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      • Record: found
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      Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights

      research-article
      Author(s): a , 2 , b , c , d , e , The FlyHealthy Research Team 3
      Other contributor(s): (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab)
      Publication date (Electronic):
      Journal: Proceedings of the National Academy of Sciences of the United States of America
      Publisher: National Academy of Sciences
      Keywords: airplane transportation, infectious disease transmission, influenza, SARS, pandemic

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          Significance

          With over 3 billion airline passengers annually, the inflight transmission of infectious diseases is an important global health concern. Over a dozen cases of inflight transmission of serious infections have been documented, and air travel can serve as a conduit for the rapid spread of newly emerging infections and pandemics. Despite sensational media stories, risks of transmission of respiratory viruses in an airplane cabin are unknown. Movements of passengers and crew may facilitate disease transmission. On 10 transcontinental US flights, we chronicled behaviors and movements of individuals in the economy cabin on single-aisle aircraft. We simulated transmission during flight based on these data. This data-driven, dynamic network transmission model of droplet-mediated respiratory disease is unique.

          Abstract

          With over 3 billion airline passengers annually, the inflight transmission of infectious diseases is an important global health concern. Over a dozen cases of inflight transmission of serious infections have been documented, and air travel can serve as a conduit for the rapid spread of newly emerging infections and pandemics. Despite sensational media stories and anecdotes, the risks of transmission of respiratory viruses in an airplane cabin are unknown. Movements of passengers and crew may facilitate disease transmission. On 10 transcontinental US flights, we chronicled behaviors and movements of individuals in the economy cabin on single-aisle aircraft. We simulated transmission during flight based on these data. Our results indicate there is low probability of direct transmission to passengers not seated in close proximity to an infectious passenger. This data-driven, dynamic network transmission model of droplet-mediated respiratory disease is unique. To measure the true pathogen burden, our team collected 229 environmental samples during the flights. Although eight flights were during Influenza season, all qPCR assays for 18 common respiratory viruses were negative.

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          Transmission of infectious diseases during commercial air travel

          Alexandra Mangili, Mark Gendreau (2005)
          Summary Because of the increasing ease and affordability of air travel and mobility of people, airborne, food-borne, vector-borne, and zoonotic infectious diseases transmitted during commercial air travel are an important public health issue. Heightened fear of bioterrorism agents has caused health officials to re-examine the potential of these agents to be spread by air travel. The severe acute respiratory syndrome outbreak of 2002 showed how air travel can have an important role in the rapid spread of newly emerging infections and could potentially even start pandemics. In addition to the flight crew, public health officials and health care professionals have an important role in the management of infectious diseases transmitted on airlines and should be familiar with guidelines provided by local and international authorities.
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            An outbreak of influenza aboard a commercial airliner.

            Jeffrey H Margolis, A P Kendal, Jeffrey Bender … (1979)
            A jet airliner with 54 persons aboard was delayed on the ground for three hours because of engine failure during a takeoff attempt. Most passengers stayed on the airplane during the delay. Within 72 hours, 72 per cent of the passengers became ill with symptoms of cough, fever, fatigue, headache, sore throat and myalgia. One passenger, the apparent index case, was ill on the airplane, and the clinical attack rate among the others varied with the amount of time spent aboard. Virus antigenically similar to A/Texas/1/77(H3N2) was isolated from 8 of 31 passengers cultured, and 20 of 22 ill persons tested had serologic evidence of infection with this virus. The airplane ventilation system was inoperative during the delay and this may account for the high attack rate.
            Article 0 comments Cited 155 times – based on 0 reviews     Review now
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              A High-Resolution Human Contact Network for Infectious Disease Transmission

              , , … (2010)
              The most frequent infectious diseases in humans - and those with the highest potential for rapid pandemic spread - are usually transmitted via droplets during close proximity interactions (CPIs). Despite the importance of this transmission route, very little is known about the dynamic patterns of CPIs. Using wireless sensor network technology, we obtained high-resolution data of CPIs during a typical day at an American high school, permitting the reconstruction of the social network relevant for infectious disease transmission. At a 94% coverage, we collected 762,868 CPIs at a maximal distance of 3 meters among 788 individuals. The data revealed a high density network with typical small world properties and a relatively homogenous distribution of both interaction time and interaction partners among subjects. Computer simulations of the spread of an influenza-like disease on the weighted contact graph are in good agreement with absentee data during the most recent influenza season. Analysis of targeted immunization strategies suggested that contact network data are required to design strategies that are significantly more effective than random immunization. Immunization strategies based on contact network data were most effective at high vaccination coverage.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Proc Natl Acad Sci U S A
                Journal ID (iso-abbrev): Proc. Natl. Acad. Sci. U.S.A
                Journal ID (hwp): pnas
                Journal ID (pmc): pnas
                Journal ID (publisher-id): PNAS
                Title: Proceedings of the National Academy of Sciences of the United States of America
                Publisher: National Academy of Sciences
                ISSN (Print): 0027-8424
                ISSN (Electronic): 1091-6490
                Publication date (Print): 3 April 2018
                Publication date (Electronic): 19 March 2018
                Publication date PMC-release: 19 March 2018
                Volume: 115
                Issue: 14
                Pages: 3623-3627
                Affiliations
                [1] aNell Hodgson Woodruff School of Nursing, Emory University , Atlanta, GA 30322;
                [2] bSchool of Mathematics, Georgia Institute of Technology , Atlanta, GA 30313;
                [3] cDepartment of Biostatistics and Bioinformatics, Emory University , Atlanta, GA 30322;
                [4] dDepartment of Mathematics and Computer Science, Emory University , Atlanta, GA 30322;
                [5] eBoeing Commercial Airplanes , The Boeing Company, Bellevue, WA 98004
                Author notes
                2To whom correspondence should be addressed. Email: vhertzb@ 123456emory.edu .

                Edited by Burton H. Singer, University of Florida, Gainesville, FL, and approved February 13, 2018 (received for review June 30, 2017)

                Author contributions: V.S.H., H.W., S.N., and the F.R.T. designed research; V.S.H., H.W., and the F.R.T. performed research; V.S.H., H.W., L.E., and W.S. contributed new analytic tools; V.S.H., L.E., W.S., and the F.R.T. analyzed data; and V.S.H., H.W., and L.E. wrote the paper.

                1V.S.H. and H.W. contributed equally to this work.

                Author information
                http://orcid.org/0000-0002-8834-4363
                Article
                Publisher ID: 201711611
                DOI: 10.1073/pnas.1711611115
                PMC ID: 5889623
                PubMed ID: 29555754
                SO-VID: 180d3dad-ea3d-4bd4-8106-9fac935d75a9
                Copyright © Copyright © 2018 the Author(s). Published by PNAS.
                License:

                This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).

                History
                Page count
                Pages: 5
                Funding
                Funded by: The Boeing Company
                Award ID: 2001-041-1
                Categories
                Subject: Social Sciences
                Subject: Social Sciences
                Subject: Biological Sciences
                Subject: Applied Biological Sciences

                Keywords: airplane transportation,infectious disease transmission,influenza,sars,pandemic
                Data availability:
                Keywords: airplane transportation, infectious disease transmission, influenza, sars, pandemic

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