What are the possible avenues of tuberculosis transmission among individuals? Is it direct contact by the air route, though spray that is expelled by an act of coughing, or through dried sputum in public places? In answer to this question it may be said, that if the results of investigations of the influenza-pneumonia epidemic can be taken as a key to sputum-borne disease transmission, the transmission rate resultant from the distribution of tuberculosis by the air route among adults is of minor importance.1 In the infant, however, another link may be added to this avenue of transmission: that of soiling the hands on a contaminated floor.
In contrast to direct contact, transmission may take place through several common routes by indirect contact: (a) through hand-to-mouth infection, the hands being soiled by contaminated inanimate objects, and (b) through inanimate object-to-mouth infection, the objects entering the mouth of the tuberculous as
CUMMING JG. CAN THE TUBERCULOSIS TRANSMISSION RATE BE REDUCED?. JAMA. 1920;74(16):1072-1074. doi:10.1001/jama.1920.02620160012005