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Air Travel Is Low Risk For Ebola Transmission

October 3, 2014 - There has been an awful lot of news coverage of the Ebola virus disease (EVD) since learning that on Tuesday a passenger who arrived in the United States on a commercial flight from Liberia had been admitted into a Dallas hospital after being diagnosed with Ebola.

The unidentified man had not shown any symptoms until several days after he arrived in the U.S. When the news broke on Tuesday, the number one tweet on Twitter was the subject Ebola, and many of those tweets were concerns of flying on a commercial flight. 

The Ebola virus is a disease that effects humans and it is believed that the virus was introduced into the population through the food consumption of the fruit bat which is not affected by the virus, or by means of a misquote that has bitten a carrier fruit bat. 


The Ebola virus was first detected in Liberia in March 2014, and the Ebola outbreak crossed into Liberia in the remote border region with Guinea. The Centers for Disease Control and Prevention (CDC) has issued warnings to avoid nonessential travel to Liberia, Sierra Leone and Guinea, the countries hit the hardest by the outbreak. 

The CDC is also advising against the handling or consuming bush meat to include bats, monkeys, gorillas, and other primates that appear to be responsible for starting human outbreaks of EVD. 

Once human infection occurs, the belief is that the only way that another human can get it, is from contact with body fluids from the infected person. It has also been reported that male survivors may be able to transmit the disease via semen for nearly two months. Symptoms start two days to three weeks after contracting the virus.



Passengers in these countries affected by Ebola are now being screened for a fever before they board an international flight and passengers arriving from these countries to the United States are as well being screened after they disembark the aircraft. Stephan Monroe from the CDC said, "It's very unlikely that (Ebola victims) would be able to spread the disease to fellow passengers."

Communicable diseases have spread by different modes of transportation throughout history. In the Fourteenth Century, bubonic plague, the Black Death, crossed Europe in 5 years, the speed of an ox cart. In the Nineteenth Century, Cholera circled the world in sailing ships. In 1918 and 1919, the Influenza Pandemic girded the world in six months and killed more people than died in World War I, spread by steamships and railroads. In 1958, two missionaries infected with influenza B flew from Hong Kong to Iowa to attend a convention. Within two weeks the great Hong Kong flu pandemic was worldwide. The West Nile virus that struck North America in 2001-2 probably originated when an infected carrier emigrated from the Middle East to the United States in 2001.

Aviation has the ability to disseminate diseases worldwide. Today we can transport an incubating Ebola patient from Africa to anyplace on the planet in 24 hours. We have the knowledge and skills to control and prevent diseases from entering new ecosystems and becoming new epidemics. Airports designated as International must meet mandatory World Health Organization requirements. These include quarantine zones, health and customs inspections, and at least a quarter mile zone around the airport free from breeding grounds for mosquitoes. Flight crews operating to and through international airports are provided with additional medical support in terms of planning and prevention. These may include preventive vaccinations, medications, and protocols for occupational illness and injuries.

On Thursday the Air Line Pilots Association, Int’l (ALPA) issued a statement regarding the recent Ebola health concern as it relates to air transportation. “ALPA has full confidence in the air travel procedures currently in place related to the Ebola outbreak. Airports in countries affected by the Ebola virus are screening airline passengers, and various U.S. government agencies are working to monitor individuals arriving in the United States from affected international airports."

"If a passenger who appears ill arrives at an airport gate or attempts to board a flight, U.S. airlines have the ability under U.S. law to deny that individual permission to board. Flight crews have guidance available and access to medical services to address a medical emergency while a flight is airborne. Should a medical emergency occur during a flight, the pilot in command, using available information and guidance, will determine the appropriate course of action with the single goal of ensuring the safety of the passengers and crew on board.”

Back in August the World Health Organization (WHO) stated the of transmission of Ebola virus disease during air travel remains low. Dr Isabelle Nuttall, Director of WHO Global Capacity Alert and Response said, “unlike infections such as influenza or tuberculosis, Ebola is not airborne. It can only be transmitted by direct contact with the body fluids of a person who is sick with the disease.”

On the small chance that someone on the plane is sick with Ebola, the likelihood of other passengers and crew having contact with their body fluids is even smaller. Usually when someone is sick with Ebola, they are so unwell that they cannot travel. WHO is therefore advising against travel bans to and from affected countries. Nuttall  further stated, “because the risk of Ebola transmission on airplanes is so low, WHO does not consider air transport hubs at high risk for further spread of Ebola.”

How are airlines preparing for Ebola?

The FAA is working with the CDC which has developed guidance for airline crews, cleaning and cargo personnel, and air medical transport. The CDC’s notices and guidelines are well publicized. U.S. airlines have CDC’s guidance and have been sharing the information with their crews. The FAA will continue to work collaboratively with the U.S. aviation industry and public health authorities.

What should a crewmember do if they suspect someone is infected with Ebola?

The CDC, through a network of Quarantine Stations located at 20 ports of entry and land-border crossings, has routine health inspection procedures that consist of working with airline, cargo ship, and cruise ship companies to protect passengers and crews from certain infectious diseases.

Quarantine inspectors meet arriving aircraft and ships reporting ill passengers and/or crew (as defined in the foreign quarantine regulations) and assist them in getting appropriate medical treatment. If the flight crew of a commercial aircraft ARRIVING in the U.S. becomes aware of an ill person on board which may include a person with Ebola symptoms, the captain is REQUIRED by law (42 CFR 71.21(b)) to report the illness to the nearest U.S.

Quarantine Station, who will arrange the appropriate medical response at the flight’s destination airport. International Civil Aviation Organization (ICAO) standards and procedures provide for reports to be made to air traffic control. Once the FAA receives a report, it promptly communicates it to the CDC Emergency Operations Center (EOC).

What are airlines doing to clean airplanes arriving from countries who have citizens infected with Ebola?

On September 5, 2014, the CDC provided airlines with updated guidance for airline cleaning personnel, as well as general infection control precautions.

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