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January 8, 2010 | H1N1 virus more easily spread during plane travel | Washington: In a first of its kind study, researchers at University
of California, Los Angeles (UCLA) have predicted that H1N1 flu infections are more easily spread during plane travel. Dr. Sally Blower, along with Bradley Wagner
and Brian Coburn, used novel mathematical modelling techniques to predict in-flight
transmission of the H1N1 virus. They found that transmission could be rather significant,
particularly during long flights, if the infected individual travels in economy
class. Specifically, two to five infections could occur during a five-hour flight,
five to 10 during an 11-hour flight, and seven to 17 during a 17-hour flight.
"Clearly, it was air travel, by transporting infectious individuals from the epicenter
in Mexico to other geographic locations, that significantly affected the spread
of H1N1 during the outbreak last spring. However, until our study, it hadn't been
determined how important in-flight transmission could be. Therefore, we decided
to make a mathematical model and predict what could be expected to occur during
a flight," said Coburn. The researchers used methods from the field of quantitative
microbial risk assessment, and determined the number of potential infections in
one transatlantic flight, assuming there was just a single infected passenger
on board. Specifically, they used the long-established Wells-Riley equation, which
is based on the number of exposed individuals, the respiratory rate of the infected
person, the length of exposure to the infectious droplets and the concentration
of infectious viral particles over time. Within an aircraft, the concentration
of particles over time is determined via ventilation rates, the volume of the
cabins in the aircraft and how sick the infected person is. "Importantly, we found
that the number of infections that would occur on a flight was very dependent
on which cabin the infected individual was sitting in. We found that many infections
could occur if the infected individual was travelling in economy class but relatively
few if the individual was travelling in first class," said Blower. The researchers
tried to find out why more infections occur in economy class. "Primarily, it's
the more crowded conditions in economy. And unfortunately, there is a very high
probability - 75 percent - that if an infected person is on board, they will be
in the economy cabin," said Coburn. The researchers noted that their results have
important implications for understanding and predicting the global dissemination
of H1N1, suggesting that air-travel restrictions may be useful in controlling
influenza pandemics. "Our results imply that one individual travelling by plane,
by infecting other travelers on the same flight, could cause multiple simultaneous
outbreaks in different geographic locations rather than causing only one outbreak.
For that reason, quarantining passengers who travel in economy class on long-haul
flights could potentially be an important control strategy this winter, but there
is no point quarantining passengers in first class," said Wagner. The study has
been published in the current online edition of the journal BMC Medicine. |
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