Abstract:In April 2009, influenza A(H1N1)pdm09 virus infection was confirmed in a person who had been symptomatic while traveling on a commercial flight from Mexico to the United Kingdom. Retrospective public health investigation and contact tracing led to the identification of 8 additional confirmed cases among passengers and community contacts of passengers.
“…Two investigations (one historical cohort study and one retrospective investigation) apparently reported about the same flight. 23 , 24 However, both studies were included in our analysis, as different contact tracing strategies were applied and resulting data differed (e.g., the number of index cases, secondary cases, passengers traced, and passengers aboard). The other 16 articles were excluded as they reported findings using modeling techniques and experimental approaches rather than analyzing actual transmission events aboard aircraft.…”
“…Two investigations (one historical cohort study and one retrospective investigation) apparently reported about the same flight. 23 , 24 However, both studies were included in our analysis, as different contact tracing strategies were applied and resulting data differed (e.g., the number of index cases, secondary cases, passengers traced, and passengers aboard). The other 16 articles were excluded as they reported findings using modeling techniques and experimental approaches rather than analyzing actual transmission events aboard aircraft.…”
Respiratory tract infections can be caused by a wide variety of viruses. Airborne transmission via droplets and aerosols enables some of these viruses to spread efficiently among humans, causing outbreaks that are difficult to control. Many outbreaks have been investigated retrospectively to study the possible routes of inter-human virus transmission. The results of these studies are often inconclusive and at the same time data from controlled experiments is sparse. Therefore, fundamental knowledge on transmission routes that could be used to improve intervention strategies is still missing. We here present an overview of the available data from experimental and observational studies on the transmission routes of respiratory viruses between humans, identify knowledge gaps, and discuss how the available knowledge is currently implemented in isolation guidelines in health care settings.
“…In April 2009, on a 9.5-hour flight from Mexico to Birmingham, UK, a passenger contagious with novel H1N1 virus infected 6 passengers. 22 Only 2 of the infected passengers were seated within 2 rows of the infectious passenger.…”
Infection at a distance from the index case indicates other factors, such as airflow, movement of passenger/crew members, fomites and contacts between passengers in the departure gate before boarding, or after deplaning, are involved.
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