Dynamic of infectious aerosols generated by cough from patients with pulmonary tuberculosis

Tuberculosis (TB) is an ancient disease transmitted through aerosols frequently generated by coughing and it is still unknown whether there is variability in cough aerosol output throughout the day and whether this may impact patients' infectivity categorization. To study the dynamic of infectious aerosols generated by cough, we conducted a cross-sectional study on pulmonary TB patients (n=16) who had their cough-generated aerosols sampled twice daily for two consecutive days for the Cough Aerosol Sampling System (CASS) assay. Most patients were classified as Variable Low Producers and Variable High Producers (n=10; 62.5%), followed by Negative Producers (n = 4; 25%) and Consistent Producers (n = 2; 12.5%). Additionally, most recovered bacilli (88.7 %) within a respiratory aerosol size range. Although the time of collection did not appear to impact on aerosol infectivity, performing CASS with multiple samples allowed for more accurate detection and distinction among aerosol producers.