Just a few moments in a toilet during an 11-hour flight could be the reason why a woman became infected with Covid-19.

It is believed the 28-year-old only briefly took off her N95 mask while in the toilet on one of the first flights out of Italy at the height of its pandemic earlier this year.

She was on an evacuation plane to South Korea with 310 passengers from Milan in March.

Researchers have examined the passengers and published their findings in the US Centers for Disease Control and Prevention’s publication Emerging Infectious Diseases.

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US Centers for Disease Control and Prevention

Location of 6 asymptomatic patients and subsequently infected patient on the flight.

The researchers at Soonchunhyang University College of Medicine in Seoul wrote that the airline and the woman had followed all safety precautions.

”When the passengers arrived at the Milan airport, medical staff performed physical examinations, medical interviews, and body temperature checks outside the airport before boarding, and 11 symptomatic passengers were removed from the flight,” they wrote.

Passengers were given N95 masks and kept two metres apart for physical distancing during preboarding.

”A 28-year-old woman who had no underlying disease had a confirmed positive test result for Covid-19. On the flight from Milan, Italy, to South Korea, she wore an N95 mask, except when she used a toilet,” they wrote.

“The toilet was shared by passengers sitting nearby, including an asymptomatic patient. She was seated 3 rows away from the asymptomatic patient.

“Given that she did not go outside and had self-quarantined for 3 weeks alone at her home in Italy before the flight and did not use public transportation to get to the airport, it is highly likely that her infection was transmitted in the flight via indirect contact with an asymptomatic patient.”

Of the passengers on board, six tested positive soon after arrival in South Korea.

The researchers concluded with the three rules to help prevent the spread on planes.

“First, masks should be worn during the flight. Second, because contact with contaminated surfaces increases the risk for transmission of SARS-CoV-2 among passengers, hand hygiene is necessary to prevent infections. Third, physical distance should be maintained before boarding and after disembarking from the aircraft.”

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