The association between international and domestic air traffic and the coronavirus (COVID-19) outbreak.

BACKGROUND: The World Health Organization (WHO) has declared the current outbreak of the novel coronavirus (COVID-19) a global pandemic. Many countries are facing increasing numbers of COVID-19 cases, which are, in their origin mostly attributed to regular international flight connections with China. This study aims to investigate this relation by analyzing available data on air traffic volume and the spread of COVID-19 cases. METHODS: and findings: We analyzed available data on current domestic and international passenger volume and flight routes and compared these to the distribution of domestic and international COVID-19 cases. RESULTS: Our data indicate a strong linear correlation between domestic COVID-19 cases and passenger volume for regions within China (r2 = 0.92, p = 0.19) and a significant correlation between international COVID-19 cases and passenger volume (r2 = 0.98, p < 0.01). CONCLUSIONS: The number of flight routes as well as total passenger volume are highly relevant risk factors for the spread of current COVID-19. Multiple regions within Asia, as well as some in North America and Europe are at serious risk of constant exposure to COVID-19 from China and other highly infected countries. Risk for COVID-19 exposure remains relatively low in South America and Africa. If adequate measures are taken, including on-site disease detection and temporary passenger quarantine, limited but not terminated air traffic can be a feasible option to prevent a long-term crisis. Reasonable risk calculations and case evaluations per passenger volume are crucial aspects which must be considered when reducing international flights.

Could African swine fever and classical swine fever viruses enter into the United States via swine products carried in air passengers' luggage?

On average 8,000 pork derived products are annually confiscated by Customs and Border Protection at the United States (US) ports of entry such as international airports, harbours or mail offices. These swine products with unknown sanitary status could pose a risk for foreign animal diseases introduction into the US. This study aimed at analysing the risk of African swine fever virus (ASFV) and classical swine fever virus (CSFV) being introduced into the US through prohibited swine products carried by air passengers (PSPAP) and identifying locations and time periods at higher risk where and when preventive and mitigation measures should be implemented. Our results estimated that the risk for CSFV entry was seven times higher and further spread between US airports than for ASFV. Specifically, the overall mean annual probability of ASFV entry was estimated as 0.061 at 95% confidence interval (CI) [0.007, 0.216] while the probability of CSFV entry was estimated as 0.414 (95% CI [0.074, 1]). For both diseases, July and May were the months at highest risk for entry. For ASFV, the origin countries of those PSPAP that represented the highest risk (above 70% of the total risk) were Ghana, Cape Verde, Ethiopia and the Russian Federation, while for CSFV above 90% of the risk at origin was concentrated in the Dominican Republic and Cuba, followed by India, Colombia, Peru, Ecuador and China. These results could be used to implement and feed real time surveillance systems, which could potentially help customs to increase the detection rate of smuggled products, indicating when and where to look for them. Similarly, these systems could be adapted and implemented to other diseases improving the cost-effectiveness of the resources invested in preventing entrance of diseases via air passengers' luggage.

Presence of pathogenic enteric viruses in illegally imported meat and meat products to EU by international air travelers.

One hundred twenty two meat samples confiscated from passengers on flights from non-European countries at the International Airport of Bilbao (Spain) were tested for the presence of the main foodborne viral pathogens (human noroviruses genogroups I and II, hepatitis A and E viruses) during 2012 and 2013. A sample process control virus, murine norovirus, was used to evaluate the correct performance of the method. Overall, 67 samples were positive for at least one enteric viruses, 65 being positive for hepatitis E virus (53.3%), 3 for human norovirus genogroup I (2.5%) and 1 for human norovirus genogroup II (0.8%), whereas hepatitis A virus was not detected in any sample. The type of positive meat samples was diverse, but mainly was pork meat products (64.2%). The geographical origin of the positive samples was wide and diverse; samples from 15 out 19 countries tested were positive for at least one virus. However, the estimated virus load was low, ranging from 55 to 9.0 × 10(4) PDU per gram of product. The results obtained showed the potential introduction of viral agents in travelers' luggage, which constitute a neglected route of introduction and transmission.

Identification and molecular characterization of pathogenic bacteria in foods confiscated from non-EU flights passengers at one Spanish airport.

Two hundred food samples of animal origin confiscated from passengers arriving on flights from non-European countries at the International Airport of Bilbao (Spain) were tested for the presence of four main bacterial foodborne pathogens (Campylobacter spp., Escherichia coli O157:H7, Listeria monocytogenes and Salmonella spp.) during 2012 and 2013. Overall, 20 samples were positive for L. monocytogenes (10%) and 11 for Salmonella spp. (5.5%), whereas Campylobacter spp. and E. coli O157:H7 were not detected in any sample. The positive isolates were widely clustered: 14 and 7 different pulsotypes for L. monocytogenes and Salmonella spp. isolates, respectively. Nine sequence types (ST) were detected for L. monocytogenes: ST2 (45%), ST9 (15% isolates), ST8 and ST87 (10%), and ST308, ST37, ST155 and ST378 (5%). The Salmonella spp. isolates belonged to seven serovars: monophasic serovar 4,12:d:- (3; 27.3%), Rauform (2; 18.2%), Anatum (2; 18.2%), Oranienburg, Enteritidis, Newport and Typhimurium (1; 9.1% each). Antibiotic resistance among L. monocytogenes isolates was high, especially for clindamycin and daptomycin (more than 95% of the isolates). These results indicate that food samples imported by travelers in their personal luggage may harbor the most prevalent L. monocytogenes genotypes and Salmonella spp. serovars responsible for foodborne outbreaks worldwide. Consequently, international travel can play an important role in the prevalence and dissemination of successful clones of foodborne pathogenic bacteria, and continuous monitoring of international movements is of importance to better understand clonal evolution and emergence and dissemination of successful lineages.

Contact tracing for influenza A(H1N1)pdm09 virus-infected passenger on international flight.

In April 2009, influenza A(H1N1)pdm09 virus infection was confirmed in a person who had been symptomatic while traveling on a commercial flight from Mexico to the United Kingdom. Retrospective public health investigation and contact tracing led to the identification of 8 additional confirmed cases among passengers and community contacts of passengers.

["Is there a doctor on board?" - legal aspects of medical care in emergency situations during spare time]. / "Is there a doctor on board?" - Rechtliches zur ärztlichen Hilfeleistung in Notfallsituationen in der Freizeit.

Medical emergencies on international flights are not uncommon. In these situations the question often arises whether physicians are obliged to render first aid and whether omission leads to legal consequences. The general obligation to aid those in need applies to everyone, not only to physicians. Evading this duty makes liable to prosecution for omittance of defence of a third person in line with Art. 128 of the Swiss Penal Code, punishable by custodial sentence up to three years or an equivalent punitive fine. Vocational and professional law extend the duty to aid for physicians to urgent cases. Although resulting from the performance of a legal obligation, malpractice occurred in the course of first aid can lead to claims for compensation - even from foreign patients, and that according to their own domestic law.

Les urgences médicales dans les avions ne sont pas rares. Dans ces situations, la question se pose souvent de savoir si les médecins sont tenus d'effectuer les premiers soins et si le fait de s'y soustraire peut avoir des conséquences au niveau juridique. Le devoir d'assister toute personne dans le besoin concerne chacun de nous, et pas seulement les médecins. Quiconque ne respecte pas ce devoir d'assistance peut être condamné, au vu de l'art. 128 du code pénal, à une amende ou même une peine d'emprisonnement pouvant aller jusqu'à trois ans. Les obligations professionnelles et la déontologie prévoient pour les médecins un devoir d'assistance accru pour les cas d'urgence. Bien que ces devoirs soient prévus par la loi, il n'empêche pas que toute erreur professionnelle en cours de traitement peut entraîner des poursuites civiles en dommages et intérêts, de même pour des patients d'origine étrangère, selon la législation en vigueur dans leur pays.