COVID-19, the new coronavirus which has killed more than 2,000 people, may spread through feces, scientists believe.
As the virus is thought to have only come to the attention of health officials late last year, when workers at a market in the Chinese city of Wuhan, Hubei province, fell ill, experts are still working to understand how it is transmitted.
More than 75,000 cases of the deadly virus—whose symptoms include a fever, dry cough and short breath—have been confirmed, predominantly in mainland China. It has spread to over 25 countries and territories, including the United States, as shown below in the infographic by Statista. The World Health Organization (WHO) says the virus is thought to spread like other members of the coronavirus family, SARS and MERS, through droplets from coughs and sneezes, close contact with others and contaminated surfaces.
However, some experts working to shed light on COVID-19 believe it is possible it could be passed on through feces.
On Saturday, the Chinese Center for Disease Control and Prevention published a report stating the virus had been found in the stool of COVID-19 patients from the northeastern province of Heilongjiang. The scientists said this led them to believe the virus can be “transmitted through the potential fecal-oral route” if the hands, food, or water are contaminated, which could enable it to enter the body through the nose, mouth, and eyes.
They argued that while droplets and close contact are the most common routes of transmission, they do not appear to account for all cases or “the reasons for the rapid spread of this virus.”
“This virus has many routes of transmission, which can partially explain its strong transmission and fast transmission speed,” the report added.
This was followed by a study published on Monday in the peer-reviewed journal Emerging Microbes & Infections by a separate team of researchers, which similarly suggested the virus might be capable of infecting people if they ingest fecal matter. The team examined a total of 178 swabs taken from the anal cavities of COVID-19 patients at a hospital in Wuhan, the city at the epicenter of the outbreak. They found the virus was present in the swabs.
“We detected the virus in oral swabs, anal swabs and blood, thus infected patients can potentially shed this pathogen through respiratory, fecal-oral or body fluid routes,” they wrote.
Similarly, an editorial published in the journal The BMJ on Wednesday detailing what is and is not known about COVID-19 cited a study published in late January which “raises the possibility of fecal transmission.”
The study was published as a preliminary report by bioRxiv, meaning it was not peer-reviewed but released to enable experts in the field to view and discuss new findings on the rapidly evolving outbreak. The team looked at samples from different parts of patients’ bodies to see if an enzyme which helps the virus enter cells was active. They found the enzyme was not only expressed in the lungs, but also in the digestive system. This indicates COVID-19 may lurk in the digestive system, they said.
Fears that COVID-19 can spread through feces were stoked last week after two residents of the same apartment building living 10 floors apart fell ill. The incident was reminiscent of the 2003 outbreak of SARS, where 42 residents died after 329 occupants of a housing estate in the city caught the bug through faulty piping. At that time a Hong Kong official said the COVID-19 cases at the apartment weren’t comparable as the pipes were outside the building during the SARS outbreak, and that virus was airborne. Tests on the 101 samples later came back negative, according to a statement by Hong Kong government.
At present, the WHO says the best way to protect oneself from COVID-19 is to follow basic and hygiene measures that should always be observed, including washing hands with soap and water often to kill the virus, or cleaning them with an alcohol-based rub if the hands aren’t visibly dirty.
Cough and sneeze into a tissue or the crook of your elbow, and immediately throw tissues into the trash. Clean your hands to prevent the bug from spreading and contaminating objects.
The agency also advises against touching the eyes, nose, and mouth, to prevent bugs from getting into the body. Also avoid contact with sick animals or those in markets, spoiled animal products, as well as their waste products or fluids. Try not to eat raw or undercooked animal products, and be careful when handling raw meat, milk, or animal organs.