WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Nat Rev Microbiol. 2021 Aug;19(8):528-545. doi: 10.1038/s41579-021-00535-6. Epub 2021 Mar 22.
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) 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.
人类呼吸道病毒感染可引起一系列呼吸道症状和疾病严重程度,导致发病率、死亡率和经济损失在全球范围内显著增加,正如 COVID-19 大流行所显示的那样。呼吸道病毒分属于不同的家族,其传播的容易程度(传染性)和传播机制(传播方式)有所不同。同一病毒的基本繁殖数(R0)或继发感染率所估计的传染性存在异质性。呼吸道病毒可通过四种主要传播方式传播:直接(身体)接触、间接接触(污染物)、(大)飞沫和(细)气溶胶。我们对特定病毒在不同环境下每种传播方式的相对贡献以及其变异如何影响传染性和传播动力学了解甚少。关于飞沫和气溶胶之间的颗粒大小阈值以及严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)和流感病毒气溶胶传播的重要性的讨论仍在继续。关于病毒减少的机制证据支持非药物干预措施的有效性;然而,我们还需要更多关于其在减少传播方面的有效性的数据。了解不同传播方式的相对贡献对于了解非药物干预措施在人群中的有效性至关重要。针对多种传播方式进行干预应该比针对单一方式更为有效。
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