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Guidance for Airlines on Reporting Onboard Deaths or Illnesses to CDC

Updated October 15, 2014

CDC requests airline crews to ask sick travelers if they were in Guinea, Liberia, or Sierra Leone in the last 21 days.

  1. If YES, AND they have any of these Ebola symptoms—fever, severe headache, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bruising or bleeding—report immediately to CDC.
  2. If NO, follow routine procedures.

For U.S. Arrivals

This information is also available as a PDF: CDC Death and Disease Reporting Tool for Airlines [PDF - 2 pages]

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.

Report to CDC all deaths or ill travelers with

*Required by U.S. regulations

  1. Fever*
    (warm to the touch, history of feeling feverish, or measured temperature of 100.4⁰F/38⁰C 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* (visible)
    • Jaundice* (yellowing of skin or eyes)
    • Persistent cough
    • Persistent vomiting
    • Difficulty breathing
    • Headache with stiff neck
    • Decreased consciousness
    • Unexplained bleeding
    OR
  3. Persistent diarrhea*

See “Definitions of symptoms for reportable illnesses” for signs and symptoms of contagious diseases.

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.

What and how to report to CDC (international or interstate flights)

[Same as ICAO document 4444, Procedures for Air Navigation Services – Air Traffic Management, Ch.16, 16.6]

Cabin crew should provide this information to the pilot
  • Aircraft identification
  • Departure airport
  • Destination airport
  • Estimated time of arrival
  • Number of persons on board
  • Number of suspected cases(s) on board
  • Nature of the public health risk, if known

Mandatory for ICAO standards

For aircraft outside U.S. airspace or for U.S. destination
Report the above information to:
  1. Air Traffic Control (ATC)
    [This reporting option complies with International Civil Aviation Organization (ICAO) reporting requirement, ICAO document 4444 and Annex 9, Ch. 8, 8.15.]
    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.
    OR

Optional for U.S. arrivals

[Meets U.S. federal regulations for reporting to CDC]

  1. Airline’s 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:

NOTE: For arrivals outside the United States, the list of signs and symptoms used to identify a possible contagious disease is somewhat different from those required to be notified to CDC on U.S. arrivals. Refer to ICAO Annex 9–Facilitation, Ch. 8, 8.15 for details).

†Fever temperatures are rounded off as 100°F/38°C in U.S. regulations and international guidance [PDF - 30 pages] for reporting purposes.

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