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Xia T, Shi S, Yang J, Sun D, Suo J, Kuang H, Sun N, Hu H, Xiao J, Yan Z. Contamination dynamics of personal protective equipment (PPE) by SARS-CoV-2 RNA in a makeshift hospital with COVID-19 positive occupants. Infect Prev Pract 2023; 5:100309. [PMID: 37744681 PMCID: PMC10514403 DOI: 10.1016/j.infpip.2023.100309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Background Personal protective equipment (PPE) helps protect healthcare workers (HCWs) from infection and prevents cross-contamination. Knowledge of the contamination dynamics of PPE during the management of COVID-19 patients in a makeshift hospital is limited. Aim To describe the rate of SARS-CoV-2 contamination in PPE and to assess the change of contamination at different time points. Methods HCWs were followed up for up to 4 hours with hourly collection of swab samples from PPE surfaces in a makeshift COVID-19 hospital setting. Swabs were tested using quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA. Results SARS-CoV-2 was detected on 50.9% of the 1620 swabbed samples from 9 different sites of full-body PPE worn by HCWs. The proportion of sites contaminated with SARS-CoV-2 RNA varied from 10.6% to 95.6%. Viral RNA was most frequently detected from the sole of the outer foot cover (95.6%) and least frequently on the face shield (10.6%). The median Ct values among positive samples were 34.20 (IQR, 32.61-35.22) and 34.05 (IQR, 32.20-35.39) for ORF1ab and N genes, respectively. The highest rate of contamination with SARS-CoV-2 RNA for the PPE swab samples was found after 3 hours of use. The positive rate of outer surface of HEPA filters from air supply device was 82.1% during the full capacity period of the makeshift hospital. Conclusion A higher rate of contamination was identified at 3 hours after the entrance to the COVID-19 patient care area. Virus-containing aerosols were trapped in the HEPA filter of air supply equipment, representing a potential protective factor against infection to HCWs.
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Affiliation(s)
- Tingting Xia
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Shi Shi
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Jinyan Yang
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Dan Sun
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Jijiang Suo
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Huihui Kuang
- Department of Laboratory Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Nana Sun
- Department of Laboratory Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Hongyan Hu
- Department of Laboratory Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Jinhan Xiao
- Department of Rehabilitation Physiotherapy, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
| | - Zhongqiang Yan
- Department of Disease Prevention and Control, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People's Republic of China
- Department of Disease Prevention and Control, The Second Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
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Agusto FB, Numfor E, Srinivasan K, Iboi EA, Fulk A, Saint Onge JM, Peterson AT. Impact of public sentiments on the transmission of COVID-19 across a geographical gradient. PeerJ 2023; 11:e14736. [PMID: 36819996 PMCID: PMC9938658 DOI: 10.7717/peerj.14736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 12/21/2022] [Indexed: 02/17/2023] Open
Abstract
COVID-19 is a respiratory disease caused by a recently discovered, novel coronavirus, SARS-COV-2. The disease has led to over 81 million confirmed cases of COVID-19, with close to two million deaths. In the current social climate, the risk of COVID-19 infection is driven by individual and public perception of risk and sentiments. A number of factors influences public perception, including an individual's belief system, prior knowledge about a disease and information about a disease. In this article, we develop a model for COVID-19 using a system of ordinary differential equations following the natural history of the infection. The model uniquely incorporates social behavioral aspects such as quarantine and quarantine violation. The model is further driven by people's sentiments (positive and negative) which accounts for the influence of disinformation. People's sentiments were obtained by parsing through and analyzing COVID-19 related tweets from Twitter, a social media platform across six countries. Our results show that our model incorporating public sentiments is able to capture the trend in the trajectory of the epidemic curve of the reported cases. Furthermore, our results show that positive public sentiments reduce disease burden in the community. Our results also show that quarantine violation and early discharge of the infected population amplifies the disease burden on the community. Hence, it is important to account for public sentiment and individual social behavior in epidemic models developed to study diseases like COVID-19.
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Affiliation(s)
| | - Eric Numfor
- Augusta University, Augusta, Georgia, United States
| | | | | | | | - Jarron M. Saint Onge
- University of Kansas, Lawrence, Kansas, United States,University of Kansas Medical Center, Kansas City, Kansas, United States
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Amara U, Rashid S, Mahmood K, Nawaz MH, Hayat A, Hassan M. Insight into prognostics, diagnostics, and management strategies for SARS CoV-2. RSC Adv 2022; 12:8059-8094. [PMID: 35424750 PMCID: PMC8982343 DOI: 10.1039/d1ra07988c] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/04/2022] [Indexed: 01/08/2023] Open
Abstract
The foremost challenge in countering infectious diseases is the shortage of effective therapeutics. The emergence of coronavirus disease (COVID-19) outbreak has posed a great menace to the public health system globally, prompting unprecedented endeavors to contain the virus. Many countries have organized research programs for therapeutics and management development. However, the longstanding process has forced authorities to implement widespread infrastructures for detailed prognostic and diagnostics study of severe acute respiratory syndrome (SARS CoV-2). This review discussed nearly all the globally developed diagnostic methodologies reported for SARS CoV-2 detection. We have highlighted in detail the approaches for evaluating COVID-19 biomarkers along with the most employed nucleic acid- and protein-based detection methodologies and the causes of their severe downfall and rejection. As the variable variants of SARS CoV-2 came into the picture, we captured the breadth of newly integrated digital sensing prototypes comprised of plasmonic and field-effect transistor-based sensors along with commercially available food and drug administration (FDA) approved detection kits. However, more efforts are required to exploit the available resources to manufacture cheap and robust diagnostic methodologies. Likewise, the visualization and characterization tools along with the current challenges associated with waste-water surveillance, food security, contact tracing, and their role during this intense period of the pandemic have also been discussed. We expect that the integrated data will be supportive and aid in the evaluation of sensing technologies not only in current but also future pandemics.
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Affiliation(s)
- Umay Amara
- Institute of Chemical Sciences, Bahauddin Zakariya University Multan 608000 Pakistan
- Interdisciplinary Research Centre in Biomedical Materials (IRCBM), COMSATS University Islamabad Lahore Campus 54000 Pakistan
| | - Sidra Rashid
- Interdisciplinary Research Centre in Biomedical Materials (IRCBM), COMSATS University Islamabad Lahore Campus 54000 Pakistan
| | - Khalid Mahmood
- Institute of Chemical Sciences, Bahauddin Zakariya University Multan 608000 Pakistan
| | - Mian Hasnain Nawaz
- Interdisciplinary Research Centre in Biomedical Materials (IRCBM), COMSATS University Islamabad Lahore Campus 54000 Pakistan
| | - Akhtar Hayat
- Interdisciplinary Research Centre in Biomedical Materials (IRCBM), COMSATS University Islamabad Lahore Campus 54000 Pakistan
| | - Maria Hassan
- Institute of Chemical Sciences, Bahauddin Zakariya University Multan 608000 Pakistan
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4
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Phuna ZX, Panda BP, Hawala Shivashekaregowda NK, Madhavan P. Nanoprotection from SARS-COV-2: would nanotechnology help in Personal Protection Equipment (PPE) to control the transmission of COVID-19? INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022:1-30. [PMID: 35253535 DOI: 10.1080/09603123.2022.2046710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
The coronavirus disease 2019 (COVID-19) has caused a worldwide outbreak. The severe acute respiratory syndrome coronavirus 2 virus can be transmitted human-to-human through droplets and close contact where personal protective equipment (PPE) is imperative to protect the individuals. The advancement of nanotechnology with significant nanosized properties can confer a higher form of protection. Incorporation of nanotechnology into facemasks can exhibit antiviral properties. Nanocoating on surfaces can achieve self-disinfecting purposes and be applied in highly populated places. Moreover, nano-based hand sanitizers can confer better sterilizing efficacies with low skin irritation as compared to alcohol-based hand sanitizers. The present review discusses the incorporation of nanotechnology into nano-based materials and coatings in facemasks, self-surface disinfectants and hand sanitizers, in the hope to contribute to the current understanding of PPE to combat COVID-19.
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Affiliation(s)
- Zhi Xin Phuna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Bibhu Prasad Panda
- Department of Pharmaceutical Technology, Schoolof Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | | | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
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Clyne B, Jordan K, Ahern S, Walsh KA, Byrne P, Carty PG, Drummond L, O'Brien KK, Smith SM, Harrington P, Ryan M, O'Neill M. Transmission of SARS-CoV-2 by children: a rapid review, 30 December 2019 to 10 August 2020. Euro Surveill 2022; 27. [PMID: 35115076 PMCID: PMC8815097 DOI: 10.2807/1560-7917.es.2022.27.5.2001651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023] Open
Abstract
BackgroundThe role of children in the transmission of SARS-CoV-2 during the early pandemic was unclear.AimWe aimed to review studies on the transmission of SARS-CoV-2 by children during the early pandemic.MethodsWe searched MEDLINE, Embase, the Cochrane Library, Europe PubMed Central and the preprint servers medRxiv and bioRxiv from 30 December 2019 to 10 August 2020. We assessed the quality of included studies using a series of questions adapted from related tools. We provide a narrative synthesis of the results.ResultsWe identified 28 studies from 17 countries. Ten of 19 studies on household and close contact transmission reported low rates of child-to-adult or child-to-child transmission. Six studies investigated transmission of SARS-CoV-2 in educational settings, with three studies reporting 183 cases from 14,003 close contacts who may have contracted COVID-19 from children index cases at their schools. Three mathematical modelling studies estimated that children were less likely to infect others than adults. All studies were of low to moderate quality.ConclusionsDuring the early pandemic, it appeared that children were not substantially contributing to household transmission of SARS-CoV-2. School-based studies indicated that transmission rates in this setting were low. Large-scale studies of transmission chains using data collected from contact tracing and serological studies detecting past evidence of infection would be needed to verify our findings.
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Affiliation(s)
- Barbara Clyne
- Health Information and Quality Authority, Dublin, Ireland
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Karen Jordan
- Health Information and Quality Authority, Dublin, Ireland
| | - Susan Ahern
- Health Information and Quality Authority, Dublin, Ireland
| | - Kieran A Walsh
- Health Information and Quality Authority, Dublin, Ireland
| | - Paula Byrne
- Health Information and Quality Authority, Dublin, Ireland
| | - Paul G Carty
- Health Information and Quality Authority, Dublin, Ireland
| | - Linda Drummond
- Health Information and Quality Authority, Dublin, Ireland
| | | | - Susan M Smith
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Máirín Ryan
- Health Information and Quality Authority, Dublin, Ireland
- Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity Health Sciences, St James's Hospital, Dublin, Ireland
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Jung J, Song KH, Jeong H, Ham SY, Kim ES, Kim HB. Are coveralls required as personal protective equipment during the management of COVID-19 patients? Antimicrob Resist Infect Control 2021; 10:164. [PMID: 34838123 PMCID: PMC8626720 DOI: 10.1186/s13756-021-01017-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/01/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Few studies have investigated the contamination of personal protective equipment (PPE) during the management of patients with severe-to-critical coronavirus disease (COVID-19). This study aimed to determine the necessity of coveralls and foot covers for body protection during the management of COVID-19 patients. METHODS PPE samples were collected from the coveralls of physicians exiting a room after the management of a patient with severe-to-critical COVID-19 within 14 days after the patient's symptom onset. The surface of coveralls was categorized into coverall-only parts (frontal surface of the head, anterior neck, dorsal surface of the foot cover, and back and hip) and gown-covered parts (the anterior side of the forearm and the abdomen). Sampling of the high-contact surfaces in the patient's environment was performed. We attempted to identify significant differences in contamination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between the coverall-only and gown-covered parts. RESULTS A total of 105 swabs from PPEs and 28 swabs from patient rooms were collected. Of the PPE swabs, only three (2.8%) swabs from the gown-covered parts were contaminated with SARS-CoV-2. However, 23 of the 28 sites (82.1%) from patient rooms were contaminated. There was a significant difference in the contamination of PPE between the coverall-only and gown-covered parts (0.0 vs 10.0%, p = 0.022). CONCLUSIONS Coverall contamination rarely occurred while managing severe-to-critical COVID-19 patients housed in negative pressure rooms in the early stages of the illness. Long-sleeved gowns may be used in the management of COVID-19 patients.
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Affiliation(s)
- Jongtak Jung
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
| | - Hyeonju Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.,Ansung Hospital, Gyeonggi Provincial Medical Center, Ansung, Gyeonggi-do, Republic of Korea
| | - Sin Young Ham
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.,Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
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7
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Alnimr A, Alamri A, Salama KF, Radi M, Bukharie H, Alshehri B, Rabaan AA, Alshahrani M. The Environmental Deposition of Severe Acute Respiratory Syndrome Coronavirus 2 in Nosocomial Settings: Role of the Aerosolized Hydrogen Peroxide. Risk Manag Healthc Policy 2021; 14:4469-4475. [PMID: 34754253 PMCID: PMC8570375 DOI: 10.2147/rmhp.s336085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background Data on the role of aerosolized hydrogen peroxide (AHP) systems in the control of the COVID-19 pandemic are still emerging. This study provides evidence of the environmental shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the hospital environment, and the efficacy of AHP to eliminate it. Methods A total of 324 environmental sites (224 surfaces and 100 air samples) belonging to 54 patient rooms were contextually collected and tested for genes of SARS-CoV-2 using RT-PCR assays and Xpert® Xpress SARS-CoV-2. Results The SARS-CoV-2 viral genome was detected in seven sites (2.5%) of three patients’ rooms, including six highly touched surfaces and one air sample. Viral shedding was directly related to the distance from the patient, with 1, 1.9, and 3.5% of samples testing positive at 3, 2, and 1 meter, respectively (P-value=0.02). None of the sites showed the viral genome following application of 6% AHP. Of note, the viral genome was detected at 2 meters of a mildly symptomatic case on a face mask in the absence of aerosol generating procedures. Conclusion Our data support the possible role of the hospital environment as a source of infection, and the efficacy of AHP to eliminate the virus. Further studies are needed to address the viability of the pathogen in these nosocomial sites and the cost-effectiveness of routine hospital disinfection procedures using AHP for SARS-CoV-2.
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Affiliation(s)
- Amani Alnimr
- Department of Microbiology, College of Medicine & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Aisha Alamri
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khaled F Salama
- Department of Environmental Health, College of Public Health & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mahmoud Radi
- Department of Infection Control, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Huda Bukharie
- Department of Infection Control, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Bashayer Alshehri
- Microbiology Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
| | - Mohammed Alshahrani
- Emergency and Critical Care Department, College of Medicine & King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
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Alqayoudhi A, Al Manji A, Al Khalili S, Al Maani A, Alkindi H, Alyaquobi F, Al Rawahi B, Al-Jardani A, Al Wahaibi A, Al-Abri S. The role of children and adolescents in the transmission of SARS-CoV-2 virus within family clusters: A large population study from Oman. J Infect Public Health 2021; 14:1590-1594. [PMID: 34627056 PMCID: PMC8442293 DOI: 10.1016/j.jiph.2021.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/18/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In Oman, many extended families tend to live in one household. Some families can include 20-30 individuals with the majority of them being children. This study investigates the role of children in spreading SARS-CoV-2 causing COVID-19 within family clusters in Oman. METHODS This retrospective study includes data of 1026 SARS-CoV-2 positive children (≤18 years) collected from the national surveillance database for COVID-19 between 1 February 2020 and 30 May 2020. RESULTS We included 1026 patients. Most, 842 were Omani (82%), 52% male, and 28.5% asymptomatic. Close to the half of symptomatic 419 (40%), patients presented with fever associated with other respiratory symptoms. Fifty pediatric patients were index cases who transmitted the virus to 107 patients in total (86 adults and 21 children) with a mode of 1. There is no statistical significance of all studied risk factors in the transmission of the SARS-CoV-2 virus including age, gender, and cycle threshold (CT) value. CONCLUSIONS According to this study, children are not to be considered a significant driver of transmission of SARS-CoV-2 in Oman.
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Affiliation(s)
- Abdullah Alqayoudhi
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman.
| | - Abdullah Al Manji
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
| | - Sulien Al Khalili
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
| | - Amal Al Maani
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
| | - Hanan Alkindi
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
| | - Fatma Alyaquobi
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
| | - Bader Al Rawahi
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
| | - Amina Al-Jardani
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
| | - Adil Al Wahaibi
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
| | - Seif Al-Abri
- Directorate General for Disease Surveillance and Control (DGDSC), Ministry of Health, Muscat 393, Oman
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Coelho WEGDS, Perrechil F, Pedreira MLG, Lopes JL, Santos MVLD, Gabrieloni MC, Perfeito JA, Moraes MAD, Taminato M. Safety and structural integrity of N95/PFF2 respirators decontamination. Am J Infect Control 2021; 49:1221-1226. [PMID: 34229034 PMCID: PMC8254646 DOI: 10.1016/j.ajic.2021.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/24/2021] [Accepted: 06/30/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND COVID-19 is caused by the SARS-CoV-2 virus, an emerging respiratory pathogen. The work environment represents a high-risk factor for health professionals. Given the scarcity of protective personal equipment due to global demand, decontamination and reuse studies should be carried out. Thus, the aim of this study was to evaluate the safety of a method of decontamination of N95/PFF2 respirators, especially regarding structural integrity. METHODS N95/PFF2 respirators were subjected to hydrogen peroxide decontamination and analyzed using scanning electron microscopy and thermogravimetric analysis. Seven respirators of the same brand and lot were used, one being a control and the other six subjected to decontamination process. As for the sealing, a qualitative test was applied, in order to identify the changes in the structure that could damage the sealing of respirators. RESULTS Indicated that the fiber morphology in all layers was not affected by the six decontamination cycles. Also, the thermal stability in the different layers was very similar. Fit testing showed that the respiradors submitted to all cycles of decontamination were approved. CONCLUSIONS Thus, it is possible to conclude that the hydrogen peroxide decontamination method is effective, since it does not alter the physical properties of the respirators.
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Affiliation(s)
| | - Fabiana Perrechil
- Departamento de Engenharia Química, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Diadema, Brazil
| | | | - Juliana Lima Lopes
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, Brazil
| | | | | | | | - Mariana Agostini de Moraes
- Departamento de Engenharia Química, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Diadema, Brazil
| | - Monica Taminato
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, Brazil.
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10
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Li H, Zhao Y, Zhou L. Cutaneous manifestations in children with SARS-CoV-2 infection and/or COVID-19: what do we know after 10 months under this pandemic? Int J Dermatol 2021; 61:39-45. [PMID: 34530491 PMCID: PMC8653232 DOI: 10.1111/ijd.15882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global crisis. However, cutaneous manifestations in children with SARS-CoV-2 infection have received little attention. OBJECTIVE Our study was aimed to present clinical and cutaneous manifestations of children with SARS-CoV-2 and to provide the basis for early diagnosis. METHODS We analyzed the clinical data of COVID-19 infected (CI) children worldwide from December 2019 to October 6, 2020, by using search terms "COVID-19," "SARS-CoV-2," "Coronavirus" in combination with "cutaneous," "lesion," "rash," "skin," "dermatology," "epidermis," "dermis," "multisystem inflammatory syndrome." We collected and analyzed the general information, clinical symptoms, cutaneous manifestations, laboratory examination results, history of close contact with CI patients or suspected CI patients, and outcome in CI children. RESULTS Among 90 CI children, there were 46 boys (59%) and 32 girls (41%). Erythema was the most frequent lesion, followed by conjunctivitis, and edematous lesions. Face was the most commonly affected location including lips, conjunctivae, tongue, eyes, and eyelids. Sixty-three (73.3%) patients had multisystem inflammatory syndrome (MIS-C). As for clinical symptoms, 70 (81.4%) CI children suffered fever, and 34 (39.5%) patients had lung involvement. Meanwhile, 65.1% of patients had cardiac involvement, 4.7% of patients were asymptomatic, and 71.6% of patients received intravenous immunoglobulin, as well as 31.1% of CI children received systemic corticosteroids. Three children were dead. The most frequent route of infection was familial clustering. As silent virus carriers of CI children, it is important to find out the clinical and cutaneous manifestations in CI children to prevent and control COVID-19 transmission.
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Affiliation(s)
- Hongxin Li
- Department of Dermatology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Yong Zhao
- Department of Reproductive Medicine,Senior Department of Obstetrics & Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Lin Zhou
- Department of Clinical Laboratory, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
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11
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Jayakody H, Kiddle G, Perera S, Tisi L, Leese HS. Molecular diagnostics in the era of COVID-19. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2021; 13:3744-3763. [PMID: 34473144 DOI: 10.1039/d1ay00947h] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
As the COVID-19 pandemic continues to escalate globally and acquires new mutations, accurate diagnostic technologies continue to play a vital role in controlling and understanding the epidemiology of this disease. A plethora of technologies have enabled the diagnosis of individuals, informed clinical management, aided population-wide screening to determine transmission rates and identified cases within the wider community and high-risk settings. This review explores the application of molecular diagnostics technologies in controlling the spread of COVID-19, and the key factors that affect the sensitivity and specificity of the tests used.
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Affiliation(s)
- Harindi Jayakody
- Materials for Health Lab, Department of Chemical Engineering, University of Bath, Bath, UK.
- Erba Molecular, Ely, Cambridgeshire, UK.
| | - Guy Kiddle
- Erba Molecular, Ely, Cambridgeshire, UK.
| | - Semali Perera
- Materials for Health Lab, Department of Chemical Engineering, University of Bath, Bath, UK.
| | | | - Hannah S Leese
- Materials for Health Lab, Department of Chemical Engineering, University of Bath, Bath, UK.
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12
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Anand SV, Shuy YK, Lee PSS, Lee ES. One Year on: An Overview of Singapore's Response to COVID-19-What We Did, How We Fared, How We Can Move Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179125. [PMID: 34501718 PMCID: PMC8431401 DOI: 10.3390/ijerph18179125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/30/2021] [Accepted: 08/20/2021] [Indexed: 01/28/2023]
Abstract
Background—One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods—This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results—The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion—Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.
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Affiliation(s)
- S Vivek Anand
- Ministry of Health Holdings, Singapore 099253, Singapore;
| | - Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
| | - Poay Sian Sabrina Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
- Correspondence:
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13
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Djellabi R, Basilico N, Delbue S, D’Alessandro S, Parapini S, Cerrato G, Laurenti E, Falletta E, Bianchi CL. Oxidative Inactivation of SARS-CoV-2 on Photoactive AgNPs@TiO 2 Ceramic Tiles. Int J Mol Sci 2021; 22:ijms22168836. [PMID: 34445543 PMCID: PMC8396237 DOI: 10.3390/ijms22168836] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 12/29/2022] Open
Abstract
The current SARS-CoV-2 pandemic causes serious public health, social, and economic issues all over the globe. Surface transmission has been claimed as a possible SARS-CoV-2 infection route, especially in heavy contaminated environmental surfaces, including hospitals and crowded public places. Herein, we studied the deactivation of SARS-CoV-2 on photoactive AgNPs@TiO2 coated on industrial ceramic tiles under dark, UVA, and LED light irradiations. SARS-CoV-2 inactivation is effective under any light/dark conditions. The presence of AgNPs has an important key to limit the survival of SARS-CoV-2 in the dark; moreover, there is a synergistic action when TiO2 is decorated with Ag to enhance the virus photocatalytic inactivation even under LED. The radical oxidation was confirmed as the the central mechanism behind SARS-CoV-2 damage/inactivation by ESR analysis under LED light. Therefore, photoactive AgNPs@TiO2 ceramic tiles could be exploited to fight surface infections, especially during viral severe pandemics.
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Affiliation(s)
- Ridha Djellabi
- Department of Chemistry, University of Milan, Via Golgi 19, 20133 Milan, Italy;
- Correspondence: (R.D.); (C.L.B.)
| | - Nicoletta Basilico
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy; (N.B.); (S.D.)
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy; (N.B.); (S.D.)
| | - Sarah D’Alessandro
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy;
| | - Silvia Parapini
- Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy;
| | - Giuseppina Cerrato
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, 10125 Turin, Italy; (G.C.); (E.L.)
| | - Enzo Laurenti
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, 10125 Turin, Italy; (G.C.); (E.L.)
| | - Ermelinda Falletta
- Department of Chemistry, University of Milan, Via Golgi 19, 20133 Milan, Italy;
| | - Claudia Letizia Bianchi
- Department of Chemistry, University of Milan, Via Golgi 19, 20133 Milan, Italy;
- Correspondence: (R.D.); (C.L.B.)
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14
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Kanamori H, Weber DJ, Rutala WA. Role of the Healthcare Surface Environment in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission and Potential Control Measures. Clin Infect Dis 2021; 72:2052-2061. [PMID: 32985671 PMCID: PMC7543309 DOI: 10.1093/cid/ciaa1467] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023] Open
Abstract
The healthcare environment serves as one of the possible routes of transmission of epidemiologically important pathogens, but the role of the contaminated environment on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission remains unclear. We reviewed survival, contamination, and transmission of SARS-CoV-2 via environmental surfaces and shared medical devices as well as environmental disinfection of SARS-CoV-2 in healthcare settings. Coronaviruses, including SARS-CoV-2, have been demonstrated to survive for hours to days on environmental surfaces depending on experimental conditions. The healthcare environment is frequently contaminated with SARS-CoV-2 RNA in most studies but without evidence of viable virus. Although direct exposure to respiratory droplets is the main transmission route of SARS-CoV-2, the contaminated healthcare environment can potentially result in transmission of SARS-CoV-2 as described with other coronaviruses such as SARS and Middle East respiratory syndrome coronaviruses. It is important to improve thoroughness of cleaning/disinfection practices in healthcare facilities and select effective disinfectants to decontaminate inanimate surfaces and shared patient care items.
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Affiliation(s)
- Hajime Kanamori
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - David J Weber
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - William A Rutala
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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15
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Shah MR, Jan I, Johns J, Singh K, Kumar P, Belarmino N, Saggiomo KJ, Hayes C, Washington K, Toppmeyer DL, Haffty BG, Libutti SK, Evens AM. SARS-CoV-2 nosocomial infection: Real-world results of environmental surface testing from a large tertiary cancer center. Cancer 2021; 127:1926-1932. [PMID: 33599303 PMCID: PMC8014051 DOI: 10.1002/cncr.33453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 12/06/2020] [Accepted: 12/22/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite consensus guidelines, concern about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has dissuaded patients with cancer from seeking medical care. Studies have shown that contaminated surfaces may contain viable virus for up to 72 hours in laboratory settings. The purpose of this study was to investigate contamination of SARS-CoV-2 on commonly used environmental surfaces in a tertiary cancer care center. METHODS This study evaluated the incidence of SARS-CoV-2 viral RNA in high-touch outpatient and inpatient cancer center spaces. Surfaces were tested over a 2-week period after patient or staff exposure but before scheduled disinfection services according to the World Health Organization protocols for coronavirus disease 2019 (COVID-19) surface sampling. Samples were analyzed via reverse transcriptase-polymerase chain reaction for the presence of SARS-CoV-2 RNA. RESULTS Two hundred four environmental samples were obtained from inpatient and outpatient oncology clinics and infusion suites, and they were categorized as 1) public areas, 2) staff areas, or 3) medical equipment. One hundred thirty surfaces from 2 outpatient hematology and oncology clinics and 36 surfaces from an inpatient leukemia/lymphoma/chimeric antigen receptor T-cell unit were examined, and all 166 samples were negative for SARS-CoV-2. One of 38 samples (2.6%) from COVID-19+ inpatient units was positive. Altogether, the positive test rate for SARS-CoV-2 RNA across all surfaces was 0.5% (1 of 204). CONCLUSIONS This prospective, systematic quality assurance investigation of real-world environmental surfaces, performed in inpatient and outpatient hematology/oncology units, revealed overall negligible detection of SARS-CoV-2 RNA when strict mitigation strategies against COVID-19 transmission were instituted. LAY SUMMARY The potential risks of nosocomial infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have deterred patients with cancer from seeking timely care despite consensus guidelines. This study has found negligible rates of environmental contamination with SARS-CoV-2 across a multitude of commonly used surfaces in outpatient and inpatient hematology/oncology settings with adherence to strict infection control protocols.
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Affiliation(s)
- Mansi R. Shah
- Rutgers Cancer Institute of New JerseyNew BrunswickNew Jersey
| | - Imraan Jan
- Rutgers Cancer Institute of New JerseyNew BrunswickNew Jersey
| | - Jeremy Johns
- Department of Internal MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew Jersey
| | - Kuldip Singh
- Department of Internal MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew Jersey
| | - Pallavi Kumar
- Department of Internal MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew Jersey
| | - Norma Belarmino
- Rutgers Cancer Institute of New JerseyNew BrunswickNew Jersey
| | | | - Carolyn Hayes
- Rutgers Cancer Institute of New JerseyNew BrunswickNew Jersey
| | - Kimyatta Washington
- Robert Wood Johnson University Hospital, RWJBarnabas HealthNew BrunswickNew Jersey
| | | | - Bruce G. Haffty
- Rutgers Cancer Institute of New JerseyNew BrunswickNew Jersey
| | | | - Andrew M. Evens
- Rutgers Cancer Institute of New JerseyNew BrunswickNew Jersey
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16
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Moschovis PP, Yonker LM, Shah J, Singh D, Demokritou P, Kinane TB. Aerosol transmission of SARS-CoV-2 by children and adults during the COVID-19 pandemic. Pediatr Pulmonol 2021; 56:1389-1394. [PMID: 33624927 PMCID: PMC8014227 DOI: 10.1002/ppul.25330] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/13/2021] [Accepted: 02/09/2021] [Indexed: 12/23/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted via respiratory droplets, aerosols, and to a lesser extent, fomites. Defining the factors driving infectivity and transmission is critical for infection control and containment of this pandemic. We outline the major methods of transmission of SARS-CoV-2, focusing on aerosol transmission. We review principles of aerosol science and discuss their implications for mitigating the spread of SARS-CoV-2 among children and adults.
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Affiliation(s)
- Peter P Moschovis
- Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lael M Yonker
- Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jhill Shah
- Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Dilpreet Singh
- Center for Nanotechnology and Nanotoxicology, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Philip Demokritou
- Center for Nanotechnology and Nanotoxicology, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - T Bernard Kinane
- Division of Pediatric Pulmonary Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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17
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A surge in appendicitis: Management of paediatric appendicitis during the COVID-19 surge in the Royal Belfast Hospital for Sick Children. THE ULSTER MEDICAL JOURNAL 2021; 90:86-89. [PMID: 34276086 PMCID: PMC8278940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Traditional surgical dogma is that paediatric appendicitis necessitates an appendicectomy; however there is an increasing cohort of evidence suggesting that non-operative management (NOM) using antibiotic therapy is safe and effective. During the COVID-19 surge (April - June 2020) with centralization of paediatric surgical care and risks from anaesthetics to both patients and staff a NOM pathway was used to manage clinically diagnosed appendicitis in the Royal Belfast Hospital for Sick Children (RBHSC). METHODS Prospective data collection was undertaken of all children (<16 years) diagnosed with appendicitis who entered the NOM pathway in RBHSC from 01/04/2020 to 30/06/2020. This was compared to a cohort from the same timeframe in 2019. Primary end-points were inpatient success rate of NOM and 30-day success rate of NOM (success defined as no appendectomy performed). RESULTS 47 patients completed the NOM pathway, with 43% (20/47) suspected to have complicated appendicitis. The cohort was similar to that of 2019 in terms of age (p=0.1) and sex (p=0.8), but was 155% larger (42 v. 20).For those with simple appendicitis, there was a 96% (26/27) success rate of NOM on discharge, with a 93% (25/27) 30-day success rate. For complicated appendicitis, there was a 40% (8/20) success rate on discharge, with a 30% (6/20) 30-day success rate. CONCLUSION The use of a NOM pathway for paediatric appendicitis during the COVID-19 surge in Northern Ireland was safe and effective for staff and patients. With a small sample size and restricted follow up more evidence is required to prove if this is an effective treatment modality with a return to normal theatre availability. In the interests of antibiotic stewardship we would not advocate NOM pathways utilisation by non-surgical clinicians.
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18
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Bedrosian N, Mitchell E, Rohm E, Rothe M, Kelly C, String G, Lantagne D. A Systematic Review of Surface Contamination, Stability, and Disinfection Data on SARS-CoV-2 (Through July 10, 2020). ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:4162-4173. [PMID: 33227206 DOI: 10.1021/acs.est.0c05651] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We conducted a systematic review of hygiene intervention effectiveness against SARS-CoV-2, including developing inclusion criteria, conducting the search, selecting articles for inclusion, and summarizing included articles. Overall, 96 268 articles were screened and 78 articles met inclusion criteria with outcomes in surface contamination, stability, and disinfection. Surface contamination was assessed on 3343 surfaces using presence/absence methods. Laboratories had the highest percent positive surfaces (21%, n = 83), followed by patient-room healthcare facility surfaces (17%, n = 1170), non-COVID-patient-room healthcare facility surfaces (12%, n = 1429), and household surfaces (3%, n = 161). Surface stability was assessed using infectivity, SARS-CoV-2 survived on stainless steel, plastic, and nitrile for half-life 2.3-17.9 h. Half-life decreased with temperature and humidity increases, and was unvaried by surface type. Ten surface disinfection tests with SARS-CoV-2, and 15 tests with surrogates, indicated sunlight, ultraviolet light, ethanol, hydrogen peroxide, and hypochlorite attain 99.9% reduction. Overall there was (1) an inability to align SARS-CoV-2 contaminated surfaces with survivability data and effective surface disinfection methods for these surfaces; (2) a knowledge gap on fomite contribution to SARS-COV-2 transmission; (3) a need for testing method standardization to ensure data comparability; and (4) a need for research on hygiene interventions besides surfaces, particularly handwashing, to continue developing recommendations for interrupting SARS-CoV-2 transmission.
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Affiliation(s)
- Noah Bedrosian
- Tufts University School of Engineering, Medford, Massachusetts, 02155, United States
| | - Elizabeth Mitchell
- Tufts University School of Engineering, Medford, Massachusetts, 02155, United States
| | - Elsa Rohm
- Tufts University School of Engineering, Medford, Massachusetts, 02155, United States
| | - Miguel Rothe
- Tufts University School of Engineering, Medford, Massachusetts, 02155, United States
| | - Christine Kelly
- Tufts University School of Engineering, Medford, Massachusetts, 02155, United States
| | - Gabrielle String
- Tufts University School of Engineering, Medford, Massachusetts, 02155, United States
| | - Daniele Lantagne
- Tufts University School of Engineering, Medford, Massachusetts, 02155, United States
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19
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A literature review of 2019 novel coronavirus (SARS-CoV2) infection in neonates and children. Pediatr Res 2021; 89:1101-1108. [PMID: 32679582 DOI: 10.1038/s41390-020-1065-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/18/2020] [Accepted: 06/29/2020] [Indexed: 01/08/2023]
Abstract
At the time of writing, there are already millions of documented infections worldwide by the novel coronavirus 2019 (2019-nCoV or severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)), with hundreds of thousands of deaths. The great majority of fatal events have been recorded in adults older than 70 years; of them, a large proportion had comorbidities. Since data regarding the epidemiologic and clinical characteristics in neonates and children developing coronavirus disease 2019 (COVID-19) are scarce and originate mainly from one country (China), we reviewed all the current literature from 1 December 2019 to 7 May 2020 to provide useful information about SARS-CoV2 viral biology, epidemiology, diagnosis, clinical features, treatment, prevention, and hospital organization for clinicians dealing with this selected population. IMPACT: Children usually develop a mild form of COVID-19, rarely requiring high-intensity medical treatment in pediatric intensive care unit. Vertical transmission is unlikely, but not completely excluded. Children with confirmed or suspected COVID-19 must be isolated and healthcare workers should wear appropriate protective equipment. Some clinical features (higher incidence of fever, vomiting and diarrhea, and a longer incubation period) are more common in children than in adults, as well as some radiologic aspects (more patchy shadow opacities on CT scan images than ground-glass opacities). Supportive and symptomatic treatments (oxygen therapy and antibiotics for preventing/treating bacterial coinfections) are recommended in these patients.
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20
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Yung CF, Kam KQ, Nadua KD, Chong CY, Tan NWH, Li J, Lee KP, Chan YH, Thoon KC, Ng KC. Novel Coronavirus 2019 Transmission Risk in Educational Settings. Clin Infect Dis 2021; 72:1055-1058. [PMID: 32584975 PMCID: PMC7337629 DOI: 10.1093/cid/ciaa794] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/23/2020] [Indexed: 01/06/2023] Open
Abstract
Transmission risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in schools is unknown. Our investigations, especially in preschools, could not detect SARS-CoV-2 transmission despite screening of symptomatic and asymptomatic children. The data suggest that children are not the primary drivers of SARS-CoV-2 transmission in schools and could help inform exit strategies for lifting of lockdowns.
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Affiliation(s)
- Chee Fu Yung
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Kai-Qian Kam
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - Karen Donceras Nadua
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - Chia Yin Chong
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Natalie Woon Hui Tan
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Jiahui Li
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - Khai Pin Lee
- Children's Emergency, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Yoke Hwee Chan
- Duke-National University of Singapore Medical School, Singapore.,Division of Medicine, KK Women's and Children's Hospital, Singapore
| | - Koh Cheng Thoon
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Kee Chong Ng
- Duke-National University of Singapore Medical School, Singapore.,Division of Medicine, KK Women's and Children's Hospital, Singapore
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21
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A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19. ACTA ACUST UNITED AC 2021; 3:1272-1294. [PMID: 33754135 PMCID: PMC7968576 DOI: 10.1007/s42399-021-00836-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 02/07/2023]
Abstract
The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.
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22
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Kampf G, Jatzwauk L. [Is Disinfection of Public Surfaces useful for the Prevention of SARS-CoV-2 Infections?]. DAS GESUNDHEITSWESEN 2021; 83:180-185. [PMID: 33540430 PMCID: PMC8043670 DOI: 10.1055/a-1335-4549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Measures to control SARS-CoV-2 often include the regular disinfection of public surfaces. The frequency of SARS-CoV-2 detection on surfaces in the surrounding of confirmed cases was evaluated in this systematic review. Overall, 26 studies showed 0 and 100% rates of contamination with SARS-CoV-2 RNA on surfaces in the surrounding of patients. Seven studies with at least 100 samples mostly showed detection rates between 1.4 and 19%. Two other studies did not detect infectious SARS-CoV-2 on any surface. Similar results were obtained from surfaces in the surrounding of confirmed SARS- and influenza-patients. A contamination of public surfaces with infectious virus is considerably less likely because there are much less potential viral spreaders around a surface, the contact time between a person and the surface is much shorter, and the asymptomatic carriers typically have no symptoms. In addition, a hand contact with a contaminated surface transfers only a small part of the viral load. A simple cleaning reduces the number of infectious viruses already by 2 log10-steps. That is why public surfaces should in general be cleaned because the wide use of biocidal agents for surface disinfection further increases the microbial selection pressure without an expectable health benefit.
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Affiliation(s)
- Günter Kampf
- Institut für Hygiene und Umweltmedizin, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Lutz Jatzwauk
- Krankenhaushygiene, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
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23
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Lane MA, Brownsword EA, Babiker A, Ingersoll JM, Waggoner J, Ayers M, Klopman M, Uyeki TM, Lindsley WG, Kraft CS. Bioaerosol sampling for SARS-CoV-2 in a referral center with critically ill COVID-19 patients March-May 2020. Clin Infect Dis 2021; 73:e1790-e1794. [PMID: 33506256 PMCID: PMC7953966 DOI: 10.1093/cid/ciaa1880] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Indexed: 12/23/2022] Open
Abstract
Background Previous research has shown that rooms of patients with coronavirus disease 2019 (COVID-19) present the potential for healthcare-associated transmission through aerosols containing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, data on the presence of these aerosols outside of patient rooms are limited. We investigated whether virus-containing aerosols were present in nursing stations and patient room hallways in a referral center with critically ill COVID-19 patients. Methods Eight National Institute for Occupational Safety and Health BC 251 2-stage cyclone samplers were set up throughout 6 units, including nursing stations and visitor corridors in intensive care units and general medical units, for 6 h each sampling period. Samplers were placed on tripods which held 2 samplers positioned 102 cm and 152 cm above the floor. Units were sampled for 3 days. Extracted samples underwent reverse transcription polymerase chain reaction for selected gene regions of the SARS-CoV-2 virus nucleocapsid and the housekeeping gene human RNase P as an internal control. Results The units sampled varied in the number of laboratory-confirmed COVID-19 patients present on the days of sampling. Some of the units included patient rooms under negative pressure, while most were maintained at a neutral pressure. Of 528 aerosol samples collected, none were positive for SARS-CoV-2 RNA by the estimated limit of detection of 8 viral copies/m3 of air. Conclusions Aerosolized SARS-CoV-2 outside of patient rooms was undetectable. While healthcare personnel should avoid unmasked close contact with each other, these findings may provide reassurance for the use of alternatives to tight-fitting respirators in areas outside of patient rooms during the current pandemic.
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Affiliation(s)
- Morgan A Lane
- Division of Infectious Diseases, Department of Medicine Emory University, Atlanta, GA, USA
| | - Erik A Brownsword
- Division of Infectious Diseases, Department of Medicine Emory University, Atlanta, GA, USA
| | - Ahmed Babiker
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Jessica M Ingersoll
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Jesse Waggoner
- Division of Infectious Diseases, Department of Medicine Emory University, Atlanta, GA, USA.,Emory Healthcare, Atlanta, GA
| | | | - Matthew Klopman
- Emory Healthcare, Atlanta, GA.,Department of Anesthesiology, Emory University, Atlanta, GA, USA
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Colleen S Kraft
- Division of Infectious Diseases, Department of Medicine Emory University, Atlanta, GA, USA.,Emory Healthcare, Atlanta, GA.,Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
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Lin X, Chang SC, Chou TH, Chen SC, Ruangkanjanases A. Consumers' Intention to Adopt Blockchain Food Traceability Technology towards Organic Food Products. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030912. [PMID: 33494321 PMCID: PMC7908134 DOI: 10.3390/ijerph18030912] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 01/23/2023]
Abstract
Establishing a blockchain food traceability system (BFTS) is increasingly important and urgent to resolve the contradiction between consumers’ intention regarding safe food selections and the spread of polluted foods. Using the advantages of blockchain, such as immutability, decentralization, openness, and anonymity, we can build trusted food traceability systems based on these important characteristics. With reliable information, traceability from production to sales can effectively improve food safety. In this research, multiple models, namely, the information success model (ISS) and the Theory of Planned Behavior (TPB) are formed into a conceptual integrated framework to study the intentions’ influenced factors of BFTS technology for Chinese consumers to help ensure food safety and the quality of Chinese organic food products. A face-to-face questionnaire survey with 300 valid responses was analyzed by Partial Least Square from the Chinese consumers focusing on the organic food products. This study found that the attitude and perceived behavioral control qualities significantly and positively affect the usage intention in adopting BFTS, while the subjective norms are positively but not significantly correlation with the usage intention in using BFTS. The above results will inform suggestions for productors and academics along with implications to promote BFTS’ usage intention.
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Affiliation(s)
- Xin Lin
- School of Economics and Management, Northeast Electric Power University, Jilin 132012, China;
| | - Shu-Chen Chang
- College of Management, National Kaohsiung University of Science and Technology, Kaohsiung 824, Taiwan;
| | - Tung-Hsiang Chou
- Department of Information Management, National Kaohsiung University of Science and Technology, Kaohsiung 824, Taiwan;
| | - Shih-Chih Chen
- Department of Information Management, National Kaohsiung University of Science and Technology, Kaohsiung 824, Taiwan;
- Correspondence: (S.-C.C.); (A.R.)
| | - Athapol Ruangkanjanases
- Chulalongkorn Business School, Chulalongkorn University, Bangkok 10330, Thailand
- Correspondence: (S.-C.C.); (A.R.)
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Hu X, Ni W, Wang Z, Ma G, Pan B, Dong L, Gao R, Jiang F. The distribution of SARS-CoV-2 contamination on the environmental surfaces during incubation period of COVID-19 patients. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111438. [PMID: 33039873 PMCID: PMC7526608 DOI: 10.1016/j.ecoenv.2020.111438] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/16/2020] [Accepted: 09/27/2020] [Indexed: 05/02/2023]
Abstract
Roles of environmental factors in transmission of COVID-19 have been highlighted. In this study, we sampled the high-touch environmental surfaces in the quarantine room, aiming to detect the distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the environmental surfaces during the incubation period of coronavirus disease 2019 (COVID-19) patients. Fifteen sites were sampled from the quarantine room, distributing in the functional areas such as bedroom, bathroom and living room. All environmental surface samples were collected with sterile polyester-tipped applicator pre-moistened in viral transport medium and tested for SARS-CoV-2. Overall, 34.1% of samples were detected positively for SARS-CoV-2. The positive rates of Patient A, B and C, were 46.2%, 0% and 61.5%, respectively. SARS-CoV-2 was detected positively in bedroom and bathroom, with the positive rate of 50.0% and 46.7%, respectively. In contrast, living room had no positive sample detected. Environmental contamination of SARS-CoV-2 distributes widely during the incubation period of COVID-19, and the positive rates of SARS-CoV-2 on environmental surfaces are relatively high in bathroom and bedroom.
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Affiliation(s)
- Xiaowen Hu
- Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao Institute of Prevention Medicine, Qingdao, Shandong Province, China
| | - Wei Ni
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, Shandong Province, China
| | - Zhaoguo Wang
- Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao Institute of Prevention Medicine, Qingdao, Shandong Province, China
| | - Guangren Ma
- Qingdao Chest Hospital, Qingdao, Shandong Province, China
| | - Bei Pan
- Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao Institute of Prevention Medicine, Qingdao, Shandong Province, China
| | - Liyan Dong
- Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao Institute of Prevention Medicine, Qingdao, Shandong Province, China
| | - Ruqin Gao
- Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao Institute of Prevention Medicine, Qingdao, Shandong Province, China.
| | - Fachun Jiang
- Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao Institute of Prevention Medicine, Qingdao, Shandong Province, China.
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Abstract
It is important to understand the temporal trend of the paediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load to estimate the transmission potential of children in schools and communities. We determined the differences in SARS-CoV-2 viral load dynamics between nasopharyngeal samples of infected asymptomatic and symptomatic children. Serial cycle threshold values of SARS-CoV-2 from the nasopharynx of a cohort of infected children were collected for analysis. Among 17 infected children, 10 (58.8%) were symptomatic. Symptomatic children, when compared to asymptomatic children, had higher viral loads (mean cycle threshold on day 7 of illness 28.6 vs. 36.7, P = 0.02). Peak SARS-CoV-2 viral loads occurred around day 2 of illness in infected children. Although we were unable to directly demonstrate infectivity, the detection of significant amount of virus in the upper airway of asymptomatic children suggest that they have the potential to shed and transmit SARS-CoV-2. Our study highlights the importance of contact tracing and screening for SARS-CoV-2 in children with epidemiological risk factors regardless of their symptom status, in order to improve containment of the virus in the community, including educational settings.
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Nunziata F, Poeta M, Vassallo E, Continisio GI, Lo Vecchio A, Guarino A, Bruzzese E. No Spread of SARS-CoV-2 From Infected Symptomatic Children to Parents: A Prospective Cohort Study in a Controlled Hospital Setting. Front Pediatr 2021; 9:720084. [PMID: 34414146 PMCID: PMC8369826 DOI: 10.3389/fped.2021.720084] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/12/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction: The transmission rates severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from children to adults are unclear due to a lack of controlled conditions. Materials and Methods: We investigated the occurrence of SARS-CoV-2 transmission among 12 discordant child-parent pairs in our ward. In each hospital isolation room, caregivers and children lived in close contact during the entire hospitalization period. Results: A total of 136 swab-positive children (mean age, 3.6 ± 4.9 median age, 1; IQR 0-6.2, range 0.1-17) attended by their caregivers were hospitalized. Of those, 12/136 (8.8%, mean age, 6.1 ± 5.3 median age, 4.5) were attended by caregivers who were swab and serology negative at admission despite previous close contact with positive children at home. Three children were completely dependent on their mothers, one of whom was being breastfed. The mean duration of overall exposure to the index case was 20.5 ± 8.2 days. Conclusion: None of the infected children transmitted SARS-CoV-2 infection to their caregivers, raising the hypothesis of a cluster of resistant mothers or of limited transmission from children to adults despite prolonged exposure and close contact. These data might provide reassurance regarding school openings and offer the chance of investigating SARS-CoV-2 variants in the future under the same quasi-experimental conditions.
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Affiliation(s)
- Francesco Nunziata
- Department of Translational Medical Sciences, Section of Paediatrics, University of Naples Federico II, Naples, Italy
| | - Marco Poeta
- Department of Translational Medical Sciences, Section of Paediatrics, University of Naples Federico II, Naples, Italy
| | - Edoardo Vassallo
- Department of Translational Medical Sciences, Section of Paediatrics, University of Naples Federico II, Naples, Italy
| | | | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Section of Paediatrics, University of Naples Federico II, Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences, Section of Paediatrics, University of Naples Federico II, Naples, Italy
| | - Eugenia Bruzzese
- Department of Translational Medical Sciences, Section of Paediatrics, University of Naples Federico II, Naples, Italy
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Ha JF. COVID-19 in Children: A Narrative Review. Curr Pediatr Rev 2021; 17:212-219. [PMID: 34042036 DOI: 10.2174/1573396317666210526155313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/31/2020] [Accepted: 03/06/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic is caused by the third known zoonotic coronavirus. It is a disease that does not spare any age group. The scientific community has been inundated with information since January. This review aims to summarise pertinent information related to COVID-19 in children. METHODS A literature search was conducted in 2020 on the PubMed, MEDLINE, and Embase databases, with the keyword "COVID 19" and "children". A bibliographic search of articles included was also undertaken. The abstracts were scanned to assess their appropriateness to be included in this narrative review. This was updated on the 11th April, 2020. RESULTS The aetiology, transmission, incubation, pathophysiology, clinical features and complications, and management are discussed. CONCLUSION Our understanding of COVID-19 is evolving as more reports are published. The growth of SARS-CoV2 is limited in children and they are often asymptomatic. The disease course is also milder. Continued research to understand its effect on children is important to help us manage the disease in these vulnerable populations in a timely fashion.
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Affiliation(s)
- Jennifer F Ha
- Department of Paediatrics Otolaryngology-Head & Neck Surgery, Perth Children's Hospital, 15 Hospital Avenue, Nedlands 6009, Western Australia, Australia
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Belluco S, Mancin M, Marzoli F, Bortolami A, Mazzetto E, Pezzuto A, Favretti M, Terregino C, Bonfante F, Piro R. Prevalence of SARS-CoV-2 RNA on inanimate surfaces: a systematic review and meta-analysis. Eur J Epidemiol 2021; 36:685-707. [PMID: 34313896 PMCID: PMC8313411 DOI: 10.1007/s10654-021-00784-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease (COVID-19) is a respiratory disease affecting many people and able to be transmitted through direct and perhaps indirect contact. Direct contact transmission, mediated by aerosols or droplets, is widely demonstrated, whereas indirect transmission is only supported by collateral evidence such as virus persistence on inanimate surfaces and data from other similar viruses. The present systematic review aims to estimate SARS-CoV-2 prevalence on inanimate surfaces, identifying risk levels according to surface characteristics. Data were obtained from studies in published papers collected from two databases (PubMed and Embase) with the last search on 1 September 2020. Included studies had to be papers in English, had to deal with coronavirus and had to consider inanimate surfaces in real settings. Studies were coded according to our assessment of the risk that the investigated surfaces could be contaminated by SARS-CoV-2. A meta-analysis and a metaregression were carried out to quantify virus RNA prevalence and to identify important factors driving differences among studies. Thirty-nine out of forty retrieved paper reported studies carried out in healthcare settings on the prevalence of virus RNA, five studies carry out also analyses through cell culture and six tested the viability of isolated viruses. Overall prevalences of SARS-CoV-2 RNA on high-, medium- and low-risk surfaces were 0.22 (CI95 [0.152-0.296]), 0.04 (CI95 [0.007-0.090]), and 0.00 (CI95 [0.00-0.019]), respectively. The duration surfaces were exposed to virus sources (patients) was the main factor explaining differences in prevalence.
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Affiliation(s)
- Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy.
| | - Marzia Mancin
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Filippo Marzoli
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Alessio Bortolami
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Eva Mazzetto
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Alessandra Pezzuto
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Michela Favretti
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Calogero Terregino
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Francesco Bonfante
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Roberto Piro
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
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[Infection prevention and control for COVID-19 in healthcare settings]. Uirusu 2021; 71:151-162. [PMID: 37245977 DOI: 10.2222/jsv.71.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In healthcare facilities, the initial response to emerging and reemerging infectious diseases, including COVID-19, requires systematic management. The first step is to establish an initial risk assessment and subsequent response flow, using a combination of triage and clinical examination for patients. Screening tests are performed for the early diagnosis of asymptomatic patients who are judged to be at low risk in the initial assessment. However, regardless of the test results, subsequent patient care should be taken cautiously to avoid inadequate initial evaluation at the time of admission, follow-up of symptoms and infection control measures after admission. The basic principle is standard precautions, with particular emphasis on compliance with hand hygiene. Universal masking for preventing transmission from asymptomatic/pre-symptomatic patients and reducing droplet emission and inhalation become the new essential precaution. For suspected/confirmed patients with COVID-19, surgical mask or N95 mask, gloves, gown, eye protection, and cap are basically used. The policy for personal protective equipment is made based on the medical environment of each facility. A negative pressure room is not always required but should be considered in high-risk environments, if possible. While the risk of transmission from the surface environment in a standard healthcare delivery system is limited, a continuous review of the facility environment is expected, considering the importance of ventilation.
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Lo Vecchio A, Pierri L, Poeta M, Vassallo E, Varelli M, Montella E, Guarino A, Bruzzese E. Risk of SARS-CoV-2 Transmission in Health Care Personnel Working in a Pediatric COVID-19 Unit. Hosp Pediatr 2020; 11:e42-e47. [PMID: 33361399 DOI: 10.1542/hpeds.2020-003855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The paucity of symptoms and the difficulties in wearing personal protective equipment make children a potential source of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for health care workers (HCWs). Previous experience in pediatric settings reported high rate of intrahospital SARS-CoV-2 transmission in HCWs caring for children. We aimed at investigating the rate and determinants of SARS-CoV-2 infection among HCWs working in a regional reference center in the Southern Italy. METHODS A prospective observational study was conducted to monitor the occurrence of SARS-CoV-2 infections among HCWs and investigate the relation between the infection rate and hours of exposure or number and characteristics of procedures, including nasopharyngeal swab, high-flow oxygen delivery, suctioning of airway secretions, sputum induction, and nebulizer administration. RESULTS After 5 months of monitoring, 425.6 hours of SARS-CoV-2 exposure (18.5 hours per person), and 920 hospital procedures, no case of nosocomial transmission was reported among the 23 HCWs enrolled in the study. CONCLUSIONS The application of stringent preventive measures, also outside the area dedicated to patients' care, can effectively control infection spreading also in pediatric settings.
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Affiliation(s)
- Andrea Lo Vecchio
- Section of Pediatrics, Departments of Translational Medical Science and
| | - Luca Pierri
- Section of Pediatrics, Departments of Translational Medical Science and
| | - Marco Poeta
- Section of Pediatrics, Departments of Translational Medical Science and
| | - Edoardo Vassallo
- Section of Pediatrics, Departments of Translational Medical Science and
| | | | - Emma Montella
- Public Health, University of Naples Federico II, Naples, Italy; and
| | - Alfredo Guarino
- Section of Pediatrics, Departments of Translational Medical Science and
| | - Eugenia Bruzzese
- Section of Pediatrics, Departments of Translational Medical Science and
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32
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Ben-Shmuel A, Brosh-Nissimov T, Glinert I, Bar-David E, Sittner A, Poni R, Cohen R, Achdout H, Tamir H, Yahalom-Ronen Y, Politi B, Melamed S, Vitner E, Cherry L, Israeli O, Beth-Din A, Paran N, Israely T, Yitzhaki S, Levy H, Weiss S. Detection and infectivity potential of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination in isolation units and quarantine facilities. Clin Microbiol Infect 2020; 26:1658-1662. [PMID: 32919072 PMCID: PMC7481174 DOI: 10.1016/j.cmi.2020.09.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Environmental surfaces have been suggested as likely contributors in the transmission of COVID-19. This study assessed the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contaminating surfaces and objects in two hospital isolation units and a quarantine hotel. METHODS SARS-CoV-2 virus stability and infectivity on non-porous surfaces was tested under controlled laboratory conditions. Surface and air sampling were conducted at two COVID-19 isolation units and in a quarantine hotel. Viral RNA was detected by RT-PCR and infectivity was assessed by VERO E6 CPE test. RESULTS In laboratory-controlled conditions, SARS-CoV-2 gradually lost its infectivity completely by day 4 at ambient temperature, and the decay rate of viral viability on surfaces directly correlated with increase in temperature. Viral RNA was detected in 29/55 surface samples (52.7%) and 16/42 surface samples (38%) from the surroundings of symptomatic COVID-19 patients in isolation units of two hospitals and in a quarantine hotel for asymptomatic and very mild COVID-19 patients. None of the surface and air samples from the three sites (0/97) were found to contain infectious titres of SARS-Cov-2 on tissue culture assay. CONCLUSIONS Despite prolonged viability of SARS-CoV-2 under laboratory-controlled conditions, uncultivable viral contamination of inanimate surfaces might suggest low feasibility for indirect fomite transmission.
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Affiliation(s)
- Amir Ben-Shmuel
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Tal Brosh-Nissimov
- Infectious Diseases Unit, Assuta Ashdod University Hospital, Ashdod, Israel; Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheba, Israel
| | - Itai Glinert
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Elad Bar-David
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Assa Sittner
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Reut Poni
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Regev Cohen
- Infectious Diseases Unit, Laniado Hospital, Netanya, Israel
| | - Hagit Achdout
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Hadas Tamir
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Yfat Yahalom-Ronen
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Boaz Politi
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Sharon Melamed
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Einat Vitner
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Lilach Cherry
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Ofir Israeli
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Adi Beth-Din
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Nir Paran
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Tomer Israely
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Shmuel Yitzhaki
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Haim Levy
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Shay Weiss
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel.
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Li X, Xu W, Dozier M, He Y, Kirolos A, Lang Z, Song P, Theodoratou E. The role of children in the transmission of SARS-CoV2: updated rapid review. J Glob Health 2020; 10:021101. [PMID: 33312511 PMCID: PMC7719356 DOI: 10.7189/jogh.10.021101] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Understanding carriage and transmission potential of SARS-CoV-2 in children is of paramount importance to understand the spread of virus in school and community settings. METHODS We performed an updated rapid review to investigate the role of children in the transmission of SARS-CoV-2. We synthesized evidence for five categories and results are reported narratively. RESULTS A total of 33 new studies were included for this review. We did not identify additional studies that reported documented cases of SARS-CoV-2 transmission by children. We identified 15 new studies that demonstrate children's susceptibility and transmission risk of SARS-CoV-2 with evidence provided on the chance of being index or secondary cases, the potential of faecal-oral transmission, and the possibility of asymptomatic transmission. There is little data on the transmission of SARS-CoV-2 in schools. There were three studies reporting COVID-19 school outbreaks in France (Oise), Australia (New South Wales) and Israel. The remaining four studies found that all reported cases did not infect any other pupils or staff. With data from seven studies and governmental websites, the proportion of children among all confirmed COVID-19 patients was estimated for 29 countries, varying from 0.3% (lowest in Spain) up to 13.8% (highest in Argentina). Lastly, we identified seven studies reporting on PIMS-TS linked to COVID-19 among paediatric patients. CONCLUSIONS There is somewhat limited evidence available for quantifying the extent to which children may contribute to overall transmission, but the balance of evidence so far suggests that children and schools play only a limited role in overall transmission.
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Affiliation(s)
- Xue Li
- School of Public Health and the Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Wei Xu
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Marshall Dozier
- Information Services, University of Edinburgh, Edinburgh, United Kingdom
| | - Yazhou He
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Amir Kirolos
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Zhongyu Lang
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Peige Song
- School of Public Health and the Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Evropi Theodoratou
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- Cancer Research UK Edinburgh Centre, Medical Research Council Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - on behalf of UNCOVER
- School of Public Health and the Second Affiliated Hospital, Zhejiang University, Hangzhou, China
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- Information Services, University of Edinburgh, Edinburgh, United Kingdom
- Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- Cancer Research UK Edinburgh Centre, Medical Research Council Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
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Kampf G, Brüggemann Y, Kaba H, Steinmann J, Pfaender S, Scheithauer S, Steinmann E. Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2. J Hosp Infect 2020; 106:678-697. [PMID: 32956786 PMCID: PMC7500278 DOI: 10.1016/j.jhin.2020.09.022] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 12/19/2022]
Abstract
During the current SARS-CoV-2 pandemic new studies are emerging daily providing novel information about sources, transmission risks and possible prevention measures. In this review, we aimed to comprehensively summarize the current evidence on possible sources for SARS-CoV-2, including evaluation of transmission risks and effectiveness of applied prevention measures. Next to symptomatic patients, asymptomatic or pre-symptomatic carriers are a possible source with respiratory secretions as the most likely cause for viral transmission. Air and inanimate surfaces may be sources; however, viral RNA has been inconsistently detected. Similarly, even though SARS-CoV-2 RNA has been detected on or in personal protective equipment (PPE), blood, urine, eyes, the gastrointestinal tract and pets, these sources are currently thought to play a negligible role for transmission. Finally, various prevention measures such as handwashing, hand disinfection, face masks, gloves, surface disinfection or physical distancing for the healthcare setting and in public are analysed for their expected protective effect.
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Affiliation(s)
- G. Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany,Corresponding author. Address: University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Ferdinand-Sauerbruch-Strasse, 17475 Greifswald, Germany
| | - Y. Brüggemann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - H.E.J. Kaba
- Institute of Infection Control and Infectious Diseases, University Medical Center, Georg August University, Göttingen, Germany
| | - J. Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | - S. Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - S. Scheithauer
- Institute of Infection Control and Infectious Diseases, University Medical Center, Georg August University, Göttingen, Germany
| | - E. Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
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35
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Li X, Xu W, Dozier M, He Y, Kirolos A, Lang Z, Song P, Theodoratou E. The role of children in the transmission of SARS-CoV2: updated rapid review. J Glob Health 2020. [DOI: 10.7189/jogh.10.0201101] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Household Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 from Adults to Children. J Pediatr 2020; 225:249-251. [PMID: 32634405 PMCID: PMC7334921 DOI: 10.1016/j.jpeds.2020.07.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/02/2020] [Indexed: 12/14/2022]
Abstract
Knowledge of transmission dynamics of severe acute respiratory syndrome coronavirus 2 from adults to children in household settings is limited. We found an attack rate among 213 children in 137 households to be 6.1% in households with confirmed adult 2019 novel coronavirus disease index case(s). Transmission from adult to child occurred in only 5.2% of households. Young children <5 years old were at lowest risk of infection (1.3%). Children were most likely to be infected if the household index case was the mother.
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Kim UJ, Lee SY, Lee JY, Lee A, Kim SE, Choi OJ, Lee JS, Kee SJ, Jang HC. Air and Environmental Contamination Caused by COVID-19 Patients: a Multi-Center Study. J Korean Med Sci 2020; 35:e332. [PMID: 32959546 PMCID: PMC7505729 DOI: 10.3346/jkms.2020.35.e332] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/03/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine the extent of air and surface contamination of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in four health care facilities with hospitalized coronavirus disease 2019 (COVID-19) patients. METHODS We investigated air and environmental contamination in the rooms of eight COVID-19 patients in four hospitals. Some patients were in negative-pressure rooms, and others were not. None had undergone aerosol-generating procedures. On days 0, 3, 5, and 7 of hospitalization, the surfaces in the rooms and anterooms were swabbed, and air samples were collected 2 m from the patient and from the anterooms. RESULTS All 52 air samples were negative for SARS-CoV-2 RNA. Widespread surface contamination of SARS-CoV-2 RNA was observed. In total, 89 of 320 (27%) environmental surface samples were positive for SARS-CoV-2 RNA. Surface contamination of SARS-CoV-2 RNA was common in rooms without surface disinfection and in rooms sprayed with disinfectant twice a day. However, SARS-CoV-2 RNA was not detected in a room cleaned with disinfectant wipes on a regular basis. CONCLUSION Our data suggest that remote (> 2 m) airborne transmission of SARS-CoV-2 from hospitalized COVID-19 patients is uncommon when aerosol-generating procedures have not been performed. Surface contamination was widespread, except in a room routinely cleaned with disinfectant wipes.
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Affiliation(s)
- Uh Jin Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Seung Yeob Lee
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Ji Yeon Lee
- Department of Infectious Disease, Keimyung University Dongsan Hospital, Daegu, Korea
| | - Ahrang Lee
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Seung Eun Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Ok Ja Choi
- Office for Infection Control, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Ji Suk Lee
- Office for Infection Control, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Seung Jung Kee
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea.
| | - Hee Chang Jang
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea.
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Jiang FC, Jiang XL, Wang ZG, Meng ZH, Shao SF, Anderson BD, Ma MJ. Detection of Severe Acute Respiratory Syndrome Coronavirus 2 RNA on Surfaces in Quarantine Rooms. Emerg Infect Dis 2020. [PMID: 32421495 DOI: 10.3201/2feid2609.201435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
We investigated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination in 2 rooms of a quarantine hotel after 2 presymptomatic persons who stayed there were laboratory-confirmed as having coronavirus disease. We detected SARS-CoV-2 RNA on 8 (36%) of 22 surfaces, as well as on the pillow cover, sheet, and duvet cover.
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Containing COVID-19 outside the isolation ward: The impact of an infection control bundle on environmental contamination and transmission in a cohorted general ward. Am J Infect Control 2020; 48:1056-1061. [PMID: 32599101 PMCID: PMC7319619 DOI: 10.1016/j.ajic.2020.06.188] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/22/2023]
Abstract
Background During an ongoing outbreak of COVID-19, unsuspected cases may be housed outside of dedicated isolation wards. Aim At a Singaporean tertiary hospital, individuals with clinical syndromes compatible with COVID-19 but no epidemiologic risk were placed in cohorted general wards for COVID-19 testing. To mitigate risk, an infection control bundle was implemented comprising infrastructural enhancements, improved personal protective equipment, and social distancing. We assessed the impact on environmental contamination and transmission. Methods Upon detection of a case of COVID-19 in the dedicated general ward, patients and health care workers (HCWs) contacts were identified. All patient and staff close-contacts were placed on 14-day phone surveillance and followed up for 28 days; symptomatic contacts were tested. Environmental samples were also obtained. Findings Over a 3-month period, 28 unsuspected cases of COVID-19 were contained in the dedicated general ward. In 5 of the 28 cases, sampling of the patient's environment yielded SARS-CoV-2; index cases who required supplemental oxygen had higher odds of environmental contamination (P = .01). A total of 253 staff close-contacts and 45 patient close-contacts were identified; only 3 HCWs (1.2%, 3/253) required quarantine. On 28-day follow-up, no patient-to-HCW transmission was documented; only 1 symptomatic patient close-contact tested positive. Conclusions Our institution successfully implemented an intervention bundle to mitigate COVID-19 transmission in a multibedded cohorted general ward setting.
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Environmental surface testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during prolonged isolation of an asymptomatic carrier. Infect Control Hosp Epidemiol 2020; 41:1328-1330. [PMID: 32539889 PMCID: PMC7324661 DOI: 10.1017/ice.2020.300] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Environmental surface testing was performed to search for evidence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) environmental contamination by an asymptomatic SARS-CoV-2 carrier with persistently high viral loads under isolation. No evidence of environmental contamination was found. Further studies are needed to measure environmental contamination by SARS-CoV-2 carriers and to determine reasonable isolation periods.
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Rizou M, Galanakis IM, Aldawoud TMS, Galanakis CM. Safety of foods, food supply chain and environment within the COVID-19 pandemic. Trends Food Sci Technol 2020; 102:293-299. [PMID: 32834502 PMCID: PMC7295520 DOI: 10.1016/j.tifs.2020.06.008] [Citation(s) in RCA: 206] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 02/06/2023]
Abstract
Background The COVID-19 pandemic has generated a new era in the world while we still figure out the consequences in different aspects of our daily life. The food supply chain and the food industry do not comprise an exception. Scope and approach This review summarizes the possible transmission ways of COVID-19 through the foods, food supply chain, surfaces, and environment before exploring the development of corresponding detection tools of SARS-CoV-2. For the time being, the possibility of transmission through the food sector is considered negligible, and tracing of SARS-CoV-2 in working environments is not considered as a priority by public authorities. However, the adverse effects on the environment, food systems, and people along the food supply chain are already evident. Key findings and conclusions As long as we move from farm to fork, more safety measures are needed since more people (and subsequently more potential sources of infection) are involved in the process. The need for developing respective bioanalytical protocols for food and environmental safety applications to adapt in the post-lockdown period is also highlighted. The food supply chain and the food industry are affected by the COVID-19 pandemic. Review of COVID-19 transmission through food supply chain, surfaces and environment. Moving from farm to fork, more safety measures are needed. The development of respective detection tools for SARS-CoV-2 is explored. Need for analytical tools for food and environmental safety after the lockdown.
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Affiliation(s)
- Myrto Rizou
- Research & Innovation Department, Galanakis Laboratories, Chania, Greece
| | | | | | - Charis M Galanakis
- Research & Innovation Department, Galanakis Laboratories, Chania, Greece.,College of Science, King Saud University, Riyadh, Saudi Arabia.,Food Waste Recovery Group, ISEKI Food Association, Vienna, Austria
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Jung J, Kim JY, Bae S, Cha HH, Kim EO, Kim MJ, Kim SH. Contamination of personal protective equipment by SARS-CoV-2 during routine care of patients with mild COVID-19. J Infect 2020; 81:e165-e167. [PMID: 32540456 PMCID: PMC7836511 DOI: 10.1016/j.jinf.2020.06.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/10/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hye-Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun Ok Kim
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Office for Infection Control, Asan Medical Center, Seoul, South Korea.
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Cimolai N. Features of enteric disease from human coronaviruses: Implications for COVID-19. J Med Virol 2020; 92:1834-1844. [PMID: 32462689 PMCID: PMC7283829 DOI: 10.1002/jmv.26066] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/25/2020] [Indexed: 01/19/2023]
Abstract
Coronaviruses have long been studied in both human and veterinary fields. Whereas the initial detection of endemic human respiratory coronaviruses was problematic, detection of these and newly discovered human coronaviruses has been greatly facilitated with major advances in the laboratory. Nevertheless, technological factors can affect the accuracy and timeliness of virus detection. Many human coronaviruses can be variably found in stool samples. All human coronaviruses have been variably associated with symptoms of gastroenteritis. Coronaviruses can occasionally be cultured from enteric specimens, but most detection is accomplished with genetic amplification technologies. Excretion of viral RNA in stool can extend for a prolonged period. Culture‐positive stool samples have been found to exceed a fourteen day period after onset of infection for some coronaviruses. Virus can also sometimes be cultured from patients' respiratory samples during the late incubation period. Relatively asymptomatic patients may excrete virus. Both viable and nonviable virus can be found in the immediate environment of the patient, the health care worker, and less often the public. These lessons from the past study of animal and human coronaviruses can be extended to presumptions for severe acute respiratory syndrome coronavirus 2. Already, the early reports from the coronavirus disease‐2019 pandemic are confirming some concerns. These data have the cumulative potential to cause us to rethink some current and common public health and infection control strategies. coronaviruses are variably found in human enteric samples during the course of infection. abdominal and intestinal illnesses are associated with coronavirus infections. enteric excretion of live virus and viral RNA have been confirmed. occasionally, live virus can be found in stool samples to exceed a fourteen day period after disease onset, and virus can also be cultured from these samples during the late incubation period or from asymptomatic individuals.
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Affiliation(s)
- Nevio Cimolai
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, Children's and Women's Health Centre of British Columbia, The University of British Columbia, Vancouver, British Columbia, Canada
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Li X, Xu W, Dozier M, He Y, Kirolos A, Theodoratou E. The role of children in transmission of SARS-CoV-2: A rapid review. J Glob Health 2020; 10:011101. [PMID: 32612817 PMCID: PMC7323934 DOI: 10.7189/jogh.10.011101] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Understanding the role of children in the transmission of SARS-CoV-2 is urgently required given its policy implications in relation to the reopening of schools and intergenerational contacts. METHODS We conducted a rapid review of studies that investigated the role of children in the transmission of SARS-CoV-2. We synthesized evidence for four categories: 1) studies reporting documented cases of SARS-CoV-2 transmission by infected children; 2) studies presenting indirect evidence on the potential of SARS-CoV-2 transmission by (both symptomatic and asymptomatic) children; 3) studies reporting cluster outbreaks of COVID-19 in schools; 4) studies estimating the proportions of children infected by SARS-CoV-2, and reported results narratively. RESULTS A total of 16 unique studies were included for narrative synthesis. There is limited evidence detailing transmission of SARS-CoV-2 from infected children. We found two studies that reported a 3-month-old whose parents developed symptomatic COVID-19 seven days after caring for the infant and two children who may have contracted COVID-19 from the initial cases at a school in New South Wales. In addition, we identified six studies presenting indirect evidence on the potential for SARS-CoV-2 transmission by children, three of which found prolonged virus shedding in stools. There is little data on the transmission of SARS-CoV-2 in schools. We identified only two studies reporting outbreaks of COVID-19 in school settings and one case report of a child attending classes but not infecting any other pupils or staff. Lastly, we identified six studies estimating the proportion of children infected; data from population-based studies in Iceland, Italy, South Korea, Netherlands, California and a hospital-based study in the UK suggest children may be less likely to be infected. CONCLUSIONS Preliminary results from population-based and school-based studies suggest that children may be less frequently infected or infect others, however current evidence is limited. Prolonged faecal shedding observed in studies highlights the potentially increased risk of faeco-oral transmission in children. Further seroprevalence studies (powered adequately for the paediatric population) are urgently required to establish whether children are in fact less likely to be infected compared to adults. NOTE We plan to update this rapid review as new data becomes available. These updates are available at https://www.ed.ac.uk/usher/uncover/completed-uncover-reviews.
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Affiliation(s)
- Xue Li
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Wei Xu
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Marshall Dozier
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Yazhou He
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Amir Kirolos
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, Medical Research Council Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - on behalf of UNCOVER
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
- Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, UK
- Cancer Research UK Edinburgh Centre, Medical Research Council Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
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Lee‐Archer P, von Ungern‐Sternberg BS. Pediatric anesthetic implications of COVID-19-A review of current literature. Paediatr Anaesth 2020; 30:136-141. [PMID: 32306440 PMCID: PMC7264528 DOI: 10.1111/pan.13889] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/21/2022]
Abstract
Pediatric anesthetists have an important role to play in the management of patients suspected or confirmed to have COVID-19. In many institutions, the COVID-19 intubation teams are staffed with anesthetists as the proceduralists working throughout the hospitals also in the ICU and Emergency Departments. As practitioners who perform aerosol generating procedures involving the airway, we are at high risk of exposure to the virus SARS-CoV-2 and need to ensure we are well prepared and trained to manage such cases. This article reviews the relevant pediatric literature surrounding COVID-19 and summarizes the key recommendations for anesthetists involved in the care of children during this pandemic.
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Affiliation(s)
- Paul Lee‐Archer
- Department of Anaesthesia and Pain ManagementQueensland Children’s HospitalBrisbaneQLDAustralia
| | - Britta S. von Ungern‐Sternberg
- Department of Anaesthesia and Pain ManagementPerth Children’s HospitalPerthWAAustralia,Emergency Medicine, Anaesthesia and Pain MedicineMedical SchoolThe University of Western AustraliaPerthWAAustralia,Team Perioperative MedicineTelethon Kids InstitutePerthWAAustralia
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47
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Jiang FC, Jiang XL, Wang ZG, Meng ZH, Shao SF, Anderson BD, Ma MJ. Detection of Severe Acute Respiratory Syndrome Coronavirus 2 RNA on Surfaces in Quarantine Rooms. Emerg Infect Dis 2020; 26. [PMID: 32421495 PMCID: PMC7454114 DOI: 10.3201/eid2609.201435] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We investigated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination in 2 rooms of a quarantine hotel after 2 presymptomatic persons who stayed there were laboratory-confirmed as having coronavirus disease. We detected SARS-CoV-2 RNA on 8 (36%) of 22 surfaces, as well as on the pillow cover, sheet, and duvet cover.
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48
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Miranda-Schaeubinger M, Blumfield E, Chavhan GB, Farkas AB, Joshi A, Kamps SE, Kaplan SL, Sammer MBK, Silvestro E, Stanescu AL, Sze RW, Zerr DM, Chandra T, Edwards EA, Khan N, Rubio EI, Vera CD, Iyer RS. A primer for pediatric radiologists on infection control in an era of COVID-19. Pediatr Radiol 2020; 50:1191-1204. [PMID: 32638055 PMCID: PMC7340753 DOI: 10.1007/s00247-020-04713-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 04/28/2020] [Accepted: 05/12/2020] [Indexed: 02/07/2023]
Abstract
Pediatric radiology departments across the globe face unique challenges in the midst of the current COVID-19 pandemic that have not been addressed in professional guidelines. Providing a safe environment for personnel while continuing to deliver optimal care to patients is feasible when abiding by fundamental recommendations. In this article, we review current infection control practices across the multiple pediatric institutions represented on the Society for Pediatric Radiology (SPR) Quality and Safety committee. We discuss the routes of infectious transmission and appropriate transmission-based precautions, in addition to exploring strategies to optimize personal protective equipment (PPE) supplies. This work serves as a summary of current evidence-based recommendations for infection control, and current best practices specific to pediatric radiologists.
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Affiliation(s)
| | - Einat Blumfield
- Department of Radiology, Children's Hospital of Montefiore, Albert Einstein College of Medicine, New York, NY, USA
| | - Govind B Chavhan
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - Amy B Farkas
- Department of Radiology, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Aparna Joshi
- Section of Pediatric Radiology, C. S. Mott Children's Hospital, Department of Radiology, Michigan Medicine, Ann Arbor, MI, USA
| | - Shawn E Kamps
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, MA.7.220, Seattle, WA, 98105, USA
| | - Summer L Kaplan
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Marla B K Sammer
- Department of Radiology, Texas Children's Hospital,, Houston, TX, USA
| | - Elizabeth Silvestro
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - A Luana Stanescu
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, MA.7.220, Seattle, WA, 98105, USA
| | - Raymond W Sze
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Danielle M Zerr
- Department of Infectious Disease, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Tushar Chandra
- Department of Radiology, Nemours Children's Hospital, Orlando, FL, USA
| | - Emily A Edwards
- Department of Radiology, Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, OR, USA
| | - Naeem Khan
- Department of Diagnostic Imaging, IWK Health Center,, Halifax, NS, Canada
| | - Eva I Rubio
- Department of Diagnostic Imaging and Radiology,, Children's National Hospital, Washington, DC, USA
| | - Chido D Vera
- Department of Radiology, The University of Pittsburgh, Pittsburgh, PA, USA
| | - Ramesh S Iyer
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, MA.7.220, Seattle, WA, 98105, USA.
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