An Outbreak of Influenza a/Taiwan/1/86 (H1n1) Infections at a Naval Base and Its Association With Airplane Travel

Klontz, Karl C.; Hynes, Noreen A.; Gunn, Robert A.; Wilder, Michael H.; Harmon, Maurice W.; Kendal, Alan P.

doi:10.1093/oxfordjournals.aje.a115137

Cited by 82 publications

(65 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In some reported outbreaks of respiratory diseases in aircraft cabins (Klontz et al 1989;Marsden 2003;Olsen et al 2003;Kenyon et al 1996), it can be observed that many of the passengers seated in the same row or one row in front of the index patient had been infected or developed illness. From Table 1, passengers seated in these two rows generally had higher exposures than those seated further had.…”

Section: Discussionmentioning

confidence: 99%

Experimental Study of Dispersion and Deposition of Expiratory Aerosols in Aircraft Cabins and Impact on Infectious Disease Transmission

To¹,

Wan²,

Chao³

et al. 2009

Aerosol Science and Technology

View full text Add to dashboard Cite

The dispersion and deposition characteristics of polydispersed expiratory aerosols were investigated in an aircraft cabin mockup to study the transmission of infectious diseases. The airflow was characterized by particle image velocimetry (PIV) measurements. Aerosol dispersion was measured by the Interferometric Mie Imaging (IMI) method combined with an aerosol spectrometer. Deposition was investigated using the fluorescent dye technique. Downward air currents were observed near the seats next to the side walls while upward airflows were observed near other seats. The downward airflow showed some effects on suppressing the dispersion of aerosols expelled by the passenger sitting in the window seat. Results show that the cough jet could bring significant amount of aerosols forward to the row of seats ahead of the cougher and the aerosols were then dispersed by the bulk air movements in the lateral direction. The aerosols expelled from a cough took 20-30 s to reach the breathing zones of the passengers seated within two rows from the cougher. Increasing the ventilation rate improved the dilution and reduced the aerosol exposure to passengers seated close to the source, but the aerosol dispersion increased, which heightened the exposure to passengers seated further away. 60-70% of expiratory aerosols in mass were deposited, with significant portions on surfaces close to the source, suggesting that disease transmission risk via indirect contact in addition to airborne risk is possible. The physical transport processes of expiratory aerosols could be used to shed insights on some epidemiological observations on in-flight transmission of certain infectious diseases.

show abstract

Section: Discussionmentioning

confidence: 99%

Experimental Study of Dispersion and Deposition of Expiratory Aerosols in Aircraft Cabins and Impact on Infectious Disease Transmission

To¹,

Wan²,

Chao³

et al. 2009

Aerosol Science and Technology

View full text Add to dashboard Cite

show abstract

“…3 Transmission of seasonal influenza during air travel has been documented by epidemiologic investigations and is supported by model simulations. [5][6][7][8][9] Published studies of pH1N1 transmission among air travelers report that virus transmission during air travel is probable, but the risk of infection to susceptible passengers and crew may be limited, and the role of the aircraft cabin environment is unclear. [10][11][12] Documented risk factors associated with seasonal influenza virus transmission include receiving or providing health care 13 ; being in close quarters (e.g., in a household, daycare, or schools) with index patients 14 ; and close proximity to (within 1 m) or being in crowded or enclosed environments (including aircraft cabins) with an index patient who is coughing and sneezing.…”

Section: Introductionmentioning

confidence: 99%

Influenza A(H1N1)pdm09 during air travel

Neatherlin

Cramer

Dubray

et al. 2013

Travel Medicine and Infectious Disease

View full text Add to dashboard Cite

SummaryThe global spread of the influenza A(H1N1)pdm09 virus (pH1N1) associated with travelers from North America during the onset of the 2009 pandemic demonstrates the central role of international air travel in virus migration. To characterize risk factors for pH1N1 transmission during air travel, we investigated travelers and airline employees from four North American flights carrying ill travelers with confirmed pH1N1 infection. Of 392 passengers and crew identified, information was available for 290 (74%) passengers were interviewed. Overall attack rates for acute respiratory infection and influenza-like illness 1-7 days after travel were 5.2% and 2.4% respectively. Of 43 individuals that provided sera, 4 (9.3%) tested positive for pH1N1 antibodies, including 3 with serologic evidence of asymptomatic infection. Investigation of novel influenza aboard aircraft may be instructive. However, beyond the initial outbreak phase, it may compete with community-based mitigation activities, and interpretation of findings will be difficult in the context of established community transmission.

show abstract

“…A number of epidemiological investigations, e.g., Kenyon et al (1996) and Miller et al (1996), suggested that some tuberculosis outbreaks were very likely caused by airborne transmission among passengers in aircraft cabins. In-flight transmission of diseases that are believed to be transmitted by large droplets, such as severe acute respiratory syndrome (SARS) (e.g., Olsen et al 2003,) and influenza (e.g., Moser et al 1979;Klontz et al 1989), are also well documented.…”

Section: Introductionmentioning

confidence: 99%

Modeling the Fate of Expiratory Aerosols and the Associated Infection Risk in an Aircraft Cabin Environment

Wan

Chao

et al. 2009

Aerosol Science and Technology

111

106

View full text Add to dashboard Cite

The transport and deposition of polydispersed expiratory aerosols in an aircraft cabin were simulated using a Lagrangianbased model validated by experiments conducted in an aircraft cabin mockup. Infection risk by inhalation was estimated using the aerosol dispersion data and a model was developed to estimate the risk of infection by contact. The environmental control system (ECS) in a cabin creates air circulation mainly in the lateral direction, making lateral dispersions of aerosols much faster than longitudinal dispersions. Aerosols with initial sizes under 28 µm in diameter can stay airborne for comparatively long periods and are favorable for airborne transport. Using influenza data as an example, the estimated risk of infection by inhalation are at least two orders of magnitude higher than the risk of infection by contact. An increase in the supply airflow rate enhances ventilation removal and the dispersion of these aerosols. It reduces the risk of infection by inhalation for passengers seated within one row and one column from the index patient but it increases the risk for passengers seated further away. The deposition fraction increases with aerosol size. The ECS supply airflow rate has insignificant impact on the deposition behavior of these large aerosols, making the impact on the risk of infection by contact insignificant. Comparatively, the contact behavior of passengers is highly influential to the contact infection risk. Passengers seated within one row from the index patient are subject to contact risks that are one to two orders of magnitude higher than are passengers seated further away.

show abstract

An Outbreak of Influenza a/Taiwan/1/86 (H1n1) Infections at a Naval Base and Its Association With Airplane Travel

Cited by 82 publications

References 8 publications

Experimental Study of Dispersion and Deposition of Expiratory Aerosols in Aircraft Cabins and Impact on Infectious Disease Transmission

Experimental Study of Dispersion and Deposition of Expiratory Aerosols in Aircraft Cabins and Impact on Infectious Disease Transmission

Influenza A(H1N1)pdm09 during air travel

Modeling the Fate of Expiratory Aerosols and the Associated Infection Risk in an Aircraft Cabin Environment

Contact Info

Product

Resources

About