Transmission of Respiratory Viral Diseases to Health Care Workers: COVID-19 as an Example

Amanda M. Wilson, Darrah K. Sleeth, Camie Schaefer, Rachael M. Jones

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations


Health care workers (HCWs) can acquire infectious diseases, including coronavirus disease 2019 (COVID-19), from patients. Herein, COVID-19 is used with the source-pathway-receptor framework as an example to assess evidence for the roles of aerosol transmission and indirect contact transmission in viral respiratory infectious diseases. Evidence for both routes is strong for COVID-19 and other respiratory viruses, but aerosol transmission is likely dominant for COVID-19. Key knowledge gaps about transmission processes and control strategies include the distribution of viable virus among respiratory aerosols of different sizes, the mechanisms and efficiency by which virus deposited on the facial mucous membrane moves to infection sites inside the body, and the performance of source controls such as face coverings and aerosol containment devices. To ensure that HCWs are adequately protected from infection, guidelines and regulations must be updated to reflect the evidence that respiratory viruses are transmitted via aerosols.

Original languageEnglish (US)
Pages (from-to)311-330
Number of pages20
JournalAnnual review of public health
StatePublished - Apr 2022


  • COVID-19
  • aerosol
  • health care worker
  • occupational health
  • respiratory virus

ASJC Scopus subject areas

  • Medicine(all)


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