Transmission of the severe acute respiratory syndrome on aircraft
Transmission of the severe acute respiratory syndrome on aircraft
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DOI：
10.1056/nejmoa031349
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发表时间：
2003-12-18
影响因子：
158.5
通讯作者：
Dowell, SF
中科院分区：
文献类型：
--
作者：
Olsen, SJ;Chang, H;Dowell, SF
背景：严重急性呼吸系统综合征（SARS）在世界范围内迅速传播，主要是因为感染了SARS相关冠状病毒（SARS- cov）的人乘坐飞机前往遥远的城市。虽然许多感染者乘坐商用飞机旅行，但飞行中传播的风险（如果有的话）尚不清楚。方法：我们试图在乘客和机组人员乘坐运送SARS患者的三个航班之一至少10天后采访他们。所有指数型患者均符合世界卫生组织SARS疑似病例标准，指数型或继发性病例经逆转录酶聚合酶链反应或血清学检测均为SARS冠状病毒阳性。结果：1次航班携带1名有症状者和119名其他人员，其中16人经实验室确诊为SARS， 2人被诊断为可能的SARS， 4人报告患有SARS但无法接受采访。在22名患病人员中，从飞行到出现症状的平均时间为4天（范围为2至8天），并且在飞行前后均未与SARS患者接触。乘客的疾病与与指示病人的身体距离有关，坐在指示病人前面三排的23人中有8人报告了疾病，而坐在其他地方的88人中有10人报告了疾病（相对风险为3.1；95%置信区间为1.4至6.9）。相比之下，另一架载有四名有症状者的航班最多传染给了另外一人，而载有症状前SARS患者的航班上的乘客没有患病记录。结论：SARS的传播可能发生在航空器上，当感染者在疾病的症状期飞行时。有必要采取措施减少传播风险。
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.