Bird Flu Alarm

2006-03-10-Airports not ready for large-scale bird flu quarantine

Understanding Avian Influenza

2006-03-10-Airports not ready for large-scale bird flu quarantine

The nation's major airports aren't prepared to quarantine a planeload of international passengers if someone is suspected of carrying bird flu, airport and government officials say.
Eighteen airports with heavy international traffic have small federal quarantine stations. They must rely on airlines and state and local authorities to help identify sick travelers and, if needed, quarantine other passengers.

"Do we have enough people? No," says Robert Tapia, chief of Honolulu's five-person quarantine station. "If we have 25 international flights a day here and get a surge of four or five airlines reporting illness, how do we get to them all?"

Bird flu response plans are still being developed at many airports, where the first human case could show up. Few airports have practiced quarantine scenarios. It has been more than 40 years since a U.S. airport quarantined a passenger, for smallpox.

The deadly H5N1 strain of the bird flu virus can't be passed yet from person to person. Until it can, the risk is slight except to those in contact with infected wild birds and poultry. Bird flu has been found in animals in 39 countries. It has infected 175 people and killed 96 since December 2003.

If human-to-human transmission evolves, the stakes rise because airline passengers could be infectious and able to spread bird flu without showing symptoms themselves.

Most major airports ? Logan in Boston, Dulles outside Washington, Seattle's SeaTac, Miami and New York's JFK among them ? haven't found facilities they can seal off to house a large number of potentially exposed passengers for several days.

Los Angeles International plans to use a vacant maintenance hangar, but it has no plumbing or other amenities to meet passenger needs. Honolulu is outfitting two remote gates and has found two nearby warehouses that could serve as quarantine sites.

If passengers on a jumbo jet needed to be quarantined, "I don't know what we would do except leave them on the plane while we scramble, and that's not a good answer," says Jeff Fitch, SeaTac's public safety director.

Marty Cetron, head of the federal Centers for Disease Control and Prevention's quarantine division, says, "There's a great deal of variability in operational readiness. Where we're not seeing the rubber hit the road is actual tactical planning at specific airports."

The CDC and the airlines haven't resolved how to improve in-flight reporting of sick passengers to destination airports, a legal requirement that has had spotty compliance. The CDC wants the airlines to add passenger home addresses and emergency contacts to flight manifests. Airlines oppose the changes. "The rule needs significant work," says Katherine Andrus of the Air Transport Association, the airlines' trade group. She says airlines have been working to improve in-flight illness reporting.

"It can be a challenge for (flight crews) who aren't medical professionals," Andrus says. "Outwardly, a respiratory infection can look like a common cold."

Understanding Avian Influenza