Airborne transmission of pathogens, books and review articles

Table of Contents

  1. Books about airborne transmission of pathogens
  2. Review articles about airborne transmission of pathogens
  3. Historical review articles
  4. Studies detecting pathogens in the air
  5. Other topics

List of books and review articles about airborne transmission of pathogens. Here’s a direct link over to the thread listing review articles about airborne transmission:

1. Books about airborne transmission of pathogens

Moulton, Forest Ray, ed. 1942. Aerobiology. American Association for the Advancement of Science

Airborne Contagion and Air Hygiene: An Ecological Study of Droplet Infections by William Firth Wells. 1955 and

I happily present to you, kind readers, the Bible of airborne transmission of pathogens. It is on Internet Archive but also on Google Books. Click the gear icon to download it as a PDF. Interesting that I found it on Google Books, because I thought I had searched for this book there in the past and it wasn’t available for download.

Richard L. Riley, Francis O’Grady. 1961. Airborne Infection: Transmission and Control

Riley worked with Mr. Wells on aerobiology his whole life.

Mr. Wells wrote the book I mentioned a few posts up. He was the husband of Dr. Wells, who also worked on aerobiology but passed away in the 40s. WHO. 2009. “Natural ventilation in health care for infection control”

A World Health Organization #WHO publication, which they never mention for some odd reason

Kundsin, Ruth B, editor. 1980. Airborne Contagion. New York, N.Y. : New York Academy of Sciences.

Papers include:

This piecs is, interestingly, not in the Langmuir collection Hmm.

From “Airborne Contagion”:

“Airborne transmission is the most important mode of transmission of respiratory infections from person to person indoors. It may well be the most important mode of transmission for other human infections not considered as primarily respiratory. There is published evidence of droplet nuclei transmission of hepatitis B virus, smallpox, rabies, chicken pox, mumps, measles as well as tuberculosis. I am deeply grateful to Dr. Lloyd G. Herman, Dr. Richard L. Riley, and Dr. Carl W. Walter for their interest, support, and total dedication to the theme of this conference: airborne contagion.”


The titles of the various articles in Kundsin’s conference compilation:

Part I. History and Epidemiology

Historical Background. By RICHARD L. RILEY 3

Spread of Tuberculosis via Recirculated Air in a Naval Vessel: The Byrd Study. By VERNON N. HOUK 10

The Role of Ventilation in the Spread of Measles in an Elementary School. By EDWARD C. RILEY 25

Changing Concepts of Airborne Infection of Acute Contagious Diseases: A Reconsideration of Classic Epidemiologic Theories. By ALEXANDER D. LANGMUIR 35

Part II. Epidemiology

The Epidemiology of Influenza in Humans. By MICHAEL B. GREGG 45

Epidemiology of the Common Cold. By JACK M. GWALTNEY, JR 54

Legionellosis: Evidence of Airborne Transmission. By DAVID W. FRASER 61

Legionellosis: Environmental Aspects. By G. F. MALLISON 67

Physics of Airborne Particles and Their Deposition in the Lung. By PAUL E. MORROW 71

A Tribute to William Firth Wells. By EDWARD C. RILEY 81

Part III. Bacteria as Agents of Airborne Contagion

Inhalation Anthrax. By PHILIP S. BRACHMAN 83

Aerosol Dissemination of Bacterial Plant Pathogens. By MONTY D. HARRISON 94


Part IV. Fungi as Agents of Airborne Contagion

Introduction. By LLOYD G. HERMAN 115

Aerial Dissemination of Fungal Spores. By DONALD E. AYLOR and PAUL E. WAGGONER 116

(Philosophical) Review of Air Currents as a Continuing Vector. By CHARLOTTE C. CAMPBELL 123

Aspergillus in Patient Care Areas. By LLOYD G. HERMAN 140

Part V. Viruses as Agents of Airborne Contagion

Viruses as Agents of Airborne Contagion. By VERNON KNIGHT 147

Aerosol Spread of Plant Viruses: Potential Role in Disease Outbreaks. By ERNEST E. BANTTARI AND JAMES R. VENETTE 167

Overview of Airborne Contagion in Animals. By LAWRENCE A. FALK, JR. and RONALD D. HUNT 174

Spread of Plant Viruses and Spiroplasmas through Airborne Vectors. By KARL MARAMOROSCH 179

Part VI. Airborne Transmission—Other Considerations

Long-Range Transmission of Bacteria. By AKE BOVALLIUS, ROGER ROFFEY, and EVA HENNINGSON 186

Surf-to-Wind Transfer of Viruses. By EDWARD R. BAYLOR and MARTHA B. BAYLOR 201

Spread of Microorganisms by Air-Conditioning Systems—Especially in Hospitals. By K. O. GUNDERMANN 209

The Role of Airborne Bacteria in the Contamination of Fine Particle Nebulizers and the Development of Noscomial Pneumonia. By STEVEN G. KELSEN and MARYANNE MCGUCKIN 218

Air Sampling in Hospitals. By DIETER H. M. GROSCHEL 230

Techniques Used for Sampling Airborne Microorganisms Associated with Industrial Clean Rooms and Spacecraft Assembly Areas. By MARTIN

Part VII. Airborne Infections in Hospitals

Documentation of Airborne Infection During Surgery. By RUTH B. KUNDSIN 255

Reduction of Deep Sepsis Following Total Hip Arthroplasty. By ROBERT H.

Ultraviolet Light for the Control of Airborne Bacteria in the Operating Room. By J. LEONARD GOLDNER, MARY MOGGIO, STEPHEN F. BEISSINGER, and DONALD E. MCCOLLUM 271

Ultraviolet Radiation and Reduction of Deep Wound Infection Following Hip and Knee Arthroplasty. By J. DRENNAN LOWELL, RUTH B. KUNDSIN, CHARLES M. SCHWARTZ, and DEBORAH POZIN 285

The Treatment of Burn Patients in a Laminar Airflow Environment. By ROBERT H. DEMLING and JEANNE MALY 294

The Contribution of A Bacterially Isolated Environment to the Prevention of Infections in Seriously Burned Patients. By GENN E. BEHRINGER and JOHN F. BURKE 300

Part VIII. Prevention and Control

Speculations on the Possible Effects of the Indoor Air on Airborne Contagion. By DONALD F. PROCTOR 308

Prevention and Control of Airborne Infection in Hospitals. By CARL W. WALTER 312

Prevention and Control of Airborne Infection in the Community. By RICHARD L. RILEY 331

Index of Contributors 341

Financial assistance was received from:

The Air Spora. 2006 : 15–34

The Aerobiology Pathway Guest Editor (s): Maureen E. Lacey and Jonathan S. West doi:10.1007/978-0-387-30253-9_2 PMCID: PMC7120664

2016. Aerobiology The Toxicology of Airborne Pathogens

Salem, Harry, and Sidney A Katz, eds. Aerobiology. Cambridge: Royal Society of Chemistry, 2016

2. Review articles about airborne transmission

This is not all of the reviews, just the top ones.

2006. Tang, J. W., Y. Li, I. Eames, P. K. S. Chan, and G. L. Ridgway. ‘Factors Involved in the Aerosol Transmission of Infection and Control of Ventilation in Healthcare Premises’. The Journal of Hospital Infection 64, no. 2 (October 2006): 100–114 or

2020 March. Bourouiba, Lydia. ‘Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19’. JAMA, 26 March 2020

– droplets travel further than 2 meters

2020 April. Bahl, Prateek, Doolan, de Silva, Chughtai, Bourouiba, and MacIntyre. ‘Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019?’ The Journal of Infectious Diseases, no. jiaa189 (16 April 2020)

2020 June. Morawska, Lidia, and Donald K Milton. ‘It Is Time to Address Airborne Transmission of Coronavirus Disease 2019 (COVID-19)’. Clinical Infectious Diseases, 6 July 2020, ciaa939

2020 Sept. Morawska, Lidia, Julian W. Tang, William Bahnfleth, Philomena M. Bluyssen, Atze Boerstra, Giorgio Buonanno, Junji Cao, et al. ‘How Can Airborne Transmission of COVID-19 Indoors Be Minimised?’ Env Intl 142 (1 September 2020): 105832

2020 Oct. Prather, Kimberly A, Linsey C Marr, Robert T Schooley, Melissa A McDiarmid, Mary E Wilson, and Donald K Milton. ‘Airborne Transmission of SARS-CoV-2’. Science 370, no. 6514 (16 October 2020): 303–4

2021 Jan. Samet, Jonathan M, Kimberly Prather, Georges Benjamin, Seema Lakdawala, John-Martin Lowe, Arthur Reingold, John Volckens, and Linsey Marr. ‘Airborne Transmission of SARS-CoV-2: What We Know’. Clin. Infect. Dis., 18 January 2021

2021 April. Tang, J W, Bahnfleth, Bluyssen, Buonanno, Jimenez, J Kurnitski, Y Li, et al. ‘Dismantling Myths on the Airborne Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)’. J. Hosp. Infect. 110 (April 2021): 89–96

2021 May. Morawska, Lidia, Joseph Allen, William Bahnfleth, Philomena M Bluyssen, Atze Boerstra, Giorgio Buonanno, Junji Cao, et al. ‘A Paradigm Shift to Combat Indoor Respiratory Infection’. Science 372, no. 6543 (14 May 2021): 689–91

2021 May. Greenhalgh et al.‘Ten Scientific Reasons in Support of Airborne Transmission of SARS-CoV-2’. The Lancet 397, no. 10285 (1 May 2021): 1603–5

2021 August. Wang et al. ‘Airborne Transmission of Respiratory Viruses’. Science 373, no. 6558 (27 August 2021)

2020 June. Morawska, Lidia, and Junji Cao. ‘Airborne Transmission of SARS-CoV-2: The World Should Face the Reality’. Environ. Int. 139 (June 2020): 105730

So as not to mislead you into thinking this is a recent development, I will just provide ONE reference from 1987:

1987. Sattar, Syed A., Mohammad Khalid Ijaz, and Charles P. Gerba. ‘Spread of Viral Infections by Aerosols’. Critical Reviews in Env Control 17, no. 2 (January 1987): 89–131

These people were never confused about 5um, etc. 4.5x Aerosols are dispersions in air of particles of a variety of sizes. The larger of these particles rapidly settle out, but particles of smaller size can remain suspended in air for longer periods. If the air were to be perfectly still, it would take a 100 ym diameter particle 10 sec to fall through the height of an ordinary room (about 3 m); particles with diameters of 40, 20, and 10 um would require 1, 4, and 17 min, respectively, to settle out under the same set of conditions.?? Under real conditions, the time during which aerosol particles remain suspended and the distance which they can travel from the point of their generation are greatly influenced by airflow and turbulance. Many common and natural activities in the domestic, work, or animal husbandry environments regularly result in the generation of aerosols from microbially contami- nated liquids or the resuspension in air of previously dried infectious material. For example, sneezing, coughing, and even speaking by persons carrying viruses in their mouth and respiratory tract frequently lead to the aerosolization of viruses.*$ The particles produced during sneezing and speaking (particularly when pronouncing sibi- lants) are generally larger and most of them rapidly settle out of air. Coughing, on the other hand, is known to produce more small-particle aerosols which are potentially better suited for the airborne spread of viral infections.®

Oh, re: the lab leak issue, enjoy last line.

Again, from 1987. 5.6x VI. VIRAL AEROSOLS GENERATED IN THE WORK AND HOME ENVIRONMENT The first record of a laboratory-acquired infection dates back to 1885.!! Since then, much attention has been given to the possible spread of viruses and other infectious agents to laboratory workers involved in their handling. Sulkin and Pike’** summa- rized the data from 222 reports of laboratory-acquired infections. The following types of viruses were among the infectious agents involved: eastern, western, and Venezuelan equine encephalitis; Russian spring summer encephalitis; louping ill; lymphocytic cho- riomeningitis; poliomyelitis; encephalomyocarditis; Newcastle disease; yellow fever; dengue fever; Rift Valley fever; Colorado tick fever; mumps; influenza; hepatitis; ru- bella; and agents of viral diarrhea. Analysis of the reports indicated that 30% of the infections were due to contaminated laboratory air.

And exposure to air leading to infection, and filtration slashing infection.

It’s all there, if you are open to it. 5.4x Marek’s disease Chickens Exposure to effluent air from ““donor cages’ housing 164 virus (MDV) infected animals resulted in a high incidence of MDV infection in test chicks; passage of contaminated air through certain filters partially or completely pre- vented such infection

Same article, from 1987: 5.6x E. Lymphocytic Choriomeningitis An outbreak of lymphocytic choriomeningitis (LCM) occurred in 1972 to 1973 in personnel at a medical center in Rochester, New York.’*® Epidemiological and virol- ogical studies indicated that the source of the infection were Syrian hamsters being used there for tumor research. Cell cultures derived from these animals were also found to be contaminated with the virus. The cases of human infection were shown to occur not only through direct contact with the animals, but also from mere presence in the room where the animals were being held.

6.3x … studies indicated that the source of the infection were Syrian hamsters being used there for tumor research. Cell cultures derived from these animals were also found

Addleman, Sarah, Victor Leung, Leyla Asadi, Abdu Sharkawy, and Jennifer McDonald. ‘Mitigating Airborne Transmission of SARS-CoV-2’. CMAJ, 1 January 2021

Leung, Nancy H. L. ‘Transmissibility and Transmission of Respiratory Viruses’. Nature Reviews Microbiology 19, no. 8 (August 2021): 528–45

Tang, Song, Yixin Mao, Rachael M. Jones, Qiyue Tan, John S. Ji, Na Li, Jin Shen, et al. ‘Aerosol Transmission of SARS-CoV-2? Evidence, Prevention and Control’. Environment International 144 (1 November 2020): 106039

Wilson, N. M., A. Norton, F. P. Young, and D. W. Collins. ‘Airborne Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 to Healthcare Workers: A Narrative Review’. Anaesthesia 75, no. 8 (August 2020): 1086–95

Let me be very clear. These reviews are all (mostly) written by people who work on aerosols. They are broad summaries (hence, “reviews”) of the field. Start here with your reading. You can then drill down to the actual studies if you want.

That means they aren’t public health people fooling around with an air sampler they just bought and unboxed. Not joking.

Missed this one. Top people.

2019. Tellier, Raymond, Yuguo Li, Benjamin J. Cowling, and Julian W. Tang. ‘Recognition of Aerosol Transmission of Infectious Agents: A Commentary’. BMC Infectious Diseases 19, no. 1 (31 January 2019): 101

2011. By mechanical engineers in Canada

2021. Bourouiba, Lydia. ‘Fluid Dynamics of Respiratory Infectious Diseases’. Annual Review of Biomedical Engineering 23, no. 1 (2021): 547–77

Review from 2021, also should be in the “top” pile.

Randomly found another review, discussing SARS and MERS airborne, amongst others

2020 May. Anderson, Elizabeth L., Paul Turnham, John R. Griffin, and Chester C. Clarke. ‘Consideration of the Aerosol Transmission for COVID‐19 and Public Health’. Risk Analysis 40, no. 5 (May 2020): 902–7

Another saying we should look at aerosol.

1987. Ijaz, M. Khalid et al and Sattar, Syed A.. ‘Generic Aspects of the Airborne Spread of Human Pathogens Indoors and Emerging Air Decontamination Technologies’. American Journal of Infection Control 44, no. 9 (September 2016): S109–20

Same authors as in 1980s, still writing about aerosol.

Editorial in Indoor Air, entitled “all respiratory viruses are airborne.”

Tang, Tellier and Yuguo Li are all experts.

3. Historical review papers

Jose-Luis Colorado et al

And for a more comprehensive historical overview, this article spearheaded by jljcolorado is very good, I dare say. (Full disclosure: I am a co-author.)

(pre-print, will replace with final link shortly)

Randall, Ewing, Marr, Jimenez and Bourouiba. ‘How Did We Get Here: What Are Droplets and Aerosols and How Far Do They Go? A Historical Perspective on the Transmission of Respiratory Infectious Diseases’. Interface Focus 11, no. 6 (Nov 2021)

Pepper, Ian L., and Charles P. Gerba. ‘Aeromicrobiology’. Environmental Microbiology, 2015, 89–110

But very disappointed they repeated the 5uM fiction, and the idea of droplet. So that’s a big negative. And Brankston (pic 4) is garbage.

Otherwise, the chapter is a good overview of the area.

Information Box 5.3: examples of airborne plant pathogens (and then a list of about 16 pathogens) Information Box 5.4: Examples of airborne animal pathogens. And then a list of about 17 items.

A table of aerosolized endotoxin concentrations detected downwind of biosolids operations (waste treatment facilities) Influenza virus transmission among humans can occur via four mechanisms: by direct contact with infected indi- viduals: by indirect contact with contaminated objects of fomites; by inhalation of droplets that contain the virus; or by inhalation of aerosolized virus. Interestingly. despitc 70 years of research since the influenza A virus was dis- covered, ther is sill debate about the modes of influenza transmission, specifically whether influenza is mainly transmitted via true bioaerosols, or by droplets, or by direct or indirect contact (Brankston ef al 2007).

2022. Moreno T and Gibbons W. ‘Aerosol Transmission of Human Pathogens: From Miasmata to Modern Viral Pandemics and Their Preservation Potential in the Anthropocene Record’. Geoscience Frontiers 13, no. 6 (November 2022): 101282

4. Studies detecting pathogens (e.g. viruses or their RNA) in the air


April 2020. Liu, Yuan, Zhi Ning, Yu Chen, Ming Guo, Yingle Liu, Nirmal Kumar Gali, Li Sun, et al. ‘Aerodynamic Analysis of SARS-CoV-2 in Two Wuhan Hospitals’. Nature 582, no. 7813 (April 2020): 557–60

Found SARS-CoV-2 RNA in hospital air, China

2020-04-23 Park et al

This should have been ID doctors’ wake up call that this was airborne, but no, the denial was strong in this group.

May 2020. Chia, Po Ying, Kristen Kelli Coleman, et al. ‘Detection of Air and Surface Contamination by SARS-CoV-2 in Hospital Rooms of Infected Patients’. Nature Communications 11, no. 1 (29 May 2020): 2800

Found SARS-CoV-2 RNA in hospital air in Singapore

Kotwa et al. ‘Surface and Air Contamination with SARS-CoV-2 from Hospitalized COVID-19 Patients in Toronto, Canada, March-May 2020’. J Inf Dis, 27 November 2021, jiab578

The conclusion of the following paper is a defensive “it’s safe for workers” article. They say b/c “ infrequent recovery of infectious virus suggests risk is limited” (they took 36 samples got 6 cultured not bad I bet, actually). However, they were able to sample live virus from air

2020. Santarpia et al.‘Aerosol and Surface Contamination of SARS-CoV-2 Observed in Quarantine and Isolation Care’ Sci Rep 10, no 1 (29 July 2020): 12732

One more. Santarpia, which originally reported RNA only, then amended because they cultured viable.

Razzini, Katia et al. ‘SARS-CoV-2 RNA Detection in the Air and on Surfaces in the COVID-19 Ward of a Hospital in Milan, Italy’. The Science of the Total Environment 742 (10 November 2020): 140540

SARS-CoV-2 RNA in hospital air, Italy. November 2020

November 2020. Nissen, Karolina et al. ‘Long-Distance Airborne Dispersal of SARS-CoV-2 in COVID-19 Wards’. Scientific Reports 10, no. 1 (11 November 2020): 19589

SARS-CoV-2 RNA in Swedish hospital ventilation system. Over long range

Moore et al. ‘Detection of SARS-CoV-2 within the Healthcare Environment: A Multi-Centre Study Conducted during the First Wave of the COVID-19 Outbreak in England’. J Hosp Inf 108 (1 February 2021): 189–96

These authors were mostly sampling surfaces, but they found SARS-CoV-2 RNA in air. Couldn’t culture live virus from surface samples. I guess that means no touch right? 🤡🚗

Lednicky, John A. et al. ‘Viable SARS-CoV-2 in the Air of a Hospital Room with COVID-19 Patients’. Intl J Inf Dis 100 (1 Nov 2020): 476–82

Viable SARS-CoV-2 virus from patent room in hospital in the US.

2021. Horve, Patrick F. et al. ‘Identification of SARS-CoV-2 RNA in Healthcare Heating, Ventilation, and Air Conditioning Units’. Indoor Air, 29 June 2021

SARS-CoV-2 RNA found in air vents.

2022 Jan. Man, P. de, et al. ‘Airborne SARS-CoV-2 in Home and Hospital Environments Investigated with a High-Powered Air Sampler’. J Hosp Inf 119 (1 January 2022): 126–31

Last one, high volume sampler used to find SARS-CoV-2 RNA in homes and hospitals.

2023. Gutmann et al. ‘Aerosol Measurement Identifies SARS-CoV 2 PCR Positive Adults …’. Env Res 216 (Jan 2023)

Measured SARS-CoV-2 particles out of COVID-positive and negative people. Many more out of +ve.


“in SARS-CoV-2 PCR-positive group, 15.6% (n = 10/64) … were responsible for 64.8% of all exhaled particles counts in the group. Moreover, the 15.6%, equating to 3.5% of all patients (n = 10/288), was responsible for 51.2% of all exhaled particles.”

Fortin et al ‘Detection of Viable SARS-CoV-2 in Retrospective Analysis of Aerosol Samples Collected from Hospital Rooms of Patients with COVID-19’. Clin Microb Inf (22 March 2023)

Zhang et al. Monitoring SARS-CoV-2 in air and on surfaces and estimating infection risk …. April 27, 2022

SARS-CoV-2 detected in air.

Parhizkar, Hooman, Leslie Dietz, Andreas Olsen-Martinez, Patrick F Horve, Liliana Barnatan, Dale Northcutt, and Kevin G Van Den Wymelenberg. ‘Quantifying Environmental Mitigation of Aerosol Viral Load in a Controlled Chamber With Participants Diagnosed With Coronavirus Disease 2019’. Clinical Infectious Diseases 75, no. 1 (1 July 2022): e174–84

Had people live in a little modular room and measured air.

Tested viral load as against virus in air.

Because the scientists and engineers are gettin’ things done while doctors downplay, naysay, and say “get out of our lane”


Booth, Timothy F et al. ‘Detection of Airborne Severe Acute Respiratory Syndrome (SARS) Coronavirus and Environmental Contamination in SARS Outbreak Units’. J. Infect. Dis. 191, no. 9 (1 May 2005): 1472–77

Yu, Ignatius T S, Yuguo Li, Tze Wai Wong, Wilson Tam, Andy T Chan, Joseph H W Lee, Dennis Y C Leung, and Tommy Ho. ‘Evidence of Airborne Transmission of the Severe Acute Respiratory Syndrome Virus’. N. Engl. J. Med. 350, no. 17 (22 April 2004): 1731–39

Agranovski, Igor E et al. ‘Monitoring of Viable Airborne SARS Virus in Ambient Air’. Atmospheric Environment 38, no. 23 (July 2004): 3879–84

Viable SARS-1 in air.

Christian, Michael D et al. ‘Possible SARS Coronavirus Transmission during Cardiopulmonary Resuscitation’. Emerging Infectious Diseases 10, no. 2 (February 2004): 287–93

It was in the room air, not because of an aerosol generating medical procedure, of course, but they wanted to reduce “panic” so they lied and said it was droplet+AGMP.

Li, Y., X. Huang, I. T. S. Yu, T. W. Wong, and H. Qian. ‘Role of Air Distribution in SARS Transmission during the Largest Nosocomial Outbreak in Hong Kong’. Indoor Air 15, no. 2 (April 2005): 83–95

air modelling matched the infecteds

Amoy Gardens

And everything written about Amoy Gardens, showing the spread between buildings, caused by negative pressure sucking air up the sewage stacks and then (a) into units (b) in plumes to buildings downwind…

other coronaviruses

About a chicken coronavirus (IBV)

(Not sampling, just a review article.)

“The virus spreads by both air and the fecal-oral route”

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Mohammad Khalid Ijaz. Studies of the Airborne Survival of Rotaviruses and a Human Coronavirus. U of Ottawa, School of Med

Coronaviruses - suspended in air and viable 150 hours later. [posted July 2020]

This thesis (1985) looked at effect of humidity & temp on aerosolized coronavirus. To keep the aerosol from depositing, put in drum rotating at 4 RPM. Not that fast.Cultured live virus up to 150 hours later Just an example. Very artificial conditions. Just shows can last in the air.

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Azhar, Esam I et al. ‘Detection of the Middle East Respiratory Syndrome Coronavirus Genome in an Air Sample Originating from a Camel Barn Owned by an Infected Patient’. MBio, 22 July 2014

MERS, detected in air. They could not culture viable virus.

Memish, Ziad A., Abdullah M. Assiri, and Jaffar A. Al-Tawfiq. ‘Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Viral Shedding in the Respiratory Tract: An Observational Analysis with Infection Control Implications’. International Journal of Infectious Diseases 29 (December 2014): 307–8

MERS in respiratory secretions. Not in the air, but where do you think this implies it might also be, eh?

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Kim, Sung-Han et al. ‘Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards’. Clin Inf Dise 63, no. 3 (1 August 2016): 363–69

Detour! Viable MERS virus in hospital air. 2016. Ya, they cultured it, you nay-saying ID doctor angling for a hospital promotion, you

Corman, Victor M., Ali M. Albarrak, Ali Senosi Omrani, Mohammed M. Albarrak, Mohamed Elamin Farah, Malak Almasri, Doreen Muth, et al. ‘Viral Shedding and Antibody Response in 37 Patients With Middle East Respiratory Syndrome Coronavirus Infection’. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 62, no. 4 (15 February 2016): 477–83

MERS in respiratory secretions #2

“As in SARS, MERS-CoV nosocomial transmission was repeatedly ascribed to the potential of some patients to act as super-shedders or super-spreaders [6, 20]. Our analysis of viral loads, particularly in the early acute phase of disease, supports the existence of a limited number of patients with extraordinarily high viral loads. As these patients were not more likely to die of the infection, they might not have had more severe symptoms, and thus might have been able to engage in social contact despite their disease.”

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Azhar et al. ‘Detection of the Middle East Respiratory Syndrome Coronavirus Genome in an Air Sample Originating from a Camel Barn Owned by an Infected Patient’. mBio, 22 July 2014

MERS RNA in an air sample from a barn.

Fellow had camels. Camels caught MERS. He caught MERS from camels.

MERS was found in the air.

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Filovirus (Ebola)

Mekibib, Berhanu, and Kevin K Ariën. ‘Aerosol Transmission of Filoviruses’. Viruses 8, no. 5 (23 May 2016)

This review article dealt with that question. Authors noted:

“At the very least, the potential exists for aerosol transmission, given that virus is detected in bodily secretions, the pulmonary alveolar interstitial cells, and within lung spaces.”

Ponce De Leon-Rosales, et al. ‘Ebola, Through Air or Not Through Air: That Is the Question’. Frontiers in Public Health 2 (19 January 2015): 292

Possible that the dose is very low and transmission by air might be possible even if droplet precautions are used.

“If we consider that the infectious dose may be very low – at only 10 virus particles (3) – and that an airborne particle may contain thousands of Ebola virions, thus an exposure carried by air can be risky.”


2008 Gloster - foot-and-mouth … (talking about recovering viable aerosolized virus (viable) from pigs)

2008 Verreault - methods for sampling

Christensen et al. “Detection of foot-and-mouth disease virus in the breath of infected cattle using a hand-held device to collect aerosols”

Animal studies are very useful because you can experimentally infect them. Here, they measured actual virus in cow breath.

““The estimated total release of airborne FMDV in 24 h from cattle is in the range of 10^4–10^5 TCID50 per 24 h depending on virus strains (Sellers and Parker, 1969; Donaldson et al., 1970; Alexandersen et al., 2002). Virus are shed in this way at a concentration of 1.0–1.5 log10 TCID50 per mL of exhaled air”


Pettersson, Lisa ‘Hantavirus RNA in Saliva from Patients with Hemorrhagic Fever with Renal Syndrome’. Emerging Infectious Diseases 14, no. 3 (March 2008): 406–11.

Which other do you want me to do? For fun, hantavirus in saliva. You know what that probably means …


2009 Fabian et al (Milton) - An optimized method to … (detected viable flu from air)

Blachere, Francoise M, et al. ‘Measurement of Airborne Influenza Virus in a Hospital Emergency Department’. Clin. Infect. Dis. 48, no. 4 (15 February 2009): 438–40

Airborne influenza A detected in the air in emergency rooms (Blachere et al., 2009).

Lindsley, William G. et al. ‘Viable Influenza A Virus in Airborne Particles from Human Coughs’. Journal of Occupational and Environmental Hygiene 12, no. 2 (2015): 107–13

Influenza and viable virus again.

Lindsley, William G. et al. ‘Viable Influenza A Virus in Airborne Particles Expelled during Coughs versus Exhalations’. Influenza and Other Respiratory Viruses 10, no. 5 (September 2016): 404–13

Influenza and viable virus.

Leung, Nancy H. L., Jie Zhou, Daniel K. W. Chu, Han Yu, William G. Lindsley, Donald H. Beezhold, Hui-Ling Yen, et al. ‘Quantification of Influenza Virus RNA in Aerosols in Patient Rooms’. PloS One 11, no. 2 (2016): e0148669

Airborne influenza A detected in the air in patient rooms (Leung et al., 2016).

Traxler, Selina et al ‘VOC Breath Profile in Spontaneously Breathing Awake Swine during Influenza A Infection’. Scientific Reports 8, no. 1 (5 October 2018): 14857

Bui, Vuong N et al. ‘Bioaerosol Sampling to Detect Avian Influenza Virus in Hanoi’s Largest Live Poultry Market’. Clinical Infectious Diseases 68, no. 6 (5 March 2019): 972–75

“The association between positive sample types (over time and position) was strong, with 91.7% of positive OP pooled swab samples confirmed by positive aerosol samples and 81% of influenza A positive aerosol samples confirmed by positive OP swab samples.”

Dubuis, Marie-Eve et al. ‘High and Low Flowrate Sampling of Airborne Influenza in Hospital Rooms during Three Outbreaks’. Journal of Aerosol Science 158 (1 November 2021): 10582

2018. Yan, Jing ‘Infectious Virus in Exhaled Breath of Symptomatic Seasonal Influenza Cases from a College Community’. Proceedings of the National Academy of Sciences 115, no. 5 (30 January 2018): 1081–86

Influenza. Found viable virus in air.

1962. Nature

Flu in the air. There are probably hundreds of articles over the 20th century about air spread. There’s not a single one for droplet by the way.

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La Rosa et al. Viral infections acquired indoors through airborne, droplet or contact transmission

This article refers to multiple viruses sampled out of the air. There are some refs in this article about sampling flu out of the air and flu RNA, etc.

... In clinical studies, virus-laden particles within the respirable aerosol fraction have been detected in exhaled breaths of patients with influenza and in the air samples from healthcare settings during seasonal peak [9]. Moreover, the scientific literature presents evidence in support of a contribution of aerosol transmission to the spread of influenza A, including the prolonged persistence of infectious aerosolized influenza virus at low humidity; the transmission of influenza by aerosols, reproducing the full spectrum of disease, at doses much smaller than those required by intranasal drop inoculation (large droplet transmission); and the interruption of transmission of in- fluenza by blocking the aerosol route through UV irradia- tion of upper room air [9-12]. A paper by Brankston and

quences for hospitalized patients [14-16]. Using real-time polymerase chain reaction, Blachere and coworkers mea- sured the amount and size of airborne particles containing influenza virus in an emergency department. The authors confirmed the presence of airborne influenza virus, and found over 50% of detectable influenza virus particles to be within the respirable aerosol fraction [10]. Lindsley and

be within the respirable aerosol fraction [10]. Lindsley and colleagues detected small airborne particles containing in- fluenza RNA in a health care facility during influenza sea- son. They also found a correlation between the number of influenza-positive samples and the number and location of patients with influenza [17]. As for contact transmis-

Probably aint yer hands, you dirty monster bros

influenza season [ 18, 19]. Viruses can be transferred from surfaces to hands, and vice versa. The importance of this mode of transmission for influenza is unclear however, since, while the virus can survive on surfaces for hours or even days, it cannot survive on hands for longer than five minutes [20]. A recent study concluded that influenza A transmission via fomites is possible but unlikely to occur [19]. The overall burden of health care facility-acquired in-

Thread about this article (from 2013) is here, listing many viruses found in the air over the years, including coronaviruses, influenza, adenovirus, etc.


Bonifait et al. ‘Detection and Quantification of Airborne Norovirus during Outbreaks in Healthcare Facilities’. Clin Inf Dis: 61, no. 3 (1 August 2015): 299–304


Sawyer, M. H., C. J. Chamberlin, Y. N. Wu, N. Aintablian, and M. R. Wallace. ‘Detection of Varicella-Zoster Virus DNA in Air Samples from Hospital Rooms’. The Journal of Infectious Diseases 169, no. 1 (January 1994): 91–94

“VZV was detected 1.2-5.5 m from patients’ beds and for 1-6 days following onset of rash. On some occasions, VZV DNA could be detected outside the hospital isolation rooms housing patients.”

Brankston, a very anti-airborne article, admitted airborne chickenpox had been proven, citing Sawyer and saying:

“If influenza could be transmitted over long distances via the airborne route, then we would have expected to review studies citing evidence similar to that reported for the varicella zoster virus and Mycobacterium tuberculosis, both of which undergo known airborne transmission.” [then citing Sawyer, above, for varicella DNA being found in the air 1.2-5.5m from beds up to 24 h later]

Brankston also said

“Two epidemiological studies of varicella transmission were supplemented by airflow studies that showed directional airflow consistent with the spread of the illness.50,51”

and cited these two other famous chickenpox articles: [50] Gustafson et al An outbreak of airborne nosocomial varicella. Pediatrics 1982; 70: 550–56. 51 [51] Leclair et al Airborne transmission of chickenpox in a hospital. N Engl J Med 1980; 302: 450–53.

[50] Gustafson described the following

Index remained in isolation in room. 8 of 70 caught it, and seems like on a quick skim all 8 were there one afternoon.

Hmm, hit rate far less than some case descriptions of COVID-19.

One wonders if people are reading these old case descriptions or not.

[51] Leclair was a report of a chickenpox patient on a ward who infected 15 others

The introduction says chickenpox precautions are airborne, but “airborne spread has never been unequivocally demonstrated” and “Moreover, the low secondary attack rate after exposure to chicken pox in nonresidential settings suggests that airborne spread is less important than …contact.”

“We describe an epidemic of chickenpox occurring in a hospital in which airflow studies [prove] airborne.”

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The biggest attack rate was in room G, 9/10 people caught it - the HVAC was broken in that room.

Room C was under strict gown and gloves precautions and patient still caught it.

Because chickenpox, like most viruses, predominantly transmits by air.

The rash is a red herring re touch. If throughout your body it’s in your blood and systemic. Also in saliva.

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Dinkele et al ‘Aerosolization of Mycobacterium Tuberculosis by Tidal Breathing’. American Journal of Respiratory and Critical Care Medicine 206, no. 2 (15 July 2022): 206–16

Tidal breathing spreads TB bacteria. And while coughs produce more TB per cough, their infrequency means tidal breathing contributes more to exhalation than cough.

Dharmadhikari et al. ‘Surgical Face Masks Worn by Patients with Multidrug-Resistant Tuberculosis: Impact on Infectivity of Air on a Hospital Ward’. American Journal of Respiratory and Critical Care Medicine 185, no. 10 (15 May 2012): 1104–9

Patients wearing surgical masks lowered spread

“Methods: Over 3 months, 17 patients with pulmonary MDR-TB occupied an MDR-TB ward in South Africa and wore face masks on alternate days. Ward air was exhausted to two identical chambers, each housing 90 pathogen-free guinea pigs that breathed ward air either when patients wore surgical face masks (intervention group) or when patients did not wear masks (control group). Efficacy was based on differences in guinea pig infections in each chamber….”


“… Results: Sixty-nine of 90 control guinea pigs (76.6%; 95% confidence interval [CI], 68–85%) became infected, compared with 36 of 90 intervention guinea pigs (40%; 95% CI, 31–51%), representing a 56% (95% CI, 33–70.5%) decreased risk of TB transmission when patients used masks. Conclusions: Surgical face masks on patients with MDR-TB significantly reduced transmission and offer an adjunct measure for reducing TB transmission from infectious patients.”

Menzies, Dick, Neill Adhikari, Marie Arietta, and Vivian Loo. ‘Efficacy of Environmental Measures in Reducing Potentially Infectious Bioaerosols During Sputum Induction’. Infection Control & Hospital Epidemiology 24, no. 7 (July 2003): 483–89

TB in air rapidly climbed when you induced sputum. Overwhelmed ventilation.

Detected TB by plates, so cultured for all the fantastic, absolutely miserable skeptic ID/IPAC out there.

Riley, R L, C C Mills, F O’Grady, L U Sultan, F Wittstadt, and D N Shivpuri. ‘Infectiousness of Air from a Tuberculosis Ward. Ultraviolet Irradiation of Infected Air: Comparative Infectiousness of Different Patients’. The American Review of Respiratory Disease 85 (April 1962): 511–25

The famous study that showed TB was in air. Patients’ rooms connected to guinea pigs by vents. Guinea pigs would get infected over time.

Kantor et al. ‘Nosocomial Transmission of Tuberculosis from Unsuspected Disease’. The American Journal of Medicine 84, no. 5 (May 1988): 833–38

Not about detecting it in air, but here 9 of 56 people working in a hospital caught TB from a patient who hadn’t been diagnosed with it. He seemed to infect 5 during his time on the ward before he died.

His bacteria riddled lungs infected the next 4, in the autopsy room, when they were compressed during the post-mortem

Escombe, A. Roderick, Clarissa Oeser, Robert H. Gilman, Marcos Navincopa, Eduardo Ticona, Carlos Martínez, Luz Caviedes, et al. ‘The Detection of Airborne Transmission of Tuberculosis from HIV-Infected Patients, Using an in Vivo Air Sampling Model’. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 44, no. 10 (15 May 2007): 1349–57

Transmission TB through the air from people with HIV. HIV infects the lungs too.


2010. Bacteria in air of turkey plant

2011. More pathogens in the air of a turkey plant. Authors cultured some. 2011

2011. Review article about airborne pathogens emitted from sewage treatment plants

Francisella tularensis

Quantification of the Relationship between Bacterial Kinetics and Host Response for Monkeys Exposed to Aerosolized Francisella tularensis

“Francisella tularensis can be disseminated via aerosols, and once inhaled, only a few microorganisms may result in tularemia pneumonia.”

(This is really a quantification paper. I need a quantification thread.)

Huang and Haas @ProfCharlesHaas.


1938. Strep in air

[originally posted Jan 13, 2021]

“… the fact that 22 patients..actively inspiring strep-laden air @ 13.7 cubic ft/hour… & adding to air infection by coughing & sneezing … it does not need much stretch of imagination to accept view that infection by particles in the air is no chimera.”

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Strep is a bacteria - bigger than virus. Covs are ~0.120uM. Strep is 0.5 to 2.0uM say. More than ten times bigger. Should be even more prone to “fall quickly to the ground” to people who said that.

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5. Other topics


There isnt a single study proving droplet


There is little support for fomites

A bunch of fomite articles just to see how they described fomite spread. Turns out, pretty weakly. See

Review articles about coronaviruses

A thread with review articles about coronaviruses. They are a great place to learn all that we already knew about coronaviruses before this pandemic started. You know, from our 50 years of dealing with them. Tl;dr: most of what people “discovered” about CoVs, we already knew. Including kids, not sterilizing, persistence, in brain, etc.