vasilogiannakopoulos A, Angelakis E, Chatzipanagiotou S, Sipsas NV. Effectiveness of a Self-Decontaminating Coating Containing Usnic Acid in Reducing Environmental Microbial Load in Tertiary-Care Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085434. [PMID: 37107716 PMCID: PMC10138069 DOI: 10.3390/ijerph20085434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 05/11/2023]
Abstract
Surfaces have been implicated in the transmission of pathogens in hospitals. This study aimed to assess the effectiveness of an usnic-acid-containing self-decontaminating coating in reducing microbial surface contamination in tertiary-care hospitals. Samples were collected from surfaces 9 days before coating application, and 3, 10, and 21 days after its application (phases 1, 2, 3, and 4, respectively). Samples were tested for bacteria, fungi, and SARS-CoV2. In phase 1, 53/69 (76.8%) samples tested positive for bacteria, 9/69 (13.0%) for fungi, and 10/139 (7.2%) for SARS-CoV-2. In phase 2, 4/69 (5.8%) samples tested positive for bacteria, while 69 and 139 samples were negative for fungi and SARS-CoV-2, respectively. In phase 3, 3/69 (4.3%) samples were positive for bacteria, 1/139 (0.7%) samples tested positive for SARS-CoV-2, while 69 samples were negative for fungi. In phase 4, 1/69 (1.4%) tested positive for bacteria, while no fungus or SARS-CoV-2 were detected. After the coating was applied, the bacterial load was reduced by 87% in phase 2 (RR = 0.132; 95% CI: 0.108-0.162); 99% in phase 3 (RR = 0.006; 95% CI: 0.003-0.015); and 100% in phase 4 (RR = 0.001; 95% CI: 0.000-0.009). These data indicate that the usnic-acid-containing coating was effective in eliminating bacterial, fungal, and SARS-CoV-2 contamination on surfaces in hospitals.Our findings support the benefit ofan usnic-acid-containing coating in reducing the microbial load on healthcare surfaces.
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Affiliation(s)
- Helena C. Maltezou
- Directorate of Research, Studies, and Documentation, National Public Health Organization, 15123 Athens, Greece
- Correspondence:
| | - Nikolaos Papamichalopoulos
- Department of Medical Biopathology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, 72–74 Vas. Sophias Ave, 11528 Athens, Greece
| | - Elina Horefti
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, 127 Vas. Sophias Ave, 11521 Athens, Greece
| | - Maria Tseroni
- Directorate of Epidemiological Surveillance for Infectious Diseases, National Public Health Organization, 15123 Athens, Greece
| | - Amalia Karapanou
- Infection Control Committee, Laiko General Hospital, 11527 Athens, Greece
| | - Maria N. Gamaletsou
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Anastasios Ioannidis
- Department of Nursing, Faculty of Health Sciences, University of Peloponnese, 22100 Tripoli, Greece
| | - Marina Panagiotou
- Infection Control Committee, Henry Dunant Hospital Center, 11526 Athens, Greece
| | | | | | - Emmanouil Angelakis
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, 127 Vas. Sophias Ave, 11521 Athens, Greece
| | - Stylianos Chatzipanagiotou
- Department of Medical Biopathology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, 72–74 Vas. Sophias Ave, 11528 Athens, Greece
| | - Nikolaos V. Sipsas
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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22
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Leal J, O'Grady HM, Armstrong L, Dixit D, Khawaja Z, Snedeker K, Ellison J, Erebor J, Jamieson P, Weiss A, Salcedo D, Roberts K, Wiens K, Croxen MA, Berenger BM, Pabbaraju K, Lin YC, Evans D, Conly JM. Patient and ward related risk factors in a multi-ward nosocomial outbreak of COVID-19: Outbreak investigation and matched case-control study. Antimicrob Resist Infect Control 2023; 12:21. [PMID: 36949510 PMCID: PMC10031162 DOI: 10.1186/s13756-023-01215-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/10/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Risk factors for nosocomial COVID-19 outbreaks continue to evolve. The aim of this study was to investigate a multi-ward nosocomial outbreak of COVID-19 between 1st September and 15th November 2020, occurring in a setting without vaccination for any healthcare workers or patients. METHODS Outbreak report and retrospective, matched case-control study using incidence density sampling in three cardiac wards in an 1100-bed tertiary teaching hospital in Calgary, Alberta, Canada. Patients were confirmed/probable COVID-19 cases and contemporaneous control patients without COVID-19. COVID-19 outbreak definitions were based on Public Health guidelines. Clinical and environmental specimens were tested by RT-PCR and as applicable quantitative viral cultures and whole genome sequencing were conducted. Controls were inpatients on the cardiac wards during the study period confirmed to be without COVID-19, matched to outbreak cases by time of symptom onset dates, age within ± 15 years and were admitted in hospital for at least 2 days. Demographics, Braden Score, baseline medications, laboratory measures, co-morbidities, and hospitalization characteristics were collected on cases and controls. Univariate and multivariate conditional logistical regression was used to identify independent risk factors for nosocomial COVID-19. RESULTS The outbreak involved 42 healthcare workers and 39 patients. The strongest independent risk factor for nosocomial COVID-19 (IRR 3.21, 95% CI 1.47-7.02) was exposure in a multi-bedded room. Of 45 strains successfully sequenced, 44 (97.8%) were B.1.128 and differed from the most common circulating community lineages. SARS-CoV-2 positive cultures were detected in 56.7% (34/60) of clinical and environmental specimens. The multidisciplinary outbreak team observed eleven contributing events to transmission during the outbreak. CONCLUSIONS Transmission routes of SARS-CoV-2 in hospital outbreaks are complex; however multi-bedded rooms play a significant role in the transmission of SARS-CoV-2.
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Affiliation(s)
- Jenine Leal
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada
| | - Heidi M O'Grady
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
| | - Logan Armstrong
- Infection Prevention and Control, Alberta Health Services, Edmonton, AB, Canada
| | - Devika Dixit
- Department of Pediatrics, Division of Infectious Diseases, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Zoha Khawaja
- W21C, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kate Snedeker
- Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Jennifer Ellison
- Infection Prevention and Control, Alberta Health Services, Lethbridge, AB, Canada
| | - Joyce Erebor
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
| | - Peter Jamieson
- Department of Family Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Amanda Weiss
- Cardiac Sciences, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Daniel Salcedo
- Cardiac Sciences, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Kimberley Roberts
- Cardiac Sciences, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Karen Wiens
- Cardiac Sciences, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Matthew A Croxen
- Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
- Alberta Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada
| | - Byron M Berenger
- Department of Pathology and Laboratory Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Alberta Public Health Laboratory, Alberta Precision Laboratories, Calgary, AB, Canada
| | - Kanti Pabbaraju
- Alberta Public Health Laboratory, Alberta Precision Laboratories, Calgary, AB, Canada
| | - Yi-Chan Lin
- Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - David Evans
- Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - John M Conly
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada.
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- O'Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada.
- Department of Pathology and Laboratory Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- Synder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- W21C, Department of Medicine, University of Calgary, Calgary, AB, Canada.
- Foothills Medical Centre, AGW5 - Special Services Bldg, 1403 29Th Street Nw, Calgary, AB, T2N 2T9, Canada.
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23
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Pfuderer L, Stark WJ, Grass RN. Synthetic Microbial Surrogates Consisting of Lipid Nanoparticles Encapsulating DNA for the Validation of Surface Disinfection Procedures. ACS APPLIED BIO MATERIALS 2023; 6:1252-1259. [PMID: 36854082 PMCID: PMC10031560 DOI: 10.1021/acsabm.3c00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Effective cleaning and disinfection procedures are an integral part of good manufacturing practice and in maintaining hygiene standards in health-care facilities. In this study, a method to validate such cleaning and disinfection procedures of surfaces was established employing lipid nanoparticles (LNPs) encapsulating DNA. It was possible to determine and distinguish between the physical cleaning effect (dilution) and the chemical cleaning effect (disintegration) on the LNPs during the cleaning and disinfection procedure (wiping). After treatment with 70 v % ethanol as a disinfectant and SDS solution as a cleaning agent, LNPs showed log10 reductions of 4.5 and 4.0, respectively. These values are similar to the log10 reductions exhibited by common bacteria, such as Escherichia coli and Serratia marcescens. Therefore, LNPs pose as useful tools for cleaning validation with advantages over the already existing tools and enable a separate detection of dilution and chemical disinfectant action.
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Affiliation(s)
- Lara Pfuderer
- Institute for Chemical and Bioengineering, ETH Zurich, Vladimir-Prelog-Weg 1, 8093 Zurich, Switzerland
| | - Wendelin J Stark
- Institute for Chemical and Bioengineering, ETH Zurich, Vladimir-Prelog-Weg 1, 8093 Zurich, Switzerland
| | - Robert N Grass
- Institute for Chemical and Bioengineering, ETH Zurich, Vladimir-Prelog-Weg 1, 8093 Zurich, Switzerland
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24
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Sah GP, Kovalick G, Chopyk J, Kuo P, Huang L, Ghatbale P, Das P, Realegeno S, Knight R, Gilbert JA, Pride DT. Characterization of SARS-CoV-2 Distribution and Microbial Succession in a Clinical Microbiology Testing Facility during the SARS-CoV-2 Pandemic. Microbiol Spectr 2023; 11:e0450922. [PMID: 36916973 PMCID: PMC10100919 DOI: 10.1128/spectrum.04509-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/11/2023] [Indexed: 03/15/2023] Open
Abstract
The exchange of microbes between humans and the built environment is a dynamic process that has significant impact on health. Most studies exploring the microbiome of the built environment have been predicated on improving our understanding of pathogen emergence, persistence, and transmission. Previous studies have demonstrated that SARS-CoV-2 presence significantly correlates with the proportional abundance of specific bacteria on surfaces in the built environment. However, in these studies, SARS-CoV-2 originated from infected patients. Here, we perform a similar assessment for a clinical microbiology lab while staff were handling SARS-CoV-2 infected samples. The goal of this study was to understand the distribution and dynamics of microbial population on various surfaces within different sections of a clinical microbiology lab during a short period of 2020 Coronavirus disease (COVID-19) pandemic. We sampled floors, benches, and sinks in 3 sections (bacteriology, molecular microbiology, and COVID) of an active clinical microbiology lab over a 3-month period. Although floor samples harbored SARS-CoV-2, it was rarely identified on other surfaces, and bacterial diversity was significantly greater on floors than sinks and benches. The floors were primarily colonized by bacteria common to natural environments (e.g., soils), and benchtops harbored a greater proportion of human-associated microbes, including Staphylococcus and Streptococcus. Finally, we show that the microbial composition of these surfaces did not change over time and remained stable. Despite finding viruses on the floors, no lab-acquired infections were reported during the study period, which suggests that lab safety protocols and sanitation practices were sufficient to prevent pathogen exposures. IMPORTANCE For decades, diagnostic clinical laboratories have been an integral part of the health care systems that perform diagnostic tests on patient's specimens in bulk on a regular basis. Understanding their microbiota should assist in designing and implementing disinfection, and cleaning regime in more effective way. To our knowledge, there is a lack of information on the composition and dynamics of microbiota in the clinical laboratory environments, and, through this study, we have tried to fill that gap. This study has wider implications as understanding the makeup of microbes on various surfaces within clinical laboratories could help identify any pathogenic bacterial taxa that could have colonized these surfaces, and might act as a potential source of laboratory-acquired infections. Mapping the microbial community within these built environments may also be critical in assessing the reliability of laboratory safety and sanitation practices to lower any potential risk of exposures to health care workers.
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Affiliation(s)
- Govind Prasad Sah
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Grace Kovalick
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Jessica Chopyk
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Peiting Kuo
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Lina Huang
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Pooja Ghatbale
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Promi Das
- Department of Pediatrics, University of California San Diego, San Diego, California, USA
- Center for Microbiome Innovation, University of California San Diego, San Diego, California, USA
| | - Susan Realegeno
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, San Diego, California, USA
- Center for Microbiome Innovation, University of California San Diego, San Diego, California, USA
- Department of Bioengineering, University of California San Diego, San Diego, California, USA
- Department of Computer Science & Engineering, University of California San Diego, San Diego, California, USA
| | - Jack A. Gilbert
- Department of Pediatrics, University of California San Diego, San Diego, California, USA
- Center for Microbiome Innovation, University of California San Diego, San Diego, California, USA
- Scripps Institution of Oceanography and Department of Pediatrics, University of California San Diego, San Diego, California, USA
| | - David T. Pride
- Department of Pathology, University of California San Diego, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
- Center for Microbiome Innovation, University of California San Diego, San Diego, California, USA
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25
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Loh MM, Yaxley N, Moore G, Holmes D, Todd S, Smith A, Macdonald E, Semple S, Cherrie M, Patel M, Hamill R, Leckie A, Dancer SJ, Cherrie JW. Measurement of SARS-CoV-2 in air and on surfaces in Scottish hospitals. J Hosp Infect 2023; 133:1-7. [PMID: 36473553 PMCID: PMC9721166 DOI: 10.1016/j.jhin.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/27/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND There are still uncertainties in our knowledge of the amount of SARS-CoV-2 virus present in the environment - where it can be found, and potential exposure determinants - limiting our ability to effectively model and compare interventions for risk management. AIM This study measured SARS-CoV-2 in three hospitals in Scotland on surfaces and in air, alongside ventilation and patient care activities. METHODS Air sampling at 200 L/min for 20 min and surface sampling were performed in two wards designated to treat COVID-19-positive patients and two non-COVID-19 wards across three hospitals in November and December 2020. FINDINGS Detectable samples of SARS-CoV-2 were found in COVID-19 treatment wards but not in non-COVID-19 wards. Most samples were below assay detection limits, but maximum concentrations reached 1.7×103 genomic copies/m3 in air and 1.9×104 copies per surface swab (3.2×102 copies/cm2 for surface loading). The estimated geometric mean air concentration (geometric standard deviation) across all hospitals was 0.41 (71) genomic copies/m3 and the corresponding values for surface contamination were 2.9 (29) copies/swab. SARS-CoV-2 RNA was found in non-patient areas (patient/visitor waiting rooms and personal protective equipment changing areas) associated with COVID-19 treatment wards. CONCLUSION Non-patient areas of the hospital may pose risks for infection transmission and further attention should be paid to these areas. Standardization of sampling methods will improve understanding of levels of environmental contamination. The pandemic has demonstrated a need to review and act upon the challenges of older hospital buildings meeting current ventilation guidance.
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Affiliation(s)
- M M Loh
- Institute of Occupational Medicine, Edinburgh, UK.
| | - N Yaxley
- UK Health Security Agency, Porton Down, UK
| | - G Moore
- UK Health Security Agency, Porton Down, UK
| | - D Holmes
- Institute of Occupational Medicine, Edinburgh, UK
| | - S Todd
- Institute of Occupational Medicine, Edinburgh, UK
| | - A Smith
- Institute of Occupational Medicine, Edinburgh, UK
| | | | - S Semple
- Institute for Social Marketing & Health, University of Stirling, Stirling, UK
| | - M Cherrie
- Institute of Occupational Medicine, Edinburgh, UK
| | | | | | | | - S J Dancer
- NHS Lanarkshire, UK; Edinburgh Napier University, UK
| | - J W Cherrie
- Institute of Occupational Medicine, Edinburgh, UK; Heriot Watt University, Edinburgh, UK
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26
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Cox J, Christensen B, Burton N, Dunn KH, Finnegan M, Ruess A, Estill C. Transmission of SARS-CoV-2 in the workplace: Key findings from a rapid review of the literature. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2023; 57:233-254. [PMID: 37213938 PMCID: PMC10193509 DOI: 10.1080/02786826.2023.2166394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/27/2022] [Indexed: 05/23/2023]
Abstract
At the beginning of the COVID-19 pandemic, the primary route of transmission of the SARS-CoV-2 virus was not well understood. Research gathered from other respiratory infectious diseases, including other coronaviruses, was the basis for the initial perceptions for transmission of SARS-CoV-2. To better understand transmission of SARS-CoV-2, a rapid literature review was conducted from literature generated March 19, 2020, through September 23, 2021. 18,616 unique results were identified from literature databases and screened. Of these, 279 key articles were reviewed and abstracted covering critical topics such as environmental/workplace monitoring, sampling and analytical method evaluation, and the ability of the virus to remain intact and infectious during sampling. This paper describes the results of the rapid literature review, which evaluated pathways that contribute to transmission as well as the strengths and limitations of current sampling approaches. This review also evaluates how different factors, including environmental conditions and surface characteristics, could impact the transmission potential of SARS-CoV-2. A continual rapid review in the midst of a pandemic proved particularly useful for quickly understanding the transmission parameters of the virus and enabled us to comprehensively assess literature, respond to workplace questions, and evaluate our understanding as the science evolved. Air and surface sampling with the accompanying analytical methods were not generally effective in recovering SARS-CoV-2 viable virus or RNA in many likely contaminated environments. In light of these findings, the development of validated sampling and analysis methods is critical for determining worker exposure to SARS-CoV-2 and to assess the impact of mitigation efforts.
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Affiliation(s)
- Jennie Cox
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Brian Christensen
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Nancy Burton
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Kevin H. Dunn
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | | | - Ana Ruess
- Gryphon Scientific, Takoma Park, MD, USA
| | - Cherie Estill
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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27
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Li Y, Lu Y, Wang Y, Liu L, Zhou H, Lin B, Peng Z, Yuan Y. Investigation on the effectiveness of ventilation dilution on mitigating COVID-19 patients' secondary airway damage due to exposure to disinfectants. BUILDING AND ENVIRONMENT 2023; 228:109787. [PMID: 36407877 PMCID: PMC9652096 DOI: 10.1016/j.buildenv.2022.109787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/04/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
Chlorine-containing disinfectants are widely used in hospitals to prevent hospital-acquired severe acute respiratory syndrome coronavirus 2 infection. Meanwhile, ventilation is a simple but effective means to maintain clean air. It is essential to explore the exposure level and health effects of coronavirus disease 2019 patients' inhalation exposure to by-products of chloride-containing disinfectants under frequent surface disinfection and understand the role of ventilation in mitigating subsequent airway damage. We determined ventilation dilution performance and indoor air quality of two intensive care unit wards of the largest temporary hospital constructed in China, Leishenshan Hospital. The chloride inhalation exposure levels, and health risks indicated by interleukin-6 and D-dimer test results of 32 patients were analysed. The mean ± standard deviation values of the outdoor air change rate in the two intensive care unit wards were 8.8 ± 1.5 h-1 (Intensive care unit 1) and 4.1 ± 1.4 h-1 (Intensive care unit 2). The median carbon dioxide and fine particulate matter concentrations were 480 ppm and 19 μg/m3 for intensive care unit 1, and 567 ppm and 21 μg/m3 for intensive care unit 2, all of which were around the average levels of those in permanent hospitals (579 ppm and 21 μg/m3). Of these patients, the median (lower quartile, upper quartile) chloride exposure time and calculated dose were 26.66 (2.89, 57.21) h and 0.357 (0.008, 1.317) mg, respectively. A statistically significant positive correlation was observed between interleukin-6 and D-dimer concentrations. To conclude, ventilation helped maintain ward air cleanliness and health risks were not observed.
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Affiliation(s)
- Yifan Li
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Laboratory of Eco-Planning & Green Building, Ministry of Education, Tsinghua University, Beijing 100084, China
| | - Yiran Lu
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Laboratory of Eco-Planning & Green Building, Ministry of Education, Tsinghua University, Beijing 100084, China
| | - Ying Wang
- Department of Infection Management, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
- Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan, Hubei 430071, China
| | - Li Liu
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Laboratory of Eco-Planning & Green Building, Ministry of Education, Tsinghua University, Beijing 100084, China
- Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan, Hubei 430071, China
| | - Hao Zhou
- Laboratory of Eco-Planning & Green Building, Ministry of Education, Tsinghua University, Beijing 100084, China
- Institute for Urban Governance and Sustainable Development, Tsinghua University, Beijing 100084, China
| | - Borong Lin
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Laboratory of Eco-Planning & Green Building, Ministry of Education, Tsinghua University, Beijing 100084, China
| | - Zhiyong Peng
- Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan, Hubei 430071, China
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Yufeng Yuan
- Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan, Hubei 430071, China
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
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Maryam S, Ul Haq I, Yahya G, Ul Haq M, Algammal AM, Saber S, Cavalu S. COVID-19 surveillance in wastewater: An epidemiological tool for the monitoring of SARS-CoV-2. Front Cell Infect Microbiol 2023; 12:978643. [PMID: 36683701 PMCID: PMC9854263 DOI: 10.3389/fcimb.2022.978643] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/03/2022] [Indexed: 01/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has prompted a lot of questions globally regarding the range of information about the virus's possible routes of transmission, diagnostics, and therapeutic tools. Worldwide studies have pointed out the importance of monitoring and early surveillance techniques based on the identification of viral RNA in wastewater. These studies indicated the presence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in human feces, which is shed via excreta including mucus, feces, saliva, and sputum. Subsequently, they get dumped into wastewater, and their presence in wastewater provides a possibility of using it as a tool to help prevent and eradicate the virus. Its monitoring is still done in many regions worldwide and serves as an early "warning signal"; however, a lot of limitations of wastewater surveillance have also been identified.
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Affiliation(s)
- Sajida Maryam
- Department of Biosciences, The Commission on Science and Technology for Sustainable Development in the South (COMSATS) University Islamabad (CUI), Islamabad, Pakistan
| | - Ihtisham Ul Haq
- Department of Biosciences, The Commission on Science and Technology for Sustainable Development in the South (COMSATS) University Islamabad (CUI), Islamabad, Pakistan
- Department of Physical Chemistry and Polymers Technology, Silesian University of Technology, Gliwice, Poland
- Joint Doctoral School, Silesian University of Technology, Gliwice, Poland
| | - Galal Yahya
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Mehboob Ul Haq
- Department of Biosciences, The Commission on Science and Technology for Sustainable Development in the South (COMSATS) University Islamabad (CUI), Islamabad, Pakistan
| | - Abdelazeem M Algammal
- Department of Bacteriology, Immunology, and Mycology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Sameh Saber
- Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Egypt
| | - Simona Cavalu
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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Al‐Emran HM, Rahman S, Hasan MS, Ul Alam R, Islam OK, Anwar A, Jahid MIK, Hossain A. Microbiome analysis revealing microbial interactions and secondary bacterial infections in COVID-19 patients comorbidly affected by Type 2 diabetes. J Med Virol 2023; 95:e28234. [PMID: 36258280 PMCID: PMC9874868 DOI: 10.1002/jmv.28234] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/03/2022] [Accepted: 10/13/2022] [Indexed: 01/27/2023]
Abstract
The mortality of coronavirus disease 2019 (COVID-19) disease is very high among the elderly or individuals having comorbidities such as obesity, cardiovascular diseases, lung infections, hypertension, and/or diabetes. Our study characterizes the metagenomic features in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected patients with or without type 2 diabetes, to identify the microbial interactions associated with its fatal consequences.This study compared the baseline nasopharyngeal microbiome of SARS-CoV-2-infected diabetic and nondiabetic patients with controls adjusted for age and gender. The metagenomics based on next-generation sequencing was performed using Ion GeneStudio S5 Series and the data were analyzed by the Vegan-package in R. All three groups possessed significant bacterial diversity and dissimilarity indexes (p < 0.05). Spearman's correlation coefficient network analysis illustrated 183 significant positive correlations and 13 negative correlations of pathogenic bacteria (r = 0.6-1.0, p < 0.05), and 109 positive correlations between normal flora and probiotic bacteria (r > 0.6, p < 0.05). The SARS-CoV-2 diabetic group exhibited a significant increase in pathogens and secondary infection-causing bacteria (p < 0.05) with a simultaneous decrease of normal flora (p < 0.05). The dysbiosis of the bacterial community might be linked with severe consequences of COVID-19-infected diabetic patients, although a few probiotic strains inhibited numerous pathogens in the same pathological niches. This study suggested that the promotion of normal flora and probiotics through dietary supplementation and excessive inflammation reduction by preventing secondary infections might lead to a better outcome for those comorbid patients.
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Affiliation(s)
- Hassan M. Al‐Emran
- Department of Biomedical EngineeringJashore University of Science and TechnologyJashoreBangladesh
| | - Shaminur Rahman
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
| | - Md. Shazid Hasan
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
| | - Rubayet Ul Alam
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
| | - Ovinu Kibria Islam
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
| | - Ajwad Anwar
- Department of MicrobiologyUniversity of DhakaDhakaBangladesh
| | - Md. Iqbal K. Jahid
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
- Genome CenterJashore University of Science and TechnologyJashoreBangladesh
| | - Anwar Hossain
- Genome CenterJashore University of Science and TechnologyJashoreBangladesh
- Department of MicrobiologyUniversity of DhakaDhakaBangladesh
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30
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Ziegler MJ, Huang E, Bekele S, Reesey E, Tolomeo P, Loughrey S, David MZ, Lautenbach E, Kelly BJ. Spatial and temporal effects on severe acute respiratory coronavirus virus 2 (SARS-CoV-2) contamination of the healthcare environment. Infect Control Hosp Epidemiol 2022; 43:1773-1778. [PMID: 34955111 PMCID: PMC8755533 DOI: 10.1017/ice.2021.530] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND The spatial and temporal extent of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) environmental contamination has not been precisely defined. We sought to elucidate contamination of different surface types and how contamination changes over time. METHODS We sampled surfaces longitudinally within COVID-19 patient rooms, performed quantitative RT-PCR for the detection of SARS-CoV-2 RNA, and modeled distance, time, and severity of illness on the probability of detecting SARS-CoV-2 using a mixed-effects binomial model. RESULTS The probability of detecting SARS-CoV-2 RNA in a patient room did not vary with distance. However, we found that surface type predicted probability of detection, with floors and high-touch surfaces having the highest probability of detection: floors (odds ratio [OR], 67.8; 95% credible interval [CrI], 36.3-131) and high-touch elevated surfaces (OR, 7.39; 95% CrI, 4.31-13.1). Increased surface contamination was observed in room where patients required high-flow oxygen, positive airway pressure, or mechanical ventilation (OR, 1.6; 95% CrI, 1.03-2.53). The probability of elevated surface contamination decayed with prolonged hospitalization, but the probability of floor detection increased with the duration of the local pandemic wave. CONCLUSIONS Distance from a patient's bed did not predict SARS-CoV-2 RNA deposition in patient rooms, but surface type, severity of illness, and time from local pandemic wave predicted surface deposition.
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Affiliation(s)
- Matthew J. Ziegler
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elizabeth Huang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Selamawit Bekele
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emily Reesey
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Pam Tolomeo
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sean Loughrey
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael Z. David
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ebbing Lautenbach
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brendan J. Kelly
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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31
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Baeza-Trinidad R, Brito-Diaz AY, Mosquera-Lozano JD, Azcona-Gutierrez JM. Could the stethoscope be a SARS-CoV-2 vector? ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:522-523. [PMID: 36336382 PMCID: PMC9631335 DOI: 10.1016/j.eimce.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/20/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Ramón Baeza-Trinidad
- Internal Medicine Department, Hospital San Pedro, Logroño, Spain,Corresponding author
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Wee LE, Arora S, Ko KKK, Conceicao EP, Coleman KK, Tan KY, Tohid HB, Liu Q, Tung GLT, See SWJ, Suphavilai C, Ling ML, Venkatachalam I. Environmental contamination and evaluation of healthcare-associated SARS-CoV-2 transmission risk in temporary isolation wards during the COVID-19 pandemic. Am J Infect Control 2022; 51:413-419. [PMID: 37010998 PMCID: PMC9613445 DOI: 10.1016/j.ajic.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
Background Temporary isolation wards have been introduced to meet demands for airborne-infection-isolation-rooms (AIIRs) during the COVID-19 pandemic. Environmental sampling and outbreak investigation was conducted in temporary isolation wards converted from general wards and/or prefabricated containers, in order to evaluate the ability of such temporary isolation wards to safely manage COVID-19 cases over a period of sustained use. Methods Environmental sampling for SARS-CoV-2 RNA was conducted in temporary isolation ward rooms constructed from pre-fabricated containers (N = 20) or converted from normal-pressure general wards (N = 47). Whole genome sequencing (WGS) was utilized to ascertain health care-associated transmission when clusters were reported amongst HCWs working in isolation areas from July 2020 to December 2021. Results A total of 355 environmental swabs were collected; 22.4% (15/67) of patients had at least one positive environmental sample. Patients housed in temporary isolation ward rooms constructed from pre-fabricated containers (adjusted-odds-ratio, aOR = 10.46, 95% CI = 3.89-58.91, P = .008) had greater odds of detectable environmental contamination, with positive environmental samples obtained from the toilet area (60.0%, 12/20) and patient equipment, including electronic devices used for patient communication (8/20, 40.0%). A single HCW cluster was reported amongst staff working in the temporary isolation ward constructed from pre-fabricated containers; however, health care-associated transmission was deemed unlikely based on WGS and/or epidemiological investigations. Conclusion Environmental contamination with SARS-CoV-2 RNA was observed in temporary isolation wards, particularly from the toilet area and smartphones used for patient communication. However, despite intensive surveillance, no healthcare-associated transmission was detected in temporary isolation wards over 18 months of prolonged usage, demonstrating their capacity for sustained use during succeeding pandemic waves.
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Affiliation(s)
- Liang En Wee
- Department of Infectious Diseases, Singapore General Hospital, Singapore.
| | - Shalvi Arora
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Karrie Kwan-Ki Ko
- Department of Molecular Pathology, Singapore General Hospital, Singapore; Department of Microbiology, Singapore General Hospital, Singapore; Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Edwin Philip Conceicao
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | | | - Kwee Yuen Tan
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Hatijah Binti Tohid
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Qinnan Liu
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | | | - Shawn Wee Jin See
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Chayaporn Suphavilai
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Moi Lin Ling
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Indumathi Venkatachalam
- Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
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Thuresson S, Fraenkel CJ, Sasinovich S, Soldemyr J, Widell A, Medstrand P, Alsved M, Löndahl J. Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Hospitals: Effects of Aerosol-Generating Procedures, HEPA-Filtration Units, Patient Viral Load, and Physical Distance. Clin Infect Dis 2022; 75:e89-e96. [PMID: 35226740 PMCID: PMC9383519 DOI: 10.1093/cid/ciac161] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Transmission of coronavirus disease 2019 (COVID-19) can occur through inhalation of fine droplets or aerosols containing infectious virus. The objective of this study was to identify situations, patient characteristics, environmental parameters, and aerosol-generating procedures (AGPs) associated with airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. METHODS Air samples were collected near hospitalized COVID-19 patients and analyzed by RT-qPCR. Results were related to distance to the patient, most recent patient diagnostic PCR cycle threshold (Ct) value, room ventilation, and ongoing potential AGPs. RESULTS In total, 310 air samples were collected; of these, 26 (8%) were positive for SARS-CoV-2. Of the 231 samples from patient rooms, 22 (10%) were positive for SARS-CoV-2. Positive air samples were associated with a low patient Ct value (OR, 5.0 for Ct <25 vs >25; P = .01; 95% CI: 1.18-29.5) and a shorter physical distance to the patient (OR, 2.0 for every meter closer to the patient; P = .05; 95% CI: 1.0-3.8). A mobile HEPA-filtration unit in the room decreased the proportion of positive samples (OR, .3; P = .02; 95% CI: .12-.98). No association was observed between SARS-CoV-2-positive air samples and mechanical ventilation, high-flow nasal cannula, nebulizer treatment, or noninvasive ventilation. An association was found with positive expiratory pressure training (P < .01) and a trend towards an association for airway manipulation, including bronchoscopies and in- and extubations. CONCLUSIONS Our results show that major risk factors for airborne SARS-CoV-2 include short physical distance, high patient viral load, and poor room ventilation. AGPs, as traditionally defined, seem to be of secondary importance.
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Affiliation(s)
- Sara Thuresson
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Carl Johan Fraenkel
- Department of Infection Control, Region Skåne, Lund, Sweden
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Swedenand
| | | | - Jonathan Soldemyr
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Anders Widell
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Patrik Medstrand
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Malin Alsved
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Jakob Löndahl
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
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Yan K, Lin J, Albaugh S, Yang M, Wang E, Cyberski T, Abasiyanik MF, Wroblewski KE, O'Connor M, Klock A, Tung A, Shahul S, Kurian D, Tay S, Pinto JM. Measuring SARS-CoV-2 aerosolization in rooms of hospitalized patients. Laryngoscope Investig Otolaryngol 2022; 7:1033-1041. [PMID: 35942422 PMCID: PMC9350181 DOI: 10.1002/lio2.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/12/2022] [Indexed: 11/11/2022] Open
Abstract
Objective Airborne spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a significant risk for healthcare workers. Understanding transmission of SARS-CoV-2 in the hospital could help minimize nosocomial infection. The objective of this pilot study was to measure aerosolization of SARS-CoV-2 in the hospital rooms of COVID-19 patients. Methods Two air samplers (Inspirotec) were placed 1 and 4 m away from adults with SARS-CoV-2 infection hospitalized at an urban, academic tertiary care center from June to October 2020. Airborne SARS-CoV-2 concentration was measured by quantitative reverse transcription polymerase chain reaction and analyzed by clinical parameters and patient demographics. Results Thirteen patients with COVID-19 (eight females [61.5%], median age: 57 years old, range 25-82) presented with shortness of breath (100%), cough (38.5%) and fever (15.4%). Respiratory therapy during air sampling varied: mechanical ventilation via endotracheal tube (n = 3), high flow nasal cannula (n = 4), nasal cannula (n = 4), respiratory helmet (n = 1), and room air (n = 1). SARS-CoV-2 RNA was identified in rooms of three out of three intubated patients compared with one out of 10 of the non-intubated patients (p = .014). Airborne SARS-CoV-2 tended to decrease with distance (1 vs. 4 m) in rooms of intubated patients. Conclusions Hospital rooms of intubated patients had higher levels of aerosolized SARS-CoV-2, consistent with increased aerosolization of virus in patients with severe disease or treatment with positive pressure ventilation through an endotracheal tube. While preliminary, these data have safety implications for health care workers and design of protective measures in the hospital. Level of Evidence 2.
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Affiliation(s)
- Kenneth Yan
- Department of Head and Neck SurgeryUniversity of California Los AngelesCaliforniaLos AngelesUSA
| | - Jing Lin
- Pritzker School of Molecular EngineeringThe University of ChicagoChicagoIllinoisUSA
- Institute for Genomics and Systems BiologyThe University of ChicagoChicagoIllinoisUSA
| | - Shaley Albaugh
- Pritzker School of MedicineThe University of ChicagoChicagoIllinoisUSA
| | - Meredith Yang
- Pritzker School of MedicineThe University of ChicagoChicagoIllinoisUSA
| | - Esther Wang
- Pritzker School of MedicineThe University of ChicagoChicagoIllinoisUSA
| | - Thomas Cyberski
- Pritzker School of MedicineThe University of ChicagoChicagoIllinoisUSA
| | - Mustafa Fatih Abasiyanik
- Pritzker School of Molecular EngineeringThe University of ChicagoChicagoIllinoisUSA
- Institute for Genomics and Systems BiologyThe University of ChicagoChicagoIllinoisUSA
| | | | - Michael O'Connor
- Department of Anesthesiology & Critical CareThe University of ChicagoChicagoIllinoisUSA
| | - Allan Klock
- Department of Anesthesiology & Critical CareThe University of ChicagoChicagoIllinoisUSA
| | - Avery Tung
- Department of Anesthesiology & Critical CareThe University of ChicagoChicagoIllinoisUSA
| | - Sajid Shahul
- Department of Anesthesiology & Critical CareThe University of ChicagoChicagoIllinoisUSA
| | - Dinesh Kurian
- Department of Anesthesiology & Critical CareThe University of ChicagoChicagoIllinoisUSA
| | - Savaş Tay
- Pritzker School of Molecular EngineeringThe University of ChicagoChicagoIllinoisUSA
- Institute for Genomics and Systems BiologyThe University of ChicagoChicagoIllinoisUSA
| | - Jayant M. Pinto
- Section of Otolaryngology‐Head and Neck Surgery, Department of SurgeryThe University of ChicagoChicagoIllinoisUSA
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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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Bukha KK, Sharif EA, Eldaghayes IM. The One Health concept for the threat of severe acute respiratory syndrome coronavirus-2 to marine ecosystems. INTERNATIONAL JOURNAL OF ONE HEALTH 2022. [DOI: 10.14202/ijoh.2022.48-57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health threat. This virus is the causative agent for coronavirus disease 2019 (COVID-19). Pandemic prevention is best addressed through an integrated One Health (OH) approach. Understanding zoonotic pathogen fatality and spillover from wildlife to humans are effective for controlling and preventing zoonotic outbreaks. The OH concept depends on the interface of humans, animals, and their environment. Collaboration among veterinary medicine, public health workers and clinicians, and veterinary public health is necessary for rapid response to emerging zoonotic pathogens. SARS-CoV-2 affects aquatic environments, primarily through untreated sewage. Patients with COVID-19 discharge the virus in urine and feces into residential wastewater. Thus, marine organisms may be infected with SARS-CoV-2 by the subsequent discharge of partially treated or untreated wastewater to marine waters. Viral loads can be monitored in sewage and surface waters. Furthermore, shellfish are vulnerable to SARS-CoV-2 infection. Filter-feeding organisms might be monitored to protect consumers. Finally, the stability of SARS-CoV-2 to various environmental factors aids in viral studies. This article highlights the presence and survival of SARS-CoV-2 in the marine environment and its potential to enter marine ecosystems through wastewater. Furthermore, the OH approach is discussed for improving readiness for successive outbreaks. This review analyzes information from public health and epidemiological monitoring tools to control COVID-19 transmission.
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Affiliation(s)
- Khawla K. Bukha
- Department of Poultry and Fish Diseases, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
| | - Ehab A. Sharif
- Department of Poultry and Fish Diseases, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
| | - Ibrahim M. Eldaghayes
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
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Baselga M, Alba JJ, Schuhmacher AJ. The Control of Metabolic CO 2 in Public Transport as a Strategy to Reduce the Transmission of Respiratory Infectious Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6605. [PMID: 35682191 PMCID: PMC9180361 DOI: 10.3390/ijerph19116605] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 01/27/2023]
Abstract
The global acceptance of the SARS-CoV-2 airborne transmission led to prevention measures based on quality control and air renewal. Among them, carbon dioxide (CO2) measurement has positioned itself as a cost-efficiency, reliable, and straightforward method to assess indoor air renewal indirectly. Through the control of CO2, it is possible to implement and validate the effectiveness of prevention measures to reduce the risk of contagion of respiratory diseases by aerosols. Thanks to the method scalability, CO2 measurement has become the gold standard for diagnosing air quality in shared spaces. Even though collective transport is considered one of the environments with the highest rate of COVID-19 propagation, little research has been done where the air inside vehicles is analyzed. This work explores the generation and accumulation of metabolic CO2 in a tramway (Zaragoza, Spain) operation. Importantly, we propose to use the indicator ppm/person as a basis for comparing environments under different conditions. Our study concludes with an experimental evaluation of the benefit of modifying some parameters of the Heating-Ventilation-Air conditioning (HVAC) system. The study of the particle retention efficiency of the implemented filters shows a poor air cleaning performance that, at present, can be counteracted by opening windows. Seeking a post-pandemic scenario, it will be crucial to seek strategies to improve air quality in public transport to prevent the transmission of infectious diseases.
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Affiliation(s)
- Marta Baselga
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (J.J.A.)
| | - Juan J. Alba
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (J.J.A.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
| | - Alberto J. Schuhmacher
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (J.J.A.)
- Fundación Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), 500018 Zaragoza, Spain
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Le Neindre K, Couturier J, Schnuriger A, Jolivet S, Gouot C, Majerholc M, Supplisson P, Tan C, Perrier M, Lazare C, Morand-Joubert L, Barbut F. Environmental severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contamination in hospital rooms during the first and third coronavirus disease 2019 (COVID-19) waves. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e82. [PMID: 36483393 PMCID: PMC9726484 DOI: 10.1017/ash.2022.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 06/17/2023]
Abstract
We investigated the frequency, distribution, and risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination around infected patients during the first and third wave of the coronavirus disease 2019 pandemic. The shedding of SARS-CoV-2 in rooms of infected patients was limited in our hospital setting.
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Affiliation(s)
- Killian Le Neindre
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Jeanne Couturier
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Aurélie Schnuriger
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
- Department of Virology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sarah Jolivet
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Cyril Gouot
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Mickaël Majerholc
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Pierre Supplisson
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Céline Tan
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Marine Perrier
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
| | - Christelle Lazare
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Laurence Morand-Joubert
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
- Department of Virology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Frédéric Barbut
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
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Cardinale D, Tafuro M, Mancusi A, Girardi S, Capuano F, Proroga YTR, Corrado F, D’Auria JL, Coppola A, Rofrano G, Volzone P, Galdi P, De Vita S, Gallo A, Suffredini E, Pierri B, Cerino P, Morgante M. Sponge Whirl-Pak Sampling Method and Droplet Digital RT-PCR Assay for Monitoring of SARS-CoV-2 on Surfaces in Public and Working Environments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105861. [PMID: 35627397 PMCID: PMC9141805 DOI: 10.3390/ijerph19105861] [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] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/05/2022] [Accepted: 05/08/2022] [Indexed: 02/06/2023]
Abstract
The SARS-CoV-2 can spread directly via saliva, respiratory aerosols and droplets, and indirectly by contact through contaminated objects and/or surfaces and by air. In the context of COVID-19 fomites can be an important vehicle of virus transmission and contribute to infection risk in public environments. The aim of the study was to analyze through surface sampling (sponge method) the presence of SARS-CoV-2 in public and working environments, in order to evaluate the risk for virus transmission. Seventy-seven environmental samples were taken using sterile sponges in 17 animal farms, 4 public transport buses, 1 supermarket and 1 hotel receptive structure. Furthermore, 246 and 93 swab samples were taken in the farms from animals and from workers, respectively. SARS-CoV-2 detection was conducted by real-time RT-PCR and by digital droplet RT-PCR (dd RT-PCR) using RdRp, gene E and gene N as targets. None of the human and animal swab samples were positive for SARS-CoV-2, while detection was achieved in 20 of the 77 sponge samples (26%) using dd RT-PCR. Traces of the RdRp gene, gene E and gene N were found in 17/77 samples (22%, average concentration 31.2 g.c./cm2, range 5.6 to 132 g.c./cm2), 8/77 samples (10%, average concentration 15.1 g.c./cm2, range 6 to 36 g.c./cm2), and in 1/77 (1%, concentration 7.2 g.c./cm2). Higher detection rates were associated with sampling in animal farms and on public transport buses (32% and 30%) compared to the supermarket (21%) and the hotel (no detection). The result of the study suggests that the risk of contamination of surfaces with SARS-CoV-2 increases in environments in which sanitation strategies are not suitable and/or in highly frequented locations, such as public transportation. Considering the analytical methods, the dd RT-PCR was the only approach achieving detection of SARS-CoV-2 traces in environmental samples. Thus, dd RT-PCR emerges as a reliable tool for sensitive SARS-CoV-2 detection.
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Affiliation(s)
- Davide Cardinale
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Maria Tafuro
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Andrea Mancusi
- Department of Food Security Coordination, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (A.M.); (S.G.); (F.C.); (Y.T.R.P.)
| | - Santa Girardi
- Department of Food Security Coordination, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (A.M.); (S.G.); (F.C.); (Y.T.R.P.)
| | - Federico Capuano
- Department of Food Security Coordination, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (A.M.); (S.G.); (F.C.); (Y.T.R.P.)
| | - Yolande Thérèse Rose Proroga
- Department of Food Security Coordination, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (A.M.); (S.G.); (F.C.); (Y.T.R.P.)
| | - Federica Corrado
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Jacopo Luigi D’Auria
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Annachiara Coppola
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Giuseppe Rofrano
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Palmiero Volzone
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Pio Galdi
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Sabato De Vita
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Alfonso Gallo
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy;
| | - Biancamaria Pierri
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
- Correspondence:
| | - Pellegrino Cerino
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute n. 2, 80055 Portici, Italy; (D.C.); (M.T.); (F.C.); (J.L.D.); (A.C.); (G.R.); (P.V.); (P.G.); (S.D.V.); (A.G.); (P.C.)
| | - Maria Morgante
- Azienda Sanitaria Locale Avellino, 83100 Avellino, Italy;
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Baselga M, Güemes A, Alba JJ, Schuhmacher AJ. SARS-CoV-2 Droplet and Airborne Transmission Heterogeneity. J Clin Med 2022; 11:2607. [PMID: 35566733 PMCID: PMC9099777 DOI: 10.3390/jcm11092607] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/21/2022] [Accepted: 05/03/2022] [Indexed: 12/13/2022] Open
Abstract
The spread dynamics of the SARS-CoV-2 virus have not yet been fully understood after two years of the pandemic. The virus's global spread represented a unique scenario for advancing infectious disease research. Consequently, mechanistic epidemiological theories were quickly dismissed, and more attention was paid to other approaches that considered heterogeneity in the spread. One of the most critical advances in aerial pathogens transmission was the global acceptance of the airborne model, where the airway is presented as the epicenter of the spread of the disease. Although the aerodynamics and persistence of the SARS-CoV-2 virus in the air have been extensively studied, the actual probability of contagion is still unknown. In this work, the individual heterogeneity in the transmission of 22 patients infected with COVID-19 was analyzed by close contact (cough samples) and air (environmental samples). Viral RNA was detected in 2/19 cough samples from patient subgroups, with a mean Ct (Cycle Threshold in Quantitative Polymerase Chain Reaction analysis) of 25.7 ± 7.0. Nevertheless, viral RNA was only detected in air samples from 1/8 patients, with an average Ct of 25.0 ± 4.0. Viral load in cough samples ranged from 7.3 × 105 to 8.7 × 108 copies/mL among patients, while concentrations between 1.1-4.8 copies/m3 were found in air, consistent with other reports in the literature. In patients undergoing follow-up, no viral load was found (neither in coughs nor in the air) after the third day of symptoms, which could help define quarantine periods in infected individuals. In addition, it was found that the patient's Ct should not be considered an indicator of infectiousness, since it could not be correlated with the viral load disseminated. The results of this work are in line with proposed hypotheses of superspreaders, which can attribute part of the heterogeneity of the spread to the oversized emission of a small percentage of infected people.
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Affiliation(s)
- Marta Baselga
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
| | - Antonio Güemes
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Department of Surgery, University of Zaragoza, 50009 Zaragoza, Spain
| | - Juan J. Alba
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
| | - Alberto J. Schuhmacher
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Fundación Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), 50018 Zaragoza, Spain
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Zhang Y, Hu M, Wang J, Wang P, Shi P, Zhao W, Liu X, Peng Q, Meng B, Feng X, Zhang L. A Bibliometric Analysis of Personal Protective Equipment and COVID-19 Researches. Front Public Health 2022; 10:855633. [PMID: 35570977 PMCID: PMC9099374 DOI: 10.3389/fpubh.2022.855633] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/29/2022] [Indexed: 01/09/2023] Open
Abstract
COVID-19, which occurred at the end of December 2019, has evolved into a global public health threat and affects every aspect of human life. COVID-19's high infectivity and mortality prompted governments and the scientific community to respond quickly to the pandemic outbreak. The application of personal protective equipment (PPE) is of great significance in overcoming the epidemic situation. Since the discovery of severe acute respiratory coronavirus 2 (SARS-CoV-2), bibliometric analysis has been widely used in many aspects of the COVID-19 epidemic. Although there are many reported studies about PPE and COVID-19, there is no study on the bibliometric analysis of these studies. The citation can be used as an indicator of the scientific influence of an article in its field. The aim of this study was to track the research trends and latest hotspots of COVID-19 in PPE by means of bibliometrics and visualization maps.
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Affiliation(s)
- Yu Zhang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Man Hu
- Department of Orthopedics, Dalian Medical University, Dalian, China
| | - Junwu Wang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Pingchuan Wang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Pengzhi Shi
- Department of Orthopedics, Dalian Medical University, Dalian, China
| | - Wenjie Zhao
- Department of Orthopedics, Dalian Medical University, Dalian, China
| | - Xin Liu
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Qing Peng
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Bo Meng
- Department of Orthopedics, Dalian Medical University, Dalian, China
| | - Xinmin Feng
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Liang Zhang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
- *Correspondence: Liang Zhang
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Moreno-Martos D, Foley S, Parcell B, Trucu D, Eftimie R. A computational investigation of COVID-19 transmission inside hospital wards and associated costs. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:6504-6522. [PMID: 35730269 DOI: 10.3934/mbe.2022306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has placed a particular burden on hospitals: from intra-hospital transmission of the infections to reduced admissions of non-COVID-19 patients. There are also high costs associated with the treatment of hospitalised COVID-19 patients, as well as reductions in revenues due to delayed and cancelled treatments. In this study we investigate computationally the transmission of COVID-19 inside a hospital ward that contains multiple-bed bays (with 4 or 6 beds) and multiple single-bed side rooms (that can accommodate the contacts of COVID-19-positive patients). The aim of this study is to investigate the role of 4-bed bays vs. 6-bed bays on the spread of infections and the hospital costs. We show that 4-bed bays are associated with lower infections only when we reduce the discharge time of some patients from 10 days to 5 days. This also leads to lower costs for the treatment of COVID-19 patients. In contrast, 6-bed bays are associated with reduced hospital waiting lists (especially when there are also multiple side rooms available to accommodate the contacts of COVID-19-positive patients identified inside the 6-bed bays).
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Affiliation(s)
- David Moreno-Martos
- Population Health and Genomics, School of Medicine, University of Dundee, Dundee DD2 4BF, UK
| | - Sean Foley
- Mathematics, School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK
| | - Benjamin Parcell
- Medical Microbiology, NHS Tayside, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | - Dumitru Trucu
- Mathematics, School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK
| | - Raluca Eftimie
- Mathematics, School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK
- Laboratoire mathématiques de Besançon, UMR - CNRS 6623, Université de Bourgogne Franche-Comté, Besançon 25000, France
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Blackstone J, Stirrup O, Mapp F, Panca M, Copas A, Flowers P, Hockey L, Price J, Partridge D, Peters C, de Silva T, Nebbia G, Snell LB, McComish R, Breuer J. Protocol for the COG-UK hospital-onset COVID-19 infection (HOCI) multicentre interventional clinical study: evaluating the efficacy of rapid genome sequencing of SARS-CoV-2 in limiting the spread of COVID-19 in UK NHS hospitals. BMJ Open 2022; 12:e052514. [PMID: 35440446 PMCID: PMC9019828 DOI: 10.1136/bmjopen-2021-052514] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 03/28/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Nosocomial transmission of SARS-CoV-2 has been a significant cause of mortality in National Health Service (NHS) hospitals during the COVID-19 pandemic. The COG-UK Consortium Hospital-Onset COVID-19 Infections (COG-UK HOCI) study aims to evaluate whether the use of rapid whole-genome sequencing of SARS-CoV-2, supported by a novel probabilistic reporting methodology, can inform infection prevention and control (IPC) practice within NHS hospital settings. DESIGN Multicentre, prospective, interventional, superiority study. SETTING 14 participating NHS hospitals over winter-spring 2020/2021 in the UK. PARTICIPANTS Eligible patients must be admitted to hospital with first-confirmed SARS-CoV-2 PCR-positive test result >48 hour from time of admission, where COVID-19 diagnosis not suspected on admission. The projected sample size is 2380 patients. INTERVENTION The intervention is the return of a sequence report, within 48 hours in one phase (rapid local lab processing) and within 5-10 days in a second phase (mimicking central lab), comparing the viral genome from an eligible study participant with others within and outside the hospital site. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcomes are incidence of Public Health England (PHE)/IPC-defined SARS-CoV-2 hospital-acquired infection during the baseline and two interventional phases, and proportion of hospital-onset cases with genomic evidence of transmission linkage following implementation of the intervention where such linkage was not suspected by initial IPC investigation. Secondary outcomes include incidence of hospital outbreaks, with and without sequencing data; actual and desirable changes to IPC actions; periods of healthcare worker (HCW) absence. Health economic analysis will be conducted to determine cost benefit of the intervention. A process evaluation using qualitative interviews with HCWs will be conducted alongside the study. TRIAL REGISTRATION NUMBER ISRCTN50212645. Pre-results stage. This manuscript is based on protocol V.6.0. 2 September 2021.
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Affiliation(s)
- James Blackstone
- Comprehensive Clinical Trials Unit, University College London, London, UK
| | - Oliver Stirrup
- Institute for Global Health, University College London, London, UK
| | - Fiona Mapp
- Institute for Global Health, University College London, London, UK
| | - Monica Panca
- Comprehensive Clinical Trials Unit, University College London, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Paul Flowers
- School of Psychology & Health, University of Strathclyde, Glasgow, UK
| | - Leanne Hockey
- Comprehensive Clinical Trials Unit, University College London, London, UK
| | - James Price
- Department of Infectious Disease, Imperial College London, London, UK
| | - David Partridge
- Department of Virology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Christine Peters
- Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Thushan de Silva
- Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - Gaia Nebbia
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Luke B Snell
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rachel McComish
- Comprehensive Clinical Trials Unit, University College London, London, UK
| | - Judith Breuer
- Institute of Child Health, University College London, London, UK
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Wang F, Zhan Q, Yu SP, Feng HT, Hu P, Zhong ZF, Qu TT. Environmental Monitoring of Parvovirus B19 in the Kidney Transplantation Ward of a Chinese Teaching Hospital. Infect Drug Resist 2022; 15:1903-1910. [PMID: 35465250 PMCID: PMC9030386 DOI: 10.2147/idr.s356174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/26/2022] [Indexed: 01/04/2023] Open
Abstract
Purpose Parvovirus B19 (B19V) infection is a viral threat after kidney transplantation. It is mainly transmitted by close-contact inhalation of aerosolized viral particles. The risk of nosocomial spread of B19V in the transplantation ward is quite high. This study aimed to evaluate the quality of routine disinfection and the effectiveness of isolation measures in the wards of B19V-infected kidney transplant recipients. Patients and Methods Throat swab samples of 19 kidney transplant recipients admitted to the isolation ward and three healthcare workers (HCWs) were collected for viral DNA detection. Routine disinfection procedures were performed twice a day in general and B19V isolation wards. Environmental surface and air samples were collected for viral DNA detection before and after disinfection. Results A total of four patients were diagnosed with B19V infection and transferred to the B19V isolation ward, of which only two had positive throat swab samples. The other 15 patients and all HCWs tested negative for B19V. A total of 88 environmental surface and air samples were collected. Eight of the environmental samples collected in the B19V isolation ward before disinfection tested positive for B19V, while one sample tested positive after disinfection. In the general wards, all environmental samples collected before disinfection tested negative for B19V. All 24 samples collected from ambient air, whether in B19V isolation or general wards, before or after disinfection, tested negative for B19V. Conclusion Existing methods of routine or terminal disinfection for air and object surfaces were effective in eliminating B19V from object surfaces and ambient air in the isolation and general wards. Material surfaces that are exposed to high frequency and easily contaminated by blood, body fluids, and indoor air were the focus of cleaning and disinfection. Nosocomial cross-infection of other immunocompromised patients and HCWs can be avoided if appropriate prevention and control measures are taken.
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Affiliation(s)
- Fang Wang
- Infection Control Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Qing Zhan
- Infection Control Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Shi-Ping Yu
- Kidney Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Hai-Ting Feng
- Infection Control Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Ping Hu
- Kidney Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Zi-Feng Zhong
- Infection Control Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Ting-Ting Qu
- Infection Control Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
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45
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Barrios Andrés JL, Carriba Rodriguez MJ, Aranzamendi Zaldumbide M, Hernández JM, Viciola García M. Evaluation of cleaning and disinfection protocols for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) on different hospital surfaces. Infect Control Hosp Epidemiol 2022; 43:544-545. [PMID: 33487202 PMCID: PMC7870904 DOI: 10.1017/ice.2021.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 11/09/2022]
Affiliation(s)
- José Luis Barrios Andrés
- Hospital Infection Control Division, Microbiology Service, Hospital Universitario Cruces, Barakaldo (Bizkaia), Basque Country, Spain
| | | | | | - Jose María Hernández
- Commission on Infections and Antibiotic Policy, Department of Preventive Medicine, Hospital Universitario Cruces, Barakaldo (Bizkaia), Basque Country, Spain
| | - Margarita Viciola García
- Preventive Medicine Service, Hospital Universitario Cruces, Barakaldo (Bizkaia), Basque Country, Spain
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Takeuchi K, Yanagisawa H, Kurosawa Y, Iida Y, Kawai K, Fujimaki S. Degradation of SARS-CoV-2 specific ribonucleic acid in samples for nucleic acid amplification detection. PLoS One 2022; 17:e0264541. [PMID: 35275928 PMCID: PMC8916628 DOI: 10.1371/journal.pone.0264541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/12/2022] [Indexed: 01/10/2023] Open
Abstract
The degradation of SARS-CoV-2 specific ribonucleic acid (RNA) was investigated by a numerical modeling approach based on nucleic acid amplification test (NAAT) results utilizing the SmartAmp technique. The precision of the measurement was verified by the relative standard deviation (RSD) of repeated measurements at each calibration point. The precision and detection limits were found to be 6% RSD (seven repeated measurements) and 94 copies/tube, respectively, at the lowest calibration point. RNA degradation curves obtained from NAAT data on four different temperatures were in good agreement with the first-order reaction model. By referring to rate constants derived from the results, the Arrhenius model was applied to predict RNA degradation behavior. If the initial RNA concentration was high enough, such as in samples taken from infected bodies, the NAAT results were expected to be positive during testing. On the other hand, if initial RNA concentrations were relatively low, such as RNA in residual viruses on environmental surfaces, special attention should be paid to avoid false-negative results. The results obtained in this study provide a practical guide for RNA sample management in the NAAT of non-human samples.
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Affiliation(s)
- Katsuyuki Takeuchi
- Institute of Education, Innovative Human Resource Development Division, Tokyo Medical and Dental University, Bunkyo‐ku, Tokyo, Japan
- Department of Genetics, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | | | - Yukiko Kurosawa
- Central Chemical Laboratory, SGS Japan Inc., Hodogaya-ku, Yokohama, Japan
| | - Yoritsugu Iida
- Institute of Education, Innovative Human Resource Development Division, Tokyo Medical and Dental University, Bunkyo‐ku, Tokyo, Japan
| | - Kosuke Kawai
- Central Chemical Laboratory, SGS Japan Inc., Hodogaya-ku, Yokohama, Japan
| | - Shigehiko Fujimaki
- Central Chemical Laboratory, SGS Japan Inc., Hodogaya-ku, Yokohama, Japan
- * E-mail:
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47
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Dobrynin D, Polishchuk I, Portal L, Zlotver I, Sosnik A, Pokroy B. Adsorption of SARS CoV-2 spike proteins on various functionalized surfaces correlates with the high transmissibility of Delta and Omicron variants. Mater Today Bio 2022; 14:100265. [PMID: 35465145 PMCID: PMC9017064 DOI: 10.1016/j.mtbio.2022.100265] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 12/12/2022] Open
Abstract
The SARS-CoV-2 virus emerged at the end of 2019 and rapidly developed several mutated variants, specifically the Delta and Omicron, which demonstrate higher transmissibility and escalating infection cases worldwide. The dominant transmission pathway of this virus is via human-to-human contact and aerosols which once inhaled interact with the mucosal tissue, but another possible route is through contact with surfaces contaminated with SARS-CoV-2, often exhibiting long-term survival. Here we compare the adsorption capacities of the S1 and S2 subunits of the spike (S) protein from the original variant to that of the S1 subunit from the Delta and Omicron variants on self-assembled monolayers by Quartz Crystal Microbalance. The results clearly show a significant difference in adsorption capacity between the different variants, as well as between the S1 and S2 subunits. Overall, our study demonstrates that while the Omicron variant is able to adsorb much more successfully than the Delta, both variants show enhanced adsorption capacity than that of the original strain. We also examined the influence of pH conditions on the adsorption ability of the S1 subunit and found that adsorption was strongest at pH 7.4, which is the physiological pH. The main conclusion of this study is that there is a strong correlation between the adsorption capacity and the transmissibility of the various SARS-CoV-2 variants.
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Affiliation(s)
- Daniela Dobrynin
- Bio-Inspired Surface Engineering and Biomineralization Lab, Department of Materials Science and Engineering, Technion – Israel Institute of Technology, 32000, Haifa, Israel
| | - Iryna Polishchuk
- Bio-Inspired Surface Engineering and Biomineralization Lab, Department of Materials Science and Engineering, Technion – Israel Institute of Technology, 32000, Haifa, Israel
| | - Lotan Portal
- Bio-Inspired Surface Engineering and Biomineralization Lab, Department of Materials Science and Engineering, Technion – Israel Institute of Technology, 32000, Haifa, Israel
| | - Ivan Zlotver
- Laboratory of Pharmaceutical Nanomaterials Science, Department of Materials Science and Engineering, Technion – Israel Institute of Technology, 32000, Haifa, Israel
| | - Alejandro Sosnik
- Laboratory of Pharmaceutical Nanomaterials Science, Department of Materials Science and Engineering, Technion – Israel Institute of Technology, 32000, Haifa, Israel
| | - Boaz Pokroy
- Bio-Inspired Surface Engineering and Biomineralization Lab, Department of Materials Science and Engineering, Technion – Israel Institute of Technology, 32000, Haifa, Israel
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Sobolik JS, Sajewski ET, Jaykus LA, Cooper DK, Lopman BA, Kraay ANM, Ryan PB, Leon JS. Controlling risk of SARS-CoV-2 infection in essential workers of enclosed food manufacturing facilities. Food Control 2022; 133:108632. [PMID: 34703082 PMCID: PMC8532033 DOI: 10.1016/j.foodcont.2021.108632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022]
Abstract
The SARS-CoV-2 global pandemic poses significant health risks to workers who are essential to maintaining the food supply chain. Using a quantitative risk assessment model, this study characterized the impact of risk reduction strategies for controlling SARS-CoV-2 transmission (droplet, aerosol, fomite-mediated) among front-line workers in a representative indoor fresh fruit and vegetable manufacturing facility. We simulated: 1) individual and cumulative SARS-CoV-2 infection risks from close contact (droplet and aerosols at 1-3 m), aerosol, and fomite-mediated exposures to a susceptible worker following exposure to an infected worker during an 8 h-shift; and 2) the relative reduction in SARS-CoV-2 infection risk attributed to infection control interventions (physical distancing, mask use, ventilation, surface disinfection, hand hygiene, vaccination). Without mitigation measures, the SARS-CoV-2 infection risk was largest for close contact (droplet and aerosol) at 1 m (0.96, 5th - 95th percentile: 0.67-1.0). In comparison, risk associated with fomite (0.26, 5th - 95th percentile: 0.10-0.56) or aerosol exposure alone (0.05, 5th - 95th percentile: 0.01-0.13) at 1 m distance was substantially lower (73-95%). At 1 m, droplet transmission predominated over aerosol and fomite-mediated transmission, however, this changed by 3 m, with aerosols comprising the majority of the exposure dose. Increasing physical distancing reduced risk by 84% (1-2 m) and 91% (1-3 m). Universal mask use reduced infection risk by 52-88%, depending on mask type. Increasing ventilation (from 0.1 to 2-8 air changes/hour) resulted in risk reductions of 14-54% (1 m) and 55-85% (2 m). Combining these strategies, together with handwashing and surface disinfection, resulted in <1% infection risk. Partial or full vaccination of the susceptible worker resulted in risk reductions of 73-92% (1 m risk range: 0.08-0.26). However, vaccination paired with other interventions (ACH 2, mask use, or distancing) was necessary to achieve infection risks <1%. Current industry SARS-CoV-2 risk reduction strategies, particularly when bundled, provide significant protection to essential food workers.
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Affiliation(s)
- Julia S Sobolik
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | | | - Lee-Ann Jaykus
- Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, NC, 27695, USA
| | - D Kane Cooper
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Ben A Lopman
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Alicia N M Kraay
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - P Barry Ryan
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Juan S Leon
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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Katona P, Kullar R, Zhang K. Bringing Transmission of SARS-CoV-2 to the Surface: Is there a Role for Fomites? Clin Infect Dis 2022; 75:910-916. [PMID: 35218181 PMCID: PMC8903442 DOI: 10.1093/cid/ciac157] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Indexed: 01/22/2023] Open
Abstract
Understanding the contribution of routes of transmission, particularly the role of fomites in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) transmission is important in developing and implementing successful public health infection prevention and control measures.This article will look at case reports, laboratory findings, animal studies, environmental factors, the need for disinfection, and differences in settings, as they relate to SARS-CoV-2 transmission.
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Affiliation(s)
- Peter Katona
- UCLA School of Medicine Dept. of Infectious Diseases and UCLA School of Public Health
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50
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Dinoi A, Feltracco M, Chirizzi D, Trabucco S, Conte M, Gregoris E, Barbaro E, La Bella G, Ciccarese G, Belosi F, La Salandra G, Gambaro A, Contini D. A review on measurements of SARS-CoV-2 genetic material in air in outdoor and indoor environments: Implication for airborne transmission. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 809:151137. [PMID: 34699823 PMCID: PMC8539199 DOI: 10.1016/j.scitotenv.2021.151137] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 05/03/2023]
Abstract
Airborne transmission of SARS-CoV-2 has been object of debate in the scientific community since the beginning of COVID-19 pandemic. This mechanism of transmission could arise from virus-laden aerosol released by infected individuals and it is influenced by several factors. Among these, the concentration and size distribution of virus-laden particles play an important role. The knowledge regarding aerosol transmission increases as new evidence is collected in different studies, even if it is not yet available a standard protocol regarding air sampling and analysis, which can create difficulties in the interpretation and application of results. This work reports a systematic review of current knowledge gained by 73 published papers on experimental determination of SARS-CoV-2 RNA in air comparing different environments: outdoors, indoor hospitals and healthcare settings, and public community indoors. Selected papers furnished 77 datasets: outdoor studies (9/77, 11.7%) and indoor studies (68/77. 88.3%). The indoor datasets in hospitals were the vast majority (58/68, 85.3%), and the remaining (10/68, 14.7%) were classified as community indoors. The fraction of studies having positive samples, as well as positivity rates (i.e. ratios between positive and total samples) are significantly larger in hospitals compared to the other typologies of sites. Contamination of surfaces was more frequent (in indoor datasets) compared to contamination of air samples; however, the average positivity rate was lower compared to that of air. Concentrations of SARS-CoV-2 RNA in air were highly variables and, on average, lower in outdoors compared to indoors. Among indoors, concentrations in community indoors appear to be lower than those in hospitals and healthcare settings.
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Affiliation(s)
- Adelaide Dinoi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy
| | - Matteo Feltracco
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniela Chirizzi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Sara Trabucco
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Marianna Conte
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy; Laboratory for Observations and Analyses of Earth and Climate, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy
| | - Elena Gregoris
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Elena Barbaro
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Giuseppina Ciccarese
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Franco Belosi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Andrea Gambaro
- Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniele Contini
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy.
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