Open AccessMinimal transmission in an influenza A (H3N2) human challenge-transmission model within a controlled exposure environment
Author(s) -
Jonathan S NguyenVanTam,
Ben Killingley,
Joanne Enstone,
Mary Hewitt,
Jovan Pantelic,
Michael L. Grantham,
P. Jacob Bueno de Mesquita,
Robert LambkinWilliams,
Anthony Gilbert,
Alex Mann,
John Forni,
Catherine Noakes,
Min Z. Levine,
LaShondra Berman,
Stephen Lindstrom,
Simon Cauchemez,
Werner Bischoff,
Raymond Tellier,
Donald K. Milton
Publication year - 2020
Publication title -
plos pathogens
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.719
H-Index - 206
eISSN - 1553-7374
pISSN - 1553-7366
DOI - 10.1371/journal.ppat.1008704
Subject(s) - transmission (telecommunications) , nasal administration , airborne transmission , medicine , serology , covid-19 , infection control , immunology , virology , antibody , surgery , computer science , telecommunications , disease , infectious disease (medical specialty)
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.