Airborne Precautions

An airborne disorder is any disease that is caused by a microorganism that is transmitted through the air Many clinically important airborne diseases are caused by a variety of pathogens including bacteria, viruses, and fungi  These organisms may be transmitted through sneezing, coughing, spraying of liquids, spread of dust, talking, or any activity that results in the generation of aerosolized particles It is important to be aware that airborne diseases, in general, do not include disorders caused by air pollution, poisons, smog, and dust According to the World Health Organization, “Airborne transmission of infectious agents refers to the transmission of disease caused by dissemination of droplet nuclei that remain infectious when suspended in air over long distance and time ” Airborne transmission can be characterized as obligate or preferential depending on whether it is only transmitted via droplet nuclei or if it has multiple other routes of transmission The microorganisms transmitted by an airborne route may be spread via fine mist, dust, aerosols, or liquids The aerosolized particles are generated from a source of infection such as an infected patient or animal In addition, aerosols may be generated from biological waste products that accumulate in garbage cans, caves, and dry arid containers  In aerosolization, the microorganisms that are less than 5 micrometers in size float in the air These microorganisms, contained in droplets, are then dispersed via air currents to varying distances and can be inhaled by susceptible hosts  Although a majority of the particles will drop off within the vicinity, the infected aerosolized particles often remain suspended in air and may even travel considerable distances, As the distance between the source and susceptible individuals increases, the rate of transmission decreases Airborne transmission necessitates the use of available interventions in healthcare facilities to break the transmission of airborne particles from patient to patient and patient to healthcare workers Airborne particles are considered highly infectious as they often remain suspended in the air and travel by air currents to different parts of the hospital where there is a potential of them being inhaled by others In some cases where there is inadequate ventilation, the airborne particle may remain in the hospital room for extended periods and may even be inhaled by a newly admitted patient The control and prevention of airborne transmission of infections is not simple;it requires the control of airflow with the use of specially designed ventilation systems, the practice of antiseptic techniques, wearing personalized protective equipment (PPE), and performing basic infection prevention measures like hand washing Airborne Organisms In almost all cases, airborne pathogens cause an inflammatory reaction of the upper airways affecting the nose, sinuses, throat, and lungs The involvement of these structures may result in sinus congestion, sore throat, and lower respiratory tract symptoms Any coughing or sneezing activity may then generate aerosolized particles leading to airborne transmission Some of the common pathogens that may spread via airborne transmission are: Anthrax Aspergillosis Blastomycosis Chickenpox Adenovirus Enteroviruses Rotavirus Influenza Rhinovirus Neisseria meningitidis Streptococcus pneumoniae Legionellosis Measles Mumps Smallpox Cryptococcosis Tuberculosis Bordetella pertussis Severe acute respiratory syndrome (SARS) Middle East Respiratory Syndrome (MERS) Coronavirus Disease 2019 (COVID-19) This is a non-exhaustive list that only encompasses some of the common diseases that have been implicated in airborne transmission  A special note to be made is regarding COVID-19, the 21st century pandemic which is thought to spread through airborne routes (among other routes) Active measures to prevent airborne transmission has shown to curb its spread Airborne diseases are not exclusive to humans and can also infect animals A notable example is of poultry that is often affected by an avian disorder (Newcastle disease), that is also transmitted via an airborne route However, it is important to understand that exposure to an animal or a patient with an airborne disease does not automatically ensure disease transmission The infection also depends on the host immunity, the amount of exposure, and the duration of exposure to the infected patient Airborne Particles Generated from Medical Equipment Besides patients, several medical and surgical procedures may also generate aerosolized infectious particles In most cases, these airborne particles are generated during the manipulation of the lung airways These include: Manual ventilation with a bag and mask Intubation Open endotracheal suctioning Bronchoscopy Cardiopulmonary resuscitation Sputum induction Chest physiotherapy Lung surgery Nebulizer therapy and steam inhalation Non-invasive positive pressure ventilation (BIPAP, CPAP) An autopsy of the lungs Care must be taken while performing the above medical procedures on patients known to have diseases with high transmissibility through airborne routes