IATA Stands By Existing Ebola Guidelines

Even in the wake of revelations that two Dallas healthcare workers had contracted Ebola from a Liberian man in their care, the International Air Transport Association has issued no special guidance to its airline members for containing the potential spread of the disease in airplanes. Rather, it relies on the guidance of the World Health Organization and the Centers for Disease Control and Prevention, which, according to IATA, it shares with its members.  

“Aviation has dealt with various outbreaks over the years such as SARS and Avian flu,” said IATA in a written statement to AIN. “Guidance materials have been developed with WHO and ICAO for maintenance crew, cabin crew, cleaning crew and passenger agents.

 “As has been widely reported, WHO (and CDC) have stated that risk of Ebola transmission on an aircraft is low because the disease is not spread by air. It requires direct contact with blood, secretions, organs, or other body fluids of the infected living or dead persons or animals, which are unlikely exposures for the average traveler.”

Still, even before news broke that at least two Ebola patients flew on airline flights in the U.S., airline employees had begun to question whether their companies and government have taken sufficient precautions to protect them from the disease. Now, as officials have confirmed two cases in which healthcare workers contracted Ebola from a patient admitted to their Dallas hospital, fear about the possibility of transmission in airplanes has only heightened.

In an October 7 statement, the Association of Flight Attendants said recent events have shown that airlines and health officials rely too heavily on voluntary disclosure by passengers boarding flights out of Western Africa.

“Flight attendants are the first responders to in-flight medical emergencies and we handle myriad health-related situations,” said Sara Nelson, AFA International president. “We are not, however, professional healthcare providers and our members have neither the extensive training nor the specialized personal protective equipment required for handling an Ebola patient.”

WHO protocol instructs cabin crew to follow several measures to minimize the threat of Ebola spreading to other passengers or crew, including covering the nose and mouth of a suspected carrier with a medical facemask “if tolerated.” They also call for limiting contacts with the ill passenger to only one or, at most, two crewmembers and preferably someone who has already had contact with that passenger. Other precautions should include distancing other passengers “if possible” by reseating them away from the symptomatic passenger and placing the sick individual near a toilet for his or her exclusive use.  

The second Dallas healthcare worker to have tested positive for Ebola traveled on a commercial flight on October 13, the day before she reported symptoms. As a result, the CDC asked all passengers that flew aboard Frontier Airlines Flight 1143 from Cleveland to Dallas that day to call a telephone hotline to arrange for interviews with agency officials. The CDC said it would “actively monitor” people it determines might be at risk for contracting the disease. The agency said it would work closely with Frontier Airlines to identify and notify passengers who might have traveled on the flight.

Meanwhile, in a written statement issued on Wednesday, Frontier noted that it thoroughly cleaned the airplane “per normal procedures and consistent with CDC guidelines” during its overnight stay in Dallas on October 13, after Flight 1143 landed at 8:16 p.m. local time. The airplane returned to service the next day and underwent another cleaning in Cleveland that night.

The revelation about the healthcare worker’s use of commercial air transportation the day before she reported symptoms marked the second case in which a U.S. airline needed to notify its passengers of potential exposure to Ebola. On September 23, Thomas Eric Duncan, the Liberian who subsequently died of the disease in Dallas, traveled from Brussels to Washington, D.C., on United Airlines Flight 951, then from Washington, D.C., to Dallas on Flight 822. Consequently, United had to notify all passengers aboard that they had traveled with Duncan and offered screening to the 14 flight attendants who worked on Flight 951 and Flight 822.