China has found live novel coronavirus particles in stool specimens indicates a fecal-oral route for coronavirus. This was likely the cause of the massive failure of the cruise ship quarantine. The cruise ship spread was like what is seen with gastro-causing norovirus, which also spreads along that pathway.
Strengthening sanitation and hygiene measures are needed prevent fecal-oral transmission in epidemic areas. These include drinking boiled water, avoiding eating raw food, implementing separate meal systems, frequent hand-washing, disinfecting toilets, and preventing water and food contamination from patients’ stool.
Rectal swabs tests can detect the pneumonia-causing virus in patients even when conventional oral tests are negative according to doctors in China.
The novel SARS-like coronavirus was found in oral and anal swabs, and blood. Infected patients may shed the pathogen through respiratory, fecal-oral or body fluid routes.
ABSTRACT
In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral– fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral–fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes
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