{"doi":"10.1111/irv.70133","title":"Impact of Ventilation on Respiratory Virus Transmission in College Residence Hall Cohorts: Potential for Causal Inference About Mode of Transmission","abstract":"BACKGROUND: The SARS-CoV-2 pandemic focused attention on airborne-inhalation transmission and building ventilation. However, investment in solutions lags because few epidemiologic studies demonstrate a causal effect of ventilation on acute respiratory infection (ARI) transmission. This highlights a need for improved study designs to support causal inference. METHODS: To investigate the potential for causal inference, we analyzed prospective cohorts residing in a high-ventilation (HVent, ≥ 5 L/s per person) or a neighboring low-ventilation (LVent, < 5 L/s per person) college residence hall during two spring semesters (2018 and 2019). Swab samples, analyzed using a PCR panel for respiratory pathogens, were collected based on self-reported symptoms and contacts. Our analysis focused on roommate pairs where both had been tested within a 2-week period. Roommate pairs with concordant positive PCR results were categorized as possible transmission events. We used genetic sequencing and phylogenetic analysis to identify probable transmission clusters and events. RESULTS: We analyzed data from 368 cohort participants (82 HVent and 286 LVent), including 60 person-infections, with a trend toward 54% lower ARI risk among students living in HVent versus LVent residence halls. We identified 97 roommate pairs, 64 two-week intervals where both members were tested, 36 (2 HVent and 34 LVent) intervals with ≥ 1 infection, and four possible transmission events (all LVent). Sequence data available for two of the four events confirmed one probable transmission cluster and one probable transmission event. CONCLUSIONS: Future college dorm transmission studies should prioritize enrolling roommates rather than individuals, measuring ventilation, and confirming transmission events through whole genome sequencing.","journal":"Influenza and Other Respiratory Viruses","year":2025,"id":553389,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9577,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1450022,"name":"Kathleen McPhaul","orcid":"0000-0002-7008-142X","position":1,"is_corresponding":false},{"id":1073351,"name":"Huang Lin","orcid":null,"position":2,"is_corresponding":false},{"id":1450023,"name":"Ryan Doughty","orcid":"0009-0001-8355-0926","position":3,"is_corresponding":false},{"id":290884,"name":"Irina Maljkovic Berry","orcid":"0000-0001-8555-5352","position":4,"is_corresponding":false},{"id":550223,"name":"Filbert Hong","orcid":"0000-0003-2289-5119","position":5,"is_corresponding":false},{"id":632757,"name":"Jianyu Lai","orcid":"0000-0001-5705-0138","position":6,"is_corresponding":false},{"id":29176,"name":"Todd J. Treangen","orcid":"0000-0002-3760-564X","position":7,"is_corresponding":false},{"id":1428235,"name":"Jelena Srebric","orcid":"0000-0001-6825-5091","position":8,"is_corresponding":false},{"id":550224,"name":"Donald K. Milton","orcid":"0000-0002-0550-7834","position":9,"is_corresponding":false},{"id":1450411,"name":"T. Louis Gold","orcid":null,"position":0,"is_corresponding":true}],"reference_count":15,"raw_metadata":null,"created_at":"2026-07-19T02:54:41.819682Z","pmid":"40604338","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}