Evaluating Modes of Influenza Transmission Observational Study of Community Acquired Influenza

Study Summary

The recent swine origin influenza pandemic (2009), new emergence of swine origin H3N2v, and delayed availability of vaccine for these agents highlight the need to test and optimize public health intervention strategies to reduce transmission of influenza. We will use a new technology for biological particle collection (U.S. Provisional Patent Application No. 61/162,395, McDevitt et al., Aerosol Sci Technol 2013) to make fundamental observations on infectious respiratory droplets in a study of up to 200 naturally occurring seasonal influenza cases. We will collect respiratory droplets shed by participants while breathing normally, talking, and spontaneously coughing. We will characterize the size distribution of droplets containing infectious virus. We will use these basic data to examine the roles of large and small respiratory droplets and examine how the interaction of host factors and virus type impact the shedding of infectious respiratory droplets. Subjects will be recruited through a web based respiratory illness surveillance system, health clinics and advertisement in the campus community. Sitting in the collection booth will not create additional discomfort or risk for volunteers already suffering from influenza infection. We will recruit up to 1000 persons with symptoms of acute respiratory illness for screening with collection of nasopharyngeal swabs and questionnaire. From among those screened, we will recruit 250 to give exhaled breath samples, and ask 50 people with influenza to return for follow up exhaled breath samples on up to two subsequent days. We hypothesize that (1) fine aerosols (\<5 microns in aerodynamic diameter) will contain more viral copies than coarse aerosol particles (\>= 5 microns) (2) fine aerosols will contain culturable virus indicating that the fine aerosols are infectious, (3) aerosol shedding will correlate with virus load measured by swabs, (4) presence of active cough during sampling will be associated with increased aerosol

Primary Outcome

Total viral RNA copies detected in breath aerosol exhaled during a 30-minute sample collection. Participants sit for 30 minutes with face inside the cone/funnel of the Gesundheit-II (G-II) human bioaerosol collector (https://doi.org/10.1080/02786826.2012.762973) collecting air at 130 L/min. Particles in air are concentrated into a small volume of buffer. The copies per mL of buffer is measured by PCR and corrected to the total amount collected per 30-min sample. See publication in the Proceeding

Interventions

• OTHER Observational Study of influenza aerosol shedding -- No Intervention