Images in Clinical Medicine

Coughing and Aerosols

Julian W. Tang, F.R.C.Path., and Gary S. Settles, Ph.D.

N Engl J Med 2008; 359:e19October 9, 2008

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Article

Video

Schlieren Images of a Cough.

When a healthy volunteer coughs, he expels a turbulent jet of air with density changes that distort a projected schlieren light beam (Panel A). A velocity map early in the cough (Panel B) was obtained from image analysis. Sequential schlieren images during the cough (Panel C and video) were recorded at 3000 frames per second. A maximum airspeed of 8 m per second (18 mph) was observed, averaged during the half-second cough. Several phases of cough airflow are revealed in the figure. The cough plume may project infectious aerosols into the surrounding air. There is an increasing interest in visualizing such expelled airflows without the use of intrusive methods because of concern regarding the transmission of various airborne pathogens, such as viruses that cause influenza and the severe acute respiratory syndrome (SARS).

Julian W. Tang, F.R.C.Path.
Gary S. Settles, Ph.D.
Pennsylvania State University, University Park, PA 16802

Citing Articles (5)

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   David Denison, Alice Porter, Matthew Mills, Robert C. Schroter. (2011) Forensic implications of respiratory derived blood spatter distributions. Forensic Science International 204:1-3, 144-155
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   R. Tellier. (2009) Aerosol transmission of influenza A virus: a review of new studies. Journal of The Royal Society Interface 6:Suppl_6, S783-S790
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   J. W. Tang, T. J. Liebner, B. A. Craven, G. S. Settles. (2009) A schlieren optical study of the human cough with and without wearing masks for aerosol infection control. Journal of The Royal Society Interface 6:Suppl_6, S727-S736
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   Maria-Graciela Hollm-Delgado. (2009) Molecular epidemiology of tuberculosis transmission: Contextualizing the evidence through social network theory. Social Science & Medicine 69:5, 747-753
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