Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building.
Ann Intern Med
; 173(12): 974-980, 2020 12 15.
Article
in English
| MEDLINE | ID: covidwho-738264
ABSTRACT
BACKGROUND:
The role of fecal aerosols in the transmission of severe acute respiratory syndrome coronavirus 2 has been suspected.OBJECTIVE:
To investigate the temporal and spatial distributions of 3 infected families in a high-rise apartment building and examine the associated environmental variables to verify the role of fecal aerosols.DESIGN:
Epidemiologic survey and quantitative reverse transcriptase polymerase chain reaction analyses on throat swabs from the participants; 237 surface and air samples from 11 of the 83 flats in the building, public areas, and building drainage systems; and tracer gas released into bathrooms as a surrogate for virus-laden aerosols in the drainage system.SETTING:
A high-rise apartment building in Guangzhou, China.PARTICIPANTS:
9 infected patients, 193 other residents of the building, and 24 members of the building's management staff. MEASUREMENTS Locations of infected flats and positive environmental samples, and spread of virus-laden aerosols.RESULTS:
9 infected patients in 3 families were identified. The first family had a history of travel to the coronavirus disease 2019 (COVID-19) epicenter Wuhan, whereas the other 2 families had no travel history and a later onset of symptoms. No evidence was found for transmission via the elevator or elsewhere. The families lived in 3 vertically aligned flats connected by drainage pipes in the master bathrooms. Both the observed infections and the locations of positive environmental samples are consistent with the vertical spread of virus-laden aerosols via these stacks and vents.LIMITATION:
Inability to determine whether the water seals were dried out in the flats of the infected families.CONCLUSION:
On the basis of circumstantial evidence, fecal aerosol transmission may have caused the community outbreak of COVID-19 in this high-rise building. PRIMARY FUNDING SOURCE Key-Area Research and Development Program of Guangdong Province and the Research Grants Council of Hong Kong.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
RNA, Viral
/
Disease Transmission, Infectious
/
Aerosols
/
SARS-CoV-2
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
Ann Intern Med
Year:
2020
Document Type:
Article
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