Bird flu shakes up travel rules
Proposed changes to travel quarantine regulations could cost airlines millions
Staff and news reports
FEDERAL OFFICIALS have proposed the first significant changes in quarantine rules in 25 years to broaden the definition of reportable illnesses, centralize their reporting to the federal government, and require the airline and shipping industry to keep passenger manifests electronically for 60 days.
The proposals, unveiled yesterday, also would clarify the appeals process for people subjected to quarantines to allow for administrative due process and give health officials explicit authority to offer vaccination, drugs and other appropriate means of prevention on a voluntary basis to those in quarantine.
Concerns about a potentially deadly bird flu immigrating from Asia are among the motivations for the change, said Dr. Martin Cetron, director of the Centers for Disease Control and Prevention's division of global migration and quarantine. Health officials fear the bird flu could spark a pandemic should it mutate into a form easily passed from human to human. CDC officials say federal quarantine and contact-tracing regulations are antiquated and in-need of an overhaul.
The proposals could cost the beleaguered airline industry hundreds of millions of dollars, they said.
But while Hawaii's No. 1 industry is dependent on the airlines, a top local tourism executive said it is more important to guard against bird flu, which has killed 67 people in Asia.
"Being more restrictive is a bit of a problem, but the big problem is if it (bird flu) actually shows up here," Hawaii Tourism Authority Executive Director Rex Johnson said.
"We want to do everything we can to protect from that ever happening," he added.
Federal officials are inviting public comment on the proposals, which are to be published in the Federal Register on Nov. 30, they told reporters in a telephone news conference.
The proposals are part of a broader Bush administration plan to improve response to current and potential communicable disease threats that could arise anywhere in the world.
If adopted, the new regulations "will allow the CDC to move more swiftly" when it needs to control outbreaks, Cetron said.
The outbreak of severe acute respiratory syndrome, or SARS, in 2003 underscored how quickly a disease can spread through the world and the need to modernize and strengthen quarantine measures by pointing out gaps in health workers' ability to respond quickly and effectively, Cetron said.
As CDC joined with cooperating airlines to meet flights and later collect information about passengers who had contact with others who developed SARS, the epidemiologists had to compile and process by hand data from flight manifests, customs declarations and other sources.
But manifests contained only the name and seat number, customs declarations were illegible, and when readable, the names did not match the manifests.
"The time required to track passengers was routinely longer than the incubation period," which was two to 10 days for SARS, Cetron said.
One proposed change would require airline and ship manifests to be kept electronically for 60 days and made available to CDC within 12 hours when ill passengers arrive on international and domestic flights. The proposed changes include provisions for maintaining confidentiality and privacy of health information.
Another proposed change would expand the definition of illnesses to include respiratory ailments like influenza. An ill person would be defined as having a temperature of 100.4 degrees or greater, accompanied by one or more of the following: rash, swollen lymph nodes, headache with neck stiffness (a sign of possible meningitis), and changes in level of consciousness or cognitive function.
Also, the definition of illness would include diarrhea, a fever that has persisted more than 48 hours, severe bleeding, jaundice, severe persistent cough or respiratory distress.
Captains of airplanes and ships are now required to notify local health officials about an ill passenger or crew member at the next port of call and take such measures as local officials direct.
The new proposals call for captains to bypass local health officials and report instead to the director of the CDC through quarantine officials or e-mail. The CDC, in turn, would notify local health officials.
Janice Okubo, Hawaii Department of Health spokeswoman, said she did not think that would be a problem.
"We already work closely with the CDC and are in regular contact with them, and they would notify us quickly," she said.
This month at Honolulu Airport, the state and the Queen's Medical Center opened the nation's first airport surveillance clinic to monitor and test sick passengers for the bird flu and other viruses.
The New York Times, Associated Press and Star-Bulletin reporter Leila Fujimori contributed to this report.