Transmission of pandemic A/H1N1 2009 influenza on passenger aircraft: retrospective cohort study.
Transmission of pandemic A/H1N1 2009 influenza on passenger aircraft: retrospective cohort study.
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DOI：
10.1136/bmj.c2424
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发表时间：
2010-05-21
期刊：
影响因子：
--
通讯作者：
Wilson N
中科院分区：
文献类型：
--
作者：
Baker MG;Thornley CN;Mills C;Roberts S;Perera S;Peters J;Kelso A;Barr I;Wilson N
目的评估2009年甲型H1N1流感大流行(大流行A/H1N1)从受感染的高中人群传播给航空公司航班上的其他乘客的风险，以及对暴露于此的乘客进行筛查和跟踪的有效性。设计回顾性队列调查，对旅客进行问卷调查，对有症状的旅客进行实验室调查。设置新西兰奥克兰，对乘客进行国内和国际跟踪。参与者：坐在2009年4月25日抵达的一架波音747-400长途航班后部的乘客，包括一组24名学生和教师，以及(102名)同舱的97名同意接受采访的其他乘客。主要观察指标实验室确认易感人群在抵达后3.2天内感染甲型H1N1流感大流行；流感症状对确诊感染的敏感性和特异性；接触者追踪的完整性和及时性。结果学校组有9名成员为甲型H1N1大流行感染实验室确诊病例，并在飞行中出现症状。另外两名乘客在飞行后12小时和48小时确诊感染了甲型H1N1流感大流行。他们没有报告其他潜在的感染源。他们的座位在两排受感染乘客的范围内，这意味着这两排乘客的感染风险约为3.5%。除了一名确诊的甲型H1N1流感大流行感染者外，所有人都报告了咳嗽，但对流感病例的更复杂定义的敏感度相对较低。公共卫生工作者的严格跟踪发现了93%的乘客，但只有52%的乘客在抵达后72小时内得到了联系。结论在现代商业航空旅行中，甲型H1N1大流行传播的风险很低，但可以测量。这种风险集中在有症状的受感染乘客附近。一旦暴露的乘客离开机场，对他们的跟踪和筛查就变得缓慢和困难。
Objectives To assess the risk of transmission of pandemic A/H1N1 2009 influenza (pandemic A/H1N1) from an infected high school group to other passengers on an airline flight and the effectiveness of screening and follow-up of exposed passengers. Design Retrospective cohort investigation using a questionnaire administered to passengers and laboratory investigation of those with symptoms. Setting Auckland, New Zealand, with national and international follow-up of passengers. Participants Passengers seated in the rear section of a Boeing 747-400 long haul flight that arrived on 25 April 2009, including a group of 24 students and teachers and 97 (out of 102) other passengers in the same section of the plane who agreed to be interviewed. Main outcome measures Laboratory confirmed pandemic A/H1N1 infection in susceptible passengers within 3.2 days of arrival; sensitivity and specificity of influenza symptoms for confirmed infection; and completeness and timeliness of contact tracing. Results Nine members of the school group were laboratory confirmed cases of pandemic A/H1N1 infection and had symptoms during the flight. Two other passengers developed confirmed pandemic A/H1N1 infection, 12 and 48 hours after the flight. They reported no other potential sources of infection. Their seating was within two rows of infected passengers, implying a risk of infection of about 3.5% for the 57 passengers in those rows. All but one of the confirmed pandemic A/H1N1 infected travellers reported cough, but more complex definitions of influenza cases had relatively low sensitivity. Rigorous follow-up by public health workers located 93% of passengers, but only 52% were contacted within 72 hours of arrival. Conclusions A low but measurable risk of transmission of pandemic A/H1N1 exists during modern commercial air travel. This risk is concentrated close to infected passengers with symptoms. Follow-up and screening of exposed passengers is slow and difficult once they have left the airport.
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DOI：
10.1056/nejmoa0905498
发表时间：
2009-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cauchemez S;Donnelly CA;Reed C;Ghani AC;Fraser C;Kent CK;Finelli L;Ferguson NM
通讯作者：
Ferguson NM
影响因子：
56.3
作者：
Lessler, Justin;Reich, Nicholas G.;Brookmeyer, Ron;Perl, Trish M.;Nelson, Kenrad E.;Cummings, Derek A. T.
通讯作者：
Cummings, Derek A. T.
影响因子：
5.8
作者：
Xie, X.;Li, Y.;Seto, W. H.
通讯作者：
Seto, W. H.
影响因子：
3.5
作者：
Atkinson, Michael P.;Wein, Lawrence M.
通讯作者：
Wein, Lawrence M.
影响因子：
9.3
作者：
Wagner BG;Coburn BJ;Blower S
通讯作者：
Blower S