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Exhaled Breath Aerosol Shedding by Highly Transmissible Versus Prior SARS-CoV-2 Variants.
Lai, Jianyu; Coleman, Kristen K; Tai, S-H Sheldon; German, Jennifer; Hong, Filbert; Albert, Barbara; Esparza, Yi; Srikakulapu, Aditya K; Schanz, Maria; Maldonado, Isabel Sierra; Oertel, Molly; Fadul, Naja; Gold, T Louie; Weston, Stuart; Mullins, Kristin; McPhaul, Kathleen M; Frieman, Matthew; Milton, Donald K.
  • Lai J; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Coleman KK; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Tai SS; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • German J; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Hong F; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Albert B; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Esparza Y; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Srikakulapu AK; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Schanz M; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Maldonado IS; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Oertel M; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Fadul N; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Gold TL; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Weston S; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Mullins K; Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • McPhaul KM; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
  • Frieman M; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Milton DK; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
Clin Infect Dis ; 2022 Oct 26.
Article in English | MEDLINE | ID: covidwho-2267805
ABSTRACT

BACKGROUND:

Aerosol inhalation is recognized as the dominant mode of SARS-CoV-2 transmission. Three highly transmissible lineages evolved during the pandemic. One hypothesis to explain increased transmissibility is that natural selection favors variants with higher rates of viral aerosol shedding. However, the extent of aerosol shedding of successive SARS-CoV-2 variants is unknown. We aimed to measure the infectivity and rate of SARS-CoV-2 shedding into exhaled breath aerosol (EBA) by individuals during the Delta and Omicron waves and compared those rates with those of prior SARS-CoV-2 variants from our previously published work.

METHODS:

COVID-19 cases (n = 93, 32 vaccinated and 20 boosted) were recruited to give samples, including 30-minute breath samples into a Gesundheit-II exhaled breath aerosol sampler. Samples were quantified for viral RNA using RT-PCR and cultured for virus.

RESULTS:

Alpha (n = 4), Delta (n = 3), and Omicron (n = 29) cases shed significantly more viral RNA copies into exhaled breath aerosols than cases infected with ancestral strains and variants not associated with increased transmissibility (n = 57). All Delta and Omicron cases were fully vaccinated and most Omicron cases were boosted. We cultured virus from the EBA of one boosted and three fully vaccinated cases.

CONCLUSIONS:

Alpha, Delta, and Omicron independently evolved high viral aerosol shedding phenotypes, demonstrating convergent evolution. Vaccinated and boosted cases can shed infectious SARS-CoV-2 via EBA. These findings support a dominant role of infectious aerosols in transmission of SARS-CoV-2. Monitoring aerosol shedding from new variants and emerging pathogens can be an important component of future threat assessments and guide interventions to prevent transmission.
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Full text: Available Collection: International databases Database: MEDLINE Topics: Vaccines / Variants Language: English Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Topics: Vaccines / Variants Language: English Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid