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Published on: August 22, 2018
Aerosol-Transmitted Infections-a New Consideration for Public Health and Infection Control Teams
Julian W Tang1, Peter Wilson2, Nandini Shetty2
11Clinical Microbiology, Leicester Royal Infirmary, University Hospitals Leicester, Leicester NHS Trust, Leicester, LE1 5WW UK.
Abstract:
Since the emergence of the 2003 severe acute respiratory syndrome (SARS), the 2003 reemergence of avian A/H5N1, the emergence of the 2009 pandemic influenza A/H1N1, the 2012 emergence of Middle East respiratory syndrome (MERS), the 2013 emergence of avian A/H7N9 and the 2014 Ebola virus outbreaks, the potential for the aerosol transmission of infectious agents is now routinely considered in the investigation of any outbreak. Although many organisms have traditionally been considered to be transmitted by only one route (e.g. direct/indirect contact and/or faecal-orally), it is now apparent that the aerosol transmission route is also possible and opportunistic, depending on any potentially aerosol-generating procedures, the severity of illness and the degree and duration of pathogen-shedding in the infected patient, as well as the environment in which these activities are conducted.This article reviews the evidence and characteristics of some of the accepted (tuberculosis, measles, chickenpox, whooping cough) and some of the more opportunistic (influenza, Clostridium difficile, norovirus) aerosol-transmitted infectious agents and outlines methods of detecting and quantifying transmission.
Insights
Recent outbreaks highlight that infectious agents can spread via aerosols, not just direct contact. This review examines established and opportunistic airborne pathogens and transmission detection methods.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Emerging infectious diseases like SARS, H1N1 influenza, MERS, and Ebola have increased focus on aerosol transmission routes.
- Traditionally, single transmission routes were assumed, but opportunistic aerosol spread is now recognized.
- Factors influencing aerosol transmission include procedures, illness severity, pathogen shedding, and environmental conditions.
Purpose of the Study:
- To review evidence and characteristics of accepted and opportunistic aerosol-transmitted infectious agents.
- To outline methods for detecting and quantifying aerosolized pathogen transmission.
Main Methods:
- Literature review of infectious disease outbreaks and transmission routes.
- Analysis of factors influencing aerosol generation and spread.
- Compilation of detection and quantification techniques for airborne pathogens.
Main Results:
- Established airborne pathogens include tuberculosis, measles, chickenpox, and whooping cough.
- Opportunistic airborne pathogens include influenza, Clostridium difficile, and norovirus.
- Aerosol transmission is influenced by specific procedures, patient factors, and environmental context.
Conclusions:
- Aerosol transmission is a critical consideration for outbreak investigations, alongside traditional routes.
- Understanding opportunistic aerosol spread is vital for effective infection control.
- Further research into detection and quantification methods is needed for public health preparedness.
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