[ad_1]
When the Emirates flight EK 203, from Dubai, landed in New York today with sick people on board, it was greeted by public health authorities and local authorities. Passengers and crew members were suffering from coughs, fever and stomach problems – and 11 of them were rushed to the hospital. Fear has raised some key questions: for example, when you are in a metal tube that jumps in the air, how do you get help if you get sick? And what happens once you land?
The 549 people on the flight EK 203 discovered Wednesday, when the officials evaluated them and took their temperatures. In the early afternoon on Wednesday afternoon, everyone was allowed to leave, with the exception of the 11 people who went to the hospital, according to the Centers for Disease Control and Prevention. Prevention. For now, the cause is still a mystery – but the symptoms suggest the flu, Eric Phillips, New York Mayor Bill De Blasio's press secretary tweeted.
The CDC is still investigating. Like a mosquito that spreads malaria, an airplane can also be a vector of disease. "It transmits people with diseases from one part of the world to another part of the world," says Allen Parmet, a former US Air Force flight surgeon who teaches at USC Aviation Safety and Security Program and works as a consultant in aerospace medicine.
Yet, that sort of thing is not exactly new. People have traveled the world for millennia, bringing smallpox to the Americas or spreading plague throughout Europe. What's different now, says Parmet, is speed. The planes have sped up the whole process – causing sensational fears of contagion on television and unique challenges in treating and monitoring outbreaks. "It's not a flying hospital, it's a bus," he says.
The edge spoke with Parmet about how infections spread in planes, what happens when passengers get sick, and how to investigate an outbreak in flight.
This interview has been modified for clarity and brevity.
One has the impression that every flight I went to was done by a person who coughs, how often?
If you take a passenger population every day, someone is sick. They have a cold or a respiratory infection, they have allergies. So, that would not be unusual. And the other aspect is that the humidity of an aircraft in flight is very low. And we like at least 40% humidity to be comfortable. Less than that, your eyes become dry and irritated, especially if you wear contact lenses, your throat becomes dry.
So, in fact, it is common to have someone who is coughing on a plane. There are also allergens in the plane – it is very common for people allergic to cat to be irritated. Because if you have a cat, your cat owns you, they rub you, they mark you with their dander, and their dander are very allergenic. It is actually an allergen very common in the plane.
How does the infection spread in an airplane?
The answer is not very – it's very dry, which will kill sensitive bacteria like legionnaire's disease. He dries up and dies. Others will go into their hibernation state. It is difficult to spread bacteria in such a dry environment.
Viruses must travel with droplets when you cough or sneeze. And first, the droplets start to evaporate. And secondly, they are subject to airflow and the airflow inside an airplane is extremely fast, and it goes from the ceiling to the ground virtually in all these modern planes, and it stays in your place .
How do symptoms like cough become alarming?
It's a difficult question to answer because we do not have health inspectors who look at the planes. Now, if you go to an international port in a country like Namibia, when you go through customs, you will scan with a thermal scanner to see if you have a fever. I was just in southern Africa, and all the ports in Namibia, South Africa, Botswana, you have had a thermal scanner because there is an Ebola outbreak in Congo.
Do we see people who are actively coughing? Produce sputum, bloody sputum? Not very good? This is where we really have to rely on people in the office to watch someone. I was medical director of Trans World Airlines and from time to time we would receive a customer service agent to tell me, "I have a passenger here, but he really looks sick. You can hold a conference and watch them. I refused to board a passenger who had an active illness. He died the next day.
What kind of medical care is available for passengers? What are flight attendants trained for?
All flight attendants receive CPR training and are trained in what our medical kits contain. And basically, everyone has a two-step medical kit. There is little first aid kit – dressings, bandages, armbands. There is a second medical kit [that can only be used by a licensed healthcare provider] who has limited medications and a DEA [an automated external defibrillator]. Flight attendants are trained to use a DEA. We can not put narcotics in an airplane, so how do we control them? How do we know who will use them?
When flight attendants are unable to handle these tasks, they call a flight consultant – either MedAire or the University of Pittsburgh – and seek advice. Or they call, "Is there a doctor at home?" You will almost always have someone with medical skills.
So what?
Let's say a member of the medical staff is qualified and says, "Well, this group of people has some sort of infectious disease – I do not know what it is. They look sick, it is contagious. They would inform the captain. The next question would be: is it an imminent threat to the health of these people? In other words, should we land now at the nearest airport? And they make this recommendation to the captain, who almost always takes the recommendation.
If you had to declare a medical emergency, which they would almost certainly do, they would inform air traffic control. Air traffic control would take you to the nearest airport. The airport would then inform their emergency services. If the disease is contagious, they will probably notify the public health authorities and the hospital and you will begin to make decisions about whether these dangerous people for themselves are infecting other people.
Because once you land and the ventilation system is off, others may be infected. So, how is it serious? Are we isolating this group, this compartment? Often, you have to decide if people want to stay and be evaluated or want to leave the plane? I've seen people say, "I'm going to try my luck, I'm leaving." And unless you have a major threat like Ebola, you would be somehow limited to forcing anyone to undergo medical screening, or even quarantine.
Why?
There are legal limits to what you can do to people. If you have an internationally reportable disease like Ebola, you have the power to restrict it. But if measles, which is a reportable disease, you can not put people in quarantine for measles. You can not stop them, you must have some kind of constraint to do it. Even with Ebola, when we brought back people from Africa, with the outbreak in West Africa, there was a lot of criticism to isolate and quarantine only potentially exposed people. They have already been evaluated and pose a very low risk.
What happens once the plane has landed?
We will try to isolate the sick people, and these people would go into medical care, which could include isolation – this is not quarantine, but all hospitals have areas of difficulty. isolation where air is drawn into the room through a filter, so that coughing and sneezing are not blown into the ventilation system and spread throughout the hospital. And anyone who comes into contact with them wears a glove, a mask, personal protective equipment – they seem to do it on television. And it protects other health workers from disease.
What would you ask if a group of people on a plane started to cough and report fevers?
As a doctor, I'm going to say OK, a whole bunch of fevers: it's an evolving group disease. Because fevers do not happen just because I got infected when you walked in the door. Infectious diseases take a long time to evolve. Typically, this is two to three days on the minimum side for fast-acting diseases such as influenza and MERS. [Middle East Respiratory Syndrome]. The measles you talk about 10 days.
Airborne diseases are a concern. So we look where they come from. If we have a group of people, are they all related? What did they do in common? Because now we are talking about how we do detective work in preventive medicine. Did they have a common exposure to certain chemicals? To an infectious disease? Were they all traveling together? Were they all sitting in the same waiting room for 12 hours, waiting for the plane to take off?
What is the worst scenario of air sickness possible?
Our nightmare is that someone is intentionally infected with smallpox. Smallpox takes about 10 days to become truly contagious. So, you could put an infected person on a plane, she would be asymptomatic and she could travel anywhere in the world.
Even if they become ill in flight and begin to get rid of the virus, they may contaminate and infect some of the people they travel with. Now, if I'm a clever terrorist, I'll walk down the aisles while I cough. And then you have everyone in this sick plane. If you had smallpox, you have about 10 days to get vaccines and antiserum. and we have enough vaccines for everyone in the United States.
It's a bit like our nightmare – an infectious disease like that. Fortunately, there are currently only two places in the world where the smallpox virus exists – the real agent. There are not many other things as dangerous as smallpox that are so contagious. We could, if we had an epidemic, vaccinate all men and women in the United States and keep some for the rest of the world.
[ad_2]
Source link
