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1.
Nat Biotechnol ; 38(10): 1164-1167, 2020 10.
Article in English | MEDLINE | ID: covidwho-1023956

ABSTRACT

We measured severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentrations in primary sewage sludge in the New Haven, Connecticut, USA, metropolitan area during the Coronavirus Disease 2019 (COVID-19) outbreak in Spring 2020. SARS-CoV-2 RNA was detected throughout the more than 10-week study and, when adjusted for time lags, tracked the rise and fall of cases seen in SARS-CoV-2 clinical test results and local COVID-19 hospital admissions. Relative to these indicators, SARS-CoV-2 RNA concentrations in sludge were 0-2 d ahead of SARS-CoV-2 positive test results by date of specimen collection, 0-2 d ahead of the percentage of positive tests by date of specimen collection, 1-4 d ahead of local hospital admissions and 6-8 d ahead of SARS-CoV-2 positive test results by reporting date. Our data show the utility of viral RNA monitoring in municipal wastewater for SARS-CoV-2 infection surveillance at a population-wide level. In communities facing a delay between specimen collection and the reporting of test results, immediate wastewater results can provide considerable advance notice of infection dynamics.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , RNA, Viral/analysis , Waste Water/virology , Wastewater-Based Epidemiological Monitoring , Betacoronavirus/genetics , Biotechnology , Connecticut/epidemiology , Humans , Prevalence , RNA, Viral/genetics , Sewage/virology , Time Factors
2.
J Environ Manage ; 280: 111825, 2021 Feb 15.
Article in English | MEDLINE | ID: covidwho-1023634

ABSTRACT

The SARS-CoV-2/COVID-19 pandemic has spread across the globe and affected millions of individuals as of the efficient virus transmission potential mediated via multiple virus shedding routes. The presence of SARS-CoV-2 in the stool samples and its prolonged shedding in environmental compartments like sewage and wastewater signifies a potential threat adding to the transmission cycle of this novel virus. The potential role played by the asymptomatic COVID-19 patients in transmitting the disease via the fecal-oral route is now under investigation. Hence, in the present scenario, wastewater-based epidemiology, and sewage surveillance may provide valuable insights into the prevalence of SARS-CoV-2 among the human population and could serve as a sensitive surveillance system and a crucial early warning tool. Further studies are required to determine the survival of SARS-CoV-2 in the environment, transmissibility through wastewater, and the potential to infect humans via the fecal-oral route. Appropriate frameworks with regards to evaluation and analysis of SARS-CoV-2 will help implement appropriate intervention strategies and necessary sanitation practices to ensure virus free clean water supply to have a check on the further spread of this pandemic virus.


Subject(s)
Pandemics , Humans , Public Health , Sewage , Waste Water
3.
Sci Total Environ ; 759: 143493, 2021 Mar 10.
Article in English | MEDLINE | ID: covidwho-1009853

ABSTRACT

Wastewater-based epidemiology (WBE) is successful in the detection of the spread of SARS-CoV-2. This review examines the methods used and results of recent studies on the quantification of SARS-CoV-2 in wastewater. WBE becomes essential, especially with virus transmission path uncertainty, limitations on the number of clinical tests that could be conducted, and a relatively long period for infected people to show symptoms. Wastewater surveillance was used to show the effect of lockdown on the virus spread. A WBE framework tailored for SARS-CoV-2 that incorporates lessons learnt from the reviewed studies was developed. Results of the review helped outline challenges facing the detection of SARS-CoV-2 in wastewater samples. A comparison between the various studies with regards to sample concentration and virus quantification was conducted. Five different primers sets were used for qPCR quantification; however, due to limited data availability, there is no consensus on the most sensitive primer. Correlating the slope of the relationship between the number of gene copies vs. the cumulative number of infections normalized to the total population served with the average new cases, suggests that qPCR results could help estimating the number of new infections. The correlation is improved when a lag period was introduced to account for asymptomatic infections. Based on lessons learnt from recent studies, it is recommended that future applications should consider the following: 1) ensuring occupational safety in managing sewage collection and processing, 2) evaluating the effectiveness of greywater disinfection, 3) measuring viral RNA decay due to biological and chemical activities during collection and treatment, 4) assessing the effectiveness of digital PCR, and 5) conducting large scale international studies that follow standardized protocols.


Subject(s)
Communicable Disease Control , Humans , Sewage , Waste Water
4.
Water Sci Technol ; 82(12): 2823-2836, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-992979

ABSTRACT

The infection with SARS-CoV-2 is reported to be accompanied by the shedding of the virus in fecal samples of infected patients. Earlier reports have suggested that COVID-19 agents can be present in the sewage samples and thus it can be a good indication of the pandemic extent in a community. However, no such studies have been reported in the Indian context. Hence, it becomes absolutely necessary to detect the presence of the SARS-CoV-2 in the wastewater samples from wastewater treatment plants (WWTPs) serving different localities of Jaipur city. Samples from different WWTPs and hospital wastewater samples were collected and wastewater based epidemiology (WBE) studies were carried out using the RT-PCR to confirm the presence of different COVID-19 target genes namely S gene, E gene, ORF1ab gene, RdRp gene and N gene. The results revealed that the untreated wastewater samples showed the presence of SARS-CoV-2 viral genome, which was correlated with the increased number of COVID-19 positive patients from the concerned areas, as reported in the publically available health data. This is the first study that investigated the presence of SARS-CoV-2 viral genome in wastewater, at higher ambient temperature (45 °C), further validating WBE as potential tool in predicting and mitigating outbreaks.


Subject(s)
Cities , Humans , India/epidemiology , Sewage , Wastewater-Based Epidemiological Monitoring
5.
Viruses ; 12(10)2020 10 09.
Article in English | MEDLINE | ID: covidwho-983003

ABSTRACT

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), responsible for the ongoing coronavirus disease (COVID-19) pandemic, is frequently shed in faeces during infection, and viral RNA has recently been detected in sewage in some countries. We have investigated the presence of SARS-CoV-2 RNA in wastewater samples from South-East England between 14th January and 12th May 2020. A novel nested RT-PCR approach targeting five different regions of the viral genome improved the sensitivity of RT-qPCR assays and generated nucleotide sequences at sites with known sequence polymorphisms among SARS-CoV-2 isolates. We were able to detect co-circulating virus variants, some specifically prevalent in England, and to identify changes in viral RNA sequences with time consistent with the recently reported increasing global dominance of Spike protein G614 pandemic variant. Low levels of viral RNA were detected in a sample from 11th February, 3 days before the first case was reported in the sewage plant catchment area. SARS-CoV-2 RNA concentration increased in March and April, and a sharp reduction was observed in May, showing the effects of lockdown measures. We conclude that viral RNA sequences found in sewage closely resemble those from clinical samples and that environmental surveillance can be used to monitor SARS-CoV-2 transmission, tracing virus variants and detecting virus importations.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Sewage/virology , Betacoronavirus/isolation & purification , England/epidemiology , Environmental Monitoring , Genetic Variation , Genome, Viral/genetics , Humans , Pandemics , RNA, Viral/genetics , Real-Time Polymerase Chain Reaction , Sequence Analysis, DNA , Waste Water/virology
6.
Sci Total Environ ; 756: 144105, 2021 Feb 20.
Article in English | MEDLINE | ID: covidwho-947446

ABSTRACT

Wastewater-based epidemiology (WBE) is a useful tool that has the potential to act as a complementary approach to monitor the presence of SARS-CoV-2 in the community and as an early alarm system for COVID-19 outbreak. Many studies reported low concentrations of SARS-CoV-2 in sewage and also revealed the need for methodological validation for enveloped viruses concentration in wastewater. The aim of this study was to evaluate different methodologies for the concentration of viruses in wastewaters and to select and improve an option that maximizes the recovery of SARS-CoV-2. A total of 11 concentration techniques based on different principles were evaluated: adsorption-elution protocols with negatively charged membranes followed by polyethylene glycol (PEG) precipitation (Methods 1-2), PEG precipitation (Methods 3-7), aluminum polychloride (PAC) flocculation (Method 8), ultrafiltration (Method 9), skim milk flocculation (Method 10) and adsorption-elution with negatively charged membrane followed by ultrafiltration (Method 11). To evaluate the performance of these concentration techniques, feline calicivirus (FCV) was used as a process control in order to avoid the risk associated with handling SARS-CoV-2. Two protocols, one based on PEG precipitation and the other on PAC flocculation, showed high efficiency for FCV recovery from wastewater (62.2% and 45.0%, respectively). These two methods were then tested for the specific recovery of SARS-CoV-2. Both techniques could recover SARS-CoV-2 from wastewater, PAC flocculation showed a lower limit of detection (4.3 × 102 GC/mL) than PEG precipitation (4.3 × 103 GC/mL). This work provides a critical overview of current methods used for virus concentration in wastewaters and the analysis of sensitivity for the specific recovery of SARS-CoV-2 in sewage. The data obtained here highlights the viability of WBE for the surveillance of COVID-19 infections in the community.


Subject(s)
Viruses , Humans , Sewage , Waste Water
7.
Curr Opin Gastroenterol ; 37(1): 4-8, 2021 01.
Article in English | MEDLINE | ID: covidwho-873136

ABSTRACT

PURPOSE OF REVIEW: We discuss the potential role of the faecal chain in COVID-19 and highlight recent studies using waste water-based epidemiology (WBE) to track severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). RECENT FINDINGS: WBE has been suggested as an adjunct to improve disease surveillance and aid early detection of circulating disease. SARS-CoV-2, the aetiological agent of COVID-19, is an enveloped virus, and as such, typically not associated with the waste water environment, given high susceptibility to degradation in aqueous conditions. A review of the current literature supports the ability to detect of SARS-CoV-2 in waste water and suggests methods to predict community prevalence based on viral quantification. SUMMARY: The summary of current practices shows that while the isolation of SARS-CoV-2 is possible from waste water, issues remain regarding the efficacy of virial concentration and subsequent quantification and alignment with epidemiological data.


Subject(s)
/epidemiology , Public Health Surveillance/methods , Sewage/virology , /diagnosis , Feces/virology , Global Health , Humans
8.
Sci Total Environ ; 755(Pt 1): 142855, 2021 Feb 10.
Article in English | MEDLINE | ID: covidwho-845616

ABSTRACT

Detection of SARS-CoV-2 in sewage has been employed by several researchers as an alternative early warning indicator of virus spreading in communities, covering both symptomatic and asymptomatic cases. A factor that can seriously mislead the quantitative measurement of viral copies in sewage is the adsorption of virus fragments onto the highly porous solids suspended in wastewater, making them inaccessible. This depends not only on the available amount of suspended solids, but also on the amount of other dissolved chemicals which may influence the capacity of adsorption. On this account, the present work develops a mathematical framework, at various degrees of spatial complexity, of a physicochemical model that rationalizes the quantitative measurements of total virus fragments in sewage as regards the adsorption of virus onto suspended solids and the effect of dissolved chemicals on it. The city of Thessaloniki in Greece is employed as a convenient case study to determine the values of model variables. The present data indicate the ratio of the specific absorption (UV254/DOC) over the dissolved oxygen (DO) as the parameter with the highest correlation with viral copies. This implies a strong effect on viral inaccessibility in sewage caused (i) by the presence of humic-like substances and (ii) by virus decay due to oxidation and metabolic activity of bacteria. The present results suggest days where many fold corrections in the measurement of viral copies should be applied. As a result, although the detected RNA load in June 2020 is similar to that in April 2020, virus shedding in the city is about 5 times lower in June than in April, in line with the very low SARS-CoV-2 incidence and hospital admissions for COVID-19 in Thessaloniki in June.


Subject(s)
Sewage , Greece , Humans , Waste Water
9.
Biosens Bioelectron ; 169: 112617, 2020 Dec 01.
Article in English | MEDLINE | ID: covidwho-808194

ABSTRACT

The outbreak of coronavirus disease (COVID-19) has caused a significant public health challenge worldwide. A lack of effective methods for screening potential patients, rapidly diagnosing suspected cases, and accurately monitoring of the epidemic in real time to prevent the rapid spread of COVID-19 raises significant difficulties in mitigating the epidemic in many countries. As effective point-of-care diagnosis tools, simple, low-cost and rapid sensors have the potential to greatly accelerate the screening and diagnosis of suspected patients to improve their treatment and care. In particular, there is evidence that multiple pathogens have been detected in sewage, including SARS-CoV-2, providing significant opportunities for the development of advanced sensors for wastewater-based epidemiology that provide an early warning of the pandemic within the population. Sensors could be used to screen potential carriers, provide real-time monitoring and control of the epidemic, and even support targeted drug screening and delivery within the integration of emerging mobile health (mHealth) technology. In this communication, we discuss the feasibility of an integrated point-of-care biosensor system with mobile health for wastewater-based epidemiology (iBMW) for early warning of COVID-19, screening and diagnosis of potential infectors, and improving health care and public health. The iBMW will provide an effective approach to prevent, evaluate and intervene in a fast, affordable and reliable way, thus enabling real-time guidance for the government in providing effective intervention and evaluating the effectiveness of intervention.


Subject(s)
Betacoronavirus/isolation & purification , Biosensing Techniques/instrumentation , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Telemedicine/instrumentation , Wastewater-Based Epidemiological Monitoring , Equipment Design , Feasibility Studies , Humans , Pandemics , Point-of-Care Systems , Sewage/virology
10.
Sci Total Environ ; 755(Pt 1): 142575, 2021 Feb 10.
Article in English | MEDLINE | ID: covidwho-801210

ABSTRACT

Humanity has experienced outbreaks by viruses such as severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) in 2003, Eastern respiratory syndrome coronavirus (MERS-CoV) in 2012, Ebola virus in 2014 and nowadays SARS-CoV-2. While clinicians seek for a vaccine to reduce the epidemic outbreak, environmental engineers need to understand consequence of virus entity in sewage given the reported persistency of viruses in human feces and sewage environments for more than days. Herein, we discuss about concerns associated with virus occurrence in human feces and sewage, with attention to the possible SARS-CoV-2 transmission routes, based on the review of recent studies on SARS-CoV-2 as well as the previous pandemic events. Given the reported environmental stability of coronavirus, the feces- and sewage-derived transmission routes may be of importance to prevent unprecedented spread of coronavirus disease 2019 (COVID-19) particularly in developing countries. However, so far, limited number of studies detected infectious SARS-CoV-2 even in human feces, whereas a number of virus RNA copies were identified in both feces and sewage specimens. Therefore, uncertainty remains in the possibility of this transmission pathway, and further investigation is warranted in future studies, for example, by increasing the number of specimens, examining the effectiveness of methods for viral viability test, considering the patient medical history, and so forth.


Subject(s)
Middle East Respiratory Syndrome Coronavirus , Feces , Humans , Sewage
11.
Nat Biotechnol ; 38(10): 1164-1167, 2020 10.
Article in English | MEDLINE | ID: covidwho-780018

ABSTRACT

We measured severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentrations in primary sewage sludge in the New Haven, Connecticut, USA, metropolitan area during the Coronavirus Disease 2019 (COVID-19) outbreak in Spring 2020. SARS-CoV-2 RNA was detected throughout the more than 10-week study and, when adjusted for time lags, tracked the rise and fall of cases seen in SARS-CoV-2 clinical test results and local COVID-19 hospital admissions. Relative to these indicators, SARS-CoV-2 RNA concentrations in sludge were 0-2 d ahead of SARS-CoV-2 positive test results by date of specimen collection, 0-2 d ahead of the percentage of positive tests by date of specimen collection, 1-4 d ahead of local hospital admissions and 6-8 d ahead of SARS-CoV-2 positive test results by reporting date. Our data show the utility of viral RNA monitoring in municipal wastewater for SARS-CoV-2 infection surveillance at a population-wide level. In communities facing a delay between specimen collection and the reporting of test results, immediate wastewater results can provide considerable advance notice of infection dynamics.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , RNA, Viral/analysis , Waste Water/virology , Wastewater-Based Epidemiological Monitoring , Betacoronavirus/genetics , Biotechnology , Connecticut/epidemiology , Humans , Prevalence , RNA, Viral/genetics , Sewage/virology , Time Factors
12.
ACS Chem Neurosci ; 11(19): 2903-2905, 2020 10 07.
Article in English | MEDLINE | ID: covidwho-779925

ABSTRACT

Several lines of evidence suggest the presence of severe acute respiratory coronavirus-2 (SARS-CoV-2) in wastewater. The use of sewage water for irrigation is common in many developing countries, and it is only partially treated in the majority of countries with less than 10% of collected wastewater receiving any form of treatment globally. Wastewater is unsafe for human and animal consumption and contains impurities and microbial pathogens. Here, we pose the question of whether the reuse of untreated or partially treated wastewater for irrigation can expose susceptible populations and pets, leading to COVID-19 disease recurrence in the community? It is imperative to study the ecological relationships between humans, animals, and environmental health in relation to COVID-19 to contribute to a "One Health Concept" to design preventative strategies and attain optimal health for people, animals, and the environment.


Subject(s)
Agricultural Irrigation/methods , Coronavirus Infections/transmission , Pneumonia, Viral/transmission , Waste Water/virology , Animals , Animals, Domestic/virology , Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/veterinary , Humans , Pandemics/veterinary , Pneumonia, Viral/epidemiology , Pneumonia, Viral/veterinary , Risk Factors , Sewage/virology , Water Purification/methods
13.
Int J Environ Res Public Health ; 17(14)2020 07 16.
Article in English | MEDLINE | ID: covidwho-689918

ABSTRACT

The health of individuals and communities is more interconnected than ever, and emergent technologies have the potential to improve public health monitoring at both the community and individual level. A systematic literature review of peer-reviewed and gray literature from 2000-present was conducted on the use of biosensors in sanitation infrastructure (such as toilets, sewage pipes and septic tanks) to assess individual and population health. 21 relevant papers were identified using PubMed, Embase, Global Health, CDC Stacks and NexisUni databases and a reflexive thematic analysis was conducted. Biosensors are being developed for a range of uses including monitoring illicit drug usage in communities, screening for viruses and diagnosing conditions such as diabetes. Most studies were nonrandomized, small-scale pilot or lab studies. Of the sanitation-related biosensors found in the literature, 11 gathered population-level data, seven provided real-time continuous data and 14 were noted to be more cost-effective than traditional surveillance methods. The most commonly discussed strength of these technologies was their ability to conduct rapid, on-site analysis. The findings demonstrate the potential of this emerging technology and the concept of Smart Sanitation to enhance health monitoring at the individual level (for diagnostics) as well as at the community level (for disease surveillance).


Subject(s)
Biosensing Techniques , Sanitation , Humans , Pilot Projects , Public Health , Sewage
14.
Sci Total Environ ; 754: 142329, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-759345

ABSTRACT

For the first time, we present, i) an account of decay in the genetic material loading of SARS-CoV-2 during Upflow Anaerobic Sludge Blanket (UASB) treatment of wastewater, and ii) comparative evaluation of polyethylene glycol (PEG), and ultrafiltration as virus concentration methods from wastewater for the quantification of SARS-CoV-2 genes. The objectives were achieved through tracking of SARS-CoV-2 genetic loadings i.e. ORF1ab, N and S protein genes on 8th and 27th May 2020 along the wastewater treatment plant (106000 m3 million liters per day) equipped with UASB system in Ahmedabad, India. PEG method performed better in removing materials inhibiting RT-qPCR for SARS-CoV-2 gene detection from the samples, as evident from constant and lower CT values of control (MS2). Using the PEG method, we found a reduction >1.3 log10 reduction in SARS-CoV-2 RNA abundance during UASB treatment, and the RNA was not detected at all in the final effluent. The study implies that i) conventional wastewater treatment systems is effective in SARS-CoV-2 RNA removal, and ii) UASB system significantly reduces SARS-CoV-2 genetic loadings. Finally, PEG method is recommended for better sensitivity and inhibition removal during SARS-CoV-2 RNA quantification in wastewater.


Subject(s)
Sewage , Waste Water , Anaerobiosis , Bioreactors , Humans , India , Pandemics , RNA , Waste Disposal, Fluid
15.
Infect Dis Poverty ; 9(1): 124, 2020 Aug 31.
Article in English | MEDLINE | ID: covidwho-736446

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) was confirmed in Brazil in February 2020. Since then, the disease has spread throughout the country, reaching the poorest areas. This study analyzes the relationship between COVID-19 and the population's living conditions. We aimed to identify social determinants related to the incidence, mortality, and case fatality rate of COVID-19 in Brazil, in 2020. METHODS: This is an ecological study evaluating the relationship between COVID-19 incidence, mortality, and case fatality rates and 49 social indicators of human development and social vulnerability. For the analysis, bivariate spatial correlation and multivariate and spatial regression models (spatial lag model and spatial error models) were used, considering a 95% confidence interval and a significance level of 5%. RESULTS: A total of 44.8% of municipalities registered confirmed cases of COVID-19 and 14.7% had deaths. We observed that 56.2% of municipalities with confirmed cases had very low human development (COVID-19 incidence rate: 59.00/100 000; mortality rate: 36.75/1 000 000), and 52.8% had very high vulnerability (COVID-19 incidence rate: 41.68/100 000; mortality rate: 27.46/1 000 000). The regression model showed 17 indicators associated with transmission of COVID-19 in Brazil. CONCLUSIONS: Although COVID-19 first arrived in the most developed and least vulnerable municipalities in Brazil, it has already reached locations that are farther from large urban centers, whose populations are exposed to a context of intense social vulnerability. Based on these findings, it is necessary to adopt measures that take local social aspects into account in order to contain the pandemic.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Social Determinants of Health , Adolescent , Brazil/epidemiology , Child , Child, Preschool , Confidence Intervals , Coronavirus Infections/mortality , Education , Employment , Humans , Incidence , Income , Longevity , Multivariate Analysis , Pandemics , Pneumonia, Viral/mortality , Poverty , Regression Analysis , Sanitation , Sewage , Social Conditions , Spatial Analysis , Water Supply/standards , Young Adult
17.
Environ Res ; 190: 110045, 2020 11.
Article in English | MEDLINE | ID: covidwho-710290

ABSTRACT

Some environmental aspects are being increasingly studied in relation to the COVID-19 pandemic. Specifically, studies focusing on wastewater could be used for early warning, based on wastewater based epidemiology precepts. However, sewage sludge has been poorly studied in this regard up to now. In addition, soils have not been considered in publications related to SARS-CoV-2. In this piece, some comments are included to suggest a discussion regarding the eventual convenience of considering future studies focusing on soils receiving the spreading of wastewater and sewage sludge, as well as on plants growing on them.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Severe Acute Respiratory Syndrome , Soil Microbiology , Betacoronavirus , Humans , Sewage , Soil , Waste Water
18.
Microb Biotechnol ; 13(6): 1689-1701, 2020 11.
Article in English | MEDLINE | ID: covidwho-662511

ABSTRACT

The COVID-19 pandemic is not only a challenge for public health and hospitals, but affects many aspects of our societies. This Lilliput minireview deals with problems that the pandemic causes for the food industry, addressing the presence and persistence of SARS-CoV-2 in the food environment, methods of virus inactivation and the protection of the food worker and the consumer. So far food has not been implicated in the transmission of the infection, but social disruptions caused by the pandemic could cause problems with food security.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Food Industry , Food Supply , Pneumonia, Viral/transmission , Animals , Betacoronavirus/isolation & purification , Coronavirus Infections/prevention & control , Disease Models, Animal , Feces/virology , Humans , Occupational Exposure/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Sewage/virology , Water Microbiology
19.
J Med Virol ; 92(11): 2498-2510, 2020 11.
Article in English | MEDLINE | ID: covidwho-595840

ABSTRACT

Pandemic coronavirus disease-2019 (COVID-19) gives ample reason to generally review coronavirus (CoV) containment. For establishing some preliminary views on decontamination and disinfection, surrogate CoVs have commonly been assessed. This review serves to examine the existing science in regard to CoV containment generically and then to translate these findings into timely applications for COVID-19. There is widespread dissemination of CoVs in the immediate patient environment, and CoVs can potentially be spread via respiratory secretions, urine, and stool. Interpretations of the spread however must consider whether studies examine for viral RNA, virus viability by culture, or both. Presymptomatic, asymptomatic, and post-14 day virus excretion from patients may complicate the epidemiology. Whereas droplet spread is accepted, there continues to be controversy over the extent of possible airborne spread and especially now for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CoVs are stable in body secretions and sewage at reduced temperatures. In addition to temperature, dryness or relative humidity, initial viral burden, concomitant presence of bioburden, and the type of surface can all affect stability. Generalizing, CoVs can be susceptible to radiation, temperature extremes, pH extremes, peroxides, halogens, aldehydes, many solvents, and several alcohols. Whereas detergent surfactants can have some direct activity, these agents are better used as complements to a complex disinfectant solution. Disinfectants with multiple agents and adverse pH are more likely to be best active at higher water temperatures. Real-life assessments should be encouraged with working dilutions. The use of decontamination and disinfection should be balanced with considerations of patient and caregiver safety. Processes should also be balanced with considerations for other potential pathogens that must be targeted. Given some CoV differences and given that surrogate testing provides experimental correlates at best, direct assessments with SARS-CoV, Middle East respiratory syndrome-related coronavirus (MERS-CoV), and SARS-CoV-2 are required.


Subject(s)
Coronavirus/drug effects , Decontamination , Disinfectants/chemistry , Environmental Exposure/prevention & control , Sewage/virology , /prevention & control , Humans , Hydrogen-Ion Concentration , Radiation
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