冠状病毒气溶胶传播及环境影响因素

当前,新型冠状病毒肺炎正在全球大范围流行,严重影响了人类健康和生产生活.目前已明确的新型冠状病毒的传播途径包括飞沫传播和接触传播,一些传播感染事件的研究间接证明新型冠状病毒可以通过空气传播,然而对于新型冠状病毒通过气溶胶传播机制的认识仍然不足,其对疾病传播的相对贡献等还在研究和论证中.本文分析了引起重症急性呼吸综合征、中东呼吸综合征和新型冠状病毒肺炎的不同冠状病毒通过气溶胶传播的研究结果,评述了病毒气溶胶的产生机制、病毒气溶胶的空气动力学特征、冠状病毒在气溶胶中的存活规律及环境因素的影响、以及冠状病毒在室内外环境气溶胶中的赋存和传播情况,探讨了当前对于明确新型冠状病毒的气溶胶传播研究的不足以及跨学科研究的展望.     

影响病毒在物体表面和空气中生存的因素分析

新型冠状病毒肺炎（COVID-19）疫情严重危害人类生命安全和影响国家经济发展.截至目前,关于环境条件（湿度与温度）、空气污染及人为活动对2019-nCoV传播的文献鲜见报道.由于新型冠状病毒（2019-nCoV）采样困难,难以开展直接试验研究,因此通过对国内外其他类似病毒文献调研,探究影响病毒传播和生存的影响因素,以期为疫情防控和控制2019-nCoV传播提供指导.结果表明:①冠状病毒在低温低湿的环境中能够保持较长的存活时间与传播力,尤其在干燥物体表面停留时间更长,如冠状病毒能在温度为22~25℃、相对湿度（RH）为40%~45%的光滑物体表面存活5 d以上;②同时,冠状病毒气溶胶在低温低湿的条件下也具有高存活率,提示在密闭环境中2019-nCoV气溶胶可能在温度为20~25℃、相对湿度为30%~50%的条件下具有较高的存活率;③颗粒物浓度越高,2019-nCoV传播的风险可能随之增加;④感染者的行为活动也对2019-nCoV的传播起着不可忽视的作用,应避免在人群中打喷嚏、咳嗽,并且用手、手肘或其他物品加以防护,降低病毒传播的可能性.综上,提出几点疫情防控的相关建议,如改善室内微环境和开展2019-nCoV的检测、灭活、影响因素、传播规律等相关研究工作.      

甲型流感的流行与防控分析及其对新冠肺炎疫情的启示

目前新型冠状病毒肺炎（COVID-19）疫情在全球流行,对人类生命健康造成威胁.对甲型流感这一常见传染病进行流行特征、影响因素和防控措施分析,回顾总结全球为防控甲型流感做出的努力及相关科学研究成果,为新型冠状病毒肺炎疫情提供防控经验和研究思路.结果表明:①甲型流感呈季节性流行,受气候、社会、政治和文化等多因素影响,在低温低湿、人口密集的环境中表现出强流行性.②甲型流感防控研究工作主要包括季节性流感病毒监测、流感病毒的生态学研究、广谱中和抗体及通用疫苗的研究、应对流感大流行的病原学风险评估四方面,其中季节性流感病毒监测是制定公共卫生政策及后续研究的核心防控措施.③与甲型流感类似,新型冠状病毒肺炎疫情流行受温度等气候因素影响,同时社会、政治、文化等因素也影响其传播,亟需借鉴较成熟的甲型流感的防控经验、技术和平台.建议在加强病毒监测的同时,深入开展病毒生态学研究、病原学风险评估和药物开发,对完善疫情防控工作和预警预测未来可能出现的二次暴发及传播至关重要.研究结果将为新型冠状病毒肺炎疫情和未来传染病疫情的防控及预测预警提供参考和研究思路.      

污水新型冠状病毒监测研究进展及启示

新冠肺炎疫情暴发以来,全球多个国家和地区频繁在污水中检测出新型冠状病毒核酸. 开展基于污水流行病学的污水新型冠状病毒监测,可作为人群新冠肺炎监测的重要补充,获得的核酸浓度数据和序列突变分析结果,可为新冠肺炎疫情早期预警、早期发现无症状感染者、评估感染规模、监测人群流行趋势、开展病毒溯源调查、制定防控政策等提供科学依据. 鉴于此,本文系统介绍了国内外污水中新型冠状病毒的来源及影响病毒存活的主要因素,归纳了常用的污水新型冠状病毒富集浓缩和核酸检测方法,概括了全球已开展的监测项目、进展及现存科学问题,指出了现有研究的局限性,包括缺乏污水中新型冠状病毒的分布特征及感染性研究、预测预警模型开发与应用不足等. 为我国下一阶段新冠肺炎疫情或者未来可能出现的突发重大疫情的精准防控提供借鉴与参考,提升我国应对传染病及非传染病的预测预警、流行规模评估及精准施策的能力.      

历史传染病疫情的环境与气候特征初探及对新冠肺炎疫情的思考

新型冠状病毒肺炎（COVID-19,简称“新冠肺炎”）疫情的暴发与流行对人类社会安全造成严重危害,同时也考验着世界各国公共卫生系统应对大型突发性传染病的防控能力.对历史传染病疫情暴发和流行的环境与气候特征进行总结,对于新冠肺炎疫情的科学研究及防控具有重要的参考价值.结果表明:①历史上人际传播的冠状病毒科、正粘病毒科传染病多暴发于北半球亚热带季风气候地区及冬春季节,而黄病毒科传染病多暴发在热带地区及高温多雨的夏秋季节.②全球变暖和极端天气催生影响传染病的暴发及传播.③人类对生态系统平衡的影响,迫使病毒宿主栖息地迁移和不同病毒宿主聚集,增加病毒变异概率和传染病暴发风险.在此基础上,提出了对新冠肺炎疫情的思考,认为适宜的气候因素可能利于疫情的暴发与流行,而热带国家疫情的暴发则说明需要重新审视气候、环境条件及生态因素对新型冠状病毒的影响.研究结果将为新冠肺炎疫情的防控和未来传染病疫情的预测及阻断提供参考和借鉴.      

新冠肺炎疫情期间我国居民洗手行为研究

直接接触和飞沫传播等方式是新型冠状病毒传播的主要途径,合理的洗手行为是切断暴露途径和降低病毒感染风险的有效防控措施,对于新型冠状病毒肺炎（COVID-19,简称“新冠肺炎”）疫情的防控具有重要的作用.该研究于2020年2月25日—3月14日,采用电子问卷的方式调查了覆盖我国31个省（自治区、直辖市）1 728个县（区）18岁及以上的居民,收集共计8 330名成人的洗手情形及洗手时长等信息,分析不同暴露情景下的洗手行为及其影响因素.结果表明:女性、城市地区居民在洗手比例和洗手时长上均分别高于男性、农村地区居民.人群在一般暴露情景下的洗手比例较高,而对于病毒感染风险较高的暴露情景（如咳嗽或打喷嚏后、接触他人后等）的洗手率（分别为73.6%和83.9%）排名靠后,说明人群对病毒的传播途径和防护措施有待深入理解;在洗手时间上,根据WHO规定的洗手时长标准（20 s）,仅有41.7%的人群洗手时长合格（大于20 s）,城区居民洗手时长的合格率（42.0%）显著高于农村地区（39.7%）;总体上,具有外出经历的人群洗手比例较未曾外出的人群高,新冠肺炎疫情期间居住地是否存在新冠肺炎疑似和确诊病例显著影响居民的洗手行为,但是疫情最严重的地区居民的洗手时长合格率（37.2%）最低,反而疫情最轻的地区居民的洗手时长合格率（43.6%）最高,说明居民的洗手行为可能受疫情等多方面的影响.研究显示,相比于非疫情期间而言,疫情期间我国居民洗手行为发生率提高,洗手时长合格率提高,但是仍然水平偏低.应提高居民洗手行为意识,科学地执行洗手这一防护措施,相关政策制定以及个人防护应当进一步关注和重视洗手行为的防疫作用.      

环境因素对病毒在水体中生存与传播的影响

目前,新型冠状病毒（2019-nCoV）在全球范围内广泛传播.2019-nCoV在粪便和污水中的检出揭示了病毒介水传播的可能性.了解各类环境因素对水源性病毒生存与传播的影响对介水传染病的防控及病毒风险评估具有重要意义.通过对国内外相关研究的文献调研,探究了影响病毒在水体中生存与传播的主要环境因素.研究表明,致病病毒在水环境中的存活和传播潜力与紫外线照射、水体温度、pH、盐度以及水体中存在的微生物和悬浮颗粒物等环境条件密切相关.即:①低温能够大幅延长病毒的存活时间,更有利于病毒在水体中的传播;高温能够加速病毒失活从而削弱病毒的传播潜力.②紫外线照射通过破坏病毒核酸能够有效去除和灭活病毒.③水体中的微生物能够产生对病毒颗粒不利的代谢物,或利用病毒衣壳作为营养来源,从而导致病毒失活.④各类水体中存在的大量悬浮颗粒物对病毒的吸附大大延长了病毒的存活时间,从而增强了病毒在水体中的潜在传播能力;此外,悬浮颗粒物能够促进或阻碍病毒在多孔介质中的传输与滞留.⑤pH通过改变病毒颗粒的表面电荷,影响病毒的团聚,从而影响病毒在水环境中的持久性.⑥无机离子通过影响病毒的团聚和吸附性能,从而改变其活性.环境因素对病毒存活的影响可能因不同的病毒特性而异,因此,应进一步探讨水环境中2019-nCoV存活能力的变异性,2019-nCoV在废水和饮用水处理过程中的赋存与归趋,并对废水、娱乐水域和饮用水中的2019-nCoV进行长期监测和定量风险评估.      

病毒在土壤中的存活时间与传播能力及其影响因素

土壤是病毒在自然界主要的分布场所,也是病毒传播的一种媒介.对流感病毒、肠道病毒、甲型肝炎病毒和冠状病毒在土壤中的存活与传播进行了系统分析,并探究了病毒在土壤中吸附与存活的主要影响因素.结果表明:流感病毒、肠道病毒、甲型肝炎病毒和冠状病毒均能在土壤中存活较长时间,并能以土壤为介质进行传播,进而导致人体暴露;土壤微生物、含水量、土壤类型及温度是影响病毒在土壤中吸附与存活的主要因素,土壤微生物的存在、含水量的降低以及温度的升高可能阻碍病毒在土壤中的存活,黏粒含量及pH较高的土壤中病毒的吸附量与存活率较高,而金属氧化物及有机质含量较高的土壤中病毒的吸附量与存活率较低.基于上述分析,对病毒在土壤中存活与传播的研究提出了有针对性的建议,如系统开展我国土壤病毒的调查研究,加强病毒在土壤中存活、传播规律及影响因素的研究等.研究显示,土壤在病毒的环境传播过程中具有重要作用,不可忽视病毒经土壤传播产生的风险.      

新冠肺炎疫情期间我国居民佩戴口罩防护行为研究

口罩作为阻隔病毒传染的物理方式之一,其能阻断病原体经飞沫传播,同时具有双向隔离保护作用.佩戴口罩对于公众防范新型冠状病毒（2019-nCoV）感染的风险和维持人体基本健康具有重要意义.为了解新型冠状病毒肺炎（COVID-19,简称“新冠肺炎”）疫情期间我国居民佩戴口罩的行为模式特征,基于新冠肺炎疫情期间我国人群环境暴露行为模式调查,分析全国31个省（自治区、直辖市）居民在新冠肺炎疫情期间佩戴口罩的行为特征,并探讨不同潜在风险人群佩戴口罩行为模式的差异性.结果表明:①在新冠肺炎疫情期间,我国人群外出佩戴口罩的比例在99%以上,显著高于非疫情期间的口罩佩戴率（16.05%）,其中,医务人员以及与人群广泛接触群体的口罩佩戴率最高（100%）.②居民以仅佩戴医用外科口罩、仅佩戴一次性使用医用口罩以及佩戴医用外科口罩和一次性使用医用口罩3种模式为主,占31种口罩佩戴模式的60%以上.③新冠肺炎疫情期间,不同职业人群、不同所属人群以及不同疫情地区人群佩戴口罩的比例均存在显著差异.④新冠肺炎疫情期间,我国居民佩戴口罩的更换频次多为累计使用时长4 h更换一次和累计使用时长24 h更换一次.⑤人群外出佩戴口罩的比例随新冠肺炎疫情严重程度的升高而增加.尽管新冠肺炎疫情分布特征和管控措施存在差异,但居民佩戴口罩行为均表现良好,其中居住地不存在疑似病例的人群比居住地存在疑似病例的人群的口罩佩戴率更高,说明人群佩戴口罩行为与疫情的发展可能存在一定的相互作用.研究显示,新冠肺炎疫情期间我国人群佩戴口罩这一防护行为总体执行较好.      

新冠肺炎疫情对农村人居环境整治的影响

新型冠状病毒肺炎（COVID-19,简称“新冠肺炎”）疫情的发生,影响了我国经济水平较低、环境管控力度较薄弱的农村地区的发展.通过对新冠肺炎防疫过程与农村人居环境整治工作间的相互关系进行剖析,探究新冠肺炎疫情防控对农村人居环境整治的主要影响.结果表明,农村垃圾堆积、污水处理不当、厕所粪污无害化处理不达标以及基础设施建设不完善等农村人居环境薄弱环节,存在形成病毒传播扩散途径的风险.而交通运输限制虽然有效抑制了新冠肺炎疫情扩散,但也致使农村人居整治工作延滞.同时,新冠肺炎疫情的传播扩散在短期内限制了农民行为活动,降低了群众对农村人居环境整治工作的热情.据此,建议应健全农村人居环境整治制度,完善整治工程技术,从而在有效管控新冠肺炎疫情传播的同时,更好地推进农村人居环境整治,提高农民生活质量,为疫情过后恢复农民生活、农业生产以及农村发展打下坚实的基础.      

Pre-harvest Viral Contamination of Crops Originating from Fecal Matter

Pre-harvest contamination of fresh produce and fruits is a possible route for viral transmission which should not be ignored. The contamination originates from viruses shed in human or animal fecal materials which eventually reach crops through many steps and hurdles, including spread of viruses into the agricultural environment through leakage of septic tanks/pipes or runoff from animal lagoons, virus survival during biosolids and manure treatment, virus survival and transport in soil and subsequent contamination of irrigation water, and virus transmission to crops through irrigation water, etc. Initially, large quantities of virus particles may be released from infected humans or animals, and then in the environment viruses are gradually inactivated under various natural conditions (e.g., temperature, water activity, microbial activities, etc.) and only a tiny portion of viruses may reach crops and cause the contamination. However, the fact that the infectious dose of some foodborne viruses is as low as 10–100 particles makes the pre-harvest contamination still a threat to human health. In the USA, the Environmental Protection Agency (USEPA) and United States Department of Agriculture (USDA) regulations and guidances on proper treatment and usage of manure and biosolids for agricultural purpose may largely reduce the release of viruses to the environment; however, pre-harvest viral contamination due to fecal matter is not completely avoidable. This review focuses on the current knowledge of pre-harvest viral contamination and describes the complex transmission process regarding the presence and survival of virus in soil and fecal material, the effect of different biosolids/manure treatment on virus inactivation, the transmission of virus from soil to water, the contamination of crops by irrigation water and survival of virus on crops.     

Persistence of Hepatitis A Virus in Fresh Produce and Production Environments,and the Effect of Disinfection Procedures: A Review

Although information is limited, it is evident that prolonged persistence of infectious Hepatitis A virus (HAV) is a factor in the transmission of the virus via fresh produce. Consequently, data on persistence of the virus on produce, and in environments relevant to production, such as soils, water and surfaces, are required to fully understand the dynamics of transmission of HAV via foods. Furthermore, information on effective disinfection procedures is necessary to implement effective post-harvest control measures. This review summarises current information on HAV persistence in fresh produce and on relevant disinfection procedures. On vegetables, HAV can remain infectious for several days; on frozen berries, it can persist for several months. HAV can remain infectious on surfaces for months, depending on temperature and relative humidity, and can survive desiccation. It can survive for several hours on hands. Washing hands can remove the virus, but further data are required on the appropriate procedure. Chlorination is effective in water, but not when HAV is associated with foodstuffs. Bleach and other sodium hypochlorite disinfectants at high concentrations can reduce HAV on surfaces, but are not suitable for use on fresh produce. There is only limited information on the effects of heating regimes used in the food industry on HAV. HAV is resistant to mild pasteurisation. Some food components, e.g. fats and sugars, can increase the virus’ resistance to higher temperatures. HAV is completely eliminated by boiling. Quantitative prevalence data are needed to allow the setting of appropriate disinfection log reduction targets for fresh produce.     

Minimum Infective Dose of the Major Human Respiratory and Enteric Viruses Transmitted Through Food and the Environment

Viruses are a significant cause of morbidity and mortality around the world. Determining the minimum dose of virus particles that can initiate infection, termed the minimum infective dose (MID), is important for the development of risk assessment models in the fields of food and water treatment and the implementation of appropriate infection control strategies in healthcare settings. Both respiratory and enteric viruses can be shed at high titers from infected individuals even when the infection is asymptomatic. Presence of pre-existing antibodies has been shown to affect the infectious dose and to be protective against reinfection for many, but not all viruses. Most respiratory viruses appear to be as infective in humans as in tissue culture. Doses of <1 TCID₅₀ of influenza virus, rhinovirus, and adenovirus were reported to infect 50% of the tested population. Similarly, low doses of the enteric viruses, norovirus, rotavirus, echovirus, poliovirus, and hepatitis A virus, caused infection in at least some of the volunteers tested. A number of factors may influence viruses’ infectivity in experimentally infected human volunteers. These include host and pathogen factors as well as the experimental methodology. As a result, the reported infective doses of human viruses have to be interpreted with caution.     

Issues Concerning Survival of Viruses on Surfaces

Viruses are the causative agents of an estimated 60% of human infections worldwide. The most common viral illnesses are produced by enteric and respiratory viruses. Transmission of these viruses from an infected person or animal to a new host can occur via several routes. Existing studies strongly suggest that contaminated fomites or surfaces play an important role in the spreading of viral diseases. The potential of viral spreading via contaminated surfaces depends particularly on the ability of the virus to maintain infectivity whilst it is in the environment. This is affected by a combination of biological, physical and chemical factors. This review summarises current knowledge about the influence of environmental factors on the survival and spread of viruses via contaminated surfaces.     

冠状病毒IBV和噬菌体MS2在饱和多孔介质中的运移规律

为研究病毒在土壤中的运移机理,选择鸡的传染性支气管炎冠状病毒(IBV)和噬菌体(MS2)为材料,采用土柱模拟实验研究2种病毒在不同输入方式(IBV脉冲,MS2阶跃)、不同饱和多孔介质中的运移规律.结果表明,IBV在饱和玻璃珠中的运移有少量滞留和延迟;MS2在饱和砂土中的运移随着离子强度的不同而不同,存在两个临界点,分别为0.065mol/L和0.080mol/L.在离子强度从0.002mol/L升高到0.065mol/L时,病毒吸附随着离子强度的增加而迅速增加;离子强度在0.065～0.080mol/L时,病毒吸附随着离子强度的增加而迅速降低;当离子强度超过临界点0.08mol/L后,随着离子强度的增加病毒吸附缓慢增加.在相同pH值和离子强度的不同介质中,IBV比MS2吸附和滞留较多.     

Prevalence of Human Parainfluenza Viruses and Noroviruses Genomes on Office Fomites

The aim of this study was to evaluate the potential role of office fomites in respiratory (human parainfluenza virus 1—HPIV1, human parainfluenza virus 3—HPIV3) and enteric (norovirus GI—NoV GI, norovirus GII—NoV GII) viruses transmission by assessing the occurrence of these viruses on surfaces in office buildings. Between 2016 and 2017, a total of 130 surfaces from open-space and non-open-space rooms in office buildings located in one city were evaluated for HPIV1, HPIV3, NoV GI, and NoV GII viral RNA presence. Detection of viruses was performed by RT-qPCR method. Study revealed 27 positive samples, among them 59.3% were HPIV3-positive, 25.9% HPIV1-positive, and 14.8% NoV GII-positive. All tested surfaces were NoV GI-negative. Statistical analysis of obtained data showed that the surfaces of office equipment including computer keyboards and mice, telephones, and desktops were significantly more contaminated with respiratory viruses than the surfaces of building equipment elements such as door handles, light switches, or ventilation tracts (χ ² p = 0.006; Fisher’s Exact p = 0.004). All examined surfaces were significantly more contaminated with HPIVs than NoVs (χ ² p = 0.002; Fisher’s Exact p = 0.003). Office fomites in open-space rooms were more often contaminated with HPIVs than with NoVs (χ ² p = 0.016; Fisher’s Exact p = 0.013). The highest average concentration of HPIVs RNA copies was observed on telephones (1.66 × 10² copies/100 cm²), while NoVs on the light switches (1.40 × 10² copies/100 cm²). However, the Kruskal–Wallis test did not show statistically significant differences in concentration levels of viral RNA copies on surfaces between the all tested samples. This study unequivocally showed that individuals in office environment may have contact with both respiratory and enteric viral particles present on frequently touched surfaces.     

病毒对地下水的入侵风险与防控对策浅析

病毒可能会成为人类未来的“头号公敌”,全球地下水病毒污染事件频繁发生,因此,病毒对地下水的影响和防控逐渐受到国际重视.为进一步了解地下水病毒入侵,通过文献检索调研,分析了病毒进入含水层的途径、在地下水中迁移的限制性因素、在多孔介质中的转化过程,总结了地下水病毒入侵防控相关方法、技术、政策,探讨了风险防范意识有待加强、地下水病毒科学研究存在短板、应急防控与预警能力不足等问题及挑战.参考国内外相关研究成果和实践经验,初步提出地下水病毒入侵风险防控对策建议:①源头排查风险,防患于未然.在地下水饮用水水源地保护区及补给区,排查防疫类污染源渗漏情况,经过化学或高温消毒后再使用农村地下水饮用水、生活用水.②加强地下水饮用水水源地病毒调查研究.研究病毒在土壤及地下水中的存活能力、迁移转化机制、环境行为特征、模拟预测技术、健康风险评价方法,制定相关规范、指南.③筹划应急防控对策.做好地下水应急监测预警、饮用水消毒处理、环境质量信息公开等相关准备工作,制定地下水饮用水水源地病毒应急防控预案.