Transfer of enteric viruses (adenovirus and coxsackievirus) and bacteriophage (MS2) from liquid to human skin

Indirect exposure to waterborne viruses increases risk of infection, especially amongst children with frequent hand-to-mouth contacts. Here, we quantified the transfer of one bacteriophage (MS2) and two enteric viruses (adenovirus and coxsackievirus) from liquid-to-skin. MS2, a commonly used enteric virus surrogate, was used to compare virus transfer rates in a volunteer trial to those obtained using human cadaver skin and synthetic skin. MS2 transfer to volunteer skin was similar to cadaver skin, but significantly different than to synthetic skin. MS2, adenovirus, and coxsackievirus transfer to cadaver skin was modeled using measurements for both viruses attaching to the skin (adsorbed) and virus in liquid residual on skin (unadsorbed). We find virus transfer per surface area is function of concentration of virus in the liquid and film thickness of liquid retained on the skin and is estimable using a linear model. Notably, the amount of MS2 adsorbed on the skin was significantly higher than both adenovirus (average 0.74 log10) and coxsackievirus (average 0.61 log10). Quantification of pathogenic virus retention to skin would thus be overestimated using MS2 adsorption data. This study provides models of virus transfer useful for risk assessments of water-related activities, demonstrates significant differences in transfer of pathogenic virus and MS2, and suggests cadaver skin as an alternative testing system for studying interactions between viruses and skin.