Minimal transmission in an influenza A (H3N2) human challenge-transmission model within a controlled exposure environment

Nguyen-Van-Tam, Jonathan S.; Killingley, Ben; Enstone, Joanne; Hewitt, Michael; Pantelic, Jovan; Grantham, Michael L.; Bueno de Mesquita, P. Jacob; Lambkin-Williams, Robert; Gilbert, Anthony; Mann, Alexander; Forni, John; Noakes, Catherine J.; Levine, Min Z.; Berman, LaShondra; Lindstrom, Stephen; Cauchemez, Simon; Bischoff, Werner; Tellier, Raymond; Milton, Donald K.; for the EMIT Consortium

Abstract

Uncertainty about the importance of influenza transmission by airborne droplet nuclei generates controversy for infection control. Human challenge-transmission studies have been supported as the most promising approach to fill this knowledge gap. Healthy, seronegative volunteer ‘Donors’ (n = 52) were randomly selected for intranasal challenge with influenza A/Wisconsin/67/2005 (H3N2). ‘Recipients’ randomized to Intervention (IR, n = 40) or Control (CR, n = 35) groups were exposed to Donors for four days. IRs wore face shields and hand sanitized frequently to limit large droplet and contact transmission. One transmitted infection was confirmed by serology in a CR, yielding a secondary attack rate of 2.9% among CR, 0% in IR (p = 0.47 for group difference), and 1.3% overall, significantly less than 16% (p [less than] 0.001) expected based on a proof-of-concept study secondary attack rate and considering that there were twice as many Donors and days of exposure. The main difference between these studies was mechanical building ventilation in the follow-on study, suggesting a possible role for aerosols.

Citation

Nguyen-Van-Tam, J. S., Killingley, B., Enstone, J., Hewitt, M., Pantelic, J., Grantham, M. L., …for the EMIT Consortium. (2020). Minimal transmission in an influenza A (H3N2) human challenge-transmission model within a controlled exposure environment. PLoS Pathogens, 16(7), Article e1008704. https://doi.org/10.1371/journal.ppat.1008704

• Journal Article Type: Article
• Acceptance Date: Jul 9, 2020
• Online Publication Date: Jul 13, 2020
• Publication Date: Jul 13, 2020
• Deposit Date: Jul 18, 2020
• Publicly Available Date: Jul 31, 2020
• Journal: PLOS Pathogens
• Print ISSN: 1553-7366
• Electronic ISSN: 1553-7374
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 16
• Issue: 7
• Article Number: e1008704
• DOI: https://doi.org/10.1371/journal.ppat.1008704
• Keywords: Immunology; Genetics; Molecular Biology; Microbiology; Parasitology; Virology
• Public URL: https://nottingham-repository.worktribe.com/output/4772628
• Publisher URL: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1008704