New Simulator Recreates Human Cough to Study and Stop TB Transmission

Tuberculosis (TB) remains the world’s deadliest infectious disease, claiming over a million lives annually. Despite advances in treatment, understanding how TB spreads—especially through airborne droplets—has remained a major challenge. Now, scientists at the Hackensack Meridian Health‘s Center for Discovery and Innovation (CDI) have developed a breakthrough experimental system that replicates human coughs with remarkable precision to study TB transmission.

The new platform, called the Transmission Simulation System (TSS), mimics the aerogenic spread of Mycobacterium tuberculosis by simulating the propulsion of infected droplets during a human cough. Unlike older lab models that relied on nebulizers to create dense bacterial fogs—an imprecise and unrealistic method—the TSS recreates the physical and biological characteristics of a real cough, including aerosol concentration and particle size distribution. This allows researchers to observe how TB bacteria behave while airborne and how they enter the respiratory system of a host.

The system also includes a “nose-only” pickup simulation, which completes the transmission pathway and enables more consistent, controlled observations. According to lead researcher Dr. Martin Gengenbacher, associate member of the CDI faculty, this innovation allows scientists to model the entire journey of TB in a laboratory setting. “We can now begin to study the vulnerabilities of the bacterium while it’s airborne and develop strategies to specifically interrupt this transmission pathway,” he explained.

This simulator not only enhances TB research but also lays the groundwork for studying other respiratory pathogens, including those responsible for influenza, COVID-19, and emerging airborne threats. By enabling precise, reproducible experiments, the TSS could accelerate the development of vaccines, therapeutics, and public health strategies aimed at halting transmission before infection takes hold.