Abstract
Understanding the dynamics of influenza transmission on international flights is necessary for prioritizing public health response to pandemic incursions. A retrospective cohort study to ascertain in-flight transmission of pandemic (H1N1) 2009 and influenza-like illness (ILI) was undertaken for 2 long-haul flights entering Australia during May 2009. Combined results, including survey responses from 319 (43%) of 738 passengers, showed that 13 (2%) had an ILI in flight and an ILI developed in 32 (5%) passengers during the first week post arrival. Passengers were at 3.6% increased risk of contracting pandemic (H1N1) 2009 if they sat in the same row as or within 2 rows of persons who were symptomatic preflight. A closer exposed zone (2 seats in front, 2 seats behind, and 2 seats either side) increased the risk for postflight disease to 7.7%. Efficiency of contact tracing without compromising the effectiveness of the public health intervention might be improved by limiting the exposed zone.
Highlights
Understanding the dynamics of influenza transmission on international flights is necessary for prioritizing public health response to pandemic incursions
Contact tracing by public health authorities found 5 additional passengers with influenza-like illness (ILI) who had negative test results for pandemic (H1N1) 2009
Risk of Contracting Disease and Contact Tracing We examined the risk of contracting pandemic (H1N1) 2009 infection postflight to all susceptible passengers seated in the economy section of the aircraft
Summary
Understanding the dynamics of influenza transmission on international flights is necessary for prioritizing public health response to pandemic incursions. The World Health Organization activated level 5 pandemic alert on April 29, 2009, when sustained community transmission of the pandemic virus was demonstrated in Mexico and the United States. In her address to the United Nations on May 4, 2009, Margaret Chan, Director-General of the World Health Organization, called for heightened vigilance. The aim of this study was to investigate the spread of pandemic (H1N1) 2009 infection from persons with confirmed disease on flights to Australia during May 2009. The spread of other influenza-like illness (ILI) was documented
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