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Xu Y, Jin T, Bai Y, Zhou X, Lv H, Dai C, Wu Z, Xu Q. Plasma-activated water: Candidate hand disinfectant for SARS-CoV-2 transmission disruption. Heliyon 2024; 10:e34337. [PMID: 39144986 PMCID: PMC11320155 DOI: 10.1016/j.heliyon.2024.e34337] [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: 03/21/2024] [Revised: 06/19/2024] [Accepted: 07/08/2024] [Indexed: 08/16/2024] Open
Abstract
The global epidemic caused by SARS-CoV-2 has brought about worldwide burden and a sense of danger for more than two years, leading to a wide range of social, public health, economic and environmental issues. Self-inoculation through hands has been the primary way for environmental transmission of SARS-CoV-2. Plasma-activated water (PAW) has been reported as an effective, safe and environmentally friendly disinfectant against SARS-CoV-2. However, the inactivating effect of PAW on SARS-CoV-2 located on skin surface and its underlying mechanism of action have not been elucidated. In this study, PAW was prepared using an air-pressure plasma jet device. The antiviral efficiency of PAW1, PAW3, and PAW5 on the SARS-CoV-2 pseudovirus was 8.20 % (±2.88 %), 46.24 % (±1.79 %), and 91.71 % (±0.47 %), respectively. Additionally, determination of PAW's physicochemical properties, identification of major sterile effector in PAW, transmission electron microscopy analysis, malondialdehyde (MDA) assessment, SDS-PAGE, ELISA, and qPCR were conducted to reveal the virucidal mechanism of PAW. Our experimental results suggested that peroxynitrite, which was generated by the synergism of acidic environment and reactive species, was the major sterile effector of PAW. Furthermore, we found that PAW treatment significantly inactivated SARS-CoV-2 pseudovirus through the destruction of its structure of and the degradation of the viral RNA. Therefore, the possible mechanism for the structural destruction of SARS-COV-2 by PAW is through the action of peroxynitrite generated by the synergism of acidic environment and reactive species, which might react with and destroy the lipid envelope of SARS-CoV-2 pseudovirus. Nevertheless, further studies are required to shed light on the interaction mechanism of PAW-inherent RONS and viral components, and to confirm the determinant factors for virus inactivation of SARS-COV-2 by PAW. Therefore, PAW may be a candidate hand disinfectant used to disrupt the transmission of SARS-CoV-2.
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Affiliation(s)
- Yong Xu
- Anhui Academy of Medical Sciences, Anhui Medical College, Hefei, China
| | - Tao Jin
- School of Nuclear Science and Technology, University of Science and Technology of China, Hefei, China
| | - Yu Bai
- Anhui Academy of Medical Sciences, Anhui Medical College, Hefei, China
| | - Xiuhong Zhou
- Anhui Academy of Medical Sciences, Anhui Medical College, Hefei, China
| | - Han Lv
- Anhui Academy of Medical Sciences, Anhui Medical College, Hefei, China
| | - Chenwei Dai
- Anhui Academy of Medical Sciences, Anhui Medical College, Hefei, China
| | - Zhengwei Wu
- School of Nuclear Science and Technology, University of Science and Technology of China, Hefei, China
| | - Qinghua Xu
- Anhui Academy of Medical Sciences, Anhui Medical College, Hefei, China
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
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Sutter J, Brettschneider J, Wigdahl B, Bruggeman PJ, Krebs FC, Miller V. Non-Thermal Plasma Reduces HSV-1 Infection of and Replication in HaCaT Keratinocytes In Vitro. Int J Mol Sci 2024; 25:3839. [PMID: 38612649 PMCID: PMC11011387 DOI: 10.3390/ijms25073839] [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: 02/26/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Herpes simplex virus type 1 (HSV-1) is a lifelong pathogen characterized by asymptomatic latent infection in the trigeminal ganglia (TG), with periodic outbreaks of cold sores caused by virus reactivation in the TG and subsequent replication in the oral mucosa. While antiviral therapies can provide relief from cold sores, they are unable to eliminate HSV-1. We provide experimental results that highlight non-thermal plasma (NTP) as a new alternative therapy for HSV-1 infection that would resolve cold sores faster and reduce the establishment of latent infection in the TG. Additionally, this study is the first to explore the use of NTP as a therapy that can both treat and prevent human viral infections. The antiviral effect of NTP was investigated using an in vitro model of HSV-1 epithelial infection that involved the application of NTP from two separate devices to cell-free HSV-1, HSV-1-infected cells, and uninfected cells. It was found that NTP reduced the infectivity of cell-free HSV-1, reduced viral replication in HSV-1-infected cells, and diminished the susceptibility of uninfected cells to HSV-1 infection. This triad of antiviral mechanisms of action suggests the potential of NTP as a therapeutic agent effective against HSV-1 infection.
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Affiliation(s)
- Julia Sutter
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (J.S.); (J.B.); (B.W.); (F.C.K.)
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - Jascha Brettschneider
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (J.S.); (J.B.); (B.W.); (F.C.K.)
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - Brian Wigdahl
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (J.S.); (J.B.); (B.W.); (F.C.K.)
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Peter J. Bruggeman
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Fred C. Krebs
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (J.S.); (J.B.); (B.W.); (F.C.K.)
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - Vandana Miller
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (J.S.); (J.B.); (B.W.); (F.C.K.)
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
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Sheng X, Wang J, Zhao L, Yan W, Qian J, Wang Z, Zhang J, Raghavan V. Inactivation mechanism of cold plasma combined with 222 nm ultraviolet for spike protein and its application in disinfecting of SARS-CoV-2. JOURNAL OF HAZARDOUS MATERIALS 2024; 465:133458. [PMID: 38215522 DOI: 10.1016/j.jhazmat.2024.133458] [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: 10/17/2023] [Revised: 12/14/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that has precipitated a worldwide pandemic of coronavirus disease since 2019. Developing an effective disinfection strategy is crucial to prevent the risk of surface cross-contamination by SARS-CoV-2. This study employed pseudovirus and the receptor-binding domain (RBD) protein of SARS-CoV-2 as models to investigate the spike protein inactivation process and its underlying mechanisms using a novel nonthermal technology. Cold plasma combined with 222 nm ultraviolet (CP+UV) treatment was applied to accelerate the generation of reactive species and enhance sterilization efficiency. The results indicated that the binding activity of RBD protein was completely inhibited at specific concentrations (0.01-0.05 mg/cm2) with corresponding treatment times of 15-30 s. The mechanism potentially involves the reactive species generated by CP+UV, which react with the spike protein RBD of SARS-CoV-2, leading to the loss of SARS-CoV-2 infectivity by causing damage to the β-sheet structure and chemical bonds in the RBD protein. Validated by a biosafety level 3 (BSL3) laboratory, the CP+UV treatment for 30 s could completely inactivate SARS-CoV-2 with a concentration of 19054 ± 1112 TCID50/cm2. Therefore, this study potentially provides a novel disinfection strategy for the inactivation of SARS-CoV-2 on surface cross-contamination.
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Affiliation(s)
- Xiaowei Sheng
- National Center of Meat Quality and Safety Control, Collaborative Innovation Center of Meat Production and Processing, Quality and Safety Control, College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Jin Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Luling Zhao
- National Center of Meat Quality and Safety Control, Collaborative Innovation Center of Meat Production and Processing, Quality and Safety Control, College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Wenjing Yan
- National Center of Meat Quality and Safety Control, Collaborative Innovation Center of Meat Production and Processing, Quality and Safety Control, College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Jing Qian
- National Center of Meat Quality and Safety Control, Collaborative Innovation Center of Meat Production and Processing, Quality and Safety Control, College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Zhaobin Wang
- National Center of Meat Quality and Safety Control, Collaborative Innovation Center of Meat Production and Processing, Quality and Safety Control, College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Jianhao Zhang
- National Center of Meat Quality and Safety Control, Collaborative Innovation Center of Meat Production and Processing, Quality and Safety Control, College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China.
| | - Vijaya Raghavan
- Department of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, QC H9X3V9, Canada
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Sutter J, Bruggeman PJ, Wigdahl B, Krebs FC, Miller V. Manipulation of Oxidative Stress Responses by Non-Thermal Plasma to Treat Herpes Simplex Virus Type 1 Infection and Disease. Int J Mol Sci 2023; 24:4673. [PMID: 36902102 PMCID: PMC10003306 DOI: 10.3390/ijms24054673] [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: 12/21/2022] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
Herpes simplex virus type 1 (HSV-1) is a contagious pathogen with a large global footprint, due to its ability to cause lifelong infection in patients. Current antiviral therapies are effective in limiting viral replication in the epithelial cells to alleviate clinical symptoms, but ineffective in eliminating latent viral reservoirs in neurons. Much of HSV-1 pathogenesis is dependent on its ability to manipulate oxidative stress responses to craft a cellular environment that favors HSV-1 replication. However, to maintain redox homeostasis and to promote antiviral immune responses, the infected cell can upregulate reactive oxygen and nitrogen species (RONS) while having a tight control on antioxidant concentrations to prevent cellular damage. Non-thermal plasma (NTP), which we propose as a potential therapy alternative directed against HSV-1 infection, is a means to deliver RONS that affect redox homeostasis in the infected cell. This review emphasizes how NTP can be an effective therapy for HSV-1 infections through the direct antiviral activity of RONS and via immunomodulatory changes in the infected cells that will stimulate anti-HSV-1 adaptive immune responses. Overall, NTP application can control HSV-1 replication and address the challenges of latency by decreasing the size of the viral reservoir in the nervous system.
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Affiliation(s)
- Julia Sutter
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - Peter J. Bruggeman
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Brian Wigdahl
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - Fred C. Krebs
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - Vandana Miller
- Center for Molecular Virology and Gene Therapy, Institute for Molecular Medicine and Infectious Disease, Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19129, USA
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Chen Z, Bai F, Jonas SJ, Wirz RE. Cold atmospheric plasma for addressing the COVID-19 pandemic. PLASMA PROCESSES AND POLYMERS (PRINT) 2022; 19:2200012. [PMID: 35574246 PMCID: PMC9088580 DOI: 10.1002/ppap.202200012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/11/2022] [Accepted: 03/25/2022] [Indexed: 05/16/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has greatly stressed the global community, exposing vulnerabilities in the supply chains for disinfection materials, personal protective equipment, and medical resources worldwide. Disinfection methods based on cold atmospheric plasma (CAP) technologies offer an intriguing solution to many of these challenges because they are easily deployable and do not require resource-constrained consumables or reagents needed for conventional decontamination practices. CAP technologies have shown great promise for a wide range of medical applications from wound healing and cancer treatment to sterilization methods to mitigate airborne and fomite transfer of viruses. This review engages the broader community of scientists and engineers that wish to help the medical community with the ongoing COVID-19 pandemic by establishing methods to utilize broadly applicable CAP technologies.
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Affiliation(s)
- Zhitong Chen
- Department of Mechanical and Aerospace EngineeringUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Advanced Therapy CenterNational Innovation Center for Advanced Medical DevicesShenzhenPeople's Republic of China
- Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhenPeople's Republic of China
| | - Fan Bai
- Advanced Therapy CenterNational Innovation Center for Advanced Medical DevicesShenzhenPeople's Republic of China
- Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhenPeople's Republic of China
| | - Steven J. Jonas
- Department of Pediatrics, David Geffen School of MedicineUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- California NanoSystems InstituteUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell ResearchUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - Richard E. Wirz
- Department of Mechanical and Aerospace EngineeringUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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Baek KH, Jang D, Kim T, Park JY, Kim D, Ryoo S, Lee S. Instant inactivation of aerosolized SARS-CoV-2 by dielectric filter discharge. PLoS One 2022; 17:e0268049. [PMID: 35587941 PMCID: PMC9119459 DOI: 10.1371/journal.pone.0268049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/15/2022] [Indexed: 01/02/2023] Open
Abstract
This study aimed to evaluate the instant inactivation effect of dielectric filter discharge (DFD) on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) aerosols. The filter consisted of one layer of ZrO2 beads covered by aluminum mesh electrodes; this porous structure of DFD part generates filter-type surface discharge and reactive oxygen species. In a closed cylindrical chamber, DFD treated air flow containing SARS-CoV-2 aerosols, primarily composed of particle diameters of ≤ 1 μm. A polypropylene melt-blown filter collected the treated bioaerosols for inactivation analysis. Plaque and polymerase chain reaction assays showed that the aerosolized SARS-CoV-2 that passed through the filter were more than 99.84% inactivated with degradation of SARS-CoV-2 genes (ORF1ab and E). However, ozone exposure without DFD passage was not found to be effective for bioaerosol inactivation in plaque assay.
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Affiliation(s)
- Ki Ho Baek
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, Changwon, Republic of Korea
| | - Donghwan Jang
- Clinical Research Centre, Masan National Tuberculosis Hospital, Changwon, Republic of Korea
| | - Taeyoon Kim
- Clinical Research Centre, Masan National Tuberculosis Hospital, Changwon, Republic of Korea
| | - Joo Young Park
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, Changwon, Republic of Korea
| | - Dojoon Kim
- Purunbit, Siheung-si, Gyeonggi-do, Republic of Korea
| | - Sungweon Ryoo
- Clinical Research Centre, Masan National Tuberculosis Hospital, Changwon, Republic of Korea
| | - Seunghun Lee
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, Changwon, Republic of Korea
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Khanikar RR, Kalita M, Kalita P, Kashyap B, Das S, Khan MR, Bailung H, Sankaranarayanan K. Cold atmospheric pressure plasma for attenuation of SARS-CoV-2 spike protein binding to ACE2 protein and the RNA deactivation. RSC Adv 2022; 12:9466-9472. [PMID: 35424902 PMCID: PMC8985215 DOI: 10.1039/d2ra00009a] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/18/2022] [Indexed: 11/21/2022] Open
Abstract
Cold atmospheric pressure (CAP) plasma has a profound effect on protein-protein interactions. In this work, we have highlighted the deactivation of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) spike protein by CAP plasma treatment. Complete deactivation of spike protein binding to the human ACE2 protein was observed within an exposure time of 5 minutes which is correlated to the higher concentration of hydrogen peroxide formation due to the interaction with the reactive oxygen species present in the plasma. On the other hand, we have established that CAP plasma is also capable of degrading RNA of SARS-CoV-2 virus which is also linked to hydrogen peroxide concentration. The reactive oxygen species is produced in the plasma by using noble gases such as helium, in the absence of any other chemicals. Therefore, it is a green process with no chemical waste generated and highly advantageous from the environmental safety prospects. Results of this work could be useful in designing plasma-based disinfection systems over those based on environmentally hazardous chemical-based disinfection and biomedical applications.
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Affiliation(s)
- Rakesh Ruchel Khanikar
- Physical Sciences Division, Institute of Advanced Study in Science and Technology, (An Autonomous Institute Under DST, Govt. of India) Vigyan Path, Paschim Boragaon, Garchuk Guwahati Assam 781035 India
| | - Monalisa Kalita
- Life Sciences Division, Institute of Advanced Study in Science and Technology, (An Autonomous Institute Under DST, Govt. of India) Vigyan Path, Paschim Boragaon, Garchuk Guwahati Assam 781035 India
| | - Parismita Kalita
- Physical Sciences Division, Institute of Advanced Study in Science and Technology, (An Autonomous Institute Under DST, Govt. of India) Vigyan Path, Paschim Boragaon, Garchuk Guwahati Assam 781035 India
| | - Bhaswati Kashyap
- Life Sciences Division, Institute of Advanced Study in Science and Technology, (An Autonomous Institute Under DST, Govt. of India) Vigyan Path, Paschim Boragaon, Garchuk Guwahati Assam 781035 India
| | - Santanu Das
- Life Sciences Division, Institute of Advanced Study in Science and Technology, (An Autonomous Institute Under DST, Govt. of India) Vigyan Path, Paschim Boragaon, Garchuk Guwahati Assam 781035 India
| | - Mojibur R Khan
- Life Sciences Division, Institute of Advanced Study in Science and Technology, (An Autonomous Institute Under DST, Govt. of India) Vigyan Path, Paschim Boragaon, Garchuk Guwahati Assam 781035 India
| | - Heremba Bailung
- Physical Sciences Division, Institute of Advanced Study in Science and Technology, (An Autonomous Institute Under DST, Govt. of India) Vigyan Path, Paschim Boragaon, Garchuk Guwahati Assam 781035 India
| | - Kamatchi Sankaranarayanan
- Physical Sciences Division, Institute of Advanced Study in Science and Technology, (An Autonomous Institute Under DST, Govt. of India) Vigyan Path, Paschim Boragaon, Garchuk Guwahati Assam 781035 India
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Liu J, Zheng T, Xia W, Xu S, Li Y. Cold chain and severe acute respiratory syndrome coronavirus 2 transmission: a review for challenges and coping strategies. MEDICAL REVIEW (BERLIN, GERMANY) 2022; 2:50-65. [PMID: 35658108 PMCID: PMC9047647 DOI: 10.1515/mr-2021-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/13/2021] [Indexed: 06/15/2023]
Abstract
Since June 2020, the re-emergence of coronavirus disease 2019 (COVID-19) epidemics in parts of China was linked to the cold chain, which attracted extensive attention and heated discussions from the public. According to the typical characteristics of these epidemics, we speculated a possible route of transmission from cold chain to human. A series of factors in the supply chain contributed to the epidemics if the cold chain were contaminated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), such as temperature, humidity, personal hygiene/protection, and disinfection. The workers who worked in the cold chain at the receiving end faced a higher risk of being infected when they were not well protected. Facing the difficult situation, China put forward targeted and powerful countermeasures to block the cold chain-related risk. However, in the context of the unstable pandemic situation globally, the risk of the cold chain needs to be recognized and evaluated seriously. Hence, in this review, we reviewed the cold chain-related epidemics in China, analyzed the possible mechanisms, introduced the Chinese experience, and suggested coping strategies for the global epidemic prevention and control.
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Affiliation(s)
- Jiangtao Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, United States
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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