AIRBORNE TRANSMISSION OF RESPIRATORY INFECTION WITH COXSACKIEVIRUS A TYPE 2112

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Abstract
Couch, R. B. (Dept. Microbiology, Baylor College of Medicine, Houston, Texas 77025), R. G. Douglas, Jr., K. M. Lindgren, P. J. Gerone and V. Knight. Airborne transmission of respiratory infection with coxsackievirus A type 21. Amer. J. Epid., 1970, 97: 78–86.—Thirty-nine volunteers free of antibody to coxsackievirus A type 21 were quartered in a barracks separated in the center by a double-wire barrier. Ten volunteers on one side were inoculated with A21 by small particle aerosol while 10 on the same side and 19 on the opposite side received sham inoculations. Contact between men on the two sides was prevented and contact with individuals outside the barracks was minimized. Presence of potential transmitters among the inoculated volunteers was demonstrated by collection and testing cough and sneeze samples for virus. Rapid and equal dissemination of aerosols within the building was produced by large floor fans, and occurrence of virus-contaminated air on the side opposite to inoculated men was demonstrated by collection and testing air samples with a large volume air sampler. All exposed volunteers became infected with A21 during the 26-day study. The simultaneous onset of infection in 5 volunteers with exposure only to air that had surrounded infected volunteers indicates that airborne transmission occurred. The occurrence of 20 of 29 infections in two “waves”, each of which followed a positive air sample, suggests that most and possibly all infections were acquired by the airborne route. Rhinovirus infections also occurred in 18 of the 39 volunteers and 4 different serotypes were involved. These infections may have interfered with transmission of A21 by the contact route. Protection against rhinovirus infection was associated with the presence of serum antibody.

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