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      Review of Aerosol Transmission of Influenza A Virus

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          Abstract

          Extensive evidence indicates that aerosol transmission of influenza occurs and should be taken into account for pandemic planning.

          Abstract

          In theory, influenza viruses can be transmitted through aerosols, large droplets, or direct contact with secretions (or fomites). These 3 modes are not mutually exclusive. Published findings that support the occurrence of aerosol transmission were reviewed to assess the importance of this mode of transmission. Published evidence indicates that aerosol transmission of influenza can be an important mode of transmission, which has obvious implications for pandemic influenza planning and in particular for recommendations about the use of N95 respirators as part of personal protective equipment.

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          Most cited references 26

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          Avian influenza A (H5N1) infection in humans.

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            Avian flu: influenza virus receptors in the human airway.

            Although more than 100 people have been infected by H5N1 influenza A viruses, human-to-human transmission is rare. What are the molecular barriers limiting human-to-human transmission? Here we demonstrate an anatomical difference in the distribution in the human airway of the different binding molecules preferred by the avian and human influenza viruses. The respective molecules are sialic acid linked to galactose by an alpha-2,3 linkage (SAalpha2,3Gal) and by an alpha-2,6 linkage (SAalpha2,6Gal). Our findings may provide a rational explanation for why H5N1 viruses at present rarely infect and spread between humans although they can replicate efficiently in the lungs.
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              H5N1 Virus Attachment to Lower Respiratory Tract.

              Highly pathogenic avian influenza virus (H5N1) may cause severe lower respiratory tract (LRT) disease in humans. However, the LRT cells to which the virus attaches are unknown for both humans and other mammals. We show here that H5N1 virus attached predominantly to type II pneumocytes, alveolar macrophages, and nonciliated bronchiolar cells in the human LRT, and this pattern was most closely mirrored in cat and ferret tissues. These findings may explain, at least in part, the localization and severity of H5N1 viral pneumonia in humans. They also identify the cat and the ferret as suitable experimental animals based on this criterion.
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                Author and article information

                Journal
                Emerg Infect Dis
                Emerging Infect. Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                November 2006
                : 12
                : 11
                : 1657-1662
                Affiliations
                [* ]Hospital for Sick Children, Toronto, Ontario, Canada;
                []University of Toronto, Toronto, Ontario, Canada
                Author notes
                Address for correspondence: Raymond Tellier, Division of Microbiology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario M5G 1X8, Canada; email: raymond.tellier@ 123456sickkids.ca
                Article
                06-0426
                10.3201/eid1211.060426
                3372341
                17283614
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