Onboard Death and Illness Response Tool for Cabin Crew

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U.S. federal regulations

The U.S. Code of Federal Regulations [42 CFR 71.21(b)] pertains to international flights arriving to the United States and requires the pilot to report before arrival any deaths or illnesses among travelers (passengers or cabin crew) to the Centers for Disease Control and Prevention (CDC).

Early reporting ensures prompt ground response to maximize timely care, reduce the risk for spreading disease, and minimize travel disruption.

Required reporting

In addition to any onboard deaths regardless of suspected cause, these following conditions must be reported, because they may indicate a serious contagious illness:

• Fever* reported to have lasted more than 48 hours; OR
• Fever* of any duration, plus ONE of the following:
  • rash, or
  • swelling of the lymph glands, or
  • jaundice (yellowing of skin or eyes);
  • persistent diarrhea  (frequent trips to the lavatory may indicate persistent diarrhea)
    

Requested reporting

Other conditions may also indicate a contagious illness that could pose a public health threat, so CDC also requests that you report a traveler who has fever* of any duration, plus any one of the following:

• difficulty breathing, or
• headache with a stiff neck, or
• reduced level of consciousness, or
• unexplained bleeding.

*Cabin crew should consider someone to have a fever if the ill person feels warm to the touch, gives a history of feeling feverish, or has an actual measured temperature of 100° F (37.8° C) or greater.

Give information to the pilot

In addition to following your company’s procedures for getting medical assistance, tell the pilot about the death or ill traveler.  Provide the pilot with the following information:

• traveler’s name (state passenger or crew),
• seat number or work area, 
• approximate age,
• city of departure and countries visited on this trip, and
• conditions or symptoms that brought the ill traveler to your attention. 

How information is reported to CDC

When notified by the cabin crew of a death or suspected contagious illness in a traveler, the pilot may notify CDC through

1. Air Traffic Services while in international airspace or Air Traffic Control while in U.S. airspace
    
   OR


2. Airline’s land-based point of contact (POC), who will notify CDC by contacting either the CDC Quarantine Station directly or the CDC Emergency Operations Center (EOC).

NOTE: Once notified, CDC Quarantine Station staff will contact the airline’s designated POC to get more information to determine appropriate response when the aircraft arrives.

Things to remember

• Get as much information as possible about the ill traveler and provide it to the pilot.
• Notify the pilot as soon as possible, and before arrival, so the ground response can begin quickly.

Please note that CDC Quarantine Station staff can be consulted to assist in evaluating an ill traveler, provide recommendations, and answer questions about reporting requirements.