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Is cough really necessary for TB transmission?

Cough has long been implicated in the production of infectious aerosol leading to transmission of tuberculosis (TB). However, prevalence studies frequently identify radiographic evidence of TB in subclinical individuals in the absence of reported coughing. Elucidating the role of cough in transmissi...

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Detalles Bibliográficos
Autores principales: Patterson, Benjamin, Wood, Robin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Churchill Livingstone 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688829/
https://www.ncbi.nlm.nih.gov/pubmed/31378265
http://dx.doi.org/10.1016/j.tube.2019.05.003
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author Patterson, Benjamin
Wood, Robin
author_facet Patterson, Benjamin
Wood, Robin
author_sort Patterson, Benjamin
collection PubMed
description Cough has long been implicated in the production of infectious aerosol leading to transmission of tuberculosis (TB). However, prevalence studies frequently identify radiographic evidence of TB in subclinical individuals in the absence of reported coughing. Elucidating the role of cough in transmission depends on understanding the physical process of aerosolizing and expelling mycobacterium tuberculosis (Mtb) bacilli. In the last decade, human aerosol studies have progressed with improved precision of particle detection and greater sophistication of experimental protocols. Combining principles of respiratory physiology, the site and mechanism of aerosolization of respiratory lining fluids during phases of the respiratory cycle has been investigated in detail. Additionally, recent success in the direct detection of naturally generated Mtb aerosols has allowed more detailed characterization in terms of their rate of production and size distribution. We propose that TB transmission depends on the coincidence of the site of aerosol generation with the presence of Mtb bacilli. This review will examine the evidence for site of aerosol production during cough and respiratory activities in conjunction with the characteristics of detectable Mtb aerosols and locations of tuberculosis infection. Furthermore, we propose respiratory activities that are likely to optimise aerosol sampling for investigation of transmission.
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spelling pubmed-66888292019-08-14 Is cough really necessary for TB transmission? Patterson, Benjamin Wood, Robin Tuberculosis (Edinb) Article Cough has long been implicated in the production of infectious aerosol leading to transmission of tuberculosis (TB). However, prevalence studies frequently identify radiographic evidence of TB in subclinical individuals in the absence of reported coughing. Elucidating the role of cough in transmission depends on understanding the physical process of aerosolizing and expelling mycobacterium tuberculosis (Mtb) bacilli. In the last decade, human aerosol studies have progressed with improved precision of particle detection and greater sophistication of experimental protocols. Combining principles of respiratory physiology, the site and mechanism of aerosolization of respiratory lining fluids during phases of the respiratory cycle has been investigated in detail. Additionally, recent success in the direct detection of naturally generated Mtb aerosols has allowed more detailed characterization in terms of their rate of production and size distribution. We propose that TB transmission depends on the coincidence of the site of aerosol generation with the presence of Mtb bacilli. This review will examine the evidence for site of aerosol production during cough and respiratory activities in conjunction with the characteristics of detectable Mtb aerosols and locations of tuberculosis infection. Furthermore, we propose respiratory activities that are likely to optimise aerosol sampling for investigation of transmission. Churchill Livingstone 2019-07 /pmc/articles/PMC6688829/ /pubmed/31378265 http://dx.doi.org/10.1016/j.tube.2019.05.003 Text en © 2019 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Patterson, Benjamin
Wood, Robin
Is cough really necessary for TB transmission?
title Is cough really necessary for TB transmission?
title_full Is cough really necessary for TB transmission?
title_fullStr Is cough really necessary for TB transmission?
title_full_unstemmed Is cough really necessary for TB transmission?
title_short Is cough really necessary for TB transmission?
title_sort is cough really necessary for tb transmission?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688829/
https://www.ncbi.nlm.nih.gov/pubmed/31378265
http://dx.doi.org/10.1016/j.tube.2019.05.003
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