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Edited by Burton H. Singer, University of Florida, Gainesville, FL, and approved February 13, 2018 (received for review June 30, 2017)
Significance
With over 3 billion airline passengers annually, the inflight transmission of infectious diseases is an important global health concern. Over a dozen cases of inflight transmission of serious infections have been documented, and air travel can serve as a conduit for the rapid spread of newly emerging infections and pandemics. Despite sensational media stories, risks of transmission of respiratory viruses in an airplane cabin are unknown. Movements of passengers and crew may facilitate disease transmission. On 10 transcontinental US flights, we chronicled behaviors and movements of individuals in the economy cabin on single-aisle aircraft. We simulated transmission during flight based on these data. This data-driven, dynamic network transmission model of droplet-mediated respiratory disease is unique.
Abstract
With over 3 billion airline passengers annually, the inflight transmission of infectious diseases is an important global health concern. Over a dozen cases of inflight transmission of serious infections have been documented, and air travel can serve as a conduit for the rapid spread of newly emerging infections and pandemics. Despite sensational media stories and anecdotes, the risks of transmission of respiratory viruses in an airplane cabin are unknown. Movements of passengers and crew may facilitate disease transmission. On 10 transcontinental US flights, we chronicled behaviors and movements of individuals in the economy cabin on single-aisle aircraft. We simulated transmission during flight based on these data. Our results indicate there is low probability of direct transmission to passengers not seated in close proximity to an infectious passenger. This data-driven, dynamic network transmission model of droplet-mediated respiratory disease is unique. To measure the true pathogen burden, our team collected 229 environmental samples during the flights. Although eight flights were during Influenza season, all qPCR assays for 18 common respiratory viruses were negative.
Footnotes
↵1V.S.H. and H.W. contributed equally to this work.
- ↵2To whom correspondence should be addressed. Email: vhertzb{at}emory.edu.
↵3A complete list of the FlyHealthy Research Team can be found in the Supporting Information.
Author contributions: V.S.H., H.W., S.N., and the F.R.T. designed research; V.S.H., H.W., and the F.R.T. performed research; V.S.H., H.W., L.E., and W.S. contributed new analytic tools; V.S.H., L.E., W.S., and the F.R.T. analyzed data; and V.S.H., H.W., and L.E. wrote the paper.
Conflict of interest statement: The authors received support from The Boeing Company (H.W.) by way of a subcontract to the Georgia Institute of Technology (V.S.H.). S.L.N. is an employee of Boeing.
This article is a PNAS Direct Submission.
Data deposition: Data and software for the simulations are available at dx.doi.org/10.15139/S3/OOYETQ.
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1711611115/-/DCSupplemental.
- Copyright © 2018 the Author(s). Published by PNAS.
This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).
Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights
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