Measles transmission during air travel, United States, December 1, 2008–December 31, 2011

Measles associated with international travel in the region of the Americas, Australia and Europe, 2001–2013: A systematic review

“…Furthermore, no secondary patients are expected to occur while on board as the average duration of the flight and the cruise (seven days) are shorter than the incubation time of measles (7e21 days) [57e60]. Although contact tracing guidelines differ between countries [42,43,61], modern communication tools may facilitate contacting potentially exposed passengers. Passengers should be rapidly informed to contact their health care center in case they are not protected.…”

“…For example in the USA, less than 1% of those 954 passenger-contacts for whom outcome reports were received had acquired measles, or 4% (9/249) of those with no, or unknown vaccine or disease history [42]. Data was inconsistent regarding the transmission risk in relation to a longer duration of international flights and with respect to the seating position of the infected contacts.…”

“…Data was inconsistent regarding the transmission risk in relation to a longer duration of international flights and with respect to the seating position of the infected contacts. However, spread of measles during international air travel was not rare if there was an infectious case on board and it was increased by multiple infectious cases on board [42,43]. Also further spread to family members and health care workers were described [46,48].…”

“…With respect to the seating position, 22 of 40 secondary cases with data on their seating positions were seated in the same row or within two rows fore and behind of the index case; 18 were located outside this range, one of whom was a member of the cabin crew. Secondary transmission was significantly more likely to occur if the index case was younger or when there were multiple infectious cases on board [42,43]. Most of the affected persons had an unknown vaccination status, were incompletely or unvaccinated [42].…”

“…Secondary transmission was significantly more likely to occur if the index case was younger or when there were multiple infectious cases on board [42,43]. Most of the affected persons had an unknown vaccination status, were incompletely or unvaccinated [42].…”