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Abstract

The risk of communicable disease transmission during air travel is of public health concern and has received much attention over the years. We retrospectively reviewed information from nine flights (≥ 8 hours) associated with infectious tuberculosis (TB) cases in Ireland between September 2011 and November 2014 to investigate whether possible transmission had occurred. Twenty-four flights notified in Ireland associated with sputum smear-positive pulmonary TB cases with a history of air travel were reviewed. Nine were suitable for inclusion and analysed. Six cases of infectious TB travelled on nine flights. A total of 232 passengers were identified for contact tracing; 85.3% (n = 198) had sufficient information available for follow-up. In total, 12.1% (n = 24) were reported as screened for TB. The results revealed no active TB cases among passengers and 16.7% (n = 4) were diagnosed with latent TB infection (LTBI) all of whom had other risk factors. Despite the limited sample size, we found no evidence of transmission from infectious passengers. This study identified challenges in obtaining complete timely airline manifests, leading to inadequate passenger information for follow-up. Receipt of TB screening results from international colleagues was also problematic. The challenge of interpreting the tuberculin skin test results in determining recent vs earlier infection was encountered.

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/content/10.2807/1560-7917.ES.2016.21.40.30358
2016-10-06
2017-10-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.40.30358
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References

  1. World Health Organization (WHO). Global Tuberculosis Report 2015. Geneva: WHO; 2015. Available from: http://www.who.int/tb/publications/global_report/en/
  2. European Centre for Disease Prevention and Control (ECDC). Tuberculosis Surveillance and Monitoring in Europe 2015. ECDC: Stockholm; 2015. Available from: http://ecdc.europa.eu/en/publications/Publications/tuberculosis-surveillance-monitoring-Europe-2015.pdf
  3. Health Protection Surveillance Centre (HPSC). Annual Epidemiology Report. Dublin: HPSC; 2014. Available from: http://www.hpsc.ie/AboutHPSC/AnnualReports/
  4. Centers for Disease Control and Prevention (CDC). Exposure of passengers and flight crew to Mycobacterium tuberculosis on commercial aircraft, 1992-1995. MMWR Morb Mortal Wkly Rep. 1995;44(8):137-40. PMID: 7862079 
  5. Driver CR, Valway SE, Morgan WM, Onorato IM, Castro KG. Transmission of Mycobacterium tuberculosis associated with air travel. JAMA. 1994;272(13):1031-5.  https://doi.org/10.1001/jama.1994.03520130069035  PMID: 8089885 
  6. Kenyon TA, Valway SE, Ihle WW, Onorato IM, Castro KG. Transmission of multidrug-resistant Mycobacterium tuberculosis during a long airplane flight. N Engl J Med. 1996;334(15):933-8.  https://doi.org/10.1056/NEJM199604113341501  PMID: 8596593 
  7. Abubakar I. Tuberculosis and air travel: a systematic review and analysis of policy. Lancet Infect Dis. 2010;10(3):176-83.  https://doi.org/10.1016/S1473-3099(10)70028-1  PMID: 20185096 
  8. Chemardin J, Paty MC, Renard-Dubois S, Veziris N, Antoine D. Contact tracing of passengers exposed to an extensively drug-resistant tuberculosis case during an air flight from Beirut to Paris, October 2006. Euro Surveill. 2007;12(12):E071206.2. PMID: 18067848 
  9. McFarland JW, Hickman C, Osterholm M, MacDonald KL. Exposure to Mycobacterium tuberculosis during air travel. Lancet. 1993;342(8863):112-3.  https://doi.org/10.1016/0140-6736(93)91311-9  PMID: 8100876 
  10. Miller MA, Valway S, Onorato IM. Tuberculosis risk after exposure on airplanes. Tuber Lung Dis. 1996;77(5):414-9.  https://doi.org/10.1016/S0962-8479(96)90113-6  PMID: 8959144 
  11. Moore M, Fleming KS, Sands L. A passenger with pulmonary/laryngeal tuberculosis: no evidence of transmission on two short flights. Aviat Space Environ Med. 1996;67(11):1097-100. PMID: 8908350 
  12. Wang PD. Two-step tuberculin testing of passengers and crew on a commercial airplane. Am J Infect Control. 2000;28(3):233-8.  https://doi.org/10.1067/mic.2000.103555  PMID: 10840343 
  13. Whitlock G, Calder L, Perry H. A case of infectious tuberculosis on two long-haul aircraft flights: contact investigation. N Z Med J. 2001;114(1137):353-5. PMID: 11587303 
  14. Menzies D, Tannenbaum TN, FitzGerald JM. Tuberculosis: 10. Prevention. CMAJ. 1999;161(6):717-24. PMID: 10513279 
  15. World Health Organization (WHO). Tuberculosis and air travel: guidelines for prevention and control. 3rd Ed. Geneva: WHO; 2013. www.who.int/tb/publications/2008/WHO_HTM_TB_2008.399_eng.pdf
  16. Health Protection Surveillance Centre (HPSC). Guidelines on the Prevention and Control in Ireland 2010. Dublin: HPSC; 2010. https://www.hpsc.ie/A-Z/VaccinePreventable/TuberculosisTB/Guidance/
  17. Government of Ireland. S.I. No. 390/1981: Infectious Diseases Regulations, 1981. Dublin: Stationery Office; 1981. Available from: http://www.irishstatutebook.ie/eli/1981/si/390/made/en/print
  18. Horsburgh CR Jr. Priorities for the treatment of latent tuberculosis infection in the United States. N Engl J Med. 2004;350(20):2060-7.  https://doi.org/10.1056/NEJMsa031667  PMID: 15141044 
  19. Marienau KJ, Burgess GW, Cramer E, Averhoff FM, Buff AM, Russell M, et al. Tuberculosis investigations associated with air travel: U. S. Centers for Disease Control and Prevention, January 2007-June 2008. Travel Med Infect Dis. 2010;8(2):104-12.  https://doi.org/10.1016/j.tmaid.2010.02.003  PMID: 20478518 
  20. Kotila SM, Payne Hallstrom L, Jansen N,, Helbling P, Abubakar I. Systematic review on transmission on aircraft and update of the European Centre for Disease Prevention and Control risk assessment guidelines for tuberculosis transmitted on aircrafts (RAGIDA-TB). Euro Surveill. 2016;21(4). PMID: 26848520 
  21. European Centre for Disease Prevention and Control (ECDC). Risk assessment guidelines for infectious diseases transmitted on aircraft (RAGIDA) – Tuberculosis. Technical Report. Stockholm: ECDC; 2014. Available from: http://ecdc.europa.eu/en/publications/Publications/tuberculosis-risk-assessment-guidelines-aircraft-May-2014.pdf
  22. National Institute for Health and Care Excellence (NICE). Tuberculosis: Clinical diagnosis and management of tuberculosis, and measures for its prevention and control. London: NICE; 2011. Available from: https://www.nice.org.uk/Guidance/cg117
  23. Abubakar I, Welfare R, Moore J, Watson JM. Surveillance of air-travel-related tuberculosis incidents, England and Wales: 2007-2008. Euro Surveill. 2008;13(23):18896. PMID: 18761951 
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