Carolyn B. Bridges, MD Associate Director for Science, Influenza Division, NCIRD, CDC November 4-5, 2010 Charge to Workshop Attendees Approaches to Understanding Influenza Transmission National Center for Immunization & Respiratory Diseases Workshop on Influenza Transmission, November 4-5, 2010

Purposes of the Workshop  To review state of the art science in influenza transmission  To identify gaps in understanding influenza transmission in humans  To identify the best study approaches to resolve continuing questions about the relative contributions of contact, droplet, and airborne transmission of influenza in humans.

Goals  To identify scientific gaps in understanding of influenza transmission from multiple perspectives  Influenza virology and epidemiology  Infection control  Health and safety  Aerobiology  Industrial Hygiene /Engineering  To gain input regarding best scientific approaches and study designs to determine relative contributions of different modes of transmission among humans  Considering multiple perspectives  To provide information from this workshop to other government agencies, investigators and potential funders  Summary and slides to be posted on CDC website, including results of break out sessions

What is not included in this workshop  Limited time does not permit discussion of many other aspects of influenza transmission, including  Transmission of animal-adapted viruses in humans  Policy or policy implications for emphases on different modes of transmission  Discussions of funding opportunities for work on transmission  Large-scale, population-based social distancing measures, such as school closures  Current infection control guidance Approved draft included in notebooks for reference  Several references are included in your notebooks, mostly including review articles

Considerations for Discussions Pathogen Infectious dose Receptor binding Antigenicity Pathogenesis Strain/subtype characteristics Aerobiology Environment Humidity Temperature Air exchange rates Physical barriers Other means that may reduce amount of virus including UV lights, HEPA filtration of air Host Degree of viral shedding Immunity Illness severity Cough, sneeze, etc Behaviors, e.g. hand washing Distance between people Infection

 Presenters and academic experts  Staff from throughout CDC that have contributed to meeting planning and execution  Brenda Armstrong  Tammy Otober  Kim Pittman  Tomas Rodriguez  Phyllis Terrell  Julie Zier  Planning Professionals Mollie Wallace Danny Treece  CDC Scientific Planning Committee  Daphne Copeland  Angela Couliette  Jeff Hagemen  John Jernigan  Michael Jhung  David Kuhar  Bill Lindsley  Toby Merlin  Stephen Morse  Andy Plummer  Dixie Snider  Terry Tumpey  Amra Uzicanin  Betsy Weirich  David Weissman Thank you!