Emission Patterns of Respiratory Pathogens

Study Overview
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Brief Summary
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Airborne transmission represents one of the most rapidly spreading and dangerous dissemination mechanisms for pathogens. Public health strategies to prevent and control the often explosive outbreaks associated with such pathogens are: 1) vaccination and treatment, if available, 2) isolation and barrier precautions such as face masks, and 3) decontamination of the exposed areas and surfaces. A lack of understanding how these pathogens are transmitted hampers the ability to develop effective prevention measures. This study will be used to collect preliminary data of the emission patterns of respiratory pathogens.

Detailed Description
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Airborne transmission represents one of the most rapidly spreading and dangerous dissemination mechanisms for pathogens. The study team have been investigating bacterial and viral transmission routes and barrier precautions. In a recent clinical study, it was observed that Measles virus RNA was detected from a patient for at least up to 10 feet. In addition, the group has been studying barrier precautions (facemasks) for their ability to prevent the spread of aerosolized viruses. Finally, in a controlled lab setting the investigators have assessed the impact of environmental conditions (temperature, humidity) on pathogen transmission and the effect of UV-C light to prevent the spread of influenza. The purpose of this observational study is to describe the human aerosolization patterns of respiratory pathogens. The study team hypothesizes that the emission patterns of specific airborne pathogens varies between individual patients.

Official Title
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Emission Patterns of Respiratory Pathogens

Conditions
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Pathogen Transmission

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients >18 years of age admitted to the ED or an inpatient care unit of Wake Forest Baptist Medical Center (WFBMC) Positive Exclusion Criteria: positive respiratory pathogen tests

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Respiratory syncytial virus (RSV)<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify RSV. | |
| Enteroviruses<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify enterovirus. | |
| Adenoviruses<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify adenovirus. | |
| Coronaviruses<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify coronavirus. | |
| Metapneumoviruses<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify metapneumovirus. | |
| Chlamydia pneumoniae<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify chlamydia pneumoniae. | |
| Mycoplasma<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify mycoplasma. | |
| Parainfluenza<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify parainfluenza. | |
| Neisseria meningitides<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify neisseria meningitides. | |
| Bordetella pertussis<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify bordetella pertussis. | |
| Rhinovirus<br>Patients seen at the Emergency Department or admitted to the hospital with respiratory symptoms and diagnosed with a respiratory pathogen. A nasopharyngeal swab will be obtained to identify rhinovirus. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| particle size distribution patterns: ICU | This outcome measure will determine the particle size distribution patterns of the pathogen in the intensive care unit (ICU). | throughout study completion, up to 7 days | 
| particle size distribution patterns: non-ICU setting | This outcome measure will determine the particle size distribution patterns of the pathogen in the non-intensive care unit (ICU). | throughout study completion, up to 7 days | 
| quantities of the pathogen: ICU | This outcome measure will determine the quantities of the pathogen in the intensive care unit (ICU). | throughout study completion, up to 7 days | 
| quantities of the pathogen: non-ICU setting | This outcome measure will determine the quantities of the pathogen in the non-intensive care unit (ICU). | throughout study completion, up to 7 days | 
| spatial model: ICU | This outcome measure will establish a spatial model (1 foot vs. 3- feet vs. 8-10 feet) of airborne pathogen dispersal in the ICU. | throughout study completion, up to 7 days | 
| spatial model: non-ICU setting | This outcome measure will establish a spatial model (1 foot vs. 3- feet vs. 8-10 feet) of airborne pathogen dispersal in a non-ICU setting. | throughout study completion, up to 7 days | 
| correlation between the human aerosolization patterns and the severity of illness | This outcome measure is to determine the correlation between the human aerosolization patterns and the severity of illness (fever, respiratory symptoms, malaise) in individual participants. | throughout study completion, up to 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Emission Patterns, Respiratory, Aerosolization, Airborne