Advertisement

Expulsion of group a hemolytic streptococci in droplets and droplet nuclei by sneezing, coughing and talking

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      • 1.
        1. The numbers of beta and alpha streptococci discharged into the air of an experimental room-during sneezing, coughing and talking were determined in a series of forty-eight carriers of group A streptococci. By simultaneous employment of exposed blood agar plates placed upon the floor, and “broth bubbler” samplers whose intake was 3 feet from the floor, streptococci expelled in large, rapidly falling droplets could be differentiated from those discharged as droplet nuclei which remained in the air for at least several minutes.
      • 2.
        2. The material dispersed into the air during a sneeze is chiefly saliva.
      • 3.
        3. Four dispersion patterns of beta hemolytic streptococci by sneezing were evident. In the most common, moderate numbers were expelled in large droplets which fell rapidly to the floor 1.5 feet from the sneezer, but very few or none in droplet nuclei. In one of two less common patterns, small numbers of beta streptococci were sneezed as droplet nuclei but none in large droplets; in the other, no beta streptococci were recovered from the air. In the rarest, of which only one example was found, large numbers of beta (and alpha) streptococci were expelled both as droplet nuclei and in large droplets; many were collected as far as 9.5 feet from the sneezer. The saliva of this carrier contained huge numbers of beta streptococci.
      • 4.
        4. Thirty-five per cent of twenty carriers sneezed out large numbers of alpha (salivary) streptococci as droplet nuclei. Eighty per cent discharged moderate or large numbers in heavy droplets which fell rapidly to the floor.
      • 5.
        5. About one-half the streptococci expelled into the air as droplet nuclei by sneezing were still present as long as twenty minutes after the first sneeze.
      • 6.
        6. The material expelled during coughing apparently originates in the back of the throat or below the epiglottis and contains little if any saliva.
      • 7.
        7. Only one of twenty carriers coughed large numbers of beta streptococci into the air as droplet nuclei or in large droplets; he expelled no alpha streptococci. Ninety-five per cent of the carriers coughed few or no streptococci collected by either type of air culture.
      • 8.
        8. Practically no streptococci were recovered from the air of rooms while carriers counted out loud for five minutes.
      To read this article in full you will need to make a payment

      References

        • Hamburger Morton
        • Green Margaret J.
        The problem of the dangerous carrier of hemolytic streptococci. IV. Observations upon the role of the hands, of blowing the nose, of sneezing, and of coughing in the dispersal of these microorganisms.
        J. Infect. Dis. 1946; 79: 33
        • Wells W.F.
        On air-borne infection. II. Droplets and droplet nuclei.
        Am. J. Hyg. 1934; 20: 611
        • Hare Ronald
        The expulsion of hemolytic streptococci by nasopharyngeal carriers.
        Canad. Pub. Health J. 1940; 31: 539
        • Robertson O.H.
        • Puck T.T.
        • Wise H.
        The construction and operation of experimental rooms for the study of air-borne infection.
        J. Exper. Med. 1946; 84: 559
        • Bloomfield A.L.
        • Felty A.R.
        On the mode of the transmission of the streptococci associated with tonsillitis.
        Bull. Johns Hopkins Hosp. 1924; 35: 115
        • Paine C.G.
        Aetiology of puerperal infection with special reference to droplet infection.
        Brit. M. J. 1935; 1: 243
        • Duguid J.P.
        Expulsion of pathogenic organisms from the respiratory tract.
        Brit. M. J. 1946; 1: 265
        • Hamburger Morton
        • Puck T.T.
        • Johnson Margaret A.
        • Hamburger Virginia
        Studies on the transmission of hemolytic streptococcus infections. III. Hemolytic streptococci in the air, floor dust, and bedclothing of hospital wards and their relation to cross infection.
        J. Infect. Dis. 1944; 75: 79
        • Lemon H.M.
        A method for the collection of bacteria from air and textiles.
        in: Proc. Soc. Exper. Biol. & Med.54. 1943: 298
        • Jennison M.W.
        Atomization of mouth and nose secretions into the air as revealed by high-speed photography.
        Aerobiology. 1941; : 106
        • Swift H.F.
        • Wilson A.T.
        • Lancefield R.C.
        Typing group A hemolytic streptococci by M precipitin reactions in capillary pipettes.
        J. Exper. Med. 1943; 78: 127
        • Bourdillon R.B.
        • Lidwell O.M.
        • Lovelock J.E.
        Sneezing and disinfection by hypochlorites.
        Brit. M. J. 1942; 1: 42
        • Bourdillon R.B.
        • Lidwell O.M.
        Sneezing and the spread of infection.
        Lancet. 1941; 2: 365
        • Wells William F.
        • Wells Mildred W.
        Air-borne infection.
        J. A. M. A. 1936; 107: 1698
        • Hamburger M.
        Studies on the transmission of hemolytic streptococcus infections II. Beta hemolytic streptococci in the saliva of persons with positive throat cultures.
        J. Inject. Dis. 1944; 75: 71
        • Duguid J.P.
        The size and the duration of air carriage of respiratory droplets and droplet nuclei.
        J. Hyg. 1946; 44: 471
        • Duguid J.P.
        The numbers and the sites of origin of the droplets expelled during expiratory activities.
        Edinburgh M. J. 1945; 52: 385
        • Bourdillon R.B.
        • Lidwell O.M.
        • Thomas J.C.
        A slit sampler for collecting and counting air-borne bacteria.
        J. Hyg. 1941; 41: 197
        • Hamburger Morton
        • Green Margaret
        • Hamburger Virginia G.
        The problem of the dangerous carrier of hemolytic streptococci. II. Spread of infection by individuals with strongly positive nose cultures who expelled large numbers of hemolytic streptococci.
        J. Infect. Dis. 1945; 77: 96