Peer Review History
| Original SubmissionJanuary 20, 2021 |
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PONE-D-21-02103 Ozone inactivation of airborne influenza and lack of resistance of respiratory syncytial virus to aerosolization and sampling processes PLOS ONE Dear Dr. Duchaine, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by May 23 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript:
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Kind regards, Sander Herfst Academic Editor PLOS ONE Journal requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and 2. Please provide the source of the Influenza A/Michigan/45/2015 sample you used in this study. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: Yes ********** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ********** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: Yes Reviewer #3: Yes ********** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ********** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors of this manuscript elaborated on previous work that described the inactivation of aerosolized phages and murine norovirus by ozone (Dubuis et al., 2020). Here the authors used the same approach to study the inactivation of an influenza- and respiratory syncytial virus. This study provides new insights in the aerosol stability of influenza viruses in relation with relative humidity and ozone concentration, which are placed in perspective with other studies. However, some points are unclear to the reviewer and need to be clarified prior to publication. 1. What is the composition of the non-treated nebulizing liquid (is it a buffer or a medium?) and do the authors expect hardly any inactivation after incubation in air for 60 min under these conditions? 2. The nebulizing liquid is supplemented with either BPS or STM, of which the authors stated that this was as previously done by Kormuth et al., 2018 with extra cellular material from human bronchial epithelial cells (HBE ECM) (Line 108). However although 10% supplementation is used in both studies, this does not necessarily result in comparable conditions in terms of e.g. protein/lipid content. STM for example contain albumin and pig gastric mucin, which are absent in the HBE ECM. Can the authors elaborate more on the rationale behind the supplementation of the nebulizing liquid? 3. The inactivation of the viruses are all presented as normalized infectious ratio’s or relative infectious ratio’s, which is understandable as two variables are tested: treatment of the nebulizing liquid and the effect of ozone on virus inactivation under each condition. The downside of this approach is however that the reader does not have any idea on the number of virus particles that were nebulized and were collected in each experiment and whether these numbers were comparable between the different experiments. The reviewer would recommend to show this data at least for the reference conditions for more clarity. 4. Line 279: ‘addition of BPS did not offer additional protection of airborne influenza A …”. This sentence is quite odd in the reviewers opinion as the authors previously showed that BPS affects virus infectivity with 2-3 logs (Fig. 2B) upon aging in air in absence of ozone. 5. Can the authors explain why the addition of STM is protective after 80 min expose at an RH of 34%, but resulted more inactivation at a RH of 75% after 50 minute exposure? Textual comments Line 72: Maybe specify the droplet size/volume for more clarity Line 285-286, please mention which ozone dose for clarity. Line 289: Maybe it is good to make immediately clear that this observation is obtained at 1.7 ppm ozone. Now it is stated at the end. Line 406-407. Can the authors provide references for this claim? Reviewer #2: The Dubuis et al. manuscript describes efforts to evaluate the virucidal efficacy of ozone against Influenza A and Respiratory Syncytial Virus (RSV) containing aerosols. This addresses the important topic of methods to reduce nosocomial transmission of respiratory viruses. The authors utilize a test system encompassing a 6-jet collison nebulizer introducing virus containing aerosols into a rotating drum aerosol chamber with periodic sampling with an SKC BioSampler. The authors show that 1.7+/-0.19ppm ozone at 76% relative humidity (RH) for 80 minutes resulted in a four orders of magnitude loss of infectious Influenza A. They conclude that this treatment could be used as a virucidal disinfectant for the control of nosocomial transmission of Influenza A. However, additional efforts to ensure that the loss in infectivity of Influenza A is due to ozone inactivation and not through losses to the system are required. Also, the addition of RSV aerosolization and sampling efforts adds confusion to the manuscript and disrupts its flow. Major Issues: (1) The authors were able to achieve sufficient detection of infectious Influenza A using the collison nebulizer and SKC sampler system to evaluate ozone treatment as an aerosol disinfection method. However, the authors were unable to achieve such success in detecting sufficient amounts of infectious RSV to perform similar evaluations. While the authors made progress on evaluating the stability of RSV during aerosolization and sampling, much work needs to be done in further characterizing aerosolization and sampling methods for publication. The addition of these efforts adds unnecessary confusion for the readers and detracts from the Influenza A findings. (2) In the discussion, the authors state that “the experimental set up is not leak-proof and a loss of two to three orders of magnitude can be expected.” The authors should consider additional methods to reduce and/or control this loss for several reasons. The loss in recovery over time should be reported directly, at least as a representative plot, to show readers that a significant amount of virus is lost over time due to physical loss to the chamber wall and leaks, and the loss of infectivity of Influenza A in aerosols (which has been reported in Schuit et al. JID 2020). Adding this data would also help in detailing the range in concentration of infectious virus that is being used to calculate the NIR and RIR ratios. The leakiness of the system is also likely contributing to the significant decrease in ozone levels over time in the chamber. While it is likely unavoidable in a hospital setting, ensuring the correct concentration of ozone in a closed, experimental setup is crucial before attempting to implement this type of strategy in a real-world scenario. While the authors take efforts to normalize these losses to the experimental setup through PCR and concentration within the nebulizer at the start of the experiments, additional efforts must be made to ensure that the loss in infectivity is due to ozone. Minor Issues: (1) The concentration of ozone at 76% RH is noted to approach zero after 30 minutes, however, the experiments with the greatest efficiency in inactivation are carried out for 80 minutes. Also, the mean RIR for NT +1.70+/-0.19ppm at 76% RH for 80 minutes is much lower than that of 50 minutes, even though the ozone concentrations at these time points is negligible, if present at all. Additional discussion, if meaningful, should be included to rationalize the impact of ozone at these longer time-points when the concentration are so low, especially in light of point 2 above. Reviewer #3: Comments/Critiques - Is there a reason that ozone concentration and ozone exposure time are not combined into a single "dose" parameter as is used in Chick-Watson-type considerations of disinfection? This is the approach used by Tseng and Li, which is cited in the manuscript. Such a combined parameter seems particularly important in this study since the ozone concentrations were not constant and decreased over time. Therefore trials listed in the manuscript, for example, as representing aerosol exposure to 1.7 ppm of ozone are actually exposures starting at 1.7 ppm and gradually and continuously decreasing over 70 min to less than 0.3 ppm. It is the dose - the integral under this concentration-time curve - that should be reported and should be used to infer the resulting effects. - Line 350: In discussing chamber testing, is it an accurate description to say "the chamber leaks"? Is there evidence of this that can be referenced? Is the chamber leaking or are the aerosols simply being lost to the chamber interior surfaces? The assertion of a leak in a process intended to conserve aerosol mass is troubling but can be easily assessed using a tracer gas. Such assessment is recommended if the authors maintain the view that chamber leakage is a systematic bias of the system. - Although the study cites the opportunity to introduce air treatments for preventing the spread of airborne infectious viral diseases as its motivation, the manuscript does not suggest what form such treatments might take. The ozone concentrations examined in the study are higher than generally allowed for human occupied spaces, and the exposure times examined in the study are generally longer than would be required to evacuate a(n unoccupied) room of contaminated air using the ventilation system (hospital rooms operate at ventilation rates comparable to several complete changes of room air per hour). If the motivation is air treatment, then the manuscript should provide some discussion of how this might be implemented in a way that is at least comparable to these incumbent approaches. Beyond this minimum, there are material degradation concerns that can limit ozone use that may not be most suitable for this manuscript, but are of concern and warrant some mention. Minor Critiques/Typographic and Grammatical Errors: - Line 59: The previous sentence that focuses on influenza makes clear that the authors' inference about airborne transmission stems from data resulting from measurement of airborne samples. However, for RSV (starting at Line 59), none of the various sample locations described refer to airborne samples; therefore, in the next sentence ("Only a small number....") it is not clear whether the authors are arguing that airborne transmission is unlikely due to the scarcity of *airborne* samples or whether airborne transmission is unlikely due to the scarcity of *any* samples. Please clarify. - Line 63: Manuscript would be improved if additional context were given to the characterization of "high" used to describe genome copies per cubic meter of air. Clearly, this depends on distance from the source, air changes per hour imposed by ventilation in the room, etc. - Line 71: Similar critique as above: the characterization of "low concentrations of ozone" would be greatly improved if additional context were provided. There are multiple contexts to consider. There is the context of prior studies of ozonation for sterilization as well as the limits on ozone concentrations in air for protection of human health. The latter is much lower and therefore likely would undercut any unqualified assertion that the ozone concentrations of the present studies are "low". - Line 120: The sentence beginning "Diffusion dryer tubes...." is missing a verb. - Line 133: Dilute (i.e., ppm-level) concentrations of ozone in air are inaccurately described as "ozone" (solely). - Line 145: Why was a new ozone monitor introduced? - Line 148: The second phrase in this sentence lacks a verb ("....which 20 ppb and 50 ppb, with .....") ********** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No Reviewer #3: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. 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| Revision 1 |
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Ozone inactivation of airborne influenza and lack of resistance of respiratory syncytial virus to aerosolization and sampling processes PONE-D-21-02103R1 Dear Dr. Duchaine, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Sander Herfst Academic Editor PLOS ONE Additional Editor Comments: Please explain why a co-author was added to the manuscript (what was their contribution) and what the reason is that a funding agency was removed from the acknowledgements section? Especially the latter is rather unusual. |
| Formally Accepted |
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PONE-D-21-02103R1 Ozone inactivation of airborne influenza and lack of resistance of respiratory syncytial virus to aerosolization and sampling processes Dear Dr. Duchaine: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Sander Herfst Academic Editor PLOS ONE |
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