In 2003 airlines had to deal with the Severe Acute Respiratory Syndrome (SARS) outbreak; now they must deal with the world’s largest outbreak of the Ebola virus. The disease has killed more than 3,400 people in western Africa1 and since March of 2014, more than 7,400 people have contracted Ebola in those countries considered to be in the so-called Ebola Zone – Guinea, Sierra Leone, Liberia and Nigeria.2 The first Ebola patient diagnosed in the United States died this week as a result of complications caused by the deadly disease.3
In response to these grim statistics, the United States Center for Disease Control and Prevention (CDC) issued interim guidance about the Ebola virus to airline crews, cleaning personnel and cargo personnel.4 The purpose of the guidelines is to give information to airlines on: 1) stopping ill travelers from boarding; 2) managing and reporting onboard sick travelers; 3) protecting passengers and crew from infection; and 4) cleaning and disinfecting contaminated areas.
Although a handful of airlines have chosen to cancel or reduce the number of flights to and from the Ebola Zone and some politicians are demanding a complete ban on travel from West Africa to the United States, international travel continues. The following is a review of some of the issues airlines are facing during this world health crisis:
Can an airline deny boarding to a passenger suspected to have the Ebola virus? Yes. The Air Carrier Access Act of 1986 and its implementing rule prohibit both US and foreign carriers from discriminating against passengers on the basis of a disability.5 However, the rule permits airlines to deny boarding to air travelers with serious contagious diseases that could spread during the flight, including travelers with possible Ebola symptoms.6 This rule applies to all flights of US airlines and to direct flights (no change of planes) to or from the US by foreign airlines.
What screenings are in place to assist the airlines? At the present time, prior to boarding departing flights in affected areas, airport personnel are requiring travelers to answer a questionnaire about their possible exposure to the virus and to have their temperatures taken since a fever is one of the first symptoms of the virus. Reports of inaccurate or misleading answers on the questionnaire and personnel who do not know how to operate the thermometers are causing serious concern about the effectiveness of the present screening process.
The CDC has announced the implementation of a new passenger screening process in the US. The new process will be in effect at only five airports — where an estimated 94% of all travelers from West Africa enter the United States.7 It will begin on Saturday, October 11, at New York’s JFK International Airport, which has nearly 43% of all such passengers. The process will roll out next week at Dulles International Airport outside Washington D.C., Newark Liberty International Airport in New Jersey, O’Hare International Airport in Chicago and Hartsfield-Jackson Atlanta International Airport.
As part of the new screening process, the Department of Homeland Security will identify anyone who recently has been in West Africa, whether they flew to these US airports directly or via a connecting flight in another country. Customs and Border Protection (CBP), the US federal agency charged with safeguarding US borders and airports, will take the lead escorting selected travelers to a “quarantine station.” Passengers will be asked questions about their health and possible exposure to the Ebola virus, or anything that might indicate a risk of Ebola exposure. The CBP officers also will take passenger temperatures. If there are any red flags, the person will be evaluated by a CDC public health officer on site and be given permission to go to or, be taken to a hospital, or be referred to a local health department for monitoring and support.
All passengers who fly from the Ebola Zone to the United States will be given information about how to monitor themselves for possible symptoms, will be asked to log their temperature daily and be asked to provide their contact information to authorities.
What future obligation does the airline have to passengers who are denied boarding? Passengers denied boarding under the DOT rule have the right to request a written explanation which the airline is required to provide within 10 days.8 In addition, passengers have the right to rebook their flight at the same fare without penalty for up to 90 days or request a full refund.9
What are the flight crew’s duties under the circumstances? The Captain of an international flight bound for the US is required by law10 to report any onboard deaths or ill travelers who have certain symptoms to the CDC before arrival. This regulation is consistent with the mandatory reporting standards of ICAO (i.e. fever, rash, persistent vomiting, diarrhea or unexplained bleeding).11
Reporting to CDC does not replace a carrier’s own procedures for dealing with in-flight medical emergencies or providing medical assistance to its passengers. All company procedures must still be followed to protect against potential liability.
1 See A. Fantz and E. Cohen, Texas Ebola Patient Dies, http://www.cnn.com/2014/10/08/health/ebola-us/index.html, (Oct. 8, 2014).
3 Manny Fernandez and Dave Philipps, Ebola Patient Dies in Dallas, Fueling Alarm, N.Y. Times, Oct. 9, 2014, at A1.
4 See http://www.cdc.gov.
5 49 U.S.C. § 41705; 14 C.F.R. Part 382.
6 14 C.F.R. Part 382.21.
7 Sabrina Tavernise, Newly Vigilant U.S. Will Screen Fliers for Ebola, N.Y. Times, Oct. 9, 2014, A-1.
8 14 C.F.R. 382.21(e).
9 14 C.F.R. 382.21(d).
10 42 C.F.R. 70.4 and 42 C.F.R. 71.21(b).
11 ICAO documents 4444 and Annex 9, Ch. 8 of the Chicago Convention.