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Benjamin J. Cowling, Editorial Commentary: Airborne Transmission of Influenza: Implications for Control in Healthcare and Community Settings, Clinical Infectious Diseases, Volume 54, Issue 11, 1 June 2012, Pages 1578–1580, https://doi.org/10.1093/cid/cis240
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(See the Major Article by Noti et al, on pages 1569–77).
The relative importance of alternative modes of influenza virus transmission in humans remains controversial, with consequent confusion over the most appropriate measures for infection control [1–4]. Influenza virus may spread through direct and indirect contact between individuals, and hand hygiene is thought to have some effect in reducing influenza transmission [5–7]. Influenza virus may also spread through larger droplet spray and smaller aerosol particles [1–4].
A number of steps are necessary for airborne transmission from one individual to another to occur. Infectious virus must escape the respiratory tract of the infector, survive the journey between the infector and the infectee either directly or via fomites, and then enter the respiratory tract of the infectee and invade host cells to initiate infection. Although larger droplets only travel short distances before settling [8, 9], smaller aerosolized particles with aerodynamic diameters of ≤5 μm rapidly evaporate to form droplet nuclei and then can remain airborne for long periods [2, 3]. Some authors also define as aerosols particles with aerodynamic diameters from 5 to 10 or 20 μm [3, 4]. The study by Noti and colleagues provides important evidence regarding the survival of viable aerosolized virus between an infector and an infectee [1].
