Presence of human noroviruses on bathroom surfaces: a review of the literature

Leone, Cortney; Tang, Chaoyi; Sharp, Julia L.; Jiang, Xiuping; Fraser, Angela

doi:10.1080/09603123.2015.1135312

Cited by 12 publications

(8 citation statements)

References 53 publications

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“…Most norovirus-positive samples came from the underside of the toilet seat, followed by the toilet flush handle, inner door handle, and the sink faucet. Leone et al (36) found similar results in their literature review of the presence of human norovirus on bathroom surfaces. Norovirus-positive samples were found on toilet seats in five studies (9, 15, 19, 34, 64) and on sink faucet handles (15, 22, 23), toilet flush handles (48), and bathroom door handles (22, 34, 48) in fewer studies.…”

Section: Discussionmentioning

confidence: 53%

“…Norovirus was present on 1.5% of bathroom surfaces sampled in this study, which is consistent with the 1.7 and 1.9% prevalence reported in The Netherlands in 2011 and 2015, respectively (10, 11). In a recent systematic review of seven articles published from 1980 to 2014 (36), only three included reports of norovirus-positive samples from bathroom surfaces in commercial and institutional settings under nonoutbreak conditions (10, 48, 61). One reason for the low prevalence in our study could be that human norovirus was present in such low numbers that they were below the limit of detection of our multiplex real-time RT-PCR (13) assay.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of noroviruses on shared bathroom surfaces in food establishments under both outbreak and nonoutbreak conditions have been reported (10, 11, 61). In a systematic literature review, human noroviruses were found on bathroom surfaces under outbreak ( n = 11) and nonoutbreak ( n = 5) conditions (36). Swab samples from high-touch surfaces such as toilet seats, toilet flush handles, sink faucet handles, and bathroom door handles were most likely to be positive for norovirus.…”

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confidence: 99%

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Prevalence of Human Noroviruses in Commercial Food Establishment Bathrooms

Leone

Dharmasena

Tang

et al. 2018

Journal of Food Protection

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Although transmission of human norovirus in food establishments is commonly attributed to consumption of contaminated food, transmission via contaminated environmental surfaces, such as those in bathrooms, may also play a role. Our aim was to determine the prevalence of human norovirus on bathroom surfaces in commercial food establishments in New Jersey, Ohio, and South Carolina under nonoutbreak conditions and to determine characteristics associated with the presence of human norovirus. Food establishments (751) were randomly selected from nine counties in each state. Four surfaces (underside of toilet seat, flush handle of toilet, inner door handle of stall or outer door, and sink faucet handle) were swabbed in male and female bathrooms using premoistened macrofoam swabs. A checklist was used to collect information about the characteristics, materials, and mechanisms of objects in bathrooms. In total, 61 (1.5%) of 4,163 swabs tested were presumptively positive for human norovirus, 9 of which were confirmed by sequencing. Some factors associated with the presence of human norovirus included being from South Carolina (odd ratio [OR], 2.4; 95% confidence interval [CI], 1.2 to 4.9; P < 0.05) or New Jersey (OR, 1.7; 95% CI, 0.9 to 3.3; 0.05 < P < 0.10), being a chain establishment (OR, 1.9; 95% CI, 1.1 to 3.3; P < 0.05), being a unisex bathroom (versus male: OR, 2.0; 95% CI, 0.9 to 4.1; 0.05 < P < 0.10; versus female: OR, 2.6; 95% CI, 1.2 to 5.7; P < 0.05), having a touchless outer door handle (OR, 3.3; 95% CI, 0.79 to 13.63; 0.05 < P < 0.10), and having an automatic flush toilet (OR, 2.5, 95% CI, 1.1 to 5.3; 0.05 < P < 0.10). Our findings confirm that the presence of human norovirus on bathroom surfaces in commercial food establishments under nonoutbreak conditions is a rare event. Therefore, routine environmental monitoring for human norovirus contamination during nonoutbreak periods is not an efficient method of monitoring norovirus infection risk.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Prevalence of Human Noroviruses in Commercial Food Establishment Bathrooms

Leone

Dharmasena

Tang

et al. 2018

Journal of Food Protection

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“…Careful and detailed epidemiological studies are required to link toilet use with infection incidence. This has been done for norovirus, during air and boat travel, and restaurant visits, where confirmed cases using the bathroom/toilet were linked with norovirus acquisition (Boxman et al, 2009;Carling et al, 2009;Chimonas et al, 2008;Ho et al, 1989;Jones et al, 2007;Leone et al, 2016;Widdowson et al, 2005). Other pathogenic viruses have been associated with toilets in offices and hospital, with the most contaminated surfaces reported as bathroom door handles (66%), flushing buttons (62%), toilet seats (59%), and toilet covers (52%) (Verani et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

What is the risk of acquiring SARS-CoV-2 from the use of public toilets?

Dancer

Hart

et al. 2021

Science of The Total Environment

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Public toilets may act as a contact hub point for SARS-CoV-2 transmission. • All accepted transmission mechanisms for SARS-CoV-2 co-exist in a public toilet. • Faecal and urinary derived aerosols contain viable SARS-CoV-2 virus. • Issues over space, ventilation, frequency of use, cleaning and maintenance compound the transmission risk. • Actions to prevent COVID-19 infection are offered in lieu of supportive scientific evidence.

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“…For example, one review identified six studies that implicated bathroom surfaces as primary sources of human norovirus infection. 7…”

Section: Introductionmentioning

confidence: 99%

Deficient hand washing facilities in public toilets in the time of the COVID-19 pandemic: A survey in one high-income country

Wilson

Thomson

2021

Preprint

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AimsTo identify the extent of the provision of water and soap for hand washing in public toilets at the time of the COVID-19 pandemic. To also make comparisons with a pre-pandemic survey that included a sample of the same facilities.MethodsWe collected data from 400 toilets that were open to the public; all those in three contiguous city council territories (228) and a further convenience sample of 172 around the rest of New Zealand. Comparisons were made with the data on the same facilities included in a 2012/2013 survey.ResultsFor all the toilets in this survey, 2.5% had no water for hand washing and 14.8% had no soap. There was COVID-19 related health messaging signage in 19.5% of toilets, with posters of the COVID-19 QR code used to facilitate contact tracing in 12.3%, and generic hand washing signage in 1.8%. The hand washing water had “no touch” activation at 28.0% of toilets and at 18.5% for toilet bowl flushing. Toilet bowl lids were not present at 32.8%, and 2.3% of toilets had damage which would impair their functionality (eg, broken toilet seats). For the 128 sites that had also been examined in the previous survey, this new survey found significantly increased provision of soap (risk ratio = 1.47; 95%CI: 1.25 to 1.72), but no increased provision of water.ConclusionsDespite the serious threat of the COVID-19 pandemic, the majority of hand washing facilities in public toilets sampled required tap touching, and did not have health messaging. Nevertheless there has been some modest improvements in soap (but not water) provision since the previous survey eight years before.

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Presence of human noroviruses on bathroom surfaces: a review of the literature

Cited by 12 publications

References 53 publications

Prevalence of Human Noroviruses in Commercial Food Establishment Bathrooms

Prevalence of Human Noroviruses in Commercial Food Establishment Bathrooms

What is the risk of acquiring SARS-CoV-2 from the use of public toilets?

Deficient hand washing facilities in public toilets in the time of the COVID-19 pandemic: A survey in one high-income country

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