Recognition of aerosol transmission of infectious agents: a commentary

Although short-range large-droplet transmission is possible for most respiratory infectious agents, deciding on whether the same agent is also airborne has a potentially huge impact on the types (and costs) of infection control interventions that are required.The concept and definition of aerosols is also discussed, as is the concept of large droplet transmission, and airborne transmission which is meant by most authors to be synonymous with aerosol transmission, although some use the term to mean either large droplet or aerosol transmission.However, these terms are often used confusingly when discussing specific infection control interventions for individual pathogens that are accepted to be mostly transmitted by the airborne (aerosol) route (e.g. tuberculosis, measles and chickenpox). It is therefore important to clarify such terminology, where a particular intervention, like the type of personal protective equipment (PPE) to be used, is deemed adequate to intervene for this potential mode of transmission, i.e. at an N95 rather than surgical mask level requirement.With this in mind, this review considers the commonly used term of aerosol transmission' in the context of some infectious agents that are well-recognized to be transmissible via the airborne route. It also discusses other agents, like influenza virus, where the potential for airborne transmission is much more dependent on various host, viral and environmental factors, and where its potential for aerosol transmission may be underestimated.

尽管大多数呼吸道传染病病原体都可能通过短距离大飞沫传播，但确定同一病原体是否也能通过空气传播，对所需的感染控制干预措施的类型（及成本）具有潜在的巨大影响。本文还讨论了气溶胶的概念和定义，以及大飞沫传播和空气传播的概念。大多数作者认为空气传播与气溶胶传播同义，尽管有些人使用该术语来表示大飞沫传播或气溶胶传播。然而，在讨论针对被认为主要通过空气（气溶胶）途径传播的个别病原体的具体感染控制干预措施时（例如结核病、麻疹和水痘），这些术语经常被混淆使用。因此，在明确某种特定干预措施（例如要使用的个人防护设备类型）被认为足以针对这种潜在传播方式进行干预时，即达到N95口罩而非医用外科口罩的要求水平时，澄清这些术语非常重要。有鉴于此，本综述在一些公认可通过空气途径传播的传染病病原体的背景下，对常用的“气溶胶传播”这一术语进行了探讨。它还讨论了其他病原体，如流感病毒，其空气传播的可能性在很大程度上取决于各种宿主、病毒和环境因素，并且其气溶胶传播的可能性可能被低估。