Assessment of SARS-CoV-2 Transmission on an International Flight and Among a Tourist Group

Hoehl, Sebastian; Karaca, Onur; Kohmer, Niko; Westhaus, Sandra; Graf, Jürgen; Goetsch, Udo; Ciesek, Sandra

doi:10.1001/jamanetworkopen.2020.18044

Cited by 59 publications

(52 citation statements)

References 3 publications

(4 reference statements)

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“…Other published reports describe suspected flight-associated transmission of SARS-CoV-2 (2,3,13,14), but these reports lack supportive genomic evidence. Our investigation demonstrates the value of WGS for elucidating transmission of SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing

Speake¹,

Phillips²,

Chong³

et al. 2020

Emerg. Infect. Dis.

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19 had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by PCR. All 6 passengers had disembarked from cruise ships that had recently docked in Sydney. In the subsequent 2 weeks, several other cases of SARS-CoV-2 infection were identified among passengers on that flight. Although the role of cruise ships in SARS-CoV-2 transmission is well documented (1), information regarding potential flight-associated transmission of SARS-CoV-2 (2,3) is limited. We investigated SARS-CoV-2 transmission associated with a 5-hour domestic flight by analyzing epidemiologic and whole-genome sequencing (WGS) data. Ethics approval was not required for this investigation, conducted as part of the public health response to the SARS-CoV-2 outbreak under the Western Australia Public Health Act 2016. Methods Public Health Response to Coronavirus Disease in Australia In Australia, coronavirus disease (COVID-19) is an urgently notifiable disease (4); laboratory-confirmed cases and close contacts are investigated and managed according to national guidelines produced by the Communicable Disease Network of Australia (4). Details for flights with SARS-CoV-2 infectious persons on board are published at https://www. healthywa.wa.gov.au/coronavirus. Airlines are responsible for the management of crew and are notified of potential in-flight exposure by the National Incident Room (https://www.health.gov.au/initiatives-and-programs/national-incident-room).

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Section: Discussionmentioning

confidence: 99%

Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing

Speake¹,

Phillips²,

Chong³

et al. 2020

Emerg. Infect. Dis.

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“…The ability of genomics to resolve transmission events may increase as the virus evolves and accumulates greater diversity [23]. Non-pharmaceutical interventions [1] with distancing and restricted crew/passenger interaction can contribute to prevention of COVID-19 transmission in-flight, and recent studies speculate that face coverings confer protection [24,25]. It is interesting that four of the flight cases were not seated next to any other positive case, had no contact in the transit lounge, wore face masks in-flight and would not be deemed close contacts under current guidance from the European Centre for Disease Prevention and Control (ECDC) [1].…”

Section: Discussionmentioning

confidence: 99%

A large national outbreak of COVID-19 linked to air travel, Ireland, summer 2020

Murphy¹,

Boland

Bambury

et al. 2020

Eurosurveillance

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An outbreak of 59 cases of coronavirus disease (COVID-19) originated with 13 cases linked by a 7 h, 17% occupancy flight into Ireland, summer 2020. The flight-associated attack rate was 9.8-17.8%. Spread to 46 non-flight cases occurred country-wide. Asymptomatic/pre-symptomatic transmission in-flight from a point source is implicated by 99% homology across the virus genome in five cases travelling from three different continents. Restriction of movement on arrival and robust contact tracing can limit propagation post-flight. Air travel has accelerated the global pandemic, contributing to the spread of coronavirus disease (COVID-19) throughout the world. We describe an outbreak that demonstrates in-flight transmission, providing further evidence to add to the small number of published studies in this area. This study depicts the nature of transmission on board, despite implementation of nonpharmaceutical interventions. We demonstrate widespread in-country transmission as a result of imported infection and give recommendations to reduce the risk of importation, and to curtail onwards spread. License, supplementary material and copyright This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence and indicate if changes were made.

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“…In-flight transmission has been long-standing described for multiple infectious agents, especially bacterial and viral respiratory pathogens [ 61 ], such as tuberculosis [ [62] , [63] , [64] ], influenza [ 65 , 66 ], measles [ 67 ], and coronaviruses, such as the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) [ 27 , 61 , [68] , [69] , [70] , [71] , [72] ].…”

Section: Resultsmentioning

confidence: 99%

“…The risk of transmission of droplet-mediated infections on an aircraft depends on proximity to an index case and on other factors, such as movement of passengers and crew, fomites, and contact among passengers in the departure gate [ 68 , 77 ].…”

Section: Resultsmentioning

confidence: 99%

Reprint of: Air travel and COVID-19 prevention in the pandemic and peri-pandemic period: A narrative review

Bielecki

Patel²,

Hinkelbein³

et al. 2020

Travel Medicine and Infectious Disease

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Assessment of SARS-CoV-2 Transmission on an International Flight and Among a Tourist Group

Abstract: This case series describes severe acute respiratory syndrome coronavirus (SARS-CoV-2) transmission on a international commercial airline flight.

Cited by 59 publications

References 3 publications

Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing

Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing

A large national outbreak of COVID-19 linked to air travel, Ireland, summer 2020

Reprint of: Air travel and COVID-19 prevention in the pandemic and peri-pandemic period: A narrative review

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