Osupa 28 January 2010 Health & Fitness, Lifestyle, Travel No Comment

Travel.aol.com

By Jordan Simon

Posted January 28th 2010

Every airline passenger’s worst flu season nightmare? Your neighbor hacking phlegm for hours on a packed flight. Pandemics such as SARS and now, swine flu only heighten fears. During a Today Show interview last spring, Vice President Joe Biden stated he wouldn’t recommend his family flying “in a confined aircraft,” prompting White House damage control but igniting a fevered debate: Should airlines ban obviously sick passengers? If they don’t refuse boarding, should travelers unselfishly accept rebooking penalties to avoid putting others at risk?

Both the Consumer Travel Alliance and Trip Advisor conducted recent polls that concluded the majority of air travelers would fly while infected rather than pay flight change fees ranging from $100—$250 (not including fare differentials). Multiply that exponentially for families. That doesn’t even factor in the inconvenience, or possibility of missing a reunion or celebration. And what if you get ill during a vacation? Who pays your hotel bill? Many travel agents now recommend purchasing insurance, but most policies feature limitations and hidden clauses.

Mitra Mostoufi provided a potential test case last November. She claimed taking the wrong medication at the wrong time caused her to feel nauseous on a United Airlines flight out of Tampa. She requested an air sickness bag after returning from the lavatory, upon which the crew insisted that she was sick and escorted her off the plane with her daughter. United issued a policy statement, “The crew does have the right to remove a passenger from a flight if the person is visibly ill.” The result made Mostoufi feel queasier. Not only did United not offer overnight accommodations, Mostoufi claims she didn’t even receive an apology until news outlets broadcast the story.

United eventually offered two $400 travel vouchers, but according to various interviews, Mostoufi wants FAA to compel airlines to justify their actions before forcibly ejecting a passenger. The incident, which thus far remains an exception, raises the ugly specter of racial profiling, as the Mostoufis are Iranian-American. Or is it merely discrimination against the sick?

Regardless, it also raises unsettling questions about who is qualified to make the diagnoses, especially since many H1N1 symptoms are outwardly silent. In a Today Show interview, U.S. Homeland Security Secretary Janet Napolitano placed the onus on individual airlines, stating that the problem existed “even before the swine flu was spoken about.”

Unfortunately, there’s no standardized policy. “Generally, airlines will not ban passengers due to health issues,” according to airlines.org. “However, each airline has the authority to deny boarding to passengers who might pose a threat to…the overall safety of other passengers and crew members…The decision to deny boarding is made on a case-by-case basis, in accordance with well-established airline procedures consistent with Department of Transportation regulations.” Responses not only differ between carriers, but between the same airline’s reservation agents. American and US Airways still impose change/cancellation fees for non-refundable ticketed customers. United, Continental, Northwest, Southwest, and AirTran now waive rebooking fees for most passengers who present a doctor’s note. Still, revising travel plans is a hassle.

Travelers’ Guidelines issued by the Centers for Disease Control and Prevention are just that. At their discretion, attendants may request passengers to wear a surgical mask, move them (impossible on crowded flights), even redirect the airplane to the nearest airport for their removal and medical care. All cabin and crew members must recognize flu symptoms and follow subsequent procedures and protocols, including informing the CDC Quarantine Station at the arrival airport. Yet the guidelines, especially regarding face masks, are rarely followed. Some attendants claim the plane isn’t (re)stocked; perhaps others fear an adversarial situation, and potential lawsuits. Honeymooner Andrew Speaker, who triggered a 2007 international health crisis by flying between Europe and North America with a drug-resistant form of TB, brought suit against the CDC for invasion of privacy last spring (it was dismissed).

A few studies document cases where diseases have been transmitted aboard aircraft, including tuberculosis, influenza, SARS, mumps, and norovirus. Thankfully, Harvard environmental health professor John Spengler, a Principal Director of the Center of Excellence for Airliner Cabin Environment Research, notes that HEPA filters on modern planes continually cleanse recycled air. Ventilation systems refresh cabin air, according to most industry environmental performance experts, exchanging it with outside air 10-15 times hourly.

Studies indicate low overall aircraft contaminant levels. Indeed, James May, CEO of the Air Transport Association, wrote the veep, “While individuals who are feeling ill should remain home, no responsible officials or healthcare professionals have suggested that people avoid air travel. The fact is that the air onboard a commercial aircraft is cleaner than that in most public buildings.” WHO experts believe grounding planes during pandemics merely delays the inevitable and don’t recommend closing borders to prevent transmission of the “unstoppable” H1N1.

But the tight confines in coach on a jam-packed jet present a veritable petri dish for incubation. The CDC maintains a presence in a total of 20 U.S. airports. A 2005 executive order added pandemic influenza to a list of communicable diseases for which the federal government can apprehend, detain, or quarantine people. In June 2007, a “Do Not Board” list was instituted, permitting federal officials at the Centers for Disease Control and Prevention and Department of Homeland Security to identify and exclude from flying to or from the United States on commercial aircraft people with infectious diseases deemed a serious threat. Yet airlines routinely let sick passengers fly, and only intermittently comply with regulations stipulating that they notify the CDC of certain illnesses, a critical step in combating global pandemics.

Last summer Virgin Atlantic and British Airways stated they could bar flu sufferers from flying unless they had documented medical clearance. Antonio Tajani, the European Union’s transport chief, countered, “If you are denied boarding because you are a suspected case of Influenza A (H1N1) and the measure is neither based on a decision of a sanitary authority or a medical certificate, you should be entitled to reimbursement or rerouting as well as compensation.”

But other foreign airports impose tough restrictions. Passengers arriving in China must have their temperature taken before deplaning. Singapore, Thailand, and Egypt adopted similar measures; several airports installed thermal body scanners to check passengers’ temperatures when entering. In June, 2009, New Orleans Mayor Ray Nagin and his wife were quarantined at the Shanghai, China airport after sitting on an overseas flight near a passenger infected with H1N1.

If your potential neighbor is carrying more than a laptop aboard, how do you balance the need to safeguard public health while respecting individual rights? What do you think?