Airport Preparedness Guidelines

for Outbreaks of Communicable Disease

1st Meeting of the ICAO CAPSCA Americas Project Steering Committee

Mexico City, Mexico, 25 June, 2009

 0. Content

1. Introduction
2. Responsibility
3. General Communication
4. Communication with Departing Travellers in an outbreak event
5
5. Screening
6. Inbound aircraft suspected case
7. Excercises
8. Summary
 1. Introduction

F 1. Introduction
2. Responsibility
3. General Communication
4. Communication with Departing Travellers in an outbreak event
5
5. Screening
6. Inbound aircraft suspected case
7. Excercises
8. Summary
 1. Introduction

Ó Aviation can potentially increase the rate of disease spreadness

Ó Airport operators need to protect passengers, staff and the public
Ó Rapid, collaborative decision-making and action is crucial
Ó Results of following these guidelines:
F greater predictability of the measures to be taken by the various stakeholders
 1. Introduction (2)
( )

Source: Forecast and control of epidemics in a globalized world, Hufnagel, Brockmann, Geisel, PNAS, 2004
 2. Responsibility
p y

9 1. Introduction
F 2. Responsibility
3. General Communication
4. Communication with Departing Travellers in an outbreak event
5
5. Screening
6. Inbound aircraft suspected case
7. Excercises
8. Summary
 2. Responsibility
p y (1)
( )

Ó Main Responsibility: Local/Regional/National Competent Authorities

Ó Competent Authorities as defined in IHR Article 22
Ó Risk management responsibilities for Healt Authorities and Airport Operators
Ó Gain Predictability and International Cooperation
Ó Special Focus on Personal Protection Equipment
F Including hand washing facilities and /or sanitising gels
Ó Training in aspects of preparedness planning
F Specific for each airport/non airport staff role
 2. Responsibility
p y (2)
( )

 Training Sessions in aspects of preparedness planning

 Special Focus on Personal Protection Equipment

Source: HKIA Public Health Preparedness

 3. General Communication

9 1. Introduction
9 2. Responsibility
F 3. General Communication
4. Communication with Departing Travellers in an outbreak event
5
5. Screening
6. Inbound aircraft suspected case
7. Excercises
8. Summary
 3. General Communication (1)
( )

Ó Good communication is the key of effective preparedness planning

Ó Airport operators should establish:
Ó A clear contact point of operational organisation of preparedness
Ó A responsible for the operational implementation of the airport
preparedness plan
Ó Communication links with the following entities/stakeholders:
F Internal
F External
 3. General Communication (2)
( )

Ó HKIA: Circular to all stakeholders

• airlines
• h dli agents
handling t
• air traffic management
• airport medical service providers
• emergency medical services
• police
• customs
• immigration
• security

Source: HKIA Public Health Preparedness

 4. Communication with Departing
p g Pax

9 1. Introduction
9 2. Responsibility
9 3. General Communication
F 4. Communication with Departing Travellers in an outbreak event
5
5. Screening
6. Inbound aircraft suspected case
7. Excercises
8. Summary
 4. Communication with Departing
p g Pax (1)
( )

Ó Access to consistent information for travellers and health professionals

Ó Provide information by web sites, telephone and written messages
Ó Establish links to Government and WHO media sources
Ó Provide reports and briefs to radio and TV stations is very effective
Ó In the airport,
p messages
g can be p
provided by
y
F Signage F Stands F Posters
F Electronic displays F Public address
Ó Sample information text provided in the guidelines
F Languages: at least in English and the local official language
F Explain the measures in place as fully as possible to gain confidence
 4. Communication with Departing
p g Pax (2)
( )

 Public Health information stands at HKIA

 Travel Health Service information website

Source: HKIA Public Health Preparedness

 5. Screening
g

9 1. Introduction
9 2. Responsibility
9 3. General Communication
9 4. Communication with Departing Travellers in an outbreak event
F 5.
5 Screening
6. Inbound aircraft suspected case
7. Excercises
8. Summary
 5. Screening
g (1)
( )

Ó Potential reduction of transmission opportunities

Ó Need to balance the probable effectiveness
Ó Epidemiology, extent of transmission, severity of the disease and cost
Ó Consider proportion of transmission during incubation or asymptomatic period
Ó Selection of the most appropriate
pp p screening
g method:
F Transmission characteristics
F Associated illness patterns
F Risk groups affected
Ó WHO monitors the bahaviour of new infectious agents
F WHO may recommend screening when considered effective to limit spread
F Explain the measures in place as fully as possible to gain confidence
 5. Screening
g (2)
( )

 Ceiling mounted camera

 Thermal infrared scanning

g system
y / base mounted

Source: HKIA Public Health Preparedness

 5. Screening
g (3)
( )

Ó In some cases, screening on departure is more effective

Ó Fewer passengers screened
Ó Transmission on aircraft is reduced
Ó Considerations on arrival screening
Ó For geographically isolated infection free areas (islands)
Ó Indication from epidemiological
p g data
Ó Departure screening considered inefficient
Ó Internal outbreak surveillance capacity limited
F Inefficient for any
y other cases

Ó Public health authorities to develop acceptable plans with the airport

F Costs associated would normally be met by health authorities
Ó Travellers determined as a risk: secondary medical screening
F The decision on denying acceptance has legal implications
 5. Screening
g (4)
( )

 Temperature monitor display

 Thermal Infrared camera

Source: HKIA Public Health Preparedness

 5. Screening
g (5)
( )

 Thermal Screening management flowchart Source: HKIA Public Health Preparedness

 5. Screening
g (6)
( )

Ó Positive secondary screening

Ó Appropriate diagnosis and management in accordance with IHR (2005)
Ó Quarantine facilities off-airport
Ó Negative secondary screening
Ó Passenger allowed to continue the journey
Ó Appropriate
pp p medical advise
Ó Private acceptance area should be identified at the airport
F Temporary accomodation of risk passengers
Ó Travellers through an ‘at
at risk’
risk area should be provided with the available
information about:
F risks F risk avoidance F symptoms associated with the disease
F when
h and
d where
h to report should
h ld these
h symptoms d
develop.
l
 6. Inbound aircraft suspected
p case

9 1. Introduction
9 2. Responsibility
9 3. General Communication
9 4. Communication with Departing Travellers in an outbreak event
9 5.
5 Screening
F 6. Inbound aircraft suspected case
7. Excercises
8. Summary
 6. Inbound aircraft suspected
p case (1)
( )

Ó Actions
Ó Decide on the parking position (collaborative process)
Ó Communicate this position to the pilot in command
Ó Evaluate and institute the public health response as needed
Ó Disembark passengers as soon as the situation is evaluated
Ó Considerations
Ó Flight and ground crew need to be advised
Ó Public health officials need quick and efficient acces
Ó Appropriate personal protective equipment (PPE) should be worn
Ó Passenger having a communicable respiratory disease: should wear a mask
Ó Treatment of surfaces in contact
Ó Appropriate escort of sick passenger
Ó Segregation of travellers and crew on the same aircraft as sick pax
 6. Inbound aircraft suspected
p case (2)
( )

Ó Considerations (2)
Ó Procedures in place to obtain customs & security clearance for sick pax
Ó No evidence on effectiveness of disinfection of bags
Ó No evidence on effectiveness of disinfectant mats for arriving pax
Ó Confort of passengers: provision of food, water and other essentials
Ó Affected travellers should be kept continually informed
Ó Procedure to transport a sick pax to hospital should be in place
 6. Inbound aircraft suspected
p case (3)
( )

 Category color code

 One bus for each category

Source: HKIA Public Health Preparedness

 7. Exercises

9 1. Introduction
9 2. Responsibility
9 3. General Communication
9 4. Communication with Departing Travellers in an outbreak event
9 5
5. Screening
9 6. Inbound aircraft suspected case
F 7. Excercises
8. Summary
 7. Exercises

Ó Airport operators should establish a method of testing their preparedness

Ó by means of drills/exercises involving all relevant stakeholders,
Ó especiall p
especially public
blic health a
authorities,
thorities airport operators and airlines
airlines.

Source: HKIA Public Health Preparedness

 8. Summary
y

9 1. Introduction
9 2. Responsibility
9 3. General Communication
9 4. Communication with Departing Travellers in an outbreak event
9 5
5. Screening
9 6. Inbound aircraft suspected case
9 7. Excercises
F 8. Summary
 8. Summary
y (1)
( )

Normal situation
– Communicable Minimal requirements -
disease not regarded Periodic review of plan
as a major risk and exercises
Reduce risk of
Transmission

Appearance of Level of response as

‘Triggers’ to activate determined by
plan ‘Triggers’

Sit ti
Situational
l
Advice Some or all elements Assessment
- WHO (Global of preparedness plan
/Regional / National) activated

Airport Preparedness plan – Schematic example of actions

http://www.airports.org/aci/aci/file/ACI_Priorities/Health/Airport%20preparedness%20guidelines.pdf
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