Impact of Ventilation on Respiratory Virus Transmission in College Residence Hall Cohorts: Potential for Causal Inference About Mode of Transmission

IF 4.2 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses Pub Date : 2025-07-02 DOI:10.1111/irv.70133

T. Louis Gold, Kathleen M. McPhaul, Huang Lin, Ryan Doughty, Irina Maljkovic Berry, Filbert Hong, Jianyu Lai, Todd J. Treangen, Jelena Srebric, Donald K. Milton

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引用次数: 0

Abstract

Background

The SARS-CoV-2 pandemic focused attention on airborne-inhalation transmission and building ventilation. However, investment in solutions lags because few epidemiologic studies demonstrate a causal effect of ventilation on acute respiratory infection (ARI) transmission. This highlights a need for improved study designs to support causal inference.

Methods

To investigate the potential for causal inference, we analyzed prospective cohorts residing in a high-ventilation (HVent, ≥ 5 L/s per person) or a neighboring low-ventilation (LVent, < 5 L/s per person) college residence hall during two spring semesters (2018 and 2019). Swab samples, analyzed using a PCR panel for respiratory pathogens, were collected based on self-reported symptoms and contacts. Our analysis focused on roommate pairs where both had been tested within a 2-week period. Roommate pairs with concordant positive PCR results were categorized as possible transmission events. We used genetic sequencing and phylogenetic analysis to identify probable transmission clusters and events.

Results

We analyzed data from 368 cohort participants (82 HVent and 286 LVent), including 60 person-infections, with a trend toward 54% lower ARI risk among students living in HVent versus LVent residence halls. We identified 97 roommate pairs, 64 two-week intervals where both members were tested, 36 (2 HVent and 34 LVent) intervals with ≥ 1 infection, and four possible transmission events (all LVent). Sequence data available for two of the four events confirmed one probable transmission cluster and one probable transmission event.

Conclusions

Future college dorm transmission studies should prioritize enrolling roommates rather than individuals, measuring ventilation, and confirming transmission events through whole genome sequencing.

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通风对大学宿舍呼吸道病毒传播的影响：对传播方式的潜在因果推断

背景SARS-CoV-2大流行的重点是空气吸入传播和建筑物通风。然而，对解决方案的投资滞后，因为很少有流行病学研究表明通气对急性呼吸道感染（ARI）传播有因果影响。这突出表明需要改进研究设计以支持因果推理。方法为了调查因果推断的可能性，我们分析了2018年和2019年两个春季学期（HVent，≥5 L/s /人）居住在高通风（HVent，≥5 L/s /人）或邻近低通风（LVent, <； 5 L/s /人）大学宿舍的前瞻性队列。根据自我报告的症状和接触者收集棉签样本，使用呼吸道病原体PCR试剂盒进行分析。我们的分析集中在两对室友身上，他们都在两周内接受了测试。PCR结果一致阳性的室友被归类为可能的传播事件。我们使用基因测序和系统发育分析来确定可能的传播集群和事件。结果：我们分析了来自368名队列参与者（82名HVent和286名LVent）的数据，其中包括60人感染，住在HVent的学生与住在LVent的学生相比，ARI风险降低54%。我们确定了97对室友，64个两周间隔对所有成员进行检测，36个（2个HVent和34个LVent）间隔≥1次感染，以及4个可能的传播事件（均为LVent）。四个事件中两个事件的现有序列数据证实了一个可能的传播群集和一个可能的传播事件。结论未来的大学宿舍传播研究应优先招收室友而不是个体，测量通气性，并通过全基因组测序确认传播事件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.