SARS-CoV-2 RNA has been found in patients’ feces and in anal swabs for as long as five weeks after symptom onset.  Viable viruses have been cultured from stool (Chen W et al.; Su et al.; Tang et al.; Wong et al.; World Health Organization-China; Xing et al.; Young et al.; Zhang T et al.; Zhang W et al.).  Anal swab testing might reveal more than nasopharyngeal swab testing about the patient’s infection, and for deciding the length of isolation (Xu et al.). It is not known how much fecal-oral transmission contributes to the epidemic (World Health Organization-China; Wong et al.).  But scientists found SARS-CoV-2 RNA in the air, toilet bowls, and surfaces in patients’ bath rooms.  So, the viruses may be coming from the patients breathing or coughing in bathrooms, or feces may be going into the air during defecation or from the swirling water while flushing (Liu et al.; Ong et al.).

To reduce transmission in bath rooms, people should ventilate and disinfect toilets and surfaces (Liu et al.; Ong et al.), and flush with the lid down. This potential of fecal-oral transmission underscores the benefit of hand washing after defecation.