Coronavirus Also Spreads Via Poop

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.

Journal Emerging Microbes & Infections – Molecular and serological investigation of 2019- nCoV infected patients: implication of multiple shedding routes


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

43 thoughts on “Coronavirus Also Spreads Via Poop”

  1. Less than a quarter. In a close environment. I much prefer if they would just give me the numbers instead of giving me my opinion.

  2. You must have very big lungs, or get really excited. And major constipation. 5 minutes?

    But seriously, I’ll do the calculation. “The average adult, when resting, inhales and exhales about 7 or 8 liters of air per minute.”
    So cool to be able to look things up. Glad I didn’t have to breathe into an empty garbage bag and figure out its volume.
    5 min x 8 liters. That is 40 liters.
    Looked up these beasts. It says “19,000 LFM (linear feet per minute)” The diameter of most of these spouts is about 3 inches.
    20 seconds is a third of that so 6,333 linear feet. So I get 5.37×10^5 cubic inches of air or 8,800 liters. So, yeah, very big lungs.
    To be fair, they claim it takes 10 seconds, but I have used that model and it takes about 15, I think, and there is usually water blown up your arm:
    I chose that one because I recognized it, and because it had a number.
    It is possible to use up to 200 liters of air per minute running. But that means even the heavy breathing maniac in the bathroom can’t breathe more than 1,000 liters in 5 minutes.

  3. So air dryers blow about 200x as much bacteria or spores onto a plate compared to the same plate sitting still. Sounds bad, but not too surprising. (Dryers with HEPA filters reduce that about 4x.)

    But if you go into a bathroom for 5 minutes, you probably breath about the same amount of air directly into your lungs as a hand dryer used for 20 seconds blows onto your hands.

    So, maybe use that to gauge just how bad using an air dryer is.

  4. Meanwhile, it seems China is settling down. Fewer new cases, and recoveries are climbing. 30% have recovered so far.

    Most of the countries with a small number of cases are also at zero active cases now. All either recovered or died. India in particular is one of them, which is good news.

    Right now it looks like South Korea may be the next major flare up, and Italy and Japan may be in danger.

    My impression is that Japan is better organized than Italy, but it still has cases in multiple parts of the country, plus all the cases from the Diamond Princess. I got the impression that Italy’s government is somewhat overwhelmed at the moment.

    edit: Iran also looks bad. 40+ cases with almost 20% death rate so far. That could mean one or more of three things:
    1) Their medical care is really bad.
    2) They’ve got a much deadlier strain.
    3) They have nearly 10 times more cases than they’re reporting.

    Neither of these options is good, and it’s likely at least two of them are true.

  5. The confirmed cases are known day-by-day. But given the variance in progression of the disease in different patients, which may not be well characterized, going by “cases X time ago” can be unreliable. As new cases per day eventually drops, the death rate should settle towards the correct number. Until then, using the current case count gives a conservative estimate (“at least this high”).

    First off since MERS in present in URINE AVOID PUBLIC TOILETS “Low concentrations of the virus were detected in urine”  Ergo the case for COVID-19 may be similar

    Secondly “Surprisingly, ACE2 bound to 2019-nCoV S ectodomain with ∼15 nM affinity, which is approximately 10- to 20-fold higher affinity than ACE2 binding to SARS-CoV S”
    “The high affinity of 2019-nCoV S for human ACE2 may contribute to the apparent ease with which 2019-nCoV can spread from human-to-human(1), however additional studies are needed to investigate this possibility.”

  7. The fatality rate is calculated as deaths per cases, not deaths per recoveries.

    That is how it is calculated. But is that how it SHOULD be calculated?

    The best argument I’ve heard is that the deadly cases seem to be about 1 week from diagnosis to death. So it should be calculated as
    deaths/(number of cases one week ago).

    Though that one-week number is largely a guess.

  8. A bit more on Italy: looks like they brought 19 back from the Diamond Princess, but no indication that any of those are known to be infected.

    It seems like Europe may not have been taking the situation seriously enough – from La Repubblica (Italian paper):
    ” in our country there are in fact over 50 cases of secondary infections (in people not from areas at risk) and two deaths, but the number of infections continues to grow. 
    “According to the latest data from the European Center for Disease Control (ECDC), by 20 February Germany had notified 16 cases, two of which imported and the rest secondary; France 12 (5 imported, 7 secondary and one dead); Great Britain 9 (of which only one imported); Spain 2; Belgium, Finland and Sweden one.”

    Here’s a link to the ECDC for updates on that:

    However the ECDC data for Feb22 lists only 17 cases for Italy, and the WHO site’s situation update for Feb22 claims only 9.
    The large discrepancies in these numbers is concerning…

  9. It’s interesting that some refused to leave the Diamond Princess because they didn’t trust the procedures for transporting people.

    Sounds nuts – but nutty thing is that they were sort of right. Just after they got the supposedly uninfected people on the buses, they got results showing that some of those people were definitely infected. I.e. some official took a gamble and lost.

    Given the foul-up in transport procedures, I hope the US will give those who chose to stay aboard another chance – and do a better job of quarantine this time.

  10. “it is a great way to protect the country it is docked at”
    Eventually people on board may panic and literally jump ship – and because you let the disease spread onboard, inevitably some of those will be infected.

  11. Apparently the SK spread was due to large church gatherings – which have now been shut down. But with long incubation times, I fear they’re doomed to see a lot more victims just from that. Time to restrict non-essential travel to/from SK?

    Italy also saw a big spike today – adding 45 cases for a total of 66. I haven’t found out why yet – might be due to repatriation of victims from the Diamond Princess cruise ship, just as US cases tripled from that.

  12. A ship is a poor choice for protecting those who don’t have it on the ship, but it is a great way to protect the country it is docked at.
    It can take time to get facilities together to do a proper quarantine of all these people. Though it does look like there was some foot dragging to me. Maybe a bit of…”this is not our responsibility, most of these are not our people”…going on. The Japanese are still a xenophobic people…courteous, but xenophobic.
    They could not be blatant and just take all the Japanese off the ship…and send the ship on its way. I think this was next best from their perspective. Getting the other countries to charter planes to take their people home.
    As for separating those with and those without on the ship; I think they had a full ship. If you take a sick person from their room and move them, then you have to put a healthy person in their old room that you took out of their room. No one is going to accept that. And many of the rooms have 2 people. How are you going to remove the sick one? You can’t grow more rooms or wife swap. Your only option to protect the other person in the room is to take the sick person off the boat. I think that is what they did when that happened.
    I think these cruise liners need to redesign their ships. There have been too many incidents of disease spreading wildly on these ships. If it wasn’t killing their business before, I think it is about to. The people they let out for 1 hour a day were limited to the upper deck.

  13. The fatality rate is calculated as deaths per cases, not deaths per recoveries. So 2 to 3 out of 634. That’s less than 0.5%, lower than in China. But it will likely go up, since it takes a while for the disease to run its course either way.

  14. Yeah, those things are a menace.

    Just designed to reduce the number of hours they have to pay the cleaner, because admittedly some % of the general population are complete pigs who just drop paper towels on the ground.

    My solution is to have the hand cleaning basins outside the toilet area.
    — Everyone can see you, so you are under social pressure to wash your hands, and not just throw the paper towel on the ground.
    — Also means that men and women can share the sinks, so more efficient usage of a given number of sinks.

  15. pretty much EVERYTHING points to it being a leak from the Bio lab

    Just because something was in a bio lab doesn’t mean it was artificially designed. Almost all microbes ever seen, even in labs are naturally occurring.

  16. Tinfoil hat time: The ship was used as a controlled test lab to see how infectious it REALLY is, without Chinese control of the data or any other factors the monitoring scientists couldn’t take into consideration.

    Well, we know they DID use this as an experiment, the only question is whether the value of this data affected the political decisions to keep the ship on lockdown or not.

  17. What I’ve read too. That’s why flying sick with well… doesn’t really matter- the shipboard quarantine was just a waste of time. Everyone is going back in to quarantine in the US.

  18. Japan bungled the quarantine. Just isolate in rooms, no segregation of sick and well.

    Cruise ships are notorious for spreading virii.

  19. I guess China should stop dumping unprocessed toilet waste into rivers… Nothing a million person army of construction workers can’t fix in 3 days…

  20. So you are now basically saying this virus stays alive in the air and water… and not only through coughing and spluttering. One week ago every scientist in the media claimed this was nonsense!

  21. I’m wondering why COVID-19 is not getting more attention on nextbigfuture?

    Just looking at the Diamond Princess: out of 3,711 people (passengers & crew), 634 have been confirmed with the virus, that’s 17%. Of those, 27 are in critical condition, 17 have recovered and 2 (or 3) have died. That’s 23.5% needing hospitalization, and a 12% fatality rate (2/17 but the rate will go down as it takes longer to recover than die).

    Seems it deserves a bit more attention.

  22. Right, we should just totally ignore that it originated within walking distance of China’s bio-warfare lab.

  23. The spread on the cruise ship wasn’t massive. A massive spread would be a significant portion of the people on board caught the virus and not just a handful.

  24. This is not normally a problematic transmission route in first world countries. Though granted, cruise ships and San Francisco qualify as honorary 2nd world.

    It could add a bit of extra zing to the usual salad green recalls this summer, though.

  25. This was likely the cause of the massive failure of the cruise ship quarantine.

    I’ve seen a news report that the quarantine on Diamond Princess was pretty much non-existent internally. No separation between high risk and low risk areas and people, some people walking around without masks, etc.

    They didn’t follow any containment procedures other than trying to minimize contact between passengers and crew, and keeping the passengers in their rooms most of the time – but they still let them out for a while every now and then, with full access to the entire ship.

    It was basically a virus incubator, instead of a containment area.

  26. This was suspected already due to a report from a US treatment site (Oregon?), but they had already tossed their sample so couldn’t be completely confirmed. This, coupled with the known SARS fecal route infecting a housing estate in Hong Kong due to bad sanitation, should not be that big a surprise unfortunately.

  27. Please don’t feed the conspiracy theorists… Conspiracy thought is now spreading throughout Asia along with this virus.

    “Just the FACTS please!”

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