On the 2-Row Rule for Infectious Disease Transmission on Aircraft
- PMID: 28283135
- PMCID: PMC7104167
- DOI: 10.1016/j.aogh.2016.06.003
On the 2-Row Rule for Infectious Disease Transmission on Aircraft
Abstract
Background: With over two billion airline passengers annually, in-flight transmission of infectious diseases is an important global health concern. Many instances of in-flight transmission have been documented, but the relative influence of the many factors (see below) affecting in-flight transmission has not been quantified. Long-standing guidance by public health agencies is that the primary transmission risk associated with air travel for most respiratory infectious diseases is associated with sitting within two rows of an infectious passenger. The effect of proximity may be one of these factors.
Objective: The aim of this study was to determine the risk of infection within and beyond the 2-row rule given by public health guidance.
Methods: We searched the literature for reports of in-flight transmission of infection which included seat maps indicating where the infectious and infected passengers were seated.
Findings: There is a ∼ 6% risk to passengers seated within the 2-rows of infected individual(s) and there is ∼ 2% risk to passengers seated beyond 2-rows from the infectious individual.
Discussion: Contact tracing limited to passengers within 2-rows of the infectious individual(s) could fail to detect other cases of infections. This has important consequences for assessing the spread of infectious diseases.
Conclusions: Infection at a distance from the index case indicates other factors, such as airflow, movement of passenger/crew members, fomites and contacts between passengers in the departure gate before boarding, or after deplaning, are involved.
Keywords: Airplane cabin; SARS; disease risk; infectious disease transmission; influenza.
Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Figures
Similar articles
-
Patterns of measles transmission among airplane travelers.Travel Med Infect Dis. 2012 Sep;10(5-6):230-5. doi: 10.1016/j.tmaid.2012.10.003. Epub 2012 Nov 3. Travel Med Infect Dis. 2012. PMID: 23127863 Review.
-
Navigating the risks of flying during COVID-19: a review for safe air travel.J Travel Med. 2020 Dec 23;27(8):taaa212. doi: 10.1093/jtm/taaa212. J Travel Med. 2020. PMID: 33184655 Free PMC article. Review.
-
International flight-related transmission of pandemic influenza A(H1N1)pdm09: an historical cohort study of the first identified cases in the United Kingdom.Influenza Other Respir Viruses. 2014 Jan;8(1):66-73. doi: 10.1111/irv.12181. Epub 2013 Nov 7. Influenza Other Respir Viruses. 2014. PMID: 24373291 Free PMC article.
-
Travel-associated SARS-CoV-2 transmission documented with whole genome sequencing following a long-haul international flight.J Travel Med. 2022 Sep 17;29(6):taac057. doi: 10.1093/jtm/taac057. J Travel Med. 2022. PMID: 35532195 Free PMC article.
-
Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights.Proc Natl Acad Sci U S A. 2018 Apr 3;115(14):3623-3627. doi: 10.1073/pnas.1711611115. Epub 2018 Mar 19. Proc Natl Acad Sci U S A. 2018. PMID: 29555754 Free PMC article.
Cited by
-
Risk of COVID-19 transmission on long-haul flights: During the COVID-19 pandemic.PLoS One. 2024 Aug 16;19(8):e0309044. doi: 10.1371/journal.pone.0309044. eCollection 2024. PLoS One. 2024. PMID: 39150944 Free PMC article.
-
A distributionally robust optimization approach for airline integrated recovery under in-flight pandemic transmission risks.Transp Res Part C Emerg Technol. 2023 Jul;152:104188. doi: 10.1016/j.trc.2023.104188. Epub 2023 Jun 7. Transp Res Part C Emerg Technol. 2023. PMID: 37305559 Free PMC article.
-
Spatial immunization to abate disease spreading in transportation hubs.Nat Commun. 2023 Mar 20;14(1):1448. doi: 10.1038/s41467-023-36985-0. Nat Commun. 2023. PMID: 36941266 Free PMC article.
-
Evaluation of infection probability of Covid-19 in different types of airliner cabins.Build Environ. 2023 Apr 15;234:110159. doi: 10.1016/j.buildenv.2023.110159. Epub 2023 Mar 2. Build Environ. 2023. PMID: 36895516 Free PMC article.
-
The Impact of Heating, Ventilation, and Air-Conditioning Design Features on the Transmission of Viruses, Including SARS-CoV-2: Overview of Reviews.Interact J Med Res. 2022 Dec 23;11(2):e37232. doi: 10.2196/37232. Interact J Med Res. 2022. PMID: 36343208 Free PMC article. Review.
References
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous