Editors Choice: Transocular Entry of Seasonal Influenza–Attenuated Virus Aerosols and the Efficacy of N95 Respirators Surgical Masks and Eye Protection in Humans

摘要

>Background. The efficacy of barrier precautions to prevent influenza transmission is unknown.>Methods. Twenty-eight participants were exposed to monodispersed live attenuated influenza vaccine (LAIV) particles (4.9 μm) in 6 groups: group 1, no precautions; group 2, ocular exposure only; group 3, surgical mask without eye protection; group 4, surgical mask with eye protection; group 5, fit-tested N95 respirator without eye protection; and group 6, fit-tested N95 respirator with eye protection. Influenza was detected by reverse-transcription polymerase chain reaction (RT-PCR) and culture in nasal washes. Exact 95% confidence intervals (CIs) were calculated.>Results. Influenza was detected in 4 of 4 participants in group 1 (95% CI, 0–.60), 3 of 4 in group 2 (95% CI, .006–.806]), 5 of 5 in group 3 (95% CI, 0–.522), 5 of 5 in group 4, (95% CI, 0–.522), 3 of 5 in group 5 (95% CI, .053–.853), and 1 of 5 in group 6 (95% CI, .05–.72). RT-PCR revealed significant differences between group 1 and all other groups except group 3.>Conclusions. Transocular transmission of LAIV occured in most participants suggesting the necessity of eye protection. An N95 respirator provided the best guard further enhanced by eye protection.