Cited by 890Infection Control and VentilationRespiratory viral infections researchCOVID-19 epidemiological studies

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Transmissibility and transmission of respiratory viruses

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Leung, Nancy H. L.·2021·Nature Reviews Microbiology

DOI 10.1038/s41579-021-00535-6PMC PMC7982882

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Abstract

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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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 all 890

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
Publisher: Springer Science and Business Media LLC
Published: 2021-03-22
Volume: 19
Issue: 8
Pages: 528-545
ISSN: 1740-1526 (ISSN-L)
1740-1534
DOI: 10.1038/s41579-021-00535-6
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: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
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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