E-Paper
Faeces potential source for transmission of Covid-19: NIV study
PUNE A study conducted by a Pune hospital and the National Institute of Virology (NIV), claims to confirm the probability of consistent person-to-person transmission of the novel coronavirus in hospital and family settings, and prolonged viral excretion by Covid-19 patients, after negative conversion of pharyngeal swabs
PUNE A study conducted by a Pune hospital and the National Institute of Virology (NIV), claims to confirm the probability of consistent person-to-person transmission of the novel coronavirus in hospital and family settings, and prolonged viral excretion by Covid-19 patients, after negative conversion of pharyngeal swabs.
As per the study the presence of Sars-Cov-2 RNA was demonstrated in the faeces of Covid-19 patients, suggesting the possibility of transmission via the faecal-oral route.
As per the study, a family that had four members was admitted for Covid-19 treatment. The index case was a 37-year old male healthcare worker in the Covid-19 ward. He was living with his wife (34-years old) and two children (8- and 6-years old).
The index patient showed fever, nasal discharge and generalised weakness at the onset of symptoms. He was admitted to hospital and diagnosed with Covid-19 by real-time reverse transcriptase–polymerase chain reaction (RTPCR).
Stool and urine samples were collected to check if the virus could be detected in specimens from non-respiratory sites. Additional stool samples were collected from the index case on days number 14, 21, 32, 40, 48 and 55, after the onset of symptoms, to determine the duration of excretion of the virus in faeces.
The index patient continued to excrete the virus in his stool until 48 days, despite throat/nasal swabs showing negative Viral RNA.
A rather surprising finding from the study was detection of viral RNA from the faecal specimens of patients, though none of them had diarrhoea as part of their symptoms.
Dr Sampada Patwardhan, associated with Deenanath Mangeshkar hospital said, “The study was basically by NIV to find transmission pattern of four patients in a family cluster from Pune city. All four members presented with different clinical features after being infected with Covid-19. The index case contracted this infection from the hospital and subsequently infected other members in the family. When we say that the virus is present in the faeces and that it could spread through the faecal-oral method it means that the aerosolation of the faeces either through open defecation, flushing of the toilet and sharing of public toilets in huge clusters, could prove to be means of transmission.”
Dr Patwardhan further explained, “The virus is attached to receptors heavily present in the respiratory system, which is why initial symptoms are related to respiration. However, receptors are also heavily present in the large intestine and so symptoms like diarrhoea are also prevalent. We are not denying that the family could not have been infected from the index person via other methods, but the transmission of the virus through faeces is also probable.”
The study has been authored by Sujata Ranshing, Enteric Viruses Group, ICMR-National Institute of Virolog; Mallika Lavania, National Influenza Centre; Varsha Potdar, (NIV); Dr Sampada Patwardhan, department of microbiology, Deenanath Mangeshkar hospital; Dr Parikshit S Prayag, infectious disease, Deenanath Mangeshkar; Dr Sameer Jog, critical care centre, Deenanath Mangeshkar; Dr Dhananjay Kelkar, medical director, Deenanath Mangeshkar; Dr Pradeep Sawant, Dr Manohar Shinde and Dr Nutan Chavan.
