Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation

BMC Public Health

Katrin Leitmeyer²  Dilys Morgan¹  Andreas Gilsdorf³ 

[1] Health Protection Agency, London, United Kingdom;European Centre for Diseases Prevention and Control, Stockholm, Sweden;Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany

关键词: Air travel;    Contact tracing;    Passenger trace back;    Marburg haemorrhagic fever;    Ebola haemorrhagic fever;    Lassa fever;    Viral haemorrhagic fever;   

Others  :  1162794
DOI  :  10.1186/1471-2458-12-1014

 received in 2012-04-30, accepted in 2012-11-17,  发布年份 2012

【 摘 要 】

Background

Travel from countries where viral haemorrhagic fevers (VHF) are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation.

This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back.

Method

The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus.

Results

Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/− 1 seat), crew and cleaning personal of the section of the index case should be included in the trace back.

Conclusion

No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale of a trace back always lies in the hands of the responsible people taking all relevant information into account.

【 授权许可】

   
2012 Gilsdorf et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]ACI World Airport Traffic Report 2010. www.aci.aero
• [2]UNWTO: Tourism Market Trends, 2006 Edition – Annex. http://www.unwto.org/facts/eng/pdf/indicators/ITA_africa.pdf webcite
• [3]Sidley P: Fears over Ebola spread as nurse dies. BMJ 1996, 313(7069):1351.
• [4]Beeching NJ, Fletcher TE, Hill DR, Thomson GL: Travellers and viral haemorrhagic fevers: what are the risks? Int J Antimicrob Agents 2010, 36(Suppl 1):S26-S35.
• [5]Leitmeyer K: European risk assessment guidance for infectious diseases transmitted on aircraft--the RAGIDA project. Euro Surveill 2011., 16(16) pii: 19845
• [6]ECDC: Risk Assessment Guidelines for Infectious Diseases Transmitted on Aircraft (RAGIDA), Part 1-Technical Report. 2009.
• [7]ECDC: Risk Assessment Guidelines for Diseases Transmitted on Aircraft (RAGIDA) - PART 2: Operational Guidelines for Assisting in the Evaluation of Risk for Transmission by Disease. 2011.
• [8]CDC: Imported Lassa fever--New Jersey, 2004. MMWR Morb Mortal Wkly Rep 2004, 53(38):894-897.
• [9]Atkin S, Anaraki S, Gothard P, Walsh A, Brown D, Gopal R, Hand J, Morgan D: The first case of Lassa fever imported from Mali to the United Kingdom, February 2009. Euro Surveill 2009., 14(10) pii: 19145
• [10]Crowcroft NS, Meltzer M, Evans M, Shetty N, Maguire H, Bahl M, Gair R, Brink N, Lockwood D, Gregor S, et al.: The public health response to a case of Lassa fever in London in 2000. J Infect 2004, 48(3):221-228.
• [11]Gunther S, Emmerich P, Laue T, Kuhle O, Asper M, Jung A, Grewing T, ter Meulen J, Schmitz H: Imported lassa fever in Germany: molecular characterization of a new lassa virus strain. Emerg Infect Dis 2000, 6(5):466-476.
• [12]Haas WH, Breuer T, Pfaff G, Schmitz H, Kohler P, Asper M, Emmerich P, Drosten C, Golnitz U, Fleischer K, et al.: Imported Lassa fever in Germany: surveillance and management of contact persons. Clin Infect Dis 2003, 36(10):1254-1258.
• [13]Case of Lassa Fever in a Soldier Returning to the United Kingdom. http://www.hpa.org.uk/cdr/archives/2003/cdr0703.pdf webcite
• [14]Kitching A, Addiman S, Cathcart S, Bischop L, Krahe D, Nicholas M, Coakley J, Lloyd G, Brooks T, Morgan D, et al.: A fatal case of Lassa fever in London, January 2009. Euro Surveill 2009., 14(6) pii: 19117
• [15]Schmitz H, Kohler B, Laue T, Drosten C, Veldkamp PJ, Gunther S, Emmerich P, Geisen HP, Fleischer K, Beersma MF, et al.: Monitoring of clinical and laboratory data in two cases of imported Lassa fever. Microbes Infect 2002, 4(1):43-50.
• [16]Swaan CM, van den Broek PJ, Wijnands S, van Steenbergen JE: Management of viral haemorrhagic fever in the Netherlands. Euro Surveill 2002, 7(3):48-50.
• [17]Imported Case of Lassa Fever in Germany. http://www.who.int/csr/don/2006_07_25/en/index.html webcite
• [18]Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A: Human infection due to Ebola virus, subtype Cote d’Ivoire: clinical and biologic presentation. J Infect Dis 1999, 179(Suppl 1):S48-S53.
• [19]Colebunders R, Borchert M: Ebola haemorrhagic fever–a review. J Infect 2000, 40(1):16-20.
• [20]Dowell SF, Mukunu R, Ksiazek TG, Khan AS, Rollin PE, Peters CJ: Transmission of Ebola hemorrhagic fever: a study of risk factors in family members, Kikwit, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidemies a Kikwit. J Infect Dis 1999, 179(Suppl 1):S87-S91.
• [21]Francesconi P, Yoti Z, Declich S, Onek PA, Fabiani M, Olango J, Andraghetti R, Rollin PE, Opira C, Greco D, et al.: Ebola hemorrhagic fever transmission and risk factors of contacts, Uganda. Emerg Infect Dis 2003, 9(11):1430-1437.
• [22]Timen A, Koopmans MP, Vossen AC, van Doornum GJ, Gunther S, van den Berkmortel F, Verduin KM, Dittrich S, Emmerich P, Osterhaus AD, et al.: Response to imported case of Marburg hemorrhagic fever, the Netherland. Emerg Infect Dis 2009, 15(8):1171-1175.
• [23]CDC: Imported case of Marburg hemorrhagic fever - Colorado, 2008. MMWR Morb Mortal Wkly Rep 2009, 58(49):1377-1381.
• [24]Fact Sheet Marburg Heamorrhagic Fever. http://www.who.int/mediacentre/factsheets/fs_marburg/en/index.html webcite
• [25]Bausch DG, Borchert M, Grein T, Roth C, Swanepoel R, Libande ML, Talarmin A, Bertherat E, Muyembe-Tamfum JJ, Tugume B, et al.: Risk factors for Marburg hemorrhagic fever, Democratic Republic of the Congo. Emerg Infect Dis 2003, 9(12):1531-1537.
• [26]Marburg Haemorrhagic Fever in Angola – Update 25. http://www.who.int/csr/don/2005_08_24/en/index.html webcite
• [27]Jeffs B, Roddy P, Weatherill D, de la Rosa O, Dorion C, Iscla M, Grovas I, Palma PP, Villa L, Bernal O, et al.: The Medecins Sans Frontieres intervention in the Marburg hemorrhagic fever epidemic, Uige, Angola, 2005. I. Lessons learned in the hospital. J Infect Dis 2007, 196(Suppl 2):S154-S161.
• [28]Marburg Haemorrhagic Fever in Angola – Update 26: MOH Declares Outbreak Over. http://www.who.int/csr/don/2005_11_07a/en/index.html webcite
• [29]Martini GA, Knauff HG, Schmidt HA, Mayer G, Baltzer G: A hitherto unknown infectious disease contracted from monkeys. “Marburg-virus” disease. Ger Med Mon 1968, 13(10):457-470.
• [30]Siegert R, Shu HL, Slenczka HL, Peters D, Muller G: The aetiology of an unknown human infection transmitted by monkeys (preliminary communication). Ger Med Mon 1968, 13(1):1-2.
• [31]Slenczka WG: The Marburg virus outbreak of 1967 and subsequent episodes. Curr Top Microbiol Immunol 1999, 235:49-75.
• [32]Smith DH, Johnson BK, Isaacson M, Swanapoel R, Johnson KM, Killey M, Bagshawe A, Siongok T, Keruga WK: Marburg-virus disease in Kenya. Lancet 1982, 1(8276):816-820.
• [33]Fact Sheet Lassa Heamorrhagic Fever. http://www.who.int/mediacentre/factsheets/fs179/en/index.html webcite
• [34]Fact Sheet Ebola Heamorrhagic Fever. http://www.who.int/mediacentre/factsheets/fs103/en/ webcite
• [35]Map Showing the High Risk Countries for Lassa Fever in Africa. http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/LassaFever/EpidemiologyRiskMaps/lassaafrica/ webcite
• [36]Locations of Cases/Outbreaks of Ebola and Marburg Haemorrhagic Fevers. http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/Ebola/Maps/ webcite
• [37]Recommended Surveillance Standards. http://www.helid.desastres.net/en/d/Jwho46e/8.html webcite
• [38]Briese T, Paweska JT, McMullan LK, Hutchison SK, Street C, Palacios G, Khristova ML, Weyer J, Swanepoel R, Egholm M, et al.: Genetic detection and characterization of Lujo virus, a new hemorrhagic fever-associated arenavirus from Southern Africa. PLoS Pathog 2009, 5(5):e1000455.
• [39]McCormick JB, Webb PA, Krebs JW, Johnson KM, Smith ES: A prospective study of the epidemiology and ecology of Lassa fever. J Infect Dis 1987, 155(3):437-444.
• [40]Fisher-Hoch SP: Lessons from nosocomial viral haemorrhagic fever outbreaks. Br Med Bull 2005, 73–74:123-137.
• [41]Leroy EM, Kumulungui B, Pourrut X, Rouquet P, Hassanin A, Yaba P, Delicat A, Paweska JT, Gonzalez JP, Swanepoel R: Fruit bats as reservoirs of Ebola virus. Nature 2005, 438(7068):575-576.
• [42]Ascenzi P, Bocedi A, Heptonstall J, Capobianchi MR, Di Caro A, Mastrangelo E, Bolognesi M, Ippolito G: Ebolavirus and Marburgvirus: insight the Filoviridae family. Mol Aspects Med 2008, 29(3):151-185.
• [43]Gonzalez JP, Pourrut X, Leroy E: Ebolavirus and other filoviruses. Curr Top Microbiol Immunol 2007, 315:363-387.
• [44]Swanepoel R, Smit SB, Rollin PE, Formenty P, Leman PA, Kemp A, Burt FJ, Grobbelaar AA, Croft J, Bausch DG, et al.: Studies of reservoir hosts for Marburg virus. Emerg Infect Dis 2007, 13(12):1847-1851.
• [45]Towner JS, Amman BR, Sealy TK, Carroll SA, Comer JA, Kemp A, Swanepoel R, Paddock CD, Balinandi S, Khristova ML, et al.: Isolation of genetically diverse Marburg viruses from Egyptian fruit bats. PLoS Pathog 2009, 5(7):e1000536.
• [46]Bausch DG, Towner JS, Dowell SF, Kaducu F, Lukwiya M, Sanchez A, Nichol ST, Ksiazek TG, Rollin PE: Assessment of the risk of Ebola virus transmission from bodily fluids and fomites. J Infect Dis 2007, 196(Suppl 2):S142-S147.
• [47]Galbraith NS, Berrie JR, Forbes P, Young S: Public health aspects of viral haemorrhagic fevers in Britain. R Soc Health J 1978, 98(4):152-160.
• [48]Howard CR: Arenavirus. 2005.
• [49]WHO: Viral Haemorrhagic Fevers: report of a WHO Expert Committee. WHO, Geneva; 1985.
• [50]Interim Guidance About Ebola Virus Infection for Airline Flight Crews, Cargo and Cleaning Personnel, and Personnel Interacting with Arriving Passengers. http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola/Ebola_airline.pdf webcite
• [51]Borio L, Inglesby T, Peters CJ, Schmaljohn AL, Hughes JM, Jahrling PB, Ksiazek T, Johnson KM, Meyerhoff A, O’Toole T, et al.: Hemorrhagic fever viruses as biological weapons: medical and public health management. JAMA 2002, 287(18):2391-2405.
• [52]McCormick JB, King IJ, Webb PA, Scribner CL, Craven RB, Johnson KM, Elliott LH, Belmont-Williams R: Lassa fever. Effective therapy with ribavirin. N Engl J Med 1986, 314(1):20-26.
• [53]Borchert M, Mulangu S, Swanepoel R, Libande ML, Tshomba A, Kulidri A, Muyembe-Tamfum JJ, Van der Stuyft P: Serosurvey on household contacts of Marburg hemorrhagic fever patients. Emerg Infect Dis 2006, 12(3):433-439.