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Screening of passengers for flu called a success


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POSTED: Wednesday, December 24, 2008

A voluntary screening process for flulike illnesses among international arrivals at Hono- lulu Airport worked so well it may be done more often next year, a state Health Department official said.

The process was tested recently on 435 arriving Japan Airlines passengers, said Dr. Sarah Park, chief of the Disease Outbreak Control Division.

The program is aimed at intercepting passengers with possibly infectious diseases such as bird flu or severe acute respiratory syndrome (SARS) before they can expose a broader population.

The passengers "did their part to help us out," Park said. "We were pleasantly surprised how fast they went through. Each time we do this, we're learning and tweaking the process and improving upon it."

Fearing the introduction of infectious diseases into Hawaii, the state in November 2005 became the first in the nation to set up a passive airport surveillance program for Hawaii-bound international travelers.

Pilots must notify the airport tower if they have a potentially ill passenger on board, and the U.S. Centers for Disease Control and Prevention's Quarantine Station is called to evaluate the passenger at the gate. Those who have fever and respiratory symptoms are asked to be tested for flu.

In June, the Health Department worked with the CDC, U.S. Customs and Border Protection, Department of Transportation and Hawaiian Airlines to start a pilot project. Federal officials hope that efficient standard procedures can be developed to be used across the country.

The second screening, involving a Japan Airlines flight that arrived about 6:20 a.m. Dec. 3, took longer to arrange because of efforts to address non-English-speaking passengers, Park said. "It's one thing to screen people quickly and efficiently who speak your language. It's another thing to those who don't speak the language or share your culture."

Health officials worked with the state tourism liaison to discuss the situation with the Japanese Consulate and one of the consuls asked to observe the screening, she said.

A short informational video was produced, asking the passengers to participate in a voluntary health screening and explaining a questionnaire given to them. The form, in Japanese and English, asked for basic demographic, recent travel and illness information, including presence of a fever, she said.

The airline was asked to distribute the questionnaires and show the video to passengers so there would be no surprises, she said. "We told our airline partners we don't want passengers disgruntled and upset because upset people don't comply," Park said.

All partners "were pleasantly surprised how many people did opt in and without question went through health screening with no concerns," she said.

Sixteen makeshift kiosks were set up at screening points with trained medical staff to take the questionnaires from passengers leaving the airplane and ask if they had a fever.

Two passengers didn't feel well and were referred to a medical evaluation area with registered nurses, physicians and CDC quarantine observers, she said. Neither had fever or met the criteria for an influenzalike illness, but they were given a fact sheet and advice about flu and allowed to proceed, she said.

Avian influenza hasn't mutated into human influenza, "but when it does accidentally move to the human side, it causes severe disease with high mortality," Park said.

"It has taken this long to screen a second flight," she said, "but I'm extremely confident, and our partners are confident, that should we suddenly be hit with a pandemic alert level or SARS, we're prepared in Hawaii."