Protection by face masks against influenza A(H1N1)pdm09 virus on trans-Pacific passenger aircraft, 2009

Lijie Zhang, Zhibin Peng, Jianming Ou, Guang Zeng, Robert E Fontaine, Mingbin Liu, Fuqiang Cui, Rongtao Hong, Hang Zhou, Yang Huai, Shuk-Kwan Chuang, Yiu-Hong Leung, Yunxia Feng, Yuan Luo, Tao Shen, Bao-Ping Zhu, Marc-Alain Widdowson, Hongjie Yu

Research output: Contribution to journalA1: Web of Science-articlepeer-review


In response to several influenza A(H1N1)pdm09 infections that developed in passengers after they traveled on the same 2 flights from New York, New York, USA, to Hong Kong, China, to Fuzhou, China, we assessed transmission of influenza A(H1N1)pdm09 virus on these flights. We defined a case of infection as onset of fever and respiratory symptoms and detection of virus by PCR in a passenger or crew member of either flight. Illness developed only in passengers who traveled on the New York to Hong Kong flight. We compared exposures of 9 case-passengers with those of 32 asymptomatic control-passengers. None of the 9 case-passengers, compared with 47% (15/32) of control-passengers, wore a face mask for the entire flight (odds ratio 0, 95% CI 0-0.71). The source case-passenger was not identified. Wearing a face mask was a protective factor against influenza infection. We recommend a more comprehensive intervention study to accurately estimate this effect.

Original languageEnglish
JournalEmerging Infectious Diseases
Issue number9
Pages (from-to)1403-1410
Number of pages8
Publication statusPublished - 2013


  • Adolescent
  • Adult
  • Aircraft
  • Case-Control Studies
  • Child
  • Communicable Disease Control/methods
  • Disease Outbreaks
  • Female
  • Humans
  • Influenza A Virus, H1N1 Subtype
  • Influenza, Human/epidemiology
  • Male
  • Masks
  • Middle Aged
  • Retrospective Studies
  • Travel
  • Young Adult


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