The impact of air travel on the spread of infectious diseases has led to considerable concern but limited study. More than 1 billion people travel by air each year. There are several important ways in which air travel can influence the global spread of emerging and established infectious disease. Infections may be spread on the aircraft through close contact and large droplets; airborne spread through small-particle aerosols, as in the case of severe acute respiratory syndrome (SARS); or even through contaminated food. Aircraft can transport infected disease vectors, such as rats or malaria-infected mosquitoes, as nonpaying passengers. Perhaps the greatest concern for global health, however, is the ability of a person with a contagious illness to travel to virtually any part of the world within 24 h.
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