Risk assessment of airborne infectious diseases in aircraft cabins.

UNLABELLED: Passengers in an aircraft cabin can have different risks of infection from airborne infectious diseases such as influenza, severe acute respiratory syndrome (SARS), and tuberculosis (TB) because of the non-uniform airflow in an aircraft cabin. The current investigation presents a comprehensive approach to assessing the spatial and temporal distributions of airborne infection risk in an aircraft cabin. A case of influenza outbreak was evaluated in a 4-h flight in a twin-aisle, fully occupied aircraft cabin with the index passenger seated at the center of the cabin. The approach considered the characteristics of the exhalation of the droplets carrying infectious agents from the index passenger, the dispersion of these droplets, and the inhalation of the droplets by susceptible passengers. Deterministic and probabilistic approaches were used to quantify the risks based on the amount of inhaled influenza virus RNA particles and quanta, respectively. The probabilistic approach indicated that the number of secondary infection cases can be reduced from 3 to 0 and 20 to 11, for influenza cases if N95 respirator masks are used by the passengers. The approach and methods developed can easily be implemented in other enclosed spaces such as buildings, trains, and buses to assess the infection risk. PRACTICAL IMPLICATIONS: Airborne infectious disease transmission could take place in enclosed environments such as buildings and transport vehicles. The infection risk is difficult to estimate, and very few mitigation methods are available. This study used a 4-h flight as an example in analyzing the infection risk from influenza and in mitigating the risk with an N95 mask. The results will be useful to the airline industry in providing necessary protection to passengers and crew, and the results can also be used for other enclosed spaces.