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NORWAY
Civil Aviation Authority
- Norway -
P.O. Box 243
NO-8001 BODØ
AIC-I
06/03
22 MAY

Duty to report probable cases of SARS during flight

Duty to report probable cases of SARS during flightcode/image_article.jsp

Reference is made to AIP NORWAY GEN 1.3 subparagraph 3.1.1:

“The pilot-in-command shall, before landing, report by radio to the Air Traffic Control unit concerned, cases of illness of a contagious nature which have occurred during flight. Under such circumstances, crew members and passengers are allowed to the leave the aircraft only upon special permission from the local airport authority.”

The Civil Aviation Authority – Norway advises pilots-in-command to report probable cases of SARS to the Air Traffic Control as early as possible. Flight and cabin crews should also observe WHO’s recommended measures in case of SARS (enclosed).

- ENCLOSURE -

Vedlegg / Enclosure AIC I 06/03

WHO RECOMMENDED MEASURES FOR PERSONS UNDERTAKING INTERNATIONAL TRAVEL FROM AREAS AFFECTED BY SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

As of 26 March 2003 the WHO travel advice issued on the 15 March 2003 remains unchanged. No restrictions to travel or trade are recommended by WHO based on the current understanding of the risk from SARS. Individual countries however, as they make their own travel advice, may wish to adapt these recommendations to take into account national considerations.

Since global surveillance of SARS began at the end of February 2003, there is evidence that a small number of suspect and probable cases of SARS from affected areas (http://www.who.int/csr/sarsareas/2003_03_26/en/) have undertaken international travel. Whilst the number of such cases is small, there is a concern that such travel may pose a risk to other travellers and to the global spread of the disease. For these reasons WHO is recommending that airport and port health authorities in affected areas undertake screening of passengers presenting for international travel. In addition, WHO is issuing guidance on the management of suspect cases on international flights, disinfection of aircraft carrying suspect cases and surveillance of persons who have been in contact with suspect cases whilst undertaking international travel. Although this guidance is primarily directed to air travel, the same procedures are recommended for international travel from affected areas by road, rail or sea.

Screening for suspect cases of SARS on departure from affected areas

WHO recommends that government and point of entry authorities in affected areas establish a system in collaboration with aircraft and other conveyance operators so that passengers departing for international destinations from an affected area are interviewed, preferably by a health care worker, in the port of departure prior to

check-in. The interview should assess whether the passenger:

  • currently has or has experienced in the past 48 hours any symptoms of SARS(http://www.who.int/csr/sars/casedefinition/en/) and
  • has had any contact with suspect or probable SARS cases
  • Has a fever (body temperature may be checked if appropriate)

Persons meeting the SARS case definitions should be referred to a health care facility. Persons with only fever should be requested to postpone travel and seek medical attention.

In-flight care of suspected case of SARS

If a passenger on a flight from an affected area becomes noticeably ill with a fever and respiratory symptoms, the following action is recommended for cabin crew:

  • The passenger should be, as far as possible, isolated from other passengers and crew
  • The passenger should be asked to wear a protective mask and those caring for the ill passenger should follow the infection control measures recommended for cases of SARS
  • A toilet should be identified and made available for the exclusive use of the ill passenger
  • The captain should radio ahead to the airport of destination so that health authorities are alerted to the arrival of a suspect case of SARS
  • On arrival, the ill passenger should be placed in isolation and assessed by port health authoritie

Management of contacts of the ill passenger

If the immediate medical assessment of the ill passenger excludes SARS as a possible cause of his/her illness, the passenger should be referred to local health care facilities for any necessary follow up.

If however, the initial medical assessment conducted in the airport concludes that the passenger is a suspect or probable case of SARS (http://www.who.int/csr/sars/casedefinition/en/) the following action should be taken:

Contacts

1. All contacts of the ill passenger should have already been identified during the

flight. For the purposes of air travel a contact is defined as:

  • passengers sitting in the same seat row or within at least 2 rows in front or behind the ill passenger
  • all flight attendants on board
  • Anyone having intimate contact, providing care or otherwise having contact with respiratory secretions of the ill passenger
  • Any one on the flight living in the same household as the ill passenger
  • If it is a flight attendant who is considered to be a suspect or probable SARS case all the passengers are considered to be contact

2. Contacts should provide, to the health authorities, identification and details of ddress/contact details valid for 14 days

3. Contacts should be given information about SARS and advised to seek immediate medical attention if they develop any symptoms of SARS within 10 days of the flight. In seeking medical attention they should ensure that all those treating them are aware that they have been in contact with a suspect case of SARS.

4. Contacts should be allowed to continue to travel so long as they do not have symptoms compatible with SARS.

5. If over time it becomes apparent that the suspect case is a probable case of SARS, the health authority where the case is being cared for should inform other health authorities in those areas in which contacts reside that active surveillance of each contact (daily temperature check and interview by health care worker) should be undertaken until 10 days after the flight.

Other passengers

As a precautionary measure passengers and cockpit crew not defined as contacts, should also provide to the health authorities identification and address/contact details valid for 14 days after the flight. They should be given information about SARS and advised to seek medical attention if they develop any symptoms of SARS within 10 days of the flight. These passengers should be free to travel unless they develop any symptoms compatible with SARS.

Disinfection of the aircraft

Based on the early evidence about the possible causative agent for SARS the measures outlined in the WHO Disinfection of Aircraft Guidance (http://www.who.int/csr/ihr/guide.pdf) are recommended.

In order to respond as recommended by WHO airlines will have to ensure that flights serving SARS affected areas are provided with sufficient gloves, face masks and disinfectant and that a seat in a isolated area can be made available when needed.