Transfer of Enteric Viruses Adenovirus and Coxsackievirus and Bacteriophage MS2 from Liquid to Human Skin

Viral-Bacterial Interactions That Impact Viral Thermostability and Transmission

Enteric viruses are significant human pathogens that commonly cause foodborne illnesses worldwide. These viruses initiate infection in the gastrointestinal tract, home to a diverse population of intestinal bacteria. In a novel paradigm, data indicate that enteric viruses utilize intestinal bacteria to promote viral replication and pathogenesis. While mechanisms underlying these observations are not fully understood, data suggest that some enteric viruses bind directly to bacteria, stabilizing the virion to retain infectivity. Here, we discuss the current knowledge of these viral-bacterial interactions and examine the impact of these interactions on viral transmission.

Virus on surfaces: Chemical mechanism, influence factors, disinfection strategies, and implications for virus repelling surface design

While SARS-CoV-2 is generally under control, the question of variants and infections still persists. Fundamental information on how the virus interacts with inanimate surfaces commonly found in our daily life and when in contact with the skin will be helpful in developing strategies to inhibit the spread of the virus. Here in, a critically important review of current understanding of the interaction between virus and surface is summarized from chemistry point-of-view. The Derjaguin-Landau-Verwey-Overbeek and extended Derjaguin-Landau-Verwey-Overbeek theories to model virus attachments on surfaces are introduced, along with the interaction type and strength, and quantification of each component. The virus survival and transfer are affected by a combination of biological, physical, and chemical parameters, as well as environmental parameters. The surface properties for virus and virus survival on typical surfaces such as metals, plastics, and glass are summarized. Attention is also paid to the transfer of virus to/from surfaces and skin. Typical virus disinfection strategies utilizing heat, light, chemicals, and ozone are discussed together with their disinfection mechanism. In the last section, design principles for virus repelling surface chemistry such as surperhydrophobic or surperhydrophilic surfaces are also introduced, to demonstrate how the integration of surface property control and advanced material fabrication can lead to the development of functional surfaces for mitigating the effect of viral infection upon contact.

Combined Infection Control Interventions Protect Essential Food Workers from Occupational Exposures to SARS-CoV-2 in the Agricultural Environment

Essential food workers experience elevated risks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to prolonged occupational exposures in food production and processing areas, shared transportation (car or bus), and employer-provided shared housing. Our goal was to quantify the daily cumulative risk of SARS-CoV-2 infection for healthy susceptible produce workers and to evaluate the relative reduction in risk attributable to food industry interventions and vaccination. We simulated daily SARS-CoV-2 exposures of indoor and outdoor produce workers through six linked quantitative microbial risk assessment (QMRA) model scenarios. For each scenario, the infectious viral dose emitted by a symptomatic worker was calculated across aerosol, droplet, and fomite-mediated transmission pathways. Standard industry interventions (2-m physical distancing, handwashing, surface disinfection, universal masking, ventilation) were simulated to assess relative risk reductions from baseline risk (no interventions, 1-m distance). Implementation of industry interventions reduced an indoor worker's relative infection risk by 98.0% (0.020; 95% uncertainty interval [UI], 0.005 to 0.104) from baseline risk (1.00; 95% UI, 0.995 to 1.00) and an outdoor worker's relative infection risk by 94.5% (0.027; 95% UI, 0.013 to 0.055) from baseline risk (0.487; 95% UI, 0.257 to 0.825). Integrating these interventions with two-dose mRNA vaccinations (86 to 99% efficacy), representing a worker's protective immunity to infection, reduced the relative infection risk from baseline for indoor workers by 99.9% (0.001; 95% UI, 0.0002 to 0.005) and outdoor workers by 99.6% (0.002; 95% UI, 0.0003 to 0.005). Consistent implementation of combined industry interventions, paired with vaccination, effectively mitigates the elevated risks from occupationally acquired SARS-CoV-2 infection faced by produce workers. IMPORTANCE This is the first study to estimate the daily risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across a variety of indoor and outdoor environmental settings relevant to food workers (e.g., shared transportation [car or bus], enclosed produce processing facility and accompanying breakroom, outdoor produce harvesting field, shared housing facility) through a linked quantitative microbial risk assessment framework. Our model has demonstrated that the elevated daily SARS-CoV-2 infection risk experienced by indoor and outdoor produce workers can be reduced below 1% when vaccinations (optimal vaccine efficacy, 86 to 99%) are implemented with recommended infection control strategies (e.g., handwashing, surface disinfection, universal masking, physical distancing, and increased ventilation). Our novel findings provide scenario-specific infection risk estimates that can be utilized by food industry managers to target high-risk scenarios with effective infection mitigation strategies, which was informed through more realistic and context-driven modeling estimates of the infection risk faced by essential food workers daily. Bundled interventions, particularly if they include vaccination, yield significant reductions (>99%) in daily SARS-CoV-2 infection risk for essential food workers in enclosed and open-air environments.

Anderson C, B. Boehm A, Wolfe MK. Quantifying the Viral Reduction Achieved Using Ash and Sand as Handwashing Agents

The WHO recommends handwashing with soap and water for 20-40 seconds. In settings where soap is not available, ash or sand is used for handwashing, yet their efficacy as handwashing materials is underresearched. The purpose of this study was to quantify the removal of viruses using ash and sand as handwashing agents, and compare their efficacy to commonly recommended handwashing methods. We performed a volunteer study to estimate the log reduction value (LRV) of model viruses Phi6 and MS2 on hands after six handwashing conditions: two handwashing agents (ash and water, and sand and water) with two time points (5 and 20 seconds), and two handwashing agents (soap and water, and water only) with one time point (20 seconds). Plaque assays were used to measure infectious virus reduction. Handwashing with any of the handwashing agents for 20 seconds resulted in a greater LRV than the 2-log reduction U.S. Food and Drug Administration criteria for both viruses. Soap and water resulted in a significantly greater LRV (2.7-4.8) than washing with ash and water (2.0-2.8) or sand and water (1.8-2.7) for 5 seconds for both viruses, and water only resulted in a significantly higher LRV (2.8) than all ash (2.0-2.6) and sand (1.8-2.4) conditions for MS2 only. These results suggest that using ash or sand as handwashing agents can be efficacious in reducing viruses but may be less efficacious than soap, especially when used for shorter durations. Further research should investigate the use of ash and sand as handwashing agents in real-world settings.

Novel Dynamic Technique, Nano-DIHM, for Rapid Detection of Oil, Heavy Metals, and Biological Spills in Aquatic Systems

Numerous anthropogenic and natural particle contaminants exist in diverse aquatic systems, with widely unknown environmental fates. We coupled a flow tube with a digital in-line holographic microscopy (nano-DIHM) technique for aquatic matrices, for in situ real-time analysis of particle size, shape, and phase. Nano-DIHM enables 4D tracking of particles in water and their transformations in three-dimensional space. We demonstrate that nano-DIHM can be automated to detect and track oil spills/oil droplets in dynamic systems. We provide evidence that nano-DIHM can detect the MS2 bacteriophage as a representative biological-viral material and mercury-containing particles alongside other heavy metals as common toxic contaminants. Nano-DIHM shows the capability of observation of combined materials in water, characterizing the interactions of various particles in mixtures, and particles with different coatings in a suspension. The observed sizes of the particles and droplets ranged from ∼1 to 200 μm. We herein demonstrate the ability of nano-DIHM to characterize and distinguish particle-based contaminants in water and their interactions in both stationary and dynamic modes with a 62.5 millisecond time resolution. The fully automated software for dynamic and real-time detection of contaminants will be of global significance. A comparison is also made between nano-DIHM and established techniques such as S/TEM for their different capabilities. Nano-DIHM can provide a range of physicochemical information in stationary and dynamic modes, allowing life cycle analysis of diverse particle contaminants in different aquatic systems, and serve as an effective tool for rapid response for spills and remediation of natural waters.

Attachment, re-mobilization, and inactivation of bacteriophage MS2 during bank filtration following simulation of a high virus load and an extreme rain event

Viruses, including human pathogenic viruses, can persist in water. For producing drinking water from surface water via bank filtration, natural attenuation capacities and the fate of viruses during the passage of aquatic sediments are of particular interest. Moreover, the increasing frequency of extreme hydrological events necessitate re-evaluation of the sustainability and efficacy of processes removing viruses. For this purpose, we performed bank sediment filtration experiments using a mesocosm in a technical-scale experimental facility that simulates a field situation under more tightly controlled conditions. We used the bacteriophage MS2 as a surrogate for enteric viruses to study the transport of different viral loads through the bank sediment. Additionally, we simulated a heavy rain event to investigate the re-mobilization of initially attached virus particles. We quantified the abundance of infectious MS2 phages by plaque assay and the total number of MS2 particles by qPCR. Also, we differentiated pore water concentrations by depths of the sediment column and investigated attachment to the sediment matrix at the end of the individual experimental phases. Bank filtration over a vertical distance of 80 cm through sandy sediment revealed a virus removal efficiency of 0.8 log₁₀ for total MS2 particles and 1.7 log₁₀ for infectious MS2 particles, with an initial phage concentration of 1.84 × 10⁸ gene copies mL^-1. A low load of infectious MS2 (1.9 × 10⁶ plaque forming units mL^-1) resulted in a greater removal efficiency (3.0 log₁₀). The proportion of infectious MS2 phages of the total MS2 particle mass steadily decreased over time, i.e., in the course of individual breakthrough curves and with sediment depth. The simulated pulse of rainwater caused a front of low ionic strength water which resulted in pronounced phage remobilization. The high proportion of infectious MS2 among the detached phages indicated that attachment to the sediment matrix may substantially conserve virus infectivity. Therefore, the re-mobilization of previously attached viruses owing to hydrological extremes should be considered in water quality assessment and monitoring schemes.

Phi 6 recovery from inoculated fingerpads based on elution buffer and methodology

Phi 6 (Φ6) bacteriophage is a proposed surrogate to study pathogenic enveloped viruses including SARS-CoV-2-the causative agent of COVID-19-based on structural similarities, BSL-1 status, and ease of use. To determine the role of virus-contaminated hands in disease transmission, an enhanced understanding of buffer and method performance for Φ6 recovery needs to be determined. Four buffer types and three methodologies were investigated for the recovery of Φ6 from human fingerpads over a 30 min duration. Phosphate buffered saline (PBS), PBS + 0.1 % Tween, 0.1 M glycine + 3% beef extract, and viral transport medium were evaluated as buffers for recovery of Φ6 via a dish, modified glove juice, and vigorous swabbing method. Φ6 concentrations on fingerpads were determined at 0-, 5-, 10-, and 30-min post-inoculation. While there were observed differences in virus recovery across buffer and method types depending on the time point, log PFU recovery based on buffer type or methodology was not significantly different at any time point (P > 0.05). The results presented in this study will allow for future work on Φ6 persistence, transfer between hands and surfaces, and efficacy of hand hygiene methods to be performed using a well-characterized and validated recovery method.

Transfer Rate of Enveloped and Nonenveloped Viruses between Fingerpads and Surfaces

Fomites can represent a reservoir for pathogens, which may be subsequently transferred from surfaces to skin. In this study, we aim to understand how different factors (including virus type, surface type, time since last hand wash, and direction of transfer) affect virus transfer rates, defined as the fraction of virus transferred, between fingerpads and fomites. To determine this, 360 transfer events were performed with 20 volunteers using Phi6 (a surrogate for enveloped viruses), MS2 (a surrogate for nonenveloped viruses), and three clean surfaces (stainless steel, painted wood, and plastic). Considering all transfer events (all surfaces and both transfer directions combined), the mean transfer rates of Phi6 and MS2 were 0.17 and 0.26, respectively. Transfer of MS2 was significantly higher than that of Phi6 (P < 0.05). Surface type was a significant factor that affected the transfer rate of Phi6: Phi6 is more easily transferred to and from stainless steel and plastic than to and from painted wood. Direction of transfer was a significant factor affecting MS2 transfer rates: MS2 is more easily transferred from surfaces to fingerpads than from fingerpads to surfaces. Data from these virus transfer events, and subsequent transfer rate distributions, provide information that can be used to refine quantitative microbial risk assessments. This study provides a large-scale data set of transfer events with a surrogate for enveloped viruses, which extends the reach of the study to the role of fomites in the transmission of human enveloped viruses like influenza and SARS-CoV-2. IMPORTANCE This study created a large-scale data set for the transfer of enveloped viruses between skin and surfaces. The data set produced by this study provides information on modeling the distribution of enveloped and nonenveloped virus transfer rates, which can aid in the implementation of risk assessment models in the future. Additionally, enveloped and nonenveloped viruses were applied to experimental surfaces in an equivalent matrix to avoid matrix effects, so results between different viral species can be directly compared without confounding effects of different matrices. Our results indicating how virus type, surface type, time since last hand wash, and direction of transfer affect virus transfer rates can be used in decision-making processes to lower the risk of viral infection from transmission through fomites.

Interactions of Bacteriophages with Animal and Human Organisms-Safety Issues in the Light of Phage Therapy

Bacteriophages are viruses infecting bacterial cells. Since there is a lack of specific receptors for bacteriophages on eukaryotic cells, these viruses were for a long time considered to be neutral to animals and humans. However, studies of recent years provided clear evidence that bacteriophages can interact with eukaryotic cells, significantly influencing the functions of tissues, organs, and systems of mammals, including humans. In this review article, we summarize and discuss recent discoveries in the field of interactions of phages with animal and human organisms. Possibilities of penetration of bacteriophages into eukaryotic cells, tissues, and organs are discussed, and evidence of the effects of phages on functions of the immune system, respiratory system, central nervous system, gastrointestinal system, urinary tract, and reproductive system are presented and discussed. Modulations of cancer cells by bacteriophages are indicated. Direct and indirect effects of virulent and temperate phages are discussed. We conclude that interactions of bacteriophages with animal and human organisms are robust, and they must be taken under consideration when using these viruses in medicine, especially in phage therapy, and in biotechnological applications.

Attachment of human adenovirus onto household paints

Attachment of human adenovirus 40 (HAdV40) onto surfaces coated with three compositionally different household paints was evaluated experimentally and interpreted based on measured physicochemical properties of the paints. Polar, dispersive and electrostatic interactions between HAdV40 and the paints were predicted using the extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) model. Quartz crystal microbalance (QCM-D) was used to quantify virus attachment to paints from 1 mM and 150 mM NaCl solutions, with the latter having the ionic strength of a typical respiratory fluid. Acrylic latex water-based, alkyd water-based, and alkyd oil-based paints were all determined to be highly hydrophobic (ΔG_sws < - 48 mJ/m²). XDLVO modeling and preliminary QCM-D tests evaluated virus-paint interactions within and outside pH windows of favorable virus-paint electrostatic interactions. Hydrophobic and electrostatic interactions governed virus attachment while van der Waals interactions played a relatively minor role. In higher ionic strength solutions, the extent of virus attachment correlated with the free energy of virus-paint interfacial interaction, [Formula: see text] : more negative energies corresponded to higher values of the areal mass density of attached viruses. Hydrophobicity was the dominant factor in determining virus adhesion from high ionic strength solutions where electrostatic interactions were screened out. The hydrophobicity of paints, while desirable for minimizing moisture intrusion, also facilitates attachment of colloids such as viruses. The results call for new approaches to the materials design of indoor paints with enhanced resistance to virus adhesion. Paints so formulated should help reduce human exposure to viruses.

Lip balm drying promotes virus attachment: Characterization of lip balm coatings and XDLVO modeling

HYPOTHESIS

Drying-induced decrease in lip balm surface energy enhances virus adhesion due to the emergence of strong hydrophobic colloid-surface interactions.

EXPERIMENTS

A protocol was developed for preparing lip balm coatings to enable physicochemical characterization and adhesion studies. Surface charge and hydrophobicity of four brands of lip balm (dry and hydrated) and human adenovirus 5 (HAdV5) were measured and used to calculate the extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) energy of interactions between lip balm coatings and HAdV5 as well as four other colloids: HAdV40, MS2 and P22 bacteriophages, and SiO2. Quartz crystal microbalance with dissipation monitoring (QCM-D) tests employed SiO2 colloids, HAdV5 and hydrated lip balms.

FINDINGS

Drying of lip balms results in a dramatic decrease of their surface energy (δΔGsws≥ 83.0 mJ/m2) making the surfaces highly hydrophobic. For dry lip balms, the interaction of the balm surface with all five colloids is attractive. For lip balms hydrated in 150 mM NaCl (ionic strength of human saliva), XDLVO calculations predict that hydrophilic colloids (MS2, P22, SiO2) may attach into shallow secondary minima. Due to the relative hydrophobicity of human adenoviruses, primary maxima in XDLVO profiles are low or non-existent making irreversible deposition into primary energy minima possible. Preliminary QCM-D tests with SiO2 colloids and HAdV5 confirm deposition on hydrated lip balms.

Retention of E. coli and water on the skin after liquid contact

The frequent contact people have with liquids containing pathogenic microorganisms provides opportunities for disease transmission. In this work, we quantified the transfer of bacteria-using E. coli as a model- from liquid to skin, estimated liquid retention on the skin after different contact activities (hand immersion, wet-cloth and wet-surface contact), and estimated liquid transfer following hand-to-mouth contacts. The results of our study show that the number of E. coli transferred to the skin per surface area (n [E. coli/cm2]) can be modeled using n = C (10-3.38+h), where C [E. coli/cm3] is the concentration of E. coli in the liquid, and h [cm] is the film thickness of the liquid retained on the skin. Findings from the E. coli transfer experiments reveal a significant difference between the transfer of E. coli from liquid to the skin and the previously reported transfer of viruses to the skin. Additionally, our results demonstrate that the time elapsed since the interaction significantly influences liquid retention, therefore modulating the risks associated with human interaction with contaminated liquids. The findings enhance our understanding of liquid-mediated disease transmission processes and provide quantitative estimates as inputs for microbial risk assessments.

Simulating transmission of ESKAPE pathogens plus C. difficile in relevant clinical scenarios

BACKGROUND

The prevalence of healthcare-acquired infections (HAI) and rising levels of antimicrobial resistance places significant economic and public health burdens on modern healthcare systems. A group of highly drug resistant pathogens known as the ESKAPE pathogens, along with C. difficile, are the leading causes of HAIs. Interactions between patients, healthcare workers, and environmental conditions impact disease transmission. Studying pathogen transfer under varying contact scenarios in a controlled manner is critical for understanding transmission and disinfectant strategies. In lieu of human subject research, this method has the potential to contribute to modeling the routes of pathogen transmission in healthcare settings.

METHODS

To overcome these challenges, we have developed a method that utilizes a synthetic skin surrogate to model both direct (skin-to-skin) and indirect (skin-to fomite-to skin) pathogen transfer between infected patients and healthy healthcare workers. This surrogate material includes a background microbiome community simulating typical human skin flora to more accurately mimic the effects of natural flora during transmission events.

RESULTS

We demonstrate the ability to modulate individual bacterial concentrations within this microbial community to mimic bacterial concentrations previously reported on the hands of human subjects. We also explore the effect of various decontamination approaches on pathogen transfer between human subjects, such as the use of handwashing or surface disinfectants. Using this method, we identify a potential outlier, S. aureus, that may persist and retain viability in specific transfer conditions better than the overall microbial community during decontamination events.

CONCLUSIONS

Our work describes the development of an in vitro method that uses a synthetic skin surrogate with a defined background microbiota to simulate skin-to-skin and skin-to fomite-to skin contact scenarios. These results illustrate the value of simulating a holistic microbial community for transfer studies by elucidating differences in different pathogen transmission rates and resistance to common decontamination practices. We believe this method will contribute to improvements in pathogen transmission modeling in healthcare settings and increase our ability to assess the risk associated with HAIs, although additional research is required to establish the degree of correlation of pathogen transmission by skin or synthetic alternatives.

Microbial study of household hygiene conditions and associated Listeria monocytogenes infection risks for Peruvian women

OBJECTIVES

To develop an exposure and risk assessment model to estimate listeriosis infection risks for Peruvian women.

METHODS

A simulation model was developed utilising Listeria monocytogenes concentrations on kitchen and latrine surfaces in Peruvian homes, hand trace data from Peruvian women and behavioural data from literature. Scenarios involving varying proportions of uncontaminated, or 'clean', surfaces and non-porous surfaces were simulated. Infection risks were estimated for 4, 6 and 8 h of behaviours and interactions with surfaces.

RESULTS

Although infection risks were estimated across scenarios for various time points (e.g. 4, 6, 8 h), overall mean estimated infection risks for all scenarios were ≥ 0.31. Infection risks increased as the proportions of clean surfaces decreased. Hand-to-general surface contacts accounted for the most cumulative change in L. monocytogenes concentration on hands.

CONCLUSIONS

In addition to gaining insights on how human behaviours affect exposure and infection risk, this model addressed uncertainties regarding the influence of household surface contamination levels. Understanding the influence of surface contamination in preventing pathogen transmission in households could help to develop intervention strategies to reduce L. monocytogenes infection and associated health risks.

Microbial Exchange via Fomites and Implications for Human Health

PURPOSE OF REVIEW

Fomites are inanimate objects that become colonized with microbes and serve as potential intermediaries for transmission to/from humans. This review summarizes recent literature on fomite contamination and microbial survival in the built environment, transmission between fomites and humans, and implications for human health.

RECENT FINDINGS

Applications of molecular sequencing techniques to analyze microbial samples have increased our understanding of the microbial diversity that exists in the built environment. This growing body of research has established that microbial communities on surfaces include substantial diversity, with considerable dynamics. While many microbial taxa likely die or lay dormant, some organisms survive, including those that are potentially beneficial, benign, or pathogenic. Surface characteristics also influence microbial survival and rates of transfer to and from humans. Recent research has combined experimental data, mechanistic modeling, and epidemiological approaches to shed light on the likely contributors to microbial exchange between fomites and humans and their contributions to adverse (and even potentially beneficial) human health outcomes.

SUMMARY

In addition to concerns for fomite transmission of potential pathogens, new analytical tools have uncovered other microbial matters that can be transmitted indirectly via fomites, including entire microbial communities and antibiotic-resistant bacteria. Mathematical models and epidemiological approaches can provide insight on human health implications. However, both are subject to limitations associated with study design, and there is a need to better understand appropriate input model parameters. Fomites remain an important mechanism of transmission of many microbes, along with direct contact and short- and long-range aerosols.