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Guidance for Airlines on Reporting Onboard Deaths or Illnesses to CDC

This information is also available as a PDF:  Guidance for Airlines on Reporting Onboard Deaths or Illnesses to CDC [PDF - 1 page]

U.S. Federal Regulations

The U.S. Code of Federal Regulations [42 CFR 70.4 and 71.21(b)] contains requirements for reporting death and illness on international flights arriving to the United States and flights between states.

  • 42 CFR 70.4 requires the pilot of interstate flights to report a suspected case of contagious disease among passengers or crew members before arrival to the local health authority with jurisdiction for the arrival airport. (Reporting to CDC will fulfill this requirement.)
  • 42 CFR 71.21(b) requires the pilot of international flights to the United States to report before arrival any deaths or illnesses (as defined in the regulations) among passengers or crew to the Centers for Disease Control and Prevention's (CDC) Quarantine Station at or nearest to the airport of arrival.

Conditions that require reporting are defined in federal regulations for international travel, but not in the regulations for interstate travel. CDC recommends that airlines apply the same standards for "required" and "requested" reporting to both international flights and interstate flights.

What to report to CDC

Pilots are required by law to report all deaths or ill travelers with

  1. Fever (warm to the touch, history of feeling feverish, or measured temperature of 100°F/37.8°C or greater) reported to have lasted more than 48 hours; OR
  2. Fever of any duration, AND one or more of these conditions:
    • Skin rash
    • Swollen glands
    • Jaundice (yellowing of skin or eyes), OR
  3. Persistent diarrhea

Pilots are requested by CDC to report ill travelers with

Fever of any duration, AND one or more of these conditions:

  • Persistent cough
  • Difficulty breathing
  • Persistent vomiting
  • Headache with stiff neck
  • Decreased consciousness or confusion of recent onset
  • Unexplained bleeding

For details, see Definitions of Symptoms for Reportable Illnesses.

Please note: Consult as needed with CDC Quarantine Station staff for help to evaluate ill travelers, provide recommendations, and answer questions about reporting requirements. Reporting to CDC does not replace usual company procedures for in-flight medical consultation or obtaining medical assistance.

Collect this information to report to CDC

Cabin crew should provide the pilot with the following information:

  • Ill traveler’s name and age (indicate whether passenger or crew)
  • Seat number or work area
  • City of departure, and countries visited on this trip
  • Symptoms that brought the ill traveler to the attention of the cabin crew or passengers

How to report to CDC (international or interstate flights)

Use the steps shown below. For arriving international flights, the pilot reports to CDC. For interstate flights, the pilot reports to CDC (or local health authority). CDC will then notify the local health authority in accordance with f ederal regulations. Either of these two options meets federal regulations for reporting to CDC:

  1. Air Traffic Services (ATS) if in international airspace or Air Traffic Control (ATC) if in U.S. airspace [This reporting option also complies with International Civil Aviation Organization (ICAO) reporting standard, ICAO document 4444 and Annex 9 of the Chicago Convention.]
    ATC will notify CDC’s Emergency Operations Center (EOC) through the Domestic Events Network; the EOC will notify the appropriate CDC Quarantine Station and the local health department of jurisdiction. Quarantine staff will communicate with the airline’s designated point of contact to obtain necessary information about the death or ill traveler. Also, quarantine station will provide update to DEN via EOC about the response.
  2. Airline’s land-based point of contact (e.g., Operations Center, Flight Control, airline  station manager)
    Instruct the airline’s point of contact to notify CDC by contacting the:
    • CDC Quarantine Station at or closest to the airport where the flight is arriving OR
    • CDC EOC (770.488.7100), which will then notify the appropriate CDC Quarantine Station.