Norovirus on a Commercial Airline- Not Just for Cruise Ships

Flying has become troublesome enough already with security checks, having to remove your shoes, pat downs, etc. Now, one can add norovirus (diarrheal infection) to the list of potential inconveniences. Recurring norovirus infection on an airplane was recently reported in Clinical Infectious Diseases.


During October 2009, an outbreak of diarrhea and vomiting occurred among different groups of flight attendants who had worked on separate flights on the same airplane. 


The investigation identified a passenger who vomited on a Boeing 777-200 airplane.  Sixty-three (82%) of 77 flight attendants who worked on the airplane during 13-18 October provided information, and 27 (43%) met the case definition for norovirus infection. The attack rate among flight attendants decreased significantly over successive flights from 13 October onward (P < .001). Working as a supervisor was independently associated with development of illness (adjusted odds ratio, 5.8; 95% confidence interval, 1.3-25.6).  

The investigation suggested that the vomiting incident was the inciting step. Transmission to flight attendants may have occurred through direct contact with vomit or virus aerosolized by vomiting or indirectly by contact with the contaminated environment.


Passengers were not investigated. Nevertheless, the potential for foodservice contamination with norovirus, by flight attendants, is real and could lead to disease in passengers. That could make for an uncomfortable situation, especially on a long flight.


One has to wonder what sort of disinfection practices are in place in the event of a vomiting episode(s) on a commercial airline....