Airborne transmission of respiratory viruses

• Published in: Science (American Association for the Advancement of Science) Vol. 373; no. 6558
• Main Authors: Wang, Chia C., Prather, Kimberly A., Sznitman, Josué, Jimenez, Jose L., Lakdawala, Seema S., Tufekci, Zeynep, Marr, Linsey C.
• Format: Journal Article
• Language: English
• Published: United States The American Association for the Advancement of Science 27.08.2021; American Association for the Advancement of Science
• Subjects: Aerosols; Air flow; Air Microbiology; Airborne infection; Airborne sensing; Alveoli; Animal research; Coronavirus; Coronaviruses; COVID-19; COVID-19 - transmission; COVID-19 - virology; Disease control; Disease transmission; Disease Transmission, Infectious; Disinfection; Droplets; Emitters; Environmental factors; Environmental Influences; Evidence; Eye protection; Fomites; Humans; Indoor environments; Infections; Infectious diseases; Influenza; Inhalation; Measurement techniques; Mechanical ventilation; Medicine; Microbial Viability; Pandemics; Particle Size; Pathogens; Physicochemical properties; Public health; Relative humidity; Respiration; Respiratory diseases; Respiratory syncytial virus; Respiratory System - virology; Respiratory tract; Respiratory Tract Infections - transmission; Respiratory Tract Infections - virology; Review; Reviews; Rhinovirus; SARS-CoV-2 - isolation & purification; SARS-CoV-2 - physiology; Severe acute respiratory syndrome coronavirus 2; Spray deposition; Ultraviolet radiation; Ventilation; Viral diseases; Viral Load; Virus Diseases - transmission; Virus Diseases - virology; Virus Physiological Phenomena; Viruses; Viruses - isolation & purification
• ISSN: 0036-8075; 1095-9203; 1095-9203
• DOI: 10.1126/science.abd9149

The COVID-19 pandemic has highlighted controversies and unknowns about how respiratory pathogens spread between hosts. Traditionally, it was thought that respiratory pathogens spread between people through large droplets produced in coughs and through contact with contaminated surfaces (fomites). However, several respiratory pathogens are known to spread through small respiratory aerosols, which can float and travel in air flows, infecting people who inhale them at short and long distances from the infected person. Wang et al . review recent advances in understanding airborne transmission gained from studying the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and other respiratory pathogens. The authors suggest that airborne transmission may be the dominant form of transmission for several respiratory pathogens, including SARS-CoV-2, and that further understanding of the mechanisms underlying infection from the airborne route will better inform mitigation measures. —GKA A Review discusses the scientific basis of and factors controlling airborne transmission of respiratory viruses including coronavirus. The COVID-19 pandemic has revealed critical knowledge gaps in our understanding of and a need to update the traditional view of transmission pathways for respiratory viruses. The long-standing definitions of droplet and airborne transmission do not account for the mechanisms by which virus-laden respiratory droplets and aerosols travel through the air and lead to infection. In this Review, we discuss current evidence regarding the transmission of respiratory viruses by aerosols—how they are generated, transported, and deposited, as well as the factors affecting the relative contributions of droplet-spray deposition versus aerosol inhalation as modes of transmission. Improved understanding of aerosol transmission brought about by studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection requires a reevaluation of the major transmission pathways for other respiratory viruses, which will allow better-informed controls to reduce airborne transmission.