Epidemic Meningococcal Disease in an Elementary-School Classroom

Appraisal of recommended respiratory infection control practices in primary care and emergency department settings

“…Patient separation was reported more commonly in ED than PC settings, which may reflect differences in physical layout and capacity of the facilities. However, although evidence suggests that spatial separation can reduce the spread of droplet-transmissible infections, 23 implementation in a crowded waiting room is challenging 24 and in most settings requires significant planning and financial resources to identify appropriate additional space.…”

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings

“…Respiratory droplets are generated when an infected person coughs, sneezes, or talks 91,92 or during such procedures as suctioning, endotracheal intubation, [93][94][95][96] cough induction by chest physiotherapy, 97 and cardiopulmonary resuscitation. 98,99 Evidence for droplet transmission comes from epidemiologic studies of disease outbreaks, [100][101][102][103] from experimental studies, 104 and from information on aerosol dynamics. 91,105 Studies have shown that the nasal mucosa, conjunctivae, and, less frequently, the mouth are susceptible portals of entry for respiratory viruses.…”

Modality of human expired aerosol size distributions

“…This was based on an assumption that infection would require exposure to droplet transmission in which pathogen laden respiratory droplets are deposited directly on mucosal surfaces of the respiratory tract. Although a maximum distance for droplet transmission cannot readily be defined, a safe distance of 1 m was often assumed, based on simulations with specific organisms and epidemiological studies (Dick et al, 1987;Feigin et al, 1982). But even droplets as large as 30 mm can remain suspended in the air for extended periods (Cole & Cook, 1998), and airborne transmission has been unambiguously documented for Varicella (Leclair et al, 1980;Sawyer et al, 1994) and Measles (Chen et al, 1989;Ehresmann et al, 1995).…”