Aerosols, feces, sewage, SARS

People got SARS from toilet flushing

By —— Bio and Archives--March 17, 2008

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On Thursday when Hong Kong shut all kindergartens and primary schools, affecting more than 500,000 children, Toronto environmentalist Maureen Reilly, BA sent an email to Scott Dowell, Coordinating Officer for Global Health, Center for Disease Control (CDC) in Atlanta, Georgia.

Reilly, who is researching the proper protocol for managing fecal waste from Severe Acute Respiratory Syndrome (SARS), has for the past decade studied the issue of pathogens in municipal effluents and land applied sludge wastes.

“I am wondering how SARS (or avian flu) fecal waste should be managed in a hospital setting,” she wrote Dowell.

  Citing issues that include the aerosolization of pathogens into the washroom (i.e. Amoy Gardens (Hong Kong); the infection of sewage treatment workers; the release of pathogens into receiving waters in sewage effluents, the application of sludges on farm and food chain lands and the development of more virulent forms of the pathogen through the sewage treatment plant processes, the environmentalist asked “Shouldn’t the fecal waste in these cases be autoclaved?”

  One of the most effective methods for the destruction of all types of micro-organisms, the autoclave is a pressurized, steam heat vessel used for sterilization.

  “I did some SARS work long ago but didn’t focus on fecal waste,” Dowell wrote back to Reilly.  “And why are you interested in SARS at this point?”

“The common toilet,” says Reilly, “is not a disinfection machine.” 

  “I now have emails from Dr. Donald Low, microbiologist in chief at Toronto’s Mount Sinai Hospital and from the CDC saying that the protocol for SARS-infected feces is the toilet,” Reilly told Canada Free Press (CFP).  “But reports prove that flushing toilets aerosolized the pathogen, infecting hundreds.

“Even one SARS hospital reported that the nurses in two infected wings shared a washroom.

  “What is going on?  Don’t they read their own reports?

  “And why is it that in 2003—the year of SARS—Toronto spread only 3% of its sludge on farmland”
  “Do you think they decided not to because of SARS, but couldn’t tell anyone because how could they get the SARS across the border to the US landfill they were using?”

The respected environmentalist whose work appears in the Canadian Journal of Infectious Diseases, (see full report here) could have easily written back to the CDC when asked why she was interested in SARS at this point. “No better time to be interested in SARS then now”.

  The World Heath Organization issued a Travel Advisory about Toronto as a travel destination in 2003.  Forty-four people died from SARS when Toronto resident Sui-Chu Kwan, 78 and her husband returned to Toronto from Hong Kong.  The couple had stayed at the Metropole Hotel, which was believed to be the source of the outbreak.

  In addition to closing schools, the Chinese government last week named Yuen Kwok-yung, a University of Hong Kong microbiologist who helped discover the cause of the 2003 SARS outbreak, to head a panel charged with finding whether flu strains are mutating into a more lethal form.

  Hong Kong remains on flu alert after the unexplained deaths of four young children with flu-like symptoms. 
  “Worried residents are donning surgical masks, flooding hospital waiting rooms and buying up supplies of antibacterial soap as they remember the SARS outbreak that killed 299 people five years ago.” (Bloomberg.com, March 16, 2008).

  There is no proof that the flu-like symptoms that killed four Hong Kong children was SARS.  But neither is there any proof that it is not SARS or proof that SARS, which disappeared in 2003, won’t be coming back.

  “When SARS first happened, it was sporadic and no one expected it to become a disaster,” said Wong, who also has a 6-year-old daughter.  “The recent deaths are haunting me.”

  The first in the current spate of deaths was that of a 21-month-old boy on Feb. 24, the city’s Health Department said.  Two of the victims tested positive for influenza A, although the disease hasn’t been identified as the cause of their deaths.  Two other children died after suffering flu-like symptoms, though tests haven’t yet confirmed the presence of influenza A, the subtype that causes seasonal outbreaks of the disease.

“Hong Kong is simply experiencing a seasonal flu outbreak,” said peter Cordingley, the Manila-based spokesman for the World Health Organization’s Western Pacific region.

  “If you look back to SARS, you can understand why there is a high level of anxiety in Hong Kong among the public at the moment,” he said.  “There is nothing exceptional n what is happening in Hong Kong at the moment.”

  But microbiologists are tying to find whether flu strains are mutating into a more lethal form.
  Surely the time to decide the proper protocol for the management of SARS patients’ fecal waste should be determined before another potential outbreak.

  “We know that the Corona virus (SARS virus) lives up to 24 hours on surfaces,” says Reilly.  “We know the feces are infectious.  We know hundreds of people in Amoy Gardens got SARS from aerosols from a flushing toilet.
  The same people at risk during the 2003 SARS outbreak are still at risk.

  “There are risks to patients and hospital staff from SARS virus aerosolized in the toilet (both inhaled and from later touching surfaces).

  “There are risks to sewage treatment plant workers.  There are risks to the environment if the virus is released into surface waters, onto farms in sludges, and know that there is a risk of infecting not only people but also animals.

  “We also don’t want those virulent diseases sharing that virulent DNA and creating new pathogens in the sewage treatment plant.  DNA is shared—increasing virulence and antibiotic resistance factors during the sewage process.

  “The infectious fecal waste should be destroyed in all instances—not passed along to workers, and into the environment.

  Some of the answers in mitigating the SARS risk to human life lie in the past.

  “I was told by an Environmental Health Officer in Durham Region that after the SARS outbreak in 2003, all the SARS patients home addresses were tracked down by health authorities to see if they lived on a septic system, to see if the system had been emptied, and if so, where was the fecal material placed.

  “So the Public Health Department WAS worried about the potential of passing on SARS through placement of fecal waste into the environment.”

  Meanwhile, we need to think these things through in the event of another SARS outbreak.
  “The common toilet,” says Reilly, “is not a disinfection machine.” 

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Judi McLeod -- Bio and Archives | Comments

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Judi McLeod is an award-winning journalist with 30 years’ experience in the print media. A former Toronto Sun columnist, she also worked for the Kingston Whig Standard. Her work has appeared on Rush Limbaugh, Newsmax.com, Drudge Report, Foxnews.com.

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