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Abstract

When a person with contagious measles has travelled by aircraft, European guidelines recommend contact tracing of passengers and crew within 5 days of exposure for post-exposure prophylaxis (PEP), and within 12 days of exposure for informing passengers and crew, in order to prevent further transmissions. To be effective, contact tracing requires prompt diagnosis, immediate notification of public health authorities and rapid availability of passenger contact data. We report two events of contact tracing initiated in Germany after two individuals with measles travelled on three international flights. In one event, contact tracing was initiated late because laboratory confirmation of a clinically diagnosed measles case was awaited unnecessarily. Accessing passenger contact data was difficult in both events because of data protection issues with the airline which was not based in Germany. In both events, passengers were not reached in time to provide PEP, and one event resulted in at least two secondary measles cases. As all passengers were reached before the incubation period ended, tertiary cases were most probably prevented. Public health authorities and the transport sector must collaborate to resolve competing legal regulations for infection prevention and data protection, to simplify and accelerate identification of air travellers exposed to communicable diseases.

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/content/10.2807/1560-7917.ES.2019.24.19.1800500
2019-05-09
2019-05-26
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.19.1800500
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References

  1. World Health Organization (WHO). Measles. Fact sheet Geneva: WHO; 2018. Available from: www.who.int/mediacentre/factsheets/fs286/en/
  2. Gesetz zur Verhütung und Bekämpfung von Infektionskrankheiten beim Menschen (Infektionsschutzgesetz - IfSG). [Act for the prevention and control of human infectious diseases (Protection against infection act)]. Berlin: Bundesministerium der Justiz und für Verbraucherschutz. 2018. Bundesgesetzblatt Part I, 20 Jul 2000, pp. 1045-77. Zuletzt geändert durch Artikel 6 des Gesetzes vom 11.12.2018 (BGBl. I S. 2394). German. Available from: https://www.gesetze-im-internet.de/ifsg/IfSG.pdf
  3. European Centre for Disease Prevention and Control (ECDC). Measles and rubella surveillance 2017. Stockholm: ECDC; 2018. Available from: https://ecdc.europa.eu/sites/portal/files/documents/Measles-and-Rubella-Surveillance-2017.pdf
  4. Coleman KP, Markey PG. Measles transmission in immunized and partially immunized air travellers. Epidemiol Infect. 2010;138(7):1012-5.  https://doi.org/10.1017/S0950268809991129  PMID: 19878613 
  5. Cotter S, O’Flanagan D, Cooney F, Thornton L, McKeown P. Probable measles transmission during transatlantic travel. Epi-Insight. 2010;11(8). Available from: http://ndsc.newsweaver.ie/epiinsight/ghclnh7rdptt6pex6po7cd
  6. Edelson PJ. Patterns of measles transmission among airplane travelers. Travel Med Infect Dis. 2012;10(5-6):230-5.  https://doi.org/10.1016/j.tmaid.2012.10.003  PMID: 23127863 
  7. Mangili A, Gendreau MA. Transmission of infectious diseases during commercial air travel. Lancet. 2005;365(9463):989-96.  https://doi.org/10.1016/S0140-6736(05)71089-8  PMID: 15767002 
  8. Nic Lochlainn L, Mandal S, de Sousa R, Paranthaman K, van Binnendijk R, Ramsay M, et al. A unique measles B3 cluster in the United Kingdom and the Netherlands linked to air travel and transit at a large international airport, February to April 2014. Euro Surveill. 2016;21(13):30177.  https://doi.org/10.2807/1560-7917.ES.2016.21.13.30177  PMID: 27074646 
  9. European Centre for Disease Prevention and Control (ECDC). Risk assessment guidelines for diseases transmitted on aircraft. 2nd ed. Stockholm: ECDC; 2010. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/1012_GUI_RAGIDA_2.pdf
  10. Robert Koch Institute. Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut –2017/2018. [Recommendations of the Standing Committee on Vaccination at the Robert Koch Institute – 2017/2018]. Epidemiologisches Bulletin. 2017;34. German. Available from: https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2017/Ausgaben/34_17.pdf;jsessionid=F7888EF84FE57273A69E6E10D746B3F0.1_cid363?__blob=publicationFile
  11. Leitmeyer K. European risk assessment guidance for infectious diseases transmitted on aircraft--the RAGIDA project. Euro Surveill. 2011;16(16):19845. PMID: 21527131 
  12. Swaan CM, Appels R, Kretzschmar ME, van Steenbergen JE. Timeliness of contact tracing among flight passengers for influenza A/H1N1 2009. BMC Infect Dis. 2011;11(1):355.  https://doi.org/10.1186/1471-2334-11-355  PMID: 22204494 
  13. World Health Organization (WHO). International Health Regulations. 3rd ed. Geneva: WHO; 2005. Available from: https://apps.who.int/iris/bitstream/handle/10665/246107/9789241580496-eng.pdf?sequence=1
  14. Gesetz zur Durchführung der Internationalen Gesundheitsvorschriften 2005 (IGV-Durchführungsgesetz - IGV-DG). [Act to implement the International Health Regulations (2005)]. Berlin: Bundesministerium der Justiz und für Verbraucherschutz. Bundesgesetzblatt Part I, 28 Mar 2013, pp. 566-84. German. Available from: http://www.ilo.org/dyn/natlex/docs/ELECTRONIC/95783/112899/F-216424569/bgbl113s0566_20818.pdf
  15. European Centre for Disease Prevention and Control (ECDC). Ongoing outbreak of measles in Romania, risk of spread and epidemiological situation in EU/EEA countries - 3 March 2017. Stockholm: ECDC; 2017. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/27-02-2017-RRA-Measles-Romania%2C%20European%20Union%20countries.pdf
  16. International Air Transport Association (IATA). Request Form for Passenger Contact Tracing. Montreal: IATA. [Accessed: 5 Sep 2018]. Available from: www.iata.org/whatwedo/safety/health/Documents/request-form-passenger-contact-tracing.pdf
  17. International Civil Aviation Organization (ICAO). Convention on international civil aviation. Montreal: ICAO; 2006. Available from: https://www.icao.int/publications/Documents/7300_9ed.pdf
  18. International Civil Aviation Organization (ICAO). Managing communicable disease in aviation. Montreal: ICAO. [Accessed: 5 Sep 2018]. Available from: www.icao.int/safety/aviation-medicine/Pages/healthrisks.aspx
  19. Collaborative Arrangement for the Prevention and Management of Public Health Events in Civil Aviation (CAPSCA). [Accessed: 12 Dec 2018]. Available from: www.capsca.org/
  20. AIRSAN. Contact tracing – collaboration between the public health and the aviation sector. AIRSAN; 2015. Available from: www.airsan.eu/Portals/0/docs/AIRSAN_Guidance%20Document_Contact%20Tracing_May2015.pdf
Contact tracing following measles exposure on three international flights, Germany, 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Sebastian+Thole&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Thole Sebastian</a>, <a href="/search?value1=Daniela+Kalhoefer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kalhoefer Daniela</a>, <a href="/search?value1=Maria+an+der+Heiden&option1=author&noRedirect=true" class="nonDisambigAuthorLink">an der Heiden Maria</a>, <a href="/search?value1=Doris+Nordmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nordmann Doris</a>, <a href="/search?value1=Inka+Daniels-Haardt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Daniels-Haardt Inka</a>, <a href="/search?value1=Annette+Jurke&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jurke Annette</a></span>. Contact tracing following measles exposure on three international flights, Germany, 2017. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(19):pii=1800500. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.19.1800500" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.19.1800500</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 07 Sep 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 20 Dec 2018 </span> </p>
/content/10.2807/1560-7917.ES.2019.24.19.1800500
/content/10.2807/1560-7917.ES.2019.24.19.1800500
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