• Werner E Bischoff, Tanya Reid, Gregory B Russell, and Timothy R Peters.
• Department of Internal Medicine, Section on Infectious Diseases, Winston-Salem, North Carolina 27157-1042, USA. wbischof@wfubmc.edu
• J. Infect. Dis. 2011 Jul 15; 204 (2): 193-9.

BackgroundThe efficacy of barrier precautions to prevent influenza transmission is unknown.MethodsTwenty-eight participants were exposed to monodispersed live attenuated influenza vaccine (LAIV) particles (4.9 μm) in 6 groups: group 1, no precautions; group 2, ocular exposure only; group 3, surgical mask without eye protection; group 4, surgical mask with eye protection; group 5, fit-tested N95 respirator without eye protection; and group 6, fit-tested N95 respirator with eye protection. Influenza was detected by reverse-transcription polymerase chain reaction (RT-PCR) and culture in nasal washes. Exact 95% confidence intervals (CIs) were calculated.ResultsInfluenza was detected in 4 of 4 participants in group 1 (95% CI, 0-.60), 3 of 4 in group 2 (95% CI, .006-.806]), 5 of 5 in group 3 (95% CI, 0-.522), 5 of 5 in group 4, (95% CI, 0-.522), 3 of 5 in group 5 (95% CI, .053-.853), and 1 of 5 in group 6 (95% CI, .05-.72). RT-PCR revealed significant differences between group 1 and all other groups except group 3.ConclusionsTransocular transmission of LAIV occured in most participants suggesting the necessity of eye protection. An N95 respirator provided the best guard further enhanced by eye protection.

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