COVID-19 faecal-oral transmission: Are we asking the right questions?
COVID-19 faecal-oral transmission: Are we asking the right questions?
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DOI：
10.1016/j.scitotenv.2020.138919
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发表时间：
2020-08-10
影响因子：
9.8
通讯作者：
Greco, Dirceu B.
中科院分区：
文献类型：
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作者：
Heller, Leo;Mota, Cesar R.;Greco, Dirceu B.
最近有报告称在粪便和污水中检测到SARS-CoV-2病毒，提出了粪口传播的假设。如果得到证实，这可能对公共卫生和流行病控制战略产生深远的影响。在本文中，我们认为，一个全面的和更细致入微的分析，需要测试这一假设，同时考虑到环境动态和病毒传染性的持久性。首先，我们检查粪便和污水中存在病毒的证据。然后，我们讨论了目前的疾病传播的框架，通过水和排泄物，以及如何传播的呼吸道疾病fittedinit. Because这一背景下，我们提出了一个框架来测试粪便-口腔假说，解开不同的环境路径从粪便到themouth易感的人。这一框架不应被视为对这一假设的确认，而应被视为对其复杂性的扩展看法，这可能有助于形成一个议程，以便对一些悬而未决的问题进行研究。最后，本文简要讨论了实际影响，根据目前的知识，遏制大流行病。(C)2020 Elsevier B. V.保留所有权利。
Detection of the SARS-CoV-2 virus in stools and sewage has recently been reported, raising the hypothesis of faecal-oral transmission. If confirmed, this could have far-reaching consequences for public health and for pandemic control strategies. In this paper, we argue that a comprehensive and more nuanced analysis is required to test this hypothesis, taking into consideration both environmental dynamics and the persistence of viral infectivity. First, we examine the evidence regarding the presence of the virus in stools and sewage. Then we discuss the current framework of disease transmission through water and excreta and how the transmission of a respiratory disease fits into it. Against this background, we propose a framework to test the faecal-oral hypothesis, unpacking the different environmental routes from faeces to themouth of a susceptible person. This framework should not be seen as a confirmation of the hypothesis but rather as an expanded viewof its complexities, which could help shaping an agenda for research into a number of unanswered questions. Finally, the paper briefly discusses practical implications, based on current knowledge, for containment of the pandemic. (C) 2020 Elsevier B.V. All rights reserved.