Air of Caution at CDC After Mumps Outbreak

This year, 600 cases of mumps have been reported, with at least nine victims hospitalized.
This year, 600 cases of mumps have been reported, with at least nine victims hospitalized. (Matthew Holst - AP)
By Keith L. Alexander
Tuesday, April 18, 2006

It was the kind of news that many frequent fliers had long suspected.

At a news conference last week, officials from the Centers for Disease Control and Prevention confirmed that there is a possibility that airline travelers could contract mumps, measles or even tuberculosis from other airline passengers during flights.

The alert came in the wake of a recent mumps outbreak in the Midwest that began in Iowa and has spread to six neighboring states: Illinois, Kansas, Minnesota, Missouri, Nebraska and Wisconsin. So far, 600 cases have been reported, with at least nine victims hospitalized.

"The transmission of diseases during air travel is something we don't have a complete understanding of," said Ram Koppaka, chief of quarantine and border health services at the CDC. "Our belief is there is a risk of transmission."

Koppaka said the CDC isn't concerned about any existing outbreaks of measles or TB related to air travel but that there is the possibility that these diseases also can be spread among airline passengers. The focus on mumps comes on the heels of the recent outbreak, which has been linked to two airline passengers who were potentially infectious during travel on nine commercial flights involving two airlines between March 26 and April 2.

Two of the flights carried Washington passengers: Northwest Airlines Flight 260 on March 27 from Detroit to Reagan National Airport and Northwest Flight 1705 on March 29 from National to Minneapolis.

Also involved were three other Northwest flights: Flight 3025 on March 26 from Waterloo, Iowa, to Minneapolis; Flight 760 from Minneapolis to Detroit; and on March 29, Flight 3026 from Minneapolis to Waterloo.

Four American Airlines flights on April 2 also could have played a role. They were Flight 1216 from Tucson to Dallas, Flight 3617 from Dallas to Lafayette, Ark., Flight 5399 from Lafayette to St. Louis, and Flight 5498 from St. Louis to Cedar Rapids, Iowa.

The mumps outbreak is the latest example of how quickly diseases might be spread as a result of air travel. The air circulation systems of planes, long suspected as promoting the spread of disease, are no longer believed responsible for outbreaks. The systems are equipped with sophisticated filtering mechanisms that help prevent the recirculation of contaminated air. But passengers are at a greater risk aboard airliners for the simple reason that they are stuck in confined spaces for extended periods of time with potentially ill seat mates.

Mumps is a viral infection spread by coughing and sneezing. Because its incubation period is two to three weeks, CDC officials believe some cases may begin appearing now for people on the affected flights. The CDC is urging travelers on those flights to be alert to symptoms that may include a stiff jaw, sore throats, fever and coughing.

The concern over mumps, measles and other infectious diseases comes as the government is working on a response plan in the event of a pandemic influenza outbreak. Alarm has intensified with the emergence of the avian flu, a particularly virulent strain that so far has affected mostly birds but also has infected about 200 people worldwide, killing about half.

The CDC's Koppaka encourages airline passengers to make sure their vaccinations are current. He also encouraged passengers to wash their hands often, even on flights when possible.

Sara Laughlin, a Los Angeles management consultant, says she tries to change seats on a flight whenever she notices that the person sitting next to her is coughing uncontrollably. "One or two coughs don't bother me. But if they are coughing uncontrollably for a while, you better believe I have grabbed my stuff and moved," she said. "It may seem rude, but my health is worth more than a few hard feelings."

The nation's airlines say airline passengers should refrain from traveling if they're feeling ill. "Of course, any time you are in contact with other people, there is a possibility of transmission of communicable disease from a common cold to something more rare and potentially more serious," said Katherine B. Andrus, assistant general counsel for the Air Transport Association. "It's also important that people monitor their own health and defer travel if they are ill. Just as you wouldn't want your co-worker to come into the office if he or she is sick, you don't want to sit next to someone on a bus, at the airport or on an airplane who may be contagious."

In December, the CDC announced it is collecting detailed airline traveler information so federal health officials can warn passengers of potential outbreaks of communicable diseases. The CDC is attempting to maintain a database of traveler information, such as home addresses, emergency contact information, phone numbers, e-mail addresses and even the names of travel companions. Creation of the database is still about two years away.

The CDC said it decided to step up its efforts after trying to contact travelers who may have been exposed to severe acute respiratory syndrome, or SARS, in late 2002 and early 2003. Airline executives said collecting the passenger information while maintaining traveler privacy is a major undertaking and may even require some airlines to update their reservation systems, an investment that many airlines may find difficult to afford.

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