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Zhang Y, Shankar SN, Vass WB, Lednicky JA, Fan ZH, Agdas D, Makuch R, Wu CY. Air Change Rate and SARS-CoV-2 Exposure in Hospitals and Residences: A Meta-Analysis. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2024; 58:217-243. [PMID: 38764553 PMCID: PMC11101186 DOI: 10.1080/02786826.2024.2312178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/16/2024] [Indexed: 05/21/2024]
Abstract
As SARS-CoV-2 swept across the globe, increased ventilation and implementation of air cleaning were emphasized by the US CDC and WHO as important strategies to reduce the risk of inhalation exposure to the virus. To assess whether higher ventilation and air cleaning rates lead to lower exposure risk to SARS-CoV-2, 1274 manuscripts published between April 2020 and September 2022 were screened using key words "airborne SARS-CoV-2 or "SARS-CoV-2 aerosol". Ninety-three studies involved air sampling at locations with known sources (hospitals and residences) were selected and associated data were compiled. Two metrics were used to assess exposure risk: SARS-CoV-2 concentration and SARS-CoV-2 detection rate in air samples. Locations were categorized by type (hospital or residence) and proximity to the sampling location housing the isolated/quarantined patient (primary or secondary). The results showed that hospital wards had lower airborne virus concentrations than residential isolation rooms. A negative correlation was found between airborne virus concentrations in primary-occupancy areas and air changes per hour (ACH). In hospital settings, sample positivity rates were significantly reduced in secondary-occupancy areas compared to primary-occupancy areas, but they were similar across sampling locations in residential settings. ACH and sample positivity rates were negatively correlated, though the effect was diminished when ACH values exceeded 8. While limitations associated with diverse sampling protocols exist, data considered by this meta-analysis support the notion that higher ACH may reduce exposure risks to the virus in ambient air.
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Affiliation(s)
- Yuetong Zhang
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columnia, Canada
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Environmental & Public Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - William B. Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - John A. Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Z. Hugh Fan
- Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | - Duzgun Agdas
- Engineering School of Sustainable Infrastructure & Environment, University of Florida, Gainesville, Florida, USA
| | - Robert Makuch
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, Florida, USA
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Zhou X, Liu X, Zhao H, Guo G, Jiang X, Liu S, Sun X, Yang H. Research advances in microfluidic collection and detection of virus, bacterial, and fungal bioaerosols. Mikrochim Acta 2024; 191:132. [PMID: 38351367 DOI: 10.1007/s00604-024-06213-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/14/2024] [Indexed: 02/16/2024]
Abstract
Bioaerosols are airborne suspensions of fine solid or liquid particles containing biological substances such as viruses, bacteria, cellular debris, fungal spores, mycelium, and byproducts of microbial metabolism. The global Coronavirus disease 2019 (COVID-19) pandemic and the previous emergence of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and influenza have increased the need for reliable and effective monitoring tools for bioaerosols. Bioaerosol collection and detection have aroused considerable attention. Current bioaerosol sampling and detection techniques suffer from long response time, low sensitivity, and high costs, and these drawbacks have forced the development of novel monitoring strategies. Microfluidic technique is considered a breakthrough for high performance analysis of bioaerosols. In recent years, several emerging methods based on microfluidics have been developed and reported for collection and detection of bioaerosols. The unique advantages of microfluidic technique have enabled the integration of bioaerosol collection and detection, which has a higher efficiency over conventional methods. This review focused on the research progress of bioaerosol collection and detection methods based on microfluidic techniques, with special attention on virus aerosols and bacterial aerosols. Different from the existing reviews, this work took a unique perspective of the targets to be collected and detected in bioaerosols, which would provide a direct index of bioaerosol categories readers may be interested in. We also discussed integrated microfluidic monitoring system for bioaerosols. Additionally, the application of bioaerosol detection in biomedicine was presented. Finally, the current challenges in the field of bioaerosol monitoring are presented and an outlook given of future developments.
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Affiliation(s)
- Xinyue Zhou
- Department of Respiratory Medicine, The Fourth Hospital of China Medical University, No. 4, Chongshan East Road, Huanggu District, Shenyang, 110032, Liaoning, China
| | - Xin Liu
- Department of Respiratory Medicine, The Fourth Hospital of China Medical University, No. 4, Chongshan East Road, Huanggu District, Shenyang, 110032, Liaoning, China
| | - Haiyang Zhao
- Teaching Center for Basic Medical Experiment, China Medical University, No.77, Puhe Road, Shenyang, 110122, Liaoning Province, China
| | - Guanqi Guo
- Teaching Center for Basic Medical Experiment, China Medical University, No.77, Puhe Road, Shenyang, 110122, Liaoning Province, China
| | - Xiran Jiang
- School of Intelligent Medicine, China Medical University, No.77, Puhe Road, Shenyang, 110122, Liaoning Province, China.
| | - Shuo Liu
- Department of Respiratory Medicine, The Fourth Hospital of China Medical University, No. 4, Chongshan East Road, Huanggu District, Shenyang, 110032, Liaoning, China.
| | - Xiaoting Sun
- School of Forensic Medicine, China Medical University, No.77, Puhe Road, Shenyang, 110122, Liaoning Province, China.
| | - Huazhe Yang
- School of Intelligent Medicine, China Medical University, No.77, Puhe Road, Shenyang, 110122, Liaoning Province, China.
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Buratti CR, Veillette M, Bridier A, Aubin CE, Lebrun M, Ammaiyappan AK, Vanoli E, Crawford C, Duchaine C, Jouvet P. Effectiveness of SplashGuard Caregiver prototype in reducing the risk of aerosol transmission in intensive care unit rooms of SARS-CoV-2 patients: a prospective and simulation study. J Hosp Infect 2024; 144:75-84. [PMID: 38040038 DOI: 10.1016/j.jhin.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The contagiousness of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is known to be linked to the emission of bioaerosols. Thus, aerosol-generating procedures (AGPs) could increase the risk of infection among healthcare workers (HCWs). AIM To investigate the impact of an aerosol protection box, the SplashGuard Caregiver (SGGC) with suction system, by direct analysis of the presence of viral particles after an AGP, and by using the computational fluid dynamics (CFD) simulation method. METHODS This prospective observational study investigated HCWs caring for patients with SARS-CoV-2 admitted to an intensive care unit (ICU). Rooms were categorized as: SGCG present and SGCG absent. Virus detection was performed through direct analysis, and using a CFD model to simulate the movement dynamics of airborne particles produced by a patient's respiratory activities. FINDINGS Of the 67 analyses performed, three samples tested positive on quantitative polymerase chain reaction: one of 33 analyses in the SCCG group (3%) and two of 34 analyses in the non-SGCG group (5.9%). CFD simulations showed that: (1) reduction of the gaps of an SGCG could decrease the number of emitted particles remaining airborne within the room by up to 70%; and (2) positioning HCWs facing the opposite direction to the main air flow would reduce their exposure. CONCLUSIONS This study documented the presence of SARS-CoV-2 among HCWs in a negative pressure ICU room of an infected patient with or without the use of an SGCG. The simulation will help to improve the design of the SGCG and the positioning of HCWs in the room.
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Affiliation(s)
- C R Buratti
- Pediatric Intensive Care Unit, Department of Pediatrics, Hospital da Criança Santo Antônio, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - M Veillette
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec, Québec, Canada
| | - A Bridier
- Paediatric Intensive Care, Department of Paediatrics, Purpan Hospital, University of Toulouse, Toulouse, France
| | - C E Aubin
- Polytechnique Montreal, University Hospital Centre Sainte-Justine, Montréal, Québec, Canada
| | - M Lebrun
- Dassault Systèmes Simulia Corporation, Vélizy-Villacoublay, France
| | | | - E Vanoli
- Dassault Systèmes Simulia Corporation, Vélizy-Villacoublay, France
| | - C Crawford
- Dassault Systèmes Simulia Corporation, Vélizy-Villacoublay, France
| | - C Duchaine
- Université Laval, Québec, Québec, Canada
| | - P Jouvet
- Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital Centre Sainte-Justine, Montréal, Québec, Canada.
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Puthussery JV, Ghumra DP, McBrearty KR, Doherty BM, Sumlin BJ, Sarabandi A, Mandal AG, Shetty NJ, Gardiner WD, Magrecki JP, Brody DL, Esparza TJ, Bricker TL, Boon ACM, Yuede CM, Cirrito JR, Chakrabarty RK. Real-time environmental surveillance of SARS-CoV-2 aerosols. Nat Commun 2023; 14:3692. [PMID: 37429842 DOI: 10.1038/s41467-023-39419-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/12/2023] [Indexed: 07/12/2023] Open
Abstract
Real-time surveillance of airborne SARS-CoV-2 virus is a technological gap that has eluded the scientific community since the beginning of the COVID-19 pandemic. Offline air sampling techniques for SARS-CoV-2 detection suffer from longer turnaround times and require skilled labor. Here, we present a proof-of-concept pathogen Air Quality (pAQ) monitor for real-time (5 min time resolution) direct detection of SARS-CoV-2 aerosols. The system synergistically integrates a high flow (~1000 lpm) wet cyclone air sampler and a nanobody-based ultrasensitive micro-immunoelectrode biosensor. The wet cyclone showed comparable or better virus sampling performance than commercially available samplers. Laboratory experiments demonstrate a device sensitivity of 77-83% and a limit of detection of 7-35 viral RNA copies/m3 of air. Our pAQ monitor is suited for point-of-need surveillance of SARS-CoV-2 variants in indoor environments and can be adapted for multiplexed detection of other respiratory pathogens of interest. Widespread adoption of such technology could assist public health officials with implementing rapid disease control measures.
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Affiliation(s)
- Joseph V Puthussery
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Dishit P Ghumra
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Kevin R McBrearty
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA
| | - Brookelyn M Doherty
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA
| | - Benjamin J Sumlin
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Amirhossein Sarabandi
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Anushka Garg Mandal
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
- Department of Chemical Engineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Nishit J Shetty
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA
- Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Woodrow D Gardiner
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA
| | - Jordan P Magrecki
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA
| | - David L Brody
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Thomas J Esparza
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Traci L Bricker
- Department of Medicine, Washington University, St. Louis, MO, 63110, USA
| | - Adrianus C M Boon
- Department of Medicine, Washington University, St. Louis, MO, 63110, USA
- Departments Molecular Microbiology, and Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carla M Yuede
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA.
| | - John R Cirrito
- Department of Neurology, Hope Center for Neurological Disease, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, 63110, USA.
| | - Rajan K Chakrabarty
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA.
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Martínez-Espinosa E, Carvajal-Mariscal I. Virus-laden droplet nuclei in vortical structures associated with recirculation zones in indoor environments: A possible airborne transmission of SARS-CoV-2. ENVIRONMENTAL ADVANCES 2023; 12:100376. [PMID: 37193349 PMCID: PMC10163794 DOI: 10.1016/j.envadv.2023.100376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023]
Abstract
Droplet nuclei dispersion patterns in indoor environments are reviewed from a physics view to explore the possibility of airborne transmission of SARS-CoV-2. This review analyzes works on particle dispersion patterns and their concentration in vortical structures in different indoor environments. Numerical simulations and experiments reveal the formation of the buildings' recirculation zones and vortex flow regions by flow separation, airflow interaction around objects, internal dispersion of airflow, or thermal plume. These vortical structures showed high particle concentration because particles are trapped for long periods. Then a hypothesis is proposed to explain why some medical studies detect the presence of SARS-CoV-2 and others do not detect the virus. The hypothesis proposes that airborne transmission is possible if virus-laden droplet nuclei are trapped in vortical structures associated with recirculation zones. This hypothesis is reinforced by a numerical study in a restaurant that presented possible evidence of airborne transmission by a large recirculating air zone. Furthermore, a medical study in a hospital is discussed from a physical view for identifying the formation of recirculation zones and their relation with positive tests for viruses. The observations show air sampling site located in this vortical structure is positive for the SARS-CoV-2 RNA. Therefore, the formation of vortical structures associated with recirculation zones should be avoided to minimize the possibility of airborne transmission. This work tries to understand the complex phenomenon of airborne transmission as a way in the prevention of transmission of infectious diseases.
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Affiliation(s)
- E Martínez-Espinosa
- Industrial and Environmental Processes Department, Instituto de Ingeniería, UNAM, Ciudad Universitaria, Mexico City 04510, México
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6
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Cox J, Christensen B, Burton N, Dunn KH, Finnegan M, Ruess A, Estill C. Transmission of SARS-CoV-2 in the workplace: Key findings from a rapid review of the literature. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2023; 57:233-254. [PMID: 37213938 PMCID: PMC10193509 DOI: 10.1080/02786826.2023.2166394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/27/2022] [Indexed: 05/23/2023]
Abstract
At the beginning of the COVID-19 pandemic, the primary route of transmission of the SARS-CoV-2 virus was not well understood. Research gathered from other respiratory infectious diseases, including other coronaviruses, was the basis for the initial perceptions for transmission of SARS-CoV-2. To better understand transmission of SARS-CoV-2, a rapid literature review was conducted from literature generated March 19, 2020, through September 23, 2021. 18,616 unique results were identified from literature databases and screened. Of these, 279 key articles were reviewed and abstracted covering critical topics such as environmental/workplace monitoring, sampling and analytical method evaluation, and the ability of the virus to remain intact and infectious during sampling. This paper describes the results of the rapid literature review, which evaluated pathways that contribute to transmission as well as the strengths and limitations of current sampling approaches. This review also evaluates how different factors, including environmental conditions and surface characteristics, could impact the transmission potential of SARS-CoV-2. A continual rapid review in the midst of a pandemic proved particularly useful for quickly understanding the transmission parameters of the virus and enabled us to comprehensively assess literature, respond to workplace questions, and evaluate our understanding as the science evolved. Air and surface sampling with the accompanying analytical methods were not generally effective in recovering SARS-CoV-2 viable virus or RNA in many likely contaminated environments. In light of these findings, the development of validated sampling and analysis methods is critical for determining worker exposure to SARS-CoV-2 and to assess the impact of mitigation efforts.
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Affiliation(s)
- Jennie Cox
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Brian Christensen
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Nancy Burton
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Kevin H. Dunn
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | | | - Ana Ruess
- Gryphon Scientific, Takoma Park, MD, USA
| | - Cherie Estill
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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Joan TV, Kristiyan SA, Ernest SL, Nuria TP, Herme GB, Josep MB. Efficiency and sensitivity optimization of a protocol to quantify indoor airborne SARS-CoV-2 levels. J Hosp Infect 2022; 130:44-51. [PMID: 36100140 PMCID: PMC9465472 DOI: 10.1016/j.jhin.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022]
Abstract
Background Development of methodologies to quantify airborne micro-organisms is needed for the prevention and control of infections. It is difficult to conclude which is the most efficient and sensitive strategy to assess airborne SARS-CoV-2 RNA levels due to the disparity of results reported in clinical settings. Aim To improve our previously reported protocol of measuring SARS-CoV-2 RNA levels, which was based on bioaerosol collection with a liquid impinger and RNA quantification with droplet digital polymerase chain reaction (ddPCR). Methods Air samples were collected in COVID-19 patient rooms to assess efficiency and/or sensitivity of different air samplers, liquid collection media, and reverse transcriptases (RT). Findings Mineral oil retains airborne RNA better than does hydrophilic media without impairing integrity. SARS-CoV-2 ORF1ab target was detected in 80% of the air samples using BioSampler with mineral oil. No significant differences in effectiveness were obtained with MD8 sampler equipped with gelatine membrane filters, but the SARS-CoV-2 copies/m3 air obtained with the latter were lower (28.4 ± 6.1 vs 9 ± 1.7). SuperScript II RT allows the detection of a single SARS-CoV-2 genome RNA molecule by ddPCR with high efficiency. This was the only RT that allowed the detection of SARS-CoV-2 N1 target in air samples. Conclusion The collection efficiency and detection sensivity of a protocol to quantify SARS-CoV-2 RNA levels in indoor air has been improved in the present study. Such optimization is important to improve our understanding of the microbiological safety of indoor air.
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Affiliation(s)
- Truyols-Vives Joan
- Molecular Biology and One Health Research Group (MolONE), Universitat de Les Illes Balears (UIB), Palma, Spain
| | | | - Sala-Llinàs Ernest
- Molecular Biology and One Health Research Group (MolONE), Universitat de Les Illes Balears (UIB), Palma, Spain; Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Spain; Department of Pulmonary Medicine, Hospital Universitari Son Espases (HUSE), Balearic Islands, Spain; Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain
| | - Toledo-Pons Nuria
- Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Spain; Department of Pulmonary Medicine, Hospital Universitari Son Espases (HUSE), Balearic Islands, Spain
| | - G Baldoví Herme
- Department of Chemistry, Universitat Politècnica de València (UPV)
| | - Mercader-Barceló Josep
- Molecular Biology and One Health Research Group (MolONE), Universitat de Les Illes Balears (UIB), Palma, Spain; Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Spain.
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Fujita R, Kurosu H, Norizuki M, Ohishi T, Zamoto-Niikura A, Iwaki M, Mochida K, Takagi H, Harada T, Tsushima K, Matsumoto T, Hanaki KI, Sugai M, Yamagishi T. Potential risk of SARS-CoV-2 infection among people handling linens used by COVID-19 patients before and after washing. Sci Rep 2022; 12:14994. [PMID: 36056067 PMCID: PMC9438874 DOI: 10.1038/s41598-022-18945-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022] Open
Abstract
The risk of SARS-CoV-2 infection when people handle linens is uncertain. We examined the presence of SARS-CoV-2 on linens, in the air, and on personal protective equipment (PPE) to assess potential infection risk among individuals who handle linens used by SARS-CoV-2-infected people. Patients in a hospital and an accommodation facility who tested positive for SARS-CoV-2 participated in this study in 2020. Linen samples before washing or disinfection, rinse water after washing or disinfection, air in the workplace at the hospital and an accommodation facility, and the PPE worn by linen-handling people were tested for SARS-CoV-2 RNA and viable viruses. Among 700 samples from 13 SARS-CoV-2-infected participants and their surrounding environment, SARS-CoV-2 RNA was detected from 14% (52/362) of the linens used by COVID-19 patients (cycle threshold [Ct] value: 33-40). SARS-CoV-2 RNA was detected from 8% (2/26) of rinse water after washing or disinfection, from 15% (16/104) of air samples in the workspace, and from 10% (5/52) of gowns worn by linen-handling people, all with high Ct values (> 36). No SARS-CoV-2 was isolated from any samples. The potential risk of SARS-CoV-2 infection from handling linens used by SARS-CoV-2-infected people exists but appears to below.
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Affiliation(s)
- Retsu Fujita
- Graduate School of Medicine, International University of Health and Welfare, 4-1-26, Akasaka, Minato-ku, Tokyo, 107-8402, Japan
| | - Hitomi Kurosu
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Masataro Norizuki
- Graduate School of Medicine, International University of Health and Welfare, 4-1-26, Akasaka, Minato-ku, Tokyo, 107-8402, Japan
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Takayuki Ohishi
- Department of Infection Control and Prevention, Saiseikai Yokohama City Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumiku, Yokohama, Kanagawa, 230-8765, Japan
| | - Aya Zamoto-Niikura
- Management Department of Biosafety , Laboratory Animal, and Pathogen Bank, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Masaaki Iwaki
- Management Department of Biosafety , Laboratory Animal, and Pathogen Bank, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Keiko Mochida
- Management Department of Biosafety , Laboratory Animal, and Pathogen Bank, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Hirotaka Takagi
- Management Department of Biosafety , Laboratory Animal, and Pathogen Bank, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Toshihiko Harada
- Management Department of Biosafety , Laboratory Animal, and Pathogen Bank, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Kenji Tsushima
- International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Tetsuya Matsumoto
- International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Ken-Ichi Hanaki
- Management Department of Biosafety , Laboratory Animal, and Pathogen Bank, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Takuya Yamagishi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan.
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Silva PG, Branco PTBS, Soares RRG, Mesquita JR, Sousa SIV. SARS-CoV-2 air sampling: A systematic review on the methodologies for detection and infectivity. INDOOR AIR 2022; 32:e13083. [PMID: 36040285 PMCID: PMC9538005 DOI: 10.1111/ina.13083] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
This systematic review aims to present an overview of the current aerosol sampling methods (and equipment) being used to investigate the presence of SARS-CoV-2 in the air, along with the main parameters reported in the studies that are essential to analyze the advantages and disadvantages of each method and perspectives for future research regarding this mode of transmission. A systematic literature review was performed on PubMed/MEDLINE, Web of Science, and Scopus to assess the current air sampling methodologies being applied to SARS-CoV-2. Most of the studies took place in indoor environments and healthcare settings and included air and environmental sampling. The collection mechanisms used were impinger, cyclone, impactor, filters, water-based condensation, and passive sampling. Most of the reviewed studies used RT-PCR to test the presence of SARS-CoV-2 RNA in the collected samples. SARS-CoV-2 RNA was detected with all collection mechanisms. From the studies detecting the presence of SARS-CoV-2 RNA, fourteen assessed infectivity. Five studies detected viable viruses using impactor, water-based condensation, and cyclone collection mechanisms. There is a need for a standardized protocol for sampling SARS-CoV-2 in air, which should also account for other influencing parameters, including air exchange ratio in the room sampled, relative humidity, temperature, and lighting conditions.
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Affiliation(s)
- Priscilla G Silva
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Pedro T B S Branco
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Ruben R G Soares
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Solna, Sweden
- Division of Nanobiotechnology, Department of Protein Science, Science for Life Laboratory, KTH Royal Institute of Technology, Solna, Sweden
| | - João R Mesquita
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Sofia I V Sousa
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
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10
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Asif Z, Chen Z, Stranges S, Zhao X, Sadiq R, Olea-Popelka F, Peng C, Haghighat F, Yu T. Dynamics of SARS-CoV-2 spreading under the influence of environmental factors and strategies to tackle the pandemic: A systematic review. SUSTAINABLE CITIES AND SOCIETY 2022; 81:103840. [PMID: 35317188 PMCID: PMC8925199 DOI: 10.1016/j.scs.2022.103840] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 05/05/2023]
Abstract
COVID-19 is deemed as the most critical world health calamity of the 21st century, leading to dramatic life loss. There is a pressing need to understand the multi-stage dynamics, including transmission routes of the virus and environmental conditions due to the possibility of multiple waves of COVID-19 in the future. In this paper, a systematic examination of the literature is conducted associating the virus-laden-aerosol and transmission of these microparticles into the multimedia environment, including built environments. Particularly, this paper provides a critical review of state-of-the-art modelling tools apt for COVID-19 spread and transmission pathways. GIS-based, risk-based, and artificial intelligence-based tools are discussed for their application in the surveillance and forecasting of COVID-19. Primary environmental factors that act as simulators for the spread of the virus include meteorological variation, low air quality, pollen abundance, and spatial-temporal variation. However, the influence of these environmental factors on COVID-19 spread is still equivocal because of other non-pharmaceutical factors. The limitations of different modelling methods suggest the need for a multidisciplinary approach, including the 'One-Health' concept. Extended One-Health-based decision tools would assist policymakers in making informed decisions such as social gatherings, indoor environment improvement, and COVID-19 risk mitigation by adapting the control measurements.
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Affiliation(s)
- Zunaira Asif
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Canada
| | - Zhi Chen
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Western University, Ontario, Canada
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Xin Zhao
- Department of Animal Science, McGill University, Montreal, Canada
| | - Rehan Sadiq
- School of Engineering (Okanagan Campus), University of British Columbia, Kelowna, BC, Canada
| | | | - Changhui Peng
- Department of Biological Sciences, University of Quebec in Montreal, Canada
| | - Fariborz Haghighat
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Canada
| | - Tong Yu
- Department of Civil and Environmental Engineering, University of Alberta, Canada
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11
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Tao Y, Zhang X, Qiu G, Spillmann M, Ji Z, Wang J. SARS-CoV-2 and other airborne respiratory viruses in outdoor aerosols in three Swiss cities before and during the first wave of the COVID-19 pandemic. ENVIRONMENT INTERNATIONAL 2022; 164:107266. [PMID: 35512527 PMCID: PMC9060371 DOI: 10.1016/j.envint.2022.107266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 05/02/2023]
Abstract
Caused by the SARS-CoV-2 virus, Coronavirus disease 2019 (COVID-19) has been affecting the world since the end of 2019. While virus-laden particles have been commonly detected and studied in the aerosol samples from indoor healthcare settings, studies are scarce on air surveillance of the virus in outdoor non-healthcare environments, including the correlations between SARS-CoV-2 and other respiratory viruses, between viruses and environmental factors, and between viruses and human behavior changes due to the public health measures against COVID-19. Therefore, in this study, we collected airborne particulate matter (PM) samples from November 2019 to April 2020 in Bern, Lugano, and Zurich. Among 14 detected viruses, influenza A, HCoV-NL63, HCoV-HKU1, and HCoV-229E were abundant in air. SARS-CoV-2 and enterovirus were moderately common, while the remaining viruses occurred only in low concentrations. SARS-CoV-2 was detected in PM10 (PM below 10 µm) samples of Bern and Zurich, and PM2.5 (PM below 2.5 µm) samples of Bern which exhibited a concentration positively correlated with the local COVID-19 case number. The concentration was also correlated with the concentration of enterovirus which raised the concern of coinfection. The estimated COVID-19 infection risks of an hour exposure at these two sites were generally low but still cannot be neglected. Our study demonstrated the potential functionality of outdoor air surveillance of airborne respiratory viruses, especially at transportation hubs and traffic arteries.
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Affiliation(s)
- Yile Tao
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Xiaole Zhang
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Guangyu Qiu
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Martin Spillmann
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Zheng Ji
- School of Geography and Tourism, Shaanxi Normal University, Xi'an 710119, China
| | - Jing Wang
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland.
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12
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Baselga M, Alba JJ, Schuhmacher AJ. The Control of Metabolic CO 2 in Public Transport as a Strategy to Reduce the Transmission of Respiratory Infectious Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6605. [PMID: 35682191 PMCID: PMC9180361 DOI: 10.3390/ijerph19116605] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 01/27/2023]
Abstract
The global acceptance of the SARS-CoV-2 airborne transmission led to prevention measures based on quality control and air renewal. Among them, carbon dioxide (CO2) measurement has positioned itself as a cost-efficiency, reliable, and straightforward method to assess indoor air renewal indirectly. Through the control of CO2, it is possible to implement and validate the effectiveness of prevention measures to reduce the risk of contagion of respiratory diseases by aerosols. Thanks to the method scalability, CO2 measurement has become the gold standard for diagnosing air quality in shared spaces. Even though collective transport is considered one of the environments with the highest rate of COVID-19 propagation, little research has been done where the air inside vehicles is analyzed. This work explores the generation and accumulation of metabolic CO2 in a tramway (Zaragoza, Spain) operation. Importantly, we propose to use the indicator ppm/person as a basis for comparing environments under different conditions. Our study concludes with an experimental evaluation of the benefit of modifying some parameters of the Heating-Ventilation-Air conditioning (HVAC) system. The study of the particle retention efficiency of the implemented filters shows a poor air cleaning performance that, at present, can be counteracted by opening windows. Seeking a post-pandemic scenario, it will be crucial to seek strategies to improve air quality in public transport to prevent the transmission of infectious diseases.
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Affiliation(s)
- Marta Baselga
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (J.J.A.)
| | - Juan J. Alba
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (J.J.A.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
| | - Alberto J. Schuhmacher
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (J.J.A.)
- Fundación Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), 500018 Zaragoza, Spain
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13
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Baselga M, Güemes A, Alba JJ, Schuhmacher AJ. SARS-CoV-2 Droplet and Airborne Transmission Heterogeneity. J Clin Med 2022; 11:2607. [PMID: 35566733 PMCID: PMC9099777 DOI: 10.3390/jcm11092607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/21/2022] [Accepted: 05/03/2022] [Indexed: 12/13/2022] Open
Abstract
The spread dynamics of the SARS-CoV-2 virus have not yet been fully understood after two years of the pandemic. The virus's global spread represented a unique scenario for advancing infectious disease research. Consequently, mechanistic epidemiological theories were quickly dismissed, and more attention was paid to other approaches that considered heterogeneity in the spread. One of the most critical advances in aerial pathogens transmission was the global acceptance of the airborne model, where the airway is presented as the epicenter of the spread of the disease. Although the aerodynamics and persistence of the SARS-CoV-2 virus in the air have been extensively studied, the actual probability of contagion is still unknown. In this work, the individual heterogeneity in the transmission of 22 patients infected with COVID-19 was analyzed by close contact (cough samples) and air (environmental samples). Viral RNA was detected in 2/19 cough samples from patient subgroups, with a mean Ct (Cycle Threshold in Quantitative Polymerase Chain Reaction analysis) of 25.7 ± 7.0. Nevertheless, viral RNA was only detected in air samples from 1/8 patients, with an average Ct of 25.0 ± 4.0. Viral load in cough samples ranged from 7.3 × 105 to 8.7 × 108 copies/mL among patients, while concentrations between 1.1-4.8 copies/m3 were found in air, consistent with other reports in the literature. In patients undergoing follow-up, no viral load was found (neither in coughs nor in the air) after the third day of symptoms, which could help define quarantine periods in infected individuals. In addition, it was found that the patient's Ct should not be considered an indicator of infectiousness, since it could not be correlated with the viral load disseminated. The results of this work are in line with proposed hypotheses of superspreaders, which can attribute part of the heterogeneity of the spread to the oversized emission of a small percentage of infected people.
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Affiliation(s)
- Marta Baselga
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
| | - Antonio Güemes
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Department of Surgery, University of Zaragoza, 50009 Zaragoza, Spain
| | - Juan J. Alba
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
| | - Alberto J. Schuhmacher
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Fundación Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), 50018 Zaragoza, Spain
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14
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Rufino de Sousa N, Steponaviciute L, Margerie L, Nissen K, Kjellin M, Reinius B, Salaneck E, Udekwu KI, Rothfuchs AG. Detection and isolation of airborne SARS-CoV-2 in a hospital setting. INDOOR AIR 2022; 32:e13023. [PMID: 35347788 PMCID: PMC9111425 DOI: 10.1111/ina.13023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/21/2022] [Accepted: 03/10/2022] [Indexed: 05/15/2023]
Abstract
Transmission mechanisms for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are incompletely understood. In particular, aerosol transmission remains unclear, with viral detection in air and demonstration of its infection potential being actively investigated. To this end, we employed a novel electrostatic collector to sample air from rooms occupied by COVID-19 patients in a major Swedish hospital. Electrostatic air sampling in conjunction with extraction-free, reverse-transcriptase polymerase chain reaction (hid-RT-PCR) enabled detection of SARS-CoV-2 in air from patient rooms (9/22; 41%) and adjoining anterooms (10/22; 45%). Detection with hid-RT-PCR was concomitant with viral RNA presence on the surface of exhaust ventilation channels in patients and anterooms more than 2 m from the COVID-19 patient. Importantly, it was possible to detect active SARS-CoV-2 particles from room air, with a total of 496 plaque-forming units (PFUs) being isolated, establishing the presence of infectious, airborne SARS-CoV-2 in rooms occupied by COVID-19 patients. Our results support circulation of SARS-CoV-2 via aerosols and urge the revision of existing infection control frameworks to include airborne transmission.
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Affiliation(s)
- Nuno Rufino de Sousa
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Laura Steponaviciute
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Lucille Margerie
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Karolina Nissen
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Midori Kjellin
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Björn Reinius
- Department of Medical Biochemistry and Biophysics (MBB)Karolinska InstitutetStockholmSweden
| | - Erik Salaneck
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Klas I. Udekwu
- Department of Aquatic Sciences and AssessmentSwedish University of Agricultural SciencesUppsalaSweden
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15
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Dinoi A, Feltracco M, Chirizzi D, Trabucco S, Conte M, Gregoris E, Barbaro E, La Bella G, Ciccarese G, Belosi F, La Salandra G, Gambaro A, Contini D. A review on measurements of SARS-CoV-2 genetic material in air in outdoor and indoor environments: Implication for airborne transmission. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 809:151137. [PMID: 34699823 PMCID: PMC8539199 DOI: 10.1016/j.scitotenv.2021.151137] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 05/03/2023]
Abstract
Airborne transmission of SARS-CoV-2 has been object of debate in the scientific community since the beginning of COVID-19 pandemic. This mechanism of transmission could arise from virus-laden aerosol released by infected individuals and it is influenced by several factors. Among these, the concentration and size distribution of virus-laden particles play an important role. The knowledge regarding aerosol transmission increases as new evidence is collected in different studies, even if it is not yet available a standard protocol regarding air sampling and analysis, which can create difficulties in the interpretation and application of results. This work reports a systematic review of current knowledge gained by 73 published papers on experimental determination of SARS-CoV-2 RNA in air comparing different environments: outdoors, indoor hospitals and healthcare settings, and public community indoors. Selected papers furnished 77 datasets: outdoor studies (9/77, 11.7%) and indoor studies (68/77. 88.3%). The indoor datasets in hospitals were the vast majority (58/68, 85.3%), and the remaining (10/68, 14.7%) were classified as community indoors. The fraction of studies having positive samples, as well as positivity rates (i.e. ratios between positive and total samples) are significantly larger in hospitals compared to the other typologies of sites. Contamination of surfaces was more frequent (in indoor datasets) compared to contamination of air samples; however, the average positivity rate was lower compared to that of air. Concentrations of SARS-CoV-2 RNA in air were highly variables and, on average, lower in outdoors compared to indoors. Among indoors, concentrations in community indoors appear to be lower than those in hospitals and healthcare settings.
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Affiliation(s)
- Adelaide Dinoi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy
| | - Matteo Feltracco
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniela Chirizzi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Sara Trabucco
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Marianna Conte
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy; Laboratory for Observations and Analyses of Earth and Climate, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy
| | - Elena Gregoris
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Elena Barbaro
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Giuseppina Ciccarese
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Franco Belosi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Andrea Gambaro
- Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniele Contini
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy.
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16
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Truyols Vives J, Muncunill J, Toledo Pons N, Baldoví HG, Sala Llinàs E, Mercader Barceló J. SARS-CoV-2 detection in bioaerosols using a liquid impinger collector and ddPCR. INDOOR AIR 2022; 32:e13002. [PMID: 35225399 PMCID: PMC9111801 DOI: 10.1111/ina.13002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 06/14/2023]
Abstract
The airborne route is the dominant form of COVID-19 transmission, and therefore, the development of methodologies to quantify SARS-CoV-2 in bioaerosols is needed. We aimed to identify SARS-CoV-2 in bioaerosols by using a highly efficient sampler for the collection of 1-3 µm particles, followed by a highly sensitive detection method. 65 bioaerosol samples were collected in hospital rooms in the presence of a COVID-19 patient using a liquid impinger sampler. The SARS-CoV-2 genome was detected by ddPCR using different primer/probe sets. 44.6% of the samples resulted positive for SARS-CoV-2 following this protocol. By increasing the sampled air volume from 339 to 650 L, the percentage of positive samples went from 41% to 50%. We detected five times less positives with a commercial one-step RT-PCR assay. However, the selection of primer/probe sets might be one of the most determining factor for bioaerosol SARS-CoV-2 detection since with the ORF1ab set more than 40% of the samples were positive, compared to <10% with other sets. In conclusion, the use of a liquid impinger collector and ddPCR is an adequate strategy to detect SARS-CoV-2 in bioaerosols. However, there are still some methodological aspects that must be adjusted to optimize and standardize a definitive protocol.
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Affiliation(s)
- Joan Truyols Vives
- Molecular Biology and One Health research group (MolONE)Universitat de les Illes Balears (UIB)PalmaSpain
| | - Josep Muncunill
- Health Research Institute of the Balearic Islands (IdISBa)Balearic IslandsSpain
| | - Núria Toledo Pons
- Health Research Institute of the Balearic Islands (IdISBa)Balearic IslandsSpain
- Department of Pulmonary MedicineHospital Universitari Son Espases (HUSE)Balearic IslandsSpain
| | - Herme G. Baldoví
- Department of ChemistryUniversitat Politècnica de València (UPV)ValenciaSpain
| | - Ernest Sala Llinàs
- Molecular Biology and One Health research group (MolONE)Universitat de les Illes Balears (UIB)PalmaSpain
- Health Research Institute of the Balearic Islands (IdISBa)Balearic IslandsSpain
- Department of Pulmonary MedicineHospital Universitari Son Espases (HUSE)Balearic IslandsSpain
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES)MadridSpain
| | - Josep Mercader Barceló
- Molecular Biology and One Health research group (MolONE)Universitat de les Illes Balears (UIB)PalmaSpain
- Health Research Institute of the Balearic Islands (IdISBa)Balearic IslandsSpain
- Foners Medicina Veterinària i Innovació SLPPalmaSpain
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17
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Breshears LE, Nguyen BT, Mata Robles S, Wu L, Yoon JY. Biosensor detection of airborne respiratory viruses such as SARS-CoV-2. SLAS Technol 2022; 27:4-17. [PMID: 35058206 PMCID: PMC8720388 DOI: 10.1016/j.slast.2021.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Airborne SARS-CoV-2 transmission represents a significant route for possible human infection that is not yet fully understood. Viruses in droplets and aerosols are difficult to detect because they are typically present in low amounts. In addition, the current techniques used, such as RT-PCR and virus culturing, require large amounts of time to get results. Biosensor technology can provide rapid, handheld, and point-of-care systems that can identify virus presence quickly and accurately. This paper reviews the background of airborne virus transmission and the characteristics of SARS-CoV-2, its relative risk for transmission even at distances greater than the currently suggested 6 feet (or 2 m) physical distancing. Publications on biosensor technology that may be applied to the detection of airborne SARS-CoV-2 and other respiratory viruses are also summarized. Based on the current research we believe that there is a pressing need for continued research into handheld and rapid methods for sensitive collection and detection of airborne viruses. We propose a paper-based microfluidic chip and immunofluorescence assay as one method that could be investigated as a low-cost and portable option.
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Affiliation(s)
- Lane E Breshears
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Brandon T Nguyen
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Samantha Mata Robles
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Lillian Wu
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Jeong-Yeol Yoon
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States.
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18
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Abdeldayem OM, Dabbish AM, Habashy MM, Mostafa MK, Elhefnawy M, Amin L, Al-Sakkari EG, Ragab A, Rene ER. Viral outbreaks detection and surveillance using wastewater-based epidemiology, viral air sampling, and machine learning techniques: A comprehensive review and outlook. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 803:149834. [PMID: 34525746 PMCID: PMC8379898 DOI: 10.1016/j.scitotenv.2021.149834] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/05/2021] [Accepted: 08/18/2021] [Indexed: 05/06/2023]
Abstract
A viral outbreak is a global challenge that affects public health and safety. The coronavirus disease 2019 (COVID-19) has been spreading globally, affecting millions of people worldwide, and led to significant loss of lives and deterioration of the global economy. The current adverse effects caused by the COVID-19 pandemic demands finding new detection methods for future viral outbreaks. The environment's transmission pathways include and are not limited to air, surface water, and wastewater environments. The wastewater surveillance, known as wastewater-based epidemiology (WBE), can potentially monitor viral outbreaks and provide a complementary clinical testing method. Another investigated outbreak surveillance technique that has not been yet implemented in a sufficient number of studies is the surveillance of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) in the air. Artificial intelligence (AI) and its related machine learning (ML) and deep learning (DL) technologies are currently emerging techniques for detecting viral outbreaks using global data. To date, there are no reports that illustrate the potential of using WBE with AI to detect viral outbreaks. This study investigates the transmission pathways of SARS-CoV-2 in the environment and provides current updates on the surveillance of viral outbreaks using WBE, viral air sampling, and AI. It also proposes a novel framework based on an ensemble of ML and DL algorithms to provide a beneficial supportive tool for decision-makers. The framework exploits available data from reliable sources to discover meaningful insights and knowledge that allows researchers and practitioners to build efficient methods and protocols that accurately monitor and detect viral outbreaks. The proposed framework could provide early detection of viruses, forecast risk maps and vulnerable areas, and estimate the number of infected citizens.
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Affiliation(s)
- Omar M Abdeldayem
- Department of Water Supply, Sanitation and Environmental Engineering, IHE Delft Institute for Water Education, Westvest 7, 2611AX Delft, the Netherlands.
| | - Areeg M Dabbish
- Biotechnology Graduate Program, Biology Department, School of Science and Engineering, The American University in Cairo, New Cairo 11835, Egypt
| | - Mahmoud M Habashy
- Department of Water Supply, Sanitation and Environmental Engineering, IHE Delft Institute for Water Education, Westvest 7, 2611AX Delft, the Netherlands
| | - Mohamed K Mostafa
- Faculty of Engineering and Technology, Badr University in Cairo (BUC), Cairo 11829, Egypt
| | - Mohamed Elhefnawy
- CanmetENERGY, 1615 Lionel-Boulet Blvd, P.O. Box 4800, Varennes, Québec J3X 1P7, Canada; Department of Mathematics and Industrial Engineering, Polytechnique Montréal 2500 Chemin de Polytechnique, Montréal, Québec H3T 1J4, Canada
| | - Lobna Amin
- Department of Water Supply, Sanitation and Environmental Engineering, IHE Delft Institute for Water Education, Westvest 7, 2611AX Delft, the Netherlands; Department of Built Environment, Aalto University, PO Box 15200, FI-00076, Aalto, Finland
| | - Eslam G Al-Sakkari
- Chemical Engineering Department, Cairo University, Cairo University Road, 12613 Giza, Egypt
| | - Ahmed Ragab
- CanmetENERGY, 1615 Lionel-Boulet Blvd, P.O. Box 4800, Varennes, Québec J3X 1P7, Canada; Department of Mathematics and Industrial Engineering, Polytechnique Montréal 2500 Chemin de Polytechnique, Montréal, Québec H3T 1J4, Canada; Faculty of Electronic Engineering, Menoufia University, 32952, Menouf, Egypt
| | - Eldon R Rene
- Department of Water Supply, Sanitation and Environmental Engineering, IHE Delft Institute for Water Education, Westvest 7, 2611AX Delft, the Netherlands
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19
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Wang Q, Liu L. On the Critical Role of Human Feces and Public Toilets in the Transmission of COVID-19: Evidence from China. SUSTAINABLE CITIES AND SOCIETY 2021; 75:103350. [PMID: 34540563 PMCID: PMC8433098 DOI: 10.1016/j.scs.2021.103350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 05/05/2023]
Abstract
The surprising spread speed of the COVID-19 pandemic creates an urgent need for investigating the transmission chain or transmission pattern of COVID-19 beyond the traditional respiratory channels. This study therefore examines whether human feces and public toilets play a critical role in the transmission of COVID-19. First, it develops a theoretical model that simulates the transmission chain of COVID-19 through public restrooms. Second, it uses stabilized epidemic data from China to empirically examine this theory, conducting an empirical estimation using a two-stage least squares (2SLS) model with appropriate instrumental variables (IVs). This study confirms that the wastewater directly promotes the transmission of COVID-19 within a city. However, the role of garbage in this transmission chain is more indirect in the sense that garbage has a complex relationship with public toilets, and it promotes the transmission of COVID-19 within a city through interaction with public toilets and, hence, human feces. These findings have very strong policy implications in the sense that if we can somehow use the ratio of public toilets as a policy instrument, then we can find a way to minimize the total number of infections in a region. As shown in this study, pushing the ratio of public toilets (against open defecation) to the local population in a city to its optimal level would help to reduce the total infection in a region.
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Affiliation(s)
- Qiuyun Wang
- School of Economics, Southwestern University of Finance and Economics, P.R China
| | - Lu Liu
- School of Economics, Southwestern University of Finance and Economics, P.R China
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20
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Bhardwaj J, Hong S, Jang J, Han CH, Lee J, Jang J. Recent advancements in the measurement of pathogenic airborne viruses. JOURNAL OF HAZARDOUS MATERIALS 2021; 420:126574. [PMID: 34252679 PMCID: PMC8256664 DOI: 10.1016/j.jhazmat.2021.126574] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/24/2021] [Accepted: 07/02/2021] [Indexed: 05/11/2023]
Abstract
Air-transmissible pathogenic viruses, such as influenza viruses and coronaviruses, are some of the most fatal strains and spread rapidly by air, necessitating quick and stable measurements from sample air volumes to prevent further spread of diseases and to take appropriate steps rapidly. Measurements of airborne viruses generally require their collection into liquids or onto solid surfaces, with subsequent hydrosolization and then analysis using the growth method, nucleic-acid-based techniques, or immunoassays. Measurements can also be performed in real time without sampling, where species-specific determination is generally disabled. In this review, we introduce some recent advancements in the measurement of pathogenic airborne viruses. Air sampling and measurement technologies for viral aerosols are reviewed, with special focus on the effects of air sampling on damage to the sampled viruses and their measurements. Measurement of pathogenic airborne viruses is an interdisciplinary research area that requires understanding of both aerosol technology and biotechnology to effectively address the issues. Hence, this review is expected to provide some useful guidelines regarding appropriate air sampling and virus detection methods for particular applications.
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Affiliation(s)
- Jyoti Bhardwaj
- Sensors and Aerosols Laboratory, Department of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | | | - Junbeom Jang
- Sensors and Aerosols Laboratory, Department of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - Chang-Ho Han
- Sensors and Aerosols Laboratory, Department of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - Jaegil Lee
- Sensors and Aerosols Laboratory, Department of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - Jaesung Jang
- Sensors and Aerosols Laboratory, Department of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea; Department of Biomedical Engineering & Department of Urban and Environmental Engineering, UNIST, Ulsan 44919, Republic of Korea.
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21
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Cherrie JW, Cherrie MPC, Smith A, Holmes D, Semple S, Steinle S, Macdonald E, Moore G, Loh M. Contamination of Air and Surfaces in Workplaces with SARS-CoV-2 Virus: A Systematic Review. Ann Work Expo Health 2021; 65:879-892. [PMID: 34329379 PMCID: PMC8385829 DOI: 10.1093/annweh/wxab026] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES This systematic review aimed to evaluate the evidence for air and surface contamination of workplace environments with SARS-CoV-2 RNA and the quality of the methods used to identify actions necessary to improve the quality of the data. METHODS We searched Web of Science and Google Scholar until 24 December 2020 for relevant articles and extracted data on methodology and results. RESULTS The vast majority of data come from healthcare settings, with typically around 6% of samples having detectable concentrations of SARS-CoV-2 RNA and almost none of the samples collected had viable virus. There were a wide variety of methods used to measure airborne virus, although surface sampling was generally undertaken using nylon flocked swabs. Overall, the quality of the measurements was poor. Only a small number of studies reported the airborne concentration of SARS-CoV-2 virus RNA, mostly just reporting the detectable concentration values without reference to the detection limit. Imputing the geometric mean air concentration assuming the limit of detection was the lowest reported value, suggests typical concentrations in healthcare settings may be around 0.01 SARS-CoV-2 virus RNA copies m-3. Data on surface virus loading per unit area were mostly unavailable. CONCLUSIONS The reliability of the reported data is uncertain. The methods used for measuring SARS-CoV-2 and other respiratory viruses in work environments should be standardized to facilitate more consistent interpretation of contamination and to help reliably estimate worker exposure.
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Affiliation(s)
- John W Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
- Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Riccarton, Edinburgh, UK
| | - Mark P C Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
- University of Edinburgh, School of Geosciences, Edinburgh, UK
| | - Alice Smith
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - David Holmes
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - Sean Semple
- University of Stirling, Institute for Social Marketing and Health, Stirling, UK
| | - Susanne Steinle
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - Ewan Macdonald
- University of Glasgow, Institute of Health and Wellbeing, Glasgow, UK
| | - Ginny Moore
- National Infection Service, Public Health England, Porton Down, Salisbury, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
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22
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Mallach G, Kasloff SB, Kovesi T, Kumar A, Kulka R, Krishnan J, Robert B, McGuinty M, den Otter-Moore S, Yazji B, Cutts T. Aerosol SARS-CoV-2 in hospitals and long-term care homes during the COVID-19 pandemic. PLoS One 2021; 16:e0258151. [PMID: 34591919 PMCID: PMC8483369 DOI: 10.1371/journal.pone.0258151] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/19/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Few studies have quantified aerosol concentrations of SARS-CoV-2 in hospitals and long-term care homes, and fewer still have examined samples for viability. This information is needed to clarify transmission risks beyond close contact. METHODS We deployed particulate air samplers in rooms with COVID-19 positive patients in hospital ward and ICU rooms, rooms in long-term care homes experiencing outbreaks, and a correctional facility experiencing an outbreak. Samplers were placed between 2 and 3 meters from the patient. Aerosol (small liquid particles suspended in air) samples were collected onto gelatin filters by Ultrasonic Personal Air Samplers (UPAS) fitted with <2.5μm (micrometer) and <10 μm size-selective inlets operated for 16 hours (total 1.92m3), and with a Coriolis Biosampler over 10 minutes (total 1.5m3). Samples were assayed for viable SARS-CoV-2 virus and for the viral genome by multiplex PCR using the E and N protein target sequences. We validated the sampling methods by inoculating gelatin filters with viable vesicular stomatitis virus (VSV), and with three concentrations of viable SARS-CoV-2, operating personal samplers for 16hrs, and quantifying viable virus recovery by TCID50 assay. RESULTS In total, 138 samples were collected from 99 rooms. RNA samples were positive in 9.1% (6/66) of samples obtained with the UPAS 2.5μm samplers, 13.5% (7/52) with the UPAS 10μm samplers, and 10.0% (2/20) samples obtained with the Coriolis samplers. Culturable virus was not recovered in any samples. Viral RNA was detected in 15.1% of the rooms sampled. There was no significant difference in viral RNA recovery between the different room locations or samplers. Method development experiments indicated minimal loss of SARS-CoV-2 viability via the personal air sampler operation.
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Affiliation(s)
- Gary Mallach
- Water and Air Quality Bureau, Health Canada, Ottawa, Canada
| | - Samantha B. Kasloff
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Tom Kovesi
- Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Anand Kumar
- Sections of Critical Care Medicine and Infectious Diseases, Departments of Medicine, Medical Microbiology and Pharmacology, University of Manitoba, Winnipeg, Canada
| | - Ryan Kulka
- Water and Air Quality Bureau, Health Canada, Ottawa, Canada
| | - Jay Krishnan
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Benoit Robert
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Michaeline McGuinty
- Department of Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | | | - Bashour Yazji
- Department of Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | - Todd Cutts
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
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23
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Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu SV, Kindrachuk J. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infect Dis 2021; 21:710. [PMID: 34315427 PMCID: PMC8314268 DOI: 10.1186/s12879-021-06357-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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Affiliation(s)
- Kevin Escandón
- School of Medicine, Universidad del Valle, Cali, Colombia.
| | - Angela L Rasmussen
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Isaac I Bogoch
- Division of Infectious Diseases, University of Toronto, Toronto General Hospital, Toronto, Canada
| | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Karina Escandón
- Department of Anthropology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Saskia V Popescu
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
- Schar School of Policy and Government, George Mason University, Fairfax, VA, USA
| | - Jason Kindrachuk
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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24
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Dubuis ME, Racine É, Vyskocil JM, Turgeon N, Tremblay C, Mukawera E, Boivin G, Grandvaux N, Duchaine C. Ozone inactivation of airborne influenza and lack of resistance of respiratory syncytial virus to aerosolization and sampling processes. PLoS One 2021; 16:e0253022. [PMID: 34252093 PMCID: PMC8274922 DOI: 10.1371/journal.pone.0253022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/26/2021] [Indexed: 11/18/2022] Open
Abstract
Influenza and RSV are human viruses responsible for outbreaks in hospitals, long-term care facilities and nursing homes. The present study assessed an air treatment using ozone at two relative humidity conditions (RHs) in order to reduce the infectivity of airborne influenza. Bovine pulmonary surfactant (BPS) and synthetic tracheal mucus (STM) were used as aerosols protectants to better reflect the human aerosol composition. Residual ozone concentration inside the aerosol chamber was also measured. RSV's sensitivity resulted in testing its resistance to aerosolization and sampling processes instead of ozone exposure. The results showed that without supplement and with STM, a reduction in influenza A infectivity of four orders of magnitude was obtained with an exposure to 1.70 ± 0.19 ppm of ozone at 76% RH for 80 min. Consequently, ozone could be considered as a virucidal disinfectant for airborne influenza A. RSV did not withstand the aerosolization and sampling processes required for the use of the experimental setup. Therefore, ozone exposure could not be performed for this virus. Nonetheless, this study provides great insight for the efficacy of ozone as an air treatment for the control of nosocomial influenza A outbreaks.
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Affiliation(s)
- Marie-Eve Dubuis
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec–Université Laval, Quebec City, Quebec, Canada
- Département de Biochimie, de Microbiologie et de Bio-informatique, Faculté des Sciences et de Génie, Université Laval, Quebec City, Quebec, Canada
| | - Étienne Racine
- Faculté de Médecine, Université Laval, Quebec City, Quebec, Canada
| | - Jonathan M. Vyskocil
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec–Université Laval, Quebec City, Quebec, Canada
- Département de Biochimie, de Microbiologie et de Bio-informatique, Faculté des Sciences et de Génie, Université Laval, Quebec City, Quebec, Canada
| | - Nathalie Turgeon
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec–Université Laval, Quebec City, Quebec, Canada
| | - Christophe Tremblay
- Département de Biochimie, de Microbiologie et de Bio-informatique, Faculté des Sciences et de Génie, Université Laval, Quebec City, Quebec, Canada
| | - Espérance Mukawera
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Département de Biochimie et Médecine Moléculaire, Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
| | - Guy Boivin
- Centre de Recherche du Centre Hospitalier Universitaire de Québec–Université Laval, Quebec City, Quebec, Canada
- Département de Microbiologie-Infectiologie et d’Immunologie, Faculté de Médecine, Université Laval, Quebec City, Quebec, Canada
| | - Nathalie Grandvaux
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Département de Biochimie et Médecine Moléculaire, Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
| | - Caroline Duchaine
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec–Université Laval, Quebec City, Quebec, Canada
- Département de Biochimie, de Microbiologie et de Bio-informatique, Faculté des Sciences et de Génie, Université Laval, Quebec City, Quebec, Canada
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25
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Polastri M, Pehlivan E. Preventing indoor contamination in private physiotherapy practices. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2021.0118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Massimiliano Polastri
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, St Orsola University Hospital, Bologna, Italy
| | - Esra Pehlivan
- Department of Physical Therapy and Rehabilitation, University of Health Sciences Turkey, School of Health Sciences, Istanbul, Turkey
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26
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Positive no-touch surfaces and undetectable SARS-CoV-2 aerosols in long-term care facilities: An attempt to understand the contributing factors and the importance of timing in air sampling campaigns. Am J Infect Control 2021; 49:701-706. [PMID: 33587983 PMCID: PMC7879049 DOI: 10.1016/j.ajic.2021.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Long-term care facilities (LTCF) are environments particularly favorable to coronavirus disease (SARS-CoV-2) pandemic outbreaks, due to the at-risk population they welcome and the close proximity of residents. Yet, the transmission dynamics of the disease in these establishments remain unclear. METHODS Air and no-touch surfaces of 31 rooms from 7 LTCFs were sampled and SARS-CoV-2 was quantified by real-time reverse transcription polymerase chain reaction (RT-qPCR). RESULTS Air samples were negative but viral genomes were recovered from 20 of 62 surface samples at concentrations ranging from 13 to 36,612 genomes/surface. Virus isolation (culture) from surface samples (n = 7) was negative. CONCLUSIONS The presence of viral RNA on no-touch surfaces is evidence of viral dissemination through air, but the lack of airborne viral particles in air samples suggests that they were not aerosolized in a significant manner during air sampling sessions. The air samples were collected 8 to 30 days after the residents' symptom onset, which could indicate that viruses are aerosolized early in the infection process. Additional research is needed to evaluate viral viability conservation and the potential role of direct contact and aerosols in SARS-CoV-2 transmission in these institutions.
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27
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Luo R, Delaunay‐Moisan A, Timmis K, Danchin A. SARS-CoV-2 biology and variants: anticipation of viral evolution and what needs to be done. Environ Microbiol 2021; 23:2339-2363. [PMID: 33769683 PMCID: PMC8251359 DOI: 10.1111/1462-2920.15487] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/14/2022]
Abstract
The global propagation of SARS-CoV-2 and the detection of a large number of variants, some of which have replaced the original clade to become dominant, underscores the fact that the virus is actively exploring its evolutionary space. The longer high levels of viral multiplication occur - permitted by high levels of transmission -, the more the virus can adapt to the human host and find ways to success. The third wave of the COVID-19 pandemic is starting in different parts of the world, emphasizing that transmission containment measures that are being imposed are not adequate. Part of the consideration in determining containment measures is the rationale that vaccination will soon stop transmission and allow a return to normality. However, vaccines themselves represent a selection pressure for evolution of vaccine-resistant variants, so the coupling of a policy of permitting high levels of transmission/virus multiplication during vaccine roll-out with the expectation that vaccines will deal with the pandemic, is unrealistic. In the absence of effective antivirals, it is not improbable that SARS-CoV-2 infection prophylaxis will involve an annual vaccination campaign against 'dominant' viral variants, similar to influenza prophylaxis. Living with COVID-19 will be an issue of SARS-CoV-2 variants and evolution. It is therefore crucial to understand how SARS-CoV-2 evolves and what constrains its evolution, in order to anticipate the variants that will emerge. Thus far, the focus has been on the receptor-binding spike protein, but the virus is complex, encoding 26 proteins which interact with a large number of host factors, so the possibilities for evolution are manifold and not predictable a priori. However, if we are to mount the best defence against COVID-19, we must mount it against the variants, and to do this, we must have knowledge about the evolutionary possibilities of the virus. In addition to the generic cellular interactions of the virus, there are extensive polymorphisms in humans (e.g. Lewis, HLA, etc.), some distributed within most or all populations, some restricted to specific ethnic populations and these variations pose additional opportunities for/constraints on viral evolution. We now have the wherewithal - viral genome sequencing, protein structure determination/modelling, protein interaction analysis - to functionally characterize viral variants, but access to comprehensive genome data is extremely uneven. Yet, to develop an understanding of the impacts of such evolution on transmission and disease, we must link it to transmission (viral epidemiology) and disease data (patient clinical data), and the population granularities of these. In this editorial, we explore key facets of viral biology and the influence of relevant aspects of human polymorphisms, human behaviour, geography and climate and, based on this, derive a series of recommendations to monitor viral evolution and predict the types of variants that are likely to arise.
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Affiliation(s)
- Ruibang Luo
- Department of Computer ScienceThe University of Hong KongBonham RoadPokfulamHong Kong
| | - Agnès Delaunay‐Moisan
- Université Paris‐Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC)Gif‐sur‐Yvette91198France
| | - Kenneth Timmis
- Institute of MicrobiologyTechnical University of BraunschweigBraunschweigGermany
| | - Antoine Danchin
- Kodikos Labs, Institut Cochin, 24 rue du Faubourg Saint‐JacquesParis75014France
- School of Biomedical Sciences, Li Kashing Faculty of MedicineUniversity of Hong Kong21 Sassoon RoadHong Kong
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28
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Gross JV, Fritschi L, Mohren J, Wild U, Erren TC. Contribution of Occupational Health to multidisciplinary team work for COVID-19 prevention and management. LA MEDICINA DEL LAVORO 2021; 112:171-176. [PMID: 33881012 PMCID: PMC8095326 DOI: 10.23749/mdl.v112i2.11056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/26/2021] [Indexed: 12/29/2022]
Abstract
Introduction: The SARS-CoV-2/Covid-19 pandemic is a challenge for public health and occupational medicine and developing prevention and protection strategies needs expertise from many disciplines. To make prevention successful, individuals have to be motivated to participate and, in turn, motivation depends on understanding how and why prevention measures are implemented. We present a structured approach (the Cycle of prevention) which involves different stakeholders and perspectives to develop, and monitor, prevention strategies in transparent and effective ways.
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Affiliation(s)
- J Valérie Gross
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne.
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Australia.
| | - Judith Mohren
- 1Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, D-50938 Cologne, Germany.
| | - Ursula Wild
- 1Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, D-50938 Cologne, Germany.
| | - Thomas C Erren
- 1Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, D-50938 Cologne, Germany.
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