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The National Academies

ACRP 11-02/Task 13 [Completed]

Symposium on the Tranmission of Disease at Airports and on Aircraft
[ ACRP 11-02 (Quick Response for Special Needs) ]

  Project Data
Funds: $100,000
Research Agency: TRB Technical Activities Division
Effective Date: 8/1/2008

An ad hoc committee will plan and conduct a public symposium that will feature invited presentations on the status of research on or related to the transmission of disease on aircraft and/or in airports. The purpose is to provide an opportunity for the research community to share data, models and methods; discuss findings and preliminary conclusions of ongoing research; and identify gaps to inform future research projects. Specifically, a symposium agenda will be developed by the planning committee to examine some or all of the following topics: (1) the status of research on or related to the transmission of disease on aircraft and in airports; (2) the potential application of research results to the development of protocols and standards for managing communicable disease incidents in an aviation setting; and (3) areas where additional research is needed in the future. An individually authored summary including synopses of presentations at the symposium will be prepared.

In addition to facilitating discussion within the research community, this event will provide other participants from the public sector (federal agencies, state and local agencies including public airports) and private sector (airlines, consultants with expertise in the various facets of airport emergency response) an opportunity to learn about current research and to consider ways that future research might be conducted and funded.
The committee will include a mix of individuals with the appropriate expertise, including representation from the public sector (federal agencies, state and local agencies including public airports), private sector (airlines, consultants with expertise in the various facets of airport emergency response), and research institutions.

The planning committee will meet at least twice to develop the symposium program. One or more of these meetings will likely be held by teleconference. The committee will identify topics and issues to be addressed in the presentations, which will provide overviews of completed and ongoing research in this area. The resulting report will be an individually authored summary including synopses of the presentations from the symposium.

Background: During the 2003 outbreak of severe acute respiratory syndrome (SARS), concerns were expressed about the chance that an infected air passenger might spread the disease to others on the same flight. More recently, attention has been focused on the potential spread by air travelers of drug-resistant tuberculosis (TB) or a novel strain of influenza that could cause a pandemic.

As a result of these concerns, and in an effort to minimize the spread of communicable disease by air travelers, several U.S. and international agencies--including the Centers for Disease Control and Prevention, the Federal Aviation Administration, the Department of Homeland Security, the International Civil Aviation Organization, and the World Health Organization--have been developing and updating guidance for managing communicable diseases on aircraft and at airports. Among the issues this guidance will address are the cleaning and disinfection of facilities, isolation and quarantine of passengers, and follow-up with travelers thought to have been exposed.

Despite the operational and financial implications of some of the proposed standards and protocols, there is little scientific basis for this guidance. For example, many people assume that it is advisable to disinfect some or all of an aircraft cabin interior after a passenger with a serious communicable disease has been on board, or that it would be necessary to quarantine an entire planeload of people if one passenger exhibits symptoms of SARS or pandemic influenza in order to prevent further spread of the disease. On the other hand, the risk of exposure during air travel to so-called "childhood diseases" such as chicken pox and measles seems to be less concerning, even though these diseases can cause serious complications and even death. Without a better understanding of the relative risk of exposure, based on scientific evidence of how specific diseases are transmitted in an aviation setting, it is likely that the aviation industry will over- or under-react to a communicable disease incident.

Although there have been a few case studies published on the transmission of SARS, TB, and other diseases on aircraft, this work does not provide a sufficient basis for assessing the potential risk to the traveling public and aviation workers more generally. In particular, there is a lack of understanding of the potential transmission of disease via contaminated surfaces on aircraft or in airports, which is needed to establish reasonable disinfection protocols. Additional information regarding the person-to-person spread of respiratory infections in an aviation setting (e.g., seated on a plane or standing in a security line) is also needed to better understand possible exposure and define criteria for isolating or quarantining travelers.

A significant amount of research activity is under way on these and related topics both in the United States and in Europe, through academic institutions, government agencies, industry, and consortia such as the Airliner Cabin Environment Research (ACER) Center of Excellence (which leverage the resources of all three groups). Some of this research is specific to the aviation environment; other research may be relevant although it is not directed specifically at the problem of disease transmission at airports or on aircraft. Most of this research has not yet been published in peer-reviewed scientific journals. Responding to these concerns, the Airport Cooperative Research Program Oversight Committee (AOC)-a group appointed by the U.S. Secretary of Transportation to select projects for and oversee the TRB-managed Airport Cooperative Research Program-committed funds at its meeting on July 20, 2008, to support a TRB-NRC symposium that would bring together members of the research community to discuss their recent and ongoing efforts to address this topic. Specifically, it was felt that it would be timely and valuable for such a group to discuss the status of research on or related to the transmission of disease on aircraft or in airports; the potential application of research results to the development of protocols and standards for managing communicable disease incidents in an aviation setting; and areas where additional research is needed.

STATUS: The conference proceedings are published and available at http://www.trb.org/Publications/Blurbs/163870.aspx.

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