Reporting Onboard Deaths and Illnesses: A Tool for Cabin Crew
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U.S. federal regulations
The U.S. Code of Federal Regulations [42 CFR 70.4 and 71.21(b)] contains death and illness reporting requirements for flights engaged in interstate traffic and international flights arriving into the United States, respectively. 42 CFR 70.4 requires the commander in charge of the aircraft (interstate flights) to report before arrival a case or suspected case of communicable disease among passengers or crew members to the local health authority with jurisdiction for the arrival airport. 42 CFR 71.21(b) requires the commander of an aircraft (international flights) arriving into 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. Conditions that require reporting are explicitly defined in the regulations for international travel, but not in the regulations for interstate travel. CDC recommends that airlines apply the same “required” and “requested” reporting standards for international flights to interstate flights.
What to report to the local health authority or CDC
In addition to any onboard deaths, the regulations state that a pilot must report to CDC any of the following conditions, as they may indicate a serious contagious illness:
- Fever* reported to have lasted more than 48 hours; OR
- Fever* of any duration, plus any one of the following: rash, or swelling of the lymph glands, or jaundice (yellowing of skin or eyes); OR
- Persistent diarrhea
Other symptoms may also indicate a contagious illness that could pose a public health threat. CDC requests that the pilot also report any illness with the following conditions:
- Fever* of any duration, plus any one of the following: persistent cough, persistent vomiting, difficulty breathing, headache with stiff neck, reduced level of consciousness, or unexplained bleeding.
* Cabin crew should consider someone to have a fever if the ill person feels warm to the touch, gives a history of feeling feverish, or has an actual measured temperature of 100° F (37.8° C) or greater.
What information to give to the pilot
In addition to following your company’s procedures for getting medical assistance, tell the pilot about the death or ill traveler, including:
- Traveler’s name (indicate whether passenger or crew)
- Seat number or work area
- Approximate age
- City of departure and countries visited on this trip
- Conditions or symptoms that brought the ill traveler to your attention.
How to report to CDC (interstate or international flights)
For interstate flights, the pilot may notify CDC instead of the local health authority. Either of the following options meets federal regulations for reporting to CDC. The pilot may notify CDC through:
- Air Traffic Services (ATS) if in international airspace or Air Traffic Control (ATC) if in U.S. airspace
- Airline’s POC (e.g., Operations Center, Flight Control, airline station manager)
The POC will notify CDC by contacting either the CDC Quarantine Station directly or the CDC Emergency Operations Center. Once notified, CDC Quarantine Station staff will contact the airline’s designated POC to get more information to determine appropriate response when the aircraft arrives.
Things to remember
- Get as much information as possible about the ill traveler and provide it to the pilot.
- Notify the pilot as soon as possible, and before arrival, so the ground response can begin quickly.
- CDC Quarantine Station staff can be consulted to assist in evaluating an ill traveler and provide recommendations.
Early reporting ensures prompt ground response to maximize timely care, reduce the risk for spreading disease, and minimize travel disruption.