November 11, 2005

US airlines could be on front lines for bird flu

By John Crawley

WASHINGTON (Reuters) - U.S. airlines could be on the front
lines in a bird flu outbreak and federal health officials are
streamlining procedures for the possible quarantine of sick

But some airline workers and health experts see shortfalls
in planning and recommend additional steps they say could save
lives and help a financially fragile industry fly through a
potential nightmare.

The Bush administration hopes quick action can contain any
U.S. outbreak and has not ruled out travel restrictions.

Federal health officials have authority to detain or
isolate any airline passenger suspected of harboring the avian
flu virus, which scientists fear could mutate to leap from
person to person and quickly spread globally.

Air travel was crucial in spreading the deadly Severe Acute
Respiratory Syndrome, or SARS, virus around Asia and to Canada
in 2003. SARS ended up killing around 800 people globally
before it was contained.

SARS was harder to catch than the flu and, unlike
influenza, only spread after patients began showing symptoms,
but airlines and health officials are basing some bird flu
preparations on the SARS experience.

The U.S. Centers for Disease Control and Prevention has
increased the number of quarantine centers at big airports and
land crossings from eight in 2003 to 18 now, partly due to the
bird flu threat.

There are plans to expand to 25 centers, depending on
resources and need, said Ram Koppaka, chief of the CDC's
quarantine and border health division.

Pacific entry points, including Hawaii, Los Angeles, San
Francisco and Seattle, are emphasized.

The H5N1 virus is entrenched in poultry flocks in much of
Asia. It has infected more than 120 people, killing at 64
people in Indonesia, Vietnam, Thailand and Cambodia in two

U.S. health officials are also working with airlines to
review the cleaning of plane interiors and the handling of
passengers with signs of viral illness.

"At this point we are comfortable with our relationship
with the CDC and confident that they will inform us if the
situation changes that mandates a different approach," said
Katherine Andrus, assistant general counsel for the Air
Transport Association, the lead U.S. airline trade group.


International travel on all carriers to and from the United
States for 2005 was forecast at 137 million people, government
estimates show. About 16 percent were on Pacific flights. U.S.
airlines handle about half the traffic.

But Georges Benjamin, executive director of the American
Public Health Association who led a recent CDC-sponsored study
of quarantine planning, said a more robust approach is needed.

The difficulty of quickly locating passengers who may have
been exposed to infectious agents posed a "significant" gap in
the quarantine system, the study concluded.

The report supported traveler cards embedded with personal
contact data and flight and seat information to help locate
people. It also found that CDC is stretched thin and there was
no single organization within the government with the authority
and the resources to coordinate quarantine responsibilities.

The CDC works with with border control, human services and
local health agencies.

The Professional Flight Attendants Association at Northwest
Airlines wants lawmakers to mandate that carriers keep planes
properly ventilated on the ground and provide early access to
antiviral drugs or a bird flu vaccine -- if health authorities
turn to either.

Bankrupt Northwest, a big U.S. carrier to Asia, referred
questions on its plans to the Air Transport Association.

British entrepreneur Richard Branson has purchased 10,000
doses of the antiviral Tamiflu in Canada for airline employees
at Virgin Group Ltd. in an attempt to protect them from bird
flu. Global cargo giant FedEx Corp is also "in the process" of
buying a "small reserve" of the drug in the United States to
distribute to workers if an outbreak occurs and only under
strict circumstances, a company spokeswoman said.

No. 2 United Airlines, which also flies to Asia and plans
more international service after bankruptcy, has no plans to
stockpile antiviral medication, said Dr. Gary Kohn, the
carrier's medical director.

U.S. health officials do not support stockpiling drugs
partly because it is unclear if Tamiflu, made by Switzerland's
Roche or other antivirals are the correct treatment.

"I think what we have to remember at this point is that
there is not a human pandemic," said CDC's Koppaka. "It's
primarily bird populations and there have been a limited number
of human cases in close contact with infected birds."