National Academies Press: OpenBook

Preparing Airports for Communicable Diseases on Arriving Flights (2017)

Chapter: Chapter One - Introduction

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Suggested Citation:"Chapter One - Introduction." National Academies of Sciences, Engineering, and Medicine. 2017. Preparing Airports for Communicable Diseases on Arriving Flights. Washington, DC: The National Academies Press. doi: 10.17226/24880.
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3 chapter one IntroductIon In the 2011 biomedical thriller Contagion, American filmmaker Steven Soderbergh dramatized the challenges of communicable disease response. In the film’s opening sequence, we learn that Beth Emhoff (played by Gwyneth Paltrow) recently has returned to her family in their suburban Minnesota home after a trip to Hong Kong and brief layover in Chicago, where she reconnected with a former lover. Although she appears to have contracted a mild influenza virus on her trip, her symptoms rap- idly worsen after returning home. Within 48 hours she experiences violent seizures and dies of what appears to be massive hemorrhaging in her brain, which initially is misdiagnosed as meningitis. We soon learn that she has passed the disease to her son, Clark, who quickly dies. The film touches on several key themes: the political and economic dimensions of mass quar- antine and vaccine development, the fear of panic and anomie that often accompany outbreaks of novel diseases, how news media and social media shape public risk perception, the deeply intercon- nected nature of the global economy and our anxieties about its effects, and the epidemiological complexities of contact tracing. The use of high-profile cast members (in addition to Paltrow, the film stars Matt Damon, Laurence Fishburne, Jude Law, Marion Cotillard, and Kate Winslet) and the key roles played by senior U.S. public health officials in the script development and promotion of the film helped ensure its critical reception; Contagion was the top-grossing film in its debut week, generating $8 million on opening day, and was screened in numerous professional and public settings, prompting a broader discussion about the complex challenges of dealing with threatening vector-borne pathogens. Inspired by real-world experiences with severe acute respiratory syndrome (SARS), Contagion illustrated how rapid modern air travel can be an efficient vector for the spread of disease and reduces the time available to public health authorities to prepare for and mount effective interventions [Airports Council International (ACI) and International Civil Aviation Organization (ICAO) 2009]. When a disease outbreak occurs on an international scale, the readiness of all aspects of the public health sector and air travel industry will be tested. Airports, airlines, health agencies, and other stake- holders would do well to cooperate, share resources, and prepare in advance. Such preparations may not be able to halt the spread of some diseases; however, they may limit their acceleration and make it possible to reduce the consequences. Although the film presents the issue of a global pandemic threat in dramatic form, sick people travel by air every day. Passengers board flights with any number of illnesses, from the common cold to influenza viruses and more serious infectious diseases. The risk this poses to the public can be serious and requires an effective response that is appropriate to the nature of the disease. Such a response requires not only clear policies and guidelines but also established partnerships among airports, local health departments, national public health agencies, and other stakeholders. This synthesis looks at how such a partnership can work most effectively to prepare airports to deal with arriving passengers with communicable diseases and thereby protect populations to the greatest extent possible.

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TRB's Airport Cooperative Research Program (ACRP) Synthesis 83: Preparing Airports for Communicable Diseases on Arriving Flights examines current disease preparedness and response practices at U.S. and Canadian airports in coordination with public health officers and partners. While larger airports that receive international flights are most likely to experience the challenges associated with these events, the preparedness and response lessons are transferable to the aviation sector more widely. Smaller airports may be final destinations of those traveling with communicable diseases, so report findings are useful to all airport operators and local public health officers.

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