Evidence supporting the possibility of a fecally mediated route of transmission of SARS-CoV-2 has been accumulating.
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Several descriptive case series have reported the presence of viral genetic material in the stool of some COVID-19 patients.
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If the possibility of fecal transmission (e.g., fecal–oral, fecal–fomite, or fecal–aerosol/droplet) is established, it will impact public health messaging and recommendations, including guidelines on sewage exposure, nosocomial infections, residential care facilities, and food preparation.
Abstract
Coronavirus disease 2019 (COVID-19) emerged in Hubei Province, China in December 2019 and has since become a global pandemic, with hundreds of thousands of cases and over 165 countries affected. Primary routes of transmission of the causative virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are through respiratory droplets and close person-to-person contact. While information about other potential modes of transmission are relatively sparse, evidence supporting the possibility of a fecally mediated mode of transmission has been accumulating. Here, current knowledge on the potential for fecal transmission is briefly reviewed and the possible implications are discussed from a public health perspective.