The history of air sampling stretches back further than most people realize. The Smithsonian’s National Museum of American History holds photographs of samplers dating to the 19th century, including the Sedgwick-Tucker device which aimed to detect bacteria and fungi and looks more like Victorian laboratory furniture than anything you’d recognize today. By the 1950s, the AISI automatic tape sampler had arrived, bulky and loud, but a genuine leap forward in continuous air monitoring for particulate matter.

The samplers used by the Lungfish project today look very different.

One of these samplers is InBio’s Apollo and, at just six by six inches, it’s roughly the size of two iPhones placed side by side. More importantly, it’s quiet. Earlier generations of air samplers announced themselves with mechanical whirring and hum; the Apollo blends into the background, operating unnoticed in the spaces people actually use. That combination of size and silence isn’t just convenient. It’s transformative for where and how air surveillance can happen.

Breathing new life into disease surveillance

In a webinar on May 21st hosted by InBio, Dr. Shelby O’Connor laid out an ambitious vision for what air sampling could ultimately become: a public health forecasting tool, not unlike the weather forecast you check before leaving the house. Imagine an app that tells you the risk of encountering a circulating respiratory pathogen in your neighborhood today, whether low, moderate, or high. Some people might pull on a mask for a moderate-risk day, the same way they grab an umbrella when the sky looks like it might rain. Others might skip an indoor gathering entirely when the risk is elevated, just as you would cancel a picnic in a downpour.

To get there, Lungfish is testing whether air sampling can reliably detect respiratory pathogens in real-world settings across three very different environments.

Zambia: Proving the concept in a low-resource setting

In 2025, Lungfish deployed four Apollo samplers to clinics run by the Macha Research Trust in Zambia. This site was chosen because respiratory infection surveillance is limited in low- and middle-income countries, so environmental surveillance might offer a quick and cost-effective way to obtain helpful information about circulating respiratory pathogens. After sampling three times a week, the Lungfish team and their partners found that the information detected through air sampling matched clinical data obtained from nasal swabs.

Nepal: Catching tuberculosis earlier

Tuberculosis (TB) remains the world’s deadliest infectious disease, killing more than one million people each year. In Nepal, multidrug-resistant TB is among the top ten causes of death. Treatment for drug-resistant TB is arduous, and patients may spend up to 18 months in specialized TB “hostels,” isolated from family while undergoing complex drug regimens. The earlier people are diagnosed with TB, the better their chances are for survival.

Lungfish is currently sampling the air inside three TB hostels in Nepal. The immediate goal is validation: can air sampling detect Mycobacterium tuberculosis DNA in the air of spaces where people with confirmed TB cases are residing? If so, can we use next-generation sequencing to show strain level correlation between the air samples and patient samples. And finally, can we move this process beyond sampling in hostels, to hospitals, clinics, and community spaces, to see whether air surveillance can flag TB transmission before symptoms drive anyone to test.

Wisconsin schools: ORCHARDS-Air Study

Finally, Dr. O’Connor described Lungfish’s work in Wisconsin schools. In a partnership with the team leading the Oregon Child Absenteeism due to Respiratory Disease study (ORCHARDS), Dr. O’Connor explained how Lungfish worked to determine if air sampling was feasible in households. During the 2025-2026 academic year, if a child fell ill, the family would be offered an Apollo air sampler to place in their home for 14 days along with nasal swabs of the child and family members living in the household. The results indicated, once again, that the detections found through air sampling in households matched the clinical diagnosis of the index case.

What comes next

The Lungfish project has plans to continue air sampling in schools and healthcare facilities in the United States, and also expand to clinical sites in Brazil and Taiwan. The information collected by the Lungfish project so far has confirmed that the presence of respiratory pathogens corresponds to sick individuals in these indoor spaces. Our future work will assess if we can detect pathogen signals from the air and use those findings to design interventions to prevent transmission.