The COVID-19 pandemic has revealed critical knowledge gaps in our understanding of and a need to update the traditional view of transmission pathways for respiratory viruses. The long-standing definitions of droplet and airborne transmission do not account for the mechanisms by which virus-laden respiratory droplets and aerosols travel through the air and lead to infection. In this Review, we discuss current evidence regarding the transmission of respiratory viruses by aerosols—how they are generated, transported, and deposited, as well as the factors affecting the relative contributions of droplet-spray deposition versus aerosol inhalation as modes of transmission. Improved understanding of aerosol transmission brought about by studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection requires a reevaluation of the major transmission pathways for other respiratory viruses, which will allow better-informed controls to reduce airborne transmission.

COVID-19 大流行暴露了我们对呼吸道病毒传播途径的理解存在严重的知识差距，需要更新这一传统观点。飞沫和空气传播的长期定义并没有解释携带病毒的呼吸道飞沫和气溶胶通过空气传播并导致感染的机制。在这篇综述中，我们讨论了有关呼吸道病毒通过气溶胶传播的现有证据——它们是如何产生、传播和沉积的，以及影响飞沫喷雾沉积与气溶胶吸入作为传播方式的相对贡献的因素。通过对严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染的研究，加深了对气溶胶传播的了解，需要重新评估其他呼吸道病毒的主要传播途径，这将有助于采取更明智的控制措施，减少空气传播。