Open defecation and squat toilets, an overlooked risk of fecal transmission of COVID-19 and other pathogens in developing communities

Sun, Shumei; Han, Jun

doi:10.1007/s10311-020-01143-1

Cited by 44 publications

(30 citation statements)

References 34 publications

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“…Epidemiological studies on outpatient visits, respiratory emergency department visits and hospital admissions manifested a positive association between particle exposure and human respiratory infections Strosnider et al 2019;Xia et al 2017). Similar conclusions were drawn from related animal models that exposure to particulate matter increased susceptibility to pulmonary infections (Liu et al 2019;Zhao et al 2014).…”

Section: Increased Covid-19 Morbidity and Mortality Due To Exposure Tsupporting

confidence: 65%

“…However, no experimental data or evidence were supplied in those discussions to validate the hypotheses. Given the ubiquitous presence of indoor aerosol particles and the elevated risks of transmitting respiratory pathogens in enclosed environments, an effective transmission route mediated by those invisible agents—once we achieve a better understanding on their roles—would require urgent assessment and public attention in the ongoing pandemic with worsening situations and re-emergent outbreaks reported in countries and regions (Han et al 2020 ; Sun and Han 2020 ; WHO 2020c ).…”

Section: Introductionmentioning

confidence: 99%

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Role of indoor aerosols for COVID-19 viral transmission: a review

2021

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The relationship between outdoor atmospheric pollution by particulate matter and the morbidity and mortality of coronavirus disease 2019 (COVID-19) infections was recently disclosed, yet the role of indoor aerosols is poorly known. Since people spend most of their time indoor, indoor aerosols are closer to human occupants than outdoors, thus favoring airborne transmission of COVID-19. Therefore, here we review the characteristics of aerosol particles emitted from indoor sources, and how exposure to particles affects human respiratory infections and transport of airborne pathogens. We found that tobacco smoking, cooking, vacuum cleaning, laser printing, burning candles, mosquito coils and incenses generate large quantities of particles, mostly in the ultrafine range below 100 nm. These tiny particles stay airborne, are deposited in the deeper regions of human airways and are difficult to be removed by the respiratory system. As a consequence, adverse effects can be induced by inhaled aerosol particles via oxidative stress and inflammation. Early epidemiological evidence and animal studies have revealed the adverse effects of particle exposure in respiratory infections. In particular, inhaled particles can impair human respiratory systems and immune functions, and induce the upregulation of angiotensin-converting enzyme 2, thus inducing higher vulnerability to COVID-19 infection. Moreover, co-production of inflammation mediators by COVID-19 infection and particle exposure magnifies the cytokine storm and aggravates symptoms in patients. We also discuss the role of indoor aerosol particles as virus carriers. Although many hypotheses were proposed, there is still few knowledge on interactions between aerosol articles and virus-laden droplets or droplet nuclei.

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Section: Increased Covid-19 Morbidity and Mortality Due To Exposure Tsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Role of indoor aerosols for COVID-19 viral transmission: a review

2021

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“…Adding to the existing hand washing facilities and importantly ensuring frequent supply of these consumables including hand sanitizers are critical to enhancing COVID-19 hygienic practices at the landing beaches. Although very little fish in the artisanal fish value chain goes through cold storage, cold-chain transportation of food including fish is reportedly an important way of spreading the virus 25 . Therefore, instituting modalities for disinfecting frozen fish at imported fish outlets and the transhipped fish (Saiko) landing sites is also very critical as both the transhipped fish from industrial trawlers and imported fish end up mainly with fish processors along the coast.…”

Section: Discussionmentioning

confidence: 99%

Physical distancing and risk of COVID-19 in small-scale fisheries: a remote sensing assessment in coastal Ghana

Okyere

Chuku

Ekumah

et al. 2020

Sci Rep

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The novel coronavirus is predicted to have dire implications on global food systems including fisheries value chains due to restrictions imposed on human movements in many countries. In Ghana, food production, both agriculture and fisheries, is exempted from restrictions as an essential service. The enforcement of COVID-19 prevention protocols, particularly social distancing, has been widely reported in Ghana’s agricultural markets whereas casual observations and media reports on fish landing sites suggest no such enforcements are in place. This study aimed to provide sound scientific evidence as a basis for informed policy direction and intervention for the artisanal fishing sector in these challenging times. We employed an unmanned aerial vehicle in assessing the risk of artisanal fishers to the pandemic using physical distancing as a proxy. From analysis of cumulative distribution function (G-function) of the nearest-neighbour distances, this study underscored crowding at all surveyed fish landing beaches, and identified potential “hotspots” for disease transmission. Aerial measurements taken at times of peak landing beach activity indicated that the highest proportion of people, representing 56%, 48%, 39% and 78% in Elmina, Winneba, Apam and Mumford respectively, were located at distances of less than one metre from their nearest neighbour. Risk of crowding was independent of the population at the landing beaches, suggesting that all categories of fish landing sites along the coast would require equal urgency and measured attention towards preventing and mitigating the spread of the disease.

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“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causation agent of the current COVID-19 pandemic, is primarily transmitted via respiratory droplets, contact surfaces (Han et al 2020 ; Wang et al 2020a ) and fecal routes (Sun and Han 2020a ), the former being generated by human respiratory activities such as coughing, sneezing and talking (WHO 2020b ). Recently, researchers began to realize that airborne transmission played an essential role in several large clustered infections of COVID-19 (Lewis 2020 ).…”

Section: Transmission Of Covid-19 By Virus-laden Droplets and Indoor mentioning

confidence: 99%

How human thermal plume influences near-human transport of respiratory droplets and airborne particles: a review

Sun

Han

2021

Environ Chem Lett

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With mounting evidence and notable cases of large clustered infections, airborne transmission via droplets and particles has been recently acknowledged as an effective mode of transmission for COVID-19. How droplets and aerosol particles disperse are being transported into the human breathing zone-the last few inches for airborne transmission to effectuate-remains a key question which has been widely overlooked. Human thermal plume refers to the constantly rising airflows around the boundary layer of human body due to persisting temperature gradients between the body surfaces and the ambient air. Ample evidence indicated that the thermal plume controls the dispersion and transport of aerosols in the human microenvironment. Given that in calm indoor environments most air inhaled by human comes from the boundary layer where thermal plume flows through constantly, the role of thermal plume needs to be scrutinized to predict the diffusion of droplets, aerosols and other airborne carriers of the novel coronavirus around the human body for prioritizing infection control strategies. Here, we assessed the potential influences of the thermal plume on the transmission of COVID-19 and other airborne pathogens by reviewing the most pertinent evidence and analyzing key variables in the formation of thermal plume in indoor environments, e.g., ambient temperature, human posture and type of clothing. Our reviewed evidence and data indicate that the human thermal plume should facilitate the airborne transmission of COVID-19 in enclosed spaces by elevating small droplets and airborne particles into the breathing zone from lower regions and ascending respiratory droplets from the sources into the upper atmosphere. By drawing attention to aerosol transport dynamics in the human microenvironment, these insights may be useful for understanding COVID-19 transmission in enclosed spaces, especially those intended for public use.

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Open defecation and squat toilets, an overlooked risk of fecal transmission of COVID-19 and other pathogens in developing communities

Cited by 44 publications

References 34 publications

Role of indoor aerosols for COVID-19 viral transmission: a review

Role of indoor aerosols for COVID-19 viral transmission: a review

Physical distancing and risk of COVID-19 in small-scale fisheries: a remote sensing assessment in coastal Ghana

How human thermal plume influences near-human transport of respiratory droplets and airborne particles: a review

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