The study objective was to evaluate human faecal contamination impacts in the Yal-ku lagoon in the Mexican Caribbean and to estimate adenovirus infection and illness risks associated with recreational exposure during water activities. A total of 20 water samples (10 from each site x 2 sites) (50 L) were collected monthly over a period of 12 months from two selected sampling sites in the swimming area of the Yal-ku lagoon. The occurrence of faecal-associated viruses was explored, and human adenovirus (HAdV) and pepper mild mottle virus (PMMoV) concentrations were quantified. A quantitative microbial risk assessment (QMRA) model was used to estimate exposure and subsequent adenovirus infection and illness risk for 1 h of swimming or snorkelling. Somatic and F + -specific coliphages occurred in 100% of the samples. Both HAdV and PMMoV were detected at a 60% frequency thereby indicating persistent faecal inputs. PMMoV concentrations (44-370 GC/L) were relatively lower than the concentrations of HAdV (64-1,000 GC/L). Estimated mean adenovirus risks were greater for snorkelling than for swimming by roughly one to two orders of magnitude and estimated mean illness risks for snorkelling were <32/1,000. Human faecal contamination is frequent in the Yal-ku lagoon, which is associated with human gastrointestinal illness.

Restroom use has been implicated in a number of viral outbreaks. In this study, we apply quantitative microbial risk assessment to quantify the risk of viral transmission by contaminated restroom fomites. We estimate risk from high-touch fomite surfaces (entrance/exit door, toilet seat) for three viruses of interest (SARS-CoV-2, adenovirus, norovirus) through eight exposure scenarios involving differing user behaviors, and the use of hand sanitizer following each scenario. We assessed the impacts of several sequences of fomite contacts in the restroom, reflecting the variability of human behavior, on infection risks for these viruses. Touching of the toilet seat was assumed to model adjustment of the seat (open vs. closed), a common touch point in single-user restrooms (home, small business, hospital). A Monte Carlo simulation was conducted for each exposure scenario (10,000 simulations each). Norovirus resulted in the highest probability of infection for all exposure scenarios with fomite surfaces. Post-restroom automatic-dispensing hand sanitizer use reduced the probability of infection for each virus by up to 99.75%. Handwashing within the restroom, an important risk-reduction intervention, was not found to be as effective as use of a non-touch hand sanitizer dispenser for reducing risk to near or below 1/1,000,000, a commonly used risk threshold for comparison.

BACKGROUND:Contaminated laundry contributes to infectious disease spread in residential and home health care settings. The objectives were to (1) evaluate pathogen transmission risks for individuals doing laundry, and (2) compare hand hygiene timing to reduce risks. METHODS:A quantitative microbial risk assessment using experimental data from a laundry washing effectiveness study was applied to estimate infection risks from SARS-CoV-2, rotavirus, norovirus, nontyphoidal Salmonella, and Escherichia coli in 4 laundry scenarios: 1 baseline scenario (no hand hygiene event) and 3 hand hygiene scenarios (scenario 1: after moving dirty clothes to the washing machine, scenario 2: after moving washed clothes to the dryer, and scenario 3: hand hygiene events following scenario 1 and 2). RESULTS:The average infection risks for the baseline scenario were all greater than 2 common risk thresholds (1.0×10-6and 1.0×10-4). For all organisms, scenario 1 yielded greater risk reductions (39.95%-99.86%) than scenario 2 (1.35%-55.25%). Scenario 3 further reduced risk, achieving 1.0×10-6(SARS-CoV-2) and 1.0×10-4risk thresholds (norovirus and E. coli). CONCLUSIONS:The modeled results suggest individuals should reduce hand-to-facial orifice (eyes, nose, and mouth) contacts and conduct proper hand hygiene when handling contaminated garments. More empirical data are needed to confirm the estimated risks. DATA AVAILABILITY STATEMENT:The data and code that support the findings of this study can be retrieved via a Creative Commons Zero v1.0 Universal license in GitHub at https://github.com/yhjung1231/Laundry-QMRAproject-2022.git DOI: http://doi.org/10.5281/zenodo.7122065.

The aim of this study was to determine how the transfer efficiency of MS‐2 coliphage from the toilet seat to hands and fingertip to lip differs according to the suspension of the inoculum.

Wastewater treatment plants (WWTPs) have rapidly increased in India during the last decade. Nonetheless, there are only a few labs in India that can perform culture-based screening for microbial quality.

Exposure models are useful tools for relating environmental monitoring data to expected health outcomes. The objective of this study was to (1) compare two Legionella shower exposure models, and (2) develop a risk calculator tool for relating environmental monitoring data to estimated Legionella infection risks and Legionnaires' Disease (LD) illness risks. Legionella infection risks for a single shower event were compared using two shower Legionella exposure models. These models varied in their description of partitioning of Legionella in aerosols and aerosol deposition in the lung, where Model 1 had larger and fewer aerosol ranges than Model 2. Model 2 described conventional vs. water efficient showers separately, while Model 1 described exposure for an unspecified shower type (did not describe it as conventional or water efficient). A Monte Carlo approach was used to account for variability and uncertainty in these aerosolization and deposition parameters, Legionella concentrations, and the dose-response parameter. Methods for relating infection risks to illness risks accounting for demographic differences were used to inform the risk calculator web application ("app"). Model 2 consistently estimated higher infection risks than Model 1 for the same Legionella concentration in water and estimated deposited doses with less variability. For a 7.8-min shower with a Legionella concentration of 0.1 CFU/mL, the average infection risks estimated using Model 2 were 4.8 x 10-6 (SD=3.0 x 10-6) (conventional shower) and 2.3 x 10-6 (SD=1.7 x 10-6) (water efficient). Average infection risk estimated by Model 1 was 1.1 x 10-6 (SD=9.7 x 10-7). Model 2 was used for app development due to more conservative risk estimates and less variability in estimated dose. While multiple Legionella shower models are available for quantitative microbial risk assessments (QMRAs), they may yield notably different infection risks for the same environmental microbial concentration. Model comparisons will inform decisions regarding their integration with risk assessment tools. The development of risk calculator tools for relating environmental microbiology data to infection risks will increase the impact of exposure models for informing water treatment decisions and achieving risk targets.

The goal of good toilet hygiene is minimizing the potential for pathogen transmission. Control of odours is also socially important and believed to be a societal measure of cleanliness. Understanding the need for good cleaning and disinfecting is even more important today considering the potential spread of emerging pathogens such as SARS-CoV-2 virus. While the flush toilet was a major advancement in achieving these objectives, exposure to pathogens can occur from failure to clean and disinfect areas within a restroom, as well as poor hand hygiene. The build-up of biofilm within a toilet bowl/urinal including sink can result in the persistence of pathogens and odours. During flushing, pathogens can be ejected from the toilet bowl/urinal/sink and be transmitted by inhalation and contaminated fomites. Use of automatic toilet bowl cleaners can reduce the number of microorganisms ejected during a flush. Salmonella bacteria can colonize the underside of the rim of toilets and persist up to 50 days. Pathogenic enteric bacteria appear in greater numbers in the biofilm found in toilets than in the water. Source tracking of bacteria in homes has demonstrated that during cleaning enteric bacteria are transferred from the toilet to the bathroom sinks and that these same bacteria colonize cleaning tools used in the restroom. Quantitative microbial risk assessment has shown that significant risks exist from both aerosols and fomites in restrooms. Cleaning with soaps and detergents without the use of disinfectants in public restrooms may spread bacteria and viruses throughout the restroom. Odours in restrooms are largely controlled by ventilation and flushing volume in toilet/urinals. However, this results in increased energy and water usage. Contamination of both the air and surfaces in restrooms is well documented. Better quantification of the risks of infection are needed as this will help determine what interventions will minimize these risks.

Laundering of textiles—clothing, linens, and cleaning cloths—functionally removes dirt and bodily fluids, which prevents the transmission of and reexposure to pathogens as well as providing odor control. Thus, proper laundering is key to controlling microbes that cause illness and produce odors.

First responders may have high SARS-CoV-2 infection risks due to working with potentially infected patients in enclosed spaces. The study objective was to estimate infection risks per transport for first responders and quantify how first responder use of N95 respirators and patient use of cloth masks can reduce these risks. A model was developed for two Scenarios: an ambulance transport with a patient actively emitting a virus in small aerosols that could lead to airborne transmission (Scenario 1) and a subsequent transport with the same respirator or mask use conditions, an uninfected patient; and remaining airborne SARS-CoV-2 and contaminated surfaces due to aerosol deposition from the previous transport (Scenario 2). A compartmental Monte Carlo simulation model was used to estimate the dispersion and deposition of SARS-CoV-2 and subsequent infection risks for first responders, accounting for variability and uncertainty in input parameters (i.e., transport duration, transfer efficiencies, SARS-CoV-2 emission rates from infected patients, etc.). Infection risk distributions and changes in concentration on hands and surfaces over time were estimated across sub-Scenarios of first responder respirator use and patient cloth mask use. For Scenario 1, predicted mean infection risks were reduced by 69%, 48%, and 85% from a baseline risk (no respirators or face masks used) of 2.9 x 10(-2) +/- 3.4 x 10(-2) when simulated first responders wore respirators, the patient wore a cloth mask, and when first responders and the patient wore respirators or a cloth mask, respectively. For Scenario 2, infection risk reductions for these same Scenarios were 69%, 50%, and 85%, respectively (baseline risk of 7.2 x 10(-3) +/- 1.0 x 10(-2)). While aerosol transmission routes contributed more to viral dose in Scenario 1, our simulations demonstrate the ability of face masks worn by patients to additionally reduce surface transmission by reducing viral deposition on surfaces. Based on these simulations, we recommend the patient wear a face mask and first responders wear respirators, when possible, and disinfection should prioritize high use equipment.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has increased demands for surgical and respirator masks for healthcare workers (HCWs) and other frontline staff. The debate over the importance of airborne transmission of SARS-CoV-2 continues, but air and laboratory studies have shown that SARS-CoV-2 is viable for >12 h in aerosols [1Chia K. Coleman K. Tan Y. Ong S. Gum M. Lau S. et al.Detection of air and surface contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in hospital rooms of infected patients.medRxiv. 2020; https://doi.org/10.1101/2020.03.29.20046557Crossref Google Scholar, 2Fears A. Klimstra W. Duprex P. Hartman A. Weaver S. Plante K. et al.Comparative dynamic aerosol efficiencies of three emergent coronaviruses and the unusual persistence of SARS-CoV-2 in aerosol suspensions.medRxiv. 2020; https://doi.org/10.1101/2020.04.13.20063784Crossref PubMed Scopus (0) Google Scholar, 3Ong S.W.X. Tan Y.K. Chia P.Y. Lee T.H. Ng O.T. Wong M.S.Y. et al.Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient.JAMA. 2020; https://doi.org/10.1001/jama.2020.3227Crossref PubMed Scopus (1564) Google Scholar]. Low sampling volumes, location of air outlet fan and potential virus damage during sampling may explain the variability in detection of SARS-CoV-2 [1Chia K. Coleman K. Tan Y. Ong S. Gum M. Lau S. et al.Detection of air and surface contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in hospital rooms of infected patients.medRxiv. 2020; https://doi.org/10.1101/2020.03.29.20046557Crossref Google Scholar,3Ong S.W.X. Tan Y.K. Chia P.Y. Lee T.H. Ng O.T. Wong M.S.Y. et al.Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient.JAMA. 2020; https://doi.org/10.1001/jama.2020.3227Crossref PubMed Scopus (1564) Google Scholar]. A limited supply of masks creates a risk for the exposure of HCWs to SARS-CoV-2. Non-traditional materials are widely recommended for public use (source control) and have been considered in place of regulated masks in health care, especially in social care settings. While various materials are effective for filtering large droplets, aerosols generated from sneezing, coughing and aerosol-generating procedures may pass more readily through materials or leakage points [4Weber A. Willeke K. Marchioni R. Myojo T. Mckay R. Donnelly J. et al.Aerosol penetration and leakage characteristics of masks used in the health care industry.Am J Infect Control. 1993; 21: 167-173Abstract Full Text PDF PubMed Scopus (134) Google Scholar]. Few data exist on the efficacy of filtration, and no quantitative modelling of efficacies to reduce the risk of infection is currently available. A probabilistic model was developed to estimate the risk of infection for short (30-s, brief patient check) and long (20-min, duration required for patient intubation) inhalation exposure scenarios. These included situations in a room with a patient with coronavirus disease 2019 (COVID-19) when no mask was worn; when an FFP2 (N95) respirator, FFP3 (N99) respirator or surgical mask was worn; or when a non-traditional material mask (silk, tea towel, vacuum cleaner bag, pillowcase, antimicrobial pillowcase, cotton mix, 100% cotton T-shirt, linen or scarf) was worn. Inhaled viral dose was estimated using published concentrations (RNA/m3) of SARS-CoV-2 for >4- and 1–4-μm droplets measured in a hospital setting [1Chia K. Coleman K. Tan Y. Ong S. Gum M. Lau S. et al.Detection of air and surface contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in hospital rooms of infected patients.medRxiv. 2020; https://doi.org/10.1101/2020.03.29.20046557Crossref Google Scholar]. Ranges from reported concentration data originating from a symptomatic and an asymptomatic patient were used to calculate minimum and maximum values for randomly sampled uniform distributions [1Chia K. Coleman K. Tan Y. Ong S. Gum M. Lau S. et al.Detection of air and surface contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in hospital rooms of infected patients.medRxiv. 2020; https://doi.org/10.1101/2020.03.29.20046557Crossref Google Scholar]. Viral exposures for these two size ranges were summed to estimate the total inhaled dose. Doses were estimated for three assumed infectious fractions of total detected viral RNA: 0.1%, 1% and 10%. Inhaled volumes (m3) were estimated using inhalation rates for men and women, where the 5th and 99th percentiles of inhalation rates offered the uniform distribution minimum and maximum, respectively [5U.S. Environmental Protection AgencyExposure factors handbook. US EPA, Washington, DC2011Google Scholar]. Filtration efficacies (fraction of total virus filtered out by the material) were used to model the reduction in viral inhalation exposure for each material type. Due to lack of particle-size-specific filtration efficacy data for these materials, it was assumed that filtration efficacy distributions were applicable to both particle size ranges. For each 10,000 combinations investigated, a filtration efficacy was sampled at random from a normal distribution, left- and right-truncated at 0 and 1, respectively. For surgical masks and non-traditional materials, means and standard deviations (SD) of efficacies were informed by MS2 filtration efficacies [6Davies A. Thompson K.A. Giri K. Kafatos G. Walker J. Bennett A. Testing the efficacy of homemade masks: would they protect in an influenza pandemic?.Disaster Med Public Health Prep. 2013; 7: 413-418Crossref PubMed Scopus (400) Google Scholar]. Mean efficacies of 95% and 99% were assumed for FFP2 and FFP3 respirators, respectively. SDs were provided by Rengasamy et al. (2009), where larger SDs of two manufacturer versions were chosen as a conservative risk approach [7Rengasamy S. Eimer B.C. Shaffer R.E. Comparison of nanoparticle filtration performance of NIOSH-approved and CE-marked particulate filtering facepiece respirators.Ann Occup Hyg. 2009; 53: 117-128Crossref PubMed Scopus (134) Google Scholar]. Data from SARS-CoV and human coronavirus 229E (HCoV-229E) dose–response curves were used to estimate a SARS-CoV-2 exact beta-Poisson curve [8Watanabe T. Bartrand T.A. Weir M.H. Omura T. Haas C.N. Development of a dose–response model for SARS coronavirus.Risk Anal. 2010; 30: 1129-1138Crossref PubMed Scopus (266) Google Scholar]. Based on current epidemiological knowledge, the infectivity of SARS-CoV-2 was assumed to lie between SARS-CoV and HCoV-229E. Pairs of bootstrapped alpha and beta values were used to estimate infection risk per dose. Comparing no protection (baseline) for 20-min and 30-s exposures, it was predicted that the mean risk of infection was reduced by 24–94% and 44–99% depending on the mask. Risk reductions decreased as exposure durations increased. The greatest reduction in estimated mean risk of infection was for FFP3 masks, which reduced baseline mean risks by 94% and 99% for 20-min and 30-s exposures, respectively (Figure 1). Of non-traditional materials, the vacuum cleaner bag resulted in the greatest reduction in mean risk of infection (20-min exposure 58%, 30-s exposure 83%), while scarves offered the lowest reduction (20-min exposure 24%, 30-s exposure 44%) (Figure 1). However, large variability in filtration, such as for silk or the tea towel, should be considered when comparing non-traditional mask materials (Figure 1). Limitations include not accounting for viral transfer from the hands to the mask during mask adjustments, and assuming that all masks were worn in the same way. Realistically, the fit of homemade masks is likely to be more variable than the fit of regulated masks. While the HCoV-229E data utilized for the dose–response curve were based on human data, the SARS-CoV dose–response data originated from an animal-feeding study [8Watanabe T. Bartrand T.A. Weir M.H. Omura T. Haas C.N. Development of a dose–response model for SARS coronavirus.Risk Anal. 2010; 30: 1129-1138Crossref PubMed Scopus (266) Google Scholar]. Future work includes updating the dose–response curve as data on SARS-CoV-2 emerge, and addressing the effects of design/fit on the risk of infection. This study demonstrated that some materials, such as vacuum cleaner bags, may be effective alternatives to reduce the risk of infection. While N95 masks (and similar respirators) are recommended for HCWs and others in close proximity to aerosol-generating procedures, alternative materials may be useful where there are shortages of personal protective equipment (PPE). This may be of particular relevance in low-resource settings where access to PPE is considerably more limited. None declared. A.M. Wilson was supported by the University of Arizona Foundation and the Hispanic Women's Corporation/Zuckerman Family Foundation Student Scholarship Award through the Mel and Enid Zuckerman College of Public Health, University of Arizona. M-F. King and C.J. Noakes were funded by the Engineering and Physical Sciences Research Council, UK: Healthcare Environment Control, Optimisation and Infection Risk Assessment (https://HECOIRA.leeds.ac.uk) (Grant Code: EP/P023312/1). M. López-García was funded by the Medical Research Council, UK (MR/N014855/1). J. Proctor was funded by EPSRC Centre for Doctoral Training in Fluid Dynamics at Leeds (Grant Code EP/L01615X/1). S.E. Abney was funded by a research assistantship from the US-Israel Binational Agricultural Research Development Fund and through a University of Arizona Graduate Access Scholarship.

Alcohol‐use disorder (AUD) is the third leading cause of preventable death in the United States following tobacco and obesity, and current treatments for AUD yield disappointing remission rates. Chronic alcohol intake has been established to negatively impact the body’s immune system, and the endocannabinoid system has been shown to modulate the abuse‐related effects of ethanol. In this study, and we investigated the effects of 30 mg/kg caryophyllene oxide ( BCPO), in two widely accepted animal models of AUD: two‐bottle choice ethanol consumption and ethanol‐induced conditioned place preference (CPP). Finally, we used multiplex bead‐based flow cytometry to evaluate the effect of BCPO on plasma level of cytokines following these behavioral assays. BCPO significantly decreased ethanol intake and preference without changing total fluid intake in mice that consumed high amounts of ethanol. In mice that consumed low amounts of ethanol, BCPO did not alter ethanol intake, preference, or total fluid intake. BCPO significantly attenuated the expression of an ethanol‐induced CPP. Following the CPP assay, we observed a significant decrease in circulating levels of IFNγ, TNFα, MCP1, IL12p70, IL1b, and IL10 which was reversed by treatment with BCPO. Our findings support the current knowledge that excessive consumption of alcohol may lead to immune suppression and predispose individuals to a number of infections as well as neoplastic diseases. This study expands and supports the use of immunoregulatory molecules as a viable target for the treatment of AUD.

Age-related cognitive decline has been associated with proinflammatory cytokines, yet the precise relationship between cognitive decline and cytokine load remains to be elucidated. beta-caryophyllene (BCP) is a cannabinoid receptor 2 (CB2) agonist with established anti-inflammatory effects that is known to improve memory and increase lifespan. It is of interest to explore the potential of BCP to reduce age-related cognitive decline and proinflammatory cytokine load. In this study, we assessed changes in circulating cytokines across the lifespan, memory performance in young and aged mice, and the effects of BCP on memory function and cytokine load. The plasma levels of 12 cytokines were assessed in male Swiss-Webster mice at 3, 12, and 18 months of age using multiplexed flow cytometry. Working memory was compared in 3 and 12 month-old mice using spontaneous alternations. A dose-response function (100-300 mg/kg, subchronic administration) for BCP-induced memory restoration was determined in 3- and 12- month-old mice. Finally, the effects on cytokine levels of the peak memory enhancing dose of BCP were assessed in 18- month-old mice. Circulating levels of several cytokines significantly increased with age. Multilinear regression analysis showed that IL-23 levels were most strongly associated with age. Aged mice showed deficits in working memory and higher levels of IL-23, both of which were reversed by BCP treatment. BCP appears to reverse age-associated impairments in memory and modulates cytokine production. IL-23 may play a significant role in the aging process, and future research should determine whether it has utility as a biomarker for novel anti-aging therapeutics.