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Transmission of the severe acute respiratory syndrome on aircraft.
N Engl J Med. 2003 Dec 18; 349(25):2416-22.NEJM

Abstract

BACKGROUND

The severe acute respiratory syndrome (SARS) spread rapidly around the world, largely because persons infected with the SARS-associated coronavirus (SARS-CoV) traveled on aircraft to distant cities. Although many infected persons traveled on commercial aircraft, the risk, if any, of in-flight transmission is unknown.

METHODS

We attempted to interview passengers and crew members at least 10 days after they had taken one of three flights that transported a patient or patients with SARS. All index patients met the criteria of the World Health Organization for a probable case of SARS, and index or secondary cases were confirmed to be positive for SARS-CoV on reverse-transcriptase polymerase chain reaction or serologic testing.

RESULTS

After one flight carrying a symptomatic person and 119 other persons, laboratory-confirmed SARS developed in 16 persons, 2 others were given diagnoses of probable SARS, and 4 were reported to have SARS but could not be interviewed. Among the 22 persons with illness, the mean time from the flight to the onset of symptoms was four days (range, two to eight), and there were no recognized exposures to patients with SARS before or after the flight. Illness in passengers was related to the physical proximity to the index patient, with illness reported in 8 of the 23 persons who were seated in the three rows in front of the index patient, as compared with 10 of the 88 persons who were seated elsewhere (relative risk, 3.1; 95 percent confidence interval, 1.4 to 6.9). In contrast, another flight carrying four symptomatic persons resulted in transmission to at most one other person, and no illness was documented in passengers on the flight that carried a person who had presymptomatic SARS.

CONCLUSIONS

Transmission of SARS may occur on an aircraft when infected persons fly during the symptomatic phase of illness. Measures to reduce the risk of transmission are warranted.

Authors+Show Affiliations

International Emerging Infections Program, Centers for Disease Control and Prevention, Nonthaburi, Thailand. sco2@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14681507

Citation

Olsen, Sonja J., et al. "Transmission of the Severe Acute Respiratory Syndrome On Aircraft." The New England Journal of Medicine, vol. 349, no. 25, 2003, pp. 2416-22.
Olsen SJ, Chang HL, Cheung TY, et al. Transmission of the severe acute respiratory syndrome on aircraft. N Engl J Med. 2003;349(25):2416-22.
Olsen, S. J., Chang, H. L., Cheung, T. Y., Tang, A. F., Fisk, T. L., Ooi, S. P., Kuo, H. W., Jiang, D. D., Chen, K. T., Lando, J., Hsu, K. H., Chen, T. J., & Dowell, S. F. (2003). Transmission of the severe acute respiratory syndrome on aircraft. The New England Journal of Medicine, 349(25), 2416-22.
Olsen SJ, et al. Transmission of the Severe Acute Respiratory Syndrome On Aircraft. N Engl J Med. 2003 Dec 18;349(25):2416-22. PubMed PMID: 14681507.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transmission of the severe acute respiratory syndrome on aircraft. AU - Olsen,Sonja J, AU - Chang,Hsiao-Ling, AU - Cheung,Terence Yung-Yan, AU - Tang,Antony Fai-Yu, AU - Fisk,Tamara L, AU - Ooi,Steven Peng-Lim, AU - Kuo,Hung-Wei, AU - Jiang,Donald Dah-Shyong, AU - Chen,Kow-Tong, AU - Lando,Jim, AU - Hsu,Kwo-Hsiung, AU - Chen,Tzay-Jinn, AU - Dowell,Scott F, PY - 2003/12/19/pubmed PY - 2003/12/24/medline PY - 2003/12/19/entrez SP - 2416 EP - 22 JF - The New England journal of medicine JO - N Engl J Med VL - 349 IS - 25 N2 - BACKGROUND: The severe acute respiratory syndrome (SARS) spread rapidly around the world, largely because persons infected with the SARS-associated coronavirus (SARS-CoV) traveled on aircraft to distant cities. Although many infected persons traveled on commercial aircraft, the risk, if any, of in-flight transmission is unknown. METHODS: We attempted to interview passengers and crew members at least 10 days after they had taken one of three flights that transported a patient or patients with SARS. All index patients met the criteria of the World Health Organization for a probable case of SARS, and index or secondary cases were confirmed to be positive for SARS-CoV on reverse-transcriptase polymerase chain reaction or serologic testing. RESULTS: After one flight carrying a symptomatic person and 119 other persons, laboratory-confirmed SARS developed in 16 persons, 2 others were given diagnoses of probable SARS, and 4 were reported to have SARS but could not be interviewed. Among the 22 persons with illness, the mean time from the flight to the onset of symptoms was four days (range, two to eight), and there were no recognized exposures to patients with SARS before or after the flight. Illness in passengers was related to the physical proximity to the index patient, with illness reported in 8 of the 23 persons who were seated in the three rows in front of the index patient, as compared with 10 of the 88 persons who were seated elsewhere (relative risk, 3.1; 95 percent confidence interval, 1.4 to 6.9). In contrast, another flight carrying four symptomatic persons resulted in transmission to at most one other person, and no illness was documented in passengers on the flight that carried a person who had presymptomatic SARS. CONCLUSIONS: Transmission of SARS may occur on an aircraft when infected persons fly during the symptomatic phase of illness. Measures to reduce the risk of transmission are warranted. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/14681507/Transmission_of_the_severe_acute_respiratory_syndrome_on_aircraft_ DB - PRIME DP - Unbound Medicine ER -