Abstract
There is mounting evidence that the aerosol transmission route plays a significant role in the spread of influenza in temperate regions and that the efficiency of this route depends on humidity. Nevertheless, the precise mechanisms by which humidity might influence transmissibility via the aerosol route have not been elucidated. We hypothesize that airborne concentrations of infectious influenza A viruses (IAVs) vary with humidity through its influence on virus inactivation rate and respiratory droplet size. To gain insight into the mechanisms by which humidity might influence aerosol transmission, we modeled the size distribution and dynamics of IAVs emitted from a cough in typical residential and public settings over a relative humidity (RH) range of 10–90%. The model incorporates the size transformation of virus-containing droplets due to evaporation and then removal by gravitational settling, ventilation, and virus inactivation. The predicted concentration of infectious IAVs in air is 2.4 times higher at 10% RH than at 90% RH after 10 min in a residential setting, and this ratio grows over time. Settling is important for removal of large droplets containing large amounts of IAVs, while ventilation and inactivation are relatively more important for removal of IAVs associated with droplets <5 µm. The inactivation rate increases linearly with RH; at the highest RH, inactivation can remove up to 28% of IAVs in 10 min. Humidity is an important variable in aerosol transmission of IAVs because it both induces droplet size transformation and affects IAV inactivation rates. Our model advances a mechanistic understanding of the aerosol transmission route, and results complement recent studies on the relationship between humidity and influenza's seasonality. Maintaining a high indoor RH and ventilation rate may help reduce chances of IAV infection.
Highlights
Influenza A has a clear seasonal pattern in temperate regions, yet the underlying cause for it remains controversial despite nearly a century of investigation
To advance a mechanistic understanding of the role of humidity in aerosol transmission, we model the change in size of respiratory droplets and influenza A viruses (IAVs) inactivation at relative humidity (RH) ranging from 10% to 90%
We further model the dynamics of droplets emitted from a cough in an indoor environment and illustrate the evolution of infectious IAV concentrations and size distributions, considering removal by gravitational settling, ventilation, and viral inactivation
Summary
Influenza A has a clear seasonal pattern in temperate regions, yet the underlying cause for it remains controversial despite nearly a century of investigation. The literature identifies numerous factors that may influence influenza’s seasonality: environmental conditions such as temperature, humidity, and ultraviolet radiation; immune function; school schedules; and human mobility patterns and contact rates [1]. Recent studies using a guinea pig experimental model [3,4] indicate that low relative humidity (RH) favors aerosol transmission of influenza A viruses (IAVs), in which they are transmitted by small respiratory droplets expelled from infected hosts. The precise mechanisms by which humidity might influence influenza viability and transmissibility via the aerosol route have not been elucidated
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