In preparation for a possible pandemic caused by a highly lethal virus such as influenza A (H5N1), making the assumption that the role of aerosols in transmission of this virus will be similar to their role in the transmission of known human influenza viruses would seem rational. Indeed, the relevant chapters of many reference books, written by recognized authorities, refer to aerosols as an important mode of transmission for influenza ( 6 – 9). ![]() ![]() This position contradicts the knowledge on influenza virus transmission accumulated in the past several decades. For example, the Canadian Pandemic Influenza Plan and the US Department of Health and Human Services Pandemic Influenza Plan ( 4, 5) recommend surgical masks, not N95 respirators, as part of personal protective equipment (PPE) for routine patient care. As a consequence of this opinion, protection against infectious aerosols is often ignored for influenza, including in the context of influenza pandemic preparedness. Several authors have stated that large-droplet transmission is the predominant mode by which influenza virus infection is acquired ( 1 – 3). ![]() The highly pathogenic strains of influenza A (H5N1) virus circulating in Asia, Europe, and Africa have become the most feared candidates for giving rise to a pandemic strain. Concerns about the likely occurrence of an influenza pandemic in the near future are increasing.
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