As the 2025–2026 winter respiratory season begins, hospitals are preparing for what may be a particularly difficult year. A newly identified H3N2 “subclade K” strain has raised concern that this season’s H3N2 vaccine component may be a poor match, potentially reducing vaccine effectiveness. At the same time, rising flu activity in the U.K., Canada, and Japan is raising alarms that the U.S. could also face a harsher flu season than usual.
For emergency departments (EDs), this may mean not only more patients with influenza-like illness, and also greater pressure to protect staff during each and every encounter. ED leaders may consider re-evaluating all methods to prevent exposure and how respiratory therapies are delivered to remain effective for patients while minimizing cross-contamination risk for clinicians. Monaghan Medical’s evidence-backed aerosol delivery devices are designed to help EDs meet that challenge.
Why This Season Poses Greater Risk
Influenza, COVID-19 variants, and RSV all spread efficiently through respiratory particles, making hospital emergency departments a high-risk environment during peak respiratory season. Crowded waiting rooms, close-contact care, and aerosol-generating procedures (AGPs) may increase the risk of exposure for healthcare workers.
One of the most important factors influencing infection risk is the combination of how much virus a clinician is exposed to and for how long. In other words, prolonged proximity to airborne particles increases the likelihood of transmission—a concept emphasized throughout current respiratory-care education.
Patients exhale bioaerosols comprised of airway lining fluid which are an important vector for the transmission of infectious disease.1 When mixed with medicinal aerosols from a nebulizer they may be carried farther from the source and remain airborne for several hours.
The use of traditional continuous-output (jet) nebulizers can significantly increase the volume of aerosol circulating through a treatment space – a substantial fraction of which can become “fugitive emissions”; aerosols that are released from a nebulizer during a patient exhalation and include the medicinal aerosols that are inhaled by the patient but pass back into the atmosphere.
Research shows that up to 50% of the aerosol produced by a standard jet nebulizer can become environmental contamination2, circulating through the room and increasing the chance of secondary infections among staff. During a season when viral loads are high and patient volumes surge, these emissions have the potential to amplify the exposure risk for clinicians providing frontline care.
Why Breath Actuation Matters
Unlike traditional nebulizers that generate aerosol continuously, the AEROECLIPSE® II BAN® Nebulizer produces aerosol only during inhalation. By limiting aerosol generation to the patient’s inspiratory phase, breath-actuated delivery helps reduce fugitive emissions while maintaining efficient drug delivery.
Real-world evidence from an emergency department:
A study with three treatment arms was completed from November 2016 to March of 2018 looking at staff influenza transmission in an Emergency Department (Lee’s Summit, Missouri). In one of the worst flu seasons reported by the CDC (2018), the AeroEclipse® II BAN® Nebulizer study arm reported the following benefits over the other two treatment pathways:
- Staff sick days dropped from 17 → 2
- Positive influenza tests among staff dropped from 9 → 2
- Costs from sick days dropped from $4,471 → $284
- Call-back pay days dropped from 17 → 2
These gains become even more critical in a season where a new H3N2 subclade may drive more infections despite vaccination.
Add-On Filtration Provides Another Layer of Protection
During peak respiratory season, adding high-efficiency viral/bacterial filtration further strengthens infection-prevention efforts. Monaghan’s filtered mouthpiece kit has been tested to filter 99.997% of viral particles and 99.9997% of bacterial particles, helping prevent contaminated exhaled aerosol from entering the environment and lowering the microbial burden in shared spaces.
High-efficiency filters help prevent contaminated exhaled aerosol from entering the environment – and each 0.1% gain in filtration efficiency significantly reduces the number of microbes that escape into the air.
Why Monaghan Devices Are Essential for ED Preparedness
In a season with an emerging strain like H3N2 subclade K and potential vaccine mismatch, EDs need aerosol delivery tools that protect staff from avoidable exposure, deliver medication efficiently, conserve medications, and minimize environmental contamination—while working across variable patient breathing patterns and supporting pathways that may decrease length of stay and unnecessary admissions.
Monaghan Medical’s devices, supported by published evidence and real-world clinical experience, offer a proven, practical strategy to help EDs navigate a challenging flu, COVID, and RSV season more safely.
Being Prepared Starts Now
This respiratory season is projected to be one of the most challenging in recent years. Ensuring emergency departments have the tools to deliver aerosol therapies safely is not optional – it is essential. Connect with your Territory Manager today to review the data and explore simple changes to help protect your frontline teams this season.
Citations:
1. Edwards DA, Man JC, Brand P, et al. Inhaling to mitigate exhaled bioaerosols. Proc Natl Acad Sci U S A. 2004;101(50):17383-17388. doi:10.1073/pnas.0408159101
2. McGrath J, O’Toole C, GB, Joyce M, Byrne M, MacLoughlin R. Investigation of fugitive aerosols released into the environment during high-flow therapy. Pharmaceutics 2019;11:254.
3. Benge C, Barwise J. Aerosolization of COVID-19 and contamination risks during respiratory treatments. Federal Practicioner 2020;37(4):160–163.
