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Influenza Infection Risk and Predominate Exposure Route: Uncertainty Analysis

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  • Rachael M. Jones
  • Elodie Adida

Abstract

An effective nonpharmaceutical intervention for influenza interrupts an exposure route that contributes significantly to infection risk. Herein, we use uncertainty analysis (point‐interval method) and Monte Carlo simulation to explore the magnitude of infection risk and predominant route of exposure. We utilized a previously published mathematical model of a susceptible person attending a bed‐ridden infectious person. Infection risk is sensitive to the magnitude of virus emission and contact rates. The contribution of droplet spray exposure to infection risk increases with cough frequency, and decreases with virus concentration in cough particles. We consider two infectivity scenarios: greater infectivity of virus deposited in the upper respiratory tract than virus inhaled in respirable aerosols, based on human studies; and equal infectivity in the two locations, based on studies in guinea pigs. Given that virus have equal probability of infection throughout the respiratory tract, the mean overall infection risk is 9.8 × 10−2 (95th percentile 0.78). However, when virus in the upper respiratory tract is less infectious than inhaled virus, the overall infection risk is several orders of magnitude lower. In this event, inhalation is a significant exposure route. Contact transmission is important in both infectivity scenarios. The presence of virus in only respirable particles increases the mean overall infection risk by 1–3 orders of magnitude, with inhalation contributing ≥99% of the infection risk. The analysis indicates that reduction of uncertainties in the concentration of virus in expiratory particles of different sizes, expiratory event frequency, and infectivity at different sites in the respiratory tract will clarify the predominate exposure routes for influenza.

Suggested Citation

  • Rachael M. Jones & Elodie Adida, 2011. "Influenza Infection Risk and Predominate Exposure Route: Uncertainty Analysis," Risk Analysis, John Wiley & Sons, vol. 31(10), pages 1622-1631, October.
  • Handle: RePEc:wly:riskan:v:31:y:2011:i:10:p:1622-1631
    DOI: 10.1111/j.1539-6924.2011.01600.x
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    References listed on IDEAS

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    1. Jianping Xue & Valerie G. Zartarian & Halûk Özkaynak & Winston Dang & Graham Glen & Luther Smith & Casson Stallings, 2006. "A Probabilistic Arsenic Exposure Assessment for Children Who Contact Chromated Copper Arsenate (CCA)‐Treated Playsets and Decks, Part 2: Sensitivity and Uncertainty Analyses," Risk Analysis, John Wiley & Sons, vol. 26(2), pages 533-541, April.
    2. Mark Nicas & Rachael M. Jones, 2009. "Relative Contributions of Four Exposure Pathways to Influenza Infection Risk," Risk Analysis, John Wiley & Sons, vol. 29(9), pages 1292-1303, September.
    3. Kyoko Shinya & Masahito Ebina & Shinya Yamada & Masao Ono & Noriyuki Kasai & Yoshihiro Kawaoka, 2006. "Influenza virus receptors in the human airway," Nature, Nature, vol. 440(7083), pages 435-436, March.
    4. Mark Nicas & Gang Sun, 2006. "An Integrated Model of Infection Risk in a Health‐Care Environment," Risk Analysis, John Wiley & Sons, vol. 26(4), pages 1085-1096, August.
    5. Timothy R. Julian & Robert A. Canales & James O. Leckie & Alexandria B. Boehm, 2009. "A Model of Exposure to Rotavirus from Nondietary Ingestion Iterated by Simulated Intermittent Contacts," Risk Analysis, John Wiley & Sons, vol. 29(5), pages 617-632, May.
    6. Lawrence M. Wein & Michael P. Atkinson, 2009. "Assessing Infection Control Measures for Pandemic Influenza," Risk Analysis, John Wiley & Sons, vol. 29(7), pages 949-962, July.
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    1. Siming You & Man Pun Wan, 2015. "A Risk Assessment Scheme of Infection Transmission Indoors Incorporating the Impact of Resuspension," Risk Analysis, John Wiley & Sons, vol. 35(8), pages 1488-1502, August.
    2. Edward M. Fisher & John D. Noti & William G. Lindsley & Francoise M. Blachere & Ronald E. Shaffer, 2014. "Validation and Application of Models to Predict Facemask Influenza Contamination in Healthcare Settings," Risk Analysis, John Wiley & Sons, vol. 34(8), pages 1423-1434, August.
    3. Christos Nicolaides & Demetris Avraam & Luis Cueto‐Felgueroso & Marta C. González & Ruben Juanes, 2020. "Hand‐Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network," Risk Analysis, John Wiley & Sons, vol. 40(4), pages 723-740, April.
    4. Rachael M. Jones & Elodie Adida, 2013. "Selecting Nonpharmaceutical Interventions for Influenza," Risk Analysis, John Wiley & Sons, vol. 33(8), pages 1473-1488, August.
    5. Rachael M. Jones & Yulin Xia, 2018. "Annual Burden of Occupationally‐Acquired Influenza Infections in Hospitals and Emergency Departments in the United States," Risk Analysis, John Wiley & Sons, vol. 38(3), pages 442-453, March.

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