Airborne Transmission Of Influenza Viruses Research Articles

Quantitative Assessment of Airborne Transmission of Human and Animal Influenza Viruses in the Ferret Model

The WHO has developed a tool to assess the risk of newly emerging influenza viruses with pandemic potential (TIPRA). According to TIPRA, the main parameters for assessing the risk of human-to-human transmission of a novel influenza virus are its ability to bind to human cell receptors of the upper respiratory tract (URT) and transmit in model animals. The aim of this study was to quantify airborne transmission of human and animal influenza viruses in the ferret model. The transmission of influenza viruses was studied in the ferret model in an aerobiology chamber. Airborne particles concentration and fractional composition in the aerobiology chamber were measured using an aerosol particle counter and analytical aerosol filters. Viral load in ferret nasal washings and aerosol filters was determined by titration in MDCK cells and quantitative RT-PCR. Genetic analysis of influenza viruses was performed using virus genome sequences obtained by NGS. After intranasal infection, human and animal influenza viruses replicated in the cells of nasal mucosa in ferrets. The level of virus airborne particles contamination provided by infected animals depends on the infectious dose and differs significantly between influenza virus strains. The studied avian influenza viruses show insufficient transmission in the ferret model, while human and swine influenza viruses are highly transmitted in ferrets. We propose a quantitative model of airborne transmission of influenza virus from donor to recipient ferrets. Level of influenza virus transmission in the ferret model correlates with genetic markers of virus receptor specificity and the level of virus airborne particle contamination induced by donor ferrets.

Airborne Transmission of Influenza Virus in a Hospital of Qinhuangdao During 2017-2018 Flu Season.

The 2017-2018 flu season is considered to be one of the most severe, with numerous influenza outbreaks worldwide. In an infectious disease hospital of Qinhuangdao, air samples were collected daily from outpatient hall, clinical laboratory, fever clinic, children's ward (Children's Ward I/Children's Ward II), and adult ward during 23-29 January 2018 (peak flu activity) and 9-15 April 2018 (low flu activity). The air samples were collected with SLC-SiOH magnetic beads using impingement samplers. Real-time PCR assay was used to detect the RNA of airborne influenza (IFVA and IFVB) in the 91 collected aerosol samples. The results indicated that the air samples collected from the children's wards, adult ward and fever clinic were detected with airborne influenza viruses. However, the samples collected from outpatient hall and clinical laboratory were absence of influenza viruses. In addition, the subtypes of pH1N1/IFVA, H3N2/IFVA, yamagata/IFVB, and victoria/IFVB were detected among the samples with positive IFVA and IFVB. Notably, a new developed subtype of pH1N1 (an epidemic in 2018) was detected in the aerosol samples. In summary, this study profiled the distribution of airborne influenza in an infectious hospital in Qinhuangdao during 2017-2018 flu season. Patients infected with influenza could release airborne particles containing the virus into their environment. Healthcare workers and visitors in those places might have frequent exposure to airborne influenza virus. Therefore, we recommend some protective measures such as air disinfection and mask wearing to prevent and control the transmission of airborne influenza in hospital.

Amino Acid Substitutions That Affect Receptor Binding and Stability of the Hemagglutinin of Influenza A/H7N9 Virus.

Receptor-binding preference and stability of hemagglutinin have been implicated as crucial determinants of airborne transmission of influenza viruses. Here, amino acid substitutions previously identified to affect these traits were tested in the context of an A/H7N9 virus. Some combinations of substitutions, most notably G219S and K58I, resulted in relatively high affinity for α2,6-linked sialic acid receptor and acid and temperature stability. Thus, the hemagglutinin of the A/H7N9 virus may adopt traits associated with airborne transmission.

Reply to “Comments on Fouchier's Calculation of Risk and Elapsed Time for Escape of a Laboratory-Acquired Infection from His Laboratory”

In a letter to the editor (1), Dr. Lynn C. Klotz challenges my conclusion (2) that laboratory-acquired infections (LAIs) are expected to occur at an extremely low frequency in facilities such as those used at Erasmus MC for studies on airborne transmission of influenza viruses between ferrets and that these studies pose negligible risks to humans and the environment. Unfortunately, Dr. Klotz does not provide a scientific justification of how the numbers should be adjusted based on the biosafety measures that are in place in these facilities, which is the key challenge in this debate. Dr. Klotz suggests that incidents at the U.S. CDC laboratories and the long history of escape of LAI agents and other escapes from laboratories show that my estimates of the likelihood of LAIs occurring at the Erasmus MC facility are too low. However, it is unclear to me how the incidents at the U.S. CDC—which did not lead to LAIs—would affect my calculations. In addition, I have pointed out previously that historical data on LAIs do not take into account the specific …

Avian influenza virus transmission to mammals.

Influenza A viruses cause yearly epidemics and occasional pandemics. In addition, zoonotic influenza A viruses sporadically infect humans and may cause severe respiratory disease and fatalities. Fortunately, most of these viruses do not have the ability to be efficiently spread among humans via aerosols or respiratory droplets (airborne transmission) and to subsequently cause a pandemic. However, adaptation of these zoonotic viruses to humans by mutation or reassortment with human influenza A viruses may result in airborne transmissible viruses with pandemic potential. Although our knowledge of factors that affect mammalian adaptation and transmissibility of influenza viruses is still limited, we are beginning to understand some of the biological traits that drive airborne transmission of influenza viruses among mammals. Increased understanding of the determinants and mechanisms of airborne transmission may aid in assessing the risks posed by avian influenza viruses to human health, and preparedness for such risks. This chapter summarizes recent discoveries on the genetic and phenotypic traits required for avian influenza viruses to become airborne transmissible between mammals.

Determination of Infective Dose of H9N2 Avian Influenza Virus in Different Routes: Aerosol, Intranasal, and Gastrointestinal

Background: Low pathogenic H9N2 avian influenza virus (AIV) has been spreading worldwide, leading to huge economic losses to poultry husbandry, but few studies were concerned about its aerosol infection. Methods: This study compared the infective doses of H9N2 AIV to chickens by three different routes, aerosol infection, intranasal and gastrointestinal infection, and determination of the results was conducted by detecting virus shedding and seroconversion of chickens. Results: The results indicated that chickens were susceptible to H9N2 AIV with a different infection rate which depended on the route of inoculation. H9N2 AIV media aerosol-infective dose (aID₅₀) to chickens was about 491 TCID₅₀, intranasal infection was 398 TCID₅₀, and gastrointestinal infection was 19,952 TCID₅₀. Conclusion: The infection ability of H9N2 AIV to chickens was related to its way of invading. The respiratory infection ability was about 40 times more effective than gastrointestinal infection, which suggested that urgent attention should be paid to environmental disinfection to block airborne transmission of influenza virus.

Comparison of spike and aerosol challenge tests for the recovery of viable influenza virus from non‐woven fabrics

BackgroundTo experimentally determine the survival kinetics of influenza virus on personal protective equipment (PPE) and to evaluate the risk of virus transfer from PPE, it is important to compare the effects on virus recovery of the method used to contaminate the PPE with virus and the type of eluent used to recover it.MethodsAvian influenza virus (AIV) was applied as a liquid suspension (spike test) and as an aerosol to three types of non‐woven fabrics [polypropylene (PP), polyester (PET), and polyamide (Nylon)] that are commonly used in the manufacture of PPE. This was followed by virus recovery using eight different eluents (phosphate‐buffered saline, minimum essential medium, and 1·5% or 3·0% beef extract at pH 7, 8, or 9).ResultsFor spike tests, no statistically significant difference was found in virus recovery using any of the eluents tested. Hydrophobic surfaces (PP and PET) yielded higher spiked virus recovery than hydrophilic Nylon. From all materials, the virus recovery was much lower in aerosol challenge tests than in spike tests.ConclusionsSignificant differences were found in the recovery of viable AIV from non‐woven fabrics between spike and aerosol challenge tests. The findings of this study demonstrate the need for realistic aerosol challenge tests rather than liquid spike tests in studies of virus survival on surfaces where airborne transmission of influenza virus may get involved.

Aerosol transmission of influenza A virus: a review of new studies.

Over the past few years, prompted by pandemic preparedness initiatives, the debate over the modes of transmission of influenza has been rekindled and several reviews have appeared. Arguments supporting an important role for aerosol transmission that were reviewed included prolonged survival of the virus in aerosol suspensions, demonstration of the low infectious dose required for aerosol transmission in human volunteers, and clinical and epidemiological observations were disentanglements of large droplets and aerosol transmission was possible. Since these reviews were published, several new studies have been done and generated new data. These include direct demonstration of the presence of influenza viruses in aerosolized droplets from the tidal breathing of infected persons and in the air of an emergency department; the establishment of the guinea pig model for influenza transmission, where it was shown that aerosol transmission is important and probably modulated by temperature and humidity; the demonstration of some genetic determinants of airborne transmission of influenza viruses as assessed using the ferret model; and mathematical modelling studies that strongly support the aerosol route. These recent results and their implication for infection control of influenza are discussed in this review.