Introduction
Viruses are causative agents of an estimated 60% of human infections worldwide (Barker et al. 2001). For centuries it was assumed that these viral diseases were spread primarily through direct patient contact or by the airborne route, and surrounding environment played little or no role in disease transmissions. Due to the opinion that nosocomial infections were not related to microbial contamination of surfaces, the Centre for Disease Control (CDC) and the American Hospital Association focussed only on patient diagnosis up to 1987. Over the years studies have changed perspectives on viral transmission and have integrated a more complex multifactorial model of disease spreading including the contaminated environment (Boone and Gerba 2007).
Viral transmission from an infected person or an animal to a new host can occur by direct or indirect routes. During indirect transmission, contaminated surfaces can play an important role. This kind of transmission is dependent on several factors, which include the quantity of viral particles excreted by an infected organism, their stability in the environment, the potential to spread within a closed environment, as well as interaction of the virus and the host organism. Large numbers of viral particles can be shed via various body fluids including blood, faeces, vomit, saliva, urine, and respiratory secretions from infected individuals or carriers. The more viruses are shed, the greater their chance is to survive and reach a new host organism (Rzezutka and Cook 2004).
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A critical factor of viral transmission is its ability to survive in the environment. Previous studies have shown that viral particles can persist for extended periods on surfaces such as medical devices, fomites or human skin (Abad et al. 2001; Sattar et al. 1986, 1987; Todd et al. 2009). Even if some viruses survive relatively poorly in the environment, the low infective dose suggests that these viruses are able to persist in sufficient numbers to act as a source of infection for several days, week or in some cases months (Barker et al. 2001; Boone and Gerba 2007).
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Surfaces can be contaminated directly by their contact with body secretions and fluids or indirectly through virus contaminated aerosol or other contaminated fomites. Once a surface is contaminated, the transfer of infectious viral particles may easily occur between inanimate or animated objects, or vice versa, e.g. hands and work surfaces with the potential of subsequent transfer to food or direct hand-to-mouth transfer (Goldmann 2000; Marks et al. 2000; Rzezutka and Cook 2004). Rapid spread of viral infections through contaminated surfaces is common particularly in crowded indoor establishments such as schools, day-care facilities, nursing homes, business offices, hospitals or transport systems (Barker et al. 2001). The influences of environmental factors on the stability and spread of bacterial infections are well documented, especially in hospitals. The comparable knowledge concerning the role of surfaces or fomites in viral transmission is still lacking and further investigation is needed (Boone and Gerba 2007; von Rheinbaben et al. 2000).
The objective of this review is to summarise current knowledge about influences of environmental factors on survival and spread of viruses via contaminated surfaces.
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