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Zambrana W, Boehm AB. Occurrence of Human Viruses on Fomites in the Environment: A Systematic Review and Meta-analysis. ACS ENVIRONMENTAL AU 2023; 3:277-294. [PMID: 37743950 PMCID: PMC10515712 DOI: 10.1021/acsenvironau.3c00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 09/26/2023]
Abstract
Documenting the occurrence of viruses on fomites is crucial in determining the significance of fomite-mediated transmission and the potential use of fomites for environmental disease surveillance. We conducted a systematic review and meta-analysis to compile information on the occurrence of human viruses on fomites in the environment; we identified 134 peer-reviewed papers. We compiled sampling and measurement methods, results, quality control information, and whether virus data were compared with community health data from the papers. We conducted univariate and multivariate analyses to investigate if presence of virus on fomites was associated with virus type (enveloped, nonenveloped), sampling location (healthcare setting, nonhealthcare temporary setting, nonhealthcare nontemporary setting), and area of fomite swabbed (<50, 50-100, >100 cm2). Across 275 data sets from the 134 papers, there was the most data available for Coronaviridae and from fomites at hospitals. Positivity rates, defined as the percent positive fomite samples, were low (median = 6%). Data were available on viruses from 16 different viral families, but data on viruses from 9 families had few (n < 5) data sets. Many human virus families were not identified in this review (11 families). Less than 15% of the data sets reported virus concentrations in externally valid units (viruses per area of surface), and 16% provided a quantitative comparison between virus and health data. Virus type and area swabbed were significant predictors of virus presence on fomites, and the positivity rate of data sets collected from healthcare settings and nonhealthcare nontemporary settings (e.g., individual housing) were significantly higher than those collected in nonhealthcare temporary settings (e.g., restaurants). Data from this review indicates that viruses may be present on fomites, that fomite-mediated virus transmission may occur, and that fomites may provide information on circulation of infectious diseases in the community. However, more quantitative data on diverse viruses are needed, and method reporting needs significant improvements.
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Affiliation(s)
- Winnie Zambrana
- Department
of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Alexandria B. Boehm
- Department
of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
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2
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Wang F, Nisar HJ, Li Y, Araud E, Nguyen TH, Kesavadas T. Low-Cost UVBot Using SLAM to Mitigate the Spread of Noroviruses in Occupational Spaces. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22228926. [PMID: 36433523 PMCID: PMC9696947 DOI: 10.3390/s22228926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 05/28/2023]
Abstract
Noroviruses (NoVs) cause over 90% of non-bacterial gastroenteritis outbreaks in adults and children in developed countries. Therefore, there is a need for approaches to mitigate the transmission of noroviruses in workplaces to reduce their substantial health burden. We developed and validated a low-cost, autonomous robot called the UVBot to disinfect occupational spaces using ultraviolet (UV) lamps. The total cost of the UVBOT is less than USD 1000, which is much lower than existing commercial robots that cost as much as USD 35,000. The user-friendly desktop application allows users to control the robot remotely, check the disinfection map, and add virtual walls to the map. A 2D LiDAR and a simultaneous localization and mapping (SLAM) algorithm was used to generate a map of the space being disinfected. Tulane virus (TV), a human norovirus surrogate, was used to validate the UVBot's effectiveness. TV was deposited on a painted drywall and exposed to UV radiation at different doses. A 3-log (99.9%) reduction of TV infectivity was achieved at a UV dose of 45 mJ/cm2. We further calculated the sanitizing speed as 3.5 cm/s and the efficient sanitizing distance reached up to 40 cm from the UV bulb. The design, software, and environment test data are available to the public so that any organization with minimal engineering capabilities can reproduce the UVBot system.
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Affiliation(s)
- Fanxin Wang
- Health Care Engineering Systems Center, Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Harris Junaid Nisar
- Health Care Engineering Systems Center, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Yao Li
- Department of Mathematics, Harbin Institute of Technology, Haerbin 150001, China
| | - Elbashir Araud
- Holonyak Micro & Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Thanh H. Nguyen
- Institute of Genomic Biology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Thenkurussi Kesavadas
- Research and Economic Development, University at Albany—State University of New York, Albany, NY 12222, USA
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3
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Fanaselle W, Pouillot R, Papafragkou E, Liggins G, Williams L, Doren JMVAN. Evaluation of the Impact of Compliance with Mitigation Strategies and Frequency of Restaurant Surface Cleaning and Sanitizing on Control of Norovirus Transmission from Ill Food Employees Using an Existing Quantitative Risk Assessment Model. J Food Prot 2022; 85:1177-1191. [PMID: 35358310 DOI: 10.4315/jfp-21-423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/29/2022] [Indexed: 11/11/2022]
Abstract
ABSTRACT Reduction of foodborne illness caused by norovirus (NoV) continues to be a focus for the food safety community. Using a previously published quantitative risk assessment model, we evaluated more than 60 scenarios examining the impact of implementation of and compliance with risk management strategies identified in the U.S. Food and Drug Administration Food Code for (a) surface cleaning and sanitizing, (b) hand hygiene, (c) exclusion, or (d) restriction of ill employees. Implementation of and compliance with hand hygiene and ill food employee exclusion strategies had the largest impact on the predicted number of highly contaminated food servings and associated consumer illnesses. In scenarios in which gloves were always worn and hand washing compliance was 90%, the model estimated reductions in the number of highly contaminated food servings and ill consumers to 39 and 43% of baseline estimates (i.e., typical practice), respectively. Reductions were smaller when gloves were never worn. Hand washing compliance after using the restroom strongly impacted predicted numbers of highly contaminated servings and consumer illnesses. Ten percent compliance with removing or excluding ill food employees was predicted to increase the number of highly contaminated food servings and ill consumers to 221 and 213% of baseline estimates, respectively. Ninety-four percent compliance with exclusion of ill food employees was predicted to decrease these numbers to 69 and 71% of baseline estimates, respectively. Surface cleaning in food establishments had a relatively small impact on these measures. Restriction of food employees (removed from contact with food and food contact equipment and utensils) was not effective for reducing NoV illness unless this restriction included additional provisions. The results from this study can help risk managers prioritize mitigation strategies and their implementation for controlling the transmission of NoV and subsequent consumer foodborne illness. HIGHLIGHTS
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Affiliation(s)
- Wendy Fanaselle
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, College Park, Maryland 20740, USA
| | - Régis Pouillot
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, College Park, Maryland 20740, USA
| | - Efstathia Papafragkou
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, College Park, Maryland 20740, USA
| | - Girvin Liggins
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, College Park, Maryland 20740, USA
| | - Laurie Williams
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, College Park, Maryland 20740, USA
| | - Jane M VAN Doren
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, College Park, Maryland 20740, USA
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Bakke M. A Comprehensive Analysis of ATP Tests: Practical Use and Recent Progress in the Total Adenylate Test for the Effective Monitoring of Hygiene. J Food Prot 2022; 85:1079-1095. [PMID: 35503956 DOI: 10.4315/jfp-21-384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/26/2022] [Indexed: 11/11/2022]
Abstract
ABSTRACT Rapid hygiene monitoring tests based on the presence of ATP have been widely used in the food industry to ensure that adequate cleanliness is maintained. In this study, the practical applications and limitations of these tests and recent technological progress for facilitating more accurate control were evaluated. The presence of ATP on a surface indicates improper cleaning and the presence of contaminants, including organic debris and bacteria. Food residues are indicators of insufficient cleaning and are direct hazards because they may provide safe harbors for bacteria, provide sources of nutrients for bacterial growth, interfere with the antimicrobial activity of disinfectants, and support the formation of biofilms. Residues of allergenic foods on a surface may increase the risk of allergen cross-contact. However, ATP tests cannot detect bacteria or allergenic proteins directly. To ensure efficient use of commercially available ATP tests, in-depth knowledge is needed regarding their practical applications, methods for determining pass-fail limits, and differences in performance. Conventional ATP tests have limitations due to possible hydrolysis of ATP to ADP and AMP, which further hinders the identification of food residues. To overcome this problem, a total adenylate test was developed that could detect ATP+ADP+AMP (A3 test). The A3 test is suitable for the detection of adenylates from food residues and useful for verification of hygiene levels. The A3 test in conjunction with other methods, such as microorganism culture and food allergen tests, may be a useful strategy for identifying contamination sources and facilitating effective hygiene management. HIGHLIGHTS
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Affiliation(s)
- Mikio Bakke
- Kikkoman Biochemifa Company, Marketing & Planning Division, 2-1-1 Nishi-shinbashi, Minato-ku, Tokyo 105-0003, Japan
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5
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Cannon JL, Park GW, Anderson B, Leone C, Chao M, Vinjé J, Fraser AM. Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning. Am J Infect Control 2022; 50:289-294. [PMID: 35184878 PMCID: PMC8903150 DOI: 10.1016/j.ajic.2021.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Norovirus and C. difficile are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities and can be transmitted by contaminated environmental surfaces. Hygienic monitoring tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal contamination can help to identify LTC facility surfaces with cleaning deficiencies. METHODS High-touch surfaces in 11 LTC facilities were swabbed and tested for contamination by norovirus, a fecal indicator virus, crAssphage, and ATP which detects organic debris. High levels of contamination were defined as log ATP relative light unit values or crAssphage log genomic copy values in the 75th percentile of values obtained from each facility. RESULTS Over 90% of surfaces tested positive for crAssphage or gave failing ATP scores. Norovirus contamination was not detected. Handrails, equipment controls, and patient beds were 4 times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails and tables and chairs in patient lounges had high levels of both ATP and crAssphage. CONCLUSIONS Surfaces with high levels of ATP and crAssphage were identified. Quantifying levels of contamination longitudinally and before and after cleaning might enhance infection prevention and control procedures for reducing diarrheal illnesses in LTC facilities.
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Affiliation(s)
- Jennifer L. Cannon
- National Foundation for the Centers for Disease Control and Prevention Inc., 600 Peachtree St. NE #1000, Atlanta, GA, 30308, USA,Center for Food Safety, University of Georgia, 1109 Experiment St, Griffin, GA, 30223, USA,Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA,Correspondence: Jennifer Cannon, 1600 Clifton Rd. NE, H18-7, Atlanta, GA, 30333, USA,
| | - Geun Woo Park
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Benjamin Anderson
- Center for Food Safety, University of Georgia, 1109 Experiment St, Griffin, GA, 30223, USA
| | - Cortney Leone
- Food, Nutrition, and Packaging Sciences Department, Clemson University, 206 Poole Agricultural Center, Clemson, SC, 29334, USA
| | - Morgan Chao
- Food, Nutrition, and Packaging Sciences Department, Clemson University, 206 Poole Agricultural Center, Clemson, SC, 29334, USA
| | - Jan Vinjé
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Angela M. Fraser
- Food, Nutrition, and Packaging Sciences Department, Clemson University, 206 Poole Agricultural Center, Clemson, SC, 29334, USA
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Overbey KN, Zachos NC, Coulter C, Schwab KJ. Optimizing Human Intestinal Enteroids for Environmental Monitoring of Human Norovirus. FOOD AND ENVIRONMENTAL VIROLOGY 2021; 13:470-484. [PMID: 34191266 PMCID: PMC8956203 DOI: 10.1007/s12560-021-09486-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/23/2021] [Indexed: 05/02/2023]
Abstract
Human noroviruses (HuNoV) are the leading cause of gastrointestinal illness and environmental monitoring is crucial to prevent HuNoV outbreaks. The recent development of a HuNoV cell culture assay in human intestinal enteroids (HIEs) has enabled detection of infectious HuNoV. However, this complex approach requires adaptation of HIEs to facilitate HuNoV replication from environmental matrixes. Integrating data from 200 experiments, we examined six variables: HIE age, HIE basement membrane compounds (BMC), HuNoV inoculum processing, HuNoV inoculum volume, treatment of data below limit of detection (LOD), and cutoff criteria for determining positive HuNoV growth. We infected HIEs with HuNoV GII.4 Sydney positive stool and determined 1.4 × 103 genome equivalents per HIE well were required for HuNoV replication. HIE age had minimal effect on assay outcomes. LOD replacement and cutoff affected data interpretation, with lower values resulting in higher estimated HuNoV detection. Higher inoculum volumes lead to minimal decreases in HuNoV growth, with an optimal volume of 250uL facilitating capture of low concentrations of HuNoVs present in environmental isolates. Processing of HuNoV inoculum is valuable for disinfection studies and concentrating samples but is not necessary for all HIE applications. This work enhances the HuNoV HIE cell culture approach for environmental monitoring. Future HIE research should report cell age as days of growth and should clearly describe BMC choice, LOD handling, and positive cutoff.
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Affiliation(s)
- Katie N Overbey
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicholas C Zachos
- Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Caroline Coulter
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kellogg J Schwab
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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7
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Overbey KN, Zachos NC, Coulter C, Jacangelo J, Schwab KJ. Recovery of Infectious Human Norovirus GII.4 Sydney From Fomites via Replication in Human Intestinal Enteroids. Front Cell Infect Microbiol 2021; 11:693090. [PMID: 34307195 PMCID: PMC8294327 DOI: 10.3389/fcimb.2021.693090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/17/2021] [Indexed: 01/14/2023] Open
Abstract
Contamination of fomites by human norovirus (HuNoV) can initiate and prolong outbreaks. Fomite swabbing is necessary to predict HuNoV exposure and target interventions. Historically, swab recovered HuNoV has been measured by molecular methods that detect viral RNA but not infectious HuNoV. The recent development of HuNoV cultivation in human intestinal enteroids (HIEs) enables detection of infectious HuNoV. It is unknown if the swabbing process and swab matrix will allow for cultivation of fomite recovered HuNoV. We used HIEs to culture swab-recovered HuNoV GII.4 Sydney from experimentally infected surfaces—a hospital bed tray (N = 32), door handle (N = 10), and sanitizer dispenser (N = 11). Each surface was swabbed with macrofoam swabs premoistened in PBS plus 0.02% Tween80. Swab eluate was tested for infectious HuNoV by cultivation in HIE monolayers. Infectious HuNoV can be recovered from surfaces inoculated with at least 105 HuNoV genome equivalents/3 cm2. In total, 57% (N = 53) of recovered swabs contained infectious HuNoV detected by HIEs. No difference in percent positive swabs was observed between the three surfaces at p = 0.2. We demonstrate that fomite swabbing can be combined with the HIE method to cultivate high titer infectious HuNoV from the environment, filling a significant gap in HuNoV detection. Currently, high titers of HuNoV are required to measure growth in HIEs and the HIE system precludes absolute quantification of infectious viruses. However, the HIE system can provide a binary indication of infectious HuNoV which enhances existing detection methods. Identification of infectious HuNoVs from swabs can increase monitoring accuracy, enhance risk estimates, and help prevent outbreaks.
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Affiliation(s)
- Katie N Overbey
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Nicholas C Zachos
- Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Caroline Coulter
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Joseph Jacangelo
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.,Stantec, Washington, DC, United States
| | - Kellogg J Schwab
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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8
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Buckley D, Dharmasena M, Wang H, Huang J, Adams J, Pettigrew C, Fraser A, Jiang X. Efficacy of novel aqueous photo-chlorine dioxide against a human norovirus surrogate, bacteriophage MS2 and Clostridium difficile endospores, in suspension, on stainless steel and under greenhouse conditions. J Appl Microbiol 2020; 130:1531-1545. [PMID: 33025608 DOI: 10.1111/jam.14887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/12/2020] [Accepted: 10/01/2020] [Indexed: 11/27/2022]
Abstract
AIMS The efficacy of a novel photochemical method for generating chlorine dioxide (photoClO2 ) was evaluated against human noroviruses (HuNoV) surrogate, bacteriophage MS2, and Clostridium difficile endospores. METHODS AND RESULTS Chlorine dioxide was generated by mixing 1% sodium chlorite with 10 parts-per-million (ppm) Eosin Y and irradiating with a photo-activator-excitable light. PhotoClO2 efficacy was assessed against bacteriophage MS2 and C. difficile endospores in suspension, on hard surfaces and greenhouse conditions under soiled and unsoiled conditions. The estimated effective photoClO2 produced and consumed was 20·39 ± 0·16 ppm at a rate of 8·16 ppm per min in a 1% sodium chlorite solution. In suspension, MS2 phage was reduced by 3·35 and >5·10 log10 PFU per ml in 120 and 90 min, with and without soil, respectively. At the same time, when dried on stainless steel surface, MS2 phage was reduced by >4·53 log10 PFU per carrier in 30 min under both conditions. On the other hand, C. difficile endospores in suspension were reduced by 2·26 and 3·65 log10 CFU per ml in 120 min with and without soiling, respectively. However, on stainless steel surface, maximal reductions of the C. difficile endospores were 0·8 and 1·5 log10 CFU per carrier with and without soiling, respectively, and a maximal reduction of 2·97 log10 CFU per carrier under greenhouse conditions at 24 h. CONCLUSIONS Overall, photoClO2 showed promise as a technology to control HuNoV contamination on environmental surfaces but requires further optimization and testing against C. difficile endospores. SIGNIFICANCE AND IMPACT OF THE STUDY Results from this investigation will serve as a model for how to generate and quantify photoClO2 and how to appropriately evaluate this new class of disinfectants against environmentally resilient pathogens: viruses and bacterial endospores.
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Affiliation(s)
- D Buckley
- Department of Biological Sciences, Clemson University, Clemson, SC, USA
| | - M Dharmasena
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC, USA
| | - H Wang
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC, USA
| | - J Huang
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC, USA
| | - J Adams
- The Procter and Gamble Co, Cincinnati, OH, USA
| | - C Pettigrew
- The Procter and Gamble Co, Cincinnati, OH, USA
| | - A Fraser
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC, USA
| | - X Jiang
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC, USA
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Park GW, Ng TFF, Freeland AL, Marconi VC, Boom JA, Staat MA, Montmayeur AM, Browne H, Narayanan J, Payne DC, Cardemil CV, Treffiletti A, Vinjé J. CrAssphage as a Novel Tool to Detect Human Fecal Contamination on Environmental Surfaces and Hands. Emerg Infect Dis 2020; 26:1731-1739. [PMID: 32511090 PMCID: PMC7392416 DOI: 10.3201/eid2608.200346] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
CrAssphage is a recently discovered human gut–associated bacteriophage. To validate the potential use of crAssphage for detecting human fecal contamination on environmental surfaces and hands, we tested stool samples (n = 60), hand samples (n = 30), and environmental swab samples (n = 201) from 17 norovirus outbreaks for crAssphage by real-time PCR. In addition, we tested stool samples from healthy persons (n = 173), respiratory samples (n = 113), and animal fecal specimens (n = 68) and further sequenced positive samples. Overall, we detected crAssphage in 71.4% of outbreak stool samples, 48%–68.5% of stool samples from healthy persons, 56.2% of environmental swabs, and 60% of hand rinse samples, but not in human respiratory samples or animal fecal samples. CrAssphage sequences could be grouped into 2 major genetic clusters. Our data suggest that crAssphage could be used to detect human fecal contamination on environmental surfaces and hands.
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10
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Rico E, Pérez C, Belver A, Sabaté S, Razquin E, de Benito J, Coronas L, Domínguez A, Jané M. Norovirus detection in environmental samples in norovirus outbreaks in closed and semi-closed settings. J Hosp Infect 2020; 105:3-9. [PMID: 32092369 DOI: 10.1016/j.jhin.2020.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Environmental surfaces are a potential vehicle for the transmission of norovirus outbreaks in closed and semi-closed settings. Testing of environmental samples may help control outbreaks. AIM To assess the level of environmental contamination by norovirus in acute gastroenteritis outbreaks in closed or semi-closed settings (nursing homes, schools, kindergartens, youth accommodations, hospitals and social health centres) in the Barcelona region between January 2017 and March 2019. METHODS A prospective surveillance study was carried out. Environmental samples (529) were collected in 46 of the 50 outbreaks of acute norovirus gastroenteritis from environmental surfaces of common areas, bathrooms and kitchens in closed and semi-closed settings when the outbreak was notified and 10 days later. Instructions for taking environmental samples were distributed to public health inspectors. Norovirus was detected by reverse transcription polymerase chain reaction. FINDINGS Environmental samples were positive for norovirus in 31 (67.4%) outbreaks. Norovirus was most frequently detected on elevator buttons (4/17, 24%), toilet handles (16/66, 24%) and handrail bars (7/34, 21%). Positive samples from the first sampling were mainly found in bathrooms and greater viral persistence in the second sampling was found on elevator buttons and TV remote controls. Nursing homes were the setting with the most types of environmental surfaces contaminated (82% in first samples and 55% in second samples). CONCLUSION The probability of virus detection is independent of the time between notification of the outbreak or symptom onset and sample collection. Our results suggest possible defects in cleaning protocols and disinfection in closed and semi-closed settings.
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Affiliation(s)
- E Rico
- Sub-direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain
| | - C Pérez
- Sub-direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain
| | - A Belver
- Sub-direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain
| | - S Sabaté
- Laboratori de l'Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - E Razquin
- Laboratori de l'Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - J de Benito
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - L Coronas
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
| | - A Domínguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - M Jané
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Sub-direcció General de Vigilància i Resposta a Emergències de Salut Pública, Barcelona, Spain
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