Aerosol transmission is an important mode of influenza A virus spread

Benjamin J. Cowling (), Dennis K. M. Ip, Vicky J. Fang, Piyarat Suntarattiwong, Sonja J. Olsen, Jens Levy, Timothy M. Uyeki, Gabriel M. Leung, J. S. Malik Peiris, Tawee Chotpitayasunondh, Hiroshi Nishiura and James Mark Simmerman
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Benjamin J. Cowling: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
Dennis K. M. Ip: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
Vicky J. Fang: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
Piyarat Suntarattiwong: Queen Sirikit National Institute of Child Health
Sonja J. Olsen: Influenza Program, Thailand MOPH-US CDC Collaboration
Jens Levy: Influenza Program, Thailand MOPH-US CDC Collaboration
Timothy M. Uyeki: US Centers for Disease Control and Prevention
Gabriel M. Leung: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
J. S. Malik Peiris: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
Tawee Chotpitayasunondh: Queen Sirikit National Institute of Child Health
Hiroshi Nishiura: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
James Mark Simmerman: Epidemiology and Medical Affairs, Sanofi Pasteur

Nature Communications, 2013, vol. 4, issue 1, 1-6

Abstract: Abstract Influenza A viruses are believed to spread between humans through contact, large respiratory droplets and small particle droplet nuclei (aerosols), but the relative importance of each of these modes of transmission is unclear. Volunteer studies suggest that infections via aerosol transmission may have a higher risk of febrile illness. Here we apply a mathematical model to data from randomized controlled trials of hand hygiene and surgical face masks in Hong Kong and Bangkok households. In these particular environments, inferences on the relative importance of modes of transmission are facilitated by information on the timing of secondary infections and apparent differences in clinical presentation of secondary infections resulting from aerosol transmission. We find that aerosol transmission accounts for approximately half of all transmission events. This implies that measures to reduce transmission by contact or large droplets may not be sufficient to control influenza A virus transmission in households.

Date: 2013
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DOI: 10.1038/ncomms2922

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