Infection control implications of respiratory virus exposure and transmission

The communicability of infectious diseases caused by respiratory viruses is enhanced by the ability of these viruses to transmit infection by direct and indirect contact and aerosolised transmission routes. There is however limited understanding of the specific factors that drive the transmission of respiratory viruses from an infected host to a susceptible individual. Consequently, this gap in our knowledge limits infection control attempts to prevent virus exposure and dissemination within healthcare facilities and in the wider community. The principal aim of this thesis is to examine the effectiveness, uptake and suitability of the infection control measures used for the prevention and control of respiratory viruses. To achieve this aim, four investigations were undertaken to construct this thesis. The first investigation assessed the evidence base for infection control measures (mask use, vaccination and antiviral prophylaxis) and was then used to develop an infection control algorithm for the prevention of exposure, transmission and infection of a pandemic influenza virus. In the second investigation the predictors of self-protective infection control behaviour among healthcare workers exposed to respiratory viruses were explored. The third investigation considered the suitability of droplet precautions for minimising exposure to virus-carrying particles produced by infected individuals in clinical settings. The final investigation examined the possibility of virus carriage on personal clothing and among asymptomatic individuals and the subsequent infection control implications in a community setting. The findings of this thesis provide a significant contribution to the eventual elucidation of how respiratory viruses transmit disease within the population. In turn, these findings also inform the advocacy and use of the most appropriate infection control practices. As a result of the investigations undertaken in this thesis, there will be improved understanding of both the transmission behaviours of respiratory viruses and the infection control behaviours of humans. With such knowledge, the spread of respiratory viruses may be better prevented and contained in the future through the use of the most effective infection control measures. In essence, this thesis is a testimony and exploration of the interdependent behaviours of respiratory viruses and humans, which ultimately determines the establishment or the prevention of respiratory virus infections