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Updated: Jun 27, 2026
A Tuberculosis Molecular Bacterial Load Assay (TB-MBLA)
Published on: April 30, 2020
Characterizing the risk of infection from Mycobacterium tuberculosis in commercial passenger aircraft using
Rachael M Jones1, Yoshifumi Masago, Timothy Bartrand
1School of Public Health, University of California, Berkeley, CA, USA.
Abstract:
Quantitative microbial risk assessment was used to predict the likelihood and spatial organization of Mycobacterium tuberculosis (Mtb) transmission in a commercial aircraft. Passenger exposure was predicted via a multizone Markov model in four scenarios: seated or moving infectious passengers and with or without filtration of recirculated cabin air. The traditional exponential (k = 1) and a new exponential (k = 0.0218) dose-response function were used to compute infection risk. Emission variability was included by Monte Carlo simulation. Infection risks were higher nearer and aft of the source; steady state airborne concentration levels were not attained. Expected incidence was low to moderate, with the central 95% ranging from 10(-6) to 10(-1) per 169 passengers in the four scenarios. Emission rates used were low compared to measurements from active TB patients in wards, thus a "superspreader" emitting 44 quanta/h could produce 6.2 cases or more under these scenarios. Use of respiratory protection by the infectious source and/or susceptible passengers reduced infection incidence up to one order of magnitude.
Insights
This study modeled Mycobacterium tuberculosis (Mtb) transmission on airplanes. While risks are generally low, superspreaders and lack of filtration increase transmission, which respiratory protection can mitigate.
Area of Science:
- Environmental microbiology
- Epidemiology
- Aerosol science
Background:
- Air travel facilitates the global spread of infectious diseases.
- Understanding airborne pathogen transmission dynamics in aircraft cabins is crucial for public health.
- Mycobacterium tuberculosis (Mtb) poses a significant transmission risk in enclosed environments.
Purpose of the Study:
- To quantitatively assess the risk and spatial distribution of Mtb transmission on commercial aircraft.
- To evaluate the impact of passenger movement, cabin air filtration, and varying emission rates on Mtb transmission.
- To explore the effectiveness of respiratory protection in reducing infection incidence.
Main Methods:
- Quantitative microbial risk assessment (QMRA) framework applied to aircraft cabin environment.
- Multizone Markov modeling used to predict passenger exposure under different scenarios.
- Inclusion of Monte Carlo simulation for emission variability and two dose-response functions.
- Analysis of scenarios including seated/moving infectious passengers and presence/absence of cabin air filtration.
Main Results:
- Infection risk was highest for passengers seated near and aft of the infectious source.
- Steady-state airborne concentrations were not reached during typical flight durations.
- Expected incidence ranged from 10^-6 to 10^-1 per 169 passengers across scenarios.
- A superspreader event could lead to multiple cases, especially without filtration.
- Respiratory protection reduced infection incidence by up to one order of magnitude.
Conclusions:
- Aircraft Mtb transmission risk is influenced by proximity to the source, passenger movement, and air filtration efficacy.
- While baseline risk is low, superspreader events present a notable concern.
- Respiratory protection is an effective intervention to significantly lower Mtb transmission probability during air travel.
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