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Influenza Other Respir Viruses
2013[Sep]; 7 Suppl 2
(Suppl 2
): 42-51
PMID24034483
show ga
Remarkably little is known definitively about the modes of influenza
transmission. Thus, important health policy and infection control issues remain
unresolved. These shortcomings have been exposed in national and international
pandemic preparedness activities over recent years. Indeed, WHO, CDC, ECDC and
the U.S. Institute of Medicine have prioritised understanding the modes of
influenza transmission as a critical need for pandemic planning. Studying
influenza transmission is difficult; seasonality, unpredictable attack rates,
role of environmental parameters such as temperature and humidity, numbers of
participants required and confounding variables all present considerable
obstacles to the execution of definitive studies. A range of investigations
performed to date have failed to provide definitive answers and key questions
remain. Reasons for this include the fact that many studies have not sought to
investigate routes of transmission as a primary objective (instead, they have
evaluated specific interventions) and that fieldwork in natural settings,
specifically assessing the dynamics and determinants of transmission between
humans, has been limited. The available evidence suggests that all routes of
transmission (droplet, aerosol and contact) have a role to play; their relative
significance will depend on the set of circumstances acting at a given time.
Dictating the process are factors related to the virus itself, the host and the
environment.
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