Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community.
Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community.
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DOI：
10.1073/pnas.1716561115
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发表时间：
2018-01-30
影响因子：
11.1
通讯作者：
EMIT Consortium
中科院分区：
文献类型：
--
作者：
Yan J;Grantham M;Pantelic J;Bueno de Mesquita PJ;Albert B;Liu F;Ehrman S;Milton DK;EMIT Consortium
缺乏有关流感病毒气溶胶脱落的人体数据，引发了关于空气传播重要性的争论。我们提供了压倒性的证据，证明人类会产生传染性气溶胶和定量数据，以改进传播和公共卫生干预的数学模型。我们证明，打喷嚏很少见，对于流感病毒雾化并不重要，而且咳嗽也不是必要的。我们的研究结果表明，上呼吸道感染和下呼吸道感染是独立的，呼出的细颗粒气溶胶反映了肺部感染，这为更深入地了解流感感染和传播的人类生物学开辟了途径。我们对重复疫苗接种与病毒气溶胶产生增加之间关联的观察证明了我们方法的力量，但需要证实。人们对呼出气中流感病毒的数量和传染性知之甚少。这增加了空气传播流感传播重要性的不确定性。我们筛查了 355 名患有急性呼吸道疾病的有症状志愿者，并报告了 142 例确诊的流感感染病例，他们在症状出现后第 1-3 天提供了 218 份配对鼻咽 (NP) 和 30 分钟呼吸样本（粗粒 > 5 µm 和细粒 ≤ 5 µm 部分）。我们评估了所有样本以及培养的 NP 拭子和细气溶胶的病毒 RNA 拷贝数。我们从 52 个 (39%) 细小气溶胶和 150 个 (89%) 具有有效培养物的 NP 拭子中回收了传染性病毒。每个 NP 拭子的几何平均 RNA 拷贝数为 3.8 × 104/30 分钟细颗粒、1.2 × 104/30 分钟粗颗粒气溶胶样本和 8.2 × 108。在调整后的模型中，细颗粒和粗颗粒气溶胶病毒 RNA 与体重指数和咳嗽次数呈正相关，与症状出现后天数的增加呈负相关。细小的气溶胶病毒 RNA 也与当前和上一季节的流感疫苗接种呈正相关。 NP 拭子病毒 RNA 与上呼吸道症状呈正相关，与年龄呈负相关，但与细或粗气溶胶病毒 RNA 或其预测因子没有显着相关。打喷嚏很少见，打喷嚏和咳嗽也不是产生传染性气溶胶所必需的。我们的观察表明，上呼吸道和下呼吸道的流感感染是分开且独立的。
Lack of human data on influenza virus aerosol shedding fuels debate over the importance of airborne transmission. We provide overwhelming evidence that humans generate infectious aerosols and quantitative data to improve mathematical models of transmission and public health interventions. We show that sneezing is rare and not important for—and that coughing is not required for—influenza virus aerosolization. Our findings, that upper and lower airway infection are independent and that fine-particle exhaled aerosols reflect infection in the lung, opened a pathway for a deeper understanding of the human biology of influenza infection and transmission. Our observation of an association between repeated vaccination and increased viral aerosol generation demonstrated the power of our method, but needs confirmation. Little is known about the amount and infectiousness of influenza virus shed into exhaled breath. This contributes to uncertainty about the importance of airborne influenza transmission. We screened 355 symptomatic volunteers with acute respiratory illness and report 142 cases with confirmed influenza infection who provided 218 paired nasopharyngeal (NP) and 30-minute breath samples (coarse >5-µm and fine ≤5-µm fractions) on days 1–3 after symptom onset. We assessed viral RNA copy number for all samples and cultured NP swabs and fine aerosols. We recovered infectious virus from 52 (39%) of the fine aerosols and 150 (89%) of the NP swabs with valid cultures. The geometric mean RNA copy numbers were 3.8 × 104/30-minutes fine-, 1.2 × 104/30-minutes coarse-aerosol sample, and 8.2 × 108 per NP swab. Fine- and coarse-aerosol viral RNA were positively associated with body mass index and number of coughs and negatively associated with increasing days since symptom onset in adjusted models. Fine-aerosol viral RNA was also positively associated with having influenza vaccination for both the current and prior season. NP swab viral RNA was positively associated with upper respiratory symptoms and negatively associated with age but was not significantly associated with fine- or coarse-aerosol viral RNA or their predictors. Sneezing was rare, and sneezing and coughing were not necessary for infectious aerosol generation. Our observations suggest that influenza infection in the upper and lower airways are compartmentalized and independent.
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影响因子：
6.7
作者：
Milton, Donald K.;Fabian, M. Patricia;McDevitt, James J.
通讯作者：
McDevitt, James J.
影响因子：
5.8
作者：
Liu, L.;Li, Y.;Jensen, R. L.
通讯作者：
Jensen, R. L.
影响因子：
5.4
作者：
Leonard, Ashley Sobel;Weissman, Daniel B.;Koelle, Katia
通讯作者：
Koelle, Katia
DOI：
10.1093/cid/cir442
发表时间：
2011-09
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Kwong JC;Campitelli MA;Rosella LC
通讯作者：
Rosella LC
DOI：
10.1080/02786826.2012.762973
发表时间：
2013-01-01
期刊：
Aerosol science and technology : the journal of the American Association for Aerosol Research
影响因子：
--
作者：
McDevitt JJ;Koutrakis P;Ferguson ST;Wolfson JM;Fabian MP;Martins M;Pantelic J;Milton DK
通讯作者：
Milton DK