SMH | "The explanation could only be that these agents don't come or go
anywhere. They are always here and something ignites them, maybe human
density or environmental conditions, and this is what we should look
for."
Dr Jefferson believes that the virus may be transmitted through the
sewerage system or shared toilets, not just through droplets expelled by
talking, coughing and sneezing.
Jefferson
and Professor Carl Heneghan, director of the Centre for Evidence-Based
Medicine, have called for an in-depth investigation similar to that
carried out by John Snow in 1854, which showed cholera was spreading in
London from an infected well in Soho.
Exploring why so many
outbreaks happen at food factories and meat-packing plants could uncover
major new transmission routes, they believe. It may be shared toilets
coupled with cool conditions that allow the virus to thrive.
The Tonnies slaughterhouse in Germany was the centre of a major outbreak last month, and in May, Melbourne's Cedar Meats also recorded a cluster of cases.
"We're
doing a living review, extracting environmental conditions, the ecology
of these viruses which has been grossly understudied," said Dr
Jefferson.
"There
is quite a lot of evidence of huge amounts of the virus in sewage all
over the place, and an increasing amount of evidence there is faecal
transmission. There is a high concentration where sewage is four
degrees, which is the ideal temperature for it to be stabled and
presumably activated. And meat-packing plants are often at four degrees.
"These
meat-packing clusters and isolated outbreaks don't fit with respiratory
theory, they fit with people who haven't washed their hands properly.
