SARS-CoV-2 transmission modes: Why and how contamination occurs around shared meals and drinks?

In spite of prevention measures enacted all over the world to control the COVID-19 pandemic outbreak, including mask wearing, social distancing, hand hygiene, vaccination, and other precautions, the SARS-CoV-2 virus continues to spread globally at an unabated rate of about 1 million cases per day. The specificities of superspreading events as well as evidence of human-to-human, human-to-animal and animal-to-human transmission, indoors or outdoors, raise questions about a possibly neglected viral transmission route. In addition to inhaled aerosols, which are already recognized as key contributors to transmission, the oral route represents a strong candidate, in particular when meals and drinks are shared. In this review, we intend to discuss that significant quantities of virus dispersed by large droplets during discussions at festive gatherings could explain group contamination either directly or indirectly after deposition on surfaces, food, drinks, cutlery, and several other soiled vectors. We suggest that hand hygiene and sanitary practices around objects brought to the mouth and food also need to be taken into account in order to curb transmission.

[Covid-19: is the oral transmission route during shared meals and drinks credible?] / Covid-19 : la voie de transmission orale lors des repas et des boissons partagées est-elle crédible ?

Epidemiological and observational studies converge to suspect today a risk of contracting Covid-19 around shared meals and drinks. Contamination of table objects (plates, cutlery, glasses) or food and beverages put in the mouth is possible through droplets projected during speech or through direct contacts by dirty hands. This contamination could involve employees in the food chain, restaurant or bar staff and diners among themselves. Biopersistence on hands and cold food supports the hypothesis of contamination by the food route. The oral-digestive route is also supported by the clinical presentation of the patients, the presence of ACE2 and TMPRSS2 receptors and the SARS-CoV-2 virus found in the entire digestive tract. In addition, the reproduction of the disease via the oral route in experimental animal models confirms this hypothesis. Prevention around the food chain and around the meal by strict hygiene measures, especially hand hygiene, is essential and may be extended to other fields of application of everyday life.

Shared Food, Meals and Drinks: 10 Arguments Suggesting an Oral Transmission Route of SARS-CoV-2.

Numerous observational, epidemiologic data have suggested that the risk of COVID19 is related to shared meals or drinks. The presence of ACE2 receptors in the gastrointestinal tract supports this hypothesis. Furthermore, several patients experience gastrointestinal symptoms without any respiratory disease. The SARS-CoV-2 found on food and packaging in China and the epidemic resurgence attributed to foods are also strong indications of an oral transmission route. Unprecedented biopersistence on skin, food, and beverages supports this theory. Finally, animal models reproducing the disease by oral inoculation are additional arguments in favor of an oro-digestive route of infection.