Risk Assessment for the Transmission of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) on Aircraft: A Systematic Review
Sammanfattning: Introduction: MERS-CoV causes a respiratory disease that can be fatal. Although it is most common in countries in the Arabian Peninsula, through travel it has been exported to 17 countries outside Middle East. Most of these exportations have occurred by people travelling by air. The Risk Assessment Guidelines for Infectious Disease transmitted on Aircraft (RAGIDA) produced by the European Centre of Disease Prevention and Control, advises European countries on the measures to take when an infected individual travels by air. Aim: To gather all available information on the MERS-CoV cases that have travelled by air and produce an update of the RAGIDA project. Methods: A systematic review was conducted. The online health databases used were PubMed, Embase, Scopus and Global Index Medicus. As additional information sources, Google was searched for grey literature and hand searching was performed on the Early Warning and Response System of the EU, as well as the Disease Outbreak News page of WHO. Results: A total of 48 records were identified, describing 22 cases of MERS that travelled on board a total of 31 flights. No cases of in-flight transmission were observed in any of the flights. Contact tracing (CT) was performed for 18 of the 22 cases. Most countries defined “contacts” as the passengers sitting in the same row and the two rows in front and behind the case. Only one country decided to trace all passengers and crew on board the aircraft. Conclusion: A conservative approach might be more adequate when performing CT of an aircraft where a case of MERS has travelled, because of the lack of in-flight transmission observed and the great amount of resources needed for a CT investigation.
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