Lassa virus on flight raises questions about spread of disease

John Nides and his wife had buckled up for the trip home from New York on March 31 when a passenger boarded Delta Flight 2921 who needed help from a flight attendant to navigate the walkway, according to Nides, and was garbling his words.

"Everybody thought this guy was drunk," Nides said.

The passenger, who sat right across the aisle from Nides and his wife, was infected with Lassa virus, a rat-born infection common in west Africa that hasn't been detected in the United States since 2010. Within days, the Minnesota Department of Health and the Centers for Disease Control and Prevention had launched an investigation to make sure the virus hadn't spread to others on the flight or, later, to the staff at a Twin Cities hospital where he was treated.

There is no sign that Lassa fever struck the other passengers - the virus spreads through blood and saliva, not casual contact. But the incident is raising questions about what protections are in place to prevent passengers with contagious diseases from boarding commercial flights and, through international travel, potentially spreading viruses far and wide.

"How do you let a person like that on an airplane?" Nides asked. "This guy was physically sick. This guy needed help getting on the plane."

Nides himself is still bothered by what happened on Delta 2921. He was contacted by government health officials April 5, quizzed about his proximity to the infected man, and asked to take his temperature twice daily.

Federal officials agreed that the case raised concerns about safety when they reported the infection to the public April 4. CDC Director Dr. Tom Frieden called it a reminder that "a disease anywhere can appear anywhere else in the world within hours."

Ever since the well-documented SARS and H1N1 influenza outbreaks that crossed international borders a few years ago, airlines and airports have worked with the CDC to promote awareness about the risks of infected passengers. U.S. Customs and Border Protection agents working at airports are trained to identify passengers known by federal to have communicable diseases, and to contact on-site medical personnel to check on them.

Airlines that identify potentially infected passengers are not required by federal law to keep them off flights, but pilots are required to notify health officials before they land if any passengers exhibit fevers that have lasted more than 48 hours or are accompanied by rashes, jaundice or swelling.

Airlines have worked with the CDC to develop their own protocols on how to respond if ticket agents, flight attendants or others have concerns about passengers, said Katie Connell, a spokeswoman for the Airlines for America trade group.

"A traveler who is identified as a health risk to others by public health authorities may be denied boarding," she said.

At Delta, if workers have concerns they are supposed to contact an emergency medical contractor at the University of Pittsburgh who assesses the situation and whether a passenger is fit to fly.

Federal officials said none of these rules were overlooked in the Lassa fever incident.

The infected man was coming from Nigeria when he reached a Customs checkpoint early on March 31 at JFK airport in New York, according to a statement provided by Customs spokesman Anthony Bucci. "The traveler did not exhibit any outward signs of illness and was subsequently admitted."

The fever was confirmed only after the plane landed in Minneapolis-St. Paul and the infected man was hospitalized. It's the first recorded case of Lassa virus in Minnesota.

A Delta spokeswoman declined to comment on the man's condition, but CDC spokeswoman Candice Burns Hoffmann said he didn't exhibit obvious signs of fever during the trip.

"Even if he needed assistance on the plane," she said, "this could have been due to something other than an infectious disease."

Nides disagreed. While he doesn't know whether the man appeared ill before he boarded, he said a flight attendant had to hold the passenger by the shoulder to guide him to his seat. The man also leaned forward against the seat back in front of him, Nides recalled, and repeatedly checked on him in flight. When he dropped a piece of paper, he was too weak to pick it up, Nides said.

As a frequent business traveler who sells reading glasses, Nides has had some odd experiences on airplanes. He appeared in news coverage in 2009 after being stuck on a Sun Country plane that sat on the tarmac in New York for hours instead of returning to its gate. He said he's grateful this episode didn't involve a more lethal virus that could spread through the air.

"This is just a warning," he said.

In west Africa, 300,000 people are diagnosed with Lassa infections each year; others carry the virus without symptoms. The mortality rate from known infections is 1 percent to 2 percent, but believe it would be lower in the U.S. due to better medical care.

In the days after the March 31 flight, the CDC reached out to people who came in close contact with the infected man and asked them to monitor their health and body temperatures.

Nides told them he didn't have thermometers at his Mendota Heights, Minn., home. The next day, he said, a state epidemic intelligence officer hand-delivered two of them.

5 /5 (3 votes)
add to favorites email to friend print save as pdf

Related Stories

CDC looks for 15 passengers of flight with bat

Aug 14, 2011

(AP) -- Health officials are still looking for 15 passengers who were on a flight in which a bat flew inside the airplane's cabin so they can protect them against the possibility of rabies. ...

Bat on Wisconsin flight prompts rabies probe

Aug 12, 2011

(AP) -- Health officials say a bat on a flight from Wisconsin to Atlanta last week has sparked a national search for passengers to protect them against possible rabies.

Air travelers may have been exposed to measles

Feb 27, 2011

(AP) -- Public health officials are warning travelers and workers present at four U.S. airports on two recent days that they may have been exposed to measles from a traveler arriving from London.

Recommended for you

Recorded Ebola deaths top 7,000

3 hours ago

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

8 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.