Survival of Bacteriophage MS2 on Filtering Facepiece Respirator Coupons

Fisher, Edward; Shaffer, Ronald E.

doi:10.1177/153567601001500205

Cited by 12 publications

(12 citation statements)

References 23 publications

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“…( 65 ) Similar findings were found using MS2 phage as a surrogate for respiratory viruses. ( 66 ) A surrogate for SARS coronavirus, transmissible gastroenteritis virus, was shown to remain viable for 24 hr on FFR samples with an estimated 99% (>2 log) reduction in titer. ( 67 )…”

Section: Scientific Evidence On Ffr Extended Use and Limited Reusementioning

confidence: 99%

Considerations for Recommending Extended Use and Limited Reuse of Filtering Facepiece Respirators in Health Care Settings

Fisher

Shaffer

2014

Journal of Occupational and Environmental Hygiene

114

117

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Public health organizations, such as the Centers for Disease Control and Prevention (CDC), are increasingly recommending the use of N95 filtering facepiece respirators (FFRs) in health care settings. For infection control purposes, the usual practice is to discard FFRs after close contact with a patient (“single use”). However, in some situations, such as during contact with tuberculosis patients, limited FFR reuse (i.e., repeated donning and doffing of the same FFR by the same person) is practiced. A related practice, extended use, involves wearing the same FFR for multiple patient encounters without doffing. Extended use and limited FFR reuse have been recommended during infectious disease outbreaks and pandemics to conserve FFR supplies. This commentary examines CDC recommendations related to FFR extended use and limited reuse and analyzes available data from the literature to provide a relative estimate of the risks of these practices compared to single use. Analysis of the available data and the use of disease transmission models indicate that decisions regarding whether FFR extended use or reuse should be recommended should continue to be pathogen- and event-specific. Factors to be included in developing the recommendations are the potential for the pathogen to spread via contact transmission, the potential that the event could result in or is currently causing a FFR shortage, the protection provided by FFR use, human factors, potential for self-inoculation, the potential for secondary exposures, and government policies and regulations. While recent findings largely support the previous recommendations for extended use and limited reuse in certain situations, some new cautions and limitations should be considered before issuing recommendations in the future. In general, extended use of FFRs is preferred over limited FFR reuse. Limited FFR reuse would allow the user a brief respite from extended wear times, but increases the risk of self-inoculation and preliminary data from one study suggest that some FFR models may begin to lose effectiveness after multiple donnings.

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Section: Scientific Evidence On Ffr Extended Use and Limited Reusementioning

confidence: 99%

Considerations for Recommending Extended Use and Limited Reuse of Filtering Facepiece Respirators in Health Care Settings

Fisher

Shaffer

2014

Journal of Occupational and Environmental Hygiene

114

117

View full text Add to dashboard Cite

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“…For example, stockpiling of FFRs occur on many organizational levels from individual hospitals to hospital networks and among local, state, and federal government bodies. Viscusi et al (2009) examined the effects of extended storage of FFRs on filtration performance, while other studies have examined the potential to decontaminate or inactivate viruses on the surfaces of FFRs so that they may be used again ( Viscusi et al , 2007 ; Fisher et al , 2009 ; Viscusi et al , 2009 ; Vo et al , 2009 ; Bergman et al , 2010 ; Fisher et al , 2010 ; Fisher and Shaffer, 2010 ; Fisher and Shaffer, 2011 ; Heimbuch et al , 2011 ). These studies have highlighted the complexities of effective FFR decontamination.…”

Section: Introductionmentioning

confidence: 99%

Reaerosolization of MS2 Bacteriophage from an N95 Filtering Facepiece Respirator by Simulated Coughing

Fisher

Richardson

Harpest

et al. 2011

The Annals of Occupational Hygiene

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The supply of N95 filtering facepiece respirators (FFRs) may not be adequate to match demand during a pandemic outbreak. One possible strategy to maintain supplies in healthcare settings is to extend FFR use for multiple patient encounters; however, contaminated FFRs may serve as a source for the airborne transmission of virus particles. In this study, reaerosolization of virus particles from contaminated FFRs was examined using bacteriophage MS2 as a surrogate for airborne pathogenic viruses. MS2 was applied to FFRs as droplets or droplet nuclei. A simulated cough (370 l min(-1) peak flow) provided reverse airflow through the contaminated FFR. The number and size of the reaerosolized particles were measured using gelatin filters and an Andersen Cascade Impactor (ACI). Two droplet nuclei challenges produced higher percentages of reaerosolized particles (0.21 and 0.08%) than a droplet challenge (<0.0001%). Overall, the ACI-determined size distribution of the reaerosolized particles was larger than the characterized loading virus aerosol. This study demonstrates that only a small percentage of viable MS2 viruses was reaerosolized from FFRs by reverse airflow under the conditions evaluated, suggesting that the risks of exposure due to reaerosolization associated with extended use can be considered negligible for most respiratory viruses. However, risk assessments should be updated as new viruses emerge and better workplace exposure data becomes available.

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“…In the absence of laboratory-based evidence, ample epidemiological evidence suggests nonlaunderable, soft surfaces, such as carpet, may also be a HuNoV fomite (6,7). Currently, only two laboratory-based studies have documented HuNoV and their surrogate survival on soft surfaces (13,14). Moreover, no U.S. Environmental Protection Agency-registered disinfectants rated for soft surfaces are available to disinfect these fomites in the United States (15).…”

mentioning

confidence: 99%

Recovery Optimization and Survival of the Human Norovirus Surrogates Feline Calicivirus and Murine Norovirus on Carpet

Buckley

Fraser

Huang

et al. 2017

Appl Environ Microbiol

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Carpets have been implicated in prolonged and reoccurring outbreaks of human noroviruses (HuNoV), the leading cause of acute gastroenteritis worldwide. Viral recovery from environmental surfaces, such as carpet, remains undeveloped. Our aim was to determine survival of HuNoV surrogates on an understudied environmental surface, carpet. First, we measured the zeta potential and absorption capacity of wool and nylon carpet fibers, we then developed a minispin column elution (MSC) method, and lastly we characterized the survival of HuNoV surrogates, feline calicivirus (FCV) and murine norovirus (MNV), over 60 days under 30 and 70% relative humidity (RH) on two types of carpet and one glass surface. Carpet surface charge was negative between relevant pH values (i.e., pH 7 to 9). In addition, wool could absorb approximately two times more liquid than nylon. The percent recovery efficiency obtained by the MSC method ranged from 4.34 to 20.89% and from 30.71 to 54.14% for FCV and MNV on carpet fibers, respectively, after desiccation. Overall, elution buffer type did not significantly affect recovery. Infectious FCV or MNV survived between <1 and 15 or between 3 and 15 days, respectively. However, MNV survived longer under some conditions and at significantly ( < 0.05) higher titers compared to FCV. Albeit, surrogates followed similar survival trends, i.e., both survived longest on wool then nylon and glass, while 30% RH provided a more hospitable environment compared to 70% RH. Reverse transcription-quantitative PCR signals for both surrogates were detectable for the entire study, but FCV genomic copies experienced significantly higher reductions (<3.80 log copies) on all surfaces compared to MNV (<1.10 log copies). Human noroviruses (HuNoV) are the leading cause of acute gastroenteritis worldwide. Classical symptoms of illness include vomiting and diarrhea which could lead to severe dehydration and death. HuNoV are transmitted by the fecal-oral or vomitus-oral route via person-to-person contact, food, water, and/or environmental surfaces. Published laboratory-controlled studies have documented the environmental stability of HuNoV on hard surfaces, but there is limited laboratory-based evidence available about survival on soft surfaces, e.g., carpet and upholstered furniture. Several epidemiological reports have suggested soft surfaces may be HuNoV fomites illustrating the importance of conducting a survival study. The three objectives of our research were to demonstrate techniques to characterize soft surfaces, develop a viral elution method for carpet, and characterize the survival of HuNoV surrogates on carpet. These results can be used to improve microbial risk assessments, the development of much-needed soft surface disinfectant, and standardizing protocols for future soft surface studies.

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Survival of Bacteriophage MS2 on Filtering Facepiece Respirator Coupons

Cited by 12 publications

References 23 publications

Considerations for Recommending Extended Use and Limited Reuse of Filtering Facepiece Respirators in Health Care Settings

Considerations for Recommending Extended Use and Limited Reuse of Filtering Facepiece Respirators in Health Care Settings

Reaerosolization of MS2 Bacteriophage from an N95 Filtering Facepiece Respirator by Simulated Coughing

Recovery Optimization and Survival of the Human Norovirus Surrogates Feline Calicivirus and Murine Norovirus on Carpet

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