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Routes of transmission of influenza A H1N1, SARS CoV, and norovirus in air cabin: Comparative analyses
Author(s) -
Lei H.,
Li Y.,
Xiao S.,
Lin C.H.,
Norris S. L.,
Wei D.,
Hu Z.,
Ji S.
Publication year - 2018
Publication title -
indoor air
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.387
H-Index - 99
eISSN - 1600-0668
pISSN - 0905-6947
DOI - 10.1111/ina.12445
Subject(s) - norovirus , outbreak , transmission (telecommunications) , airborne transmission , environmental health , relative risk , confidence interval , covid-19 , pandemic , medicine , veterinary medicine , virology , infectious disease (medical specialty) , disease , computer science , telecommunications
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.