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Airborne transmission

life science Maturity 11-13 Next article →

Airborne transmission occurs when infectious diseases spread through small particles suspended in the air. These particles can be viruses, bacteria, or fungi. This method of spread is a major concern in both human and veterinary medicine.

Aerosol transmission
Aerosol transmission

When an infected person breathes, talks, coughs, or sneezes, they release these particles into the environment. Other activities, such as raising dust or flushing toilets, can also generate infectious aerosols. These pathogens typically enter a new host through the nose, throat, sinuses, or lungs. Once inhaled, the microbes can affect the respiratory system and spread throughout the body.

Scientists used to distinguish between respiratory droplets and aerosols, but that distinction is no longer used. Instead, particles exist on a continuum of sizes. The fate of a particle depends on its initial size and environmental conditions. Larger droplets, which are greater than 100 micrometers, usually settle on the ground within 2 meters. Smaller particles can remain suspended in air currents for much longer periods. Particles in the 20 micrometer range are particularly interesting. They initially travel with airflows from coughs or air conditioning like aerosols. However, they eventually fall due to gravity, acting as "jet riders."

Different diseases use airborne transmission in different ways. Some are classified as obligate airborne infections. These spread only through aerosols, such as tuberculosis. Others are considered preferential airborne infections. These can use different routes but mainly rely on aerosols, like the chickenpox virus. Finally, some are opportunistic airborne infections. These typically use other modes of transmission but can spread via aerosols under favorable conditions, such as the influenza virus. Some pathogens are also anisotropic. This means their different modes of transmission can cause different types of diseases or varying levels of severity. For example, Yersinia pestis and Francisella tularensis can cause severe pneumonia when inhaled.

Environmental factors heavily influence how effectively these diseases spread. Temperature and relative humidity (RH) are among the most important factors. Relative humidity affects how quickly droplets evaporate. For instance, a 30 micrometer droplet can evaporate in seconds. If the relative humidity falls below 35%, infectious viruses may stay in the air longer. The CDC recommends maintaining indoor humidity between 40% and 60% to reduce viral infectivity. Other factors include wind, air pollution, and solar radiation. Even geographic details like latitude, altitude, and proximity to large bodies of water can be relevant to how diseases move.

Human environments and behaviors also play a significant role. Poor ventilation allows aerosols to spread undisturbed in indoor spaces. Crowded rooms increase the likelihood of encountering an infected person. In cities, airborne diseases often spread more rapidly than in rural areas. Interestingly, rural areas may favor higher airborne fungal dissemination. During the COVID-19 pandemic, researchers noted a direct link between insufficient ventilation and increased transmission. While increasing air changes per hour is helpful, understanding specific airflow patterns is even more crucial for safety.

To manage these risks, experts use a layered approach. This involves multiple levels of intervention to reduce the chance of infection. Individual actions include wearing masks and practicing good hand hygiene. Institutional measures include surface disinfection, improved ventilation, and air filtration. At the medical level, vaccination is a key tool. Public health measures include testing, contact tracing, and quarantine. Using multiple layers ensures that if one method fails, others are still in place to protect people.

Engineering solutions are considered higher on the hierarchy of control than personal protective equipment (PPE). These include high-efficiency particulate filters and effective ventilation systems. Portable air filters can be a useful solution when existing ventilation is inadequate. When using masks, the type of mask must match the particle size. Fluid-resistant surgical masks can prevent the inhalation of large droplets. However, smaller aerosols require high-level filtration masks, such as N95 respirators in the US or FFP3 respirators in the EU. Using these specialized masks has been shown to reduce infection rates among healthcare staff.

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