Dataset Information

Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building.

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 environment 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.

SUBMITTER: Kang M

PROVIDER: S-EPMC7464151 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building.

Kang Min M Wei Jianjian J Yuan Jun J Guo Juxuan J Zhang Yingtao Y Hang Jian J Qu Yabin Y Qian Hua H Zhuang Yali Y Chen Xuguang X Peng Xin X Shi Tongxing T Wang Jun J Wu Jie J Song Tie T He Jianfeng J Li Yuguo Y Zhong Nanshan N

Annals of internal medicine 20200901 12

<h4>Background</h4>The role of fecal aerosols in the transmission of severe acute respiratory syndrome coronavirus 2 has been suspected.<h4>Objective</h4>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.<h4>Design</h4>Epidemiologic survey and quantitative reverse transcriptase polymerase chain reaction analyses on throat swabs from the participants ...[more]

PMID: 32870707

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Project description:The role of heating, ventilation, and air-conditioning (HVAC) systems in the transmission of SARS-CoV-2 is unclear. To address this gap, we simulated the release of SARS-CoV-2 in a multistory office building and three social gathering settings (bar/restaurant, nightclub, wedding venue) using a well-mixed, multi-zone building model similar to those used by Wells, Riley, and others. We varied key factors of HVAC systems, such as the Air Changes Per Hour rate (ACH), Fraction of Outside Air (FOA), and Minimum Efficiency Reporting Values (MERV) to examine their effect on viral transmission, and additionally simulated the protective effects of in-unit ultraviolet light decontamination (UVC) and separate in-room air filtration. In all building types, increasing the ACH reduced simulated infections, and the effects were seen even with low aerosol emission rates. However, the benefits of increasing the fraction of outside air and filter efficiency rating were greatest when the aerosol emission rate was high. UVC filtration improved the performance of typical HVAC systems. In-room filtration in an office setting similarly reduced overall infections but worked better when placed in every room. Overall, we found little evidence that HVAC systems facilitate SARS-CoV-2 transmission; most infections in the simulated office occurred near the emission source, with some infections in individuals temporarily visiting the release zone. HVAC systems only increased infections in one scenario involving a marginal increase in airflow in a poorly ventilated space, which slightly increased the likelihood of transmission outside the release zone. We found that improving air circulation rates, increasing filter MERV rating, increasing the fraction of outside air, and applying UVC radiation and in-room filtration may reduce SARS-CoV-2 transmission indoors. However, these mitigation measures are unlikely to provide a protective benefit unless SARS-CoV-2 aerosol emission rates are high (>1,000 Plaque-forming units (PFU) / min).

Dataset Information

Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building.

Publications

Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building.

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