Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January–March and June–August 2020

Background. Evidence on the risk of SARS-CoV-2 transmission during air travel is scarce. We aimed to estimate the attack rate for wild-type SARS-CoV-2 to improve the evidence base for the adaptation of nonpharmaceutical intervention (NPI) strategies aboard airplanes. Methods. In collaboration with G...

Full description

Saved in:
Bibliographic Details
Main Authors: Felix Moek, Anna Rohde, Meike Schöll, Juliane Seidel, Jonathan H. J. Baum, Maria an der Heiden
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Canadian Journal of Infectious Diseases and Medical Microbiology
Online Access:http://dx.doi.org/10.1155/2022/8364666
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849412692815642624
author Felix Moek
Anna Rohde
Meike Schöll
Juliane Seidel
Jonathan H. J. Baum
Maria an der Heiden
author_facet Felix Moek
Anna Rohde
Meike Schöll
Juliane Seidel
Jonathan H. J. Baum
Maria an der Heiden
author_sort Felix Moek
collection DOAJ
description Background. Evidence on the risk of SARS-CoV-2 transmission during air travel is scarce. We aimed to estimate the attack rate for wild-type SARS-CoV-2 to improve the evidence base for the adaptation of nonpharmaceutical intervention (NPI) strategies aboard airplanes. Methods. In collaboration with German Public Health Authorities (PHA), we conducted a follow-up of in-flight SARS-CoV-2 contact persons. We included those contact persons whom the Emergency Operations Centre at the Robert Koch-Institute had forwarded to PHA between January to March 2020 (before masking on flights became mandatory) and June to August 2020 (after the introduction of mandatory masking). We retrospectively collected data on whether these contact persons had been successfully contacted, had become symptomatic and had been tested for SARS-CoV-2, and whether alternative exposures other than the flight were known. Results. Complete data that allowed for the calculation of attack rates were available for 108 contact persons (median age of 36 (IQR 24–53), 40% female), traveling on 46 flights with a median flight duration of 3 hours (IQR 2–3.5). 62 of these persons travelled after masking on flights became mandatory. 13/87 developed symptoms, 44/77 were tested (no data for 21 and 31). 13 persons (9 of whom had been SARS-CoV-2 positive) were excluded from the analysis of attack rates due to a likely alternative exposure. We thus identified 4 probable in-flight transmissions (2 of which occurred after the introduction of mandatory masking). The overall attack rate resulted in 4.2% (4/95; 95% CI: 1.4%–11.0%). Considering flights after mandatory masking, the attack rate was 3.6% (2/56, 95% CI 0.6%–13.4%), before masking 5.1% (2/39, 95% CI 0.9%–18.6%). Conclusions. The risk of wild-type SARS-CoV-2 transmission during air travel seemed low, but not negligible. In order to formulate an effective, evidence-based NPI protocol for air travel, further studies considering the different transmissibility of SARS-CoV-2 variants of concern and vaccination status are needed.
format Article
id doaj-art-55269d3aae7449cdbf634532cfe67b3e
institution Kabale University
issn 1918-1493
language English
publishDate 2022-01-01
publisher Wiley
record_format Article
series Canadian Journal of Infectious Diseases and Medical Microbiology
spelling doaj-art-55269d3aae7449cdbf634532cfe67b3e2025-08-20T03:34:21ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1918-14932022-01-01202210.1155/2022/8364666Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January–March and June–August 2020Felix Moek0Anna Rohde1Meike Schöll2Juliane Seidel3Jonathan H. J. Baum4Maria an der Heiden5Postgraduate Training for Applied Epidemiology (PAE)Unit for Gastrointestinal InfectionsPostgraduate Training for Applied Epidemiology (PAE)Unit for Crisis ManagementPostgraduate Training for Applied Epidemiology (PAE)Unit for Crisis ManagementBackground. Evidence on the risk of SARS-CoV-2 transmission during air travel is scarce. We aimed to estimate the attack rate for wild-type SARS-CoV-2 to improve the evidence base for the adaptation of nonpharmaceutical intervention (NPI) strategies aboard airplanes. Methods. In collaboration with German Public Health Authorities (PHA), we conducted a follow-up of in-flight SARS-CoV-2 contact persons. We included those contact persons whom the Emergency Operations Centre at the Robert Koch-Institute had forwarded to PHA between January to March 2020 (before masking on flights became mandatory) and June to August 2020 (after the introduction of mandatory masking). We retrospectively collected data on whether these contact persons had been successfully contacted, had become symptomatic and had been tested for SARS-CoV-2, and whether alternative exposures other than the flight were known. Results. Complete data that allowed for the calculation of attack rates were available for 108 contact persons (median age of 36 (IQR 24–53), 40% female), traveling on 46 flights with a median flight duration of 3 hours (IQR 2–3.5). 62 of these persons travelled after masking on flights became mandatory. 13/87 developed symptoms, 44/77 were tested (no data for 21 and 31). 13 persons (9 of whom had been SARS-CoV-2 positive) were excluded from the analysis of attack rates due to a likely alternative exposure. We thus identified 4 probable in-flight transmissions (2 of which occurred after the introduction of mandatory masking). The overall attack rate resulted in 4.2% (4/95; 95% CI: 1.4%–11.0%). Considering flights after mandatory masking, the attack rate was 3.6% (2/56, 95% CI 0.6%–13.4%), before masking 5.1% (2/39, 95% CI 0.9%–18.6%). Conclusions. The risk of wild-type SARS-CoV-2 transmission during air travel seemed low, but not negligible. In order to formulate an effective, evidence-based NPI protocol for air travel, further studies considering the different transmissibility of SARS-CoV-2 variants of concern and vaccination status are needed.http://dx.doi.org/10.1155/2022/8364666
spellingShingle Felix Moek
Anna Rohde
Meike Schöll
Juliane Seidel
Jonathan H. J. Baum
Maria an der Heiden
Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January–March and June–August 2020
Canadian Journal of Infectious Diseases and Medical Microbiology
title Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January–March and June–August 2020
title_full Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January–March and June–August 2020
title_fullStr Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January–March and June–August 2020
title_full_unstemmed Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January–March and June–August 2020
title_short Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January–March and June–August 2020
title_sort attack rate for wild type sars cov 2 during air travel results from 46 flights traced by german health authorities january march and june august 2020
url http://dx.doi.org/10.1155/2022/8364666
work_keys_str_mv AT felixmoek attackrateforwildtypesarscov2duringairtravelresultsfrom46flightstracedbygermanhealthauthoritiesjanuarymarchandjuneaugust2020
AT annarohde attackrateforwildtypesarscov2duringairtravelresultsfrom46flightstracedbygermanhealthauthoritiesjanuarymarchandjuneaugust2020
AT meikescholl attackrateforwildtypesarscov2duringairtravelresultsfrom46flightstracedbygermanhealthauthoritiesjanuarymarchandjuneaugust2020
AT julianeseidel attackrateforwildtypesarscov2duringairtravelresultsfrom46flightstracedbygermanhealthauthoritiesjanuarymarchandjuneaugust2020
AT jonathanhjbaum attackrateforwildtypesarscov2duringairtravelresultsfrom46flightstracedbygermanhealthauthoritiesjanuarymarchandjuneaugust2020
AT mariaanderheiden attackrateforwildtypesarscov2duringairtravelresultsfrom46flightstracedbygermanhealthauthoritiesjanuarymarchandjuneaugust2020