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

• Main Authors: Tara Swadi, Jemma L. Geoghegan, 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, Joep de Ligt
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2021-03-01
• Series: Emerging Infectious Diseases
• Subjects: 2019 novel coronavirus disease; coronavirus disease; COVID-19; severe acute respiratory syndrome coronavirus 2; SARS-CoV-2; viruses
• Online Access: https://wwwnc.cdc.gov/eid/article/27/3/20-4714_article

Since the first wave of coronavirus disease in March 2020, citizens and permanent residents returning to New Zealand have been required to undergo managed isolation and quarantine (MIQ) for 14 days and mandatory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of October 20, 2020, of 62,698 arrivals, testing of persons in MIQ had identified 215 cases of SARS-CoV-2 infection. Among 86 passengers on a flight from Dubai, United Arab Emirates, that arrived in New Zealand on September 29, test results were positive for 7 persons in MIQ. These passengers originated from 5 different countries before a layover in Dubai; 5 had negative predeparture SARS-CoV-2 test results. To assess possible points of infection, we analyzed information about their journeys, disease progression, and virus genomic data. All 7 SARS-CoV-2 genomes were genetically identical, except for a single mutation in 1 sample. Despite predeparture testing, multiple instances of in-flight SARS-CoV-2 transmission are likely.