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Volume 27, Number 3—March 2021

Synopsis

Genomic Evidence of In-Flight Transmission of SARS-CoV-2 Despite Predeparture Testing

Tara Swadi1, Jemma L. Geoghegan1Comments to Author , Tom Devine, Caroline McElnay, Jillian Sherwood, Phil Shoemack, Xiaoyun Ren, Matt Storey, Sarah Jefferies, Erasmus Smit, James Hadfield, Aoife Kenny, Lauren Jelley, Andrew Sporle, Andrea McNeill, G. Edwin Reynolds, Kip Mouldey, Lindsay Lowe, Gerard Sonder, Alexei J. Drummond, Sue Huang, David Welch, Edward C. Holmes, Nigel French, Colin R. Simpson, and Joep de LigtComments to Author 
Author affiliations: New Zealand Ministry of Health, Wellington, New Zealand (T. Swadi, T. Devine, A. Kenny); University of Otago, Dunedin, New Zealand (J.L. Geoghegan); Institute of Environmental Science and Research, Porirua, New Zealand (J.L. Geoghegan, J. Sherwood, X. Ren, M. Storey, S. Jefferies, E. Smit, L. Jelley, A. McNeill, G. Sonder, S. Huang, J. de Ligt); New Zealand Ministry of Health, Wellington (C. McElnay); Bay of Plenty District Health Board, Tauranga, New Zealand (P. Shoemack, K. Mouldey, L. Lowe); Fred Hutchinson Cancer Research Centre, Seattle, Washington, USA (J. Hadfield); University of Auckland, Auckland, New Zealand (A. Sporle, A.J. Drummond, D. Welch); iNZight Analytics Ltd., Auckland (A. Sporle); Auckland District Health Board, Auckland (G.E. Reynolds); The University of Sydney, Sydney, New South Wales, Australia (E.C. Holmes); Massey University, Palmerston North, New Zealand (N. French); Victoria University of Wellington, Wellington (C.R. Simpson); University of Edinburgh, Edinburgh, UK (C.R. Simpson)

Main Article

Table 1

Detailed information for 7 passengers with SARS-CoV-2 infection detected after being on flight EK448, Dubai, United Arab Emirates, to Auckland, New Zealand, September 29, 2020*

Variable Passenger
A B C D E F G
Genome
 Identical
 Identical
 Identical†
 1 additional mutation
 Identical
 Identical
 Identical
Genome ID (GISAID accession no.) (5)
 20CV0408 (EPI_ISL_
582019)
 20CV0409 (EPI_ISL_
582020)
 20CV0410 (EPI_ISL_
582021)
 20CV0401 (EPI_ISL_
582018)
 20CV0398 (EPI_ISL_
582017)
20CV0414 (EPI_ISL_
582022)
 20CV0415 (EPI_ISL_
582023)
Preflight testing result (date)‡
 Negative 
(Sep 24)
 Negative 
(Sep 24)
 Negative 
(Sep 25)
 Negative 
(Sep 24)
 Not tested
 Negative 
(Sep 25)
 Not tested
Symptom onset date
 Oct 1
 Oct 2
 Asymptomatic
 Oct 4
 Asymptomatic
 Oct 3
 Oct 9
Date tested positive
 Oct 2
 Oct 2
 Oct 2
 Oct 7
 Oct 6
 Oct 8
 Oct 8
Technology§ and Ct
 GeneXpert, 
E-gene Ct 14.3, N2-gene Ct 16.4
 GeneXpert, E-gene Ct 27, N2-gene Ct 29.3
 GeneXpert, E-gene Ct 33.3, N2-gene Ct 36.8
 GeneXpert, E-gene Ct 18.5 N2-gene Ct 20.4
 GeneXpert, E-gene Ct 18.5, N2 gene Ct 22.3
 BD Max, 
N1-gene Ct 22.0 N2-gene Ct 22.3
 BD Max, 
N1-gene Ct 22.1, N2-gene Ct 19.1
Country of origin
 Switzerland
 Switzerland
 Ukraine
 Ireland
 India
 South Africa
 South Africa
Layover time in Dubai
 9 h 27 min
 9 h 27 min
 11 h 30 min
 8 h 18 min
 70 h 54 min
 5 h 44 min
5 h 44 min
Seat no. on flight
 26G
 26D
 24C
 27D
 28G
 24D/E/F/G
PPE worn on airplane and bus‡
 Face mask 
and gloves¶
 Face mask and gloves¶
 Not reported
 Face mask and gloves
 Not reported
 Face mask
 Face mask
Bus from airport to MIQ# Bus 1 Bus 1 Bus 1 briefly, transported on bus 2 Bus 1 Bus 3 Bus 2
 Bus 2

*GISAID, https://www.gisaid.org. Ct, cycle threshold; MIQ, managed isolation and quarantine; PPE, personal protective equipment. 
†Partial genome obtained (1 amplicon failed, resulting in 1,200 ambiguous nucleotide bases) but has the 5 defining mutations of the cluster. 
‡Self-reported. 
§GeneXpert, https://www.cepheid.com; BD Max, https://www.bd.com. 
¶Reportedly removed when sleeping and seated. 
#Social distancing and mandated mask wearing on all buses.

Main Article

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Main Article

1These authors contributed equally to this article.

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