Concentration, Size Distribution, and Infectivity of Airborne Particles Carrying Swine Viruses

Filling the knowledge gap: Scoping review regarding sampling methods, assays, and further requirements to assess airborne viruses

Assessment of occupational exposure to viruses is crucial to identify virus reservoirs and sources of dissemination at an early stage and to help prevent spread between employees and to the general population. Measuring workers' exposure can facilitate assessment of the effectiveness of protective and mitigation measures in place. The aim of this scoping review is to give an overview of available methods and those already implemented for airborne virus' exposure assessment in different occupational and indoor environments. The results retrieved from the different studies may contribute to the setting of future standards and guidelines to ensure a reliable risk characterization in the occupational environments crucial for the implementation of effective control measures. The search aimed at selecting studies between January 1st 2010 and June 30th 2023 in the selected databases. Fifty papers on virus exposure assessment fitted the eligibility criteria and were selected for data extraction. Overall, this study identified gaps in knowledge regarding virus assessment and pinpointed the needs for further research. Several discrepancies were found (transport temperatures, elution steps, …), as well as a lack of publication of important data related to the exposure conditions (contextual information). With the available information, it is impossible to compare results between studies employing different methods, and even if the same methods are used, different conclusions/recommendations based on the expert judgment have been reported due to the lack of consensus in the contextual information retrieved and/or data interpretation. Future research on the field targeting sampling methods and in the laboratory regarding the assays to employ should be developed bearing in mind the different goals of the assessment.

Assessing environmental exposure to viruses in wastewater treatment plant and swine farm scenarios with next-generation sequencing and occupational risk approaches

Occupational exposure to pathogens can pose health risks. This study investigates the viral exposure of workers in a wastewater treatment plant (WWTP) and a swine farm by analyzing aerosol and surfaces samples. Viral contamination was evaluated using quantitative polymerase chain reaction (qPCR) assays, and target enrichment sequencing (TES) was performed to identify the vertebrate viruses to which workers might be exposed. Additionally, Quantitative Microbial Risk Assessment (QMRA) was conducted to estimate the occupational risk associated with viral exposure for WWTP workers, choosing Human Adenovirus (HAdV) as the reference pathogen. In the swine farm, QMRA was performed as an extrapolation, considering a hypothetical zoonotic virus with characteristics similar to Porcine Adenovirus (PAdV). The modelled exposure routes included aerosol inhalation and oral ingestion through contaminated surfaces and hand-to-mouth contact. HAdV and PAdV were widespread viruses in the WWTP and the swine farm, respectively, by qPCR assays. TES identified human and other vertebrate viruses WWTP samples, including viruses from families such as Adenoviridae, Circoviridae, Orthoherpesviridae, Papillomaviridae, and Parvoviridae. In the swine farm, most of the identified vertebrate viruses were porcine viruses belonging to Adenoviridae, Astroviridae, Circoviridae, Herpesviridae, Papillomaviridae, Parvoviridae, Picornaviridae, and Retroviridae. QMRA analysis revealed noteworthy risks of viral infections for WWTP workers if safety measures are not taken. The probability of illness due to HAdV inhalation was higher in summer compared to winter, while the greatest risk from oral ingestion was observed in workspaces during winter. Swine farm QMRA simulation suggested a potential occupational risk in the case of exposure to a hypothetical zoonotic virus. This study provides valuable insights into WWTP and swine farm worker's occupational exposure to human and other vertebrate viruses. QMRA and NGS analyses conducted in this study will assist managers in making evidence-based decisions, facilitating the implementation of protection measures, and risk mitigation practices for workers.

Comparative Review of the State of the Art in Research on the Porcine Epidemic Diarrhea Virus and SARS-CoV-2, Scope of Knowledge between Coronaviruses

This review presents comparative information corresponding to the progress in knowledge of some aspects of infection by the porcine epidemic diarrhea virus (PEDV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronaviruses. PEDV is an alphacoronavirus of great economic importance due to the million-dollar losses it generates in the pig industry. PEDV has many similarities to the SARS-CoV-2 betacoronavirus that causes COVID-19 disease. This review presents possible scenarios for SARS-CoV-2 based on the collected literature on PEDV and the tools or strategies currently developed for SARS-CoV-2 that would be useful in PEDV research. The speed of the study of SARS-CoV-2 and the generation of strategies to control the pandemic was possible due to the knowledge derived from infections caused by other human coronaviruses such as severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS). Therefore, from the information obtained from several coronaviruses, the current and future behavior of SARS-CoV-2 could be inferred and, with the large amount of information on the virus that causes COVID-19, the study of PEDV could be improved and probably that of new emerging and re-emerging coronaviruses.

The BioCascade-VIVAS system for collection and delivery of virus-laden size-fractionated airborne particles

The size of virus-laden particles determines whether aerosol or droplet transmission is dominant in the airborne transmission of pathogens. Determining dominant transmission pathways is critical to implementing effective exposure risk mitigation strategies. The aerobiology discipline greatly needs an air sampling system that can collect virus-laden airborne particles, separate them by particle diameter, and deliver them directly onto host cells without inactivating virus or killing cells. We report the use of a testing system that combines a BioAerosol Nebulizing Generator (BANG) to aerosolize Human coronavirus (HCoV)-OC43 (OC43) and an integrated air sampling system comprised of a BioCascade impactor (BC) and Viable Virus Aerosol Sampler (VIVAS), together referred to as BC-VIVAS, to deliver the aerosolized virus directly onto Vero E6 cells. Particles were collected into four stages according to their aerodynamic diameter (Stage 1: >9.43 μm, Stage 2: 3.81-9.43 μm, Stage 3: 1.41-3.81 μm and Stage 4: <1.41 μm). OC43 was detected by reverse-transcription quantitative polymerase chain reaction (RT-qPCR) analyses of samples from all BC-VIVAS stages. The calculated OC43 genome equivalent counts per cm3 of air ranged from 0.34±0.09 to 70.28±12.56, with the highest concentrations in stage 3 (1.41-3.81 μm) and stage 4 (<1.41 μm). Virus-induced cytopathic effects appeared only in cells exposed to particles collected in stages 3 and 4, demonstrating the presence of viable OC43 in particles <3.81 μm. This study demonstrates the dual utility of the BC-VIVAS as particle size-fractionating air sampler and a direct exposure system for aerosolized viruses. Such utility may help minimize conventional post-collection sample processing time required to assess the viability of airborne viruses and increase the understanding about transmission pathways for airborne pathogens.

Control technologies to prevent aerosol-based disease transmission in animal agriculture production settings: a review of established and emerging approaches

Transmission of infectious agents via aerosols is an ever-present concern in animal agriculture production settings, as the aerosol route to disease transmission can lead to difficult-to-control and costly diseases, such as porcine respiratory and reproductive syndrome virus and influenza A virus. It is increasingly necessary to implement control technologies to mitigate aerosol-based disease transmission. Here, we review currently utilized and prospective future aerosol control technologies to collect and potentially inactivate pathogens in aerosols, with an emphasis on technologies that can be incorporated into mechanically driven (forced air) ventilation systems to prevent aerosol-based disease spread from facility to facility. Broadly, we find that control technologies can be grouped into three categories: (1) currently implemented technologies; (2) scaled technologies used in industrial and medical settings; and (3) emerging technologies. Category (1) solely consists of fibrous filter media, which have been demonstrated to reduce the spread of PRRSV between swine production facilities. We review the mechanisms by which filters function and are rated (minimum efficiency reporting values). Category (2) consists of electrostatic precipitators (ESPs), used industrially to collect aerosol particles in higher flow rate systems, and ultraviolet C (UV-C) systems, used in medical settings to inactivate pathogens. Finally, category (3) consists of a variety of technologies, including ionization-based systems, microwaves, and those generating reactive oxygen species, often with the goal of pathogen inactivation in aerosols. As such technologies are typically first tested through varied means at the laboratory scale, we additionally review control technology testing techniques at various stages of development, from laboratory studies to field demonstration, and in doing so, suggest uniform testing and report standards are needed. Testing standards should consider the cost-benefit of implementing the technologies applicable to the livestock species of interest. Finally, we examine economic models for implementing aerosol control technologies, defining the collected infectious particles per unit energy demand.

Airborne transmission of common swine viruses

The transmission of viral aerosols poses a vulnerable aspect in the biosecurity measures aimed at preventing and controlling swine virus in pig production. Consequently, comprehending and mitigating the spread of aerosols holds paramount significance for the overall well-being of pig populations. This paper offers a comprehensive review of transmission characteristics, influential factors and preventive strategies of common swine viral aerosols. Firstly, certain viruses such as foot-and-mouth disease virus (FMDV), porcine reproductive and respiratory syndrome virus (PRRSV), influenza A viruses (IAV), porcine epidemic diarrhea virus (PEDV) and pseudorabies virus (PRV) have the potential to be transmitted over long distances (exceeding 150 m) through aerosols, thereby posing a substantial risk primarily to inter-farm transmission. Additionally, other viruses like classical swine fever virus (CSFV) and African swine fever virus (ASFV) can be transmitted over short distances (ranging from 0 to 150 m) through aerosols, posing a threat primarily to intra-farm transmission. Secondly, various significant factors, including aerosol particle sizes, viral strains, the host sensitivity to viruses, weather conditions, geographical conditions, as well as environmental conditions, exert a considerable influence on the transmission of viral aerosols. Researches on these factors serve as a foundation for the development of strategies to combat viral aerosol transmission in pig farms. Finally, we propose several preventive and control strategies that can be implemented in pig farms, primarily encompassing the implementation of early warning models, viral aerosol detection, and air pretreatment. This comprehensive review aims to provide a valuable reference for the formulation of efficient measures targeted at mitigating the transmission of viral aerosols among swine populations.

Emerging Infectious Diseases Are Virulent Viruses-Are We Prepared? An Overview

The recent pandemic caused by SARS-CoV-2 affected the global population, resulting in a significant loss of lives and global economic deterioration. COVID-19 highlighted the importance of public awareness and science-based decision making, and exposed global vulnerabilities in preparedness and response systems. Emerging and re-emerging viral outbreaks are becoming more frequent due to increased international travel and global warming. These viral outbreaks impose serious public health threats and have transformed national strategies for pandemic preparedness with global economic consequences. At the molecular level, viral mutations and variations are constantly thwarting vaccine efficacy, as well as diagnostic, therapeutic, and prevention strategies. Here, we discuss viral infectious diseases that were epidemic and pandemic, currently available treatments, and surveillance measures, along with their limitations.

Large Particle Emissions from Human Vocalization and Playing of Wind Instruments

Humans emit large salivary particles when talking, singing, and playing musical instruments, which have implications for respiratory disease transmission. Yet little work has been done to characterize the emission rates and size distributions of such particles. This work characterized large particle (dp > 35 μm in aerodynamic diameter) emissions from 70 volunteers of varying age and sex while vocalizing and playing wind instruments. Mitigation efficacies for face masks (while singing) and bell covers (while playing instruments) were also examined. Geometric mean particle count emission rates varied from 3.8 min-1 (geometric standard deviation [GSD] = 3.1) for brass instruments playing to 95.1 min-1 (GSD = 3.8) for talking. On average, talking produced the highest emission rates for large particles, in terms of both number and mass, followed by singing and then instrument playing. Neither age, sex, CO2 emissions, nor loudness (average dBA) were significant predictors of large particle emissions, contrary to previous findings for smaller particle sizes (i.e., for dp < 35 μm). Size distributions were similar between talking and singing (count median diameter = 53.0 μm, GSD = 1.69). Bell covers did not affect large particle emissions from most wind instruments, but face masks reduced large particle count emissions for singing by 92.5% (95% CI: 97.9%, 73.7%).

Characteristics of aerosols from swine farms: A review of the past two-decade progress

With the rapid development of large-scale and intensive swine production, the emission of aerosols from swine farms has become a growing concern, attracting extensive attention. While aerosols are found in various environments, those from swine farms are distinguished from human habitats, such as residential, suburban, and urban areas. In order to gain a comprehensive understanding of aerosols from swine farms, this paper reviewed relevant studies conducted between 2000 and 2022. The main components, concentrations, and size distribution of the aerosols were systematically reviewed. The differences between aerosols from swine farms and human living and working environments were compared. Finally, the sources, influencing factors, and reduction technologies for aerosols from swine farms were thoroughly elucidated. The results demonstrated that the concentrations of aerosols inside swine farms varied considerably, and most exceeded safety thresholds. However, further exploration is needed to fully understand the difference in airborne microorganism community structure and particles with small sizes (<1 μm) between swine farms and human living and working environments. More airborne bacterial and viruses were adhered to large particles in swine houses, while the proportion of airborne fungi in the respirable fraction was similar to that of human living and working environments. In addition, swine farms have a higher abundance and diversity of potential pathogens, airborne resistant microorganisms and resistant genes compared to the human living and working environments. The aerosols of swine farms mainly originated from sources such as manure, feed, swine hair and skin, secondary production, and waste treatment. According to the source analysis and factors influencing aerosols in swine farms, various technologies could be employed to mitigate aerosol emissions, and some end-of-pipe technologies need to be further improved before they are widely applied. Swine farms are advised not to increase aerosol concentration in human living and working environments, in order to decrease the impact of aerosols from swine farms on human health and restrain the spread of airborne potential pathogens. This review provides critical insights into aerosols of swine farms, offering guidance for taking appropriate measures to enhance air quality inside and surrounding swine farms.

Evidence of aerosol transmission of African swine fever virus between two piggeries under field conditions: a case study

African swine fever (ASF) is a devastating and economically significant infectious disease that has caused enormous losses in the commercial pig sector in China since 2018. The primary transmission routes of the African swine fever virus (ASFV), the causative agent of ASF, are direct pig-to-pig contact or indirect contact with virus-contaminated objects. While aerosol transmission of ASFV has been previously reported under experimental conditions, no reports have described it under field conditions. In this case study, aerosol-associated samples were collected over a monitoring period of 24 days in an ASFV-positive farm. A complete and clear chain of ASFV transmission through aerosols was observed: pigs in Room A on Day 0-aerosol in Room A on Day 6-dust of air outlets in Room A on Day 9-outdoor aerosols on Day 9-dust of air inlets in Room B on Day 15-aerosols/pigs in Room B on Day 21. Furthermore, a fluorescent powder experiment confirmed the transmission of dust from Room A to Room B. This study represents the first report providing evidence of aerosol transmission of ASFV under field conditions. Further research is needed to study the laws of aerosol transmission in ASFV and develop effective strategies such as air filtration or disinfection to create a low-risk environment with fresh air for pig herds.

Analysis of Nipah Virus Replication and Host Proteome Response Patterns in Differentiated Porcine Airway Epithelial Cells Cultured at the Air-Liquid Interface

Respiratory tract epithelium infection plays a primary role in Nipah virus (NiV) pathogenesis and transmission. Knowledge about infection dynamics and host responses to NiV infection in respiratory tract epithelia is scarce. Studies in non-differentiated primary respiratory tract cells or cell lines indicate insufficient interferon (IFN) responses. However, studies are lacking in the determination of complex host response patterns in differentiated respiratory tract epithelia for the understanding of NiV replication and spread in swine. Here we characterized infection and spread of NiV in differentiated primary porcine bronchial epithelial cells (PBEC) cultivated at the air-liquid interface (ALI). After the initial infection of only a few apical cells, lateral spread for 12 days with epithelium disruption was observed without releasing substantial amounts of infectious virus from the apical or basal sides. Deep time course proteomics revealed pronounced upregulation of genes related to type I/II IFN, immunoproteasomal subunits, transporter associated with antigen processing (TAP)-mediated peptide transport, and major histocompatibility complex (MHC) I antigen presentation. Spliceosomal factors were downregulated. We propose a model in which NiV replication in PBEC is slowed by a potent and broad type I/II IFN host response with conversion from 26S proteasomes to immunoproteasomal antigen processing and improved MHC I presentation for adaptive immunity priming. NiV induced cytopathic effects could reflect the focal release of cell-associated NiV, which may contribute to efficient airborne viral spread between pigs.

Unanswered questions on the airborne transmission of COVID-19

Policies and measures to control pandemics are often failing. While biological factors controlling transmission are usually well explored, little is known about the environmental drivers of transmission and infection. For instance, respiratory droplets and aerosol particles are crucial vectors for the airborne transmission of the severe acute respiratory syndrome coronavirus 2, the causation agent of the coronavirus 2019 pandemic (COVID-19). Once expectorated, respiratory droplets interact with atmospheric particulates that influence the viability and transmission of the novel coronavirus, yet there is little knowledge on this process or its consequences on virus transmission and infection. Here we review the effects of atmospheric particulate properties, vortex zones, and air pollution on virus survivability and transmission. We found that particle size, chemical constituents, electrostatic charges, and the moisture content of airborne particles can have notable effects on virus transmission, with higher survival generally associated with larger particles, yet some viruses are better preserved on small particles. Some chemical constituents and surface-adsorbed chemical species may damage peptide bonds in viral proteins and impair virus stability. Electrostatic charges and water content of atmospheric particulates may affect the adherence of virion particles and possibly their viability. In addition, vortex zones and human thermal plumes are major environmental factors altering the aerodynamics of buoyant particles in air, which can strongly influence the transport of airborne particles and the transmission of associated viruses. Insights into these factors may provide explanations for the widely observed positive correlations between COVID-19 infection and mortality with air pollution, of which particulate matter is a common constituent that may have a central role in the airborne transmission of the novel coronavirus.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10311-022-01557-z.

SARS-CoV-2 air sampling: A systematic review on the methodologies for detection and infectivity

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.

Adapting an Atmospheric Dispersion Model to Assess the Risk of Windborne Transmission of Porcine Reproductive and Respiratory Syndrome Virus between Swine Farms

Modeling the windborne transmission of aerosolized pathogens is challenging. We adapted an atmospheric dispersion model (ADM) to simulate the windborne dispersion of porcine reproductive and respiratory syndrome virus (PRRSv) between swine farms. This work focuses on determining ADM applicable parameter values for PRRSv through a literature and expert opinion-based approach. The parameters included epidemiological features of PRRSv, characteristics of the aerosolized particles, and survival of aerosolized virus in relation to key meteorological features. A case study was undertaken to perform a sensitivity analysis on key parameters. Farms experiencing ongoing PRRSv outbreaks were assigned as particle emitting sources. The wind data from the North American Mesoscale Forecast System was used to simulate dispersion. The risk was estimated semi-quantitatively based on the median daily deposition of particles and the distance to the closest emitting farm. Among the parameters tested, the ADM was most sensitive to the number of particles emitted, followed by the model runtime, and the release height was the least sensitive. Farms within 25 km from an emitting farm were at the highest risk; with 53.66% being within 10 km. An ADM-based risk estimation of windborne transmission of PRRSv may inform optimum time intervals for air sampling, plan preventive measures, and aid in ruling out the windborne dispersion in outbreak investigations.

Porcine Epidemic Diarrhea: Causative Agent, Epidemiology, Clinical Characteristics, and Treatment Strategy Targeting Main Protease

Aims:

This aimed to study the causative agent, epidemiology, clinical characteristics, and treatment strategy targeting the main protease in porcine epidemic diarrhea.

Background:

Porcine epidemic diarrhea (PED) is a contagious intestinal viral infection causing severe diarrhea, vomiting, and dehydration in pigs. High rates of mortalities and severe morbidities, approaching 100%, are reported in piglets infected with PEDV. In recent years, PED has been observed to influence the swine-farming nations in Europe, Asia, the USA, South Korea, and Canada. The PED virus (PEDV) transmission takes place through a faecal-oral route.

Objective:

The objective is to review the characteristics of PEDV and its role in the disease. In addition, we aim to outline some possible methods to combat PED infection, including targeting the main protease of coronavirus and their future perspectives.

Method:

This study is a review of literature on the PED virus.

Results:

Apart from symptomatic treatment and supportive care, there is no available specific treatment for PEDV. Appropriate disinfectants and cleaning are pivotal for the control of PEDV. To date, apart from anti-PEDV inhibitors, there are no specific drugs available commercially to treat the disease. Therefore, 3C-like protease (3CLpro) in PEDV that has highly conserved structure and catalytic mechanism serves as an alluring drug as it plays a vital role during viral polyprotein processing at the time of infection.

Conclusion:

A well synchronized and collective effort of scientists, swine veterinarians, pork industry experts, and associated authorities is essential for the accomplishment of proper execution of these required measures.

Particulate Matter in Swine Barns: A Comprehensive Review

Particulate matter (PM) represents an air quality management challenge for confined swine production systems. Due to the limited space and ventilation rate, PM can reach relatively high concentrations in swine barns. PM in swine barns possesses different physical, chemical, and biological characteristics than that in the atmosphere and other indoor environments. As a result, it exerts different environmental and health effects and creates some unique challenges regarding PM measurement and mitigation. Numerous research efforts have been made, generating massive data and information. However, relevant review reports are sporadic. This study aims to provide an updated comprehensive review of swine barn PM, focusing on publications since 1990. It covers various topics including PM characteristics, sources, measurement methods, and in-barn mitigation technologies. As PM in swine barns is primarily of biological origins, bioaerosols are reviewed in great detail. Relevant topics include bacterial/fungal counts, viruses, microbial community composition, antibiotic-resistant bacteria, antibiotic resistance genes, endotoxins, and (1→3)-β-D-glucans. For each topic, existing knowledge is summarized and discussed and knowledge gaps are identified. Overall, PM in swine barns is complicated in chemical and biological composition and highly variable in mass concentrations, size, and microbial abundance. Feed, feces, and skins constitute the major PM sources. Regarding in-barn PM mitigation, four technologies (oil/water sprinkling, ionization, alternation of feed and feeders, and recirculating air filtration) are dominant. However, none of them have been widely used in commercial barns. A collective discussion of major knowledge gaps and future research needs is offered at the end of the report.

Detection and identification of potentially infectious gastrointestinal and respiratory viruses at workplaces of wastewater treatment plants with viability qPCR/RT-qPCR

This study aimed to qualitatively and quantitatively assess the prevalence of the most common respiratory and gastrointestinal viruses in the air, surface swab, and influent/effluent samples collected in wastewater treatment plants (WWTPs). Application of qPCR/RT-qPCR (quantitative polymerase chain reaction/reverse-transcription quantitative polymerase chain reaction) assays combined with PMA (propidium monoazide) dye pretreatment allowed detecting the potentially infectious and disintegrated viral particles in collected samples. In the air at workplaces in WWTPs, the most frequent isolation with the highest concentrations (reaching up to 10³ gc/m³ of potentially infectious intact viral particles) were observed in case of adenoviruses (AdVs) and rotaviruses (RoVs), followed by noroviruses (NoVs). Viruses were significantly more often detected in the air samples collected with Coriolis μ impinger, than with MAS-100NT impactor. The temperature negatively (Spearman correlation: –1 < R < 0; p < 0.05), while RH (relative humidity) positively (0 < R < 1; p < 0.05) affected airborne concentrations of potentially infectious viral particles. In turn, the predominant viruses on studied surfaces were RoVs and noroviruses GII (NoV GII) with concentrations of potentially infectious virions up to 10⁴ gc/100 cm². In the cases of SARS-CoV-2 and presumptive SARS-CoV-2 or other coronaviruses, their concentrations reached up to 10³ gc/100 cm². The contamination level of steel surfaces in WWTPs was similar to this on plastic ones. This study revealed that the qualitative and quantitative characteristics of respiratory and gastrointestinal viruses at workplaces in WWTPs is important for proper exposure assessment and needs to be included in risk management in occupational environment with high abundance of microbial pollutants derived from wastewater.

Modelling the direct virus exposure risk associated with respiratory events

The outbreak of the COVID-19 pandemic highlighted the importance of accurately modelling the pathogen transmission via droplets and aerosols emitted while speaking, coughing and sneezing. In this work, we present an effective model for assessing the direct contagion risk associated with these pathogen-laden droplets. In particular, using the most recent studies on multi-phase flow physics, we develop an effective yet simple framework capable of predicting the infection risk associated with different respiratory activities in different ambient conditions. We start by describing the mathematical framework and benchmarking the model predictions against well-assessed literature results. Then, we provide a systematic assessment of the effects of physical distancing and face coverings on the direct infection risk. The present results indicate that the risk of infection is vastly impacted by the ambient conditions and the type of respiratory activity, suggesting the non-existence of a universal safe distance. Meanwhile, wearing face masks provides excellent protection, effectively limiting the transmission of pathogens even at short physical distances, i.e. 1 m.

The effects of air pollution, meteorological parameters, and climate change on COVID-19 comorbidity and health disparities: A systematic review

Air pollutants, especially particulate matter, and other meteorological factors serve as important carriers of infectious microbes and play a critical role in the spread of disease. However, there remains uncertainty about the relationship among particulate matter, other air pollutants, meteorological conditions and climate change and the spread of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), hereafter referred to as COVID-19. A systematic review was conducted using PRISMA guidelines to identify the relationship between air quality, meteorological conditions and climate change, and COVID-19 risk and outcomes, host related factors, co-morbidities and disparities. Out of a total of 170,296 scientific publications screened, 63 studies were identified that focused on the relationship between air pollutants and COVID-19. Additionally, the contribution of host related-factors, co-morbidities, and health disparities was discussed. This review found a preponderance of evidence of a positive relationship between PM_2.5, other air pollutants, and meteorological conditions and climate change on COVID-19 risk and outcomes. The effects of PM_2.5, air pollutants, and meteorological conditions on COVID-19 mortalities were most commonly experienced by socially disadvantaged and vulnerable populations. Results however, were not entirely consistent, and varied by geographic region and study. Opportunities for using data to guide local response to COVID-19 are identified.

Mixing at the interface of the sneezing/coughing phenomena and its effect on viral loading

The primary objective of this work is to investigate the mixing of droplets/aerosols, which originates from the sneezing/coughing (of possibly COVID-19 patient) with the ambient atmosphere. Effectively, we are studying the growth/decay of droplets/aerosols in the presence of inhomogeneous mixing, which focuses on the phenomena of entrainment of the (relatively) dry ambient air. We have varied the initial standard deviation, mean radius of the droplets/aerosols size distribution, and humidity of the ambient atmosphere to understand their effects on the final size spectra of droplets. Furthermore, a rigorous error analysis is carried out to understand the relative importance of these effects on the final spectra of droplets/aerosols. We find that these are vital parameters to determine the final spectra of droplets, which govern the broadening of the size spectra. Typically, broadening the size spectra of droplets/aerosols increases the probability of the virus-laden droplets/aerosols and thus could affect the transmission of infection in the ambient atmosphere.

Recent advancements in the measurement of pathogenic airborne viruses

Air-transmissible pathogenic viruses, such as influenza viruses and coronaviruses, are some of the most fatal strains and spread rapidly by air, necessitating quick and stable measurements from sample air volumes to prevent further spread of diseases and to take appropriate steps rapidly. Measurements of airborne viruses generally require their collection into liquids or onto solid surfaces, with subsequent hydrosolization and then analysis using the growth method, nucleic-acid-based techniques, or immunoassays. Measurements can also be performed in real time without sampling, where species-specific determination is generally disabled. In this review, we introduce some recent advancements in the measurement of pathogenic airborne viruses. Air sampling and measurement technologies for viral aerosols are reviewed, with special focus on the effects of air sampling on damage to the sampled viruses and their measurements. Measurement of pathogenic airborne viruses is an interdisciplinary research area that requires understanding of both aerosol technology and biotechnology to effectively address the issues. Hence, this review is expected to provide some useful guidelines regarding appropriate air sampling and virus detection methods for particular applications.

Short-range exposure to airborne virus transmission and current guidelines

After the Spanish flu pandemic, it was apparent that airborne transmission was crucial to spreading virus contagion, and research responded by producing several fundamental works like the experiments of Duguid [J. P. Duguid, J. Hyg. 44, 6 (1946)] and the model of Wells [W. F. Wells, Am. J. Hyg. 20, 611-618 (1934)]. These seminal works have been pillars of past and current guidelines published by health organizations. However, in about one century, understanding of turbulent aerosol transport by jets and plumes has enormously progressed, and it is now time to use this body of developed knowledge. In this work, we use detailed experiments and accurate computationally intensive numerical simulations of droplet-laden turbulent puffs emitted during sneezes in a wide range of environmental conditions. We consider the same emission-number of drops, drop size distribution, and initial velocity-and we change environmental parameters such as temperature and humidity, and we observe strong variation in droplets' evaporation or condensation in accordance with their local temperature and humidity microenvironment. We assume that 3% of the initial droplet volume is made of nonvolatile matter. Our systematic analysis confirms that droplets' lifetime is always about one order of magnitude larger compared to previous predictions, in some cases up to 200 times. Finally, we have been able to produce original virus exposure maps, which can be a useful instrument for health scientists and practitioners to calibrate new guidelines to prevent short-range airborne disease transmission.

Non-respiratory particles emitted by guinea pigs in airborne disease transmission experiments

Animal models are often used to assess the airborne transmissibility of various pathogens, which are typically assumed to be carried by expiratory droplets emitted directly from the respiratory tract of the infected animal. We recently established that influenza virus is also transmissible via "aerosolized fomites," micron-scale dust particulates released from virus-contaminated surfaces (Asadi et al. in Nat Commun 11(1):4062, 2020). Here we expand on this observation, by counting and characterizing the particles emitted from guinea pig cages using an Aerodynamic Particle Sizer (APS) and an Interferometric Mie Imaging (IMI) system. Of over 9000 airborne particles emitted from guinea pig cages and directly imaged with IMI, none had an interference pattern indicative of a liquid droplet. Separate measurements of the particle count using the APS indicate that particle concentrations spike upwards immediately following animal motion, then decay exponentially with a time constant commensurate with the air exchange rate in the cage. Taken together, the results presented here raise the possibility that a non-negligible fraction of airborne influenza transmission events between guinea pigs occurs via aerosolized fomites rather than respiratory droplets, though the relative frequencies of these two routes have yet to be definitively determined.

Challenges and Perspectives for Biosensing of Bioaerosol Containing Pathogenic Microorganisms

As an important route for disease transmission, bioaerosols have received increasing attention. In the past decades, many efforts were made to facilitate the development of bioaerosol monitoring; however, there are still some important challenges in bioaerosol collection and detection. Thus, recent advances in bioaerosol collection (such as sedimentation, filtration, centrifugation, impaction, impingement, and microfluidics) and detection methods (such as culture, molecular biological assay, and immunological assay) were summarized in this review. Besides, the important challenges and perspectives for bioaerosol biosensing were also discussed.

Airborne Coronaviruses: Observations from Veterinary Experience

The virus responsible for the pandemic that has affected 152 countries worldwide is a new strain of coronavirus (CoV), which belongs to a family of viruses widespread in many animal species, including birds, and mammals including humans. Indeed, CoVs are known in veterinary medicine affecting several species, and causing respiratory and/or enteric, systemic diseases and reproductive disease in poultry. Animal diseases caused by CoV may be considered from the following different perspectives: livestock and poultry CoVs cause mainly "population disease"; while in companion animals they are a source of mainly "individual/single subject disease". Therefore, respiratory CoV diseases in high-density, large populations of livestock or poultry may be a suitable example for the current SARS-CoV-2/COVID-19 pandemic. In this review we describe some strategies applied in veterinary medicine to control CoV and discuss if they may help to develop practical and useful strategies to control the SARS-CoV-2/COVID-19 pandemic.

Airborne spread of infectious SARS-CoV-2: Moving forward using lessons from SARS-CoV and MERS-CoV

BACKGROUND

Although an increasing body of data reports the detection of SARS-CoV-2 RNA in air, this does not correlate to the presence of infectious viruses, thus not evaluating the risk for airborne COVID-19. Hence there is a marked knowledge gap that requires urgent attention. Therefore, in this systematic review, viability/stability of airborne SARS-CoV-2, SARS-CoV and MERS-CoV viruses is discussed.

METHODS

A systematic literature review was performed on PubMed/MEDLINE, Web of Science and Scopus to assess the stability and viability of SARS-CoV, MERS-CoV and SARS-CoV-2 on air samples.

RESULTS AND DISCUSSION

The initial search identified 27 articles. Following screening of titles and abstracts and removing duplicates, 11 articles were considered relevant. Temperatures ranging from 20 °C to 25 °C and relative humidity ranging from 40% to 50% were reported to have a protective effect on viral viability for airborne SARS-CoV and MERS-CoV. As no data is yet available on the conditions influencing viability for airborne SARS-CoV-2, and given the genetic similarity to SARS-CoV and MERS-CoV, one could extrapolate that the same conditions would apply. Nonetheless, the effect of these conditions seems to be residual considering the increasing number of cases in the south of USA, Brazil and India, where high temperatures and humidities have been observed.

CONCLUSION

Higher temperatures and high relative humidity can have a modest effect on SARS-CoV-2 viability in the environment, as reported in previous studies to this date. However, these studies are experimental, and do not support the fact that the virus has efficiently spread in the tropical regions of the globe, with other transmission routes such as the contact and droplet ones probably being responsible for the majority of cases reported in these regions, along with other factors such as human mobility patterns and contact rates. Further studies are needed to investigate the extent of aerosol transmission of SARS-CoV-2 as this would have important implications for public health and infection-control policies.

Consistency of global recommendations regarding open versus laparoscopic surgery during the COVID-19 pandemic: a systematic review

Background

Throughout the COVID‐19 pandemic, there has been worldwide debate regarding whether open surgery should be performed in preference to laparoscopic surgery due to the theoretical higher risk of viral aerosolization by the release of pneumoperitoneum. We aimed to assess the consistency of national and international surgical society recommendations regarding the choice of surgical approach; assess the quality of evidence of viral emission in surgical aerosol; and assess the quality of evidence comparing aerosol generation by different surgical energy devices.

Methods

A systematic review of PubMed, Medline, Embase and Cochrane databases was performed. Three search strategies were employed. Twenty‐eight studies were included in the final analysis and quality appraised. Confidence in review findings was assessed using the GRADE‐CERQual (Confidence in Evidence from Reviews of Qualitative research) tool.

Results

Worldwide recommendations regarding open versus laparoscopic surgery are consistent, with a majority recommending that surgical approach is decided on a case‐by‐case, risk minimization approach. There is limited, low‐quality evidence that viral particles can be emitted in surgical aerosol. There is a paucity of literature on the quantity of aerosol produced by different surgical energy devices, and no evidence to support the use of certain surgical instruments to minimize aerosol production.

Conclusions

There is considerable consistency among worldwide recommendations regarding the choice of surgical approach, although the evidence base is lacking. To inform clinical recommendations, further research examining viral emission, transmission, infectivity and amount of surgical aerosol produced is required.

On secondary atomization and blockage of surrogate cough droplets in single- and multilayer face masks

Face masks prevent transmission of infectious respiratory diseases by blocking large droplets and aerosols during exhalation or inhalation. While three-layer masks are generally advised, many commonly available or makeshift masks contain single or double layers. Using carefully designed experiments involving high-speed imaging along with physics-based analysis, we show that high-momentum, large-sized (>250 micrometer) surrogate cough droplets can penetrate single- or double-layer mask material to a significant extent. The penetrated droplets can atomize into numerous much smaller (<100 micrometer) droplets, which could remain airborne for a significant time. The possibility of secondary atomization of high-momentum cough droplets by hydrodynamic focusing and extrusion through the microscale pores in the fibrous network of the single/double-layer mask material needs to be considered in determining mask efficacy. Three-layer masks can effectively block these droplets and thus could be ubiquitously used as a key tool against COVID-19 or similar respiratory diseases.

An overview of methods of fine and ultrafine particle collection for physicochemical characterisation and toxicity assessments

Particulate matter (PM) is a crucial health risk factor for respiratory and cardiovascular diseases. The smaller size fractions, ≤2.5 μm (PM_2.5; fine particles) and ≤0.1 μm (PM_0.1; ultrafine particles), show the highest bioactivity but acquiring sufficient mass for in vitro and in vivo toxicological studies is challenging. We review the suitability of available instrumentation to collect the PM mass required for these assessments. Five different microenvironments representing the diverse exposure conditions in urban environments are considered in order to establish the typical PM concentrations present. The highest concentrations of PM_2.5 and PM_0.1 were found near traffic (i.e. roadsides and traffic intersections), followed by indoor environments, parks and behind roadside vegetation. We identify key factors to consider when selecting sampling instrumentation. These include PM concentration on-site (low concentrations increase sampling time), nature of sampling sites (e.g. indoors; noise and space will be an issue), equipment handling and power supply. Physicochemical characterisation requires micro- to milli-gram quantities of PM and it may increase according to the processing methods (e.g. digestion or sonication). Toxicological assessments of PM involve numerous mechanisms (e.g. inflammatory processes and oxidative stress) requiring significant amounts of PM to obtain accurate results. Optimising air sampling techniques are therefore important for the appropriate collection medium/filter which have innate physical properties and the potential to interact with samples. An evaluation of methods and instrumentation used for airborne virus collection concludes that samplers operating cyclone sampling techniques (using centrifugal forces) are effective in collecting airborne viruses. We highlight that predictive modelling can help to identify pollution hotspots in an urban environment for the efficient collection of PM mass. This review provides guidance to prepare and plan efficient sampling campaigns to collect sufficient PM mass for various purposes in a reasonable timeframe.

Comparison of samplers collecting airborne influenza viruses: 1. Primarily impingers and cyclones

Researchers must be able to measure concentrations, sizes, and infectivity of virus-containing particles in animal agriculture facilities to know how far infectious virus-containing particles may travel through air, where they may deposit in the human or animal respiratory tract, and the most effective ways to limit exposures to them. The objective of this study was to evaluate a variety of impinger and cyclone aerosol or bioaerosol samplers to determine approaches most suitable for detecting and measuring concentrations of virus-containing particles in air. Six impinger/cyclone air samplers, a filter-based sampler, and a cascade impactor were used in separate tests to collect artificially generated aerosols of MS2 bacteriophage and swine and avian influenza viruses. Quantification of infectious MS2 coliphage was carried out using a double agar layer procedure. The influenza viruses were titrated in cell cultures to determine quantities of infectious virus. Viral RNA was extracted and used for quantitative real time RT-PCR, to provide total virus concentrations for all three viruses. The amounts of virus recovered and the measured airborne virus concentrations were calculated and compared among the samplers. Not surprisingly, high flow rate samplers generally collected greater quantities of virus than low flow samplers. However, low flow rate samplers generally measured higher, and likely more accurate, airborne concentrations of Infectious virus and viral RNA than high flow samplers. To assess airborne viruses in the field, a two-sampler approach may work well. A suitable high flow sampler may provide low limits of detection to determine if any virus is present in the air. If virus is detected, a suitable lower flow sampler may measure airborne virus concentrations accurately.

Ventilation mode performance against airborne respiratory infections in small office spaces: limits and rational improvements for Covid-19

The Coronavirus disease (Covid-19), caused by the SARS-CoV-2 virus, has produced significant social and economic disruptions in different countries. Current evidence suggests a strong correlation between the infection and the cohabitation of indoor spaces. International organizations and experts consider that the airborne transmission through aerosols can occur in specific conditions and that inadequate ventilation increases the risk of infection. As a result, the increase in ventilation rates and air filtration efficiencies are recommended for public buildings in the context of Covid-19, with significant impacts on energy consumption, and a paradigm shift in the design of ventilation systems is necessary for this new context. Therefore, this study has assessed the comparative performance of the displacement ventilation and the mixed ventilation mode on reducing the risk of long-range airborne infection for the Covid-19 in a small office application. A coupled multizone-CFD (Computational Fluid Dynamics) software developed by the National Institute of Standards and Technology was used in this study to assess the relative performance of several design solutions related to different ventilation modes, filter efficiencies, and outdoor air flow rates. The results demonstrate that the displacement ventilation technique produces a better overall performance in reducing the SARS-CoV-2 airborne infection risk than the conventional mixed ventilation for all the studied cases.

Virus-sampling technologies in different environments

Exposure to pathogenic microorganisms, especially viruses, can lead to various diseases, allergies, and hospital infections. The application of sampling procedure is still a challenge to sample viruses from different environments such as air, water, wastewater, etc. However, there are many procedures such as filtration, impactor, impinger, cyclone, electrostatic separator, and MD-8 airscan that are applied for sampling and measuring viruses from air. Among conventional filters, the gelatin type can be readily dissolved in a liquid for molecular counting or cell culture without significant changes in virus tissue. Liquid impingers are the most frequent devices that are applied for the collection of viral aerosols. Also, many methods including precipitation, ultracentrifugation, electronegative membrane, and ultrafiltration have been used to prepare samples of food, wastewater, feces, urine, and surfaces. In many studies, the aforementioned methods have been employed to sample the coronaviruses such as SARS-CoV-2 in various environments. Also, various PCR procedures have been commonly used to identify the virus from the environmental samples.

Risk assessment of airborne transmission of COVID-19 by asymptomatic individuals under different practical settings

The lack of quantitative risk assessment of airborne transmission of COVID-19 under practical settings leads to large uncertainties and inconsistencies in our preventive measures. Combining in situ measurements and computational fluid dynamics simulations, we quantify the exhaled particles from normal respiratory behaviors and their transport under elevator, small classroom, and supermarket settings to evaluate the risk of inhaling potentially virus-containing particles. Our results show that the design of ventilation is critical for reducing the risk of particle encounters. Inappropriate design can significantly limit the efficiency of particle removal, create local hot spots with orders of magnitude higher risks, and enhance particle deposition causing surface contamination. Additionally, our measurements reveal the presence of a substantial fraction of faceted particles from normal breathing and its strong correlation with breathing depth.

Size distribution of virus laden droplets from expiratory ejecta of infected subjects

For rebooting economic activities in the ongoing COVID-19 pandemic scenario, it is important to pay detailed attention to infection transfer mechanisms during interaction of people in enclosed environments. Utmost concern is the possibility of aerosol mediated infection transfer, which is largely governed by the size distributions of virus laden droplets, termed as virusols in this work, ejected from humans. We expand on the well-known theory of Poisson fluctuations which acts as statistical barrier against formation of virusols. Analysis suggests that for viral loads < 2 × 105 RNA copies/mL, often corresponding to mild-to-moderate cases of COVID-19, droplets of diameter < 20 µm at the time of emission (equivalent to ~ 10 µm desiccated residue diameter) are unlikely to be of consequence in carrying infections. Cut-off diameters below which droplets will be practically free of contamination, are presented as a function of viral loading. The median diameters of virus laden polydisperse droplet distributions will be 1.5 to 20 times higher depending upon the geometric standard deviation. The studies have implications to risk assessment as well as residence time estimates of airborne infections in indoor environments. Additionally, it will be also helpful for performance evaluation of sanitization and control technologies to mitigate infection risks in workplaces.

Insights on drying and precipitation dynamics of respiratory droplets from the perspective of COVID-19

We isolate a nano-colloidal droplet of surrogate mucosalivary fluid to gain fundamental insights into airborne nuclei's infectivity and viral load distribution during the COVID-19 pandemic. The salt-water solution containing particles at reported viral loads is acoustically trapped in a contactless environment to emulate the drying, flow, and precipitation dynamics of real airborne droplets. Similar experiments validate observations with the surrogate fluid with samples of human saliva samples from a healthy subject. A unique feature emerges regarding the final crystallite dimension; it is always 20%-30% of the initial droplet diameter for different sizes and ambient conditions. Airborne-precipitates nearly enclose the viral load within its bulk while the substrate precipitates exhibit a high percentage (∼80-90%) of exposed virions (depending on the surface). This work demonstrates the leveraging of an inert nano-colloidal system to gain insights into an equivalent biological system.

Association of particulate matter pollution and case fatality rate of COVID-19 in 49 Chinese cities

The COVID-19 epidemic, caused by the SARS-CoV-2 virus, has resulted in 3352 deaths in China as of April 12, 2020. This study aimed to investigate the associations between particulate matter (PM) concentrations and the case fatality rate (CFR) of COVID-19 in 49 Chinese cities, including the epicenter of Wuhan. We used the Global Moran's I to analyze spatial distribution and autocorrelation of CFRs, and then we used multivariate linear regression to analyze the associations between PM_2.5 and PM₁₀ concentrations and COVID-19 CFR. We found positive associations between PM pollution and COVID-19 CFR in cities both inside and outside Hubei Province. For every 10 μg/m³ increase in PM_2.5 and PM₁₀ concentrations, the COVID-19 CFR increased by 0.24% (0.01%-0.48%) and 0.26% (0.00%-0.51%), respectively. PM pollution distribution and its association with COVID-19 CFR suggests that exposure to such may affect COVID-19 prognosis.

Association of particulate matter pollution and case fatality rate of COVID-19 in 49 Chinese cities

The COVID-19 epidemic, caused by the SARS-CoV-2 virus, has resulted in 3352 deaths in China as of April 12, 2020. This study aimed to investigate the associations between particulate matter (PM) concentrations and the case fatality rate (CFR) of COVID-19 in 49 Chinese cities, including the epicenter of Wuhan. We used the Global Moran's I to analyze spatial distribution and autocorrelation of CFRs, and then we used multivariate linear regression to analyze the associations between PM_2.5 and PM₁₀ concentrations and COVID-19 CFR. We found positive associations between PM pollution and COVID-19 CFR in cities both inside and outside Hubei Province. For every 10 μg/m³ increase in PM_2.5 and PM₁₀ concentrations, the COVID-19 CFR increased by 0.24% (0.01%-0.48%) and 0.26% (0.00%-0.51%), respectively. PM pollution distribution and its association with COVID-19 CFR suggests that exposure to such may affect COVID-19 prognosis.

Aerosolization and recovery of viable murine norovirus in an experimental setup

Noroviruses are the major cause for viral acute gastroenteritis in the world. Despite the existing infection prevention strategies in hospitals, the disease continues to spread and causes extensive and numerous outbreaks. Hence, there is a need to investigate the possibility of airborne transmission of norovirus. In this study, we developed an experimental setup for studies on the infectivity of aerosolized murine norovirus (MNV), a model for the human norovirus. Two aerosol generation principles were evaluated: bubble bursting, a common natural aerosolization mechanism, and nebulization, a common aerosolization technique in laboratory studies. The aerosolization setup was characterized by physical and viral dilution factors, generated aerosol particle size distributions, and the viral infectivity after aerosolization. We found a lower physical dilution factor when using the nebulization generator than with the bubble bursting generator. The viral dilution factor of the system was higher than the physical dilution; however, when comparing the physical and viral dilution factors, bubble bursting generation was more efficient. The infectivity per virus was similar using either generation principle, suggesting that the generation itself had a minor impact on MNV infectivity and that instead, the effect of drying in air could be a major reason for infectivity losses.

Covid-19 Airborne Transmission and Its Prevention: Waiting for Evidence or Applying the Precautionary Principle?

Besides the predominant ways of transmission of SARS-CoV-2 (namely, contacts and large droplets) the airborne one is increasingly taken into consideration as a result of latest research findings. Nevertheless, this possibility has been already suggested by previous studies on other coronaviruses including SARS-CoV and MERS-CoV. To describe the state of the art of coronaviruses and airborne transmission, a systematic review was carried out using the PRISMA methodology. Overall, 64 papers were selected and classified into three main groups: laboratory experiments (12 papers), air monitoring (22) and epidemiological and airflow model studies (30). The airborne transmission of SARS-CoV-2 is suggested by the studies of the three groups, but none has yet obtained complete evidence. The sampling and detection methods have not been validated, therefore monitoring results are affected by a possible underestimation. Then, epidemiological investigations only hypothesize the airborne transmission as a possible explanation for some illness cases, but without estimating its attributable risk. Nevertheless, while waiting for more evidence, it is urgent to base advice on preventive measures, such as the use of masks, safe distancing and air ventilation, on the precautionary principle.

Porcine epidemic diarrhea virus (PEDV): An update on etiology, transmission, pathogenesis, and prevention and control

Porcine epidemic diarrhea virus (PEDV), a member of the genus Alphacoronavirus in the family Coronaviridae, causes acute diarrhea and/or vomiting, dehydration and high mortality in neonatal piglets. Two different genogroups of PEDV, S INDEL [PEDV variant containing multiple deletions and insertions in the S1 subunit of the spike (S) protein, G1b] and non-S INDEL (G2b) strains were detected during the diarrheal disease outbreak in US swine in 2013-2014. Similar viruses are also circulating globally. Continuous improvement and update of biosecurity and vaccine strains and protocols are still needed to control and prevent PEDV infections worldwide. Although the non-S INDEL PEDV was highly virulent and the S INDEL PEDV caused milder disease, the latter has the capacity to cause illness in a high number of piglets on farms with low biosecurity and herd immunity. The main PEDV transmission route is fecal-oral, but airborne transmission via the fecal-nasal route may play a role in pig-to-pig and farm-to-farm spread. PEDV infection of neonatal pigs causes fecal virus shedding (alongside frequent detection of PEDV RNA in the nasal cavity), acute viremia, severe atrophic enteritis (mainly jejunum and ileum), and increased pro-inflammatory and innate immune responses. PEDV-specific IgA effector and memory B cells in orally primed sows play a critical role in sow lactogenic immunity and passive protection of piglets. This review focuses on the etiology, transmission, pathogenesis, and prevention and control of PEDV infection.

The Hitchhiker’s Guide to Hydrogen Peroxide Fumigation, Part 2: Verifying and Validating Hydrogen Peroxide Fumigation Cycles

Introduction:

Part 1 of this two-part series describes the use of hydrogen peroxide as a fumigant and compares it with other fumigants on the market. Technical requirements are outlined while considering physical and biological limitations of the system. This second part focuses primarily on the use of process controls to verify and validate hydrogen peroxide fumigations. Finally, a model encompassing the entire fumigation process is presented.

Methods:

Part 2 of the series focuses on the authors’ long-time personal experiences in room and filter fumigation using various fumigation systems and is supplemented with relevant literature searches.

Results:

The reader is introduced to the planning and implementation of fumigation process validations. Biological indicators help users develop safe and efficient processes. Chemical indicators can be used as process controls, while measuring physical parameters will help avoid condensation of hydrogen peroxide. How many biological and chemical indicators and what type should be applied for cycle development are additionally explained.

Discussion:

It is important to consider numerous technical requirements when planning to implement hydrogen peroxide fumigation at an institution. Also, considerable thought needs to go into the verification and validation of the fumigation process.

Conclusions:

Part 1 of this series presents an overview of different fumigation systems based on hydrogen peroxide on the market and their technical requirements. Part 2 focuses on validation and verification of hydrogen peroxide fumigation while considering the entire fumigation process. The two parts together will serve users as a guide to establishing hydrogen peroxide fumigations at their facilities.

Stability and infectivity of coronaviruses in inanimate environments

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious virus that can transmit through respiratory droplets, aerosols, or contacts. Frequent touching of contaminated surfaces in public areas is therefore a potential route of SARS-CoV-2 transmission. The inanimate surfaces have often been described as a source of nosocomial infections. However, summaries on the transmissibility of coronaviruses from contaminated surfaces to induce the coronavirus disease 2019 are rare at present. This review aims to summarize data on the persistence of different coronaviruses on inanimate surfaces. The literature was systematically searched on Medline without language restrictions. All reports with experimental evidence on the duration persistence of coronaviruses on any type of surface were included. Most viruses from the respiratory tract, such as coronaviruses, influenza, SARS-CoV, or rhinovirus, can persist on surfaces for a few days. Persistence time on inanimate surfaces varied from minutes to up to one month, depending on the environmental conditions. SARS-CoV-2 can be sustained in air in closed unventilated buses for at least 30 min without losing infectivity. The most common coronaviruses may well survive or persist on surfaces for up to one month. Viruses in respiratory or fecal specimens can maintain infectivity for quite a long time at room temperature. Absorbent materials like cotton are safer than unabsorbent materials for protection from virus infection. The risk of transmission via touching contaminated paper is low. Preventive strategies such as washing hands and wearing masks are critical to the control of coronavirus disease 2019.

Stability and infectivity of coronaviruses in inanimate environments

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious virus that can transmit through respiratory droplets, aerosols, or contacts. Frequent touching of contaminated surfaces in public areas is therefore a potential route of SARS-CoV-2 transmission. The inanimate surfaces have often been described as a source of nosocomial infections. However, summaries on the transmissibility of coronaviruses from contaminated surfaces to induce the coronavirus disease 2019 are rare at present. This review aims to summarize data on the persistence of different coronaviruses on inanimate surfaces. The literature was systematically searched on Medline without language restrictions. All reports with experimental evidence on the duration persistence of coronaviruses on any type of surface were included. Most viruses from the respiratory tract, such as coronaviruses, influenza, SARS-CoV, or rhinovirus, can persist on surfaces for a few days. Persistence time on inanimate surfaces varied from minutes to up to one month, depending on the environmental conditions. SARS-CoV-2 can be sustained in air in closed unventilated buses for at least 30 min without losing infectivity. The most common coronaviruses may well survive or persist on surfaces for up to one month. Viruses in respiratory or fecal specimens can maintain infectivity for quite a long time at room temperature. Absorbent materials like cotton are safer than unabsorbent materials for protection from virus infection. The risk of transmission via touching contaminated paper is low. Preventive strategies such as washing hands and wearing masks are critical to the control of coronavirus disease 2019.

Stability and infectivity of coronaviruses in inanimate environments

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious virus that can transmit through respiratory droplets, aerosols, or contacts. Frequent touching of contaminated surfaces in public areas is therefore a potential route of SARS-CoV-2 transmission. The inanimate surfaces have often been described as a source of nosocomial infections. However, summaries on the transmissibility of coronaviruses from contaminated surfaces to induce the coronavirus disease 2019 are rare at present. This review aims to summarize data on the persistence of different coronaviruses on inanimate surfaces. The literature was systematically searched on Medline without language restrictions. All reports with experimental evidence on the duration persistence of coronaviruses on any type of surface were included. Most viruses from the respiratory tract, such as coronaviruses, influenza, SARS-CoV, or rhinovirus, can persist on surfaces for a few days. Persistence time on inanimate surfaces varied from minutes to up to one month, depending on the environmental conditions. SARS-CoV-2 can be sustained in air in closed unventilated buses for at least 30 min without losing infectivity. The most common coronaviruses may well survive or persist on surfaces for up to one month. Viruses in respiratory or fecal specimens can maintain infectivity for quite a long time at room temperature. Absorbent materials like cotton are safer than unabsorbent materials for protection from virus infection. The risk of transmission via touching contaminated paper is low. Preventive strategies such as washing hands and wearing masks are critical to the control of coronavirus disease 2019.

Benefits of influenza vaccination on the associations between ambient air pollution and allergic respiratory diseases in children and adolescents: New insights from the Seven Northeastern Cities study in China

BACKGROUND

Little information exists on interaction effects between air pollution and influenza vaccination on allergic respiratory diseases. We conducted a large population-based study to evaluate the interaction effects between influenza vaccination and long-term exposure to ambient air pollution on allergic respiratory diseases in children and adolescents.

METHODS

A cross-sectional study was investigated during 2012-2013 in 94 schools from Seven Northeastern Cities (SNEC) in China. Questionnaires surveys were obtained from 56 137 children and adolescents aged 2-17 years. Influenza vaccination was defined as receipt of the influenza vaccine. We estimated air pollutants exposure [nitrogen dioxide (NO₂) and particulate matter with aerodynamic diameters ≤1 μm (PM₁), ≤2.5 μm (PM_2.5) and ≤10 μm (PM₁₀)] using machine learning methods. We employed two-level generalized linear mix effects model to examine interactive effects between influenza vaccination and air pollution exposure on allergic respiratory diseases (asthma, asthma-related symptoms and allergic rhinitis), after controlling for important covariates.

RESULTS

We found statistically significant interactions between influenza vaccination and air pollutants on allergic respiratory diseases and related symptoms (doctor-diagnosed asthma, current wheeze, wheeze, persistent phlegm and allergic rhinitis). The adjusted ORs for doctor-diagnosed asthma, current wheeze and allergic rhinitis among the unvaccinated group per interquartile range (IQR) increase in PM₁ and PM_2.5 were significantly higher than the corresponding ORs among the vaccinated group [For PM₁, doctor-diagnosed asthma: OR: 1.89 (95%CI: 1.57-2.27) vs 1.65 (95%CI: 1.36-2.00); current wheeze: OR: 1.50 (95%CI: 1.22-1.85) vs 1.10 (95%CI: 0.89-1.37); allergic rhinitis: OR: 1.38 (95%CI: 1.15-1.66) vs 1.21 (95%CI: 1.00-1.46). For PM_2.5, doctor-diagnosed asthma: OR: 1.81 (95%CI: 1.52-2.14) vs 1.57 (95%CI: 1.32-1.88); current wheeze: OR: 1.46 (95%CI: 1.21-1.76) vs 1.11 (95%CI: 0.91-1.35); allergic rhinitis: OR: 1.35 (95%CI: 1.14-1.60) vs 1.19 (95%CI: 1.00-1.42)]. The similar patterns were observed for wheeze and persistent phlegm. The corresponding p values for interactions were less than 0.05, respectively. We assessed the risks of PM₁-related and PM_2.5-related current wheeze were decreased by 26.67% (95%CI: 1.04%-45.66%) and 23.97% (95%CI: 0.21%-42.08%) respectively, which was attributable to influenza vaccination (both p for efficiency <0.05).

CONCLUSIONS

Influenza vaccination may play an important role in mitigating the detrimental effects of long-term exposure to ambient air pollution on childhood allergic respiratory diseases. Policy targeted at increasing influenza vaccination may yield co-benefits in terms of reduced allergic respiratory diseases.

Collection, particle sizing and detection of airborne viruses

Viruses that affect humans, animals and plants are often dispersed and transmitted through airborne routes of infection. Due to current technological deficiencies, accurate determination of the presence of airborne viruses is challenging. This shortcoming limits our ability to evaluate the actual threat arising from inhalation or other relevant contact with aerosolized viruses. To improve our understanding of the mechanisms of airborne transmission of viruses, air sampling technologies that can detect the presence of aerosolized viruses, effectively collect them and maintain their viability, and determine their distribution in aerosol particles, are needed. The latest developments in sampling and detection methodologies for airborne viruses, their limitations, factors that can affect their performance and current research needs, are discussed in this review. Much more work is needed on the establishment of standard air sampling methods and their performance requirements. Sampling devices that can collect a wide size range of virus-containing aerosols and maintain the viability of the collected viruses are needed. Ideally, the devices would be portable and technology-enabled for on-the-spot detection and rapid identification of the viruses. Broad understanding of the airborne transmission of viruses is of seminal importance for the establishment of better infection control strategies.