Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
51 SeSSion 6 Discussion of Topics for Future Research The following tables are based on feedback received during discussion of topics for future research that occurred on Day 2 of the symposium. Audience members, speakers, moderators, and planning com- mittee members participated in the open discussion. These tables capture and organize the research top- ics discussed into three main categories (foundational research, airport and aircraft research, and preven- tion and mitigation opportunities for air travel) and three pathogen transmission areas (source, transit, and receptor). The research topics are presented in no par- ticular hierarchical order, and their inclusion here does not imply endorsement by the symposium participants, the planning committee, or TRB. Rather, they are sum- marized here in Tables 1, 2, and 3 as a record of the symposium discussion. TABLE 1 Source of Pathogensa Prevention and Mitigation Foundational Researchb Airport and Aircraft Researchc Opportunities for Air Traveld improve disease transport models by quan- Correlate symptomatic crew and passengers Develop methods to encourage travelers to tification of infectious particles and droplets with pathogen concentrations in flight. self-report an illness. from human exhalation. identify reasons why infectious people travel Develop protocols for screening at airports evaluate and understand differences between and assess the accuracy of their responses that optimize public health protection while biowarfare (i.e., intentional release of patho- when asked by a public health official about minimizing operational impacts. gens) and naturally occurring infectious their symptoms. diseases. Develop best practices for infection control evaluate use of personal protective equip- in airport and aircraft settings. Determine what data elements can be gath- ment by aircraft cabin crew and implications ered during outbreaks to support theoretical for safety-related functions. modeling studies. identify barriers to good public hygiene prac- Assess how modeling data can be used in tices by air travelers (e.g., limited access to survey design and investigative studies of hand-washing facilities). outbreaks. evaluate effectiveness of exit screening and Assess the effectiveness of personal protective entry screening at airports. equipment in minimizing aerosol transmission of disease. Conduct real-time assessments of passen- ger screening efforts to identify operational evaluate human behavior related to using impacts. face masks to prevent the spread of disease. identify promotional techniques to improve passive and active public hygiene practices. a infected person or other source of pathogens. b Research needed to better understand infectious diseases in general and how they are spread. c Research needed to better characterize disease transmission in airport and aircraft environments. d Application of research to measures that may prevent or mitigate the spread of disease in the airport or aircraft environment.
52 ReSeARCH on THe TRAnSMiSSion of DiSeASe in AiRPoRTS AnD on AiRCRAfT TABLE 2 Transit of Pathogensa Prevention and Mitigation Foundational Researchb Airport and Aircraft Researchc Opportunities for Air Traveld improve understanding of spore and virus Measure fomites in all areas of the aircraft Develop passive control measures to mitigate survival rates, size of particles, dose of and airport environment and compare with fomite and airborne transmission of disease release, and infectivity of transported and other environments to assess relative risk. in aircraft and in airports. deposited pathogens. evaluate the aircraft and airport environ- identify effective measures to prevent the Determine most important pathways for ment during boarding and deplaning, when transport of potentially infected insects and disease transmission. the aircraft is using auxiliary ventilation other measures to reduce the risk of vector- systems (e.g., gate-supplied air and power borne diseases. identify bioaerosol markers that could help or auxiliary power units). improve understanding of fate and transport Develop effective procedures and protocol of biological through combined biological Distinguish between the designed, within- for crew to manage infectious passengers. and physical research efforts. row convective flow induced by the eCS and the between-row flow that occurs due evaluate risk from sewage in watersheds to eddy action. through monitoring and measurement programs. Measure concentrations of airborne patho- gens in aircraft cabins in actual flight. Coupling of exposure modeling with quanti- tative microbial risk assessments to address improve characterization of microbial diver- specific science needs (e.g., relative risk). sity and related risks on domestic and inter- national aircraft. Assess quality of CDC surveillance data in their Quarantine Activity Reporting System. Assess safety of effective disinfection agents in the aircraft environment. Conduct microbial background characteriza- tion of multiple modes of transmission (e.g., Develop disease propagation models that aerosol vs. fomite) to improve usefulness of integrate flight statistics, disease severity, biosensor systems. and seasonality to assist in evaluating bio- surveillance infrastructure. Assess the role of occupancy density and ventilation rate per person in airborne evaluate the efficacy of disinfection efforts pathogen spread. to prevent the spread of malaria and other insect- and vector-borne diseases. evaluate detection and control strategies used by other industries that could transfer to airport and aircraft environment. a Movement of pathogens through space from an infected individual or other source of pathogens to a new receptor. b Research needed to better understand infectious diseases in general and how they are spread. c Research needed to better characterize disease transmission in airport and aircraft environments. dApplication of research to measures that may prevent or mitigate the spread of disease in the airport or aircraft environment.
53DiSCUSSion of ToPiCS foR fUTURe ReSeARCH TABLE 3 Receptor of Pathogensa Prevention and Mitigation Foundational Researchb Airport and Aircraft Researchc Opportunities for Air Traveld Distinguish between microbials that can be identify unique characteristics of the identify communication techniques and detected in the air or on surfaces and those airport and aircraft environment or work develop messages that clearly explain that actually cause illness. practices that would make employees risks to personnel and the traveling pub- more susceptible to infection and impli- lic, and evaluate their effectiveness in identify environmental and personal fac- cations for occupational health care reducing travel-related disease transmis- tors that make individuals more or less providers. sion. susceptible to infection (e.g., relative humidity, fatigue). evaluate relative infection risk in airports identify disinfection measures that are and on aircraft in comparison with other broad spectrum, as safe as possible, envi- identify human behavior that contributes environments (offices, hospitals). ronmentally benign, and compatible with to or mitigates infection (e.g., touching materials used in the airport and aircraft face frequently). evaluate methods for reduction of the environment. burden of illness in travelers. a A susceptible individual who may be infected by a pathogen. b Research needed to better understand infectious diseases in general and how they are spread. c Research needed to better characterize disease transmission in airport and aircraft environments. d Application of research to measures that may prevent or mitigate the spread of disease in the airport or aircraft environment.