Journal Article

Minimal transmission in an influenza A (H3N2) human challenge-transmission model within a controlled exposure environment

Noakes, Catherine J., Pantelic, Jovan, Bueno de Mesquita, P. Jacob, Forni, John, Berman, LaShondra, Cauchemez, Simon, Bischoff, Werner, Tellier, Raymond, Mann, Alexander, Enstone, Joanne, Milton, Donald K., Hewitt, Michael, Grantham, Michael L., Levine, Min Z., Lambkin-Williams, Robert, Lindstrom, Stephen, Killingley, Ben, Gilbert, Anthony, Nguyen-Van-Tam, Jonathan S.

2020

Overview

Uncertainty about the importance of influenza transmission by airborne droplet nuclei generates controversy for infection control. Human challenge-transmission studies have been supported as the most promising approach to fill this knowledge gap. Healthy, seronegative volunteer 'Donors' (n = 52) were randomly selected for intranasal challenge with influenza A/Wisconsin/67/2005 (H3N2). 'Recipients' randomized to Intervention (IR, n = 40) or Control (CR, n = 35) groups were exposed to Donors for four days. IRs wore face shields and hand sanitized frequently to limit large droplet and contact transmission. One transmitted infection was confirmed by serology in a CR, yielding a secondary attack rate of 2.9% among CR, 0% in IR (p = 0.47 for group difference), and 1.3% overall, significantly less than 16% (p<0.001) expected based on a proof-of-concept study secondary attack rate and considering that there were twice as many Donors and days of exposure. The main difference between these studies was mechanical building ventilation in the follow-on study, suggesting a possible role for aerosols.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aerosols / Airborne infection / Asymptomatic / Bioaerosols / Biology and life sciences / Consortia / Disease control / Disease prevention / Disease transmission / Droplets / Earth Sciences / Environmental health / Epidemiology / Evaluation / Exposure / Female / Humans / Humidity / Infection control / Infections / Influenza / Influenza A / Influenza A Virus, H3N2 Subtype / Influenza, Human / Influenza, Human - transmission / Intervention / Male / Mathematics / Medicine / Medicine and Health Sciences / Pandemics / Physical Sciences / Protective equipment / Public health / Quarantine / Serology / Statistics / Studies / Testing / Ventilation / Volunteers