Department of Civil & Environmental Engineering, University of Michigan, Ann Arbor, Michigan, USA.
Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.
mSphere. 2020 Oct 21;5(5):e00588-20. doi: 10.1128/mSphere.00588-20.
Supply shortages of N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic have motivated institutions to develop feasible and effective N95 respirator reuse strategies. In particular, heat decontamination is a treatment method that scales well and can be implemented in settings with variable or limited resources. Prior studies using multiple inactivation methods, however, have often focused on a single virus under narrowly defined conditions, making it difficult to develop guiding principles for inactivating emerging or difficult-to-culture viruses. We systematically explored how temperature, humidity, and virus deposition solutions impact the inactivation of viruses deposited and dried on N95 respirator coupons. We exposed four virus surrogates across a range of structures and phylogenies, including two bacteriophages (MS2 and phi6), a mouse coronavirus (murine hepatitis virus [MHV]), and a recombinant human influenza A virus subtype H3N2 (IAV), to heat treatment for 30 min in multiple deposition solutions across several temperatures and relative humidities (RHs). We observed that elevated RH was essential for effective heat inactivation of all four viruses tested. For heat treatments between 72°C and 82°C, RHs greater than 50% resulted in a >6-log inactivation of bacteriophages, and RHs greater than 25% resulted in a >3.5-log inactivation of MHV and IAV. Furthermore, deposition of viruses in host cell culture media greatly enhanced virus inactivation by heat and humidity compared to other deposition solutions, such as phosphate-buffered saline, phosphate-buffered saline with bovine serum albumin, and human saliva. Past and future heat treatment methods must therefore explicitly account for deposition solutions as a factor that will strongly influence observed virus inactivation rates. Overall, our data set can inform the design and validation of effective heat-based decontamination strategies for N95 respirators and other porous surfaces, especially for emerging viruses that may be of immediate and future public health concern. Shortages of personal protective equipment, including N95 respirators, during the coronavirus (CoV) disease 2019 (COVID-19) pandemic have highlighted the need to develop effective decontamination strategies for their reuse. This is particularly important in health care settings for reducing exposure to respiratory viruses, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. Although several treatment methods are available, a widely accessible strategy will be necessary to combat shortages on a global scale. We demonstrate that the combination of heat and humidity inactivates a range of RNA viruses, including both viral pathogens and common viral pathogen surrogates, after deposition on N95 respirators and achieves the necessary virus inactivation detailed by the U.S. Food and Drug Administration guidelines to validate N95 respirator decontamination technologies. We further demonstrate that depositing viruses onto surfaces when suspended in culture media can greatly enhance observed inactivation, adding caution to how heat and humidity treatment methods are validated.
在 2019 年冠状病毒病(COVID-19)大流行期间,N95 呼吸器的供应短缺促使各机构制定可行且有效的 N95 呼吸器重复使用策略。特别是,热消毒是一种可大规模实施且可在资源多变或有限的环境中实施的处理方法。然而,先前使用多种灭活方法的研究通常侧重于在狭义定义的条件下研究单一病毒,因此难以针对新兴或难以培养的病毒制定灭活指导原则。我们系统地研究了温度、湿度和病毒沉积溶液如何影响沉积和干燥在 N95 呼吸器滤垫上的病毒的失活。我们将四种病毒替代物暴露于多种结构和系统发育范围内,包括两种噬菌体(MS2 和 phi6)、一种鼠肝炎病毒(鼠肝炎病毒[MHV])和一种重组人甲型流感病毒亚型 H3N2(IAV),在多种温度和相对湿度(RH)下进行 30 分钟的热处理,使用多种沉积溶液。我们观察到,升高的 RH 对于有效灭活所有四种测试的病毒至关重要。对于 72°C 至 82°C 的热处理,RH 大于 50%可导致噬菌体失活超过 6 对数,RH 大于 25%可导致 MHV 和 IAV 失活超过 3.5 对数。此外,与其他沉积溶液(如磷酸盐缓冲盐水、含牛血清白蛋白的磷酸盐缓冲盐水和人唾液)相比,在细胞培养介质中沉积病毒可大大增强病毒对热和湿度的灭活。因此,过去和未来的热处理方法必须明确将沉积溶液作为一个将强烈影响观察到的病毒失活率的因素。总体而言,我们的数据集可以为 N95 呼吸器和其他多孔表面的有效基于热的消毒策略的设计和验证提供信息,特别是对于可能立即引起和未来引起公共卫生关注的新兴病毒。在 2019 年冠状病毒病(COVID-19)大流行期间,个人防护设备(包括 N95 呼吸器)短缺,这凸显了开发有效再利用消毒策略的必要性。这在医疗机构中尤其重要,可以减少接触呼吸道病毒,例如引起 COVID-19 的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)。尽管有几种治疗方法可用,但需要一种广泛适用的策略来在全球范围内应对短缺。我们证明,在 N95 呼吸器上沉积后,热和湿度的组合可使多种 RNA 病毒失活,包括病毒病原体和常见的病毒病原体替代物,并达到美国食品和药物管理局指南规定的必要病毒失活程度,以验证 N95 呼吸器的消毒技术。我们进一步证明,将病毒沉积在表面上时悬浮在培养基中可以大大增强观察到的失活,这为热和湿度处理方法的验证增加了谨慎性。