Cough Aerosols of <i>Mycobacterium tuberculosis</i> Predict New Infection. A Household Contact Study

Jones-López, Edward C.; Namugga, Olive; Mumbowa, Francis; Ssebidandi, Martin; Mbabazi, Olive; Moine, Stephanie; Mboowa, Gerald; Fox, Matthew P.; Reilly, Nancy; Ayakaka, Irene; Kim, Soyeon; Okwera, Alphonse; Joloba, Moses; Fennelly, Kevin P.

doi:10.1164/rccm.201208-1422oc

Cited by 132 publications

(166 citation statements)

References 32 publications

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“…The present study uses bacterial infection in patients with CF to demonstrate the potential for aerosol transmission in healthcare settings and adds to studies suggesting similar mechanisms for M tuberculosis and for B pertussis in non-human primate models 5 6. Our results provide further evidence, which challenges the dogma that CF bacterial pathogens within droplet nuclei have limited survival in air.…”

Section: Discussionmentioning

confidence: 58%

Viability ofPseudomonas aeruginosain cough aerosols generated by persons with cystic fibrosis

Knibbs

Johnson

Kidd

et al. 2014

Thorax

102

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BackgroundPerson-to-person transmission of respiratory pathogens, including Pseudomonas aeruginosa, is a challenge facing many cystic fibrosis (CF) centres. Viable P aeruginosa are contained in aerosols produced during coughing, raising the possibility of airborne transmission.MethodsUsing purpose-built equipment, we measured viable P aeruginosa in cough aerosols at 1, 2 and 4 m from the subject (distance) and after allowing aerosols to age for 5, 15 and 45 min in a slowly rotating drum to minimise gravitational settling and inertial impaction (duration). Aerosol particles were captured and sized employing an Anderson Impactor and cultured using conventional microbiology. Sputum was also cultured and lung function and respiratory muscle strength measured.ResultsNineteen patients with CF, mean age 25.8 (SD 9.2) years, chronically infected with P aeruginosa, and 10 healthy controls, 26.5 (8.7) years, participated. Viable P aeruginosa were detected in cough aerosols from all patients with CF, but not from controls; travelling 4 m in 17/18 (94%) and persisting for 45 min in 14/18 (78%) of the CF group. Marked inter-subject heterogeneity of P aeruginosa aerosol colony counts was seen and correlated strongly (r=0.73–0.90) with sputum bacterial loads. Modelling decay of viable P aeruginosa in a clinic room suggested that at the recommended ventilation rate of two air changes per hour almost 50 min were required for 90% to be removed after an infected patient left the room.ConclusionsViable P aeruginosa in cough aerosols travel further and last longer than recognised previously, providing additional evidence of airborne transmission between patients with CF.

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Section: Discussionmentioning

confidence: 58%

Viability ofPseudomonas aeruginosain cough aerosols generated by persons with cystic fibrosis

Knibbs

Johnson

Kidd

et al. 2014

Thorax

102

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“…Studies of aerosols generated by cough and sneeze have been shown to include particles that vary over several orders of magnitude [14][15][16][17][18] and contain pathogens. [19][20][21][22] Figure 1(a) illustrates an aerosol plume, such as might be emitted by a cough. Circles of three sizes represent particles of different sizes.…”

Section: Aerosol Transmissionmentioning

confidence: 99%

Aerosol Transmission of Infectious Disease

Jones

Brosseau

2015

Journal of Occupational &Amp; Environmental Medicine

343

299

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“…Mycobacterium tuberculosis (TB) is a highly contagious bacterium that spreads from person to person via aerosols (Dye, 2006;Jones-López et al, 2013). The worldwide spread of TB has been a continuous threat to public health globally with almost one third of the world's population infected (Dye, 2006).…”

Section: Tuberculosismentioning

confidence: 99%

Regional transport and its association with tuberculosis in the Shandong province of China, 2009–2011

Lai

Zhang

et al. 2015

Journal of Transport Geography

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Cough Aerosols of Mycobacterium tuberculosis Predict New Infection. A Household Contact Study

Abstract: Cough aerosols of M. tuberculosis are produced by a minority of patients with TB but predict transmission better than sputum smear microscopy or culture. Cough aerosols may help identify the most infectious patients with TB and thus improve the cost-effectiveness of TB control programs.

Cited by 132 publications

References 32 publications

Viability ofPseudomonas aeruginosain cough aerosols generated by persons with cystic fibrosis

Viability ofPseudomonas aeruginosain cough aerosols generated by persons with cystic fibrosis

Aerosol Transmission of Infectious Disease

Regional transport and its association with tuberculosis in the Shandong province of China, 2009–2011

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