Shedding of SARS-CoV-2 in faeces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19
Davey Jones, Professor of Soil and Environmental Science at the University of Bangor, discussed the shedding of SARS-CoV-2 in faeces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19, based on his recent publication.
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Abstract
The recent detection of SARS-CoV-2 RNA in faeces has led to speculation that it can be transmitted via the fecal-oral/ocular route. This talk will critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in faeces and urine, and whether these pose an infection risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. rivers, lakes and marine waters). Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. The abundance of the virus genetic material in both urine and faeces are much lower than in nasopharyngeal fluids. There is strong evidence of multiplication of SARS-CoV-2 in the gut and infectious virus has occasionally been recovered from both urine and stool samples. In comparison to enteric viruses transmitted via the fecal-oral route (e.g. norovirus, adenovirus), the likelihood of SARS-CoV-2 being transmitted via feces or urine appears to be very low. Our analysis also suggests the likelihood of infection due to contact with sewage-contaminated water (e.g. swimming, surfing, angling) or food (e.g. salads, shellfish) is extremely low or negligible. These conclusions are corroborated by the fact that tens of million cases of COVID-19 have occurred globally, but exposure to feces or wastewater has never been implicated as a transmission vector.