Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing

• Published in: Emerging infectious diseases Vol. 26; no. 12; pp. 2872 - 2880
• Main Authors: Speake, Hollie, Phillips, Anastasia, Chong, Tracie, Sikazwe, Chisha, Levy, Avram, Lang, Jurissa, Scalley, Benjamin, Speers, David J, Smith, David W, Effler, Paul, McEvoy, Suzanne P
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01-12-2020; Centers for Disease Control and Prevention
• Subjects: 2019 novel coronavirus disease; Adolescent; Adult; Aged; Aged, 80 and over; Air Travel; Aircraft; Australia; Child; Child, Preschool; coronavirus disease; Coronaviruses; COVID-19; COVID-19 - transmission; Disease transmission; DNA sequencing; Epidemics; Female; Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing; Genomes; Health aspects; Humans; Illnesses; Infections; Laboratories; Male; Middle Aged; Nucleotide sequencing; Pandemics; Passengers; Phylogenetics; Public health; Retrospective Studies; Risk Assessment; Risk factors; SARS-CoV-2; SARS-CoV-2 - genetics; Severe acute respiratory syndrome coronavirus 2; viruses; Whole Genome Sequencing - methods; Young Adult; Australia; Western Australia Australia; viruses; in-flight; whole-genome sequencing; aircraft; zoonoses; respiratory infections; airport; COVID-19; SARS-CoV-2; flight-associated; transmission; severe acute respiratory syndrome coronavirus 2; cruise; outbreak; 2019 novel coronavirus disease; coronavirus disease
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/EID2612.203910

To investigate potential transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during a domestic flight within Australia, we performed epidemiologic analyses with whole-genome sequencing. Eleven passengers with PCR-confirmed SARS-CoV-2 infection and symptom onset within 48 hours of the flight were considered infectious during travel; 9 had recently disembarked from a cruise ship with a retrospectively identified SARS-CoV-2 outbreak. The virus strain of those on the cruise and the flight was linked (A2-RP) and had not been previously identified in Australia. For 11 passengers, none of whom had traveled on the cruise ship, PCR-confirmed SARS-CoV-2 illness developed between 48 hours and 14 days after the flight. Eight cases were considered flight associated with the distinct SARS-CoV-2 A2-RP strain; the remaining 3 cases (1 with A2-RP) were possibly flight associated. All 11 passengers had been in the same cabin with symptomatic persons who had culture-positive A2-RP virus strain. This investigation provides evidence of flight-associated SARS-CoV-2 transmission.