Reporting Onboard Deaths or Illnesses to CDC

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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, the regulations state that a pilot must report to CDC any of the following conditions, because they may indicate a serious contagious illness:

• Fever* reported to have lasted more than 48 hours; OR
• Fever* of any duration, plus any one of the following: rash, or swelling of the lymph glands, or jaundice (yellowing of skin or eyes); OR
• Persistent Diarrhea

Requested reporting

Other symptoms may also indicate a contagious illness that could pose a public health threat. Therefore, CDC requests that the pilot also report any illness with the following conditions:

• Fever* of any duration, plus any one of the following: difficulty breathing, or headache with 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.

How to report to CDC

Either of the following options meets federal regulations for reporting to CDC. The pilot may notify CDC through

1. Air Traffic Services (ATS) if in international airspace or Air Traffic Control (ATC) if in U.S. airspace
   This reporting option also complies with International Civil Aviation Organization (ICAO) reporting standard (ICAO document 4444 and Annex 9 of the Chicago Convention).
   ATC will notify CDC’s Emergency Operations Center (EOC) through the Domestic Events Network; the EOC will notify the appropriate CDC Quarantine Station, and quarantine staff will communicate with the airline’s designated point of contact to obtain necessary information about the death or ill traveler.
   
   OR


2. The airline’s land-based point of contact (POC) (e.g., Operations Center, Flight Control, airline station manager).  Instruct the airline’s point of contact to notify CDC by contacting the:
       a) Quarantine Station with jurisdiction for the arrival airport http://www.cdc.gov/quarantine/QuarantineStationContactListFull.html
   
      OR
   
       b) CDC EOC at 770.488.7100, who will notify the appropriate CDC Quarantine Station.

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.