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2018 ; 28
(3
): 394-403
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gab.com Text
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Routes of transmission of influenza A H1N1, SARS CoV, and norovirus in air cabin:
Comparative analyses
#MMPMID29244221
Lei H
; Li Y
; Xiao S
; Lin CH
; Norris SL
; Wei D
; Hu Z
; Ji S
Indoor Air
2018[May]; 28
(3
): 394-403
PMID29244221
show ga
Identifying the exact transmission route(s) of infectious diseases in indoor
environments is a crucial step in developing effective intervention strategies.
In this study, we proposed a comparative analysis approach and built a model to
simulate outbreaks of 3 different in-flight infections in a similar cabin
environment, that is, influenza A H1N1, severe acute respiratory syndrome (SARS)
coronavirus (CoV), and norovirus. The simulation results seemed to suggest that
the close contact route was probably the most significant route (contributes 70%,
95% confidence interval [CI]: 67%-72%) in the in-flight transmission of influenza
A H1N1 transmission; as a result, passengers within 2 rows of the index case had
a significantly higher infection risk than others in the outbreak (relative risk
[RR]: 13.4, 95% CI: 1.5-121.2, P = .019). For SARS CoV, the airborne, close
contact, and fomite routes contributed 21% (95% CI: 19%-23%), 29% (95% CI:
27%-31%), and 50% (95% CI: 48%-53%), respectively. For norovirus, the simulation
results suggested that the fomite route played the dominant role (contributes
85%, 95% CI: 83%-87%) in most cases; as a result, passengers in aisle seats had a
significantly higher infection risk than others (RR: 9.5, 95% CI: 1.2-77.4,
P = .022). This work highlighted a method for using observed outbreak data to
analyze the roles of different infection transmission routes.