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SARS-CoV-2 in exhaled aerosol particles from covid-19 cases and its association to household transmission

Alsved, Malin LU orcid ; Nygren, David LU orcid ; Thuresson, Sara LU ; Medstrand, Patrik LU orcid ; Fraenkel, Carl-Johan LU and Löndahl, Jakob LU orcid (2022) In Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 75(1). p.50-56
Abstract

BACKGROUND: Covid-19 transmission via exhaled aerosol particles has been considered an important route for the spread of infection, especially during super-spreading events involving loud talking or singing. However, no study has previously linked measurements of viral aerosol emissions to transmission rates.

METHODS: During Feb-Mar 2021, covid-19 cases that were close to symptom onset were visited with a mobile laboratory for collection of exhaled aerosol particles during breathing, talking and singing, respectively, and of nasopharyngeal and saliva samples. Aerosol samples were collected using a BioSpot-VIVAS and a NIOSH bc-251 two-stage cyclone, and all samples were analyzed by RT-qPCR for SARS-CoV-2 RNA detection. We compared... (More)

BACKGROUND: Covid-19 transmission via exhaled aerosol particles has been considered an important route for the spread of infection, especially during super-spreading events involving loud talking or singing. However, no study has previously linked measurements of viral aerosol emissions to transmission rates.

METHODS: During Feb-Mar 2021, covid-19 cases that were close to symptom onset were visited with a mobile laboratory for collection of exhaled aerosol particles during breathing, talking and singing, respectively, and of nasopharyngeal and saliva samples. Aerosol samples were collected using a BioSpot-VIVAS and a NIOSH bc-251 two-stage cyclone, and all samples were analyzed by RT-qPCR for SARS-CoV-2 RNA detection. We compared transmission rates between households with aerosol-positive and aerosol-negative index cases.

RESULTS: SARS-CoV-2 RNA was detected in at least one aerosol sample from 19 of 38 (50%) included cases. The odds ratio of finding positive aerosol samples decreased with each day from symptom onset (OR 0.55, 95CI 0.30-1.0, p=0.049). The highest number of positive aerosol samples were from singing, 16 (42%), followed by talking, 11 (30%), and the least from breathing, 3 (8%). Index cases were identified for 13 households with 31 exposed contacts. Higher transmission rates were observed in households with aerosol-positive index cases, 10/16 infected (63%), compared to households with aerosol-negative index cases, 4/15 infected (27%) (Chi-square test, p=0.045).

CONCLUSIONS: Covid-19 cases were more likely to exhale SARS-CoV-2-containing aerosol particles close to symptom onset and during singing or talking as compared to breathing. This study supports that individuals with SARS-CoV-2 in exhaled aerosols are more likely to transmit covid-19.

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Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
volume
75
issue
1
pages
50 - 56
publisher
Oxford University Press
external identifiers
  • pmid:35271734
  • scopus:85144541924
ISSN
1537-6591
DOI
10.1093/cid/ciac202
language
English
LU publication?
yes
id
0f85f046-4cb2-473d-ad40-f64f203ecce8
date added to LUP
2022-05-01 12:31:18
date last changed
2024-04-18 13:01:46
@article{0f85f046-4cb2-473d-ad40-f64f203ecce8,
  abstract     = {{<p>BACKGROUND: Covid-19 transmission via exhaled aerosol particles has been considered an important route for the spread of infection, especially during super-spreading events involving loud talking or singing. However, no study has previously linked measurements of viral aerosol emissions to transmission rates.</p><p>METHODS: During Feb-Mar 2021, covid-19 cases that were close to symptom onset were visited with a mobile laboratory for collection of exhaled aerosol particles during breathing, talking and singing, respectively, and of nasopharyngeal and saliva samples. Aerosol samples were collected using a BioSpot-VIVAS and a NIOSH bc-251 two-stage cyclone, and all samples were analyzed by RT-qPCR for SARS-CoV-2 RNA detection. We compared transmission rates between households with aerosol-positive and aerosol-negative index cases.</p><p>RESULTS: SARS-CoV-2 RNA was detected in at least one aerosol sample from 19 of 38 (50%) included cases. The odds ratio of finding positive aerosol samples decreased with each day from symptom onset (OR 0.55, 95CI 0.30-1.0, p=0.049). The highest number of positive aerosol samples were from singing, 16 (42%), followed by talking, 11 (30%), and the least from breathing, 3 (8%). Index cases were identified for 13 households with 31 exposed contacts. Higher transmission rates were observed in households with aerosol-positive index cases, 10/16 infected (63%), compared to households with aerosol-negative index cases, 4/15 infected (27%) (Chi-square test, p=0.045).</p><p>CONCLUSIONS: Covid-19 cases were more likely to exhale SARS-CoV-2-containing aerosol particles close to symptom onset and during singing or talking as compared to breathing. This study supports that individuals with SARS-CoV-2 in exhaled aerosols are more likely to transmit covid-19.</p>}},
  author       = {{Alsved, Malin and Nygren, David and Thuresson, Sara and Medstrand, Patrik and Fraenkel, Carl-Johan and Löndahl, Jakob}},
  issn         = {{1537-6591}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{1}},
  pages        = {{50--56}},
  publisher    = {{Oxford University Press}},
  series       = {{Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}},
  title        = {{SARS-CoV-2 in exhaled aerosol particles from covid-19 cases and its association to household transmission}},
  url          = {{http://dx.doi.org/10.1093/cid/ciac202}},
  doi          = {{10.1093/cid/ciac202}},
  volume       = {{75}},
  year         = {{2022}},
}