Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Infect Dis. 2010 May 1;50(9):1216-21. doi: 10.1086/651597.
On 8 October 2008, members of a tour group experienced diarrhea and vomiting throughout an airplane flight from Boston, Massachusetts, to Los Angeles, California, resulting in an emergency diversion 3 h after takeoff. An investigation was conducted to determine the cause of the outbreak, assess whether transmission occurred on the airplane, and describe risk factors for transmission.
Passengers and crew were contacted to obtain information about demographics, symptoms, locations on the airplane, and possible risk factors for transmission. Case patients were defined as passengers with vomiting or diarrhea (> or =3 loose stools in 24 h) and were asked to submit stool samples for norovirus testing by real-time reverse-transcription polymerase chain reaction.
Thirty-six (88%) of 41 tour group members were interviewed, and 15 (41%) met the case definition (peak date of illness onset, 8 October 2008). Of 106 passengers who were not tour group members, 85 (80%) were interviewed, and 7 (8%) met the case definition after the flight (peak date of illness onset, 10 October 2008). Multivariate logistic regression analysis showed that sitting in an aisle seat (adjusted relative risk, 11.0; 95% confidence interval, 1.4-84.9) and sitting near any tour group member (adjusted relative risk, 7.5; 95% confidence interval, 1.7-33.6) were associated with the development of illness. Norovirus genotype II was detected by reverse-transcription polymerase chain reaction in stool samples from case patients in both groups.
Despite the short duration, transmission of norovirus likely occurred during the flight.
2008 年 10 月 8 日，一个旅行团的成员在从马萨诸塞州波士顿飞往加利福尼亚州洛杉矶的航班上出现腹泻和呕吐症状，起飞 3 小时后飞机紧急改道。进行了一项调查，以确定疫情爆发的原因，评估飞机上是否发生了传播，并描述传播的危险因素。
联系乘客和机组人员以获取有关人口统计学、症状、飞机上的位置和可能的传播危险因素的信息。将呕吐或腹泻的患者（24 小时内有>或=3 次稀便）定义为病例患者，并要求他们通过实时逆转录聚合酶链反应提交粪便样本进行诺如病毒检测。
对 41 名旅行团成员中的 36 人（88%）进行了访谈，其中 15 人（41%）符合病例定义（发病高峰日期为 2008 年 10 月 8 日）。在 106 名非旅行团成员的乘客中，对 85 人（80%）进行了访谈，其中 7 人（8%）在飞行后符合病例定义（发病高峰日期为 2008 年 10 月 10 日）。多变量逻辑回归分析表明，坐在过道座位上（调整后的相对风险，11.0；95%置信区间，1.4-84.9）和坐在任何旅行团成员附近（调整后的相对风险，7.5；95%置信区间，1.7-33.6）与发病有关。在两组病例患者的粪便样本中通过逆转录聚合酶链反应检测到诺如病毒基因型 II。
尽管飞行时间很短，但诺如病毒的传播可能在飞行过程中发生。
