Air borne transmission of diseases

疾病的空气传播是世界卫生组织等国际机构更关注的问题之一。这部分是因为人们非常担心H5 N1禽流感在某个阶段会变异成一种能够有效地在人与人之间传播的形式，导致全球大流行。目前，这种疾病只是通过长时间的密切接触在人与人之间零星和低效地直接传播。大多数最近的病例是由受感染的鸟类直接传播给人类，尽管病死率高达50- 60%。从儿童到老年人，所有年龄段的人都受到感染，目前，尽管许多疫苗正在开发中，但没有获得许可的人类疫苗。此外，抗流感药物奥司他韦的库存有限，这种药物对这种病毒有一些记录在案的效果，尽管效果相对较小。并非所有国家都能负担得起这种药物，而且它相对昂贵。如果这种H5 N1禽流感病毒或其他流感病毒变得适于有效的人传人并引起大流行，那么气溶胶传播很可能成为一种重要的传播途径，特别是在使用呼吸辅助装置（例如氧气面罩和喷雾器）和进行气溶胶生成程序（例如支气管镜检查和插管）的医院中。此外，气溶胶传播途径是进行潜在生物恐怖袭击的首选方法，例如2003年在美国一些邮政服务和政府办公室释放的炭疽孢子。本提案的目的是访问在这一领域工作的领先临床医生和工程师并与他们互动。气溶胶传播可以被简单地看作是气溶胶的运输和扩散，其中多相流和湍流方面的专家可能会在感染途径方面做出重大贡献。通过提高我对这个问题的临床方面的理解，我们将能够在评估风险方面取得显着改善，并为减少感染的传播提供投入。

Air borne transmission of diseases is one of the greater concerns for international agencies such as the WHO (World Health Organisation). This derives in part because of the tremendous worry that avian H5N1 influenza will, at some stage, mutate to a form with efficient human-to-human transmission, leading to a worldwide pandemic. At present, the disease is only sporadically and inefficiently transmitted directly between humans by prolonged close contact. Most recent cases are transmitted directly from infected birds to man, albeit with a high case-fatality rate of 50-60%. All ages of individuals have been infected from children to the elderly and at present, there are no licensed vaccines for humans, though many are in development. In addition, there are only limited stockpiles of the anti-influenza drug, oseltamivir, which has some documented, though relatively marginal effects against this virus. Not all countries are able to afford this drug and it is relatively expensive. If this H5N1 avian or other influenza viruses become adapted to efficient human-to-human transmission and cause a pandemic, then aerosol transmission may well become a significant transmission route, particularly in hospitals where respiratory assist devices (e.g. oxygen masks and nebulisers) are used, and aerosol-generating procedures (e.g. bronchoscopy and intubation) are performed. In addition, the aerosol transmission route is the preferred method for conducting potential bioterrorist attacks, e.g. the anthrax spores released in 2003, in some US mail service and government offices.The aim of this proposal is to visit and interact with leading clinicans and engineers working in this areas. Aerosol transmission can be viewed, in a simplistic manner, as aerosol transport and dispersion and one where a specialist in multiphase flow and turbulence can potentially make a substantial contribution in terms of infection routes. By improving my understanding of this problem from a clinical side, we will be able to make dramatic improvements in terms of assessing risk and provide input into reducing the spread of infection.