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11 Services down. Counseling should be provided and resources made available after the people are released from quarantine. Mental Security health issues may overlap with medication needs and become Security will be essential and law enforcement personnel part of the needs to acquire and store medications on site. are likely to be required. Again, consideration must be given to exposure of security personnel. Special Needs Language and Cultural Needs Medical Evaluation and Services An international flight will probably include individuals from Nurses and doctors may be needed to assess quarantined outside the United States who are not fluent in English. This individuals for symptoms of the quarantinable disease as well language barrier will cause communication difficulties be- as to provide evaluation and treatment of pre-existing or newly tween quarantine officials and the foreign nationals, and will occurring conditions. The same worker contamination issue require the services of interpreters. Quarantined individuals or as discussed before applies if practitioners are in direct con- airport or airline employees with multi-lingual skills may be of tact with exposed individuals. assistance in providing interpretation. If no locally-based in- Part of the initial assessment process will be to screen the terpreter is available it may be possible to provide interpreters population for existing medical conditions. For example, by phone (note: even on-site interpreters will not be able to some people may have chronic conditions that require med- have direct contact with the quarantined individuals unless ical treatment on an ongoing basis (e.g., dialysis every 48 to they themselves are quarantined). Embassy contact informa- 72 hours or a continuous supply of supplemental oxygen). tion should be provided to quarantined foreign nationals. Likewise, some people may have daily or frequent medication needs, and may only have enough medications to last for the expected duration of their trip, or may not have immediate Dietary Restrictions access to medication in their checked baggage. Many med- ications require refrigeration or room temperature storage-- Whether based on cultural practices, religious beliefs, or if bags are subjected to extreme temperatures the medicine health concerns, some people may require special food. For may need to be replaced. A quarantine plan must have pro- example, several cultures and religions do not eat pork prod- visions for replacing, storing and dispensing prescription ucts. When acquiring pre-packaged meals for the quarantine medication and other medical treatment unrelated to the area, a chicken meal and a vegetarian meal should be two of quarantinable disease. the choices. After the dietary needs of the population are Injuries and illness that could occur or develop during known, a variety of foods can be ordered. quarantine must be treated, too. First aid kits should be part of the inventory of supplies awaiting a group of people being quarantined. In addition, one Automatic External Defibril- Religious Needs lator (AED) per 100 people should be available in the quar- As with cultural differences, religious needs have to be ad- antine area. Arrangements should be made in advance with dressed in a quarantine plan. An area(s) should be designated local medical facilities for referring people subject to quar- as "quiet or meditation" zone(s). Certain faiths may ask for antine in the event that more extensive medical treatment is religious books such as a Bible or Quran. Pastors or chap- necessary. lains or other spiritual leaders may offer or request to be ad- In the event that there is an outbreak of the disease that mitted to the area to minister to the needs of the members of necessitated the quarantine or any other disease, treatment their faith. plans and the staff needed to implement them are needed. Isolation areas within the quarantine area may be necessary. Media Management Mental Health A quarantine at a U.S. airport would attract extensive While the majority of the population in quarantine will ad- media coverage. The challenges for the airport public rela- just to the situation, there may be individuals that do not. tions staff include handling media inquiries and requests There may be passengers with pre-existing mental health issues for interviews, managing (or restricting) access for media who require additional care. Part of the medical considerations on site, and coordinating closely with federal, state, and for a quarantine plan must include provisions for mental local agencies as well as with airlines to ensure consistent health services and the well being of the people in virtual lock and accurate information is provided to the public.