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Guidance for Airlines on Reporting Onboard Deaths or Illnesses to CDC

U.S. Federal Regulations

The U.S. Code of Federal Regulations [42 CFR 70.11 and 71.21] contains requirements for reporting deaths and illnesses to the Centers for Disease Control and Prevention (CDC) that occur on domestic flights between U.S. states and territories, and on international flights arriving in the United States.

42 CFR 70.11(a) The pilot in command of an aircraft operated by an airline who is conducting a commercial passenger flight in interstate traffic under a regular schedule shall report as soon as practicable to CDC the occurrence onboard of any deaths or the presence of ill persons among passengers or crew and take such measures as CDC may direct to prevent the potential spread of the communicable disease, provided that such measures do not affect the airworthiness of the aircraft or the safety of flight operations.

  • As stated in 42 CFR 70.11 (b), pilots making a report of illness or death to CDC under 70.11(a) will meet reporting obligations under 42 CFR 70.4.

42 CFR 71.21 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 CDC’s Quarantine Station at or nearest to the airport of arrival.

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 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]

The pilot in command should report the following:
  • 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

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

  1. Airline’s point of contact (e.g., Operations Center, Flight Control, Airline Station Manager)
    [Meets U.S. federal regulations for reporting to CDC]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), who will then notify the appropriate CDC Quarantine Station.

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 international guidance [PDF - 30pages].

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