About

Kristen K. Coleman is an Assistant Professor in the Department of Global, Environmental, and Occupational Health at the University of Maryland School of Public Health. Her research focuses on airborne infectious diseases, with a particular emphasis on the surveillance, epidemiology, and transmission of respiratory viruses such as influenza, adenovirus, and coronavirus. Dr. Coleman champions a One Health approach to understanding pandemic respiratory virus transmission and has authored several key research papers on airborne transmission of SARS-CoV-2. She has performed infectious disease research in multiple countries including Singapore, Malaysia, Vietnam, China, and the US, and has held positions such as senior research fellow at Duke-NUS Medical School and the Department of Medicine at NUS Yong Loo Lin School of Medicine in Singapore. Dr. Coleman is the Principal Investigator of the Airborne Pathogen Emergence and Transmission Laboratory and a collaborating member of the Public Health AeroBiology Laboratory. She is recognized for her contributions to understanding the modes of respiratory virus transmission and has been selected as the University of Maryland Baltimore Institute for Clinical & Translational Research KL2 Clinical Research Scholar.

Research topics

• Virology
• Medicine
• Immunology
• Internal medicine
• Environmental science
• Pathology
• Emergency medicine
• Biology

Selected publications

• Evaluating modes of influenza transmission (EMIT-2): Insights from lack of transmission in a controlled transmission trial with naturally infected donors

  PLoS Pathogens · 2026-01-07 · 2 citations

  articleOpen access

  A previous controlled human influenza transmission trial produced minimal transmission using nasal inoculation of an egg adapted virus. Therefore, we implemented a new trial with naturally infected Donors. We recruited healthy Recipients for four, two-week hotel quarantine cohorts and naturally infected, qRT-PCR confirmed Donors for two cohorts. Five Donors (mean age: 21; 80% female; two H1N1, three H3N2, one for cohort 24b and 4 for 24c, Jan-Feb 2024) exposed Recipients (mean age: 36; 54% female, eight in cohort 24b and 3 in 24c) in a hotel room with limited ventilation but a high air recirculation rate. We collected exhaled breath, ambient and personal bioaerosols, fomite swabs, and sera, and analyzed samples using dPCR and fluorescent focus assays, hemagglutination inhibition (HAI) assay, and enzyme-linked immunosorbent assay (ELISA). Compared with previously studied community-acquired influenza cases, we detected viral RNA (44%) and culturable virus (6%) less frequently and measured fewer viral RNA copies (79 - 8.9 × 103 copies/30-min) in Donors' exhaled fine aerosols. One of 23 surface swab samples was culture positive. At admission, 8 of 11 Recipients had HAI titers ≤10 but 9 of 11 had stronger binding antibody responses than Donors against vaccine strains corresponding to Donor viruses. No Recipient developed influenza-like illness, PCR-positive respiratory samples, or serological evidence of infection. Potential explanations and insights regarding lack of transmission include importance of cough and seasonal variation in viral aerosol shedding by Donors, of potential cross-reactive immunity in middle-aged Recipients with decades of exposure, and of exposure to concentrated exhaled breath plumes limited by rapid air mixing from environmental controls that distributed aerosols evenly. Future trials over multiple seasons, Donors that cough, younger recipients, and environments that preserve normal exhaled breath plumes will be required to observe transmission from naturally infected Donors under controlled conditions and generate new insights into influenza transmission dynamics.

  PublisherDOI

• - One Health surveillance for influenza A viruses in Vietnamese live bird markets from January 2019 to April 2021

  One Health · 2025-06-01

  articleOpen access
  PublisherDOI

• Highly Pathogenic Avian Influenza A(H5N1) Outbreak Among House Cats: A Case Series Involving Oseltamivir Treatment

  Research Square · 2025-07-07

  preprintOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Evaluating Modes of Influenza Transmission (EMIT-2): Insights from a Controlled Human Influenza Virus Infection Transmission Trial (CHIVITT)

  medRxiv · 2025-05-01

  preprintOpen access

  Abstract A previous controlled human influenza transmission trial produced minimal transmission using nasal inoculation of an egg adapted virus. Therefore, we implemented a new trial with naturally infected Donors. We recruited healthy Recipients for four, two-week hotel quarantine cohorts and naturally infected, qRT-PCR confirmed Donors for two cohorts. Five Donors (mean age: 21; 80% female; two H1N1, three H3N2, one for cohort 24b and 4 for 24c, Jan-Feb 2024) exposed Recipients (mean age: 36; 55% female, eight in cohort 24b and 3 in 24c) in a hotel room with limited ventilation but a high air recirculation rate. We collected exhaled breath, ambient and personal bioaerosols, fomite swabs, and sera, and analyzed samples using dPCR and fluorescent focus assays, hemagglutination inhibition (HAI) assay, and enzyme-linked immunosorbent assay (ELISA). Compared with previously studied community-acquired influenza cases, we detected viral RNA (44%) and culturable virus (6%) less frequently and measured fewer viral RNA copies (79 – 8.9×10 3 copies/30-min) in Donors’ exhaled fine aerosols. One of 23 surface swab samples was culture positive. At admission, 8 of 11 Recipients had HAI titers ≤10 but 9 of 11 had stronger binding antibody responses than Donors against vaccine strains corresponding to Donor viruses. No Recipient developed influenza-like illness, PCR-positive respiratory samples, or serological evidence of infection. Potential explanations and insights regarding lack of transmission include importance of cough and seasonal variation in viral aerosol shedding by Donors, of potential cross-reactive immunity in middle-aged Recipients with decades of exposure, and of exposure to concentrated exhaled breath plumes limited by rapid air mixing from environmental controls that distributed aerosols evenly. Future trials over multiple seasons, Donors that cough, younger recipients, and environments that preserve normal exhaled breath plumes will be required to observe transmission from naturally infected Donors under controlled conditions and generate new insights into influenza transmission dynamics. Author Summary Human-to-human influenza virus transmission under controlled conditions could provide insights leading to better control of epidemics and pandemics. However, a previous study using laboratory adapted viruses produced minimal transmission. Therefore, we aimed to study transmission from people naturally infected with circulating viruses. We recruited four cohorts of healthy volunteer Recipients to stay in a quarantine hotel for two weeks. We could not recruit Donors for the first two cohorts. In the last two cohorts, one Donor exposed eight Recipients in the first and four Donors exposed three Recipients in the second. The Donors coughed infrequently and shed less virus into the air than we had observed during previous influenza seasons. No Recipients became infected. Possible explanations include that people infected during mild influenza seasons or who cough very little may be minimally contagious. Our middle-aged Recipient cohorts were older than Donors and possibly less susceptible to infection because of additional years of vaccination and infection. Finally, environmental controls in the hotel distributed aerosols evenly but reduced short-range exposure to concentrated clouds of exhaled breath that may play an important role in transmission. New designs will need to address these issues.

  PublisherOA PDFDOI

• Outbreak of highly pathogenic avian influenza a(H5N1) among house cats: A case series involving oseltamivir treatment

  One Health · 2025-09-17 · 1 citations

  articleOpen accessSenior authorCorresponding

  We present a highly pathogenic avian influenza A(H5N1) outbreak among four domestic cats from the same household within close proximity to a dairy farm in Tulare, California – the epicenter of the H5N1 dairy cattle outbreaks in California, USA. We demonstrate that with early supportive care and treatment with oseltamivir, H5N1 is survivable in domestic cats, and that survivor cats may maintain high titers of neutralizing antibodies against H5N1 at least 3–4 months post recovery. • We report a highly pathogenic avian influenza A(H5N1) outbreak among four domestic cats from the same household. • With early supportive care and antiviral treatment, H5N1 is survivable in domestic cats. • Survivor cats may maintain high titers of neutralizing antibodies against H5N1 at least 3–4 months post recovery.

  PublisherDOI

• Avian Influenza Virus Infections in Felines: A Systematic Review of Two Decades of Literature

  Open Forum Infectious Diseases · 2025-04-25 · 17 citations

  reviewOpen access1st authorCorresponding

  As an avian influenza virus (AIV) panzootic is underway, the threat of a human pandemic is emerging. Infections among mammalian species in frequent contact with humans should be closely monitored. One mammalian family, the Felidae, is of particular concern. Domestic cats are susceptible to AIV infection and provide a potential pathway for zoonotic spillover to humans. Here, we provide a systematic review of the scientific literature to describe the epidemiology and global distribution of AIV infections in felines reported from 2004 to 2024. We identified 607 AIV infections in felines, including 302 associated deaths, comprising 18 countries and 12 felid species. We observed a drastic flux in the number of AIV infections among domestic cats in 2023 and 2024, commensurate with the emergence of H5N1 clade 2.3.4.4b. We estimate that this phenomenon is underreported in the scientific literature and argue that increased surveillance among domestic cats is urgently needed.

  PublisherOA PDFDOI

• P-698. Evaluating Modes of Influenza Transmission (EMIT-2): An Ongoing Controlled Human Influenza Virus Infection Transmission Trial (CHIVITT)

  Open Forum Infectious Diseases · 2025-01-29

  articleOpen access

  Abstract Background The relative importance of inhalation, spray, and touch transmission remains poorly understood. We implemented a randomized controlled trial incorporating community-acquired cases using behavioral, personal protective equipment, and environmental interventions as tools to understand the pathway of influenza transmission.Figure 1.Study design and timeline of cohorts with naturally infected influenza Donors Methods We recruited healthy volunteer Recipients and influenza Donors with PCR-confirmed community-acquired infection to a hotel quarantine. We randomized healthy volunteers to Intervention (hand hygiene and face shield) and Control Recipients. Donors and Recipients interacted in an “Event Room” with controlled ventilation (0.2–0.5 air changes per hour) and relative humidity (20-40%). We collected ambient air and personal bioaerosol exposure samples using NIOSH BC-251 samplers. We also deployed a novel cascade to liquid media bioaerosol sampler. Donors provided exhaled breath samples using a Gesundheit-II (G-II) sampler. We analyzed samples using dPCR and florescent focus assay.Figure 2.Viral RNA load in GII samples and MTS Results We ran four cohorts (February 2023 and January-February 2024); two with naturally infected influenza Donors (Figure 1). We exposed 11 Recipients (mean age: 36; 55% female) to 5 influenza Donors (mean age: 21; 80% female). Preliminary results show that eleven G-II fine (< 5µm), one G-II coarse (≥5µm) (Figure 2), four NIOSH ambient air (three ≥4µm and one 1-4µm), and three NIOSH personal bioaerosol exposure samples (two 1-4µm and one less than 1µm) were PCR positive. Virus was cultured from an ambient bioaerosol sample. No Recipient developed influenza-like illness or PCR-positive swabs; serology is pending. Conclusion We demonstrated that it is feasible to recruit Donors with new onset community-acquired influenza infections and expose Recipients under highly controlled conditions. Although initial experiments did not produce PCR-positive secondary infections, much will be learned by analyzing the immunity of the exposed Recipients and the inhaled dose of virus. This unique randomized controlled trial will provide a definitive assessment of the role of inhalation transmission and critical data on which to build effective interventions to prevent transmission. Disclosures Donald K. Milton, MD, DrPH, Lumen Bioscience, Inc: Advisor/Consultant|Lumen Bioscience, Inc: Stocks/Bonds (Private Company)

  PublisherDOI

• 104 Using noninvasive bioaerosol sampling to characterize human-to-human transmission of influenza virus in a controlled exposure setting

  Journal of Clinical and Translational Science · 2025-03-25

  articleOpen access1st authorCorresponding

  Objectives/Goals: Mathematical models of airborne virus transmission lack supporting field and clinical data such as viral aerosol emission rates and airborne infectious doses. Here, we aim to measure inhalation exposure to influenza aerosols in a room shared with persons with community-acquired influenza and estimate the infectious dose via inhalation. Methods/Study Population: We recruited healthy volunteer recipients and influenza donors with polymerase chain reaction (PCR)-confirmed community-acquired infection. On admission to a hotel quarantine, recipients provided sera to determine baseline immunity to influenza virus, and donor infections were confirmed by quantitative real-time polymerase chain reaction. Donors and recipients were housed in separate rooms and interacted in an “event room” with controlled ventilation (0.2 – 0.5 air changes/hour) and relative humidity (20–40%). We collected ambient bioaerosol exposure samples using NIOSH BC-251 samplers. Donors provided exhaled breath samples collected by a Gesundheit-II (G-II). We analyzed aerosol samples using dPCR and fluorescent focus assays for influenza A and sera by hemagglutinin inhibition assay (HAI) against donor viruses and vaccine strains. Results/Anticipated Results: Among two cohorts (24b and 24c), we exposed 11 recipients (mean age: 36; 55% female) to 5 donors (mean age: 21; 80% female) infected with influenza A H1N1 or H3N2. Eight G-II and two NIOSH bioaerosol samples (1–4 µm and ≥4 µm) were PCR positive. We cultured virus from one G-II sample. Based on previous literature, we hypothesized that ~50% of immunologically naïve people (HAI Discussion/Significance of Impact: We demonstrated that it is feasible to recruit donors with community-acquired influenza and expose recipients to measurable virus quantities under controlled conditions. However, baseline immunity was high among volunteers. Our work sets the stage for designing studies with increased sample sizes comprising immunologically naïve volunteers.

  PublisherOA PDFDOI

• Three things we can do now to reduce the risk of avian influenza spillovers

  Proceedings of the National Academy of Sciences · 2025-07-30 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• Avian Influenza Virus Infections in Felines: A Systematic Review of Two Decades of Literature

  medRxiv · 2024-05-01 · 4 citations

  reviewOpen access1st authorCorresponding

  Abstract As an avian influenza virus (AIV) panzootic is underway, the threat of a human pandemic is emerging. Infections among mammalian species in frequent contact with humans should be closely monitored. One mammalian family, the Felidae, is of particular concern. Domestic cats are susceptible to AIV infection and provide a potential pathway for zoonotic spillover to humans. Here, we provide a systematic review of the scientific literature to describe the epidemiology and global distribution of AIV infections in felines reported from 2004 – 2024. We identified 607 AIV infections in felines, including 302 associated deaths, comprising 18 countries and 12 felid species. We observed a drastic flux in the number of AIV infections among domestic cats in 2023 and 2024, commensurate with the emergence of H5N1 clade 2.3.4.4b. We estimate that this phenomenon is underreported in the scientific literature and argue that increased surveillance among domestic cats is urgently needed.

  PublisherOA PDFDOI

Frequent coauthors

• Gregory C. Gray

  The University of Texas Medical Branch at Galveston

  61 shared

• Sean Wei Xiang Ong

  Tan Tock Seng Hospital

  19 shared

• Yee‐Sin Leo

  Tan Tock Seng Hospital

  18 shared

• Kalisvar Marimuthu

  17 shared

• Donald K. Milton

  16 shared

• Brenda Ang

  Tan Tock Seng Hospital

  14 shared

• Son T. Than

  National University of Singapore

  14 shared

• Oon Tek Ng

  Tan Tock Seng Hospital

  14 shared

Labs

• Public Health AeroBiology Laboratory (PHAB Lab)PI

Education

• PhD (Biology)

  University of Toledo

  2017

Awards & honors

• University of Maryland Baltimore (UMB) Institute for Clinica…