As globalization accelerates, microbial contamination in the built environment poses a major public health challenge. Especially since Corona Virus Disease 2019 (COVID-19), microbial sterilization technology has become a crucial research area for indoor air pollution control in order to create a hygienic and safe built environment. Based on this, the study reviews sterilization technologies in the built environment, focusing on the principles, efficiency and applicability, revealing advantages and limitations, and summarizing current research advances. Despite the efficacy of single sterilization technologies in specific environments, the corresponding side effects still exist. Thus, this review highlights the efficiency of hybrid sterilization technologies, providing an in-depth understanding of the practical application in the built environment. Also, it presents an outlook on the future direction of sterilization technology, including the development of new methods that are more efficient, energy-saving, and targeted to better address microbial contamination in the complex and changing built environment. Overall, this study provides a clear guide for selecting technologies to handle microbial contamination in different building environments in the future, as well as a scientific basis for developing more effective air quality control strategies.

The pathogenic potential of airborne particles carrying the SARS-CoV-2 viral genome was examined by considering the size distribution of airborne particles at given distances from the respiratory zone of an infected patient after coughing or sneezing with a focus on time, temperature, and relative humidity. The results show an association between the size distribution of airborne particles, particularly PM1 and PM2.5, and the presence of viral genome in different stations affected by the distance from the respiratory zone and the passage of time. The correlation with time was strong with all the dependent factors except PM1. Also, the effect of time intervals on the median concentration of airborne PM in the range of PM7 and PM10 was significant. Accordingly, in the first 20 min after coughing, the COVID-19 patient was more likely to be exposed to PM-carrying RNA genomes of SARS-CoV-2. The other finding was that the two distances of 0.25 m to the patient's left of the respiratory zone and 1.0 m above the breathing zone showed positive results for the presence of SARS-CoV-2 in all studied time intervals. The patterns of results suggested that there was a high potential for distribution of the virus in an infected patient based on position and airflow and that the severity of infection and viral load may influence the presence of viral load in droplets when coughing. Based on the results, one can conclude that ventilation plays a key role in mitigating the risk of airborne virus transmission in indoor environments, and it has been shown that reductions in particulate concentrations occur when portable air purifiers are placed near the breathing zone. The use of personal protective equipment for the patient and healthcare personnel to minimize the distribution of virus particles in the air is recommended.

The poultry industry is a critical source of affordable protein worldwide; however, it faces continuous threats from various poultry diseases that significantly impact public health, economic stability, and food security. Knowledge of and examination of the transmission routes, risk factors, and environmental survival characteristics of the most important pathogens affecting poultry populations, as well as the importance of strict biosecurity, are pivotal. Transmission routes are split into direct and vector-borne pathways, and indirect ways, which include infections via contaminated surfaces and vector-borne pathways, including insects and rodents. Avian influenza virus and Newcastle disease virus spread through respiratory droplets, and their transmission risk increases with increasing stocking density. While other pathogens (e.g., infectious bursal disease virus and Salmonella spp.), to persist long-term in the environments, for example, feed and litter, increasing the probability to persist long-term in the environments, for example, feed and litter, increasing the probability of infection. The long-term resilience of pathogens in multiple pathogens in various environmental conditions highlights the role of biosecurity, sanitation, and hygiene controls in preventing disease outbreaks. High stocking density in production systems, suboptimal ventilation, and inadequate biosecurity controls further increase transmission risks. This paper summarizes important disease transmissions and reinforces the need for strict biosecurity protocols and routine health monitoring to prevent the spread of pathogens within and beyond poultry facilities. These strategies can support safe poultry production, address growing global demand, and ensure food safety and public health.

Influenza is a highly contagious respiratory disease that poses significant health and economic burdens. Mice are commonly used as animal models for studying influenza virus pathogenesis and the development of vaccines and drugs. However, the viral volume used for nasal inoculation varies substantially in reported mouse influenza infection models, and the appropriate viral dose is crucial for reproducing experimental results.

Mice were inoculated with mouse lung-adapted strains of influenza virus A/Puerto Rico/8/34 (H1N1) via intranasal administration of 10 μL, 20 μL, and 40 μL at doses of 200 plaque-forming units (PFU) and 2000 PFU. This study investigated the impact of varying viral inoculum volumes on murine outcomes at identical doses and assessed the disparities across diverse dosage levels.

Regarding weight change trajectories, mortalities, lung tissue viral titers, and pathological manifestations, the group that received the 40 μL inoculation volume within the low-dose infection mice (200 PFU) manifested a statistically significant divergence from those inoculated with both the 10 μL and 20 μL volumes. Within the context of high-dose infections (2000 PFU), groups that received inoculation volumes of 20 μL and 40 μL exhibited marked disparities when compared to those receiving the 10 μL volume.

Disparities in inoculation volume, even under uniform infection dosages, engender differential outcomes in pathogenicity. Of particular note, the viral replication efficacy at a 20 μL inoculation volume demonstrates conspicuous fluctuations across diverse infection dose regimens.

Even though the COVID-19 pandemic now belongs to the long history of infectious diseases that have struck humanity, pathogenic biological agents continue to pose a recurring threat in private places, but also and mainly in places where the public congregates. In our recent research published in this journal in 2022 and 2023, we considered the illustrative example of a commuter train coach in which a symptomatic or asymptomatic passenger, assumed to be infected with a respiratory disease, sits among other travellers. The passenger emits liquid particles containing, for example, COVID-19 virions or any other pathogen. The size spectrum of particles varies depending on whether they are produced during breathing, speaking, coughing or sneezing. More specifically, droplets associated with breathing are in the range of 1-10 µm in aerodynamic diameter, while at the other end of the spectrum, drops associated with coughing can reach 100-1000 µm. In the first part of our research, we used Computational Fluid Dynamics (CFD) to model and simulate in 3D the transport and dispersion of particles from 1 µm to 1 mm in the turbulent flow generated by the ventilation of the railway coach. We used both the Eulerian approach and the Lagrangian approach and showed that the results were strictly similar and illustrated the very distinct aerodynamics, on one hand, of the aerosol of droplets suspended in the air and, on the other hand, of the drops falling or behaving like projectiles depending on their initial speed. In the second part of our research, we developed a model of filtration through a typical surgical mask and possible leaks around the mask if it is poorly adjusted. We resumed the twin experiment of the railway coach and compared the distribution of droplets depending on whether the passengers (including the infected one) wear masks or not and whether the masks are perfectly fitted or worn loosely. Our method made it possible to quantify the particles suspended in the air of the railway coach depending on whether the infected passenger wore their mask more or less well. In this third article, we specifically explore how thermal effects due to the presence of passengers influence the spatio-temporal distribution in the railway coach of aerosols produced by the breathing infected person. We demonstrate that the influence of thermal effects on aerodynamics is very significant and can be very favourable for air decontamination if the ventilation system is judiciously configured. Beyond its application to a commuter train, our work confirms the value of validated CFD tools for describing the airflow and dispersion of particles in complex spaces that do not always allow experimentation. The models that we have developed are applicable to any other semi-confined, ventilated public place, such as a classroom, a hospital room or a performance hall, and they enable the objective assessment of whether the occupation of these spaces could be critical with regard to infectious contamination and of how to limit this ubiquitous risk.

The physicochemical properties of aerosols, including hygroscopicity, phase state, pH, and viscosity, influence important processes ranging from virus transmission and pulmonary drug delivery to atmospheric light scattering and chemical reactivity. Despite their importance, measurements of these key properties in aerosols remain experimentally challenging due to small particle sizes and low mass densities in air. Fluorescence probe spectroscopy is one of the only analytical techniques that is capable of experimentally determining these properties in situ in a nondestructive and minimally perturbative manner. However, the application of fluorescence probe spectroscopy to important classes of aerosols including exhaled respiratory and ambient atmospheric aerosols has been limited due to a typical reliance on premixing the probe molecule with particle constituents prior to particle generation, which is not always possible. Here, a method for aerosol fluorescent labeling based on probe molecule volatilization is developed. The method is first applied to label model polyethylene glycol (PEG) aerosols with two different polarity-sensitive probes, Nile red and Prodan. The similarity of the relative humidity-dependent fluorescent emission of each probe between prelabeled and volatilized-probe PEG particles validated the methodology. A preliminary application of the technique to indicate the hygroscopicity of artificial saliva respiratory particles and model atmospheric secondary organic aerosol particles is demonstrated. The methodology developed here paves the way for future studies applying powerful fluorescent probe-based analytical techniques to study exhaled or natural aerosols for which fluorescent prelabeling is not possible.

The 2017/18 influenza season was characterized by unusual high numbers of severe infections and hospitalizations. Instead of influenza A viruses, this season was dominated by infections with influenza B viruses of the Yamagata lineage. While this IBV/Yam dominance was associated with a vaccine mismatch, a contribution of virus intrinsic features to the clinical severity of the infections was speculated. Here, we performed a molecular and phenotypic characterization of three IBV isolates from patients with severe flu symptoms in 2018 and compared it to an IBV/Yam isolate from 2016 using experimental models of increasing complexity, including human lung explants, lung organoids, and alveolar macrophages. Viral genome sequencing revealed the presence of clade but also isolate specific mutations in all viral genes, except NP, M1, and NEP. Comparative replication kinetics in different cell lines provided further evidence for improved replication fitness, tolerance towards higher temperatures, and the development of immune evasion mechanisms by the 2018 IBV isolates. Most importantly, immunohistochemistry of infected human lung explants revealed an impressively altered cell tropism, extending from AT2 to AT1 cells and macrophages. Finally, transcriptomics of infected human lung explants demonstrated significantly reduced amounts of type I and type III IFNs by the 2018 IBV isolate, supporting the existence of additional immune evasion mechanisms. Our results show that the severeness of the 2017/18 Flu season was not only the result of a vaccine mismatch but was also facilitated by improved adaptation of the circulating IBV strains to the environment of the human lower respiratory tract.

Multiple genetic variants of H1 and H3 influenza A viruses (IAVs) circulate concurrently in US swine farms. Understanding the spatial transmission patterns of IAVs among these farms is crucial for developing effective control strategies and mitigating the emergence of novel IAVs. In this study, we analysed 1909 IAV genomic sequences from 785 US swine farms, representing 33 farming systems across 12 states, primarily in the Midwest from 2004 to 2023. Bayesian phylogeographic analyses were performed to identify the dispersal patterns of both H1 and H3 virus genetic lineages and to elucidate their spatial migration patterns within and between different systems. Our results showed that both intra-system and inter-system migrations occurred between the swine farms, with intra-system migrations being more frequent. However, migration rates for H1 and H3 IAVs were similar between intra-system and inter-system migration events. Spatial migration patterns aligned with expected pig movement across different compartments of swine farming systems. Sow-Farms were identified as key sources of viruses, with bi-directional migration observed between these farms and other parts of the system, including Wean-to-Finish and Gilt-Development-Units. High intra-system migration was detected across farms in the same region, while spread to geographically distant intra- and inter-system farms was less frequent. These findings suggest that prioritizing resources towards systems frequently confronting influenza problems and targeting pivotal source farms, such as sow farms, could be an effective strategy for controlling influenza in US commercial swine operations.

Exploring transmission risk of different routes has major implications for epidemic control. However, disciplinary boundaries have impeded the dissemination of epidemic information, have caused public panic about "air transmission," "air-conditioning transmission," and "environment-to-human transmission," and have triggered "hygiene theater." Animal experiments provide experimental evidence for virus transmission, but more attention is paid to whether transmission is driven by droplets or aerosols and using the dichotomy to describe most transmission events. Here, according to characteristics of experiment setups, combined with patterns of human social interactions, we reviewed and grouped animal transmission experiments into four categories-close contact, short-range, fomite, and aerosol exposure experiments-and provided enlightenment, with experimental evidence, on the transmission risk of severe acute respiratory syndrome coronavirus (SARS-COV-2) in humans via different routes. When referring to "air transmission," context should be showed in elaboration results, rather than whether close contact, short or long range is uniformly described as "air transmission." Close contact and short range are the major routes. When face-to-face, unprotected, horizontally directional airflow does promote transmission, due to virus decay and dilution in air, the probability of "air conditioning transmission" is low; the risk of "environment-to-human transmission" highly relies on surface contamination and human behavior based on indirect path of "fomite-hand-mucosa or conjunctiva" and virus decay on surfaces. Thus, when discussing the transmission risk of SARS-CoV-2, we should comprehensively consider the biological basis of virus transmission, environmental conditions, and virus decay. Otherwise, risk of certain transmission routes, such as long-range and fomite transmission, will be overrated, causing public excessive panic, triggering ineffective actions, and wasting epidemic prevention resources.

The SARS-CoV-2 pandemic has forced choirs to pause or at least to restrict rehearsals and concerts. Nevertheless, an uncertainty about the risks of infection while singing remains, especially with regard to distances, duration of singing, number of singers and their positions in the room, size of the room as well as ventilation strategies. Based on the assumption that CO2 is a suitable indicator for the exhaled aerosols in a room, it is the aim of this study to deduce recommendations for a choir rehearsal with a minimum risk of infection.

During two choir rehearsals in a typical, nonventilated classroom, we installed 30 CO2 sensors, which allow spatial and temporal evaluation of the CO2 dispersion during singing. Various singing and ventilation phases were applied and the rates of CO2 increase during singing as well as its decrease during ventilation phases were evaluated and compared for different scenarios.

The measurements reveal a linear relation between the duration of singing, size of the room and number of persons. For our size of the room of 200 m3 the average CO2 increase is 1.83 ppm/min per person. Masks or pure breathing without singing do - in contrast to aerosol dispersion - not influence the rate of CO2 increase. CO2 disperses fast and homogeneously on horizontal planes. However, a vertical layering with a maximum CO2 concentration is observed near the ceiling. Shock ventilation shows the largest CO2 decrease within the first 5 min, after 10 min of ventilation the outside base concentration of 400 ppm is reached again.

The evaluated relations allow to calculate safe singing times for a defined number of singers and size of the room until a critical threshold of 800 ppm is reached. Furthermore, in order to monitor the actual CO2 concentration during choir rehearsal, just one CO2 sensor is representative for the air quality and CO2 concentration of the whole room and thus considered sufficient. For an early warning, it should be installed near the ceiling. Direct singing into a sensor should be avoided. A ventilation time of just 5 min is recommended which represents a compromise between strong CO2 reduction and still sufficient room temperature during winter time.

Influenza A virus (IAV) spreads through exhaled aerosol particles and larger droplets. Estimating the stability of IAV is challenging and depends on factors such as the respiratory matrix and drying kinetics. Here, we combine kinetic experiments on millimeter-sized saline droplets with a biophysical aerosol model to quantify the impact of NaCl on IAV stability. We show that IAV inactivation is determined by NaCl concentration, which increases during water evaporation and then decreases again when efflorescence occurs. When drying in air with relative humidity RH = 30%, inactivation follows an inverted sigmoidal curve, with inactivation occurring most rapidly when the NaCl concentration exceeds 20 mol/(kg H2O) immediately prior to efflorescence. Efflorescence reduces the NaCl molality to saturated conditions, resulting in a significantly reduced inactivation rate. We demonstrate that the inactivation rate k depends exponentially on NaCl molality, and after the solution reaches equilibrium, the inactivation proceeds at a first-order rate. Introducing sucrose, an organic cosolute, attenuates IAV inactivation via two mechanisms: first by decreasing the NaCl molality during the drying phase and second by a protective effect against the NaCl-induced inactivation. For both pure saline and sucrose-containing droplets, our biophysical model ResAM accurately simulates the inactivation when NaCl molality is used as the only inactivating factor. This study highlights the role of NaCl molality in IAV inactivation and provides a mechanistic basis for the observed inactivation rates.

Electrostatic fields are crucial for achieving the highly efficient filtration of airborne pollutants. However, the dissipation of static charges over time, especially under humid conditions, limits their practical application. In this study, we present a self-charging air filter (SAF) powered by a triboelectric nanogenerator (TENG). This SAF is integrated into a commercial mask, termed SAFM, which can effectively capture and degrade airborne pollutants without requiring an external power source. By leveraging the triboelectric effect during breathing, the TENG within the SAFM continuously replenishes static charges, maintaining the triboelectric field. The system employs a cellulose aerogel/Ti3C2Tx composite as the electron donor and an esterified cellulose-based electrospun nanofiber as the electron acceptor. Remarkably, the triboelectric field significantly enhances filtration performance, with the SAF achieving up to 95.7% filtration efficiency for particulate matter as small as 0.3 μm. This work underscores the potential of TENG-powered triboelectric fields in the development of multifunctional, human-machine interactive facemasks.

In January 2023, a Swedish piglet-producing farm with 2800 sows in production (SIP) was diagnosed with IAV (Influenza A virus) and the isolates were shown to cluster with the human seasonal influenza (2022/2023). In December 2022, employees with flu like symptoms tended to the pigs and a few weeks later, respiratory signs appeared in different age groups; sows in farrowing units were anorectic and pyrectic. Lung and nasal swabs were tested positive for IAV and other respiratory infectious agents. Blanket vaccination against H1N1pdm09 of sows and gilts was initiated but discontinued for sows after 2 treatments. Biosecurity measures aiming to reduce the spread of virus were implemented. However, the compliance to follow the protocol was moderate.Combining immunity and strict sanitary measures is crucial to control virus circulation. As the farmer discontinued sow vaccination and just partly increased biosecurity, this may have contributed to ongoing virus circulation and clinical signs in pigs, even 5 months post-diagnosis. Although H1N1pdm09 already had been found in the herd in 2017, there were no clinical signs or diagnostic results indicating continuous circulation of this or other IAV strains afterwards. However, this cannot be entirely excluded. Swine IAVs pose a risk of reintroduction into the human population, highlighting the importance of vaccination of farm workers against seasonal influenza.

Symptom propagation occurs when the symptom set an individual experiences is correlated with the symptom set of the individual who infected them. Symptom propagation may dramatically affect epidemiological outcomes, potentially causing clusters of severe disease. Conversely, it could result in chains of mild infection, generating widespread immunity with minimal cost to public health. Despite accumulating evidence that symptom propagation occurs for many respiratory pathogens, the underlying mechanisms are not well understood. Here, we conducted a scoping literature review for 14 respiratory pathogens to ascertain the extent of evidence for symptom propagation by two mechanisms: dose-severity relationships and route-severity relationships. We identify considerable heterogeneity between pathogens in the relative importance of the two mechanisms, highlighting the importance of pathogen-specific investigations. For almost all pathogens, including influenza and SARS-CoV-2, we found support for at least one of the two mechanisms. For some pathogens, including influenza, we found convincing evidence that both mechanisms contribute to symptom propagation. Furthermore, infectious disease models traditionally do not include symptom propagation. We summarize the present state of modelling advancements to address the methodological gap. We then investigate a simplified disease outbreak scenario, finding that under strong symptom propagation, isolating mildly infected individuals can have negative epidemiological implications.

The COVID-19 pandemic has transformed our understanding of aerosol transmissible disease and the measures required to minimise transmission. Anaesthesia providers are often in close proximity to patients and other hospital staff for prolonged periods while working in operating and procedure rooms. Although enhanced ventilation provides some protection from aerosol transmissible disease in these work areas, close proximity and long duration of exposure have the opposite effect. Surgical masks provide only minimal additional protection. Surgical patients are also at risk from viral and bacterial aerosols. Despite having recently experienced the most significant pandemic in 100 yr, we continue to lack adequate understanding of the true risks encountered from aerosol transmissible diseases in the operating room, and the best course of action to protect patients and healthcare workers from them in the future. Nevertheless, hospitals can take specific actions now by providing respirators for routine use, encouraging staff to utilise respirators routinely, establishing triggers for situations that require respirator use, educating staff concerning the prevention of aerosol transmissible diseases, and providing portable air purifiers for perioperative spaces with low levels of ventilation.

The soft palate and back of the throat represent vulnerable early infection sites for SARS-CoV-2, influenza, streptococci, and many other pathogens. We demonstrate that snoring causes aerosolization of pharyngeal fluid that covers these surfaces, which previously has escaped detection because the inspired airstream carries the micron-sized droplets into the lung, inaccessible to traditional aerosol detectors. While many of these droplets will settle in the lower respiratory tract, a fraction of the respirable smallest droplets remains airborne and can be detected in exhaled breath. We distinguished these exhaled droplets from those generated by the underlying breathing activity by using a chemical tracer, thereby proving their existence. The direct transfer of pharyngeal fluids and their pathogens into the deep lung by snoring represents a plausible mechanistic link between the previously recognized association between sleep-disordered breathing and pneumonia incidence.

The COVID-19 pandemic has highlighted the need for mucosal vaccines as breakthrough infections, short-lived immune responses and emergence of new variants have challenged the efficacy provided by the first generation of vaccines against SARS-CoV-2 viruses. M2SR SARS-CoV-2, an M2-deleted single-replication influenza virus vector modified to encode the SARS-CoV-2 receptor binding domain, was evaluated following intranasal delivery in a hamster challenge model for protection against Wuhan SARS-CoV-2. An adjuvanted inactivated SARS-CoV-2 whole virus vaccine administered intramuscularly was also evaluated. The intranasal M2SR SARS-CoV-2 was more effective than the intramuscular adjuvanted inactivated whole virus vaccine in providing protection against SARS-CoV-2 challenge. M2SR SARS-CoV-2 elicited neutralizing serum antibodies against Wuhan and Omicron SARS-CoV-2 viruses in addition to cross-reactive mucosal antibodies. Furthermore, M2SR SARS-CoV-2 generated serum HAI and mucosal antibody responses against influenza similar to an H3N2 M2SR influenza vaccine. The intranasal dual influenza/COVID M2SR SARS-CoV-2 vaccine has the potential to provide protection against both influenza and COVID.

Influenza virus has presented a considerable healthcare challenge during the past years, particularly in vulnerable groups with compromised immune systems. Therapeutics and vaccination have always been in research annals since the spread of influenza. Efforts have been going on to develop an antiviral therapeutic approach that could assist in better disease management and reduce the overall disease complexity, resistance development, and fatality rates. On the other hand, vaccination presents a chance for effective, long-term, cost-benefit, and preventive response against the morbidity and mortality associated with the influenza. However, the issues of resistance development, strain mutation, antigenic variability, and inability to cure wide-spectrum and large-scale strains of the virus by available vaccines remain there. The article gathers the updated data for the therapeutics and available influenza vaccines, their mechanism of action, shortcomings, and trials under clinical experimentation. A methodological approach has been adopted to identify the prospective therapeutics and available vaccines approved and within the clinical trials against the influenza virus. Review contains influenza therapeutics, including traditional and novel antiviral drugs and inhibitor therapies against influenza virus as well as research trials based on newer drug combinations and latest technologies such as nanotechnology and organic and plant-based natural products. Most recent development of influenza vaccine has been discussed including some updates on traditional vaccination protocols and discussion on next-generation and upgraded novel technologies. This review will help the readers to understand the righteous approach for dealing with influenza virus infection and for deducing futuristic approaches for novel therapeutic and vaccine trials against Influenza.

The human exhalation flow is characterized in this work from the three-dimensional velocimetry results obtained by using the stereo particle image velocimetry (SPIV) measurement technique on the flow emitted from a realistic airway model. For this purpose, the transient exhalation flow through the mouth of a person performing two different breaths corresponding to two metabolic rates, standing relaxed (SR) and walking active (WA), is emulated and studied. To reproduce the flow realistically, a detailed three-dimensional model obtained from computed tomography measurements on real subjects is used. To cope with the variability of the experimental data, a subsequent analysis of the results is performed using the TR-PIV (time resolved particle image velocimetry) technique. Exhalation produces a transient jet that becomes a puff when flow emission ends. Three-dimensional vector fields of the jet velocity are obtained in five equally spaced transverse planes up to a distance of Image 1 from the mouth at equally spaced time instants Image 2 which will be referred to as phases (φ), from the beginning to the end of exhalation. The time evolution during exhalation of the jet area of influence, the velocity field and the jet air entrainment have been characterized for each of the jet cross sections. The importance of the use of realistic airway models for the study of this type of flow and the influence of the metabolic rate on its development are also analyzed. The results obtained contribute to the characterization of the human exhalation as a pathway of the transmission of pathogens such as SARS-CoV-2 virus.

Airborne microorganisms and biological matter (bioaerosols) play a key role in global biogeochemical cycling, human and crop health trends, and climate patterns. Their presence in the atmosphere is controlled by three main stages: emission, transport, and deposition. Aerial survival rates of bioaerosols are increased through adaptations such as ultra-violet radiation and desiccation resistance or association with particulate matter. Current research into modern concerns such as climate change, global gene transfer, and pathogenicity often neglects to consider atmospheric involvement. This comprehensive review outlines the transpiring of bioaerosols across taxa in the atmosphere, with significant focus on their interactions with environmental elements including abiotic factors (e.g., atmospheric composition, water cycle, and pollution) and events (e.g., dust storms, hurricanes, and wildfires). The aim of this review is to increase understanding and shed light on needed research regarding the interplay between global atmospheric phenomena and the aeromicrobiome. The abundantly documented bacteria and fungi are discussed in context of their cycling and human health impacts. Gaps in knowledge regarding airborne viral community, the challenges and importance of studying their composition, concentrations and survival in the air are addressed, along with understudied plant pathogenic oomycetes, and archaea cycling. Key methodologies in sampling, collection, and processing are described to provide an up-to-date picture of ameliorations in the field. We propose optimization to microbiological methods, commonly used in soil and water analysis, that adjust them to the context of aerobiology, along with other directions towards novel and necessary advancements. This review offers new perspectives into aeromicrobiology and calls for advancements in global-scale bioremediation, insights into ecology, climate change impacts, and pathogenicity transmittance.

Influenza virus infection can result in a wide range of clinical outcomes from asymptomatic infection to severe disease and death. While there are undoubtedly many factors that contribute to the severity of disease, one possible contributing factor that needs more investigation is the route of infection. In this study, we use previously published data from cynomolgus macaques infected with A/Vietnam/1203/04 (H5N1) via either aerosol (with and without bronchoalveolar lavages (BAL)) or a combined intrabronchial, oral, and intranasal route. We fit a mathematical model of within host viral kinetics to the data and find that when the macaques are infected via the aerosol route with subsequent BAL, the infecting time is significantly lower than for the other two groups. A lower infecting time indicates that the virus spreads from cell to cell more rapidly for aerosol infection with BAL than for the combined deposition or aerosol deposition alone. This study helps elucidate the mechanism behind different infection outcomes caused by differences in routes of infection.

For many viruses, narrow bottlenecks acting during transmission sharply reduce genetic diversity in a recipient host relative to the donor. Since genetic diversity represents adaptive potential, such losses of diversity are though to limit the opportunity for viral populations to undergo antigenic change and other adaptive processes. Thus, a detailed picture of evolutionary dynamics during transmission is critical to understanding the forces driving viral evolution at an epidemiologic scale. To advance this understanding, we used a novel barcoded virus library and a guinea pig model of transmission to decipher where in the transmission process diversity is lost for influenza A viruses. In inoculated guinea pigs, we show that a high level of viral genetic diversity is maintained across time. Continuity in the barcodes detected furthermore indicates that stochastic effects are not pronounced within inoculated hosts. Importantly, in both aerosol-exposed and direct contact-exposed animals, we observed many barcodes at the earliest time point(s) positive for infectious virus, indicating robust transfer of diversity through the environment. This high viral diversity is short-lived, however, with a sharp decline seen 1-2 days after initiation of infection. Although major losses of diversity at transmission are well described for influenza A virus, our data indicate that events that occur following viral transfer and during the earliest stages of natural infection have a predominant role in this process. This finding suggests that immune selection may have greater opportunity to operate during influenza A transmission than previously recognized.

Multiple respiratory viruses, including influenza A virus (IAV), can be transmitted via expiratory aerosol particles, and aerosol pH was recently identified as a major factor influencing airborne virus infectivity. Indoors, small exhaled aerosols undergo rapid acidification to pH ~4. IAV is known to be sensitive to mildly acidic conditions encountered within host endosomes; however, it is unknown whether the same mechanisms could mediate viral inactivation within the more acidic aerosol micro-environment. Here, we identified that transient exposure to pH 4 caused IAV inactivation by a two-stage process, with an initial sharp decline in infectious titers mainly attributed to premature attainment of the post-fusion conformation of viral protein haemagglutinin (HA). Protein changes were observed by hydrogen-deuterium exchange coupled to mass spectrometry (HDX-MS) as early as 10 s post-exposure to acidic conditions. Our HDX-MS data are in agreement with other more labor-intensive structural analysis techniques, such as X-ray crystallography, highlighting the ease and usefulness of whole-virus HDX-MS for multiplexed protein analyses, even within enveloped viruses such as IAV. Additionally, virion integrity was partially but irreversibly affected by acidic conditions, with a progressive unfolding of the internal matrix protein 1 (M1) that aligned with a more gradual decline in viral infectivity with time. In contrast, no acid-mediated changes to the genome or lipid envelope were detected. Improved understanding of respiratory virus fate within exhaled aerosols constitutes a global public health priority, and information gained here could aid the development of novel strategies to control the airborne persistence of seasonal and/or pandemic influenza in the future. IMPORTANCE It is well established that COVID-19, influenza, and many other respiratory diseases can be transmitted by the inhalation of aerosolized viruses. Many studies have shown that the survival time of these airborne viruses is limited, but it remains an open question as to what drives their infectivity loss. Here, we address this question for influenza A virus by investigating structural protein changes incurred by the virus under conditions relevant to respiratory aerosol particles. From prior work, we know that expelled aerosols can become highly acidic due to equilibration with indoor room air, and our results indicate that two viral proteins are affected by these acidic conditions at multiple sites, leading to virus inactivation. Our findings suggest that the development of air treatments to quicken the speed of aerosol acidification would be a major strategy to control infectious bioburdens in the air.

Humans emit large salivary particles when talking, singing, and playing musical instruments, which have implications for respiratory disease transmission. Yet little work has been done to characterize the emission rates and size distributions of such particles. This work characterized large particle (dp > 35 μm in aerodynamic diameter) emissions from 70 volunteers of varying age and sex while vocalizing and playing wind instruments. Mitigation efficacies for face masks (while singing) and bell covers (while playing instruments) were also examined. Geometric mean particle count emission rates varied from 3.8 min-1 (geometric standard deviation [GSD] = 3.1) for brass instruments playing to 95.1 min-1 (GSD = 3.8) for talking. On average, talking produced the highest emission rates for large particles, in terms of both number and mass, followed by singing and then instrument playing. Neither age, sex, CO2 emissions, nor loudness (average dBA) were significant predictors of large particle emissions, contrary to previous findings for smaller particle sizes (i.e., for dp < 35 μm). Size distributions were similar between talking and singing (count median diameter = 53.0 μm, GSD = 1.69). Bell covers did not affect large particle emissions from most wind instruments, but face masks reduced large particle count emissions for singing by 92.5% (95% CI: 97.9%, 73.7%).

In health care, measures against cross-transmission of microorganisms are codified by standard precautions, and if necessary, they are supplemented by additional precautions.

Several factors impact transmission of microorganisms via the respiratory route: size and quantity of the emitted particles, environmental conditions, nature and pathogenicity of the microorganisms, and degree of host receptivity. While some microorganisms necessitate additional airborne or droplet precautions, others do not.

For most microorganisms, transmission patterns are well-understood and transmission-based precautions are well-established. For others, measures to prevent cross-transmission in healthcare facilities remain under discussion.

Standard precautions are essential to the prevention of microorganism transmission. Understanding of the modalities of microorganism transmission is essential to implementation of additional transmission-based precautions, particularly in view of opting for appropriate respiratory protection.

The Biosafety Research Road Map reviewed the scientific literature on a viral respiratory pathogen, avian influenza virus, and a bacterial respiratory pathogen, Mycobacterium tuberculosis. This project aims at identifying gaps in the data required to conduct evidence-based biorisk assessments, as described in Blacksell et al. One significant gap is the need for definitive data on M. tuberculosis sample aerosolization to guide the selection of engineering controls for diagnostic procedures.

The literature search focused on five areas: routes of inoculation/modes of transmission, infectious dose, laboratory-acquired infections, containment releases, and disinfection and decontamination methods.

The available data regarding biosafety knowledge gaps and existing evidence have been collated and presented in Tables 1 and 2. The guidance sources on the appropriate use of biosafety cabinets for specific procedures with M. tuberculosis require clarification. Detecting vulnerabilities in the biorisk assessment for respiratory pathogens is essential to improve and develop laboratory biosafety in local and national systems.

Particulate matter (PM) and airborne viruses pose significant threats to both the environment and public health. As the most viable solution to prevent the inhalation of these pollutants, there is an urgent demand for face masks with excellent filtration efficiency and low-pressure drop. In this study, a crimped masterbatch (CM) is added to polypropylene feedstocks to produce curling fibers through melt-blown spinning. These curled fibers exhibit low filtration resistance and effective dust-holding performances when used for air filtration. The effect of adding CM on fiber diameter, pore size, crimp, porosity, roughness, and surface potential was studied. The filtration performance of the materials, including the PM filtration capabilities, recirculation filtration, and loading test performance, were also investigated. The results demonstrate that the degree of fiber crimp can be adjusted by incorporating varying amounts of CM. This curling was caused by the uneven shrinkage that occurred due to variations in thermal contraction between these polymers. The curled fibers created a fluffy structure in the fiber network and modified the distribution of pore sizes within it. Under the same filtration conditions as sodium chloride aerogel, CM-2 (PP:CM 8:2) exhibited similar filtration efficiency (95.54% vs. 94.74%), lower filtration resistance (88.68 Pa vs. 108.88 Pa), higher quality factor (0.035 Pa-1 vs. 0.028 Pa-1) and better dust holding capacity (10.39 g/m2 vs. 9.20 g/m2) compared to CM-0 (PP:CM 10:0). After 30 days of indoor storage, the filtration efficiency of CM-2 remained above 94%. The self-curling melt-blown filtration material developed here could potentially be applied in the field of protective masks.

The COVID-19 pandemic highlighted some potential limitations of transmission-based precautions. The distinction between transmission through large droplets vs aerosols, which have been fundamental concepts guiding infection control measures, has been questioned, leading to considerable variation in expert recommendations on transmission-based precautions for COVID-19. Furthermore, the application of elements of contact precautions, such as the use of gloves and gowns, is based on low-quality and inconclusive evidence and may have unintended consequences, such as increased incidence of healthcare-associated infections and spread of multidrug-resistant organisms. These observations indicate a need for high-quality studies to address the knowledge gaps and a need to revisit the theoretical background regarding various modes of transmission and the definitions of terms related to transmission. Further, we should examine the implications these definitions have on the following components of transmission-based precautions: (i) respiratory protection, (ii) use of gloves and gowns for the prevention of respiratory virus infections, (iii) aerosol-generating procedures and (iv) universal masking in healthcare settings as a control measure especially during seasonal epidemics. Such a review would ensure that transmission-based precautions are consistent and rationally based on available evidence, which would facilitate decision-making, guidance development and training, as well as their application in practice.

Adults living in Residential Aged Care Facilities (RACFs) are highly susceptible to seasonal respiratory infections. Evidence indicates that the aerosols contaminated with virus particles in closed indoor spaces may play a significant role in the transmission of respiratory infections. In this protocol paper, we outline details of a planned RCT which aims to evaluate the effectiveness of portable in room air purifiers in reducing the risk of ARIs among residents in Australian RACFs. This study uses a multi-centre double-blind randomised crossover design. Three RACFs in a regional area of New South Wales will be invited to participate in the study. Air purifiers with or without high-efficiency particulate absorbing (HEPA) filters will be placed in the rooms of residents who are enrolled in the trial. The primary outcome will be a reduction in the incidence of ARI and the secondary outcomes will be the time to first infection, number of emergency department admissions, hospital admissions, and medical consultations due to an ARI.

To our knowledge, this will be the first RCT using air purifiers in resident rooms to identify their effect in reducing ARIs in RACFs. If our findings indicate some potential benefit for in-room air purification, it will help provide support and justification for larger trials, which may include a facility wide approach to air purification.

Climatic variables constitute important extrinsic determinants of transmission and seasonality of influenza. Yet quantitative evidence of independent associations of viral transmissibility with climatic factors has thus far been scarce and little is known about the potential effects of interactions between climatic factors on transmission.

This study aimed to examine the associations of key climatic factors with risk of influenza transmission in subtropical Guangzhou.

Influenza epidemics were identified over a 17-year period using the moving epidemic method (MEM) from a dataset of N = 295,981 clinically- and laboratory-confirmed cases of influenza in Guangzhou. Data on eight key climatic variables were collected from China Meteorological Data Service Centre. Generalized additive model combined with the distributed lag non-linear model (DLNM) were developed to estimate the exposure-lag-response curve showing the trajectory of instantaneous reproduction number (R_t) across the distribution of each climatic variable after adjusting for depletion of susceptible, inter-epidemic effect and school holidays. The potential interaction effects of temperature, humidity and rainfall on influenza transmission were also examined.

Over the study period (2005-21), 21 distinct influenza epidemics with varying peak timings and durations were identified. Increasing air temperature, sunshine, absolute and relative humidity were significantly associated with lower R_t, while the associations were opposite in the case of ambient pressure, wind speed and rainfall. Rainfall, relative humidity, and ambient temperature were the top three climatic contributors to variance in transmissibility. Interaction models found that the detrimental association between high relative humidity and transmissibility was more pronounced at high temperature and rainfall.

Our findings are likely to help understand the complex role of climatic factors in influenza transmission, guiding informed climate-related mitigation and adaptation policies to reduce transmission in high density subtropical cities.

We investigated whether crowded workplaces, sharing surfaces and exposure to infections were factors associated with a positive test for influenza virus.

We studied 11 300 cases with a positive test for influenza A and 3671 cases of influenza B from Swedish registry of communicable diseases. Six controls for each case were selected from the population registry, with each control being assigned the index date of their corresponding case. We linked job histories to job-exposure matrices (JEMs), to assess different transmission dimensions of influenza and risks for different occupations compared with occupations that the JEM classifies as low exposed. We used adjusted conditional logistic analyses to estimate the ORs for influenza with 95% CI.

The highest odds were for influenza were: regular contact with infected patients (OR 1.64, 95% CI 1.54 to 1.73); never maintained social distance (OR 1.51, 95% CI 1.43 to 1.59); frequently sharing materials/surfaces with the general public (OR 1.41, 95% CI 1.34 to 1.48); close physical proximity (OR 1.54, 95% CI 1.45 to 1.62) and high exposure to diseases or infections (OR 1.54, 95% CI 1.44 to 1.64). There were small differences between influenza A and influenza B. The five occupations with the highest odds as compared with low exposed occupations were: primary care physicians, protective service workers, elementary workers, medical and laboratory technicians, and taxi drivers.

Contact with infected patients, low social distance and sharing surfaces are dimensions that increase risk for influenza A and B. Further safety measures are needed to diminish viral transmission in these contexts.

Given the limitations of existing antiviral drugs and vaccines, there is still an urgent need for new anti-influenza drugs. CAM106, a rupestonic acid derivative, was studied for its potent antiviral activity and showed a favorable inhibitory effect on influenza virus replication. However, many gaps exist in preclinical studies of CAM106. This study focused on the pharmacokinetic profile and metabolites of CAM106 in vivo. An efficient and fast bioanalytical method was successfully developed and validated for the quantitation of CAM106 in rat plasma. A mobile phase aqueous solution (A, containing 0.1% formic acid) and acetonitrile (B) worked within 0-3.5 min, with 60% B. The mass spectrum scanning mode was the parallel reaction monitoring (PRM) with a resolution of 17,500. The linear range of the method was 2.13-1063.83 ng/mL. The validated method was applied to a pharmacokinetic study in rats. The matrix effects ranged from 93.99% to 100.08% and the recovery ranged from 86.72% to 92.87%. The intra- and inter-day precisions were less than 10.24% and the relative error (RE) ranged from -8.92% to 7.1%. The oral bioavailability of CAM106 was 1.6%. Thereafter, its metabolites in rats were characterized using high-resolution mass spectrometry. The isomers M7-A, M7-B, M7-C, and M7-D were well separated. As a result, a total of 11 metabolites were identified in the feces, urine, and plasma of rats. The main metabolic pathways of CAM106 were oxidation, reduction, desaturation, and methylation. The assay was reliable and provided useful information for further clinical studies of CAM106.

Aerosol transmission has played a leading role in COVID-19 pandemic. However, there is still a poor understanding about how it is transmitted. This work was designed to study the exhaled breath flow dynamics and transmission risks under different exhaling modes. Using an infrared photography device, exhaled flow characteristics of different breathing activities, such as deep breathing, dry coughing, and laughing, together with the roles of mouth and nose were characterized by imaging CO2 flow morphologies. Both mouth and nose played an important role in the disease transmission though in the downward direction for the nose. In contrast to the trajectory commonly modeled, the exhaled airflows appeared with turbulent entrainments and obvious irregular movements, particularly the exhalations involving mouth were directed horizontal and had a higher propagation capacity and transmission risk. While the cumulative risk was high for deep breathing, those transient ones from dry coughing, yawning, and laughing were also shown to be significant. Various protective measures including masks, canteen table shields, and wearable devices were visually demonstrated to be effective for altering the exhaled flow directions. This work is useful to understanding the risk of aerosol infection and guiding the formulation of its prevention and control strategies. Experimental data also provide important information for refining model boundary conditions.

The coronavirus disease 2019 pandemic has had a wide-ranging and profound impact on how we think about the transmission of respiratory viruses This review outlines the basis on which we should consider all respiratory viruses as aerosol-transmissible infections, in order to improve our control of these pathogens in both healthcare and community settings.

We present recent studies to support the aerosol transmission of severe acute respiratory syndrome coronavirus 2, and some older studies to demonstrate the aerosol transmissibility of other, more familiar seasonal respiratory viruses.

Current knowledge on how these respiratory viruses are transmitted, and the way we control their spread, is changing. We need to embrace these changes to improve the care of patients in hospitals and care homes including others who are vulnerable to severe disease in community settings.

Using aerosol-based tracers to estimate risk of infectious aerosol transmission aids in the design of buildings with adequate protection against aerosol transmissible pathogens, such as SARS-CoV-2 and influenza. We propose a method for scaling a SARS-CoV-2 bulk aerosol quantitative microbial risk assessment (QMRA) model for impulse emissions, coughing or sneezing, with aerosolized synthetic DNA tracer concentration measurements. With point-of-emission ratios describing relationships between tracer and respiratory aerosol emission characteristics (i.e., volume and RNA or DNA concentrations) and accounting for aerosolized pathogen loss of infectivity over time, we scale the inhaled pathogen dose and risk of infection with time-integrated tracer concentrations measured with a filter sampler. This tracer-scaled QMRA model is evaluated through scenario testing, comparing the impact of ventilation, occupancy, masking, and layering interventions on infection risk. We apply the tracer-scaled QMRA model to measurement data from an ambulatory care room to estimate the risk reduction resulting from HEPA air cleaner operation. Using DNA tracer measurements to scale a bulk aerosol QMRA model is a relatively simple method of estimating risk in buildings and can be applied to understand the impact of risk mitigation efforts.

The development of fascinating materials with functional properties has revolutionized the humankind with materials comfort, stopped the spreading of diseases, relieving the environmental pollution pressure, economized government research funds, and prolonged their serving life. The outbreak of Coronavirus Disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has triggered great global public health concern. Face masks are crucial tools to impede the spreading of SARS-CoV-2 from human to human. However, current face masks exhibit in a variety of colors (opaque), like blue, black, red, etc., leading to a communication barrier between the doctor and the deaf-mute patient when wearing a mask. High optical transparency filters can be utilized for both personal protection and lip-reading. Thus, shaping face air filter into a transparent appearance is an urgent need. Electrospinning technology, as a mature technology, is commonly used to form nanofiber materials utilizing high electrical voltage. With the alteration of the diameters of nanofibers, and proper material selection, it would be possible to make the transparent face mask. In this article, the research progress in the transparent face air filter is reviewed with emphasis on three parts: mechanism of the electrospinning process and light transmission, preparation of transparent face air filter, and their innovative potential. Through the assessment of classic cases, the benefits and drawbacks of various preparation strategies and products are evaluated, to provide general knowledge for the needs of different application scenarios. In the end, the development directions of transparent face masks in protective gear, particularly their novel functional applications and potential contributions in the prevention and control of the epidemic are also proposed.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the Coronavirus disease 2019 (COVID-19). COVID-19 was first reported in China in December 2019. SARS-CoV-2 is highly contagious and spread primarily via an airborne route. Hand hygiene, surgical masks, vaccinations and boosters, air filtration, environmental sanitization, instrument sterilization, mouth rinses, and social distancing are essential infection control measures against the transmission of SARS-CoV-2. This paper aims to provide healthcare professionals with evidence-based protective strategies.

During respiratory viral infections, the precise roles of monocytes and dendritic cells (DCs) in the nasopharynx in limiting infection and influencing disease severity are incompletely described. We studied circulating and nasopharyngeal monocytes and DCs in healthy controls (HCs) and in patients with mild to moderate infections (primarily influenza A virus [IAV]). As compared to HCs, patients with acute IAV infection displayed reduced DC but increased intermediate monocytes frequencies in blood, and an accumulation of most monocyte and DC subsets in the nasopharynx. IAV patients had more mature monocytes and DCs in the nasopharynx, and higher levels of TNFα, IL-6, and IFNα in plasma and the nasopharynx than HCs. In blood, monocytes were the most frequent cellular source of TNFα during IAV infection and remained responsive to additional stimulation with TLR7/8L. Immune responses in older patients skewed towards increased monocyte frequencies rather than DCs, suggesting a contributory role for monocytes in disease severity. In patients with other respiratory virus infections, we observed changes in monocyte and DC frequencies in the nasopharynx distinct from IAV patients, while differences in blood were more similar across infection groups. Using SomaScan, a high-throughput aptamer-based assay to study proteomic changes between patients and HCs, we found differential expression of innate immunity-related proteins in plasma and nasopharyngeal secretions of IAV and SARS-CoV-2 patients. Together, our findings demonstrate tissue-specific and pathogen-specific patterns of monocyte and DC function during human respiratory viral infections and highlight the importance of comparative investigations in blood and the nasopharynx.