Virus Transfer at the Skin-Liquid Interface

Removal of virus from hands: a study on the role of washing and drying

BACKGROUND

Proper hand hygiene is extremely important to control the transmission of pathogens. Although many studies have been undertaken on the effect of washing and drying on bacterial contamination of hands, studies on viral contamination are scarce.

AIM

To assess the viral load of artificially contaminated hands after washing and after drying.

METHODS

Thirty volunteers completed a questionnaire on hand hygiene, and participated in microbial assays testing five different drying approaches, using whole-hand methodology, to quantify viruses on hands. Bacterial assays were also performed for comparison purposes.

RESULTS

For both viruses and bacteria, the washing step promoted a significant reduction in the microbial load, while the drying step only promoted a slight reduction, regardless of the drying method used. Hand dryers and paper towels did not induce recontamination of washed hands.

CONCLUSIONS

Handwashing promoted a reduction in the microbial load of hands, but none of the drying methods tested led to a significant reduction in the microbial load of hands.

Decay pattern of SARS-CoV-2 RNA surface contamination in real residences

The COVID-19 pandemic has provided valuable lessons that deserve deep thought to prepare for the future. The decay pattern of surface contamination by SARS-CoV-2 RNA in the residences of COVID-19 patients is important but still unknown. We collected 2,233 surface samples from 21 categories of objects in 141 residences of COVID-19 patients in Shanghai when attacked by the omicron variant in spring 2022. Several characteristics of the patients and their residences were investigated to identify relevant associations. The decay of contamination was explored to determine the persistence. Approximately 8.7% of the surface samples were tested positive for SARS-CoV-2 RNA. The basin, water tap, and sewer inlet had the highest positive rates, all exceeding 20%. Only time was significantly associated with the level of surface contamination with SARS-CoV-2, showing a negative association. The decrease fit a first-order decay model with a decay rate of 0.77 ± 0.07 day-1, suggesting a 90% reduction in three days. Positive associations between the cumulative number of newly diagnosed patients in the same building and the positive rate of SARS-CoV-2 RNA in the public corridor were significant during the three days. Our results, in conjunction with the likely lower infectivity or viability, demonstrate that fomite transmission played a limited role in COVID-19 spread. The time determined SARS-CoV-2 RNA contamination, which was reduced by three days. This study is the first to show the decay patterns of SARS-CoV-2 contamination in real residential environments, providing insight into the patterns of transmission, as well as community-based prevention and control of similar threats.

Viral-Bacterial Interactions That Impact Viral Thermostability and Transmission

Enteric viruses are significant human pathogens that commonly cause foodborne illnesses worldwide. These viruses initiate infection in the gastrointestinal tract, home to a diverse population of intestinal bacteria. In a novel paradigm, data indicate that enteric viruses utilize intestinal bacteria to promote viral replication and pathogenesis. While mechanisms underlying these observations are not fully understood, data suggest that some enteric viruses bind directly to bacteria, stabilizing the virion to retain infectivity. Here, we discuss the current knowledge of these viral-bacterial interactions and examine the impact of these interactions on viral transmission.

Persistence of SARS-CoV-2 and its surrogate, bacteriophage Phi6, on surfaces and in water

IMPORTANCE

The COVID-19 pandemic spurred research on the persistence of SARS-CoV-2 and its surrogates. Here we highlight the importance of evaluating viral surrogates and experimental methodologies when studying pathogen survival in the environment.

Virus on surfaces: Chemical mechanism, influence factors, disinfection strategies, and implications for virus repelling surface design

While SARS-CoV-2 is generally under control, the question of variants and infections still persists. Fundamental information on how the virus interacts with inanimate surfaces commonly found in our daily life and when in contact with the skin will be helpful in developing strategies to inhibit the spread of the virus. Here in, a critically important review of current understanding of the interaction between virus and surface is summarized from chemistry point-of-view. The Derjaguin-Landau-Verwey-Overbeek and extended Derjaguin-Landau-Verwey-Overbeek theories to model virus attachments on surfaces are introduced, along with the interaction type and strength, and quantification of each component. The virus survival and transfer are affected by a combination of biological, physical, and chemical parameters, as well as environmental parameters. The surface properties for virus and virus survival on typical surfaces such as metals, plastics, and glass are summarized. Attention is also paid to the transfer of virus to/from surfaces and skin. Typical virus disinfection strategies utilizing heat, light, chemicals, and ozone are discussed together with their disinfection mechanism. In the last section, design principles for virus repelling surface chemistry such as surperhydrophobic or surperhydrophilic surfaces are also introduced, to demonstrate how the integration of surface property control and advanced material fabrication can lead to the development of functional surfaces for mitigating the effect of viral infection upon contact.

Environmental Stability and Transmissibility of Enveloped Viruses at Varied Animate and Inanimate Interfaces

Enveloped viruses have been the leading causative agents of viral epidemics in the past decade, including the ongoing coronavirus disease 2019 outbreak. In epidemics caused by enveloped viruses, direct contact is a common route of infection, while indirect transmissions through the environment also contribute to the spread of the disease, although their significance remains controversial. Bridging the knowledge gap regarding the influence of interfacial interactions on the persistence of enveloped viruses in the environment reveals the transmission mechanisms when the virus undergoes mutations and prevents excessive disinfection during viral epidemics. Herein, from the perspective of the driving force, partition efficiency, and viral survivability at interfaces, we summarize the viral and environmental characteristics that affect the environmental transmission of viruses. We expect to provide insights for virus detection, environmental surveillance, and disinfection to limit the spread of severe acute respiratory syndrome coronavirus 2.

Simulation of contamination and elimination of Escherichia coli, Listeria monocytogenes, and Murine norovirus 1 (MNV-1) from the washing process when handling of potatoes

Root vegetables, which are in close contact with soil, are particularly vulnerable to soil contamination or decay as they can be contaminated from multiple sources, including primary production and processing. This study investigated effective washing conditions to reduce the microbial contamination of potatoes by using soaking and shaking in the washing process. The reduction of Escherichia coli, Listeria monocytogenes, and Murine norovirus 1 (MNV-1) in four washing processes (soaking only, shaking only, combined soaking-shaking I, and combined soaking-shaking I-shaking II) were compared. The numbers of E. coli and L. monocytogenes decreased by 0.55 and 0.49 log CFU/g after shaking only, 1.96 and 1.80 log CFU/g after soaking, 2.07 and 1.67 log CFU/g after soaking-shaking I, and 2.42 and 1.90 log CFU/g after soaking-shaking I-shaking II, respectively. The combined process reduced the microbial contamination more efficiently than shaking only. The reduction of E. coli in the washing process was higher than that of L. monocytogenes by approximately 0.5 logs. MNV-1 showed a reduction in the soaking and shaking steps by 1.34 and 1.98 log GC/100 g, with no significant reduction observed after the combination process. A combined process of soaking-shaking I-shaking II was effective to eliminate E. coli, L. monocytogenes, and MNV-1 from potatoes during the handling and washing process.

Transfer of Phi6 Bacteriophage Between Human Skin and Surfaces Common to Consumer-Facing Environments

AIMS

This study aimed to determine the extent of Phi6 (Φ6) transfer between skin and surfaces relevant to consumer-facing environments based on inoculum matrix, surface type, and contact time.

METHODS AND RESULTS

Φ6 transfer rates were determined from skin-to-fomite and fomite-to-skin influenced by inoculum matrix (artificial saliva and tripartite), surface type (aluminum, plastic, stainless steel, touchscreen, vinyl, and wood) and contact time (5 and 10 s). Significant differences in estimated means were observed based on surface type (both transfer directions), inoculum matrix (skin-to-fomite), and contact time (both transfer directions). During a sequential transfer experiment from fomite-to-skin, the maximum number of consecutive transfer events observed was 3.33 ± 1.19, 2.33 ± 1.20, and 1.67 ± 1.21 for plastic, touchscreen, and vinyl, respectively.

CONCLUSIONS

Contact time significantly impacted Φ6 transfer rates, which may be attributed to skin absorption dynamics. Surface type should be considered for assessing Φ6 transfer rates.

SIGNIFICANCE AND IMPACT OF THE STUDY

Although the persistence of Φ6 on fomites has been characterized, limited data is available regarding the transfer of Φ6 amongst skin and fomites. Determining Φ6 transfer rates for surfaces in consumer-facing environments based on these factors is needed to better inform future virus transmission mitigation strategies.

Monitoring SARS-CoV-2 in air and on surfaces and estimating infection risk in buildings and buses on a university campus

BACKGROUND

Evidence is needed on the presence of SARS-CoV-2 in various types of environmental samples and on the estimated transmission risks in non-healthcare settings on campus.

OBJECTIVES

The objective of this research was to collect data on SARS-CoV-2 viral load and to examine potential infection risks of people exposed to the virus in publicly accessible non-healthcare environments on a university campus.

METHODS

Air and surface samples were collected using wetted wall cyclone bioaerosol samplers and swab kits, respectively, in a longitudinal environmental surveillance program from August 2020 until April 2021 on the University of Michigan Ann Arbor campus. Quantitative rRT-PCR with primers and probes targeting gene N1 were used for SARS-CoV-2 RNA quantification. The RNA concentrations were used to estimate the probability of infection by quantitative microbial risk assessment modeling and Monte-Carlo simulation.

RESULTS

In total, 256 air samples and 517 surface samples were collected during the study period, among which positive rates were 1.6% and 1.4%, respectively. Point-biserial correlation showed that the total case number on campus was significantly higher in weeks with positive environmental samples than in non-positive weeks (p = 0.001). The estimated probability of infection was about 1 per 100 exposures to SARS-CoV-2-laden aerosols through inhalation and as high as 1 per 100,000 exposures from contacting contaminated surfaces in simulated scenarios.

SIGNIFICANCE

Viral shedding was demonstrated by the detection of viral RNA in multiple air and surface samples on a university campus. The low overall positivity rate indicated that the risk of exposure to SARS-CoV-2 at monitored locations was low. Risk modeling results suggest that inhalation is the predominant route of exposure compared to surface contact, which emphasizes the importance of protecting individuals from airborne transmission of SARS-CoV-2 and potentially other respiratory infectious diseases.

IMPACT

Given the reoccurring epidemics caused by highly infectious respiratory viruses in recent years, our manuscript reinforces the importance of monitoring environmental transmission by the simultaneous sampling and integration of multiple environmental surveillance matrices for modeling and risk assessment.

Cellulosic copper nanoparticles and a hydrogen peroxide-based disinfectant trigger rapid inactivation of pseudoviral particles expressing the Spike protein of SARS-CoV-2, SARS-CoV, and MERS-CoV

Severe acute respiratory syndrome (SARS) is a viral respiratory infection caused by human coronaviruses that include SARS-CoV-2, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV). Although their primary mode of transmission is through contaminated respiratory droplets from infected carriers, the deposition of expelled virus particles onto surfaces and fomites could contribute to viral transmission. Here, we use replication-deficient murine leukemia virus (MLV) pseudoviral particles expressing SARS-CoV-2, SARS-CoV, or MERS-CoV Spike (S) protein on their surface. These surrogates of native coronavirus counterparts serve as a model to analyze the S-mediated entry into target cells. Carboxymethyl cellulose (CMC) nanofibers that are combined with copper (Cu) exhibit strong antimicrobial properties. S-pseudovirions that are exposed to CMC-Cu nanoparticles (30 s) display a dramatic reduction in their ability to infect target Vero E6 cells, with ∼97% less infectivity as compared to untreated pseudovirions. In contrast, addition of the Cu chelator tetrathiomolybdate protects S-pseudovirions from CMC-Cu-mediated inactivation. When S-pseudovirions were treated with a hydrogen peroxide-based disinfectant (denoted SaberTM) used at 1:250 dilution, their infectivity was dramatically reduced by ∼98%. However, the combined use of SaberTM and CMC-Cu is the most effective approach to restrict infectivity of SARS-CoV-2-S, SARS-CoV-S, and MERS-CoV-S pseudovirions in Vero E6 cell assays. Together, these results show that cellulosic Cu nanoparticles enhance the effectiveness of diluted SaberTM sanitizer, setting up an improved strategy to lower the risk of surface- and fomite-mediated transmission of enveloped respiratory viruses.

Contact transmission of SARS-CoV-2 on fomite surfaces: surface survival and risk reduction

There is an unprecedented concern regarding the viral strain SARS-CoV-2 and especially its respiratory disease more commonly known as COVID-19. SARS-CoV-2 virus has the ability to survive on different surfaces for extended periods, ranging from days up to months. The new infectious properties of SARS-CoV-2 vary depending on the properties of fomite surfaces. In this review, we summarize the risk factors involved in the indirect transmission pathways of SARS-CoV-2 strains on fomite surfaces. The main mode of indirect transmission is the contamination of porous and non-porous inanimate surfaces such as textile surfaces that include clothes and most importantly personal protective equipment like personal protective equipment kits, masks, etc. In the second part of the review, we highlight materials and processes that can actively reduce the SARS-CoV-2 surface contamination pattern and the associated transmission routes. The review also focuses on some general methodologies for designing advanced and effective antiviral surfaces by physical and chemical modifications, viral inhibitors, etc.

Phi 6 recovery from inoculated fingerpads based on elution buffer and methodology

Phi 6 (Φ6) bacteriophage is a proposed surrogate to study pathogenic enveloped viruses including SARS-CoV-2-the causative agent of COVID-19-based on structural similarities, BSL-1 status, and ease of use. To determine the role of virus-contaminated hands in disease transmission, an enhanced understanding of buffer and method performance for Φ6 recovery needs to be determined. Four buffer types and three methodologies were investigated for the recovery of Φ6 from human fingerpads over a 30 min duration. Phosphate buffered saline (PBS), PBS + 0.1 % Tween, 0.1 M glycine + 3% beef extract, and viral transport medium were evaluated as buffers for recovery of Φ6 via a dish, modified glove juice, and vigorous swabbing method. Φ6 concentrations on fingerpads were determined at 0-, 5-, 10-, and 30-min post-inoculation. While there were observed differences in virus recovery across buffer and method types depending on the time point, log PFU recovery based on buffer type or methodology was not significantly different at any time point (P > 0.05). The results presented in this study will allow for future work on Φ6 persistence, transfer between hands and surfaces, and efficacy of hand hygiene methods to be performed using a well-characterized and validated recovery method.

Ethanol Inactivation of Enveloped Viruses: Structural and Surface Chemistry Insights into Phi6

Lipid-enveloped viruses, such as Ebola, influenza, or coronaviruses, are a major threat to human health. Ethanol is an efficient disinfectant that is widely used to inactivate these viruses and prevent their transmission. However, the interactions between ethanol and enveloped viruses leading to their inactivation are not yet fully understood. This study demonstrates the link between ethanol-induced viral inactivation and the nanostructural and chemical transformations of the model virus Phi6, an 85 nm diameter lipid-enveloped bacterial virus that is commonly used as surrogate for human pathogenic viruses. The virus morphology was investigated using small-angle X-ray scattering and dynamic light scattering and was related to its infectivity. The Phi6's surface chemistry was characterized by cryogenic X-ray photoelectron spectroscopy, and the modifications in protein structure were assessed by circular dichroism and fluorescence spectroscopy. Ethanol-triggered structural modifications were found in the lipid envelope, detaching from the protein capsid and forming coexisting nanostructures.

Applying Cryo-X-ray Photoelectron Spectroscopy to Study the Surface Chemical Composition of Fungi and Viruses

Interaction between microorganisms and their surroundings are generally mediated via the cell wall or cell envelope. An understanding of the overall chemical composition of these surface layers may give clues on how these interactions occur and suggest mechanisms to manipulate them. This knowledge is key, for instance, in research aiming to reduce colonization of medical devices and device-related infections from different types of microorganisms. In this context, X-ray photoelectron spectroscopy (XPS) is a powerful technique as its analysis depth below 10 nm enables studies of the outermost surface structures of microorganism. Of specific interest for the study of biological systems is cryogenic XPS (cryo-XPS). This technique allows studies of intact fast-frozen hydrated samples without the need for pre-treatment procedures that may cause the cell structure to collapse or change due to the loss of water. Previously, cryo-XPS has been applied to study bacterial and algal surfaces with respect to their composition of lipids, polysaccharides and peptide (protein and/or peptidoglycan). This contribution focuses onto two other groups of microorganisms with widely different architecture and modes of life, namely fungi and viruses. It evaluates to what extent existing models for data treatment of XPS spectra can be applied to understand the chemical composition of their very different surface layers. XPS data from model organisms as well as reference substances representing specific building blocks of their surface were collected and are presented. These results aims to guide future analysis of the surface chemical composition of biological systems.

Attachment of human adenovirus onto household paints

Attachment of human adenovirus 40 (HAdV40) onto surfaces coated with three compositionally different household paints was evaluated experimentally and interpreted based on measured physicochemical properties of the paints. Polar, dispersive and electrostatic interactions between HAdV40 and the paints were predicted using the extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) model. Quartz crystal microbalance (QCM-D) was used to quantify virus attachment to paints from 1 mM and 150 mM NaCl solutions, with the latter having the ionic strength of a typical respiratory fluid. Acrylic latex water-based, alkyd water-based, and alkyd oil-based paints were all determined to be highly hydrophobic (ΔG_sws < - 48 mJ/m²). XDLVO modeling and preliminary QCM-D tests evaluated virus-paint interactions within and outside pH windows of favorable virus-paint electrostatic interactions. Hydrophobic and electrostatic interactions governed virus attachment while van der Waals interactions played a relatively minor role. In higher ionic strength solutions, the extent of virus attachment correlated with the free energy of virus-paint interfacial interaction, [Formula: see text] : more negative energies corresponded to higher values of the areal mass density of attached viruses. Hydrophobicity was the dominant factor in determining virus adhesion from high ionic strength solutions where electrostatic interactions were screened out. The hydrophobicity of paints, while desirable for minimizing moisture intrusion, also facilitates attachment of colloids such as viruses. The results call for new approaches to the materials design of indoor paints with enhanced resistance to virus adhesion. Paints so formulated should help reduce human exposure to viruses.

Optical Tracking of the Interfacial Dynamics of Single SARS-CoV-2 Pseudoviruses

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.

Fomite Transmission, Physicochemical Origin of Virus-Surface Interactions, and Disinfection Strategies for Enveloped Viruses with Applications to SARS-CoV-2

Inanimate objects or surfaces contaminated with infectious agents, referred to as fomites, play an important role in the spread of viruses, including SARS-CoV-2, the virus responsible for the COVID-19 pandemic. The long persistence of viruses (hours to days) on surfaces calls for an urgent need for effective surface disinfection strategies to intercept virus transmission and the spread of diseases. Elucidating the physicochemical processes and surface science underlying the adsorption and transfer of virus between surfaces, as well as their inactivation, is important for understanding how diseases are transmitted and for developing effective intervention strategies. This review summarizes the current knowledge and underlying physicochemical processes of virus transmission, in particular via fomites, and common disinfection approaches. Gaps in knowledge and the areas in need of further research are also identified. The review focuses on SARS-CoV-2, but discussion of related viruses is included to provide a more comprehensive review given that much remains unknown about SARS-CoV-2. Our aim is that this review will provide a broad survey of the issues involved in fomite transmission and intervention to a wide range of readers to better enable them to take on the open research challenges.

Community Transmission of SARS-CoV-2 by Surfaces: Risks and Risk Reduction Strategies

SARS-CoV-2, the virus responsible for the COVID-19 pandemic, is perceived to be primarily transmitted via person-to-person contact through droplets produced while talking, coughing, and sneezing. Transmission may also occur through other routes, including contaminated surfaces; nevertheless, the role that surfaces have on the spread of the disease remains contested. Here, we use the Quantitative Microbial Risk Assessment framework to examine the risks of community transmission of SARS-CoV-2 through surfaces and to evaluate the effectiveness of hand and surface disinfection as potential interventions. Using conservative assumptions on input parameters of the model (e.g., dose-response relationship, ratio of genome copies to infective virus), the average of the median risks for single hand-to-surface contact followed by hand-to-face contact range from 1.6 × 10-4 to 5.6 × 10-9 for modeled prevalence rates of 0.2%-5%. For observed prevalence rates (0.2%, 1%), this corresponds to a low risk of infection (<10-6). Hand disinfection substantially reduces risks of transmission independently of the disease's prevalence and contact frequency. In contrast, the effectiveness of surface disinfection is highly dependent on the prevalence and the frequency of contacts. The work supports the current perception that contaminated surfaces are not a primary mode of transmission of SARS-CoV-2 and affirms the benefits of making hand disinfectants widely available.

Microbiological Health Risk Assessment of Water Conservation Strategies: A Case Study in Amsterdam

The aim of this study was to assess the health risks that may arise from the implementation of greywater reuse and rainwater harvesting for household use, especially for toilet flushing. In addition, the risk of cross connections between these systems and the drinking water system was considered. Quantitative microbial risk assessment (QMRA) is a method that uses mathematical modelling to estimate the risk of infection when exposure to pathogens happens and was used in this study to assess the health risks. The results showed that using rainwater without prior treatment for toilet flushing poses an annual infection risk from L. pneumophila at 0.64 per-person-per-year (pppy) which exceeds the Dutch standard of 10-4 pppy. The use of untreated greywater showed a risk that is below the standard. However, treatment is recommended due to the ability of P. aeruginosa to grow in the reuse system. Moreover, showering and drinking with cross-connected water has a high annual infection risk that exceeds the standard due to contact with Staphylococcus aureus and E. coli O157:H7. Several measures can be implemented to mitigate the risks such as treating the greywater and rainwater with a minimum of 5-log removal, closing the toilet lid while flushing, good design of greywater and rainwater collection systems, and rigorous plumbing installation procedures.

Removal and Inactivation of an Enveloped Virus Surrogate by Iron Conventional Coagulation and Electrocoagulation

It is imperative to understand the behavior of enveloped viruses during water treatment to better protect public health, especially in the light of evidence of detection of coronaviruses in wastewater. We report bench-scale experiments evaluating the extent and mechanisms of removal and/or inactivation of a coronavirus surrogate (ϕ6 bacteriophage) in water by conventional FeCl₃ coagulation and Fe(0) electrocoagulation. Both coagulation methods achieved ∼5-log removal/inactivation of ϕ6 in 20 min. Enhanced removal was attributed to the high hydrophobicity of ϕ6 imparted by its characteristic phospholipid envelope. ϕ6 adhesion to freshly precipitated iron (hydr)oxide also led to envelope damage causing inactivation in both coagulation techniques. Fourier transform infrared spectroscopy revealed oxidative damages to ϕ6 lipids only for electrocoagulation consistent with electro-Fenton reactions. Monitoring ϕ6 dsRNA by a novel reverse transcription quantitative polymerase chain reaction (RT-qPCR) method quantified significantly lower viral removal/inactivation in water compared with the plaque assay demonstrating that relying solely on RT-qPCR assays may overstate human health risks arising from viruses. Transmission electron microscopy and computationally generated electron density maps of ϕ6 showed severe morphological damages to virus' envelope and loss of capsid volume accompanying coagulation. Both conventional and electro- coagulation appear to be highly effective in controlling enveloped viruses during surface water treatment.

Longitudinal Monitoring of SARS-CoV-2 RNA on High-Touch Surfaces in a Community Setting

Environmental surveillance of surface contamination is an unexplored tool for understanding transmission of SARS-CoV-2 in community settings. We conducted longitudinal swab sampling of high-touch non-porous surfaces in a Massachusetts town during a COVID-19 outbreak from April to June 2020. Twenty-nine of 348 (8.3%) surface samples were positive for SARS-CoV-2 RNA, including crosswalk buttons, trash can handles, and door handles of essential business entrances (grocery store, liquor store, bank, and gas station). The estimated risk of infection from touching a contaminated surface was low (less than 5 in 10,000) by quantitative microbial risk assessment, suggesting fomites play a minimal role in SARS-CoV-2 community transmission. The weekly percentage of positive samples (out of n = 33 unique surfaces per week) best predicted variation in city-level COVID-19 cases with a 7-day lead time. Environmental surveillance of SARS-CoV-2 RNA on high-touch surfaces may be a useful tool to provide early warning of COVID-19 case trends.

Lip balm drying promotes virus attachment: Characterization of lip balm coatings and XDLVO modeling

HYPOTHESIS

Drying-induced decrease in lip balm surface energy enhances virus adhesion due to the emergence of strong hydrophobic colloid-surface interactions.

EXPERIMENTS

A protocol was developed for preparing lip balm coatings to enable physicochemical characterization and adhesion studies. Surface charge and hydrophobicity of four brands of lip balm (dry and hydrated) and human adenovirus 5 (HAdV5) were measured and used to calculate the extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) energy of interactions between lip balm coatings and HAdV5 as well as four other colloids: HAdV40, MS2 and P22 bacteriophages, and SiO2. Quartz crystal microbalance with dissipation monitoring (QCM-D) tests employed SiO2 colloids, HAdV5 and hydrated lip balms.

FINDINGS

Drying of lip balms results in a dramatic decrease of their surface energy (δΔGsws≥ 83.0 mJ/m2) making the surfaces highly hydrophobic. For dry lip balms, the interaction of the balm surface with all five colloids is attractive. For lip balms hydrated in 150 mM NaCl (ionic strength of human saliva), XDLVO calculations predict that hydrophilic colloids (MS2, P22, SiO2) may attach into shallow secondary minima. Due to the relative hydrophobicity of human adenoviruses, primary maxima in XDLVO profiles are low or non-existent making irreversible deposition into primary energy minima possible. Preliminary QCM-D tests with SiO2 colloids and HAdV5 confirm deposition on hydrated lip balms.

Competitive co-adsorption of bacteriophage MS2 and natural organic matter onto multiwalled carbon nanotubes

A leading challenge in drinking water treatment is to remove small-sized viruses from the water in a simple and efficient manner. Multi-walled carbon nanotubes (MWCNT) are new generation adsorbents with previously demonstrated potential as filter media to improve virus removal. This study therefore aimed to evaluate the field applicability of MWCNT-filters for virus removal in water containing natural organic matter (NOM) as co-solute to viruses, using batch equilibrium experiments. Contrary to previous studies, our results showed with MS2 bacteriophages single-solute systems that the affinity of MWCNT for MS2 was low, since after 3 h of equilibration only 4 log₁₀ reduction value (LRV) of MS2 (20 mL at an initial concentration of 10⁶ PFU MS2/mL) were reached. Single solute experiments with Suwannee river NOM (SRNOM) performed with environmentally-relevant concentrations showed MWCNT surface saturation at initial SRNOM concentrations between 10 and 15 mgC/L, for water pH between 5.2 and 8.7. These results suggested that at NOM:virus ratios found in natural waters, the NOM would competitively suppress virus adsorption onto MWCNT, even at low NOM concentrations. We confirmed this expectation with SRNOM-MS2 co-solute experiments, which showed an exponential decrease of the MS2 LRV by MWCNT with an increase in the initial SRNOM concentration. More interestingly, we showed that pre-equilibrating MWCNT with a SRNOM solution at a concentration as low as 0.4 mgC/L resulted in a LRV decrease of 3 for MS2, due to the formation of a negatively charged SRNOM adlayer on the MWCNT surface. Complementary batch experiments with natural NOM-containing waters and competition experiments with SRNOM in the presence of CaCl₂ confirmed that the presence of NOM in waters challenges virus removal by MWCNT-filters, irrespective of the concentration and type of NOM and also in the presence of Ca²⁺. We therefore conclude that MWCNT-filters produced with commercially available pristine MWCNT cannot be considered as a viable technology for drinking water virus removal.

Estimation of the potential spread risk of COVID-19: Occurrence assessment along the Yangtze, Han, and Fu River basins in Hubei, China

Given that the novel coronavirus was detected in stool and urine from diagnosed patients, the potential risk of its transmission through the water environment might not be ignored. In the current study, to investigate the spread possibility of COVID-19 via the environmental media, three typical rivers (Yangtze, Han, and Fu River) and watershed cities in Hubei province of China were selected, and a more comprehensive risk assessment analysis method was built with a risk index proposed. Results showed that the risk index in the Yangtze River Basin is about 10^-12, compared to 10^-10 and 10^-8 in the Han and Fu River Basins, and the risk index is gradually reduced from Wuhan city to the surrounding cities. The safety radius and safety time period for the Yangtze, Han, and Fu River are 8 km/14 h, 20 km/30 h and 36 km/36 h, respectively. The linear relationship between the risk potential calculated by the QMRA model and the multiple linear regression proved that the built index model is statistically significant. By comparing the theoretical removal rates for the novel coronavirus, our study proposed an effective method to estimate the potential spread risk of COVID-19 in the typical river basins.

Longitudinal monitoring of SARS-CoV-2 RNA on high-touch surfaces in a community setting

Environmental surveillance of surface contamination is an unexplored tool for understanding transmission of SARS-CoV-2 in community settings. We conducted longitudinal swab sampling of high-touch non-porous surfaces in a Massachusetts town during a COVID-19 outbreak from April to June 2020. Twenty-nine of 348 (8.3 %) surface samples were positive for SARS-CoV-2, including crosswalk buttons, trash can handles, and door handles of essential business entrances (grocery store, liquor store, bank, and gas station). The estimated risk of infection from touching a contaminated surface was low (less than 5 in 10,000), suggesting fomites play a minimal role in SARS-CoV-2 community transmission. The weekly percentage of positive samples (out of n=33 unique surfaces per week) best predicted variation in city-level COVID-19 cases using a 7-day lead time. Environmental surveillance of SARS-CoV-2 RNA on high-touch surfaces could be a useful tool to provide early warning of COVID-19 case trends.

Efficient microbial colony growth dynamics quantification with ColTapp, an automated image analysis application

Populations of genetically identical bacteria are phenotypically heterogeneous, giving rise to population functionalities that would not be possible in homogeneous populations. For instance, a proportion of non-dividing bacteria could persist through antibiotic challenges and secure population survival. This heterogeneity can be studied in complex environmental or clinical samples by spreading the bacteria on agar plates and monitoring time to growth resumption in order to infer their metabolic state distribution. We present ColTapp, the Colony Time-lapse application for bacterial colony growth quantification. Its intuitive graphical user interface allows users to analyze time-lapse images of agar plates to monitor size, color and morphology of colonies. Additionally, images at isolated timepoints can be used to estimate lag time. Using ColTapp, we analyze a dataset of Staphylococcus aureus time-lapse images including populations with heterogeneous lag time. Colonies on dense plates reach saturation early, leading to overestimation of lag time from isolated images. We show that this bias can be corrected by taking into account the area available to each colony on the plate. We envision that in clinical settings, improved analysis of colony growth dynamics may help treatment decisions oriented towards personalized antibiotic therapies.

Retention of E. coli and water on the skin after liquid contact

The frequent contact people have with liquids containing pathogenic microorganisms provides opportunities for disease transmission. In this work, we quantified the transfer of bacteria-using E. coli as a model- from liquid to skin, estimated liquid retention on the skin after different contact activities (hand immersion, wet-cloth and wet-surface contact), and estimated liquid transfer following hand-to-mouth contacts. The results of our study show that the number of E. coli transferred to the skin per surface area (n [E. coli/cm2]) can be modeled using n = C (10-3.38+h), where C [E. coli/cm3] is the concentration of E. coli in the liquid, and h [cm] is the film thickness of the liquid retained on the skin. Findings from the E. coli transfer experiments reveal a significant difference between the transfer of E. coli from liquid to the skin and the previously reported transfer of viruses to the skin. Additionally, our results demonstrate that the time elapsed since the interaction significantly influences liquid retention, therefore modulating the risks associated with human interaction with contaminated liquids. The findings enhance our understanding of liquid-mediated disease transmission processes and provide quantitative estimates as inputs for microbial risk assessments.

Surface Chemistry Can Unlock Drivers of Surface Stability of SARS-CoV-2 in a Variety of Environmental Conditions

The surface stability and resulting transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), specifically in indoor environments, have been identified as a potential pandemic challenge requiring investigation. This novel virus can be found on various surfaces in contaminated sites such as clinical places; however, the behavior and molecular interactions of the virus with respect to the surfaces are poorly understood. Regarding this, the virus adsorption onto solid surfaces can play a critical role in transmission and survival in various environments. In this article, we first give an overview of existing knowledge concerning viral spread, molecular structure of SARS-CoV-2, and the virus surface stability is presented. Then, we highlight potential drivers of the SARS-CoV-2 surface adsorption and stability in various environmental conditions. This theoretical analysis shows that different surface and environmental conditions including temperature, humidity, and pH are crucial considerations in building fundamental understanding of the virus transmission and thereby improving safety practices.

Evaluating a transfer gradient assumption in a fomite-mediated microbial transmission model using an experimental and Bayesian approach

Current microbial exposure models assume that microbial exchange follows a concentration gradient during hand-to-surface contacts. Our objectives were to evaluate this assumption using transfer efficiency experiments and to evaluate a model's ability to explain concentration changes using approximate Bayesian computation (ABC) on these experimental data. Experiments were conducted with two phages (MS2, ΦX174) simultaneously to study bidirectional transfer. Concentrations on the fingertip and surface were quantified before and after fingertip-to-surface contacts. Prior distributions for surface and fingertip swabbing efficiencies and transfer efficiency were used to estimate concentrations on the fingertip and surface post contact. To inform posterior distributions, Euclidean distances were calculated for predicted detectable concentrations (log₁₀ PFU cm⁻²) on the fingertip and surface post contact in comparison with experimental values. To demonstrate the usefulness of posterior distributions in calibrated model applications, posterior transfer efficiencies were used to estimate rotavirus infection risks for a fingertip-to-surface and subsequent fingertip-to-mouth contact. Experimental findings supported the transfer gradient assumption. Through ABC, the model explained concentration changes more consistently when concentrations on the fingertip and surface were similar. Future studies evaluating microbial transfer should consider accounting for differing fingertip-to-surface and surface-to-fingertip transfer efficiencies and extend this work for other microbial types.

Outbreaks, occurrence, and control of norovirus and hepatitis a virus contamination in berries: A review

Foodborne enteric viruses, in particular HuNoV and HAV, are the most common cause of the berry-linked viral diseases, and outbreaks around the world, and have become an important concern for health authorities. Despite the increased importance of berry fruits as a vehicle for foodborne viruses, there is limited information concerning the fate of foodborne viruses in the berry supply chain from farm to consumer. A comprehensive understanding of berry-associated viral outbreaks - with a focus on contamination sources, persistence, survival, and the effects of current postharvest and processing interventions and practices - is essential for the development of effective preventative strategies to reduce risk of illness. The purpose of this paper is twofold; (i) to critically review the published literature on the current state of knowledge regarding berry-associated foodborne viral outbreaks and the efficiency of berry processing practices and (ii) to identify and prioritize research gaps regarding practical and effective mechanism to reduce viral contamination of berries. The review found that fecally infected food handlers were the predominant source of preharvest and postharvest pathogenic viral contamination. Current industrial practices applied to fresh and frozen berries demonstrated limited efficacy for reducing the viral load. While maintaining best practice personal and environmental hygiene is a key intervention, the optimization of processing parameters (i.e., freezing, frozen storage, and washing) and/or development of alternative processing technologies to induce sufficient viral inactivation in berries along with retaining sensory and nutritional quality, is also an important direction for further research.

Validation of a Stochastic Discrete Event Model Predicting Virus Concentration on Nurse Hands

Understanding healthcare viral disease transmission and the effect of infection control interventions will inform current and future infection control protocols. In this study, a model was developed to predict virus concentration on nurses' hands using data from a bacteriophage tracer study conducted in Tucson, Arizona, in an urgent care facility. Surfaces were swabbed 2 hours, 3.5 hours, and 6 hours postseeding to measure virus spread over time. To estimate the full viral load that would have been present on hands without sampling, virus concentrations were summed across time points for 3.5- and 6-hour measurements. A stochastic discrete event model was developed to predict virus concentrations on nurses' hands, given a distribution of virus concentrations on surfaces and expected frequencies of hand-to-surface and orifice contacts and handwashing. Box plots and statistical hypothesis testing were used to compare the model-predicted and experimentally measured virus concentrations on nurses' hands. The model was validated with the experimental bacteriophage tracer data because the distribution for model-predicted virus concentrations on hands captured all observed value ranges, and interquartile ranges for model and experimental values overlapped for all comparison time points. Wilcoxon rank sum tests showed no significant differences in distributions of model-predicted and experimentally measured virus concentrations on hands. However, limitations in the tracer study indicate that more data are needed to instill more confidence in this validation. Next model development steps include addressing viral concentrations that would be found naturally in healthcare environments and measuring the risk reductions predicted for various infection control interventions.

Health Risks for Sanitation Service Workers along a Container-Based Urine Collection System and Resource Recovery Value Chain

Container-based sanitation (CBS) within a comprehensive service system value chain offers a low-cost sanitation option with potential for revenue generation but may increase microbial health risks to sanitation service workers. This study assessed occupational exposure to rotavirus and Shigella spp. during CBS urine collection and subsequent struvite fertilizer production in eThekwini, South Africa. Primary data included high resolution sequences of hand-object contacts from annotated video and measurement of fecal contamination from urine and surfaces likely to be contacted. A stochastic model incorporated chronological surface contacts, pathogen concentrations in urine, and literature data on transfer efficiencies of pathogens to model pathogen concentrations on hands and risk of infection from hand-to-mouth contacts. The probability of infection was highest from exposure to rotavirus during urine collection (∼10-1) and struvite production (∼10-2), though risks from Shigella spp. during urine collection (∼10-3) and struvite production (∼10-4) were non-negligible. Notably, risk of infection was higher during urine collection than during struvite production due to contact with contaminated urine transport containers. In the scale-up of CBS, disinfection of urine transport containers is expected to reduce pathogen transmission. Exposure data from this study can be used to evaluate the effectiveness of measures to protect sanitation service workers.

Safely Managed Hygiene: A Risk-Based Assessment of Handwashing Water Quality

Sustainable Development Goal (SDG) Indicator 6.2.1 requires household handwashing facilities to have soap and water, but there are no guidelines for handwashing water quality. In contrast, drinking water quality guidelines are defined: water must be "free from contamination" to be defined as "safely managed" (SDG Indicator 6.1.1). We modeled the hypothesized mechanism of infection due to contaminated handwashing water to inform risk-based guidelines for microbial quality of handwashing water. We defined two scenarios that should not occur: (1) if handwashing caused fecal contamination, indicated using Escherichia coli, on a person's hands to increase rather than decrease and (2) if hand-to-mouth contacts following handwashing caused an infection risk greater than an acceptable threshold. We found water containing <1000 E. coli colony-forming units (CFU) per 100 mL removes E. coli from hands with>99.9% probability. However, for the annual probability of infection to be <1:1000, handwashing water must contain <2 × 10^-6 focus-forming units of rotavirus, <1 × 10^-4 CFU of Vibrio cholerae, and <9 × 10^-6 Cryptosporidium oocysts per 100 mL. Our model suggests that handwashing with nonpotable water will generally reduce fecal contamination on hands but may be unable to lower the annual probability of infection risks from hand-to-mouth contacts below 1:1000.

Modeling the role of fomites in a norovirus outbreak

Norovirus accounts for a large portion of the gastroenteritis disease burden, and outbreaks have occurred in a wide variety of environments. Understanding the role of fomites in norovirus transmission will inform behavioral interventions, such as hand washing and surface disinfection. The purpose of this study was to estimate the contribution of fomite-mediated exposures to infection and illness risks in outbreaks. A simulation model in discrete time that accounted for hand-to-porous surfaces, hand-to-nonporous surfaces, hand-to-mouth, -eyes, -nose, and hand washing events was used to predict 17 hr of simulated human behavior. Norovirus concentrations originated from monitoring contamination levels on surfaces during an outbreak on houseboats. To predict infection risk, two dose-response models (fractional Poisson and ₂F₁ hypergeometric) were used to capture a range of infection risks. A triangular distribution describing the conditional probability of illness given an infection was multiplied by modeled infection risks to estimate illness risks. Infection risks ranged from 70.22% to 72.20% and illness risks ranged from 21.29% to 70.36%. A sensitivity analysis revealed that the number of hand-to-mouth contacts and the number of hand washing events had strong relationships with model-predicted doses. Predicted illness risks overlapped with leisure setting and environmental attack rates reported in the literature. In the outbreak associated with the viral concentrations used in this study, attack rates ranged from 50% to 86%. This model suggests that fomites may have accounted for 25% to 82% of illnesses in this outbreak. Fomite-mediated exposures may contribute to a large portion of total attack rates in outbreaks involving multiple transmission modes. The findings of this study reinforce the importance of frequent fomite cleaning and hand washing, especially when ill persons are present.

Transfer of Enteric Viruses Adenovirus and Coxsackievirus and Bacteriophage MS2 from Liquid to Human Skin

Enteric viruses (viruses that infect the gastrointestinal tract) are responsible for most water-transmitted diseases. They are shed in high concentrations in the feces of infected individuals, persist for an extended period of time in water, and are highly infective. Exposure to contaminated water directly (through ingestion) or indirectly (for example, through hand-water contacts followed by hand-to-mouth contacts) increases the risk of virus transmission. The work described herein provides a quantitative model for estimating human-pathogenic virus retention on skin following contact with contaminated water. The work will be important in refining the contribution of indirect transmission of virus to risks associated with water-related activities.

Indirect exposure to waterborne viruses increases the risk of infection, especially among children with frequent hand-to-mouth contacts. Here, we quantified the transfer of one bacteriophage (MS2) and two enteric viruses (adenovirus and coxsackievirus) from liquid to skin. MS2, a commonly used enteric virus surrogate, was used to compare virus transfer rates in a volunteer trial to those obtained using human cadaver skin and synthetic skin. MS2 transfer to volunteer skin was similar to transfer to cadaver skin but significantly different from transfer to synthetic skin. The transfer of MS2, adenovirus, and coxsackievirus to cadaver skin was modeled using measurements for viruses attaching to the skin (adsorbed) and viruses in liquid residual on skin (unadsorbed). We find virus transfer per surface area is a function of the concentration of virus in the liquid and the film thickness of liquid retained on the skin and is estimable using a linear model. Notably, the amount of MS2 adsorbed on the skin was on average 5 times higher than the amount of adenovirus and 4 times higher than the amount of coxsackievirus. Quantification of pathogenic virus retention to skin would thus be overestimated using MS2 adsorption data. This study provides models of virus transfer useful for risk assessments of water-related activities, demonstrates significant differences in the transfer of pathogenic virus and MS2, and suggests cadaver skin as an alternative testing system for studying interactions between viruses and skin.

IMPORTANCE Enteric viruses (viruses that infect the gastrointestinal tract) are responsible for most water-transmitted diseases. They are shed in high concentrations in the feces of infected individuals, persist for an extended period of time in water, and are highly infective. Exposure to contaminated water directly (through ingestion) or indirectly (for example, through hand-water contacts followed by hand-to-mouth contacts) increases the risk of virus transmission. The work described herein provides a quantitative model for estimating human-pathogenic virus retention on skin following contact with contaminated water. The work will be important in refining the contribution of indirect transmission of virus to risks associated with water-related activities.