The Role of Bedding Plays in Spreading Infectious Diseases

As the world recovered from a global pandemic, a groundbreaking study published in Lancet Microbe provides critical insights into the environmental contamination risks posed by the virus in healthcare settings. The study, conducted by a team of researchers from the UK, meticulously assessed the extent of monkeypox virus contamination within hospital isolation rooms and the implications for public health and infection control.

Background of the Study:
In May 2022, an outbreak of monkeypox infections in non-endemic countries raised global concern. With over 67,000 cases reported worldwide and more than 3,400 in the UK alone, understanding the transmission dynamics of the virus became paramount. The study aimed to investigate the potential for environmental contamination by monkeypox virus in hospital settings, a critical aspect of infection prevention and control.

Methodology:
The research team conducted an observational study at the Royal Free Hospital in London, focusing on isolation rooms housing patients with symptomatic monkeypox. They collected surface swabs from high-touch areas, personal protective equipment (PPE) of healthcare workers, and air samples before and during bedding changes. These samples were analyzed using quantitative PCR to determine contamination levels, and virus isolation was performed on selected samples to confirm the presence of infectious virus.

Findings:
The study revealed extensive surface contamination, with 93% of surface swabs testing positive for monkeypox DNA. The PPE of healthcare workers and the areas where PPE was removed (doffing areas) also showed significant contamination. Notably, 25% of air samples were positive for monkeypox virus DNA, with a higher rate of positivity during bedding changes. This suggests that certain activities, such as changing bedding, may lead to the aerosolization of the virus. Importantly, replication-competent virus was identified in 50% of the selected samples, indicating the presence of infectious virus.

Interpretation:
These findings underscore the importance of stringent cleaning protocols, proper PPE use, and meticulous doffing procedures to mitigate the risk of nosocomial transmission. The detection of viral DNA and viable virus in air samples highlights the potential for airborne transmission during specific hospital activities, necessitating careful consideration in infection control policies.

Implications:
This study adds a new dimension to our understanding of infectious diseases transmission in healthcare environments. It emphasizes the need for robust infection prevention measures to protect healthcare workers and reduce the risk of hospital-acquired infections. The evidence of environmental contamination and the potential for virus aerosolization during routine care activities should inform public health policies and the design of safety protocols in hospitals managing monkeypox patients.

In conclusion, the Lancet Microbe study provides valuable evidence that our current infection control is inadequate to curb the spread of infectious diseases within healthcare facilities, not to mention other strategically critical venues like senior living centres, schools, and transport hubs. As we continue to face new and emerging infectious diseases, healthcare providers, policymakers, and infection control specialists need to take action to review and reinforce infection control practices, ensuring they are evidence-based and capable of addressing the public health challenges .

Source: https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(22)00257-9/fulltext