{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:13:11Z","timestamp":1789074791924,"version":"build-2803163510"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","license":[{"start":{"date-parts":[[2016,2,1]],"date-time":"2016-02-01T00:00:00Z","timestamp":1454284800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective\/background:<\/jats:title>\n                    <jats:p>\n                      The aims of this talk are to: (a) provide an overview of our method of collecting, quantifying, and sizing infectious aerosols of\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      ; and (b) to review data indicating that cough aerosol cultures of\n                      <jats:italic toggle=\"yes\">M. tuberculosis<\/jats:italic>\n                      are the best predictors of infection and incident disease among household contacts of persons with active tuberculosis (TB). New infection was defined as tuberculin skin test conversion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We developed a cough aerosol sampling system by placing two Andersen cascade impactor viability samplers inside a cylinder into which patients cough via connector tubing. We recruited sputum acid fast bacilli (AFB) smear-positive patients from the tuberculosis clinic and wards at Mulago Hospital in Kampala, Uganda. Patients were asked to cough as strongly and frequently as they comfortably could for two 5-min sessions of coughing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In a cohort of 96 sputum culture positive index TB cases, 43 (45%) produced culture-positive cough aerosols. Household contacts of TB patients who produced high aerosols (\u226510colony forming units (CFU)) were more likely to have a new infection compared with contacts with low aerosol CFU (1\u20139CFU) and aerosol-negative cases (69%, 25%, and 30%, respectively,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.009). In adjusted multivariate analyses, high cough aerosols were the only predictor of new TB infection (odds ratio [OR] 4.81; 1.20\u201319.23). In a follow-up (median 3.9 years) of this cohort, 369 (84%) of the contacts could be traced; eight (2%) had developed TB disease. Incident TB disease was associated with larger bacillary load in sputum measured by days to positive in liquid culture (OR 7.9; 0.7\u201370.5), exposure to a high-aerosol TB case patient (OR 6.0, 1.4\u201325.2) and marginally to HIV infection in the contact (OR 7.2; 0.7\u201370.5). Cough aerosol studies of TB patients in Brazil and South Africa are ongoing and appear to be finding similar proportions of cough aerosol cultures among TB patients (personal communication).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Cough aerosol cultures of\n                      <jats:italic toggle=\"yes\">M. tuberculosis<\/jats:italic>\n                      are the best predictors of infectiousness and predict incident TB disease among sputum smear-positive patients in Uganda. We propose that cough aerosol cultures are a better surrogate of inhaled dose than sputum smear.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijmyco.2016.10.037","type":"journal-article","created":{"date-parts":[[2016,11,25]],"date-time":"2016-11-25T02:00:18Z","timestamp":1480039218000},"page":"S51","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["What is in a cough?"],"prefix":"10.4103","volume":"5","author":[{"given":"Kevin P.","family":"Fennelly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["The International Journal of Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S2212553116302333?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S2212553116302333?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/01929415-201605001-00032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:00:42Z","timestamp":1789074042000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01929415-201605001-00032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2]]},"references-count":0,"journal-issue":{"issue":"Suppl 1","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijmyco.2016.10.037","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2]]}}}