Influenza and other respiratory viruses · 2025
Impact of Ventilation on Respiratory Virus Transmission in College Residence Hall Cohorts: Potential for Causal Inference About Mode of Transmission.
СтатьяПоддержка NIH: внешняя программаПоддержка службы здравоохранения СШАПоддержка правительства СШАНазвание и аннотация: Перевод в очереди
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Gold T Louis, McPhaul Kathleen M, Lin Huang, Doughty Ryan, Berry Irina Maljkovic, Hong Filbert, Lai Jianyu, Treangen Todd J, Srebric Jelena, Milton Donald K
Аннотация
BACKGROUND: The SARS-CoV-2 pandemic focused attention on airborne-inhalation transmission and building ventilation. However, investment in solutions lags because few epidemiologic studies demonstrate a causal effect of ventilation on acute respiratory infection (ARI) transmission. This highlights a need for improved study designs to support causal inference.
METHODS: To investigate the potential for causal inference, we analyzed prospective cohorts residing in a high-ventilation (HVent, ≥ 5 L/s per person) or a neighboring low-ventilation (LVent, < 5 L/s per person) college residence hall during two spring semesters (2018 and 2019). Swab samples, analyzed using a PCR panel for respiratory pathogens, were collected based on self-reported symptoms and contacts. Our analysis focused on roommate pairs where both had been tested within a 2-week period. Roommate pairs with concordant positive PCR results were categorized as possible transmission events. We used genetic sequencing and phylogenetic analysis to identify probable transmission clusters and events.
RESULTS: We analyzed data from 368 cohort participants (82 HVent and 286 LVent), including 60 person-infections, with a trend toward 54% lower ARI risk among students living in HVent versus LVent residence halls. We identified 97 roommate pairs, 64 two-week intervals where both members were tested, 36 (2 HVent and 34 LVent) intervals with ≥ 1 infection, and four possible transmission events (all LVent). Sequence data available for two of the four events confirmed one probable transmission cluster and one probable transmission event.
CONCLUSIONS: Future college dorm transmission studies should prioritize enrolling roommates rather than individuals, measuring ventilation, and confirming transmission events through whole genome sequencing.
METHODS: To investigate the potential for causal inference, we analyzed prospective cohorts residing in a high-ventilation (HVent, ≥ 5 L/s per person) or a neighboring low-ventilation (LVent, < 5 L/s per person) college residence hall during two spring semesters (2018 and 2019). Swab samples, analyzed using a PCR panel for respiratory pathogens, were collected based on self-reported symptoms and contacts. Our analysis focused on roommate pairs where both had been tested within a 2-week period. Roommate pairs with concordant positive PCR results were categorized as possible transmission events. We used genetic sequencing and phylogenetic analysis to identify probable transmission clusters and events.
RESULTS: We analyzed data from 368 cohort participants (82 HVent and 286 LVent), including 60 person-infections, with a trend toward 54% lower ARI risk among students living in HVent versus LVent residence halls. We identified 97 roommate pairs, 64 two-week intervals where both members were tested, 36 (2 HVent and 34 LVent) intervals with ≥ 1 infection, and four possible transmission events (all LVent). Sequence data available for two of the four events confirmed one probable transmission cluster and one probable transmission event.
CONCLUSIONS: Future college dorm transmission studies should prioritize enrolling roommates rather than individuals, measuring ventilation, and confirming transmission events through whole genome sequencing.