The new coronavirus is primarily a respiratory illness, and it typically spreads via airborne particles from an infected patient's coughs or sneezes. Some research suggests the virus can also spread via fecal matter. Multiple studies have found traces of the virus in infected patients' poop. SARS, another coronavirus, also spread through poop. Here's what you can do to protect yourself. Visit Business Insider's homepage for more stories.
To lower your risk of catching the new coronavirus, health authorities recommend staying 6 feet from individuals who show any signs of illness. That's because the coronavirus typically spreads via airborne particles when an infected person coughs or sneezes. Those viral particles can then infect someone after they land on their nose or mouth or get inhaled. But a growing body of research suggests the coronavirus can also spread via poop particles. A study of three coronavirus patients in Singapore, published Wednesday in the Journal of the American Medical Association, revealed that the virus showed up in their stool. Samples taken from the toilet bowls and sinks in the patients' isolation rooms came back positive for the virus.
That evidence supports findings from researchers at the Chinese Center for Disease Control and Prevention, who also detected viable virus particles in coronavirus patients' feces. China's National Health Commission has confirmed that the virus can spread through contaminated poop, the South China Morning Post reported on Tuesday. The fact that the virus can be passed through both our respiratory and digestive systems may explain how it spread from its origin city of Wuhan, China to more than 80 countries in just a few months, researchers suggest. The virus can travel in poop particles The authors of the Chinese CDC study wrote that "stool samples may contaminate hands, food, water, etc.," then cause infection if the particles enter a person's mouth, nose, or eyes. For example, an infected patient could use the bathroom, forget to wash their hands or give only a cursory rinse, then touch a friend's hand. That friend could then rub their face and get virus. In medicine, this is known as fecal-oral transmission. "This virus has many routes of transmission, which can partially explain its strong transmission and fast transmission speed," the study authors wrote. That research and the new case study from Singapore adds to a growing body of evidence we have about fecal-oral transmission risk. Here are three other pieces of evidence:
Researchers detected coronavirus RNA in poop from the first US patient — a man from Snohomish County in Washington state who was diagnosed in late January — according to a report in the New England Journal of Medicine. Another January study, which has yet to be peer-reviewed, detected an enzyme signature of the virus in cells from coronavirus patients' small intestines and colons. Typically, coronavirus particles dock to cell receptors in our upper respiratory tract. But those same receptors live in our digestive system, and the study authors suggested that our intestines could be invaded too. Blood and anal swabs from nearly 140 coronavirus patients at a Wuhan hospital revealed traces of the virus as well.
Other coronaviruses — like those that infect horses and cats — frequently spread via poop. If a healthy horse eats a piece of hay contaminated with fecal matter from an infected horse, for example, it can get sick. Researchers think the new coronavirus jumped from bats to another animal before infecting humans. That initial spread from bats likely happened via poop, too. How to protect yourself The Chinese CDC said the possibility of fecal-oral transmission further underscores the importance of frequent hand washing and the need to disinfect objects and surfaces in medical facilities, transportation vehicles, public toilets, and homes.
Other viruses like Hepatitis A and Hepatitis E also spread via fecal-oral transmission. Such viruses can use "a vehicle such as food, water, or utensil, and enter a new host through the mouth," according to the US CDC. Accordingly, careful food-handling and washing is also important. Both the US and Chinese CDCs recommend boiling drinking water if there's a possibility it could be contaminated with sewage, and not eating raw food like shellfish or produce that may have been harvested or washed in contaminated water. Avoiding swimming pools that may contain contaminated water is also important. SARS spread through poop, too During the 2002-2003 SARS outbreak (SARS is also a coronavirus), researchers documented an instance in which one sick person had diarrhea in a Hong Kong apartment building, and the virus then traveled through the pipes to infect other residents. In that instance, an issue with the drainage pipes caused a situation in which running exhaust fans with the bathroom door closed created enough negative pressure to suck fecal droplets out of the sewage system and into the bathroom. Those virus-laden droplets then landed on floor mats, towels, and toiletries that residents touched.
Up to 76% of SARS patients experienced diarrhea. The symptom has also cropped up among a minority of patients with the new coronavirus: The first US patient had diarrhea the day after he arrived at the hospital. Coronavirus patients in Vietnam have also reported diarrhea as a symptom, and a non-peer-reviewed study of 1,099 Chinese patients found that 4% had diarrhea, too. But a person with the new coronavirus doesn't need to have an upset stomach to shed the virus in their poop. One of the patients from the Singapore case study had normal stool, but their poop still tested positive. Morgan McFall-Johnsen contributed reporting to this story. Read more about the new coronavirus: Some coronavirus patients experience nausea, vomiting, or diarrhea before they get a fever. They could spread the virus through poop. Workers at 6 US hospitals reveal how they respond to potential coronavirus cases — including face shields and negative-pressure isolation chambers People are racing to buy face masks amid the coronavirus outbreak, but they probably won't protect you from illness The outbreaks of both the Wuhan coronavirus and SARS likely started in Chinese wet markets. Photos show what the markets look like.Join the conversation about this story » NOW WATCH: Pathologists debunk 13 myths about the coronavirus, including why masks won't help
More like this (3)
Asymptomatic coronavirus cases seem very common – but those people might only be contagious for half as long, new research suggests
Asymptomatic coronavirus cases appear to be more prevalent than scientists initially thought. A recent study of...Asymptomatic coronavirus cases appear to be more prevalent than scientists initially thought. A recent study of a cruise ship outbreak found that 80% of passengers who tested positive for the virus were asymptomatic. A study from Wuhan, China, also found that asymptomatic patients may only be contagious for half as long as symptomatic patients. Visit Business Insider's homepage for more stories. Asymptomatic transmission is a puzzling element of any infectious disease: People without symptoms are hard to identify, so it's difficult to determine how common these cases are. When it comes to the coronavirus, the US Centers for Disease Control and Prevention (CDC) estimates that around 35% of infections are asymptomatic. But a spate of new research suggests that might be conservative. According to a recent study of a coronavirus outbreak on a cruise ship that left Argentina in mid-March, the majority of passengers who tested positive for the virus — around 80% — showed no symptoms. Another study from Wuhan, China, found that 42% of patients — 33 out of 78 tested — were asymptomatic. Additional research suggests that people with asymptomatic cases, though common, may only be contagious for a short window compared to symptomatic patients. "A lot of this is thought to be settled science, but I think that there are still a lot of questions we have about when asymptomatic transmission occurs and the circumstances that it occurs in," Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, told Business Insider. Asymptomatic carriers may only be contagious for 8 days A person's ability to transmit the virus depends partly on their viral load: the amount of viral particles they release into the environment. Research indicates that there's little difference in the viral loads between coronavirus patients who show symptoms and those who don't. "A growing body of results shows that people who are asymptomatic appear to have the same viral load as symptomatic cases," Gigi Gronvall, an immunologist and senior scholar at the Johns Hopkins Center for Health Security, told the university. "This suggests that transmission is possible equally from both asymptomatic patients and noticeably sick patients." Coronavirus patients tend to have high viral loads in the throat, nasal cavity, and upper respiratory tract, which makes the virus highly contagious. But the Wuhan study suggests that asymptomatic coronavirus patients don't shed the virus for as much time. On average, the researchers found, symptomatic patients shed for more than twice as long as asymptomatic patients: 19 days compared to eight. No asymptomatic patient in the study shed the virus beyond the 12-day mark — and some only shed for three days. Patients with symptoms, meanwhile, shed for 16 to 24 days. The researchers also found that most asymptomatic patients were women in their 20s, 30s, and 40s. Scientists aren't sure how much asymptomatic carriers fuel transmission Adalja noted that a lot of the initial data on asymptomatic spread came from a choir practice in Washington. On March 3, a person infected with the virus (who wasn't showing symptoms) attended a 2.5-hour choir practice in Skagit County. Most of the attendees subsequently became ill with the coronavirus, leading some local health officials to conclude that the virus had spread through asymptomatic transmission. But the CDC later determined that most of the choir members' exposure occurred during another practice on March 10, when the same infected person was showing symptoms. This might suggest that asymptomatic carriers aren't fueling transmission as much as scientists first thought. "Now that we've seen that incident in the choir did not involve asymptomatic transmission, that's gotten a lot of people thinking," Adalja said. Some scientists still believe, however, that asymptomatic transmission is driving transmission in confined spaces like hospitals, homeless shelters, prisons, and nursing homes. A recent editorial from researchers at the University of California, San Francisco, argued that asymptomatic patients "are playing a major role in the transmission" of the coronavirus. They pointed to an outbreak at a nursing facility in Washington, where 56% of residents tested positive for the virus without showing symptoms. Even though most of those residents developed symptoms within the following week, they likely helped spread the virus when they were asymptomatic. "Symptom-based screening alone failed to detect a high proportion of infectious cases and was not enough to control transmission in this setting," the UCSF researchers wrote. They added that asymptomatic spread was the "Achilles heel" of coronavirus mitigation strategies: Without testing for asymptomatic patients, the US might struggle to contain its outbreak. Hilary Brueck contributed reporting. Join the conversation about this story » NOW WATCH: Pathologists debunk 13 coronavirus myths
Notes to global health leaders on 10 and 11 January highlighted possible infection routesCoronavirus – latest...Notes to global health leaders on 10 and 11 January highlighted possible infection routesCoronavirus – latest updatesSee all our coronavirus coverageThe World Health Organization warned the US and other countries about the risk of human-to-human transmission of Covid-19 as early as 10 January, and urged precautions even though initial Chinese studies at that point had found no clear evidence of that route of infection.Technical guidance notes seen by the Guardian and briefings by top WHO officials warned of potential human-to-human transmission and made clear that there was a threat of catching the disease through water droplets and contaminated surfaces, based on the experience of earlier coronavirus outbreaks, such as Sars and Mers. Continue reading...
A new study could have implications for how the general public and health care workers try...A new study could have implications for how the general public and health care workers try to avoid transmission of the virus.