Genomic evidence of in-flight transmission of SARS-CoV-2 despite predeparture testing
Evidence of in-flight transmission on a flight from the United Arab Emirates to New Zealand is strongly supported by the epidemiologic data, in-flight seating plan, symptom onset dates, and genomic data for this group of travelers who tested positive for SARS-CoV-2 (passengers A–G). Among the 7 passengers, 2 (A and B) were probably index case-patients infected before the flight, 4 (C, D, E, and F) were probably infected during the flight, and the remaining passenger (G) was probably infected while in MIQ. All 7 passengers were seated in aisle seats within 2 rows of where the presumed index case-patient(s) were seated.
Combined, these data present a likely scenario of >4 SARS-CoV-2 transmission events during a long-haul flight from Dubai to Auckland. These transmission events occurred despite reported in-flight use of masks and gloves. Further transmission between travel companions then occurred after the flight, in an MIQ facility.
These conclusions are supported by genome sequencing, an in-flight seating plan, and dates of disease onset. These data do not definitively exclude an alternative exposure event, such as virus transmission at the Dubai airport before boarding (e.g., during check-in or in boarding queues). However, the close proximity of the relevant passengers on board suggests that in-flight transmission is plausible.
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