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Emerg Infect Dis. 2009 Oct;15(10):1578-81. doi: 10.3201/eid1510.091013.

Lack of airborne transmission during outbreak of pandemic (H1N1) 2009 among tour group members, China, June 2009.

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Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.


During June 2-8, 2009, an outbreak of influenza A pandemic (H1N1) 2009 occurred among 31 members of a tour group in China. To identify the mode of transmission and risk factors, we conducted a retrospective cohort investigation. The index case-patient was a female tourist from the United States. Secondary cases developed in 9 (30%) tour group members who had talked with the index case-patient and in 1 airline passenger (not a tour group member) who had sat within 2 rows of her. None of the 14 tour group members who had not talked with the index case-patient became ill. This outbreak was apparently caused by droplet transmission during coughing or talking. That airborne transmission was not a factor is supported by lack of secondary cases among fellow bus and air travelers. Our findings highlight the need to prevent transmission by droplets and fomites during a pandemic.

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