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Saved Stories – None: 10:12 AM 8/12/2020 – Can SARS-CoV-2 be transmitted via feces? “Various observational and mechanistic evidence support the hypothesis that SARS-CoV-2 can infect and be shed from the human gastrointestinal tract.” | Sars-Cov-2 fecal-respiratory transmission


Is SARS-CoV-2 Also an Enteric Pathogen With Potential Fecal–Oral ...

10:12 AM 8/12/2020

“Various observational and mechanistic evidence support the hypothesis that SARS-CoV-2 can infect and be shed from the human gastrointestinal tract.” – SARS-CoV-2 and the Role of Orofecal Transmission: Systematic Review | medRxiv


Can SARS-CoV-2 be transmitted via feces?
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Sars-Cov-2 fecal-respiratory transmissionNews


Michael Novakhov – SharedNewsLinks℠ | InBrief | 

Michael Novakhov – SharedNewsLinks 
Can SARS-CoV-2 be transmitted via feces?
SARS-CoV-2 and the Role of Orofecal Transmission: Systematic Review | medRxiv
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Michael Novakhov – SharedNewsLinks 
Can SARS-CoV-2 be transmitted via feces?

Michael_Novakhov shared this story from The Medical News.

A new study by researchers at the University of Oxford and the Trip Medical Database and published on the preprint server medRxivin August 2020 as part of the ongoing Open Evidence Review on Transmission Dynamics of COVID-19 reports the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in feces and the need for precautions to prevent orofecal spread in the surroundings of confirmed or suspected cases.

Colorized scanning electron micrograph of an apoptotic cell (green) heavily infected with SARS-CoV-2 virus particles (purple), isolated from a patient sample. Image at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. Credit: NIAIDColorized scanning electron micrograph of an apoptotic cell (green) heavily infected with SARS-CoV-2 virus particles (purple), isolated from a patient sample. Image at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. Credit: NIAID

How Does the Virus Spread?

It is essential to know how the virus spreads in order to develop effective measures to prevent its transmission in public and private settings. As far as is now understood, the virus spreads by respiratory droplets and aerosols (referring to surface contamination and direct airborne spread via the respiratory route), in the presymptomatic, asymptomatic or symptomatic individuals, as long as close contact occurs.
Fomites are objects which can harbor living infectious virus and act as a source of transmission to others. So far, the virus has been shown to contaminate and live on some surfaces successfully, but the direct fomite-to-human spread is yet to be demonstrated. However, studies of human sewage have shown that the virus can be detected. This suggests the potential for the spread of the virus through the orofecal route. This is a characteristic of locations where sanitation and hygiene facilities are painfully lacking. One route of orofecal transmission is fecal contamination of food.

The Reviews: Virus in Stool

The study used 59 studies, of which 29 were Chinese, while nine were reviews. One was a cohort study, which also included a review. There were 37 of 51 primary studies that reported the presence of the virus in fecal samples, confirmed by reverse transcriptase-polymerase chain reactions (RT PCR). In six studies, the virus was isolated from the feces. In 11 studies, fecal samples were found in sewage. Two studies used samples from bathrooms and toilets to detect viral material.
Of the reviews, six dealt with both adults and children, two with children only, one on food handling, and one on the available evidence for orofecal transmission and the potential link with wastewater management.
In one review, including 29 studies and over 4,800 patients, the researchers found that about 12% of infected patients had symptoms related to the gut diarrhea, nausea, and vomiting. In eight studies, stools were positive for viral RNA in ~41% of COVID-19-positive patients in a pooled analysis.
A second review found the possibility of orofecal transmission to be valid, supported by the third. The fourth, including 26 studies with over 800 patients, of which 540 were tested for fecal viral RNA, showed positive findings in 54%. Of these, 63% continued to shed even 47 days from the earliest symptom, even after the nasopharyngeal swab had become negative.
Another study reviewed whether stool specimens were tested for viable virus in stool and found that only 4/153 were so tested, of which half were positive. A sixth study included 15 studies with over 2,000 patients chiefly from mainland China, reporting gut symptoms to be increasingly noted as the epidemic progressed. Diarrhea, lasting about 4 days on average, was the most common and was seen in both adults and children, before and after diagnosis. Vomiting was more often seen in children. Fecal PCR and respiratory swab or specimen PCR were comparable in accuracy. Stool virus excretion continued after sputum excretion in a quarter of patients for 1-11 days.
Another review of four case studies in children showed that fecal excretion was three times as common as respiratory shedding at 14 days from symptom onset, but viral viability was not tested. Another pediatric review suggests that orofecal transmission is a possibility, and drawing on evidence of fecal excretion even at 30 days from symptom onset in SARS-CoV-1 infection, the study advised against declaring a child negative for the virus on the basis of one nasopharyngeal swab;

Is the Live Virus Found in Feces?

In six studies, the virus was isolated from nine patients. In one, the viral particle was found under electron microscopy of rectal tissue, and in another, the virus was found to infect and replicate in intestinal organoids.
A retrospective study of ~130 hospitalized COVID-19 patients showed that fecal or sputum specimens became positive for the virus after the pharyngeal swabs became negative. Another report suggested that fecal positivity continued long after respiratory samples became negative. As already quoted above, fecal shedding in one study continued for 1-33 days and, in one case, up to 47 days from symptom onset.

Viral Detection in Bathrooms of Hospitalized Patients

The study cites three patients in isolation rooms with symptoms of COVID-19, of which one showed the presence of the virus in 13/15 sites sampled in the room and 3/5 toilet sites, including the toilet bowl, sink, and door handle. In one patient, both respiratory samples and stool samples were positive in the absence of diarrhea.
In another hospital study of 37 samples from toilets, only four were positive and three weakly positive.

Virus in Sewage

Samples from two wastewater treatment plants in Australia from February 24 to April 13, 2020, were positive in 22% of cases from one point. Infections and prevalence estimates showed a strong correlation with the log10 copies of viral RNA in stool, wastewater, and feces in g/day. Hospital sewage samples also showed that the virus was present before disinfection and sometimes after disinfection, though the live virus was absent. Moreover, it can be found in live form for up to 14 days at 4oC.
Another study showed that the fecal virus preceded the clinical detection of cases, being found in frozen fecal samples on March 12, 2019, long before the first case was detected. Sewage surveillance could thus be a sensitive means of surveillance at low prevalence. Similar, viral RNA was found in half of the wastewater samples in Milan and Rome, early in the epidemic.

Prevention of Orofecal Transmission

Chlorination was found to be an effective disinfecting agent due to its lytic action, while hand hygiene is a useful tool in reducing hospital-associated infection risk.
Orofecal transmission has been suggested during earlier coronavirus epidemics as well, with many patients reporting watery diarrhea, and one outbreak being linked to a defective sewage system. Secondly, coronaviruses like MERS and SARS have been shown to replicate in the intestinal epithelium and to be excreted in stool to reach the sewage system. Glycosylation of the spike protein favors resistance of the virus against proteases in the gut, as well as to the acidity and the presence of bile salts.

Implications

The study indicates that strict attention should be paid to personal hygiene, chlorine-based surface disinfection in places where viral activity is likely, and stool testing before the discharge of patients from hospital. Stool positivity should either delay discharge or allow discharge only if quarantine and personal hygiene are guaranteed for such patients.
Moreover, further investigation into this route of excretion should be mandatory for every outbreak, with published results to find out whether the orofecal route is a valid route of viral transmission.

The study concludes: The evidence supports the hypothesis that SARS-CoV-2 can infect and be shed from the human gastrointestinal tract. This should emphasize routine surveillance of food, wastewaters and effluent, and emphasize the importance of strict personal hygiene measures, chlorine-based disinfection of surfaces in locations with presumed or known SARS CoV-2 activity.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

SARS-CoV-2 and the Role of Orofecal Transmission: Systematic Review | medRxiv

Michael_Novakhov shared this story .

Abstract

Background How SARS-CoV-2 is transmitted is of key public health importance. SARS-CoV-2 has been detected in the feces of some Covid-19 patients which suggests the possibility that the virus could additionally be transmitted via the orofecal route. Methods This review is part of an Open Evidence Review on Transmission Dynamics of Covid-19. We conduct ongoing searches using LitCovid, medRxiv, Google Scholar and Google for Covid-19; assess study quality based on five criteria and report important findings on an ongoing basis. Where necessary authors are contacted for further details or clarification on the content of their articles. Results We found 59 studies: nine reviews and 51 primary studies or reports (one cohort study also included a review) examining the potential role of orofecal transmission of SARS-CoV-2. Half (n=29) were done in China. Thirty seven studies reported positive fecal samples for SARS-CoV-2 based on RT-PCR results (n=1,034 patients). Six studies reported isolating the virus from fecal samples of nine patients, one study isolated the virus from rectal tissue and one laboratory study found that SARS-CoV-2 productively infected human small intestinal organoids. Eleven studies report on fecal samples found in sewage, and two sampled bathrooms and toilets. Conclusions Various observational and mechanistic evidence support the hypothesis that SARS-CoV-2 can infect and be shed from the human gastrointestinal tract. Policy should emphasize the importance of strict personal hygiene measures, and chlorine-based disinfection of surfaces in locations where there is presumed or known SARS-CoV-2 activity.

Google Alert – sars cov 2: Can SARS-CoV-2 be transmitted via feces?

Michael_Novakhov shared this story from Disease X-19 General Issues from Michael_Novakhov (4 sites).

… Transmission Dynamics of COVID-19 reports the presence of severe acute respiratory syndrome coronavirus 2 (SARSCoV2) in feces and the need …

 Google Alert – sars cov 2

New York City littered with trash after sanitation budget is cut by $106 million

Michael_Novakhov shared this story .

Just over a month after the Sanitation Department had its budget cut by millions, New Yorkers are beginning to see the effects. Throughout the city people are noticing trash overflowing wastebaskets, garbage littering the streets, and seemingly fearless pests, including rats and raccoons, scattering around the sidewalks.
In June, New York Citys sanitation budget was slashed by $106 million, which reduced the pickup of public litter baskets by 60%, in addition to several other changes.
Kathryn Garcia, commissioner of the NYC Department of Sanitation, says the decline in conditions is the effects of a variety of service cutbacks.
We ended the curbside composting program, we are not running any safe disposal events. We closed our special waste sites and we’re not doing highway sweeping. So much of what the city is experiencing is a real downshift in our resources, Garcia told Fox News Digital.
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She also said the department has had to reduce head count significantly, letting go of 411 uniformed staff and 88 civilian staff members.
As the sanitation commissioner points out, New York City is facing significant economic issues resulting from coronavirus-related shutdowns and a mass exodus of its wealthy residents. She believes sanitation should be among the last departments to receive budget cuts as it plays a vital role in the health of the city, both physically and economically.
Sanitation is one of the most, if not the most essential service in the city of New York No one wants to be opening a new business or trying to reopen a business that’s been closed when it’s dirty, and no resident wants to be in a neighborhood that’s dirty, said Garcia.
According to Joe Temperino, owner of Liberty Pest Control, the influx of trash in the streets is the reason people are also noticing an increased presence of rats.
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Due to the sanitation and due to the extreme amount of trash that’s out there, the problem is becoming a lot worse in New York City and in the boroughs, unfortunately, Temperino told Fox News Digital.
A large number of Temperino’s 4,300 clients have had to stop pest control treatments due to financial woes caused by coronavirus-related shutdowns. The pest control business owner says this is a big issue not only for his business but for businesses all around the city because, if left untreated, the pest problem will get very, very severe.
The health department’s gonna be back out there soon. And when they’re out there, that’s going to cause fines and other issues that us New Yorkers definitely don’t need right now.
Temperino is offering a number of his clients, many of which are restaurants, pro-bono treatments for what he says is preventative maintenance  because if left untreated, the pest problem will get out of hand and businesses will pay the consequences.
However, with coronavirus guidelines on businesses within the city remaining extremely strict, it seems restaurants will be limited to outdoor service for a while longer  leaving the streets with more trash, owners with less revenue, and customers fearing a rat may run under their table.
New York City littered with trash after sanitation budget is cut by $106 million

Michael_Novakhov shared this story from Covid-19 Review: The Pandemic As The Bio-Info-Weapon The Disease X-19.

In June, New York City’s sanitation budget was slashed by $106 million, … Kathryn Garcia, commissioner of the NYC Department of Sanitation, says the … streets is the reason people are also noticing an increased presence of rats.
5 things to know about gene editing in the COVID-19 era

Michael_Novakhov shared this story .

  • Precision medicine is playing a key role in helping scientists understand COVID-19.
  • CRISPR-based diagnostics will help rapidly and accurately diagnose a wide range of diseases, including the novel coronavirus.
  • The evolution of gene testing and gene editing will drive the future of healthcare.
One of the most common misconceptions about CRISPR is that its only useful for gene editing. In reality, CRISPR can be used for a wide variety of non-gene editing applications, ranging from diagnostics to antiviral applications.
There is also a perception that the gene-editing mechanism of CRISPR is the bottleneck for curing all disease. The reality is that, for many applications, the bottleneck is actually our understanding of the genetic code itself or the limitations of what changing that code can actually accomplish. How factors interplay with our genetic code to produce diseases is a field that is critical for unlocking gene editings full potential.

CRISPR is the search engine for biology.

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