Transmissibility and transmission of respiratory viruses
Open accessAbstract
Human respiratory virus infections lead to a spectrum of respiratory symptoms and disease severity, contributing to substantial morbidity, mortality and economic losses worldwide, as seen in the COVID-19 pandemic. Belonging to diverse families, respiratory viruses differ in how easy they spread (transmissibility) and the mechanism (modes) of transmission. Transmissibility as estimated by the basic reproduction number (R 0) or secondary attack rate is heterogeneous for the same virus. Respiratory viruses can be transmitted via four major modes of transmission: direct (physical) contact, indirect contact (fomite), (large) droplets and (fine) aerosols. We know little about the relative contribution of each mode to the transmission of a particular virus in different settings, and how its variation affects transmissibility and transmission dynamics. Discussion on the particle size threshold between droplets and aerosols and the importance of aerosol transmission for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus is ongoing. Mechanistic evidence supports the efficacies of non-pharmaceutical interventions with regard to virus reduction; however, more data are needed on their effectiveness in reducing transmission. Understanding the relative contribution of different modes to transmission is crucial to inform the effectiveness of non-pharmaceutical interventions in the population. Intervening against multiple modes of transmission should be more effective than acting on a single mode.
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Physical interventions might prevent the spread of respiratory viruses transmitted by multiple modes including respiratory particles and direct/indirect contact.
“Physical interventions, such as the use of masks and physical distancing measures, might prevent the spread of respiratory viruses which are considered to be transmitted by multiple modes of transmission including by respiratory particles of varying sizes spreading from infected to susceptible people and through direct and indirect contact (Kutter 2018; Leung 2021).”
From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Leung 2021
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Flagged first, then by citations
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Cited by
Sorted by citations
Physical interventions to interrupt or reduce the spread of respiratory viruses
Jefferson, T., Dooley, L., Ferroni, E., Al-Ansary, L. A., van Driel, M. L., Bawazeer, G. A., Jones, M. A., Hoffmann, T. C., Clark, J., Beller, E. M., et al. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006207.pub6 · Cited by 291 · see citing works
- Authors
- Leung, N. H. L.
- Affiliations
- University of Hong Kong (HK)
- Corresponding author
- Leung, Nancy H. L.
- ORCID
- Leung, Nancy H. L.
- Venue
- Nature Reviews Microbiology
- Published
- 2021-03-22
- Volume
- 19
- Issue
- 8
- Pages
- 528-545
- ISSN
- 1740-1526 (ISSN-L)
- 1740-1534
- PMC
- PMC7982882
- OpenAlex
- W3136166083
- Cited by
- 890
- References
- 244
- Citations by year
- 2026: 98 · 2025: 171 · 2024: 169 · 2023: 189 · 2022: 191 · 2021: 72
- FWCI
- 25.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Nature Reviews Microbiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University Grants Committee (T11-712/19 N)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- respiratory viruses, viral transmissibility, transmission routes, basic reproduction number, secondary attack rate, droplet transmission, airborne transmission, fomite transmission, direct contact transmission, SARS-CoV-2, COVID-19 pandemic, influenza virus, non-pharmaceutical interventions, particle size threshold
- MeSH terms
- Personal Protective Equipment, COVID-19, SARS-CoV-2, Aerosols, Humans, Hygiene
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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