A full list of contributing surgeons appears at the end of the article.

In response to the Coronavirus Disease 2019 (COVID-19) pandemic, current modeling supports the use of masks in community settings to reduce the transmission of SARS-CoV-2. However, concerns have been raised regarding the global shortage of medical grade masks and the limited evidence on the efficacy of fabric masks. This study used a standard mask testing method (ASTM F2101-14) and a model virus (bacteriophage MS2) to test the viral filtration efficiency (VFE) of fabric masks compared with commercially available disposable, surgical, and N95 masks. Five different types of fabric masks were purchased from the ecommerce website Etsy to represent a range of different fabric mask designs and materials currently available. One mask included a pocket for a filter; which was tested without a filter, with a dried baby wipe, and a section of a vacuum cleaner bag. A sixth fabric mask was also made according to the Victorian Department of Health and Human Services (DHHS) guidelines (Australia). Three masks of each type were tested. This study found that all the fabric masks had a VFE of at least 50% when tested against aerosols with an average size of 6.0 µm (VFE(6.0 µm)). The minimum VFE of fabric masks improved (to 63%) when the larger aerosols were excluded to give and average aerosol size of 2.6 µm (VFE(2.6 µm)), which better represents inhaled aerosols that can reach the lower respiratory system. The best performing fabric masks were the cotton mask with a section of vacuum cleaner bag (VFE(6.0 µm) = 99.5%, VFE(2.6 µm) = 98.8%) or a dried baby wipe (VFE(6.0 µm) = 98.5%, VFE(2.6 µm) = 97.6%) in the pocket designed for a disposable filter, the mask made using the Victorian DHHS design (VFE(6.0 µm) = 98.6%, VFE(2.6 µm) =99.1%) and one made from a layer of 100% hemp, a layer of poly membrane, and a layer of cheesecloth (VFE(6.0 µm) = 93.6%, VFE(2.6 µm) = 89.0%). The VFE of two surgical masks (VFE(6.0 µm) = 99.9% and 99.6%, VFE(2.6 µm) = 99.5% and 98.5%) and a N95 masks (VFE(6.0 µm) = 99.9%, VFE(2.6 µm) = 99.3%) were comparable to their advertised bacterial filtration efficacy. This research supports the use of fabric masks in the community to prevent the spread of SARS-CoV-2; however, future research is needed to explore the optimum design in ensuring proper fit. There is also a need for mass education campaigns to disseminate this information, along with guidelines around the proper usage and washing of fabric masks.

Strongyloides spp. are parasitic nematodes that are transmitted through the environment and are capable of causing disease. These nematodes affect an estimated 3–300 million humans worldwide. Identifying the environmental reservoirs of Strongyloides spp. is essential for the development of appropriate control strategies. This systematic literature review examined all published studies that identified Strongyloides stercoralis, Strongyloides fuelleborni, Strongyloides fuelleborni kellyi, and Strongyloides spp. from an environmental source. Most studies detected the nematode from dog and primate fecal samples. Other environmental sources identified were ruminants, cats, rodents, insects, water, soil, as well as fruit and vegetables. Most studies used microscopy-based identification techniques; however, several employed molecular-based techniques, which have become increasingly popular for the detection of Strongyloides spp. A limitation identified was a lack of studies that comprehensively screened all potential environmental samples in a region. Future research should undertake this holistic screening process to identify which environmental reservoirs pose the greatest significance to human health. Potential controls can be identified through the identification of environmental sources. Understanding where Strongyloides spp. is commonly found within the environment of endemic areas will inform environmental control strategies to reduce this neglected disease.

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