Human Coronavirus 229E Remains Infectious on Common Touch Surface Materials

Warnes, Sarah L.; Little, Zoë R.; Keevil, C. William

In 2003, a highly pathogenic coronavirus believed to have originated in bats and palm civet cats transferred to humans in Guangdong Province, China, resulting in cases of severe acute respiratory syndrome (SARS). Over 8,000 people were infected in 37 different countries, but mostly in Southeast Asia, with 10% mortality. Inefficient human-to-human transmission, severe restrictions on air travel, closure of many wild-animal markets, and quarantine procedures have successfully contained the outbreak so far. However, zoonotic transmission of a coronavirus from reservoirs in bats and possibly camels gave rise to severe respiratory infection in individuals in the Arabian Peninsula in 2012. The resulting Middle East respiratory syndrome (MERS), which affects the lower respiratory tract, is clinically similar to SARS but pathologically different. A ubiquitous host cell receptor often leads to extrapulmonary disease, often in the kidneys, and viral progeny are released through apical and basolateral respiratory cell surfaces, contributing to the high (up to 40%) mortality rate (reviewed in references 6 and 7). Late uncontrolled inflammation leads to severe pathologies which are not dependent on viral load, and human-to-human spread does occur (reviewed in references 3 and 4). This, combined with a low infectious dose, suggests that transmission of very few virus particles via person-to-person or contact with contaminated surfaces may be an infection risk. Although camels and associated food products have been found to contain the virus, a recent study of individuals constantly in contact with infected herds suggested that zoonotic transmission is rare (8) but that the risk may be highest from juvenile animals. The risk of transmission is increased, however, in clinical facilities (9) and possibly in other crowded public areas, including care homes and areas of mass gatherings, such as the Hajj Muslim pilgrimage to Mecca. In a recent outbreak in South Korea, MERS has so far (July 2015) killed 36 people and infected 186 patients in hospital-associated cases associated with the first imported case arising from travel to the Middle East (10, 11) .