Infection Control & Hospital Epidemiology
contact with contaminants of blood or bloody secretions pro- duced by index patient’s mouth or nose. In general, transmission of communicable diseases has 3 routes:
airborne, contact, and droplet. Unique control procedures and PPE are recommended for each route.10 However, there is limitation in dichotomization of airborne and droplet transmission. Some viruses such as influenza virus and severe acute respiratory syn- drome coronavirus (SARS-CoV) are transmitted through small- particle aerosols in addition to droplet and contact routes. This case supports the hypothesis that a fatally ill patient with high viral loads of SFTS may be highly contagious by releasing viable pathogen through small-particle aerosols. Therefore, additional airborne precautions such as particulate respirator (N95 mask or equivalent), a face shield, and negative pressure ventilation may be needed during aerosol generating procedures for SFTS patients, especially fatally ill patients with high viral loads. Because there is no definitive treatment or vaccine against SFTSV to date, infection control is extremely important in the healthcare setting. This study has some limitations. Case 2 was not confirmed by
detection of SFTSV RNA or 4-fold increase in serial IgG titer because his first sample was taken very late after contact. Although case 1 might have contracted the disease through contact transmission, he also immediately washed a small droplet on his intact skin. In conclusion, our findings indicate that SFTSV could be transmitted from person-to-person through aerosol, which highlight the importance of adding airborne precaution during aerosol-generating situations.
Acknowledgments. Financial support. No financial support was provided relevant to this article.
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Conflicts of interest. All authors report no conflicts of interest relevant to this article.
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