CDC Issues Flu Guidance for Flights
Interim Guidance for Airlines Regarding Flight Crews Arriving from Domestic and International Areas Affected by Swine Influenza
By Antonio Percy
April 27, 2009, The swine influenza A (H1N1) virus that has infected humans in the United States, Mexico and elsewhere is a novel influenza A virus that has not previously caused illness in people. Not all details are known at this time, but CDC and HHS are currently investigating and taking appropriate actions to ensure the protection of port-based staff who may encounter ill individuals. Symptoms of swine flu are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have also reported diarrhea and vomiting associated with swine flu. On-going human-to-human transmission is occurring with confirmed cases identified in several states and counties.
Recommendations in this guidance document are based on standard infection control and industrial hygiene practices and should be implemented immediately to protect workers and to delay the spread of this newly emerged influenza virus via airline travel. All airline personnel should follow the practices and instructions described below to prevent spreading infectious disease and becoming ill.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol based hands cleaners are also effective. Avoid touching your eyes, nose or mouth because germs spread that way. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. If you get sick, CDC recommends that you stay home from work and limit contact with others to keep from infecting them.
Swine influenza is likely to spread from person-to-person in the same way as seasonal flu. The main way that influenza is thought to spread is through the coughing or sneezing of people infected with the influenza virus. People may also become infected by touching something with flu viruses on it and then touching their mouth or nose.
Crew members should wear impermeable, disposable gloves onboard aircraft if they need to have direct contact with potentially contaminated surfaces such as airplane seats, tray tables, and lavatories used by ill passengers. They should avoid touching their face with gloved or unwashed hands. Improper use of gloves may actually increase transmission.
People with symptoms of swine influenza should not fly. If symptoms of swine influenza 2 develop during flight, the ill person should wear a surgical mask to reduce the number of droplets coughed or sneezed into the air. Likewise, crew assisting that person should wear a facemask at a minimum, but ideally use a respirator rated N-95 or higher. The optimal use of respirators requires fit testing. Proper use is recommended to maximize effectiveness. The use of facemasks may be considered as an alternative to respirators, although they might not be as effective as respirators. While facemasks provide barrier protection against droplet and contact transmission of the virus, they do not protect against inhalation of very small airborne particles
Disposable facemasks and respirators should not be reused; once removed they should be discarded. It may be difficult for some workers in certain situations, such as cabin crewmembers on lengthy flights, to wear respirators for extended periods of time and during physically heavy work loads.
During an influenza outbreak or pandemic, if a cabin or flight deck crew member or passenger is displaying signs and symptoms of an influenza-like illness prior to flight, they should not board the aircraft. If passengers or crew develop symptoms en route, they should cover their nose and mouth when coughing or sneezing, use tissues to contain respiratory secretions, dispose of used tissues in the nearest waste receptacle after use, and wear a facemask if tolerated. Hands should be washed after contact with respiratory secretions or contaminated objects or materials. If a pilot becomes ill with the symptoms of swine flu, all persons in the cockpit should wear masks.
As the guidelines for swine influenza are being developed and new information is gained, more detailed guidelines will be published to the CDC website. In the event of a widespread outbreak or pandemic, social distancing will play the primary role in preventing exposure of persons to the virus (www.pandemicflu.gov).
For additional updated information about this swine influenza outbreak, consult the CDC swine influenza web page (www.cdc.gov/swineflu/).
Manangement of Passengers or Crew Members with Symptoms of Influenza
Management of Crew Exposure After Flight Completed
Flight deck and cabin crew members and ground personnel who may have been exposed to a passenger or worker suspected of having influenza should monitor their health for 7 days after the exposure. If they become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea they should immediately take the following steps:
For More Information
Interim Guidance for Airline Flight Crews and Persons Meeting Passengers Arriving from Areas With Avian Influenza http://wwwn.cdc.gov/travel/contentAvianFluArrivingFromAreas.aspx
Travel Industry Pandemic Influenza Planning Checklist http://www.pandemicflu.gov/plan/workplaceplanning/travelchecklist.html
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