Understanding respiratory pathogen transmission is essential for public health measures aimed at reducing pathogen spread. Particle generation and size are key determinant for pathogen carriage, aerosolisation, and transmission. Production of infectious respiratory particles is dependent on the type and frequency of respiratory activity, type and site of infection and pathogen load. Further, relative humidity, particle aggregation and mucus properties influence expelled particle size and subsequent transmission. Review of 26 studies reporting particle sizes generated from breathing, coughing, sneezing and talking showed healthy individuals generate particles between 0.01 and 500 μm, and individuals with infections produce particles between 0.05 and 500 μm. This indicates that expelled particles carrying pathogens do not exclusively disperse by airborne or droplet transmission but avail of both methods simultaneously and current dichotomous infection control precautions should be updated to include measures to contain both modes of aerosolised transmission.

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The association between house dust allergy and asthma has long been recognized, and it has been demonstrated that a major allergen in house dust is related to the presence of mites of the genus Dermatophagoides. Using extracts of mite culture for skin testing, as many as 10% of the population and up to 90% of allergic asthmatics give positive immediate reactions. Although mites may occasionally become airborne during bed-making, it has also been demonstrated that they 'secrete or excrete' some allergen. Recently, we have shown that up to three-quarters of the serum IgE antibodies to mites are directed against a major allergen-antigen P1 (molecular weight 24,000). Using a radioimmunoassay it is possible to measure the concentration of this glycoprotein in both dust samples and mite cultures. These measurements, which are reported here, show that more than 95% of the allergen accumulating in mite cultures is associated with faecal particles.

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