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Uprety S, Ngo I, Maggos M, Dangol B, Sherchan SP, Shisler JL, Amarasiri M, Sano D, Nguyen TH. Multiple pathogen contamination of water, hands, and fomites in rural Nepal and the effect of WaSH interventions. Int J Hyg Environ Health 2024; 257:114341. [PMID: 38442666 DOI: 10.1016/j.ijheh.2024.114341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/23/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
Water, Sanitation, and Hygiene (WaSH) interventions are the most effective in reducing diarrheal disease severity and prevalence. However, very few studies have investigated the effectiveness of WaSH intervention in reducing pathogen presence and concentration. In this study, we employed a microfluidic PCR approach to quantify twenty bacterial pathogens in water (n = 360), hands (n = 180), and fomite (n = 540) samples collected in rural households of Nepal to assess the pathogen exposures and the effect of WaSH intervention on contamination and exposure rates. The pathogen load and the exposure pathways for each pathogen in intervention and control villages were compared to understand the effects of WaSH intervention. Pathogens were detected in higher frequency and concentration from fomites samples, toilet handle (21.42%; 5.4,0 95%CI: mean log10 of 4.69, 5.96), utensils (23.5%; 5.47, 95%CI: mean log10 of 4.77, 6.77), and water vessels (22.42%; 5.53, 95%CI: mean log10 of 4.79, 6.60) as compared to cleaning water (14.36%; 5.05, 95%CI: mean log10 of 4.36, 5.89), drinking water (14.26%; 4.37, 85%CI: mean log10 of 4.37, 5.87), and hand rinse samples (16.92%; 5.49, 95%CI: mean log10 of 4.77, 6.39). There was no clear evidence that WaSH intervention reduced overall pathogen contamination in any tested pathway. However, we observed a significant reduction (p < 0.05) in the prevalence, but not concentration, of some target pathogens, including Enterococcus spp. in the intervention village compared to the control village for water and hands rinse samples. Conversely, no significant reduction in target pathogen concentration was observed for water and hand rinse samples. In swab samples, there was a reduction mostly in pathogen concentration rather than pathogen prevalence, highlighting that a reduction in pathogen prevalence was not always accompanied by a reduction in pathogen concentration. This study provides an understanding of WaSH intervention on microbe concentrations. Such data could help with better planning of intervention activities in the future.
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Affiliation(s)
- Sital Uprety
- Department of Civil and Environmental Engineering, University of Illinois at Urbana Champaign, Urbana, IL, USA; Department of Sanitation, Water and Solid Waste for Development (Sandec), Swiss Federal Institute of Aquatic Science and Technology (Eawag), Dübendorf, Zurich, Switzerland; Department of Civil and Environmental Engineering, Tohoku University Sendai, Japan.
| | - Isaac Ngo
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Marika Maggos
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Bipin Dangol
- Environment and Public Health Organization (ENPHO), Kathmandu, Nepal
| | - Samendra P Sherchan
- Environment and Public Health Organization (ENPHO), Kathmandu, Nepal; Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; BioEnvironmental Science Program Morgan State University, Baltimore, MD, 21251, USA
| | - Joanna L Shisler
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA; Institute of Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Mohan Amarasiri
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Daisuke Sano
- Department of Frontier Sciences for Advanced Environment, Tohoku University, Sendai, Japan; Department of Civil and Environmental Engineering, Tohoku University Sendai, Japan
| | - Thanh H Nguyen
- Department of Civil and Environmental Engineering, University of Illinois at Urbana Champaign, Urbana, IL, USA; Institute of Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA
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2
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Abney SE, Higham CA, Wilson AM, Ijaz MK, McKinney J, Reynolds KA, Gerba CP. Transmission of Viruses from Restroom Use: A Quantitative Microbial Risk Assessment. Food Environ Virol 2024; 16:65-78. [PMID: 38372960 DOI: 10.1007/s12560-023-09580-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/30/2023] [Indexed: 02/20/2024]
Abstract
Restroom use has been implicated in a number of viral outbreaks. In this study, we apply quantitative microbial risk assessment to quantify the risk of viral transmission by contaminated restroom fomites. We estimate risk from high-touch fomite surfaces (entrance/exit door, toilet seat) for three viruses of interest (SARS-CoV-2, adenovirus, norovirus) through eight exposure scenarios involving differing user behaviors, and the use of hand sanitizer following each scenario. We assessed the impacts of several sequences of fomite contacts in the restroom, reflecting the variability of human behavior, on infection risks for these viruses. Touching of the toilet seat was assumed to model adjustment of the seat (open vs. closed), a common touch point in single-user restrooms (home, small business, hospital). A Monte Carlo simulation was conducted for each exposure scenario (10,000 simulations each). Norovirus resulted in the highest probability of infection for all exposure scenarios with fomite surfaces. Post-restroom automatic-dispensing hand sanitizer use reduced the probability of infection for each virus by up to 99.75%. Handwashing within the restroom, an important risk-reduction intervention, was not found to be as effective as use of a non-touch hand sanitizer dispenser for reducing risk to near or below 1/1,000,000, a commonly used risk threshold for comparison.
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Affiliation(s)
- Sarah E Abney
- Department of Environmental Science, University of Arizona, Tucson, AZ, USA
| | - Ciara A Higham
- EPSRC Centre for Doctoral Training in Fluid Dynamics, University of Leeds, Leeds, UK
| | - Amanda M Wilson
- Department of Community, Environment, & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - M Khalid Ijaz
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, USA
| | - Julie McKinney
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, USA
| | - Kelly A Reynolds
- Department of Environmental Science, University of Arizona, Tucson, AZ, USA
- Department of Community, Environment, & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Charles P Gerba
- Department of Environmental Science, University of Arizona, Tucson, AZ, USA.
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Conde A, Voces D, Medel-Plaza M, Perales C, de Ávila AI, Aguilera-Correa JJ, de Damborenea JJ, Esteban J, Domingo E, Arenas MA. Fluoride anodic films on stainless-steel fomites to reduce transmission infections. Appl Environ Microbiol 2024; 90:e0189223. [PMID: 38289132 PMCID: PMC10880592 DOI: 10.1128/aem.01892-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/05/2024] [Indexed: 02/22/2024] Open
Abstract
The growing concern arising from viruses with pandemic potential and multi-resistant bacteria responsible for hospital-acquired infections and outbreaks of food poisoning has led to an increased awareness of indirect contact transmission. This has resulted in a renewed interest to confer antimicrobial properties to commonly used metallic materials. The present work provides a full characterization of optimized fluoride anodic films grown in stainless steel 304L as well as their antimicrobial properties. Antibacterial tests show that the anodic film, composed mainly of chromium and iron fluorides, reduces the count and the percentage of the area covered by 50% and 87.7% for Pseudomonas aeruginosa and Stenotrophomonas maltophilia, respectively. Virologic tests show that the same treatment reduces the infectivity of the coronavirus HCoV-229E-GFP, in comparison with the non-anodized stainless steel 304L.IMPORTANCEThe importance of environmental surfaces as a source of infection is a topic of particular interest today, as many microorganisms can survive on these surfaces and infect humans through direct contact. Modification of these surfaces by anodizing has been shown to be useful for some alloys of medical interest. This work evaluates the effect of anodizing on stainless steel, a metal widely used in a variety of applications. According to the study, the fluoride anodic layers reduce the colonization of the surfaces by both bacteria and viruses, thus reducing the risk of acquiring infections from these sources.
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Affiliation(s)
- Ana Conde
- Centro Nacional de Investigaciones Metalúrgicas, CENIM-CSIC, Madrid, Spain
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
| | - Daniel Voces
- Centro Nacional de Investigaciones Metalúrgicas, CENIM-CSIC, Madrid, Spain
| | | | - Celia Perales
- IIS-Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
- Centro Nacional de Biotecnología, CNB-CSIC, Madrid, Spain
- CIBEREHD, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Hepáticas y Digestivas, Madrid, Spain
| | - Ana Isabel de Ávila
- CIBEREHD, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Hepáticas y Digestivas, Madrid, Spain
- Centro de Biología Molecular Severo Ochoa (CBMSO) (CSIC-UAM), Madrid, Spain
| | - John Jairo Aguilera-Correa
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
- Pathogénie mycobactérienne et nouvelles cibles thérapeutiques, Institut de Recherche en Infectiologie de Montpellier, Montpellier, France
| | - Juan Jose de Damborenea
- Centro Nacional de Investigaciones Metalúrgicas, CENIM-CSIC, Madrid, Spain
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
| | - Jaime Esteban
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
- IIS-Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Esteban Domingo
- CIBEREHD, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Hepáticas y Digestivas, Madrid, Spain
- Centro de Biología Molecular Severo Ochoa (CBMSO) (CSIC-UAM), Madrid, Spain
| | - Maria Angeles Arenas
- Centro Nacional de Investigaciones Metalúrgicas, CENIM-CSIC, Madrid, Spain
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
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Sobhy NM, Muñoz AQ, Youssef CRB, Goyal SM. Inactivation of Three Subtypes of Influenza A Virus by a Commercial Device Using Ultraviolet Light and Ozone. Avian Dis 2024; 67:305-309. [PMID: 38300651 DOI: 10.1637/aviandiseases-d-23-00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/05/2023] [Indexed: 02/02/2024]
Abstract
Avian influenza (AI) is a highly contagious disease that can be transmitted to naïve birds through fomites. The survival of AI viruses (AIV) on nonporous and porous fomites also dictates how long the fomite can serve as a vehicle for virus transmission. AIVs are known to be inactivated by ozone and ultraviolet (UV) light. However, the combined effect of UV light and ozone in combating AIV on different fomites has not been investigated. This study was undertaken to determine AIV inactivation by a commercial device called the BioSec shoe sanitizing station. This device generates both ozone and UV light for 8 sec when activated. We evaluated this device against three different subtypes of AIVs applied on seven different fomites. In general, the device inactivated all three AIV subtypes loaded on all fomites but to varying degrees of inactivation. The percentage of virus reduction on nonporous fomites (98.6%-99.9%) was higher than on porous fomites (90.0%-99.5%). In conclusion, this new device has the potential to help reduce the risk of transmission of AIV.
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Affiliation(s)
- Nader M Sobhy
- Veterinary Population Medicine Department and Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108
- Department of Animal Medicine, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Sharkia 44511, Egypt
| | - Angie Quiñonez Muñoz
- Veterinary Population Medicine Department and Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108
| | - Christiana R B Youssef
- Veterinary Population Medicine Department and Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108
- Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Sagar M Goyal
- Veterinary Population Medicine Department and Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108,
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5
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Li F, Shen X, Zhang H, Jin H, Zhang L, Lv B, Li W, Liang Z, Zhang X, Zhang D, Hou X, Pan Y, Kan B, Wang Q. Stability of mpox virus on different commonly contacted surfaces. J Med Virol 2023; 95:e29296. [PMID: 38054540 DOI: 10.1002/jmv.29296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
Mpox is still spreading globally and is mostly reported to be transmitted by skin and mucosal contact. However, transmission through contact with fomites, contaminated objects, or surfaces has been reported in general population. Evaluation of the stability of mpox virus (MPXV) on different surfaces is important to minimize mpox transmission. In the study, the stability of MPXV on different kinds of commonly contacted surfaces was determined. MPXV was observed to have a surface-dependent stability pattern. Viable virus was detected on both glass and stainless steel for up to 5 days, and on plastic surfaces for up to 3 days. In contrast, no viable MPXV was detected on wooden board and cardboard, which are porous and water-absorbent surfaces, after 1 and 2 days of incubation, respectively. In addition, MPXV nucleic acids were more stable and showed better correlation with viral titers on stainless steel, plastic, and glass. The results indicate that fomite transmission of MPXV is plausible. Moreover, the stability of MPXV was highly surface-dependent and more stable on smooth surfaces, which could provide more information for minimizing the transmission of mpox and emphasize the significance of environmental disinfection in mpox prevention and control.
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Affiliation(s)
- Fu Li
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xiaona Shen
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huijuan Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haoyuan Jin
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Lin Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Lv
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Weihong Li
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zhichao Liang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xin Zhang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Daitao Zhang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xuexin Hou
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Pan
- Beijing Center for Disease Prevention and Control, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Biao Kan
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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Meister TL, Kirchhoff L, Brüggemann Y, Todt D, Steinmann J, Steinmann E. Stability of pathogens on banknotes and coins: A narrative review. J Med Virol 2023; 95:e29312. [PMID: 38100621 DOI: 10.1002/jmv.29312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/28/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023]
Abstract
For the prevention of infectious diseases, knowledge about potential transmission routes is essential. Pathogens can be transmitted directly (i.e. respiratory droplets, hand-to-hand contact) or indirectly via contaminated surfaces (fomites). In particular, frequently touched objects/surfaces may serve as transmission vehicles for different clinically relevant bacterial, fungal, and viral pathogens. Banknotes and coins offer ample surface area and are frequently exchanged between individuals. Consequently, many concerns have been raised in the recent past, that banknotes and coins could serve as vectors for the transmission of disease-causing microorganisms. This review summarizes the latest research on the potential of paper currency and coins to serve as sources of pathogenic viral, bacterial, and fungal agents. In contrast to the current perception of banknotes and coins as important transmission vehicles, current evidence suggests, that banknotes and coins do not pose a particular risk of pathogen infection for the public.
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Affiliation(s)
- Toni Luise Meister
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital of Essen, Essen, Germany
| | - Yannick Brüggemann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Daniel Todt
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
- European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital of Essen, Essen, Germany
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Eike Steinmann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
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Arienzo A, Gallo V, Tomassetti F, Pitaro N, Pitaro M, Antonini G. A narrative review of alternative transmission routes of COVID 19: what we know so far. Pathog Glob Health 2023; 117:681-695. [PMID: 37350182 PMCID: PMC10614718 DOI: 10.1080/20477724.2023.2228048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
The Coronavirus disease 19 (COVID-19) pandemics, caused by severe acute respiratory syndrome coronaviruses, SARS-CoV-2, represent an unprecedented public health challenge. Beside person-to-person contagion via airborne droplets and aerosol, which is the main SARS-CoV-2's route of transmission, alternative modes, including transmission via fomites, food and food packaging, have been investigated for their potential impact on SARS-CoV-2 diffusion. In this context, several studies have demonstrated the persistence of SARS-CoV-2 RNA and, in some cases, of infectious particles on exposed fomites, food and water samples, confirming their possible role as sources of contamination and transmission. Indeed, fomite-to-human transmission has been demonstrated in a few cases where person-to-person transmission had been excluded. In addition, recent studies supported the possibility of acquiring COVID-19 through the fecal-oro route; the occurrence of COVID-19 gastrointestinal infections, in the absence of respiratory symptoms, also opens the intriguing possibility that these cases could be directly related to the ingestion of contaminated food and water. Overall, most of the studies considered these alternative routes of transmission of low epidemiological relevance; however, it should be considered that they could play an important role, or even be prevalent, in settings characterized by different environmental and socio-economic conditions. In this review, we discuss the most recent findings regarding SARS-CoV-2 alternative transmission routes, with the aim to disclose what is known about their impact on COVID-19 spread and to stimulate research in this field, which could potentially have a great impact, especially in low-resource contexts.
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Affiliation(s)
| | | | | | | | - Michele Pitaro
- National Institute of Biostructures and Biosystems (INBB), Rome, Italy
| | - Giovanni Antonini
- National Institute of Biostructures and Biosystems (INBB), Rome, Italy
- Department of Science, Roma Tre University, Rome, Italy
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Ijaz MK, Sattar SA, Nims RW, Boone SA, McKinney J, Gerba CP. Environmental dissemination of respiratory viruses: dynamic interdependencies of respiratory droplets, aerosols, aerial particulates, environmental surfaces, and contribution of viral re-aerosolization. PeerJ 2023; 11:e16420. [PMID: 38025703 PMCID: PMC10680453 DOI: 10.7717/peerj.16420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
During the recent pandemic of COVID-19 (SARS-CoV-2), influential public health agencies such as the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have favored the view that SARS CoV-2 spreads predominantly via droplets. Many experts in aerobiology have openly opposed that stance, forcing a vigorous debate on the topic. In this review, we discuss the various proposed modes of viral transmission, stressing the interdependencies between droplet, aerosol, and fomite spread. Relative humidity and temperature prevailing determine the rates at which respiratory aerosols and droplets emitted from an expiratory event (sneezing, coughing, etc.) evaporate to form smaller droplets or aerosols, or experience hygroscopic growth. Gravitational settling of droplets may result in contamination of environmental surfaces (fomites). Depending upon human, animal and mechanical activities in the occupied space indoors, viruses deposited on environmental surfaces may be re-aerosolized (re-suspended) to contribute to aerosols, and can be conveyed on aerial particulate matter such as dust and allergens. The transmission of respiratory viruses may then best be viewed as resulting from dynamic virus spread from infected individuals to susceptible individuals by various physical states of active respiratory emissions, instead of the current paradigm that emphasizes separate dissemination by respiratory droplets, aerosols or by contaminated fomites. To achieve the optimum outcome in terms of risk mitigation and infection prevention and control (IPAC) during seasonal infection peaks, outbreaks, and pandemics, this holistic view emphasizes the importance of dealing with all interdependent transmission modalities, rather than focusing on one modality.
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Affiliation(s)
- M. Khalid Ijaz
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, United States of America
| | - Syed A. Sattar
- Department of Biochemistry, Microbiology & Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Stephanie A. Boone
- Water & Energy Sustainable Technology Center, University of Arizona, Tucson, AZ, United States of America
| | - Julie McKinney
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, United States of America
| | - Charles P. Gerba
- Water & Energy Sustainable Technology Center, University of Arizona, Tucson, AZ, United States of America
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Kong ZM, Sandhu HS, Qiu L, Wu J, Tian WJ, Chi XJ, Tao Z, Yang CFJ, Wang XJ. Virus Dynamics and Decay in Evaporating Human Saliva Droplets on Fomites. Environ Sci Technol 2023; 57:17737-17750. [PMID: 35904357 DOI: 10.1021/acs.est.2c02311] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The transmission of most respiratory pathogens, including SARS-CoV-2, occurs via virus-containing respiratory droplets, and thus, factors that affect virus viability in droplet residues on surfaces are of critical medical and public health importance. Relative humidity (RH) is known to play a role in virus survival, with a U-shaped relationship between RH and virus viability. The mechanisms affecting virus viability in droplet residues, however, are unclear. This study examines the structure and evaporation dynamics of virus-containing saliva droplets on fomites and their impact on virus viability using four model viruses: vesicular stomatitis virus, herpes simplex virus 1, Newcastle disease virus, and coronavirus HCoV-OC43. The results support the hypothesis that the direct contact of antiviral proteins and virions within the "coffee ring" region of the droplet residue gives rise to the observed U-shaped relationship between virus viability and RH. Viruses survive much better at low and high RH, and their viability is substantially reduced at intermediate RH. A phenomenological theory explaining this phenomenon and a quantitative model analyzing and correlating the experimentally measured virus survivability are developed on the basis of the observations. The mechanisms by which RH affects virus viability are explored. At intermediate RH, antiviral proteins have optimal influence on virions because of their largest contact time and overlap area, which leads to the lowest level of virus activity.
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Affiliation(s)
- Zi-Meng Kong
- Key Laboratory of Animal Epidemiology of the Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Harpal Singh Sandhu
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Louisville, Louisville, Kentucky 40202, United States
- Department of Bioengineering, J.B. Speed School of Engineering, University of Louisville, Louisville, Kentucky 40292, United States
| | - Lu Qiu
- School of Energy and Power Engineering, Beihang University, Beijing 100191, China
| | - Jicheng Wu
- School of Energy and Power Engineering, Beihang University, Beijing 100191, China
| | - Wen-Jun Tian
- Key Laboratory of Animal Epidemiology of the Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Xiao-Jing Chi
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences, Beijing 100005, China
| | - Zhi Tao
- School of Energy and Power Engineering, Beihang University, Beijing 100191, China
| | - Chi-Fu Jeffrey Yang
- Department of Surgery, Harvard Medical School, Boston, Massachusetts 02215, United States
| | - Xiao-Jia Wang
- Key Laboratory of Animal Epidemiology of the Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
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10
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Andrup L, Krogfelt KA, Hansen KS, Madsen AM. Transmission route of rhinovirus - the causative agent for common cold. A systematic review. Am J Infect Control 2023; 51:938-957. [PMID: 36535318 DOI: 10.1016/j.ajic.2022.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Human rhinoviruses (RVs) are the most common cause of acute respiratory tract illness and upper respiratory tract infections, traditionally defined as 'common colds'. Experimental transmission of RV has been studied for more than 50 years. However, there are divergent results as to whether hands and fomites or aerosols constitute the dominant route of transmission in natural settings. METHODS We have systematically reviewed the literature according to the PRISMA 2020 statement. Searches were run in PubMed and Web of Science until August 2022. Inclusion criteria were original studies of relevance for revealing the route of transmission of rhinovirus in humans. RESULTS The search yielded 663 results, and 25 studies met the inclusion criteria and were selected for this review. These articles addressing RV transmission routes were assigned to 1 of 3 groups: (1) indirect transmission by fomites and hands, (2) direct transmission via large aerosols (droplets) or small aerosols, or (3) transmission either direct via large aerosols (droplets) or small aerosols and fomite or hands. CONCLUSIONS We found low evidence, that transmission via hands and fomite followed by self-inoculation is the dominant transmission route in real-life indoor settings. We found moderate evidence, that airborne transmission either via large aerosols or small aerosols is the major transmission route of rhinovirus transmission in real-life indoor settings. This suggests that the major transmission route of RVs in many indoor settings is through the air (airborne transmission).
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Affiliation(s)
- Lars Andrup
- The National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Karen A Krogfelt
- Department of Science and Environment, Molecular and Medical Biology, PandemiX Center Roskilde University, Roskilde, Denmark
| | | | - Anne Mette Madsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
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11
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Benedict KL, Brady HW, Newsome AL. Viral Disinfection of Porous Fomites Utilizing a Bacteriophage Model and Chlorine Dioxide Gas. Health Secur 2023; 21:303-309. [PMID: 37289796 DOI: 10.1089/hs.2022.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
The pursuit of disinfecting porous materials or fomites to inactivate viral agents has special challenges. To address these challenges, a highly portable chlorine dioxide (ClO2) gas generation system was used to ascertain the ability of a gaseous preparation to inactivate a viral agent, the MS2 bacteriophage, when associated with potentially porous fomites of cloth, paper towel, and wood. The MS2 bacteriophage is increasingly used as a model to identify means of inactivating infectious viral agents of significance to humans. Studies showed that MS2 bacteriophage can be applied to and subsequently recovered from potential porous fomites such as cloth, paper towel, and wood. Paired with viral plaque assays, this provided a means for assessing the ability of gaseous ClO2 to inactivate bacteriophage associated with the porous materials. Notable results include 100% inactivation of 6 log bacteriophage after overnight exposure to 20 parts per million(ppm) ClO2. Reducing exposure time to 90 minutes and gas ppm to lower concentrations proved to remain effective in bacteriophage elimination in association with porous materials. Stepwise reduction in gas concentration from 76 ppm to 5 ppm consistently resulted in greater than 99.99% to 100% reduction of recoverable bacteriophage. This model suggests the potential of ClO2 gas deployment systems for use in the inactivation of viral agents associated with porous potential fomites. The ClO2 gas could prove especially helpful in disinfecting enclosed areas containing viral contaminated surfaces, rather than manually spraying and wiping them.
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Affiliation(s)
- Kendall L Benedict
- Kendall L. Benedict is a Undergraduate Research Assistants, Department of Biology, Middle Tennessee State University, Murfreesboro, TN
| | - Hunter W Brady
- Hunter W. Brady is a Undergraduate Research Assistants, Department of Biology, Middle Tennessee State University, Murfreesboro, TN
| | - Anthony L Newsome
- Anthony L. Newsome, PhD, is a Professor, Department of Biology, Middle Tennessee State University, Murfreesboro, TN
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12
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Schijven JF, Wind M, Todt D, Howes J, Tamele B, Steinmann E. Risk assessment of banknotes as a fomite of SARS-CoV-2 in cash payment transactions. Risk Anal 2023; 43:700-708. [PMID: 35491413 PMCID: PMC9347741 DOI: 10.1111/risa.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The COVID 19 pandemic has triggered concerns and assumptions globally about transmission of the SARS-CoV-2 virus via cash transactions. This paper assesses the risk of contracting COVID-19 through exposure to SARS-CoV-2 via cash acting as a fomite in payment transactions. A quantitative microbial risk assessment was conducted for a scenario assuming an infectious person at the onset of symptoms, when virion concentrations in coughed droplets are at their highest. This person then contaminates a banknote by coughing on it and immediately hands it over to another person, who might then be infected by transferring the virions with a finger from the contaminated banknote to a facial mucous membrane. The scenario considered transfer efficiency of virions on the banknote to fingertips when droplets were still wet and after having dried up and subsequently being touched by finger printing or rubbing the object. Accounting for the likelihood of the scenario to occur by considering (1) a local prevalence of 100 COVID-19 cases/100,000 persons, (2) a maximum of about one-fifth of infected persons transmit high virus loads, and (3) the numbers of cash transactions/person/day, the risk of contracting COVID-19 via person-to-person cash transactions was estimated to be much lower than once per 39,000 days (107 years) for a single person. In the general populace, there will be a maximum of 2.6 expected cases/100,000 persons/day. The risk for a cashier at an average point of sale was estimated to be much less than once per 430 working days (21 months). The depicted scenario is a rare event, therefore, for a single person, the risk of contracting COVID-19 via person-to-person cash transactions is very low. At a point of sale, the risk to the cashier proportionally increases but it is still low.
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Affiliation(s)
- Jack F. Schijven
- Centre for Infectious Disease ControlNational Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
- Department of Earth SciencesUtrecht UniversityUtrechtThe Netherlands
| | - Mark Wind
- Cash Policy DepartmentDe Nederlandsche BankAmsterdamThe Netherlands
| | - Daniel Todt
- Department of Molecular & Medical VirologyRuhr University BochumBochumGermany
- European Virus Bioinformatics Centre (EVBC)JenaGermany
| | - John Howes
- European Central Bank (ECB)Frankfurt am MainGermany
| | | | - Eike Steinmann
- Department of Molecular & Medical VirologyRuhr University BochumBochumGermany
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13
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Thalheim T, Krüger T, Galle J. Indirect Virus Transmission via Fomites Can Counteract Lock-Down Effectiveness. Int J Environ Res Public Health 2022; 19:14011. [PMID: 36360891 PMCID: PMC9658534 DOI: 10.3390/ijerph192114011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
The spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has raised major health policy questions. Direct transmission via respiratory droplets seems to be the dominant route of its transmission. However, indirect transmission via shared contact of contaminated objects may also occur. The contribution of each transmission route to epidemic spread might change during lock-down scenarios. Here, we simulate viral spread of an abstract epidemic considering both routes of transmission by use of a stochastic, agent-based SEIR model. We show that efficient contact tracing (CT) at a high level of incidence can stabilize daily cases independently of the transmission route long before effects of herd immunity become relevant. CT efficacy depends on the fraction of cases that do not show symptoms. Combining CT with lock-down scenarios that reduce agent mobility lowers the incidence for exclusive direct transmission scenarios and can even eradicate the epidemic. However, even for small fractions of indirect transmission, such lockdowns can impede CT efficacy and increase case numbers. These counterproductive effects can be reduced by applying measures that favor distancing over reduced mobility. In summary, we show that the efficacy of lock-downs depends on the transmission route. Our results point to the particular importance of hygiene measures during mobility lock-downs.
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Affiliation(s)
- Torsten Thalheim
- Interdisciplinary Centre for Bioinformatics (IZBI), Leipzig University, Haertelstr. 16-18, 04107 Leipzig, Germany
| | - Tyll Krüger
- Institute of Computer Engineering, Control and Robotics, Wroclaw University of Science and Technology, Janiszewskiego 11-17, 50-372 Wrocław, Poland
| | - Jörg Galle
- Interdisciplinary Centre for Bioinformatics (IZBI), Leipzig University, Haertelstr. 16-18, 04107 Leipzig, Germany
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14
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Wilson AM, Jones RM. Exploring spatial averaging of contamination in fomite microbial transfer models and implications for dose. J Expo Sci Environ Epidemiol 2022; 32:759-766. [PMID: 34743183 PMCID: PMC8571976 DOI: 10.1038/s41370-021-00398-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND When modeling exposures from contact with fomites, there are many choices in defining the sizes of compartments representing environmental surfaces and hands, and the portions of compartments involved in contacts. These choices impact dose estimates, yet there is limited guidance for selection of these model parameters. OBJECTIVE The study objective was to explore methods for representing environmental surface and hand contact areas in exposure models and implications for estimated doses. METHODS A simple scenario was used: an individual using their hands to contact their face and two microbially contaminated environmental surfaces. Four models were developed to explore different compartmentalization strategies: (1) hands and environmental surfaces each represented by one compartment, (2) hands represented by two compartments (fingertips vs. non-fingertip areas) while environmental surfaces were represented by one compartment, (3) hands represented by a single compartment and environmental surfaces represented by two compartments, and (4) hands and environmental surfaces each represented by two compartments. Sensitivity analyses were conducted to evaluate the influence of heterogeneous surface contact frequency, hand contact type, and hand dominance on dose. RESULTS Estimated doses were greatest when hand areas and environmental surfaces were each represented by two compartments, indicating that surface area "dilutes" contaminant concentration and decreases estimated dose. SIGNIFICANCE Model compartment designations for hands and environmental surfaces affect dose estimation, but more human behavior data are needed. IMPACT STATEMENT A common problem for exposure models describing exposures via hand-to-surface contacts occurs in the way that estimated contamination across human skin (usually hands) or across environmental surfaces is spatially averaged, as opposed to accounting for concentration changes across specific parts of the hand or individual surfaces. This can lead to the dilution of estimated contaminants and biases in estimated doses in risk assessments. The magnitude of these biases and implications for the accuracy in risk assessments are unknown. We quantify differences in dose for various strategies of compartmentalizing environmental surfaces and hands to inform guidance on future exposure model development.
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Affiliation(s)
- Amanda M Wilson
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, USA.
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA.
| | - Rachael M Jones
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, USA
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
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15
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Unger K, Dietz L, Horve P, Van Den Wymelenberg K, Lin A, Kinney E, Kea B. Evaluating fomite risk of brown paper bags storing personal protective equipment exposed to SARS-CoV-2: A quasi-experimental study. PLoS One 2022; 17:e0273433. [PMID: 36026512 PMCID: PMC9417035 DOI: 10.1371/journal.pone.0273433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Literature is lacking on the safety of storing contaminated PPE in paper bags for reuse, potentially increasing exposure to frontline healthcare workers (HCW) and patients. The aim of this study is to evaluate the effectiveness of paper bags as a barrier for fomite transmission of SARS-CoV-2 by storing face masks, respirators, and face shields. Methods This quasi-experimental study evaluated the presence of SARS-CoV-2 on the interior and exterior surfaces of paper bags containing PPE that had aerosolized exposures in clinical and simulated settings. Between May and October 2020, 30 unique PPE items were collected from COVID-19 units at two urban hospitals. Exposed PPE, worn by either an infected patient or HCW during a SARS-CoV-2 aerosolizing event, were placed into an unused paper bag. Samples were tested at 30-minute and 12-hour intervals. Results A total of 177 swabs were processed from 30 PPE samples. We found a 6.8% positivity rate among all samples across both collection sites. Highest positivity rates were associated with ventilator disconnection and exposure to respiratory droplets from coughing. Positivity rates differed between hospital units. Total positivity rates were similar between 30-minute (6.7%) and 12-hour (6.9%) sample testing time intervals. Control samples exposed to inactivated SARS-CoV-2 droplets had higher total viral counts than samples exposed to nebulized aerosols. Conclusions Data suggests paper bags are not a significant fomite risk for SARS-CoV-2 transmission. However, controls demonstrated a risk with droplet exposure. Data can inform guidelines for storing and re-using PPE in situations of limited supplies during future pandemics.
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Affiliation(s)
- Kyirsty Unger
- Oregon Health & Science University, Portland, Oregon, United States of America
- * E-mail:
| | - Leslie Dietz
- University of Oregon, Eugene, Oregon, United States of America
| | - Patrick Horve
- University of Oregon, Eugene, Oregon, United States of America
| | | | - Amber Lin
- Oregon Health & Science University, Portland, Oregon, United States of America
| | - Erin Kinney
- School of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Bory Kea
- Department of Emergency Medicine, Center for Policy and Emergency Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
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16
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Meister TL, Brüggemann Y, Tamele B, Howes J, Steinmann E, Todt D. A touch transfer assay to determine surface transmission of highly pathogenic viruses. STAR Protoc 2022; 3:101188. [PMID: 35317333 PMCID: PMC8932683 DOI: 10.1016/j.xpro.2022.101188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | - Barbora Tamele
- European Central Bank (ECB), 60314 Frankfurt am Main, Germany
| | - John Howes
- European Central Bank (ECB), 60314 Frankfurt am Main, Germany
| | - Eike Steinmann
- Department for Molecular and Medical Virology, 44801 Bochum, Germany
| | - Daniel Todt
- Department for Molecular and Medical Virology, 44801 Bochum, Germany
- European Virus Bioinformatics Center, 07743 Jena, Germany
- Corresponding author
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17
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Di Battista A. A quantitative microbial risk assessment for touchscreen user interfaces using an asymmetric transfer gradient transmission mode. PLoS One 2022; 17:e0265565. [PMID: 35333886 PMCID: PMC8956170 DOI: 10.1371/journal.pone.0265565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/03/2022] [Indexed: 11/19/2022] Open
Abstract
The ubiquitous use of public touchscreen user interfaces for commercial applications has created a credible risk for fomite-mediated disease transmission. This paper presents results from a stochastic simulation designed to assess this risk. The model incorporates a queueing network to simulate people flow and touchscreen interactions. It also describes an updated model for microbial transmission using an asymmetric gradient transfer assumption that incorporates literature reviewed empirical data concerning touch-transfer efficiency between fingers and surfaces. In addition to natural decay/die-off, pathogens are removed from the system by simulated cleaning / disinfection and personal-touching rates (e.g. face, dermal, hair and clothing). The dose response is implemented with an exponential moving average filter to model the temporal dynamics of exposure. Public touchscreens were shown to pose a considerable infection risk (∼3%) using plausible default simulation parameters. Sensitivity of key model parameters, including the rate of surface disinfection is examined and discussed. A distinctive and important advancement of this simulation was its ability to distinguish between infection risk from a primary contaminated source and that due to the re-deposition of pathogens onto secondary, initially uncontaminated touchscreens from sequential use. The simulator is easily configurable and readily adapted to more general fomite-mediated transmission modelling and may provide a valuable framework for future research.
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18
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Caschera AG, McAuley J, Kim Y, Purcell D, Rymenants J, Foucher DA. Evaluation of virucidal activity of residual quaternary ammonium-treated surfaces on SARS-CoV-2. Am J Infect Control 2022; 50:325-329. [PMID: 34756967 PMCID: PMC8553632 DOI: 10.1016/j.ajic.2021.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/09/2021] [Accepted: 10/16/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The COVID-19 pandemic has had an unprecedented impact on global health and the world's economies. Proliferation of virulent and deadly SARS-CoV-2 variants require effective transmission mitigation strategies. Under reasonable environmental conditions, culturable and infectious SARS-CoV-2 can survive on contaminated fomites from hours to months. In the present study we evaluated a surface-anchored polymeric quaternary ammonium antimicrobial to help reduce fomite transmission of SARS-CoV-2 from contaminated surfaces. METHODS Two studies were performed on antimicrobial pre-treated metal disks in March 2020 by two independent Biosafety Level III (BSL-3) equipped laboratories in April 2020. These facilities were in Belgium (the Rega Medical Research Institute) and Australia (the Peter Doherty Institute) and independently applied quantitative carrier-based methodologies using the authentic SARS-CoV-2 isolates (hCoV-19/Australia/VIC01/2020, hCoV-19/Belgium/GHB-03021/2020). RESULTS Residual dry tests were independently conducted at both facilities and demonstrated sustained virion destruction (108.23 TCID50/carrier GHB-03021 isolate, and 103.66 TCID50/carrier VIC01 isolate) 1 hour (drying) + 10 minutes after inoculation. Reductions are further supported by degradation of RNA on antimicrobial-treated surfaces using qRT-PCR. CONCLUSIONS Using a polymeric quaternary ammonium antimicrobial (EPA/PMRA registered) the results independently support a sustained antiviral effect via SARS-CoV-2 virion destruction and viral RNA degradation. This indicates that silane-anchored quaternary ammonium compound (SiQAC-18) treated surfaces could play an important role in mitigating the communicability and fomite transmission of SARS-CoV-2.
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Affiliation(s)
- Alexander G Caschera
- Ryerson University, Department of Chemistry and Biology; Toronto, Ontario, Canada, M5B 2K3.
| | - Julie McAuley
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Youry Kim
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Damian Purcell
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Jasper Rymenants
- Laboratory of Virology and Chemotherapy Rega Institute for Medical Research, Leuven, Belgium
| | - Daniel A Foucher
- Ryerson University, Department of Chemistry and Biology; Toronto, Ontario, Canada, M5B 2K3
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19
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Meiksin A. Using the SEIR model to constrain the role of contaminated fomites in spreading an epidemic: An application to COVID-19 in the UK. Math Biosci Eng 2022; 19:3564-3590. [PMID: 35341264 DOI: 10.3934/mbe.2022164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The use of the SEIR model of compartmentalized population dynamics with an added fomite term is analysed as a means of statistically quantifying the contribution of contaminated fomites to the spread of a viral epidemic. It is shown that for normally expected lifetimes of a virus on fomites, the dynamics of the populations are nearly indistinguishable from the case without fomites. With additional information, such as the change in social contacts following a lockdown, however, it is shown that, under the assumption that the reproduction number for direct infection is proportional to the number of social contacts, the population dynamics may be used to place meaningful statistical constraints on the role of fomites that are not affected by the lockdown. The case of the Spring 2020 UK lockdown in response to COVID-19 is presented as an illustration. An upper limit is found on the transmission rate by contaminated fomites of fewer than 1 in 30 per day per infectious person (95% CL) when social contact information is taken into account. Applied to postal deliveries and food packaging, the upper limit on the contaminated fomite transmission rate corresponds to a probability below 1 in 70 (95% CL) that a contaminated fomite transmits the infection. The method presented here may be helpful for guiding health policy over the contribution of some fomites to the spread of infection in other epidemics until more complete risk assessments based on mechanistic modelling or epidemiological investigations may be completed.
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Affiliation(s)
- Avery Meiksin
- School of Physics and Astronomy, University of Edinburgh, James Clerk Maxwell Building, Peter Guthrie Tait Road, Edinburgh, EH9 3FD, UK
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20
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Cuevas-Ferrando E, Girón-Guzmán I, Falcó I, Pérez-Cataluña A, Díaz-Reolid A, Aznar R, Randazzo W, Sánchez G. Discrimination of non-infectious SARS-CoV-2 particles from fomites by viability RT-qPCR. Environ Res 2022; 203:111831. [PMID: 34352235 PMCID: PMC8327643 DOI: 10.1016/j.envres.2021.111831] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/01/2021] [Accepted: 08/01/2021] [Indexed: 05/05/2023]
Abstract
The ongoing coronavirus 2019 (COVID-19) pandemic constitutes a concerning global threat to public health and economy. In the midst of this pandemic scenario, the role of environment-to-human COVID-19 spread is still a matter of debate because mixed results have been reported concerning SARS-CoV-2 stability on high-touch surfaces in real-life scenarios. Up to now, no alternative and accessible procedures for cell culture have been applied to evaluate SARS-CoV-2 infectivity on fomites. Several strategies based on viral capsid integrity have latterly been developed using viability markers to selectively remove false-positive qPCR signals resulting from free nucleic acids and damaged viruses. These have finally allowed an estimation of viral infectivity. The present study aims to provide a rapid molecular-based protocol for detection and quantification of viable SARS-CoV-2 from fomites based on the discrimination of non-infectious SARS-CoV-2 particles by platinum chloride (IV) (PtCl4) viability RT-qPCR. An initial assessment compared two different swabbing procedures to recover inactivated SARS-CoV-2 particles from fomites coupled with two RNA extraction methods. Procedures were validated with human (E229) and porcine (PEDV) coronavirus surrogates, and compared with inactivated SARS-CoV-2 suspensions on glass, steel and plastic surfaces. The viability RT-qPCR efficiently removed the PCR amplification signals from heat and gamma-irradiated inactivated SARS-CoV-2 suspensions that had been collected from specified surfaces. This study proposes a rapid viability RT-qPCR that discriminates non-infectious SARS-CoV-2 particles on surfaces thus helping researchers to better understand the risk of contracting COVID-19 through contact with fomites and to develop more efficient epidemiological measures.
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Affiliation(s)
- Enric Cuevas-Ferrando
- Department of Preservation and Food Safety Technologies, Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain
| | - Inés Girón-Guzmán
- Department of Preservation and Food Safety Technologies, Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain; Department of Microbiology and Ecology, University of Valencia, Valencia, Spain
| | - Irene Falcó
- Department of Preservation and Food Safety Technologies, Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain
| | - Alba Pérez-Cataluña
- Department of Preservation and Food Safety Technologies, Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain
| | - Azahara Díaz-Reolid
- Department of Preservation and Food Safety Technologies, Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain
| | - Rosa Aznar
- Department of Preservation and Food Safety Technologies, Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain; Department of Microbiology and Ecology, University of Valencia, Valencia, Spain
| | - Walter Randazzo
- Department of Preservation and Food Safety Technologies, Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain
| | - Gloria Sánchez
- Department of Preservation and Food Safety Technologies, Institute of Agrochemistry and Food Technology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980, Valencia, Spain.
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21
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Overbey KN, Hamra GB, Nachman KE, Rock C, Schwab KJ. Quantitative microbial risk assessment of human norovirus infection in environmental service workers due to healthcare-associated fomites. J Hosp Infect 2021; 117:52-64. [PMID: 34403766 PMCID: PMC8978295 DOI: 10.1016/j.jhin.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Healthcare-associated norovirus outbreaks place a large burden on healthcare staff. Environmental service workers (ESWs), however, remain understudied despite high contact with potentially contaminated surfaces. Understanding the magnitude of the risk of norovirus infection in healthcare ESWs can protect workers and improve infection control. AIM This study simulated the risk of norovirus infection for unprotected ESWs after a single fomite contact, assuming no disinfection or protective equipment, in norovirus-positive patient rooms. In addition, the risk of secondary surface transmission from norovirus-exposed ESWs was simulated. METHODS A quantitative microbial risk assessment employing two-dimensional Monte Carlo simulation with parameters extracted from the literature was used to estimate norovirus infection from multiple fomite contact scenarios defined by: norovirus source (patient vomit/diarrhoea), location (bathroom/patient room) and target outcome (ESW/secondary illness). FINDINGS Unprotected ESWs have a maximum estimated risk of norovirus infection of 33% (1:3) for a single fomite contact in a room where a norovirus-positive patient had a diarrhoeal event. Patient vomit events lead to fomite contact risk estimates that are four orders of magnitude lower than those for diarrhoeal events. The estimated risk of secondary illness from touching a common surface is as high as 25% (1:4) after single fomite exposure following a diarrhoeal event. CONCLUSIONS A single fomite contact may lead to sizable risk of norovirus infection in ESWs if personal protective equipment and disinfection are not used appropriately. ESWs can also transfer virus to secondary surfaces, initiating further infections. Interventions are needed to reduce fomite transfer of norovirus, and protect patients and staff from nosocomial infections.
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Affiliation(s)
- K N Overbey
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - G B Hamra
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - K E Nachman
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - C Rock
- Division of Infectious Diseases, Johns Hopkins Medicine, Baltimore, MD, USA
| | - K J Schwab
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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22
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Zupin L, Licen S, Milani M, Clemente L, Martello L, Semeraro S, Fontana F, Ruscio M, Miani A, Crovella S, Barbieri P. Evaluation of Residual Infectivity after SARS-CoV-2 Aerosol Transmission in a Controlled Laboratory Setting. Int J Environ Res Public Health 2021; 18:11172. [PMID: 34769691 PMCID: PMC8582643 DOI: 10.3390/ijerph182111172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 02/08/2023]
Abstract
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is mainly transmitted through respiratory droplets, aerosols, or direct contact with fomites from an infected subject. It has been reported that SARS-CoV-2 is stable and viable in aerosol up to 16 h in controlled laboratory conditions. However, the aerosolization conditions varied a lot between the studies. In this work, an experimental laboratory model of SARS-CoV-2 aerosolization was established, employing an impinger nebulizer, a cylindrical chamber for aerosol travel, and a SKC biosampler for the collection of particles. The efficiency of the system was assessed based on the molecular determination of the viral load in the nebulizer after the aerosolization and in the aerosol collected at the end of the travel. Moreover, the residual infectivity was tested in vitro on the Vero E6 cell line, through the observation of the cytopathic effect (CPE), and the quantification of the viral load in the supernatants at 7 days post inoculation (dpi). A high RNA viral load was found in the SKC biosampler after aerosolization, indicating that it was possible to transport a high virus titer through the 30-cm chamber with all the dilutions (initial 105, 104, 103 plaque forming unit-PFU/mL). At the 7 dpi, an increment of the RNA viral load was determined for the dilutions 105 and 104 PFU/mL tested, while only the initial 105 PFU/mL resulted in visible CPE. Our findings allowed us to achieve the resilience of SARS-CoV-2 in aerosol form, at a concentration comparable to those reported for clinical samples. This mode of transmission should be considered for the mitigation and preventive measures to counteract SARS-CoV-2 spreading.
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Affiliation(s)
- Luisa Zupin
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell’Istria 65/1, 34137 Trieste, Italy
| | - Sabina Licen
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (S.L.); (L.M.); (P.B.)
| | - Margherita Milani
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34137 Trieste, Italy;
| | - Libera Clemente
- Ospedale San Polo, Azienda Sanitaria Universitaria Giuliano Isontina, Via Luigi Galvani 1, 34074 Monfalcone, Italy; (L.C.); (F.F.)
| | - Lorenzo Martello
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (S.L.); (L.M.); (P.B.)
| | - Sabrina Semeraro
- INSTM National Interuniversity Consortium of Materials Science and Technology, Via G. Giusti 9, 50121 Firenze, Italy;
| | - Francesco Fontana
- Ospedale San Polo, Azienda Sanitaria Universitaria Giuliano Isontina, Via Luigi Galvani 1, 34074 Monfalcone, Italy; (L.C.); (F.F.)
| | - Maurizio Ruscio
- Ospedale Maggiore, Azienda Sanitaria Universitaria Giuliano Isontina, Piazza dell’Ospitale 1, 34129 Trieste, Italy;
| | - Alessandro Miani
- Department of Environmental Science and Policy, University of Milan, Via Festa del Perdono 7, 20122 Milano, Italy;
| | - Sergio Crovella
- Department of Biological and Environmental Sciences, College of Arts and Sciences, University of Qatar, Doha 2713, Qatar;
| | - Pierluigi Barbieri
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (S.L.); (L.M.); (P.B.)
- INSTM National Interuniversity Consortium of Materials Science and Technology, Via G. Giusti 9, 50121 Firenze, Italy;
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23
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Mohamadi M, Babington-Ashaye A, Lefort A, Flahault A. Risks of Infection with SARS-CoV-2 Due to Contaminated Surfaces: A Scoping Review. Int J Environ Res Public Health 2021; 18:11019. [PMID: 34769538 PMCID: PMC8583529 DOI: 10.3390/ijerph182111019] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 outbreak is a global health concern. Understanding the transmission modes of the SARS-CoV-2 virus is key to limit the spread of the pandemic. A lack of knowledge about the possibility of SARS-CoV-2 transmission and infection through contaminated surfaces is noticeable and recent studies have stated conflicting findings. This scoping review aims to understand the risks of contaminations via fomites better. Relevant publications were selected through Google Scholar, Web of Science, PubMed, Embase, Medline, and Cochrane Library, with related keywords. PRISMA-ScR guidelines were followed. Out of the 565 articles found, exclusion criteria were applied, duplicates removed, and a total of 25 articles were finally included in the study. The included documents were assessed by the contamination risk: "low" (37.5%), "high" (16.7%), "plausible" (8.3%), "unlikely" (8.3%) risk, and "insufficient evidence" (29.2%). Research in hospital settings was found as the main setting in the reviewed papers, which precisely indicated the risk of contaminated surfaces. This scoping review underscores the risk of SARS-CoV-2 infection via contaminated surfaces assessed as low in the majority of the reviewed articles. Further evaluation of the risk of the virus transmission by fomites and providing adequate information on its infectivity via contaminated surfaces in real-life conditions is essential.
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Affiliation(s)
- Marjan Mohamadi
- Faculty of Medicine, Institute of Global Health, University of Geneva, 1202 Geneva, Switzerland; (M.M.); (A.F.)
| | - Awa Babington-Ashaye
- Faculty of Medicine, Institute of Global Health, University of Geneva, 1202 Geneva, Switzerland; (M.M.); (A.F.)
| | - Agnès Lefort
- Service de Médecine Interne, Hôpital Beaujon, Clichy and IAME, UMR1137, INSERM and Université de Paris, 75006 Paris, France;
| | - Antoine Flahault
- Faculty of Medicine, Institute of Global Health, University of Geneva, 1202 Geneva, Switzerland; (M.M.); (A.F.)
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24
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Rasheed A, Sharma S, Kabi P, Saha A, Chaudhuri S, Basu S. Precipitation dynamics of surrogate respiratory sessile droplets leading to possible fomites. J Colloid Interface Sci 2021; 600:1-13. [PMID: 34022720 DOI: 10.1016/j.jcis.2021.04.128] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 12/24/2022]
Abstract
HYPOTHESIS The droplets ejected from an infected host during expiratory events can get deposited as fomites on everyday use surfaces. Recognizing that these fomites can be a secondary route for disease transmission, exploring the deposition pattern of such sessile respiratory droplets on daily-use substrates thus becomes crucial. EXPERIMENTS The used surrogate respiratory fluid is composed of a water-based salt-protein solution, and its precipitation dynamics is studied on four different substrates (glass, ceramic, steel, and PET). For tracking the final deposition of viruses in these droplets, 100 nm virus emulating particles (VEP) are used and their distribution in dried-out patterns is identified using fluorescence and SEM imaging techniques. FINDINGS The final precipitation pattern and VEP deposition strongly depend on the interfacial transport processes, edge evaporation, and crystallization dynamics. A constant contact radius mode of evaporation with a mixture of capillary and Marangoni flows results in spatio-temporally varying edge deposits. Dendritic and cruciform-shaped crystals are majorly seen in all substrates except on steel, where regular cubical crystals are formed. The VEP deposition is higher near the three-phase contact line and crystal surfaces. The results showed the role of interfacial processes in determining the initiation of fomite-type infection pathways in the context of COVID-19.
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Affiliation(s)
- Abdur Rasheed
- Department of Mechanical Engineering, Indian Institute of Science, Bengaluru, KA 560012, India
| | - Shubham Sharma
- Department of Mechanical Engineering, Indian Institute of Science, Bengaluru, KA 560012, India
| | - Prasenjit Kabi
- Interdisciplinary Centre for Energy Research, Indian Institute of Science, Bengaluru, KA 560012, India
| | - Abhishek Saha
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Swetaprovo Chaudhuri
- Institute for Aerospace Studies, University of Toronto, Toronto, Ontario M3H 5T6, Canada
| | - Saptarshi Basu
- Department of Mechanical Engineering, Indian Institute of Science, Bengaluru, KA 560012, India; Interdisciplinary Centre for Energy Research, Indian Institute of Science, Bengaluru, KA 560012, India.
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25
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Kim S, Kim WY, Nam SH, Shin S, Choi SH, Kim DH, Lee H, Choi HJ, Lee E, Park JH, Jo I, Fang NX, Cho YT. Microstructured Surfaces for Reducing Chances of Fomite Transmission via Virus-Containing Respiratory Droplets. ACS Nano 2021; 15:14049-14060. [PMID: 34339604 DOI: 10.1021/acsnano.1c01636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Evaporation-induced particle aggregation in drying droplets is of significant importance in the prevention of pathogen transfer due to the possibility of indirect fomite transmission of the infectious virus particles. In this study, particle aggregation was directionally controlled using contact line dynamics (pinned or slipping) and geometrical gradients on microstructured surfaces by the systematic investigation of the evaporation process on sessile droplets and sprayed microdroplets laden with virus-simulant nanoparticles. Using this mechanism, we designed robust particle capture surfaces by significantly inhibiting the contact transfer of particles from fomite surfaces. For the proof-of-concept, interconnected hexagonal and inverted pyramidal microwall were fabricated using ultraviolet-based nanoimprint lithography, which is considered to be a promising scalable manufacturing process. We demonstrated the potentials of an engineered microcavity surface to limit the contact transfer of particle aggregates deposited with the evaporation of microdroplets by 93% for hexagonal microwall and by 96% for inverted pyramidal microwall. The particle capture potential of the interconnected microstructures was also investigated using biological particles, including adenoviruses and lung-derived extracellular vesicles. The findings indicate that the proposed microstructured surfaces can reduce the indirect fomite transmission of highly infectious agents, including norovirus, rotavirus, or SARS-CoV-2, via respiratory droplets.
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Affiliation(s)
- Seok Kim
- Department of Mechanical Engineering, Changwon National University, Changwon 51140, South Korea
- Department of Smart Manufacturing Engineering, Changwon National University, Changwon 51140, South Korea
| | - Woo Young Kim
- Department of Smart Manufacturing Engineering, Changwon National University, Changwon 51140, South Korea
| | - Sang-Hoon Nam
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Seunghang Shin
- Department of Smart Manufacturing Engineering, Changwon National University, Changwon 51140, South Korea
| | - Su Hyun Choi
- Department of Mechanical Engineering, Changwon National University, Changwon 51140, South Korea
| | - Do Hyeog Kim
- Department of Mechanical Engineering, Changwon National University, Changwon 51140, South Korea
| | - Heedoo Lee
- Department of Biology and Chemistry, Changwon National University, Changwon 51140, South Korea
| | - Hyeok Jae Choi
- Department of Biology and Chemistry, Changwon National University, Changwon 51140, South Korea
| | - Eungman Lee
- Department of Radiation Oncology, College of Medicine, Ewha Womans University, Seoul 07804, South Korea
| | - Jung-Hyun Park
- Department of Molecular Medicine, College of Medicine, Ewha Womans University, Seoul 07804, South Korea
| | - Inho Jo
- Department of Molecular Medicine, College of Medicine, Ewha Womans University, Seoul 07804, South Korea
- Ewha Education & Research Center for Infection, Ewha Womans University Medical Center, Seoul 07804, South Korea
| | - Nicholas X Fang
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Young Tae Cho
- Department of Mechanical Engineering, Changwon National University, Changwon 51140, South Korea
- Department of Smart Manufacturing Engineering, Changwon National University, Changwon 51140, South Korea
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26
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Wilson AM, Weir MH, King MF, Jones RM. Comparing approaches for modelling indirect contact transmission of infectious diseases. J R Soc Interface 2021; 18:20210281. [PMID: 34465207 PMCID: PMC8437226 DOI: 10.1098/rsif.2021.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/02/2021] [Indexed: 11/12/2022] Open
Abstract
Mathematical models describing indirect contact transmission are an important component of infectious disease mitigation and risk assessment. A model that tracks microorganisms between compartments by coupled ordinary differential equations or a Markov chain is benchmarked against a mechanistic interpretation of the physical transfer of microorganisms from surfaces to fingers and subsequently to a susceptible person's facial mucosal membranes. The primary objective was to compare these models in their estimates of doses and changes in microorganism concentrations on hands and fomites over time. The abilities of the models to capture the impact of episodic events, such as hand hygiene, and of contact patterns were also explored. For both models, greater doses were estimated for the asymmetrical scenarios in which a more contaminated fomite was touched more often. Differing representations of hand hygiene in the Markov model did not notably impact estimated doses but affected pathogen concentration dynamics on hands. When using the Markov model, losses due to hand hygiene should be handled as separate events as opposed to time-averaging expected losses. The discrete event model demonstrated the effect of hand-to-mouth contact timing on the dose. Understanding how model design influences estimated doses is important for advancing models as reliable risk assessment tools.
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Affiliation(s)
- Amanda M. Wilson
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, USA
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Mark H. Weir
- Division of Environmental Health Sciences, School of Public Health, The Ohio State University, Columbus, OT, USA
| | - Marco-Felipe King
- School of Civil Engineering, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK
| | - Rachael M. Jones
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, USA
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27
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Jaradat ZW, Khwaileh M, Al Mousa W, Ababneh QO, Al Nabulsi A. Occurrence, distribution and pattern analysis of methicillin resistant (MRSA) and methicillin sensitive (MSSA) Staphylococcus aureus on fomites in public facilities. Pathog Glob Health 2021; 115:377-391. [PMID: 34338618 PMCID: PMC8592605 DOI: 10.1080/20477724.2021.1906563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a human pathogen incriminated as a causative agent of hospital nosocomial infections as well as a wide range of diseases in communities. This study was conducted to assess the occurrence and distribution of MRSA and methicillin-sensitive (MSSA) on different fomites in public facilities in northern Jordan and to determine their antibiograms, toxin genes profiles, as well as identify their genetic relatedness. A total of 2600 swabs were collected from 14 fomite surfaces in a variety of public facilities including hospitals, universities, schools, transportation sites, and market places. The identity of the 380 S. aureus isolates was confirmed. Among them, 158 (41.6%) were MRSA while the rest of the isolates, 222 (58.4%) were MSSA. MRSA isolates were recovered from all fomites sites. However, among the total collected samples, the percentages of MRSA in public facilities were significantly higher in hospitals and transportation fomites, while percentages of MRSA among fomites sites were higher in public reception sites, chairs, and toilet seats. Antibiotic resistance profiles indicated that 24.5% of the isolates were resistant to cefoxitin, oxacillin, and oxytetracycline. In contrast, only 3.95% were resistant to trimethoprim-sulfamethoxazole, and 15.3% were resistant to ciprofloxacin. Multidrug-resistant patterns were higher in MRSA than in MSSA isolates. There was no apparent difference in toxin gene profiles between MRSA and MSSA. Molecular analysis revealed 85 patterns and 16 clusters at a 9% mean similarity level. In conclusion, this study provides evidence for the potential of MRSA transmission via inanimate surfaces.
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Affiliation(s)
- Ziad W Jaradat
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Maysoon Khwaileh
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Waseem Al Mousa
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Qutaiba O Ababneh
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Anas Al Nabulsi
- Department of Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan
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28
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Port JR, Yinda CK, Owusu IO, Holbrook M, Fischer R, Bushmaker T, Avanzato VA, Schulz JE, Martens C, van Doremalen N, Clancy CS, Munster VJ. SARS-CoV-2 disease severity and transmission efficiency is increased for airborne compared to fomite exposure in Syrian hamsters. Nat Commun 2021; 12:4985. [PMID: 34404778 PMCID: PMC8371001 DOI: 10.1038/s41467-021-25156-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/14/2021] [Indexed: 12/15/2022] Open
Abstract
Transmission of SARS-CoV-2 is driven by contact, fomite, and airborne transmission. The relative contribution of different transmission routes remains subject to debate. Here, we show Syrian hamsters are susceptible to SARS-CoV-2 infection through intranasal, aerosol and fomite exposure. Different routes of exposure present with distinct disease manifestations. Intranasal and aerosol inoculation causes severe respiratory pathology, higher virus loads and increased weight loss. In contrast, fomite exposure leads to milder disease manifestation characterized by an anti-inflammatory immune state and delayed shedding pattern. Whereas the overall magnitude of respiratory virus shedding is not linked to disease severity, the onset of shedding is. Early shedding is linked to an increase in disease severity. Airborne transmission is more efficient than fomite transmission and dependent on the direction of the airflow. Carefully characterized SARS-CoV-2 transmission models will be crucial to assess potential changes in transmission and pathogenic potential in the light of the ongoing SARS-CoV-2 evolution.
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Affiliation(s)
- Julia R Port
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Claude Kwe Yinda
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Irene Offei Owusu
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Myndi Holbrook
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Robert Fischer
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Trenton Bushmaker
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
- Montana State University, Bozeman, MT, USA
| | - Victoria A Avanzato
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Jonathan E Schulz
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Craig Martens
- Rocky Mountain Genomics Core Facility, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Neeltje van Doremalen
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Chad S Clancy
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA
| | - Vincent J Munster
- Laboratory of Virology, Division of Intramural Research, National Institutes of Health, Hamilton, MT, USA.
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29
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Wang P, Zhang N, Miao T, Chan JPT, Huang H, Lee PKH, Li Y. Surface touch network structure determines bacterial contamination spread on surfaces and occupant exposure. J Hazard Mater 2021; 416:126137. [PMID: 34492926 DOI: 10.1016/j.jhazmat.2021.126137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/08/2021] [Accepted: 05/13/2021] [Indexed: 06/13/2023]
Abstract
Fomites are known to spread infectious diseases, but their role in determining transmission risk remains unclear. The association of surface touch networks (STNs), proposed to explain this risk, with real-life surface contamination has not yet been demonstrated. To construct STNs, we collected surface touch data from 23 to 26 scholars through 2 independent experiments conducted in office spaces for 13 h each. In parallel, a tracer bacterium (Lactobacillus bulgaricus) was spread by a designated carrier in each experiment during normal activities; the subsequent extent of surface contamination was assessed using qPCR. The touch data were also analyzed using an agent-based model that predicted the observed contamination. Touching public (door handles) and hidden public (desks, chair seatbacks) surfaces that connected occupants, sparse hand-to-hand contact, and active carriers contributed significantly to contamination spread, which was also correlated with the size of the social group containing carriers. The natural and unsupervised experiments reflected realistic exposure levels of mouths (1-10 ppm of total contamination spread by one root carrier), nostrils (~1 ppm), and eyes (~0.1 ppm). We conclude that the contamination degree of known and hidden public surfaces can indicate fomite exposure risk. The social group effect could trigger superspreading events through fomite transmission.
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Affiliation(s)
- Peihua Wang
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China
| | - Nan Zhang
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China; Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Te Miao
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China
| | - Jack P T Chan
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China
| | - Hong Huang
- Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Patrick K H Lee
- School of Energy and Environment, City University of Hong Kong, Hong Kong, China
| | - Yuguo Li
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China; School of Public Health, University of Hong Kong, Hong Kong, China.
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30
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Hu Q, He L, Zhang Y. Community Transmission via Indirect Media-To-Person Route: A Missing Link in the Rapid Spread of COVID-19. Front Public Health 2021; 9:687937. [PMID: 34395365 PMCID: PMC8355519 DOI: 10.3389/fpubh.2021.687937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
To prevent the spread of coronavirus disease 2019 (COVID-19), stringent quarantine measures have been implemented so that healthy people and virus carriers have isolated themselves in the same community owing to the limit capacity of healthcare facilities. With the exponential growth of the infected population, the residential environment is contaminated by fomites from the infected residents and consequently threating the health of susceptible residents. Till now, little has been acknowledged on this indirect transmission route and its role on community transmission. Here we address the impact of self-isolated virus carriers on the residential environment and elucidate the potential transmission pathways via contaminated environment in communities. We urge further investigation on the superspreading cases in communities and hope to arouse the attention to evaluate the potential risk of indirect transmission route as well as the corresponding control measures.
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Affiliation(s)
- Qunfang Hu
- Shanghai Institute of Disaster Prevention and Relief, Tongji University, Shanghai, China
| | - Lei He
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Ying Zhang
- College of Environment and Resource, Fuzhou University, Fuzhou, China
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31
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Marzoli F, Bortolami A, Pezzuto A, Mazzetto E, Piro R, Terregino C, Bonfante F, Belluco S. A systematic review of human coronaviruses survival on environmental surfaces. Sci Total Environ 2021; 778:146191. [PMID: 33714096 PMCID: PMC7927581 DOI: 10.1016/j.scitotenv.2021.146191] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/08/2021] [Accepted: 02/24/2021] [Indexed: 05/02/2023]
Abstract
The current pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has led people to implement preventive measures, including surface disinfection and use of alcohol-based hand gel, in order to avoid viral transmission via fomites. However, the role of surface transmission is still debated. The present systematic review aims to summarize all the evidence on surface survival of coronaviruses infecting humans. The analysis of 18 studies showed the longest coronavirus survival time is 28 days at room temperature (RT) on different surfaces: polymer banknotes, vinyl, steel, glass, and paper banknotes. Concerning SARS-CoV-2 human infection from contaminated surfaces, dangerous viral load on surfaces for up to 21 days was determined on polymer banknotes, steel, glass and paper banknotes. For viruses other than SARS-CoV-2, the longest period of survival was 14 days, recorded on glass. Environmental conditions can affect virus survival, and indeed, low temperatures and low humidity support prolonged survival of viruses on contaminated surfaces independently of surface type. Furthermore, it has been shown that exposure to sunlight significantly reduces the risk of surface transmission. Although studies are increasingly investigating the topic of coronavirus survival, it is difficult to compare them, given the methodology differences. For this reason, it is advisable to define a reference working protocol for virus survival trials, but, as an immediate measure, there is also a need for further investigations of coronavirus survival on surfaces.
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Affiliation(s)
- 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
| | - Alessandra Pezzuto
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Eva Mazzetto
- 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
| | - 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
| | - Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
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32
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Dallner M, Harlow J, Nasheri N. Human Coronaviruses Do Not Transfer Efficiently between Surfaces in the Absence of Organic Materials. Viruses 2021; 13:1352. [PMID: 34372557 PMCID: PMC8310000 DOI: 10.3390/v13071352] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/23/2022] Open
Abstract
Human coronaviruses, including SARS-CoV-2, are known to spread mainly via close contact and respiratory droplets. However, other potential means of transmission may be present. Fomite-mediated transmission occurs when viruses are deposited onto a surface and then transfer to a subsequent individual. Surfaces can become contaminated directly from respiratory droplets or from a contaminated hand. Due to mask mandates in many countries around the world, the former is less likely. Hands can become contaminated if respiratory droplets are deposited on them (i.e., coughing or sneezing) or through contact with fecal material where human coronaviruses (HCoVs) can be shed. The focus of this paper is on whether human coronaviruses can transfer efficiently from contaminated hands to food or food contact surfaces. The surfaces chosen were: stainless steel, plastic, cucumber and apple. Transfer was first tested with cellular maintenance media and three viruses: two human coronaviruses, 229E and OC43, and murine norovirus-1, as a surrogate for human norovirus. There was no transfer for either of the human coronaviruses to any of the surfaces. Murine norovirus-1 did transfer to stainless steel, cucumber and apple, with transfer efficiencies of 9.19%, 5.95% and 0.329%, respectively. Human coronavirus OC43 transfer was then tested in the presence of fecal material, and transfer was observed for stainless steel (0.52%), cucumber (19.82%) and apple (15.51%) but not plastic. This study indicates that human coronaviruses do not transfer effectively from contaminated hands to contact surfaces without the presence of fecal material.
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Affiliation(s)
- Matthew Dallner
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Health Canada, Ottawa, ON K1A 0K9, Canada; (M.D.); (J.H.)
| | - Jennifer Harlow
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Health Canada, Ottawa, ON K1A 0K9, Canada; (M.D.); (J.H.)
| | - Neda Nasheri
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Health Canada, Ottawa, ON K1A 0K9, Canada; (M.D.); (J.H.)
- Department of Biochemistry Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
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33
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Mondelli MU, Colaneri M, Seminari EM, Baldanti F, Bruno R. Low risk of SARS-CoV-2 transmission by fomites in real-life conditions. Lancet Infect Dis 2021; 21:e112. [PMID: 33007224 PMCID: PMC7524520 DOI: 10.1016/s1473-3099(20)30678-2] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/30/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Mario U Mondelli
- Divisions of Infectious Diseases II and Immunology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
| | - Marta Colaneri
- Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Elena M Seminari
- Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fausto Baldanti
- Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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34
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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). Environ Sci Technol 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] [What about the content of this article? (0)] [Affiliation(s)] [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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35
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Liu YN, Lv ZT, Yang SY, Liu XW. Optical Tracking of the Interfacial Dynamics of Single SARS-CoV-2 Pseudoviruses. Environ Sci Technol 2021; 55:4115-4122. [PMID: 33566596 PMCID: PMC7885801 DOI: 10.1021/acs.est.0c06962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 05/20/2023]
Abstract
The frequent detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in healthcare environments, accommodations, and wastewater has attracted great attention to the risk of viral transmission by environmental fomites. However, the process of SARS-CoV-2 adsorption to exposed surfaces in high-risk environments remains unclear. In this study, we investigated the interfacial dynamics of single SARS-CoV-2 pseudoviruses with plasmonic imaging technology. Through the use of this technique, which has high spatial and temporal resolution, we tracked the collision of viruses at a surface and differentiated their stable adsorption and transient adsorption. We determined the effect of the electrostatic force on virus adhesion by correlating the solution and surface chemistry with the interfacial diffusion velocity and equilibrium position. Viral adsorption was found to be enhanced in real scenarios, such as in simulated saliva. This work not only describes a plasmonic imaging method to examine the interfacial dynamics of a single virus but also provides direct measurements of the factors that regulate the interfacial adsorption of SARS-CoV-2 pseudovirus. Such information is valuable for understanding virus transport and environmental transmission and even for designing anticontamination surfaces.
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Affiliation(s)
- Yi-Nan Liu
- Chinese Academy of Sciences Key Laboratory of Urban
Pollutant Conversion, Department of Environmental Science and Engineering,
University of Science and Technology of China, Hefei 230026,
China
| | - Zhen-Ting Lv
- Chinese Academy of Sciences Key Laboratory of Urban
Pollutant Conversion, Department of Environmental Science and Engineering,
University of Science and Technology of China, Hefei 230026,
China
| | - Si-Yu Yang
- Chinese Academy of Sciences Key Laboratory of Urban
Pollutant Conversion, Department of Environmental Science and Engineering,
University of Science and Technology of China, Hefei 230026,
China
| | - Xian-Wei Liu
- Chinese Academy of Sciences Key Laboratory of Urban
Pollutant Conversion, Department of Environmental Science and Engineering,
University of Science and Technology of China, Hefei 230026,
China
- Department of Applied Chemistry,
University of Science and Technology of China, Hefei 230026,
China
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36
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Dargahi A, Jeddi F, Vosoughi M, Karami C, Hadisi A, Ahamad Mokhtari S, Ghobadi H, Alighadri M, Haghighi SB, Sadeghi H. Investigation of SARS CoV-2 virus in environmental surface. Environ Res 2021; 195:110765. [PMID: 33497684 PMCID: PMC7826054 DOI: 10.1016/j.envres.2021.110765] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/16/2021] [Accepted: 01/17/2021] [Indexed: 05/17/2023]
Abstract
The prevalent respiratory viruses such as SARS-CoV-2 probably persist for a long time on fomites and environmental surfaces. Some recent studies have detected SARS-CoV-2 RNA on the surface of cell phones, door handles and other items in the inhabited sites of confirmed cases. For the aim of this study, a total of 50 environmental surface samples of SARS-CoV-2 was collected from Imam Khomeini Hospital in Ardabil. Forty-one environmental surface samples were proved negative for SARS-CoV-2 RNA while nine surface samples were positive. Our findings regarding surfaces contaminated with the virus are consistent with the results of recent similar researches as it was revealed that a number of different samples taken from hospital surfaces such as handles, cupboards, light switches, and door handles were positive for the presence of SARS-Cov-2.
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Affiliation(s)
- Abdollah Dargahi
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Farhad Jeddi
- Department of Genetics and Pathology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Vosoughi
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Chiman Karami
- Department of Microbiology, Parasitology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran; Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Aidin Hadisi
- Department of Microbiology, Parasitology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - S Ahamad Mokhtari
- Department of Environmental Health Engineering, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hasan Ghobadi
- Department of Internal Medicine, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Morteza Alighadri
- Department of Environmental Health Engineering, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Hadi Sadeghi
- Department of Environmental Health Engineering, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
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37
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Onakpoya IJ, Heneghan CJ, Spencer EA, Brassey J, Plüddemann A, Evans DH, Conly JM, Jefferson T. SARS-CoV-2 and the role of fomite transmission: a systematic review. F1000Res 2021; 10:233. [PMID: 34136133 PMCID: PMC8176266 DOI: 10.12688/f1000research.51590.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 11/08/2023] Open
Abstract
Background: SARS-CoV-2 has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission. Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis. Results: We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83). Conclusions: The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures and variation in cycle thresholds create uncertainty about fomites as a mode of transmission. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted.
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Affiliation(s)
- Igho J. Onakpoya
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Carl J. Heneghan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Elizabeth A. Spencer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | | | - Annette Plüddemann
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - David H. Evans
- Department of Medical Microbiology & Immunology, Li Ka Shing Institute of Virology, Alberta, Canada
| | - John M. Conly
- University of Calgary and Alberta Health Services, Calgary, AB T2N 4Z6, Canada
| | - Tom Jefferson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
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38
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Abstract
Background: SARS-CoV-2 RNA has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission. Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis. Results: We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83). Conclusions: The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures suggests that the risk of transmission of SARS-CoV-2 through fomites is low. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted.
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Affiliation(s)
- Igho J. Onakpoya
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Carl J. Heneghan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Elizabeth A. Spencer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | | | - Annette Plüddemann
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - David H. Evans
- Department of Medical Microbiology & Immunology, Li Ka Shing Institute of Virology, Alberta, Canada
| | - John M. Conly
- University of Calgary and Alberta Health Services, Calgary, AB T2N 4Z6, Canada
| | - Tom Jefferson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
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Onakpoya IJ, Heneghan CJ, Spencer EA, Brassey J, Plüddemann A, Evans DH, Conly JM, Jefferson T. SARS-CoV-2 and the role of fomite transmission: a systematic review. F1000Res 2021; 10:233. [PMID: 34136133 PMCID: PMC8176266 DOI: 10.12688/f1000research.51590.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 11/08/2023] Open
Abstract
Background: SARS-CoV-2 RNA has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission. Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis. Results: We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83). Conclusions: The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures suggests that the risk of transmission of SARS-CoV-2 through fomites is low. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted.
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Affiliation(s)
- Igho J. Onakpoya
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Carl J. Heneghan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Elizabeth A. Spencer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | | | - Annette Plüddemann
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - David H. Evans
- Department of Medical Microbiology & Immunology, Li Ka Shing Institute of Virology, Alberta, Canada
| | - John M. Conly
- University of Calgary and Alberta Health Services, Calgary, AB T2N 4Z6, Canada
| | - Tom Jefferson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
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40
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Orenes-Piñero E, Baño F, Navas-Carrillo D, Moreno-Docón A, Marín JM, Misiego R, Ramírez P. Evidences of SARS-CoV-2 virus air transmission indoors using several untouched surfaces: A pilot study. Sci Total Environ 2021; 751:142317. [PMID: 33182011 PMCID: PMC7836800 DOI: 10.1016/j.scitotenv.2020.142317] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 04/13/2023]
Abstract
Nowadays, there is an important controversy about coronavirus air transmission. The aim of this study was to determine aerosol transmission from patients with coronavirus infection using "COVID-19 traps" that included different untouched surfaces within them. 42 swab samples of 6 different surfaces placed in the rooms of 6 patients with a positive diagnostic of COVID-19 were analyzed with RT-PCR technique to evaluate the presence of the virus and its stability. Samples were collected at 24, 48 and 72 h. Patients were in an intensive care unit (ICU) and in a COVID-19 ward unit (CWU) at a Spanish referral hospital. None of the samples placed in the ICU unit were positive for COVID-19. However, two surfaces, placed in a CWU room with a patient that required the use of respiratory assistance were positive for coronavirus at 72 h. Surfaces could not be touched by patients or health workers, so viral spreading was unequivocally produced by air transmission. Thus, fomites should be considered as a possible mode of transmission of coronavirus and frequent disinfection of surfaces should be taken into account. Our results, although preliminary, point the importance of SARS-CoV-2 virus air transmission indoors and may shed some light in this debate.
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Affiliation(s)
- Esteban Orenes-Piñero
- Proteomic Unit, Instituto Murciano de Investigaciones Biosanitarias (IMIB-Arrixaca), Murcia, Spain.
| | - Francisco Baño
- Department of Biochemistry and Molecular Biology-A, University of Murcia, Murcia, Spain
| | | | - Antonio Moreno-Docón
- Department of Virology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Juana María Marín
- Department of Emergencies, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain
| | - Rocío Misiego
- School of Chemical Engineering, Purdue University, West Lafayette, USA
| | - Pablo Ramírez
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain
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Abstract
Over the past 2 decades, in hospital centers worldwide, there have been numerous outbreaks of multidrug-resistant organisms that have since been attributed to endoscopic transmission of the infections between patients, primarily from duodenoscopes. These outbreaks have focused the attention of endoscope manufacturers, professional societies, and regulatory agencies on improving the reprocessing of these devices. The key steps in this process are point-of-use precleaning, leak testing, manual cleaning, high-level disinfection, and finally drying and storage. The promise of these initial efforts suggest that the aim of minimizing and ultimately eliminating events of endoscope-/duodenoscope-associated transmission of infectious organisms between patients can be achieved.
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Affiliation(s)
- Neil B Marya
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 200 UCLA Medical Plaza, Suite 214, Los Angeles, CA 90095, USA
| | - Raman V Muthusamy
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 200 UCLA Medical Plaza, Suite 214, Los Angeles, CA 90095, USA.
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42
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Hajipour N, Moosavy MH, Rostamzadeh B, Hajibemani A. Contamination of coins and banknotes as sources of transmission of parasitic pathogens: a pilot study from Iran. Public Health 2020; 186:116-118. [PMID: 32805663 DOI: 10.1016/j.puhe.2020.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/24/2020] [Accepted: 07/03/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study was conducted to determine the presence, type, and rate of parasitic contamination in Iranian currencies. STUDY DESIGN This was a cross-sectional study. METHODS Coins and banknotes of different denominations were randomly collected from sellers and markets in Tabriz, Northwest of Iran, for examining parasitic contamination. RESULTS Entamoeba coli and Giardia intestinalis were the most identified species of parasites in this study. Other parasites detected were Cryptosporidium parvum, Ascaris lumbricoides, Entamoeba histolytica, Fasciola hepatica, and Toxocara cati. A high rate of parasitic contamination was found in banknotes compared with coins, and a statistically significant association was found between parasitic contamination and the apparent condition of the currencies. The notes of lower denominations showed the highest contamination rates. The highest parasitic contamination was found in coins and banknotes obtained from public toilet services, butchers, and beggars. CONCLUSIONS The findings emphasize the role of circulating coins and banknotes in the risk of pathogenic parasite transmission.
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Affiliation(s)
- N Hajipour
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran.
| | - M H Moosavy
- Department of Food Hygiene and Aquatic, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran.
| | - B Rostamzadeh
- Department of Food Hygiene and Aquatic, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - A Hajibemani
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
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43
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Lei H, Xiao S, Cowling BJ, Li Y. Hand hygiene and surface cleaning should be paired for prevention of fomite transmission. Indoor Air 2020; 30:49-59. [PMID: 31545534 DOI: 10.1111/ina.12606] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/10/2019] [Accepted: 09/19/2019] [Indexed: 05/28/2023]
Abstract
Touching contaminated surfaces might lead to the spread of pathogens, that is, the fomite transmission route. Although hand- and surface-hygiene practices are potentially important non-pharmaceutical interventions for the fomite route, the two interventions have been mostly studied separately in the literature. In this study, we develop a new conceptual model based on the law of mass action, analyze the temporal diffusion of contaminated surfaces and hands, and verify the model with simulations in an assumed norovirus outbreak in a buffet restaurant. A quantitative hygiene criterion is developed for the required frequency of surface disinfection and hand hygiene to control the fomite transmission in indoor environments. To eliminate surface contaminations, the product of pathogen-removal rates (including hygiene and natural death) on hands and surfaces must be no smaller than that of the human hand and surface contact frequency (ie, the net removal product must be non-negative). When the net removal product is negative, the number of contaminated surfaces and hands would show a logistic growth trend and finally approach the equilibrium. Our approach sheds light into how to optimize the combined use of hand hygiene and environmental decontamination for the best effectiveness under different settings.
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Affiliation(s)
- Hao Lei
- School of Public Health, Zhejiang University, Hangzhou, P. R. China
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, P. R. China
| | - Shenglan Xiao
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, P. R. China
| | - Benjamin J Cowling
- School of Public Health, Li Ka Shing, Faculty of Medicine, The University of Hong Kong, Pokfulam, P. R. China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, P. R. China
- School of Public Health, Li Ka Shing, Faculty of Medicine, The University of Hong Kong, Pokfulam, P. R. China
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44
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Zou ZY, Lei L, Chen QY, Wang YQ, Cai C, Li WQ, Zhang Z, Shao B, Wang Y. Prevalence and dissemination risk of antimicrobial-resistant Enterobacteriaceae from shared bikes in Beijing, China. Environ Int 2019; 132:105119. [PMID: 31491607 DOI: 10.1016/j.envint.2019.105119] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/17/2019] [Accepted: 08/22/2019] [Indexed: 06/10/2023]
Abstract
Bike-sharing as a common public transportation has been booming in China in recent years. Previous studies showed that the surfaces of public transport can act as reservoirs of antimicrobial-resistant (AR) bacteria, but AR bacterial contamination of shared bikes has not been investigated. Otherwise, the AR-Enterobacteriaceae is considered as a global health threat for humans. Herein, we aimed to investigate the prevalence of AR Enterobacteriaceae on shared bikes and examine correlations between AR Enterobacteriaceae from shared bikes and public buildings around Metro stations in Beijing. We collected 2117 samples from shared bikes at 240 Metro stations in Beijing. A total of 444 non-duplicate Enterobacteriaceae were isolated from 418 samples at 166 stations. The isolates exhibited low rates of resistance (0.5%-6.3%) to all antimicrobial agents except sulfamethoxazole-trimethoprim (31.5%). Three ceftazidime-resistant E. coli isolates were positive for blaCTX-M-199 and two of them were positive for carbapenemase-producing gene blaNDM-5. Multivariable logistic regression model revealed that variable "secondary/tertiary non-profit hospital nearby" was significantly (p < 0.05) associated with isolation of AR Enterobacteriaceae from the shared bikes around the Metro stations. Low AR rates of Enterobacteriaceae observed in this study suggested the risk of dissemination of AR-Enterobacteriaceae via shared bikes is limited. However, we identified hospitals as a risk factor for the dissemination of AR Enterobacteriaceae among shared bike users. More attention should be paid to both comprehensive hygiene managements in the surrounding environment of hospitals and the increasing of public awareness on the personal hygienic habits.
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Affiliation(s)
- Zhi-Yu Zou
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Lei Lei
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Qi-Yan Chen
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Yong-Qiang Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Microbiology and Immunology Department of Preventive Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Chang Cai
- Research and Innovation Office, Murdoch University, Murdoch, Western Australia 6150, Australia; China Australia Joint Laboratory for Animal Health Big Data Analytics, College of Animal Science and Technology, Zhejiang Agricultural and Forestry University, Hangzhou 311300, China
| | - Wan-Qi Li
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Zan Zhang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Bing Shao
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, Beijing 100013, China.
| | - Yang Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China.
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45
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Abstract
Bronchoscopy is classified as an aerosol-generating procedure, but it is unclear what drives the elevated infection risk observed among healthcare personnel performing the procedure. The objective of this study was to characterize pathways through which bronchoscopists may be exposed to infectious agents during bronchoscopy procedures. Aerosol number concentrations (0.2-1 µm aerodynamic diameter) were measured using a P-Trak Ultrafine Particle Counter 8525 and mass concentrations (<10 µm) were measured using a SidePak Personal Aerosol Monitor AM510 near the head of patients during bronchoscopy procedures. Procedure pathway, number of patient coughs, number of suctioning events, number of contacts with different surfaces by the pulmonologist, and the use and doffing of personal protective equipment were recorded by the investigator on a specially designed form. Any pulmonologist performing a bronchoscopy procedure was eligible to participate. A total of 18 procedures were observed. Mean particle number and mass concentrations were not elevated during procedures relative to those measured before or after the procedure, on average, but the concentrations were highly variable, exhibiting high levels periodically. Patients frequently coughed during procedures (median 65 coughs, range: 0-565 coughs), and suctioning was commonly performed (median 6.5 suctioning events, range: 0-42). In all procedures, pulmonologists contacted the patient (mean 22.3 contacts, range: 1-48), bronchoscope (mean 19.4 contacts, range: 1-46), and at least one environmental surface (mean 31.2 contacts, range: 3-62). In the majority of procedures, the participant contacted his or her body or personal protective equipment (PPE), with a mean of 17.3 contacts (range: 4-48). More often than not, the observed PPE doffing practices differed from those recommended. Bronchoscopy procedures were associated with short-term increased ultrafine or respirable aerosol concentrations, and there were opportunities for contact transmission.
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Affiliation(s)
- Maryshe Zietsman
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Linh T. Phan
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Rachael M. Jones
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
- CONTACT Rachael M. Jones Rocky Mount Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, 391 Chipeta Way, Suite C, Salt Lake City, UT 84108
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46
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Affiliation(s)
- Alison While
- Emeritus Professor of Community Nursing, King's College London, Florence Nightingale Faculty of Nursing and Midwifery and Fellow of the QNI
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47
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Hassan MZ, Sazzad HMS, Luby SP, Sturm-Ramirez K, Bhuiyan MU, Rahman MZ, Islam MM, Ströher U, Sultana S, Kafi MAH, Daszak P, Rahman M, Gurley ES. Nipah Virus Contamination of Hospital Surfaces during Outbreaks, Bangladesh, 2013-2014. Emerg Infect Dis 2018; 24:15-21. [PMID: 29260663 PMCID: PMC5749460 DOI: 10.3201/eid2401.161758] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Nipah virus (NiV) has been transmitted from patient to caregivers in Bangladesh presumably through oral secretions. We aimed to detect whether NiV-infected patients contaminate hospital surfaces with the virus. During December 2013–April 2014, we collected 1 swab sample from 5 surfaces near NiV-infected patients and tested surface and oral swab samples by real-time reverse transcription PCR for NiV RNA. We identified 16 Nipah patients; 12 cases were laboratory-confirmed and 4 probable. Of the 12 laboratory-confirmed cases, 10 showed NiV RNA in oral swab specimens. We obtained surface swab samples for 6 Nipah patients; 5 had evidence of NiV RNA on >1 surface: 4 patients contaminated towels, 3 bed sheets, and 1 the bed rail. Patients with NiV RNA in oral swab samples were significantly more likely than other Nipah patients to die. To reduce the risk for fomite transmission of NiV, infection control should target hospital surfaces.
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48
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Chabrelie A, Mitchell J, Rose J, Charbonneau D, Ishida Y. Evaluation of the Influenza Risk Reduction from Antimicrobial Spray Application on Porous Surfaces. Risk Anal 2018; 38:1502-1517. [PMID: 29278668 DOI: 10.1111/risa.12952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 04/14/2017] [Accepted: 11/16/2017] [Indexed: 05/04/2023]
Abstract
Antimicrobial spray products are used by millions of people around the world for cleaning and disinfection of commonly touched surfaces. Influenza A is a pathogen of major concern, leading to up to 49,000 deaths and 114,000 hospitalizations per year in the United States alone. One of the recognized routes of transmission for influenza A is by transfer of viruses from surfaces to hands and subsequently to mucous membranes. Therefore, routine cleaning and disinfection of surfaces is an important part of the environmental management of influenza A. While the emphasis is generally on spraying hard surfaces and laundering cloth and linens with high temperature machine drying, not all surfaces can be treated in this manner. The quantitative microbial risk assessment (QMRA) approach was used to develop a stochastic risk model for estimating the risk of infection from indirect contact with porous fomite with and without surface treatment with an antimicrobial spray. The data collected from laboratory analysis combined with the risk model show that influenza A infection risk can be lowered by four logs after using an antimicrobial spray on a porous surface. Median risk associated with a single touch to a contaminated fabric was estimated to be 1.25 × 10-4 for the untreated surface, and 3.6 × 10-8 for the treated surface as a base case assumption. This single touch scenario was used to develop a generalizable model for estimating risks and comparing scenarios with and without treatment to more realistic multiple touch scenarios over time periods and with contact rates previously reported in the literature. The results of this study and understanding of product efficacy on risk reduction inform and broaden the range of risk management strategies for influenza A by demonstrating effective risk reduction associated with treating nonporous fomites that cannot be laundered at high temperatures.
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Affiliation(s)
- Alexandre Chabrelie
- Department of Biosystem and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
| | - Jade Mitchell
- Department of Biosystem and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
| | - Joan Rose
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
| | | | - Yoshiki Ishida
- Procter & Gamble International Operations S.A., Singapore Branch, Singapore
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49
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Das A, Conti J, Hanrahan J, Kaelber DC. Comparison of keyboard colonization before and after use in an inpatient setting and the effect of keyboard covers. Am J Infect Control 2018; 46:474-476. [PMID: 29129271 DOI: 10.1016/j.ajic.2017.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/06/2017] [Accepted: 09/07/2017] [Indexed: 11/19/2022]
Abstract
Computer keyboards may contribute to patient infections. We cultured new keyboards, with/without keyboard covers, before placing them in adult inpatient rooms and recultured after 6 months. Nonpathogenic bacteria were present initially but potentially pathogenic bacteria were cultured only after use. Coagulase negative Staphylococcus colonization increased after use (P < .001). Keyboards with a cover had more potentially pathogenic bacteria (22% vs 16%), which although not significant statistically (P = .72), likely due to sample size, trended against covers offering protection.
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Affiliation(s)
- Anirudha Das
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH; Center for Clinical Informatics Research and Education, The MetroHealth System, Case Western Reserve University, Cleveland, OH
| | - Jennifer Conti
- The Center for Quality, The MetroHealth System, Cleveland, OH
| | - Jennifer Hanrahan
- The Center for Quality, The MetroHealth System, Cleveland, OH; Department of Internal Medicine, The MetroHealth System, Case Western Reserve University, Cleveland, OH
| | - David C Kaelber
- Center for Clinical Informatics Research and Education, The MetroHealth System, Case Western Reserve University, Cleveland, OH; Department of Internal Medicine, The MetroHealth System, Case Western Reserve University, Cleveland, OH; Department of Pediatrics, The MetroHealth System, Case Western Reserve University, Cleveland, OH; Department of Population and Quantitative Health Sciences, The MetroHealth System, Case Western Reserve University, Cleveland, OH.
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50
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Xiao S, Tang JW, Li Y. Airborne or Fomite Transmission for Norovirus? A Case Study Revisited. Int J Environ Res Public Health 2017; 14:ijerph14121571. [PMID: 29240665 PMCID: PMC5750989 DOI: 10.3390/ijerph14121571] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/10/2017] [Accepted: 12/12/2017] [Indexed: 01/03/2023]
Abstract
Norovirus infection, a highly prevalent condition associated with a high rate of morbidity, comprises a significant health issue. Although norovirus transmission mainly occurs via the fecal-oral and vomit-oral routes, airborne transmission has been proposed in recent decades. This paper re-examines a previously described norovirus outbreak in a hotel restaurant wherein airborne transmission was originally inferred. Specifically, the original evidence that suggested airborne transmission was re-analyzed by exploring an alternative hypothesis: could this outbreak instead have occurred via fomite transmission? This re-analysis was based on whether fomite transmission could have yielded similar attack rate distribution patterns. Seven representative serving pathways used by waiters were considered, and the infection risk distributions of the alternative fomite transmission routes were predicted using a multi-agent model. These distributions were compared to the reported attack rate distribution in the original study using a least square methods approach. The results show that with some reasonable assumptions of human behavior patterns and parameter values, the attack rate distribution corresponded well with that of the infection risk via the fomite route. This finding offers an alternative interpretation of the transmission routes that underlay this particular norovirus outbreak and an important consideration in the development of infection control guidelines and the investigation of similar norovirus outbreaks in future.
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Affiliation(s)
- Shenglan Xiao
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China.
| | - Julian W Tang
- Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester LE1 7RH, UK.
- Infection, Immunity, Inflammation, University of Leicester, Leicester LE1 7RH, UK.
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China.
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