key: cord-331300-u5fltc10
authors: Patel, Jay
title: Viability of SARS‐CoV‐2 in faecal bio‐aerosols
date: 2020-06-09
journal: Colorectal Dis
DOI: 10.1111/codi.15181
sha: 
doc_id: 331300
cord_uid: u5fltc10

I read with interest the rapid review by Gupta and colleagues [1] concerning the incidence and timing of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) positive faecal samples in patients with coronavirus disease 2019 (COVID‐19). The authors acknowledge insufficient evidence in support of transmission via faeco‐oral route and identify the need for further research regarding the viability of SARS‐CoV‐2 in the context of human faeces. However, it is equally pertinent to consider the viability of the virus in faecal bio‐aerosols generated by toilet plumes [2].

Dear Editor, I read with interest the rapid review by Gupta and colleagues [1] concerning the incidence and timing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive faecal samples in patients with coronavirus disease 2019 (COVID-19). The authors acknowledge insufficient evidence in support of transmission via faeco-oral route and identify the need for further Accepted Article research regarding the viability of SARS-CoV-2 in the context of human faeces. However, it is equally pertinent to consider the viability of the virus in faecal bio-aerosols generated by toilet plumes [2] . During the SARS outbreak, it was suggested that a major contributor for the rapid transmission of the initial 187 cases in Hong Kong was propagated by an aerosolisation effect of SARS-CoV-1 in faeces with notably high viral load [3] . There is considerable variation in the This consideration extends to the handling of faecal wastes discharged from hospitals and others sources. Sewage discharged from two hospitals in Beijing during the SARS outbreak identified positive for SARS-CoV-1 [4] . Using quantitative real-time reverse transcription PCR methods, Wang and colleagues confirmed the presence of SARS-CoV-2 RNA in hospital inlets of a preprocessing disinfection sewage pool [5] . Though this review is currently dismissive of faecooral transmission based on the available evidence, data in this area is rapidly evolving. Given the far-reaching consequences that this would pose for the environment and nosocomial infection risk, the viability of SARS-CoV-2 in faecal bio-aerosols in addition to human faeces should be considered an urgent priority. Heightened care in the management of faecal wastes is an imperative intervention until these questions are answered.

Persistent viral shedding of SARS-CoV-2 in faeces -a rapid review

Put a lid on it: Are faecal bio-aerosols a route of transmission for SARS-CoV-2?

Evidence of airborne transmission of the severe acute respiratory syndrome virus

Concentration and detection of SARS coronavirus in sewage from Xiao Tang Shan Hospital and the 309th Hospital of the Chinese People's Liberation Army

SARS-CoV-2 RNA detection of hospital isolation wards hygiene monitoring during the Coronavirus Disease 2019 outbreak in a Chinese hospital

Accepted Article