Airplanes and Infectious Disease

  • Harriet A. BurgeEmail author
Part of the The Handbook of Environmental Chemistry book series (HEC, volume 4H)


Air travel is associated with crowded conditions that can facilitate the transmission of airborne infectious diseases. The risk of contracting such diseases depends on the presence of an infected person who is shedding infectious particles and sufficient exposure of a sensitive person to achieve an adequate dose to cause disease. Proximity to the infectious person and the length of time spent near the person are the most important risks for contracting a disease. Ventilation patterns play a lesser role in disease transmission. Well-documented outbreaks of influenza, severe acute respiratory syndrome (SARS), and tuberculosis have occurred. Other common respiratory illnesses have probably also been spread via aircraft, but outbreaks remain unrecognized. Research on the spread of infectious disease in aircraft has focused on sampling for microorganisms in air (which has little relevance), and on the development of models to predict the risks for specific diseases.

Aircraft Infection Contagious disease Airborne Tuberculosis Influenza SARS  





Severe acute respiratory syndrome


  1. 1.
    DeHart RL (2003) Annu Rev Public Health 24:133 Google Scholar
  2. 2.
    Lamar JE 2nd, Malakooti MA (2003) Mil Med 168:523 Google Scholar
  3. 3.
    Al-Jahdali H, Memish ZA, Menzies D (2003) Int J Antimicrob Agents 21:125 Google Scholar
  4. 4.
    Brown TP, Shuker LK, Rushton L, Warren F, Stevens J (2001) J R Soc Health 121:177 Google Scholar
  5. 5.
    Guillet P, Germain MC, Giacomini T, Chandre F, Akogbeto M, Faye O, Kone A, Manga L, Mouchet J (1998) Trop Med Int Health 3:700 CrossRefGoogle Scholar
  6. 6.
    Russell RC, Paton R (1989) Bull World Health Organ 67:543 Google Scholar
  7. 7.
    Hedberg CW, Levine WC, White KE, Carlson RH, Winsor DK, Cameron DN, MacDonald KL, Osterholm MT (1992) Jama 268:3208 Google Scholar
  8. 8.
    Back E, Romanus V, Sjoberg L, Svenungsson B, Bottiger M, Kallings LO (1977) Scand J Infect Dis 9:175 Google Scholar
  9. 9.
    Eisenberg MS, Gaarslev K, Brown W, Horwitz M, Hill D (1975) Lancet 2:595 Google Scholar
  10. 10.
    Shieh YS, Baric RS, Sobsey MD (1997) Appl Environ Microbiol 63:4401 Google Scholar
  11. 11.
    Grais RF, Ellis JH, Kress A, Glass GE (2004) Health Care Manag Sci 7:127 Google Scholar
  12. 12.
    Grais RF, Ellis JH, Glass GE (2003) Epidemiol Infect 131:849 CrossRefGoogle Scholar
  13. 13.
    Rose DM, Jung D, Parera D, Konietzko J (1999) Z Arztl Fortbild Qualitatssich 93:481 Google Scholar
  14. 14.
    Rheinbaben F, Schunemann S, Gross T, Wolff MH (2000) J Hosp Infect 46:61 CrossRefGoogle Scholar
  15. 15.
    Bridges CB, Kuehnert MJ, Hall CB (2003) Clin Infect Dis 37:1094 CrossRefGoogle Scholar
  16. 16.
    Regan SF, Fowler C (2002) J Gerontol Nurs 28:30 Google Scholar
  17. 17.
    Fennelly KP, Martyny JW, Fulton KE, Orme IM, Cave DM, Heifets LB (2004) Am J Respir Crit Care Med 169:604 CrossRefGoogle Scholar
  18. 18.
    (2004) MMWR Morb Mortal Wkly Rep 53:389 Google Scholar
  19. 19.
    Paunio M, Peltola H, Valle M, Davidkin I, Virtanen M, Heinonen OP (1998) Am J Epidemiol 148:1103 Google Scholar
  20. 20.
    Ehresmann KR, Hedberg CW, Grimm MB, Norton CA, MacDonald KL, Osterholm MT (1995) J Infect Dis 171:679 Google Scholar
  21. 21.
    Yu IT, Li Y, Wong TW, Tam W, Chan AT, Lee JH, Leung DY, Ho T (2004) N Engl J Med 350:1731 Google Scholar
  22. 22.
    Keeler N, Lingappa J (2004) Curr Opin Pediatr 16:61 Google Scholar
  23. 23.
    Brundage JF, Scott RM, Lednar WM, Smith DW, Miller RN (1988) Jama 259:2108 CrossRefGoogle Scholar
  24. 24.
    Goldmann DA (2000) Pediatr Infect Dis J 19:97 Google Scholar
  25. 25.
    Baillargeon J, Black SA, Leach CT, Jenson H, Pulvino J, Bradshaw P, Murray O (2004) Prev Med 38:607 CrossRefGoogle Scholar
  26. 26.
    White MC, Tulsky JP, Portillo CJ, Menendez E, Cruz E, Goldenson J (2001) Int J Tuberc Lung Dis 5:400 Google Scholar
  27. 27.
    Utrup LJ, Frey AH (2004) Exp Biol Med (Maywood) 229:345 Google Scholar
  28. 28.
    Ko G, First MW, Burge HA (2000) Tuber Lung Dis 80:217 CrossRefGoogle Scholar
  29. 29.
    Ko G, First MW, Burge HA (2002) Environ Health Perspect 110:95 Google Scholar
  30. 30.
    Reed SE (1975) J Hyg (Lond) 75:249 Google Scholar
  31. 31.
    Menzies D, Adhikari N, Arietta M, Loo V (2003) Infect Control Hosp Epidemiol 24:483 Google Scholar
  32. 32.
    Alani A, Barton IE, Seymour MJ, Wrobel LC (2001) Int J Environ Health Res 11:219 CrossRefGoogle Scholar
  33. 33.
    Mileno MD, Bia FJ (1998) Infect Dis Clin North Am 12:369 CrossRefGoogle Scholar
  34. 34.
    Ko G, Thompson KM, Nardell EA (2004) Risk Anal 24:379 CrossRefGoogle Scholar
  35. 35.
    Zitter JN, Mazonson PD, Miller DP, Hulley SB, Balmes JR (2002) Jama 288:483 CrossRefGoogle Scholar
  36. 36.
    Moser MR, Bender TR, Margolis HS, Noble GR, Kendal AP, Ritter DG (1979) Am J Epidemiol 110:1 Google Scholar
  37. 37.
    Houk VN (1980) Ann N Y Acad Sci 353:10 Google Scholar
  38. 38.
    Driver CR, Valway SE, Morgan WM, Onorato IM, Castro KG (1994) Jama 272:1031 CrossRefGoogle Scholar
  39. 39.
    Kenyon TA, Valway SE, Ihle WW, Onorato IM, Castro KG (1996) N Engl J Med 334:933 CrossRefGoogle Scholar
  40. 40.
    Wang PD (2000) Am J Infect Control 28:233 CrossRefGoogle Scholar
  41. 41.
    Parmet AJ (1999) Aviat Space Environ Med 70:817 Google Scholar
  42. 42.
    Hsueh PR, Chen PJ, Hsiao CH, Yeh SH, Cheng WC, Wang JL, Chiang BL, Chang SC, Chang FY, Wong WW, Kao CL, Yang PC (2004) Emerg Infect Dis 10:489 Google Scholar
  43. 43.
    Desenclos JC, van der Werf S, Bonmarin I, Levy-Bruhl D, Yazdanpanah Y, Hoen B, Emmanuelli J, Lesens O, Dupon M, Natali F, Michelet C, Reynes J, Guery B, Larsen C, Semaille C, Mouton D, Andre M, Escriou N, Burguiere A, Manuguerra JC, Coignard B, Lepoutre A, Meffre C, Bitar D, Decludt B, Capek I, Antona D, Che D, Herida M, Infuso A, Sauri C, Brucker G, Hubert B, LeGoff D, Scheidegger S (2004) Emerg Infect Dis 10:195 Google Scholar
  44. 44.
    Olsen SJ, Chang HL, Cheung TY, Tang AF, Fisk TL, Ooi SP, Kuo HW, Jiang DD, Chen KT, Lando J, Hsu KH, Chen TJ, Dowell SF (2003) N Engl J Med 349:2416 Google Scholar
  45. 45.
    Wilder-Smith A, Paton NI, Goh KT (2003) Trop Med Int Health 8:1035 CrossRefGoogle Scholar
  46. 46.
    Bloch AB, Orenstein WA, Ewing WM, Spain WH, Mallison GF, Herrmann KL, Hinman AR (1985) Pediatrics 75:676 Google Scholar
  47. 47.
    Amornkul PN, Takahashi H, Bogard AK, Nakata M, Harpaz R, Effler PV (2004) J Infect Dis 189 Suppl 1:81 Google Scholar
  48. 48.
    (2001) MMWR Morb Mortal Wkly Rep 50:485 Google Scholar
  49. 49.
    Wick RL Jr, Irvine LA (1995) Aviat Space Environ Med 66:220 Google Scholar
  50. 50.
    Dechow M, Sohn H, Steinhanses J (1997) Chemosphere 35:21 CrossRefGoogle Scholar
  51. 51.
    Rudnick SN, Milton DK (2003) Indoor Air 13:237 CrossRefGoogle Scholar
  52. 52.
    Beggs CB, Noakes CJ, Sleigh PA, Fletcher LA, Siddiqi K (2003) Int J Tuberc Lung Dis 7:1015 Google Scholar
  53. 53.
    Gammaitoni L, Nucci MC (1997) Emerg Infect Dis 3:335 Google Scholar
  54. 54.
    Rydock JP (2004) Aviat Space Environ Med 75:168 Google Scholar
  55. 55.
    Daley CL, Kawamura LM (2003) Int J Tuberc Lung Dis 7:458 Google Scholar

Authors and Affiliations

  1. 1.Environmental Microbiology LaboratorySan BrunoUSA

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