# 4520
A couple of news reports in USA Today, and a relevant blog post from Jimmy Jazz at Break Glass (see Quickly Noted: Proposed Quarantine Regulations Dropped), highlight the difficulties involved in trying to keep potentially infectious individuals from boarding commercial airline flights.
The video above, which as been making the rounds for a couple of years, was made by ZHAW (Zürcher Hochschule für Angewandte Wissenschaften) or The Zurich University of Applied Sciences.
It is a simulation (using real data) showing 24 hours of air traffic around the world.
Every year there are more than 17,000,000 commercial airline flights (data from year 2000 - it's probably higher now) that carry hundreds of millions of passengers each year.
And on any given day, some percentage of those passengers are likely to be infected with potentially communicable diseases. And not all of them will be symptomatic.
During the initial outbreak of novel H1N, there were demands by many that authorities try to identify and interdict sick passengers in the hope of preventing the spread of the virus.
But as many predicted, and as events later proved, doing so was nigh on impossible.
Last June, in Vietnam Discovers Passengers Beating Thermal Scanners, we learned that many passengers were taking Tylenol and other fever reducers prior to flying simply so they would not be detected by thermal scanners and detained.
And even before the pandemic outbreak began, we saw studies that questioned the effectiveness of airport screening for pandemic flu, such as Can Island Nations Effectively Quarantine Against Pandemic Flu? and Study: U.S. Airport Entry Screening In Response To Pandemic Influenza.
Roughly three weeks ago it was quietly announced that the Obama administration was going to drop sweeping quarantine regulations that the CDC had promoted back in 2006.
Obama administration scraps quarantine regulations
Posted 4/1/2010 8:53 PM |
By Alison Young, USA TODAY
The Obama administration has quietly scrapped plans to enact sweeping new federal quarantine regulations that the Centers for Disease Control and Prevention touted four years ago as critical to protecting Americans from dangerous diseases spread by travelers.
The regulations, proposed in 2005 during the Bush administration amid fears of avian flu, would have given the federal government additional powers to detain sick airline passengers and those exposed to certain diseases. They also would have expanded requirements for airlines to report ill passengers to the CDC and mandated that airlines collect and maintain contact information for fliers in case they later needed to be traced as part of an investigation into an outbreak.
The CDC and the HHS are said to be drafting new recommendations based on lessons learned since those proposals were made.
In a related report from yesterday, we learn that the reporting requirements currently in place are apparently not identifying all those who fall ill (or even die) on airline flights in the United States.
Review: Many sick airline passengers aren't reported
- By Alison Young, USA TODAY
Hundreds of people at major U.S. airports each year are severely ill with symptoms of potentially contagious diseases, yet few are reported to health officials as intended under U.S. regulations and international guidelines, a USA TODAY review of ambulance records and federal data shows.
To detect diseases such as pandemic flu, tuberculosis and measles, federal regulations require airlines to notify health officials of passenger illnesses involving diarrhea or fever plus rash, swollen glands or jaundice. The International Civil Aviation Organization, a United Nations agency, also includes persistent vomiting or coughing in its guidelines.
Obviously nobody would choose to be seated next to someone shaking with chills, a fever, vomiting, diarrhea, or other such symptoms. And identifying sick passengers, and following up to see if they presented some sort of a public health threat, makes sense.
But the simple truth is that unless you are a hermit, you probably come in daily contact with people carrying all manner of potentially infectious diseases.
Rhinoviruses, adenoviruses, noroviruses, influenza and even more serious pathogens like Tuberculosis.
Some of those people will be symptomatic, while others won’t appear to be ill at all.
No screening process is going to catch them all. And no reporting system is going to identify every sick passenger for CDC follow up.
While I wish I could be more optimistic about such interventions, I’m resigned to the fact that whatever is devised is going to be an imperfect solution.
