# 594
Last night an airline flight out of Hong Kong was delayed for several hours at the Newark, New Jersey Airport while officials tried to determine the cause of an illness that had struck a number of passengers.
'Sick' flight is held at Newark airport
Avian flu ruled out on jet from Hong Kong
Tuesday, March 27, 2007
BY MARK MUELLER AND MARY JO PATTERSON
Star-Ledger Staff
A Continental flight loaded with 272 passengers from Hong Kong -- some of them sick -- was kept on the tarmac at Newark Liberty International Airport yesterday until health officials ruled out avian flu as the source of their illness.
The culprit was most likely "seasonal flu," said Shelly Diaz, a spokeswoman for the U.S. Centers for Disease Control and Prevention in Atlanta, which dispatched a medical crew to Newark. Initial reports put the number of sick passengers at seven.
Flight 98 arrived at 2:05 p.m., but no one was allowed to disembark until about 4 p.m., said Mary Clark, a spokeswoman for Continental Airlines. She said the flight crew noticed "a number of" passengers who appeared ill upon boarding in Hong Kong and contacted authorities.
They were members of a large tour group returning to Quebec, Canada, from a Chinese river cruise, she said. Their final destination was Montreal.
Officials with the CDC's Global Migration and Quarantine office at LaGuardia Airport dispatched an emergency medical services crew, who boarded the plane and interviewed everyone on board, Diaz of the CDC said.
"They asked (them) about their symptoms, and whether they had been exposed to any sick or dead poultry or birds," she said.
The fear, of course, is that one day a sick passenger will bring the H5N1 virus to our country, and that it will spread.
The reality is, of course, that should the virus mutate and become a pandemic strain, all we can possibly hope for is to buy a little time by intercepting symptomatic patients on an inbound flight. At some point, despite our best efforts, the virus would enter this, and every other country.
While I am comforted by the quick response on the part of the aircrew, and the examination of the passengers before being allowed to disembark, I am a bit troubled by this story.
First, let me be clear. I highly doubt that these passengers had anything more ominous than seasonal flu. The fear of this scenario runs high enough in official circles, that if there were any real indications of something more serious, I believe they'd have quarantined the entire flight.
But one has to wonder why, in this age of heightened concern over bird flu, obviously sick passengers were allowed to make a 15 hour flight from Hong Kong? This article clearly states that several passengers had flu symptoms prior to boarding the flight.
The other thing that concerns me is the litmus test currently in place for suspecting H5N1; and that is known exposure to birds in an area where H5N1 has been reported.
While it is true that most infected humans have been linked (oft times tenuously) to sick or dead birds, that hasn't been true in every case. Yesterday Indonesia reported the death of a 22-year-old woman who reputedly had no contact with birds, but lived in a house with 10 cats.
In recent months, cats have been linked to the H5N1 virus. And roughly 20% of all human cases have not been directly linked to birds.
The criteria for suspecting, and testing for the H5N1 virus in ambulatory patients is, according to the HHS Pandemic Influenza plan, as follows:
* Testing for avian influenza A (H5N1) should be considered on a case-by-case basis in consultation with state and local health departments for hospitalized or ambulatory patients with:
o Documented temperature of >100.4°F (>38°C); and
o One or more of the following: cough, sore throat, or shortness of breath; and
o History of contact with poultry (e.g., visited a poultry farm, a household raising poultry, or a bird market) or a known or suspected human case of influenza A (H5N1) in an H5N1-affected country within 10 days prior to onset of symptoms.
Despite the cynicism that abounds these days on the Internet, the medical response teams charged with checking these cases out are not fools, and if they suspected something, I believe they would have acted. I'm confident that officials would have waived this last requirement had any of the passengers appeared extremely ill or exhibited a high fever along with a severe cough, sore throat, or shortness of breath.
But it may be time, given that this criteria is more than a year old, and we know more today about potential vectors than we did in 2005, to review the standards for suspecting avian influenza.
