Transocular Entry of Seasonal Influenza-Attenuated Virus Aerosols and the Efficacy of N95 Respirators, Surgical Masks, and Eye Protection in Humans
Open accessAbstract
BACKGROUND: The efficacy of barrier precautions to prevent influenza transmission is unknown. METHODS: Twenty-eight participants were exposed to monodispersed live attenuated influenza vaccine (LAIV) particles (4.9 μm) in 6 groups: group 1, no precautions; group 2, ocular exposure only; group 3, surgical mask without eye protection; group 4, surgical mask with eye protection; group 5, fit-tested N95 respirator without eye protection; and group 6, fit-tested N95 respirator with eye protection. Influenza was detected by reverse-transcription polymerase chain reaction (RT-PCR) and culture in nasal washes. Exact 95% confidence intervals (CIs) were calculated. RESULTS: Influenza was detected in 4 of 4 participants in group 1 (95% CI, 0-.60), 3 of 4 in group 2 (95% CI, .006-.806]), 5 of 5 in group 3 (95% CI, 0-.522), 5 of 5 in group 4, (95% CI, 0-.522), 3 of 5 in group 5 (95% CI, .053-.853), and 1 of 5 in group 6 (95% CI, .05-.72). RT-PCR revealed significant differences between group 1 and all other groups except group 3. CONCLUSIONS: Transocular transmission of LAIV occured in most participants suggesting the necessity of eye protection. An N95 respirator provided the best guard further enhanced by eye protection.
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In human subjects exposed to live attenuated influenza vaccine particles, wearing N95 respirators offered a higher level of protection than surgical masks against influenza transmission.
“Analysis for influenza virus in the nasal washes of test subjects by reverse transcription-polymerase chain reaction technique showed that wearing N95 respirators offered a higher level of protection than SMs.”
The inverse relationship between filter efficiency and TIL provides a better explanation for the higher levels of respiratory protection offered by N95 FFRs than SMs reported previously.
“The inverse relationship between filter efficiency and TIL provides a better explanation for the higher levels of respiratory protection offered by the N95 FFRs than the SMs reported previously. (12,14,15)”
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Self-citationEffectiveness of surgical masks against influenza bioaerosols
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“(12,14,15) The MPPS was ~45 nm for N1, N2, and SM1 models, and ~350 nm for SM2 with no faceseal leakage.”
Influential
- Authors
- Bischoff, W. E., Reid, T., Russell, G. B., & Peters, T. R.
- Affiliations
- Wake Forest University Health Sciences (US)
- Venue
- Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-06-14
- Volume
- 204
- Issue
- 2
- Pages
- 193-199
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- PMC
- PMC3164472
- OpenAlex
- W2144384307
- Cited by
- 89
- References
- 5
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 7 · 2021: 8 · 2020: 23 · 2019: 2 · 2018: 5 · 2017: 2 · 2016: 4 · 2015: 6 · 2014: 6 · 2013: 13 · 2012: 4
- FWCI
- 7.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention (U01CI000474, 5u01ci000474-02)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- live attenuated influenza vaccine, airborne transmission, eye protection, N95 respirators, surgical masks, barrier precautions, ocular exposure, respiratory protection
- MeSH terms
- Adult, Aerosols, Female, Humans, Influenza, Human, Male, Middle Aged, Nasal Mucosa, Respiratory Protective Devices, RNA, Viral, Eye Infections, Viral, Reverse Transcriptase Polymerase Chain Reaction
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