Environmental contamination in the isolation rooms of COVID-19 patients with severe pneumonia requiring mechanical ventilation or high-flow oxygen therapy.

BACKGROUND: Identifying the extent of environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection control and prevention. The extent of environmental contamination has not been fully investigated in the context of severe coronavirus disease (COVID-19) patients. AIM: To investigate environmental SARS-CoV-2 contamination in the isolation rooms of severe COVID-19 patients requiring mechanical ventilation or high-flow oxygen therapy. METHODS: Environmental swab samples and air samples were collected from the isolation rooms of three COVID-19 patients with severe pneumonia. Patients 1 and 2 received mechanical ventilation with a closed suction system, while patient 3 received high-flow oxygen therapy and non-invasive ventilation. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) was used to detect SARS-CoV-2; viral cultures were performed for samples not negative on rRT-PCR. FINDINGS: Of the 48 swab samples collected in the rooms of patients 1 and 2, only samples from the outside surfaces of the endotracheal tubes tested positive for SARS-CoV-2 by rRT-PCR. However, in patient 3's room, 13 of the 28 environmental samples (fomites, fixed structures, and ventilation exit on the ceiling) showed positive results. Air samples were negative for SARS-CoV-2. Viable viruses were identified on the surface of the endotracheal tube of patient 1 and seven sites in patient 3's room. CONCLUSION: Environmental contamination of SARS-CoV-2 may be a route of viral transmission. However, it might be minimized when patients receive mechanical ventilation with a closed suction system. These findings can provide evidence for guidelines for the safe use of personal protective equipment.

Application of water-assisted pulsed light treatment to decontaminate raspberries and blueberries from Salmonella.

We developed and evaluated a small scaled-up water-assisted pulsed light (WPL) system, in which berries were washed in a flume washer while being irradiated by pulsed light (PL). Hydrogen peroxide (H2O2) was used in combination with PL as an advanced oxidation process and chlorine wash was used as a control. The effects of organic load, water turbidity, berry type and PL energy output on the inactivation of Salmonella using the WPL system were investigated. The combination of WPL and 1% H2O2 (WPL-H2O2) was the most effective treatment which reduced Salmonella on raspberries and blueberries by 4.0 and >5.6logCFU/g, respectively, in clear water. When high organic load and SiO2, as a soil simulator, were added in wash water, the free chlorine level in chlorinated water decreased significantly (P<0.05); however, no significant difference (P>0.05) was observed for the decontamination efficacy of 1-min WPL-H2O2 treatment. Even in the presence of high organic load and water turbidity, no viable bacterial cells were recovered from the wash water, which showed that WPL-H2O2 could effectively prevent the risk of cross-contamination during treatment. Taken together, 1-min WPL treatment without H2O2 could provide a chemical free alternative to chlorine washing with similar and in some cases significantly higher bactericidal efficacy. Compared with chlorine washing, the combination of WPL and H2O2 resulted in significantly higher (P<0.05) reduction of Salmonella on berries, providing a novel intervention for processing of small berries intended for fresh-cut and frozen berry products.

Inactivation of internalized and surface contaminated enteric viruses in green onions.

With increasing outbreaks of gastroenteritis associated with produce, it is important to assess interventions to reduce the risk of illness. UV, ozone and high pressure are non-thermal processing technologies that have potential to inactivate human pathogens on produce and allow the retention of fresh-like organoleptic properties. The objective of this study was to determine if UV, ozone, and high pressure are effective technologies compared to traditional chlorine spray on green onions to reduce enteric viral pathogens and to determine the effect of location of the virus (surface or internalized) on the efficacy of these processes. Mature green onion plants were inoculated with murine norovirus (MNV), hepatitis A virus (HAV) and human adenovirus type 41 (Ad41) either on the surface through spot inoculation or through inoculating contaminated hydroponic solution allowing for uptake of the virus into the internal tissues. Inoculated green onions were treated with UV (240 mJ s/cm(2)), ozone (6.25 ppm for 10 min), pressure (500 MPa, for 5 min at 20°C), or sprayed with calcium hypochlorite (150 ppm, 4°C). Viral inactivation was determined by comparing treated and untreated inoculated plants using cell culture infectivity assays. Processing treatments were observed to greatly affect viral inactivation. Viral inactivation for all three viruses was greatest after pressure treatment and the lowest inactivation was observed after chlorine and UV treatment. Both surface inoculated viruses and viruses internalized in green onions were inactivated to some extent by these post-harvest processing treatments. These results suggest that ozone and high pressure processes aimed to reduce the level of microbial contamination of produce have the ability to inactivate viruses if they become localized in the interior portions of produce.

Position paper update: ipecac syrup for gastrointestinal decontamination.

CONTEXT: An update of the first position paper on ipecac syrup from 1997 was published by the American Academy of Clinical Toxicology and the European Association of Poison Centres and Clinical Toxicologists in 2004. The aims of this paper are to briefly summarize the content of the 2004 Position Paper and to present any new data. METHODS: A systematic review of the literature from the year 2003 forward. RESULTS: The literature search yielded a limited number of meaningful articles, and there remains no convincing evidence from clinical studies that ipecac improves the outcome of poisoned patients. Furthermore, the availability of ipecac is rapidly diminishing. CONCLUSIONS: The routine administration of ipecac at the site of ingestion or in the emergency department should definitely be avoided. Ipecac may delay the administration or reduce the effectiveness of activated charcoal, oral antidotes, and whole bowel irrigation. There is not sufficient evidence to warrant any change in the previous ipecac position papers. There are, however, insufficient data to support or exclude ipecac administration soon after ingestion of some specific poisons in rare situations.

A simplified method to create quantitative, "fixed" uranyl-contaminated metal coupons.

A method was developed and validated to quantitatively apply and "fix" uranyl contamination onto a metal surface (steel). Simple approaches are needed to create test surfaces in order to quantify contaminant removal or "decon" methods. We used steel discs sized to allow direct and accurate alpha counting in a Ludlum scanner from radioactive contaminants. A typical 3.8-cm-diameter coupon had a depleted uranyl loading of about 0.1 mg U cm with a count of 980 dpm. The resulting alpha radiation was measured with a precision of >97% for the same coupon. The alpha concentration on replicate coupons differed by as much as 9% (standard deviation). This method, based on earlier methods, required a uranyl solution to be dried but lowers the baking temperature to less than 100 degrees C to increase safety in a typical radiological laboratory. A dike was used to provide a uniform coating of the uranyl solution.

Intoxicación por la administración de tabletas de Thevetia peruviana como tratamiento para bajar de peso: presentación de un caso / Intoxication from thevetia perviana tablets as a weight-reduction treatment: a case study

La administración de productos de plantas medicinales de procedencia dudosa, que no están debidamente registrados ni autorizado su uso, puede ocasionar graves daños a la salud por contener sustancias tóxicas para órganos y sistemas. El objetivo del presente trabajo fue describir un caso clínico de intoxicación por ingestión de tabletas que contienen semillas de la planta Thevetia peruviana (semilla indú), comúnmente denominada retama. Se trata de paciente femenina de 32 años de edad, evaluada en centro clínico privado, quien después de la administración de tabletas indicadas como tratamiento para bajar de peso presentó: parestesia generalizada, náuseas, vómitos, alteraciones electrocardiográficas (bradicardia, bloqueo A-V grado II), hypocalemia (2 meq/L) y shock anafiláctico, lo que requirió su ingreso en la unidad de cuidados coronarios, recibiendo como tratamiento diálisis gastrointestinal y medidas de soporte electrolíticas y cardiacas, produciéndose remisión de las alteraciones gastrointestinales e ectrolíticas y electrocard ográficas. Se concluyó que las manifestaciones observadas en la paciente, son compatibles con los efectos tóxicos producidos por los glucósidos cardiotónicos presentes en la planta Thevetia peruviana. (AU)

A battery of toxicity tests as indicators of decontamination in composting oily waste.

Heterogeneous oily waste from an old dumping site was composted in three windrows constructed from different proportions of waste, sewage sludge, and bark. The objectives of this pilot study were to examine the usefulness of composting as a treatment method for this particular waste and to study decontamination in the composting process by using a battery of toxicity tests. Five samples from the windrow having intermediate oil concentrations were tested with toxicity tests based on microbes (Pseudomonas putida growth inhibition test, ToxiChromotest, MetPLATE, and three different modifications of a luminescent bacterial test), enzyme inhibition (reverse electron transport), plants (duckweed growth inhibition and red clover seed germination), and soil animals (Folsomia candida, Enchytraeus albidus, and Enchytraeus sp.). The luminescent bacterial tests were used as prescreening tests. Chemical analyses of samples were carried out simultaneously. Both toxicity and oil concentration, including those of polyaromatic hydrocarbons (PAHs), were reduced during composting and soil quality improved significantly. The total oil hydrocarbon concentration decreased from 90,000 to 19,000 mg/kg, measured with the IR method, in 4 months, and from 86,000 to 1400 mg/kg, measured with GC method. The concentration of PAHs decreased from 135 to 23.5 mg/kg. During the fourth month of composting (stabilization stage), the proportion of the heaviest oil fractions (asphaltenes) became dominant. Toxicity varied between different samples and between different bioassays; however, the first sample was significantly more toxic than the others, and most of the tests revealed a decrease in toxicity during the composting process.

Decontamination of human skin exposed to 2,3,7,8-tetrachlorodibenzo-p-Dioxin (TCDD) in vitro.

Human post-mortem skin was exposed in vitro to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) at 32 degrees C, under controlled humidity. In one-half of the samples, damage to the surface of the skin was simulated by stripping of the stratum corneum. After incubation with TCDD for 100 min, four different decontamination protocols were performed: (1) the sample was wiped with dry, adsorbent material (cotton balls); (2) a 10-min topical treatment with mineral oil was followed by dry wiping with cotton balls; (3) a 10-min topical treatment with mineral oil was followed by wiping with acetone-soaked cotton balls; and (4) the sample was washed with water and soap. After decontamination, skin samples were incubated (up to 300 min) again at 32 degrees C. One set of both intact and stripped TCDD-exposed skin samples was incubated for 300 min--absent decontamination--and was used as a control. Mineral oil treatment and acetone wipes, or water and soap, were effective in reducing (i.e., about two-fold) the amount of TCDD in the stratum corneum of intact skin. Mineral oil plus dry wipes reduced the amount of TCDD in the stratum corneum by about one-third, whereas dry wiping alone was ineffective. All protocols, however, were similarly effective in reducing the amount of TCDD in the epidermis and upper dermis; TCDD concentrations were decreased locally by factors of up to ten. In the lower dermis, a minimal effect of the decontamination procedures was observed.(ABSTRACT TRUNCATED AT 250 WORDS)