Multiscale Airborne Infectious Disease Transmission

Airborne disease transmission is central to many scientific disciplines, including agriculture, veterinary biosafety, medicine, and public health. Legal and regulatory standards are in place to prevent agricultural, nosocomial, and community airborne disease transmission. However, the overall importance of the airborne pathway is underappreciated; e.g., the U.S. National Library of Medicine's Medical Subjects Headings (MESH) thesaurus lacks an airborne disease transmission indexing term. This has practical consequences, as airborne precautions to control epidemic disease spread may not be taken when airborne transmission is important but unrecognized. Publishing clearer practical methodological guidelines for surveillance studies and disease outbreak evaluations could help address this situation. To inform future work, this paper highlights selected, well-established airborne transmission events, largely cases replicated in multiple, independently conducted scientific studies. Methodologies include field experiments, modeling, epidemiology studies, disease outbreak investigations, and mitigation studies. Collectively, this literature demonstrates that airborne viruses, bacteria, and fungal pathogens have the ability to cause disease in plants, animals, and humans over multiple distances, from near range (<5 m) to continental (>500 km) in scale. The plausibility and implications of undetected airborne disease transmission are discussed, including the notable under-reporting of disease burdens for several airborne-transmitted diseases.

Automated summary

Airborne disease transmission is crucial to various scientific fields, but its overall importance is often underestimated, leading to a lack of indexing terms and under-reporting of disease burdens. Studies show that pathogens in the air can cause disease across different distances, but the plausibility and implications of undetected airborne disease transmission are significant.