Spectrum of viruses and atypical bacteria in intercontinental air travelers with symptoms of acute respiratory infection

Abstract

Respiratory infections after air travel are frequent, but epidemiological data are incomplete. Using sensitive polymerase chain reactions, we studied the spectrum of atypical bacteria and respiratory viruses in travelers fulfilling the case definition of severe acute respiratory syndrome. A pathogen was identified in 67 travelers (43.2%). Influenza and parainfluenza viruses were most prevalent, at 14.2% and 15.5%, respectively. Prevalences of adenoviruses, human metapneumovirus, coronaviruses, and rhinoviruses ranged between 2.6% and 4.8%. Human bocavirus, respiratory syncytial virus, and Legionella, Mycoplasma, and Chlamydophila species were absent or appeared at frequencies of <1%. To our knowledge, these are the first specific baseline data for the mentioned agents in the context of air travel.

Figure 1

A, Age distribution of patients (left) and rates of detection of any tested agent in 4 different age groups (middle and right). The age of 15 of 172 patients could not be recorded because these were coded requests forwarded to us by other laboratories. Range lines in the middle and right panels depict 95% confidence intervals (CIs). Note that large CIs in the contacts panel are due to the small no. of patients in this group (n=17). Sample sizes in the different age np17 groups were as follows. In the middle panel (flight patients), 1–18 years, 8 patients; 19–35 years, 37 patients; 36–60 years, 64 patients; and 61–79 years, 31 patients. In the right panel (contact patients), 1–18 years, 1 patient; 19–35 years, 5 patients; 36–60 years, 8 patients; and 61–79 years, 3 patients. B, Relative detection rates of agents in travelers. AdV, adenovirus; BoV, bocavirus; hCoV, human coronavirus; hMPV, human metapneumovirus; hPIV, human parainfluenza virus; Inf, influenza virus; RSV, respiratory syncytial virus; RV, rhinovirus.