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Bugs on a Plane

Influenza and parainfluenza viruses were the most common respiratory pathogens in sick passengers.

Airplane travelers may be exposed to a variety of noxious respiratory pathogens, but few data are available on exactly what these organisms are. Researchers now offer some baseline descriptive data on which respiratory pathogens tend to travel by airplane.

During a 2-month period amid the international severe acute respiratory syndrome (SARS) scare in 2003, air passengers arriving in Germany from SARS-endemic areas with clinical symptoms compatible with SARS were screened with PCR assays against a variety of viral and bacterial pathogens. At least one pathogen was detected in 67 (43%) of 155 screened passengers, most between ages 19 and 60: Parainfluenza virus was identified in 24 (15%); influenza A or B in 22 (14%); adenovirus or coronavirus in 11 (7%). Other respiratory viruses, mycoplasma, and legionella were found in fewer than five patients each. The researchers could find no evidence of clustering to suggest transmission during the flights to Germany, although they lacked complete flight data to evaluate transmission during prior flights.

Comment: These data do not imply that the sick passengers acquired their infections en route, but merely provide some information on the spectrum of respiratory pathogens to which other, healthy passengers may be exposed. An editorialist enumerates all the things we still do not know about the spread of respiratory infections on a plane in flight, including the relative threats of large droplets, small particles, and contaminated surfaces, and the effectiveness of the high-efficiency particulate air (HEPA) filters now installed in some, but not all, aircraft (not to mention the effects of time of year, degree of crowding on the plane, and itinerary).

— Abigail Zuger, MD

Published in Journal Watch General Medicine March 22, 2007

Citation(s):

Luna LK et al. Spectrum of viruses and atypical bacteria in intercontinental air travelers with symptoms of acute respiratory infection. J Infect Dis 2007 Mar 1; 195:675-9. [Erratum in: J Infect Dis 2007 Apr 15; 195:1237.] [Medline® abstract]

Pavia AT. Germs on a plane: Aircraft, international travel, and the global spread of disease. J Infect Dis 2007 Mar 1; 195:621-2. [Medline® abstract]

Copyright © 2007. Massachusetts Medical Society. All rights reserved.