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Measurements of airborne influenza virus in aerosol particles from human coughs.

Lindsley-WG; Blachere-FM; Thewlis-RE; Vishnu-A; Davis-KA; Cao-G; Palmer-JE; Clark-KE; Fisher-MA; Khakoo-R; Beezhold-DH
PLoS One 2010 Nov; 5(11):e15100
Influenza is thought to be communicated from person to person by multiple pathways. However, the relative importance of different routes of influenza transmission is unclear. To better understand the potential for the airborne spread of influenza, we measured the amount and size of aerosol particles containing influenza virus that were produced by coughing. Subjects were recruited from patients presenting at a student health clinic with influenza-like symptoms. Nasopharyngeal swabs were collected from the volunteers and they were asked to cough three times into a spirometer. After each cough, the cough-generated aerosol was collected using a NIOSH two-stage bioaerosol cyclone sampler or an SKC BioSampler. The amount of influenza viral RNA contained in the samplers was analyzed using quantitative real-time reverse-transcription PCR (qPCR) targeting the matrix gene M1. For half of the subjects, viral plaque assays were performed on the nasopharyngeal swabs and cough aerosol samples to determine if viable virus was present. Fifty-eight subjects were tested, of whom 47 were positive for influenza virus by qPCR. Influenza viral RNA was detected in coughs from 38 of these subjects (81%). Thirty-five percent of the influenza RNA was contained in particles >4 microm in aerodynamic diameter, while 23% was in particles 1 to 4 microm and 42% in particles <1 microm. Viable influenza virus was detected in the cough aerosols from 2 of 21 subjects with influenza. These results show that coughing by influenza patients emits aerosol particles containing influenza virus and that much of the viral RNA is contained within particles in the respirable size range. The results support the idea that the airborne route may be a pathway for influenza transmission, especially in the immediate vicinity of an influenza patient. Further research is needed on the viability of airborne influenza viruses and the risk of transmission.
Infectious-diseases; Respiratory-infections; Respiratory-system-disorders; Lung-disease; Pulmonary-congestion; Pulmonary-disorders; Viral-infections; Disease-transmission; Aerosol-particles; Airborne-particles; Spirometry; Sampling; Sampling-methods; Recombinant-DNA; Particle-aerodynamics
William G. Lindsley, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Allergy and Clinical Immunology Branch, 1095 Willowdale Road, Morgantown, WV 26505
Publication Date
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Journal Article
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Interagency Agreement
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NIOSH Division
Priority Area
Healthcare and Social Assistance
Source Name
Public Library of Science One