Efficacy of common disinfectant/cleaning agents in inactivating murine norovirus and feline calicivirus as surrogate viruses for human norovirus

Outbreaks of nosocomial feline calicivirus-associated virulent systemic disease in Korea

IMPORTANCE

Feline calicivirus (FCV)-associated viral systemic disease (VSD) is a severe systemic disease caused by virulent FCV strains and has a very poor prognosis.

OBJECTIVE

To evaluate the clinical characteristics of a nosocomial FCV-VSD outbreak involving 18 cats in Korea.

METHODS

Medical records of cats diagnosed with FCV-VSD from March to September 2018 at a referral veterinary hospital were reviewed. The patient's signalment, history, clinical features, diagnosis, treatment, and prognosis were evaluated.

RESULTS

Two outbreaks involving 18 cats diagnosed with FCV-VSD occurred over a 6-month period at a referral hospital in Korea. Anorexia, lethargy, fever, and limb edema were the most commonly observed clinical symptoms. Lymphopenia and macrothrombocytopenia were the most common hematological findings, and hyperbilirubinemia and increased levels of aspartate aminotransferase, creatine kinase, and serum amyloid A were the most frequent results of serum biochemistry. FCV was detected by reverse transcription polymerase chain reaction in 11 patients and the remaining 7 were suspected with FCV-VSD. The overall mortality rate was 72.2%. The hospital was closed and disinfected twice, and no additional outbreaks have occurred since the last patient.

CONCLUSIONS AND RELEVANCE

The clinical and diagnostic characteristics and outcomes of FCV-VSD described in this study can be used to recognize and contain infectious diseases through quick action. To the best of the authors' knowledge, this is the first report of a nosocomial outbreak of FCV-VSD in Asia.

Epidemiological Surveillance of Respiratory Diseases in Urban Stray Cats in Shanghai

Urban stray cats are cats without owners that survive in the wild for extended periods of time. They are one of the most common stray animals in cities, and as such, monitoring the pathogens carried by urban stray cats is an important component of urban epidemiological surveillance. In order to understand the prevalence of respiratory diseases in urban stray cats in Shanghai and provide scientific evidence for the development of targeted prevention and control strategies for respiratory diseases in stray cats, we collected 374 ocular, nasal, and oropharyngeal swabs from urban stray cats in Shanghai from January 2022 to December 2022. After RNA extraction, we used real-time PCR to detect six respiratory pathogens, including influenza A virus, feline calicivirus, feline herpesvirus type 1, Mycoplasma, Chlamydia, and Bordetella bronchiseptica. The results showed that among the 374 samples, 146 tested positive, with a positivity rate of 39.04%. The highest positivity rate was observed for Mycoplasma felis at 18.72% (70/374), followed by Chlamydia felis at 11.76% (44/374), feline calicivirus at 3.74% (14/374), feline herpesvirus 1 at 3.48% (13/374), Bordetella bronchiseptica at 1.34% (5/374), and influenza A virus was not detected. The highest positivity rate for Mycoplasma felis was in Minhang District at 31.94% (23/72), while Chlamydia felis and Bordetella bronchiseptica had the highest positivity rates in Jiading District at 23.53% (8/34) and 5.88% (2/34), respectively. The highest positivity rates for feline calicivirus and feline herpesvirus 1 were both observed in Qingpu District, at 14.46% (12/83) and 9.64% (8/83), respectively. A total of 36 samples showed mixed infections with two or more pathogens, with Mycoplasma felis being involved in 32 of these mixed infections, with the highest number of mixed infections being with Chlamydia felis at 25 samples. Respiratory pathogen positivity was detected throughout the year, with peak detection rates in summer and winter. The positivity rates of cat respiratory pathogens in different seasons showed statistical differences (χ2 = 27.73, p < 0.01). There was no statistical difference in the positivity rates of respiratory pathogens between cats of different genders (χ2 = 0.92, p > 0.05). The positivity rates of respiratory pathogens in cats of different age groups showed statistical differences (χ2 = 44.41, p < 0.01). Mycoplasma felis and Chlamydia felis were the main pathogens causing respiratory infections in stray cats, with Mycoplasma felis showing a much higher positivity rate than other respiratory pathogens and often co-infecting with Chlamydia felis and feline calicivirus. The positivity rate of Mycoplasma felis was high in summer, autumn, and winter, with no statistical difference between seasons. These results indicate a serious overall prevalence of respiratory pathogens in urban stray cats in the Shanghai area, showing seasonal trends and mixed infections with other pathogens. These findings suggest the need for comprehensive prevention and control measures to address respiratory pathogen infections in urban stray cats in the Shanghai area.

Update on feline calicivirus: viral evolution, pathogenesis, epidemiology, prevention and control

Feline calicivirus (FCV) is a prevalent and impactful viral pathogen affecting domestic cats. As an RNA virus, FCV exhibits high mutability and genetic plasticity, enabling its persistence within cat populations. Viral genetic diversity is associated with a broad spectrum of clinical manifestations, ranging from asymptomatic infections and mild oral and upper respiratory tract diseases to the potential development of virulent systemic, and even fatal conditions. This diversity poses distinctive challenges in diagnosis, treatment, and prevention of diseases caused by FCV. Over the past four decades, research has significantly deepened understanding of this pathogen, with an emphasis on molecular biology, evolutionary dynamics, vaccine development, and disease management strategies. This review discusses various facets of FCV, including its genomic structure, evolution, innate immunity, pathogenesis, epidemiology, and approaches to disease management. FCV remains a complex and evolving concern in feline health, requiring continuous research to enhance understanding of its genetic diversity, to improve vaccine efficacy, and to explore novel treatment options.

Virucidal Activity of Lemon Essential Oil against Feline Calicivirus Used as Surrogate for Norovirus

Norovirus (NoV) is regarded as a common cause of acute gastrointestinal illness worldwide in all age groups, with substantial morbidity across health care and community settings. The lack of in vitro cell culture systems for human NoV has prompted the use of cultivatable caliciviruses (such as feline calicivirus, FCV, or murine NoV) as surrogates for in vitro evaluation of antivirals. Essential oils (EOs) may represent a valid tool to counteract viral infections, particularly as food preservatives. In the present study, the virucidal efficacy of lemon EO (LEO) against FCV was assessed in vitro. The gas chromatography hyphenated with mass spectrometry (GC/MS) technique was used to reveal the chemical composition of LEO. The following small molecules were detected as major components of LEO: limonene (53%), β-pinene (14.5%), γ-terpinene (5.9%), citral (3.8%), α-pinene (2.4%), and β-thujene (1.94%). LEO at 302.0 μg/mL, exceeding the maximum non cytotoxic limit, significantly decreased viral titre of 0.75 log₁₀ TCID50/50 μL after 8 h. Moreover, virucidal activity was tested using LEO at 3020.00 μg/mL, determining a reduction of viral titre as high as 1.25 log₁₀ TCID50/50 μL after 8 h of time contact. These results open up perspectives for the development of alternative prophylaxis approaches for the control of NoV infection.

Calicivirus Infection in Cats

Feline calicivirus (FCV) is a common pathogen in domestic cats that is highly contagious, resistant to many disinfectants and demonstrates a high genetic variability. FCV infection can lead to serious or even fatal diseases. In this review, the European Advisory Board on Cat Diseases (ABCD), a scientifically independent board of experts in feline medicine from 11 European countries, presents the current knowledge of FCV infection and fills gaps with expert opinions. FCV infections are particularly problematic in multicat environments. FCV-infected cats often show painful erosions in the mouth and mild upper respiratory disease and, particularly in kittens, even fatal pneumonia. However, infection can be associated with chronic gingivostomatitis. Rarely, highly virulent FCV variants can induce severe systemic disease with epizootic spread and high mortality. FCV can best be detected by reverse-transcriptase PCR. However, a negative result does not rule out FCV infection and healthy cats can test positive. All cats should be vaccinated against FCV (core vaccine); however, vaccination protects cats from disease but not from infection. Considering the high variability of FCV, changing to different vaccine strain(s) may be of benefit if disease occurs in fully vaccinated cats. Infection-induced immunity is not life-long and does not protect against all strains; therefore, vaccination of cats that have recovered from caliciviral disease is recommended.

A systematic review of chlorine-based surface disinfection efficacy to inform recommendations for low-resource outbreak settings

BACKGROUND

Infectious diseases can be transmitted via fomites (contaminated surfaces/objects); disinfection can interrupt this transmission route. However, disinfection guidelines for low-resource outbreak settings are inconsistent and not evidence-based.

METHODS

A systematic review of surface disinfection efficacy studies was conducted to inform low-resource outbreak guideline development. Due to variation in experimental procedures, outcomes were synthesized in a narrative summary focusing on chlorine-based disinfection against 7 pathogens with potential to produce outbreaks in low-resource settings (Mycobacterium tuberculosis, Vibrio cholerae, Salmonella spp., hepatitis A virus, rotavirus, norovirus, and Ebola virus).

RESULTS

Data were extracted from 89 laboratory studies and made available, including 20 studies on relevant pathogens used in combination with surrogate data to determine minimum target concentration × time ("CT") factors. Stainless steel (68%) and chlorine-based disinfectants (56%) were most commonly tested. No consistent trend was seen in the influence of chlorine concentration and exposure time on disinfection efficacy. Disinfectant application mode; soil load; and surface type were frequently identified as influential factors in included studies.

CONCLUSIONS

This review highlights that surface disinfection efficacy estimates are strongly influenced by each study's experimental conditions. We therefore recommend laboratory testing to be followed by field-based testing/monitoring to ensure effectiveness is achieved in situ.

Concerns and strategies for wastewater treatment during COVID-19 pandemic to stop plausible transmission

Along with outbreak of the pandemic COVID-19 caused by SARS-CoV-2, the problem of biomedical wastewater disposal has caused widespread public concern, as reportedly the presence is confirmed in wastewater. Keeping in mind (i) available evidence indicating need to better understand potential of wastewater mediated transmission and (ii) knowledge gaps in its occurrence, viability, persistence, and inactivation in wastewater, in this present work, we wanted to re-emphasize some strategies for management of SARS-CoV-2 contaminated wastewater to minimise any possible secondary transmission to human and environment. The immediate challenges to consider while considering wastewater management are uncertainty about this new biothreat, relying on prediction based treatments options, significant population being the latent asymptomatic carrier increased risk of passing out of the virus to sewage network, inadequacy of wastewater treatment facility particularly in populated developing countries and increased generation of wastewater due to increased cleanliness concern. In absence of regulated central treatment facility, installation of decentralized wastewater treatment units with single or multiple disinfection barriers in medical units, quarantine centre, isolation wards, testing facilities seems to be urgent for minimizing any potential risk of wastewater transmission. Employing some emerging disinfectants (peracetic acid, performic acid, sodium dichloro isocyanurate, chloramines, chlorine dioxide, benzalconium chloride) shows prospects in terms of virucidal properties. However, there is need of additional research on coronaviruses specific disinfection data generation, regular monitoring of performance considering all factors influencing virus survival, performance evaluation in actual water treatment, need of augmenting disinfection dosages, environmental considerations to select the most appropriate disinfection technology.

Sanitizing agents for virus inactivation and disinfection

Viral epidemics develop from the emergence of new variants of infectious viruses. The lack of effective antiviral treatments for the new viral infections coupled with rapid community spread of the infection often result in major human and financial loss. Viral transmissions can occur via close human-to-human contact or via contacting a contaminated surface. Thus, careful disinfection or sanitization is essential to curtail viral spread. A myriad of disinfectants/sanitizing agents/biocidal agents are available that can inactivate viruses, but their effectiveness is dependent upon many factors such as concentration of agent, reaction time, temperature, and organic load. In this work, we review common commercially available disinfectants agents available on the market and evaluate their effectiveness under various application conditions. In addition, this work also seeks to debunk common myths about viral inactivation and highlight new exciting advances in the development of potential sanitizing agents.

Ozone efficacy for the control of airborne viruses: Bacteriophage and norovirus models

This study was designed to test the efficacy of an air treatment using ozone and relative humidity (RH) for the inactivation of airborne viruses. Four phages (φX174, PR772, MS2 and φ6) and one eukaryotic virus (murine norovirus MNV-1) were exposed to low ozone concentrations (1.23 ppm for phages and 0.23 ppm for MNV-1) and various levels of RH for 10 to 70 minutes. The inactivation of these viruses was then assessed to determine which of the tested conditions provided the greatest reduction in virus infectivity. An inactivation of at least two orders of magnitude for φX174, MS2 and MNV-1 was achieved with an ozone exposure of 40 minutes at 85% RH. For PR772 and φ6, exposure to the reference condition at 20% RH for 10 minutes yielded the same results. These findings suggest that ozone used at a low concentration is a powerful disinfectant for airborne viruses when combined with a high RH. Air treatment could therefore be implemented inside hospital rooms ventilated naturally.

Inactivation of Non-Enveloped Viruses and Bacteria by an Electrically Charged Disinfectant Containing Meso-Structure Nanoparticles via Modification of the Genome

INTRODUCTION

A previous study demonstrated the virucidal effect of an electrically charged disinfectant (CAC-717), which contains meso-structure nanoparticles, on enveloped viruses (influenza viruses). However, the effect of CAC-717 on other microorganisms and the mechanisms by which CAC-717 inactivates the microorganisms remain unclear. In this study, CAC-717 was further evaluated in terms of its biocidal and virucidal activity as well as its effect on bacterial and viral nucleic acids.

METHODS

The inactivation effects of CAC-717 against various microorganisms [non-enveloped virus, feline calicivirus (FCV); bacteria, Salmonella enterica and Escherichia coli] were investigated by comparing the viral titer of the medium tissue culture infectious dose (TCID50) and the D value (estimated treatment time required to reduce the number of microorganisms by 90%). Furthermore, the effects of CAC-717 on viral and bacterial genomic RNA/DNA were examined using a polymerase chain reaction (PCR).

RESULTS

Treatment of an equal volume of CAC-717 with cell lysate infected with a non-enveloped virus, feline calicivirus (FCV), reduced the TCID50. Viral titer dropped below the detection limit after 2 min of treatment. The D value of FCV was 0.256 min (average of multiple endpoint D values) and endpoint D value was 0.341 min. The D value for E. coli and S. enterica was 0.290 min and 0.080 min (average of multiple endpoint D values), respectively and the endpoint D value was 0.545 min and 0.054 min, respectively. In addition, PCR showed the inhibition of nucleic acid amplification of the RNA and DNA genome of FCV and bacteria, respectively.

CONCLUSION

Our findings suggest that CAC-717 inactivates viruses and bacteria by modifying the viral and bacterial nucleic acids.

Efficient inactivation of pseudotyped HIV-based lentiviral vectors and infectious HIV

Lentiviral vectors and lentiviruses are important tools for basic and applied biomedical research. Yet, biosafety regulations from legal authorities have to be fulfilled when transferring BSL-2 to -3 vectors/viruses to facilities with lower biosafety level. Here, we (re-)evaluated different chemical and thermal approaches to inactivate vesicular stomatitis virus G-protein (VSV-G) pseudotyped lentiviral vectors and either wildtype or VSV-G pseudotyped human immunodeficiency viruses (HIV). Aldehydes, detergents and alcohols were as effective as thermal inactivation procedures to efficiently inactivate purified lentiviral vectors and replication-competent HIV. In addition, no residual infectivity was detected when inactivating HIV-infected TZM-bl reporter cells with selected detergents and aldehydes. Thus, our established inactivation protocols can be used by other laboratories working with lentiviral vectors or infectious lentiviruses and provide a template for viruses with similar physicochemical properties.

Efficacy of Silver Dihydrogen Citrate and Steam Vapor against a Human Norovirus Surrogate, Feline Calicivirus, in Suspension, on Glass, and on Carpet

Carpets and other soft surfaces have been associated with prolonged and reoccurring human norovirus (HuNoV) outbreaks. Environmental hygiene programs are important to prevent and control HuNoV outbreaks. Despite our knowledge of HuNoV transmission via soft surfaces, no commercially available disinfectants have been evaluated on carpets. Our aim was to adapt a current standardized method for virucidal testing by assessing two disinfection technologies, silver dihydrogen citrate (SDC) and steam vapor, against one HuNoV surrogate, feline calicivirus (FCV), on wool and nylon carpets. First, we evaluated the effect of both technologies on the appearance of carpet. Next, we evaluated the efficacy of SDC in suspension and the efficacy of SDC and steam vapor against FCV on a glass surface, each with and without serum. Lastly, we tested both technologies on two types of carpet, wool and nylon. Both carpets exhibited no obvious color changes; however, SDC treatments left a residue while steam vapor left minor abrasions to fibers. SDC in suspension and on glass reduced FCV by 4.65 log10 and >4.66 log10 PFU, respectively, but demonstrated reduced efficacy in the presence of serum. However, SDC was only efficacious against FCV on nylon (3.62-log10 PFU reduction) and not wool (1.82-log10 PFU reduction). Steam vapor reduced FCV by >4.93 log10 PFU on glass in 10 s and >3.68 log10 PFU on wool and nylon carpet carriers in 90 s. There was a limited reduction of FCV RNA under both treatments compared to that of infectivity assays, but RNA reductions were higher in samples that contained serum.IMPORTANCE Human noroviruses (HuNoV) account for ca. 20% of all diarrheal cases worldwide. Disease symptoms may include diarrhea and vomit, with both known to contribute to transmission. The prevention and control of HuNoV are difficult because they are environmentally resilient and resistant to many disinfectants. Several field studies have linked both hard and soft surfaces to HuNoV outbreaks. However, many disinfectants efficacious against HuNoV surrogates are recommended for hard surfaces, but no commercially available products have demonstrated efficacy against these surrogates on soft surfaces. Our research objectives were to evaluate liquid and steam-based technologies in suspension and on hard surface carriers in addition to adapting and testing a protocol for assessing the virucidal effects of disinfection technologies on carpet carriers. These results will inform both the government and industry regarding a standard method for evaluating the virucidal effects of disinfectants on carpet while demonstrating their efficacy relative to suspension and hard-surface tests.

Quantitative Risk Assessment of Norovirus Transmission in Food Establishments: Evaluating the Impact of Intervention Strategies and Food Employee Behavior on the Risk Associated with Norovirus in Foods

We developed a quantitative risk assessment model using a discrete event framework to quantify and study the risk associated with norovirus transmission to consumers through food contaminated by infected food employees in a retail food setting. This study focused on the impact of ill food workers experiencing symptoms of diarrhea and vomiting and potential control measures for the transmission of norovirus to foods. The model examined the behavior of food employees regarding exclusion from work while ill and after symptom resolution and preventive measures limiting food contamination during preparation. The mean numbers of infected customers estimated for 21 scenarios were compared to the estimate for a baseline scenario representing current practices. Results show that prevention strategies examined could not prevent norovirus transmission to food when a symptomatic employee was present in the food establishment. Compliance with exclusion from work of symptomatic food employees is thus critical, with an estimated range of 75-226% of the baseline mean for full to no compliance, respectively. Results also suggest that efficient handwashing, handwashing frequency associated with gloving compliance, and elimination of contact between hands, faucets, and door handles in restrooms reduced the mean number of infected customers to 58%, 62%, and 75% of the baseline, respectively. This study provides quantitative data to evaluate the relative efficacy of policy and practices at retail to reduce norovirus illnesses and provides new insights into the interactions and interplay of prevention strategies and compliance in reducing transmission of foodborne norovirus.

Virucidal efficacy of food additive grade calcium hydroxide against surrogate of human norovirus

An alkaline agent, namely, food additive grade calcium hydroxide (FdCa(OH)₂) in the solution, powder and suspension forms was evaluated as a virucidal agent, using a murine norovirus (MNV) as the surrogate for human norovirus. The main constituent of FdCa(OH)₂ is Ca(OH)₂, which has pH 13 in 0.17% solution. The results showed that 0.17% FdCa(OH)₂ solution could inactivate MNV within 30s even in the presence of organic materials (5% fetal bovine serum (FBS)). In a contaminated surface experiment, MNV with 5% FBS was inoculated on rayon sheets, and the result showed FdCa(OH)₂ solution could markedly reduce virus titer within 1min. When mouse feces were spiked with MNV and FdCa(OH)₂ powder as 10% and 20% w/w was added to the feces, these concentrations could inactivate the virus within 30min and 15min, respectively. Whereas, FdCa(OH)₂ suspension at 2.5% and 5% could inactivate the virus within 30min and at 1% within 45min. These and additional results obtained here indicate that FdCa(OH)₂ is an effective virucidal agent against MNV, and can serve as a useful alternative disinfectant for inactivation and prevention of human norovirus in house and hospital.

Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals

Experts agree that careful cleaning and disinfection of environmental surfaces are essential elements of effective infection prevention programs. However, traditional manual cleaning and disinfection practices in hospitals are often suboptimal. This is often due in part to a variety of personnel issues that many Environmental Services departments encounter. Failure to follow manufacturer’s recommendations for disinfectant use and lack of antimicrobial activity of some disinfectants against healthcare-associated pathogens may also affect the efficacy of disinfection practices.

Improved hydrogen peroxide-based liquid surface disinfectants and a combination product containing peracetic acid and hydrogen peroxide are effective alternatives to disinfectants currently in widespread use, and electrolyzed water (hypochlorous acid) and cold atmospheric pressure plasma show potential for use in hospitals. Creating “self-disinfecting” surfaces by coating medical equipment with metals such as copper or silver, or applying liquid compounds that have persistent antimicrobial activity surfaces are additional strategies that require further investigation.

Newer “no-touch” (automated) decontamination technologies include aerosol and vaporized hydrogen peroxide, mobile devices that emit continuous ultraviolet (UV-C) light, a pulsed-xenon UV light system, and use of high-intensity narrow-spectrum (405 nm) light. These “no-touch” technologies have been shown to reduce bacterial contamination of surfaces. A micro-condensation hydrogen peroxide system has been associated in multiple studies with reductions in healthcare-associated colonization or infection, while there is more limited evidence of infection reduction by the pulsed-xenon system. A recently completed prospective, randomized controlled trial of continuous UV-C light should help determine the extent to which this technology can reduce healthcare-associated colonization and infections.

In conclusion, continued efforts to improve traditional manual disinfection of surfaces are needed. In addition, Environmental Services departments should consider the use of newer disinfectants and no-touch decontamination technologies to improve disinfection of surfaces in healthcare.

Nosocomial feline calicivirus-associated virulent systemic disease in a veterinary emergency and critical care unit in France

CASE SERIES SUMMARY

In October 2011, an abnormally large morbidity and mortality event was noted in the intensive care unit (ICU) of a veterinary school hospital in Nantes, France. Cats, and cats only, transferred from the emergency room presented with fever, ulcers on the tongue and cutaneous lesions around venepuncture or surgical incision sites, leading to suspicion of a feline calicivirus-associated virulent systemic disease confirmed with reverse transcriptase-polymerase chain reaction. A total of 14 cats were suspected. The clinical features and the origin of the contamination were described for each cat. The median length of incubation was 4.5 days. Fifty-seven percent of the cats were euthanased (8/14) and 21% died (3/14), with a combined mortality of 79% (11/14) - the highest ever reported. Median survival was 12 days. The recovery rate was 21% (3/14).

RELEVANCE AND NOVEL INFORMATION

Eight outbreaks have been reported, in veterinary clinics or in group-housed cats. The main unusual aspects of the present outbreak were: (1) the extreme flare-up of lesions at sites of skin breach, precluding any puncture/incision; (2) the suggested better survival rate at home than in hospital; and (3) the immediate control of the outbreak after recognition of the disease. Other striking but less unusual features of this outbreak were: (4) the increasing of the virulence of the calicivirus with the passage of time; and (5) the primary role that the caregivers' hands played in the spread of the outbreak.