title: Detection and quantification of airborne norovirus during outbreaks in healthcare facilities.
abstract: BACKGROUND
  Noroviruses are responsible for at least 50% of all gastroenteritis outbreaks worldwide. Noroviruses GII can infect humans via multiple routes including direct contact with an infected person, fecal matter, or vomitus, and contact with contaminated surfaces. Although norovirus is an intestinal pathogen, aerosols could, if inhaled, settle in the pharynx and later be swallowed. The aims of this study were to investigate the presence of norovirus GII bioaerosols during gastroenteritis outbreaks in healthcare facilities and to study the in vitro effects of aerosolization and air sampling on the noroviruses using murine norovirus as a surrogate.
  
  
  METHODS
  A total of 48 air samples were collected during norovirus outbreaks in 8 healthcare facilities. Samples were taken 1 m away from each patient, in front of the patient's room and at the nurses' station. The resistance to aerosolization stress of murine norovirus type 1 (MNV-1) bioaerosols was also tested in vitro using an aerosol chamber.
  
  
  RESULTS
  Norovirus genomes were detected in 6 of 8 healthcare centers. The concentrations ranged from 1.35 × 10(1) to 2.35 × 10(3) genomes/m(3) in 47% of air samples. MNV-1 preserved its infectivity and integrity during in vitro aerosol studies.
  
  
  CONCLUSIONS
  Norovirus genomes are frequently detected in the air of healthcare facilities during outbreaks, even outside patients' rooms. In addition, in vitro models suggest that this virus may withstand aerosolization.
authors.affiliation: Centre de recherche de l'institut universitaire de cardiologie et de pneumologie de Québec.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Bonifait
authors.affiliation: Centre de recherche de l'institut universitaire de cardiologie et de pneumologie de Québec.
authors.forename: Rémi
authors.initials: R
authors.lastname: Charlebois
authors.affiliation: Institut sur la nutrition et les aliments fonctionnels, Laval University, Quebec.
authors.forename: Allison
authors.initials: A
authors.lastname: Vimont
authors.affiliation: Centre de recherche de l'institut universitaire de cardiologie et de pneumologie de Québec.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Turgeon
authors.affiliation: Centre de recherche de l'institut universitaire de cardiologie et de pneumologie de Québec.
authors.forename: Marc
authors.initials: M
authors.lastname: Veillette
authors.affiliation: Lady Davis Institute of Medical Research at the Jewish General Hospital and McGill University Faculty of Medicine, Montreal.
authors.forename: Yves
authors.initials: Y
authors.lastname: Longtin
authors.affiliation: Institut sur la nutrition et les aliments fonctionnels, Laval University, Quebec Département des sciences des aliments et de nutrition, Faculté des sciences de l'agriculture et de l'alimentation.
authors.forename: Julie
authors.initials: J
authors.lastname: Jean
authors.affiliation: Centre de recherche de l'institut universitaire de cardiologie et de pneumologie de Québec Département de biochimie, de microbiologie et de bio-informatique, Faculté des sciences et de génie, Laval University, Quebec, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Duchaine
mesh_terms: D000391:Air Microbiology; D000818:Animals; D017250:Caliciviridae Infections / Q000635:transmission / Q000821:virology; D003428:Cross Infection / Q000635:transmission / Q000821:virology; D004196:Disease Outbreaks; D006268:Health Facilities; D006801:Humans; D051379:Mice; D008954:Models, Biological; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification*; D000067996:RAW 264.7 Cells; D012367:RNA, Viral / Q000032:analysis
chemical_list: D012367:RNA, Viral
keywords: GenaMini chamber; airborne transmission; norovirus; nosocomial infection