Number of COVID-19 cases required in a population to detect SARS-CoV-2 RNA in wastewater in the province of Alberta, Canada: Sensitivity assessment

With a unique and large size of testing results of 1,842 samples collected from 12 wastewater treatment plants (WWTP) for 14 months through from low to high prevalence of COVID-19, the sensitivity of RT-qPCR detection of SARS-CoV-2 RNA in wastewater that correspond to the communities was computed by using Probit analysis. This study determined the number of new COVID-19 cases per 100,000 population required to detect SARS-CoV-2 RNA in wastewater at defined probabilities and provided an evidence-based framework of wastewater-based epidemiology surveillance (WBE). Input data were positive and negative test results of SARS-CoV-2 RNA in wastewater samples and the corresponding new COVID-19 case rates per 100,000 population served by each WWTP. The analyses determined that RT-qPCR-based SARS-CoV-2 RNA detection threshold at 50%, 80% and 99% probability required a median of 8 (range: 4-19), 18 (9-43), and 38 (17-97) of new COVID-19 cases /100,000, respectively. Namely, the positive detection rate at 50%, 80% and 99% probability were 0.01%, 0.02%, and 0.04% averagely for new cases in the population. This study improves understanding of the performance of WBE SARS-CoV-2 RNA detection using the large datasets and prolonged study period. Estimated COVID-19 burden at a community level that would result in a positive detection of SARS-CoV-2 in wastewater is critical to support WBE application as a supplementary warning/monitoring system for COVID-19 prevention and control.     

Environmental surveillance of SARS-CoV-2 RNA in wastewater systems and related environments in Wuhan: April to May of 2020

Wastewater-based epidemiology(WBE) has emerged as an effective environmental surveillance tool in monitoring fecal-oral pathogen infections within a community. Congruently, SARS-Co V-2, the etiologic agent of COVID-19, has been demonstrated to infect the gastrointestinal tissues, and be shed in feces. In the present study, SARS-Co V-2 RNA was concentrated from wastewater, sludge, surface water, ground water, sediment, and soil samples of municipal and hospital wastewater systems and related envi...     

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.      

Identification of Workers at Increased Risk of Infection During a COVID-19 Outbreak in a Meat Processing Plant,France, May 2020

Food and Environmental Virology - On 13 May 2020, a COVID-19 cluster was detected in a French processing plant. Infected workers were described. The associations between the SARS-CoV-2 infection...     

SARS-CoV-2 in the context of past coronaviruses epidemics: Consideration for prenatal care

Since December 2019, the novel SARS-CoV-2 outbreak has resulted in millions of cases and more than 200 000 deaths worldwide. The clinical course among nonpregnant women has been described, but data about potential risks for women and their fetus remain scarce. The SARS and MERS epidemics were responsible for miscarriages, adverse fetal and neonatal outcomes, and maternal deaths. For COVID-19 infection, only nine cases of maternal death have been reported as of 22 April 2020, and pregnant women seem to develop the same clinical presentation as the general population. However, severe maternal cases, as well as prematurity, fetal distress, and stillbirth among newborns have been reported. The SARS-CoV-2 pandemic greatly impacts prenatal management and surveillance and raise the need for clear unanimous guidelines. In this narrative review, we describe the current knowledge about coronaviruses (SARS, MERS, and SARS-CoV-2) risks and consequences on pregnancies, and we summarize available current candidate therapeutic options for pregnant women. Finally, we compare current guidance proposed by The Royal College of Obstetricians and Gynaecologists, The American College of Obstetricians and Gynecologists, and the World Health Organization to give an overview of prenatal management which should be utilized until future data appear.     

A reasoned approach towards administering COVID-19 vaccines to pregnant women

There are over 50 SARS-CoV-2 candidate vaccines undergoing Phase II and III clinical trials. Several vaccines have been approved by regulatory authorities and rolled out for use in different countries. Due to concerns of potential teratogenicity or adverse effect on maternal physiology, pregnancy has been a specific exclusion criterion for most vaccine trials with only two trials not excluding pregnant women. Thus, other than limited animal studies, gradually emerging development and reproductive toxicity data, and observational data from vaccine registries, there is a paucity of reliable information to guide recommendations for the safe vaccination of pregnant women. Pregnancy is a risk factor for severe COVID-19, especially in women with comorbidities, resulting in increased rates of preterm birth and maternal morbidity. We discuss the major SARS-CoV-2 vaccines, their mechanisms of action, efficacy, safety profile and possible benefits to the maternal-fetal dyad to create a rational approach towards maternal vaccination while anticipating and mitigating vaccine-related complications. Pregnant women with high exposure risks or co-morbidities predisposing to severe COVID-19 infection should be prioritised for vaccination. Those with risk factors for adverse effects should be counselled accordingly. It is essential to support patient autonomy by shared decision-making involving a risk-benefit discussion with the pregnant woman.     

Environment and COVID-19 incidence: A critical review

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented worldwide health crisis. Many previous research studies have found and investigated its links with one or some natural or human environmental factors. However, a review on the relationship between COVID-19 incidence and both the natural and human environment is still lacking. This review summarizes the inter-correlation between COVID-19 incidence and environmental factors. Based on keyword searching, we reviewed 100 relevant peer-reviewed articles and other research literature published since January 2020. This review is focused on three main findings. One, we found that individual environmental factors have impacts on COVID-19 incidence, but with spatial heterogeneity and uncertainty. Two, environmental factors exert interactive effects on COVID-19 incidence. In particular, the interactions of natural factors can affect COVID-19 transmission in micro- and macro- ways by impacting SARS-CoV-2 survival, as well as human mobility and behaviors. Three, the impact of COVID-19 incidence on the environment lies in the fact that COVID-19-induced lockdowns caused air quality improvement, wildlife shifts and socio-economic depression. The additional value of this review is that we recommend future research perspectives and adaptation strategies regarding the interactions of the environment and COVID-19. Future research should be extended to cover both the effects of the environment on the COVID-19 pandemic and COVID-19-induced impacts on the environment. Future adaptation strategies should focus on sustainable environmental and public policy responses.     

Monitoring SARS-CoV-2 in the Wastewater and Rivers of Tapachula,a Migratory Hub in Southern Mexico

Food and Environmental Virology - The COVID-19 pandemic has been monitored by applying different strategies, including SARS-CoV-2 detection with clinical testing or through wastewater-based...     

Control of exhaled SARS-CoV-2-laden aerosols in the interpersonal breathing microenvironment in a ventilated room with limited space air stability

The Coronavirus Disease 2019 (COVID-19) highlights the importance of understanding and controlling the spread of the coronavirus between persons. We experimentally and numerically investigated an advanced engineering and environmental method on controlling the transmission of airborne SARS-CoV-2-laden aerosols in the breathing microenvironment between two persons during interactive breathing process by combining the limited space air stability and a ventilation method. Experiments were carried out in a full-scale ventilated room with different limited space air stability conditions, i.e., stable condition, neutral condition and unstable condition. Two real humans were involved to conducted normal breathing process in the room and the exhaled carbon dioxide was used as the surrogate of infectious airborne SARS-CoV-2-laden aerosols from respiratory activities. A correspondent numerical model was established to visualize the temperature field and contaminated field in the test room. Results show that the performance of a ventilation system on removing infectious airborne SARS-CoV-2-laden aerosols from the interpersonal breathing microenvironment is dependent on the limited space air stability conditions. Appropriate ventilation method should be implemented based on an evaluation of the air condition. It is recommended that total volume ventilation methods are suitable for unstable and neutral conditions and local ventilation methods are preferable for stable conditions. This study provides an insight into the transmission of airborne SARS-CoV-2-laden aerosols between persons in ventilated rooms with different limited space air stability conditions. Useful guidance has been provided to cope with COVID-19 in limited spaces.     

Major brain lesions by intrauterine herpes simplex virus infection: MRI contribution

The majority of neonatal Herpes Simplex Virus (HSV) infections are acquired at birth as a consequence of direct fetal contact with the infected birth canal or through an ascending infection after premature rupture of the amniotic membranes. Intrauterine transmission of HSV infection from mother to the fetus is rare; in only 5% of the cases it occurs from haematogenous transplacental dissemination. We present a case of transplacental intrauterine HSV infection after a primary maternal HSV infection in the first trimester of pregnancy. The diagnosis was assessed by viral culture and serologic tests. Ultrasound imaging revealed fetal brain damage in the third trimester. Finally, the MRI showed the devastating extensiveness of the HSV infection, which was beyond the expectation based on the ultrasound images. Copyright © 2007 John Wiley & Sons, Ltd.     

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.     

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.      

Prenatal diagnosis of congenital cytomegalovirus infection in 189 pregnancies with known outcome

An Erratum has been published for this article in Prenatal Diagnosis 21(7) 2001, 605. Prenatal diagnosis (PD) of fetal cytomegalovirus (CMV) infection was performed in 242 pregnancies, with known outcome in 189 cases. In 141/189 pregnancies, PD was carried out on account of suspicious maternal CMV serology up to gestational week (WG) 23, and in 48 cases on account of abnormal ultrasonic findings detected between WG 18 and 39. Chorionic villus samples (n=6), amniotic fluid (AF, n=176) and/or fetal blood specimens (n=80) were investigated for detection of virus by cell culture, shell vial assay, PCR and/or CMV-specific IgM antibodies. Of 189 fetuses correctly evaluated by CMV detection either in fetal tissue following therapeutic abortion/stillbirth (n=24) or in urine of neonates within the first 2 weeks of life (n=33), 57 were congenitally infected. In women with proven or suspected primary infection, the intrauterine transmission rates were 20.6% (7/34) and 24.4% (10/41), respectively. Of the congenitally infected live-born infants, 57.6% (19/33) had symptoms of varying degree. The overall sensitivity of PD in the serologic and ultrasound risk groups was 89.5% (51/57). A sensitivity of 100% was achieved by combining detection of CMV-DNA and CMV-specific IgM in fetal blood or by combined testing of AF and fetal blood for CMV-DNA or IgM antibodies. There was no instance of intrauterine death following the invasive procedure. The predictive value of PD for fetal infection was 95.7% (132/138) for negative results and 100% (51/51) for positive results. Correct results for congenital CMV infection by testing AF samples can be expected with samples obtained after WG 21 and after a time interval of at least 6 weeks between first diagnosis of maternal infection and PD. In case of negative findings in AF or fetal blood and the absence of ultrasound abnormalities at WG 22–23, fetal infection and neonatal disease could be excluded with high confidence. Positive findings for CMV infection in AF and/or fetal blood in combination with CMV suspicious ultrasound abnormalities predicted a high risk of cytomegalic inclusion disease (CID). Furthermore, detection of specific IgM antibodies in fetal blood was significantly correlated with severe outcome for the fetus or the newborn (p=0.0224). However, normal ultrasound of infected fetuses at WG 22–23 can neither completely exclude an abnormal ultrasound at a later WG and the birth of a severely damaged child nor the birth of neonates which are afflicted by single manifestations at birth or later and of the kind which are not detectable by currently available ultrasonographic techniques. Copyright © 2001 John Wiley & Sons, Ltd.     

Environmental Surveillance of SARS-CoV-2 RNA in Wastewater and Groundwater in Quintana Roo,Mexico

The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater has been reported as a result of fecal shedding of infected individuals. In this study, the occurrence of SARS-CoV-2 RNA was explored in primary-treated wastewater from two municipal wastewater treatment plants in Quintana Roo, Mexico, along with groundwater from sinkholes, a household well, and submarine groundwater discharges. Physicochemical variables were obtained in situ, and coliphage densities were determined. Three virus concentration methods based on adsorption-elution and sequential filtration were used followed by RNA isolation. Quantification of SARS-CoV-2 was done by RT-qPCR using the CDC 2020 assay, 2019-nCoV_N1 and 2019-nCoV_N2. The Pepper mild mottle virus, one of the most abundant RNA viruses in wastewater was quantified by RT-qPCR and compared to SARS-CoV-2 concentrations. The use of three combined virus concentration methods together with two qPCR assays allowed the detection of SARS-CoV-2 RNA in 58% of the wastewater samples analyzed, whereas none of the groundwater samples were positive for SARS-CoV-2 RNA. Concentrations of SARS-CoV-2 in wastewater were from 1.8 × 10³ to 7.5 × 10³ genome copies per liter (GC l⁻¹), using the N1 RT-qPCR assay, and from 2.4 × 10² to 5.9 × 10³ GC l⁻¹ using the N2 RT-qPCR assay. Based on PMMoV prevalence detected in all wastewater and groundwater samples tested, the three viral concentration methods used could be successfully applied for SARS-CoV-2 RNA detection in further studies. This study represents the first detection of SARS-CoV-2 RNA in wastewater in southeast Mexico and provides a baseline for developing a wastewater-based epidemiology approach in the area.

     

新冠肺炎疫情期间我国人群交通出行行为分析

为了解我国新型冠状病毒肺炎（COVID-19,简称“新冠肺炎”）疫情期间人群出行频次及交通方式,调查收集了2020年2月25日—3月14日我国31个省（自治区、直辖市）8 330名居民疫情期间的出行频次及交通方式等信息,并分析了其影响因素;对我国31个省（自治区、直辖市）按疫情严重程度进行等级划分,分析不同疫情等级下人群交通出行方式的差异,并与非疫情期间进行对比.结果表明:①新冠肺炎疫情期间调查人群中有75.1%的人有出行行为,其中,5.5%的人一天多次外出,17.6%的人每周出行频次不到一次.出行过程中乘坐公共交通和出租车这两类感染风险较高的交通工具的人数占比分别为6.3%和4.0%.②新冠肺炎疫情期间,我国居民的出行频次和交通方式可能受性别、年龄、城乡、片区等人口统计学变量以及当地或附近疑似/确诊病例情况的影响,还可能与所在省份疫情严重程度有关.西藏自治区、青海省等地区人群出行频次及交通方式受疫情影响变化相对较小,湖北省居民出行频次及交通方式与非疫情期间相比变化最大.③新冠肺炎疫情期间,我国成人居民选择步行和小轿车（出租车和私家车）出行的人数占比远高于非疫情期间,而选择公共交通和自行车或电动车等交通方式的人数占比与非疫情期间相比有所降低.研究发现,新冠肺炎疫情极大地改变了我国人群出行频次及交通方式.      

The fetal intrahepatic umbilical vein as an alternative to cord needling for prenatal diagnosis and therapy

Seventy-one fetal blood samplings (FBS) were attempted from the intrahepatic portion of the umbilical vein (IHV) at 18–34 weeks; 54 were attempted primarily and 17 secondarily after a failed attempt at the placental cord insertion. Fetal blood was obtained in 89 per cent of the cases. Intravascular transfusion (IVT) was attempted on 31 occasions and successful in 24 (77 per cent). In all cases of failed sampling or transfusion via the IHV, prenatal diagnosis and/or therapy was accomplished using alternative procedures. On only one occasion was the procedure postponed. There were no losses or neonatal morbidity attributable to the procedure. FBS from the IHV may be considered as an alternative approach to sampling the placental cord insertion. It is recommended in cases where the approach to the placental cord insertion is difficult or hazardous.     

Changes in air pollution during COVID-19 lockdown in Spain: A multi-city study

The COVID-19 pandemic has escalated into one of the largest crises of the 21st Century. The new SARS-CoV-2 coronavirus, responsible for COVID-19, has spread rapidly all around the world. The Spanish Government was forced to declare a nationwide lockdown in view of the rapidly spreading virus and high mortality rate in the nation. This study investigated the impact of short-term lockdown during the period from March 15th to April 12th 2020 on the atmospheric levels of CO, SO₂, PM₁₀, O₃, and NO₂ over 11 representative Spanish cities. The possible influence of several meteorological factors (temperature, precipitation, wind, sunlight hours, minimum and maximum pressure) on the pollutants' levels were also considered. The results obtained show that the 4-week lockdown had significant impact on reducing the atmospheric levels of NO₂ in all cities except for the small city of Santander as well as CO, SO₂, and PM₁₀ in some cities, but resulted in increase of O₃ level.     

Protective Effect of Food Against Inactivation of Human Coronavirus OC43 by Gastrointestinal Fluids

Food and Environmental Virology - The involvement of the gastrointestinal (GI) tract in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been reported in multiple studies....     

Resorbed co-twin as an explanation for discrepant chorionic villus results: Non-mosaic 47,XX, +16 in villi (direct and culture) with normal (46,XX) amniotic fluid and neonatal blood

Non-mosaic trisomy 16 was observed in chorionic villus cytotrophoblasts (direct) as well as cultured mesenchymal core cells derived from the pregnancy of a 38-year-old woman. Chromosome preparations from amniotic fluid and neonatal cultures (cord blood) were 46,XX. Normal fetal growth as determined by serial ultrasound examinations occurred throughout the pregnancy, which resulted in a healthy 2724 g female. Multiple biopsies taken from the umbilical cord, placental cotyledons, and fetal membranes were 46,XX. However, a placental nodule and three of six cultures initiated from membranes (amnion and chorion) showed 46,XX/47,XX, + 16 mosaicism. We propose that the trisomy 16 cells arose from residual villi derived from a trisomic cotwin that never developed. This case further demonstrates that normal fetal growth may presage normal outcome irrespective of cytogenetic findings in cytotrophoblasts (direct) and cultured mesenchymal core cells.