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Leading health agencies present updated terminology for airborne pathogens

Leading health agencies present updated terminology for airborne pathogens

 


After consultation with public health agencies and experts, the World Health Organization (WHO) publishes a global technical consultation report introducing updated terminology for airborne pathogens. Agents covered include those that cause respiratory infections, eg, COVID-19, influenza, measles, Middle East Respiratory Syndrome (MERS), severe acute respiratory syndrome (SARS), and tuberculosis, among others.

The publication entitled “Report of the Global Technical Consultation on Proposed Terminology for Airborne Pathogens“, is the result of an extensive, multi-year collaborative effort and reflects a shared agreement on terminology between WHO, experts and four major public health agencies: the African Centers for Disease Control and Prevention; Chinese Center for Disease Control and Prevention; European Center for Disease Prevention and Control; and the US Centers for Disease Control and Prevention. This agreement underscores the collective commitment of public health agencies to move forward together on this issue.

An extensive consultation was carried out in several steps in 2021-2023 and addressed the lack of common terminology to describe airborne pathogen transmission across scientific disciplines. The challenge became particularly evident during the COVID-19 pandemic as experts from different sectors had to provide scientific and policy guidance. Different terminology has highlighted gaps in common understanding and contributed to challenges in public communication and efforts to control pathogen transmission.

“Together with a very diverse range of leading public health agencies and multidisciplinary experts, we are pleased to have been able to address this complex and timely issue and reach consensus,” said Dr Jeremy Farrar, WHO's Chief Scientist. “An agreed terminology for airborne pathogens will help set a new path for research agendas and implementation of public health interventions to identify, communicate and respond to existing and emerging pathogens.”

Extensive consultation resulted in the introduction of the following common descriptors for characterizing airborne pathogen transmission (under typical circumstances):

  • Individuals infected with a respiratory pathogen can create and expel infectious particles containing the pathogen through the mouth or nose by breathing, speaking, singing, spitting, coughing, or sneezing. These particles should be described as 'infectious respiratory particles' or IRP.
  • IRPs exist on a continuous size spectrum and no single cut-off point should be applied to distinguish smaller from larger particles. This makes it easier to move away from the dichotomy of previously used terms: 'aerosols' (generally smaller particles) and 'droplets' (generally larger particles).
  • The descriptor 'airborne' can be used in a general way to characterize an infectious disease where the main mode of transmission involves the pathogen traveling through the air or floating in the air. Two descriptors can be used under the umbrella of 'airborne':

    1. Transmission by air or inhalation, for cases where IRPs are released into the air and inhaled by another person. Airborne transmission or inhalation can occur at a short or long distance from an infected person, and the distance depends on various factors (air flow, humidity, temperature, ventilation, etc.). IRPs can theoretically enter the body at any point along the human respiratory tract, but preferred sites of entry may be pathogen-specific.

    2. Direct deposition, for cases where IRPs are released into the air by an infected person and then directly deposited on the exposed mouth, nose, or eyes of another nearby person, then enter the human respiratory system and potentially cause infection.

    “This global technical consultation process was a collaborative effort by many influential and experienced experts,” said Dr. Gagandeep Kang, Christian Medical College, Vellore, India, who co-chairs the WHO Technical Working Group. “Achieving consensus on these terminologies that bring stakeholders together in an unprecedented way was no small feat. The completion of this consultation gives us a new opportunity and starting point to move forward with better understanding and agreed principles for airborne diseases,” added Dr. Yuguo Li of the University of Hong Kong, Hong Kong SAR (China), who also co-chaired the Technical working group.

    This consultation was the first phase of global scientific discussions led by WHO. Next steps include further technical and multidisciplinary research and exploring the wider implementation implications of the updated descriptors.

    Sources

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    2/ https://www.who.int/news/item/18-04-2024-leading-health-agencies-outline-updated-terminology-for-pathogens-that-transmit-through-the-air

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