Locked and Loaded: Honolulu Airport Is Prepared for Bird Flu

March 29, 2006 — -- About 2 million international passengers arrive at Honolulu International Airport every year -- most of them from Asia, where bird flu has struck.

The airport is on the front lines of the United States' defense against a possible pandemic.

"It's important for us as the western door of America to be as prepared as we can, to help protect not only our people here in Hawaii but the nation," Dr. Chiyome Fukino, Hawaii's director of public health, said.

Though bird flu remains mostly a problem for birds, its danger lies in its potential for human-to-human transmission. With that in mind, the airport has its own isolation room, armed with negative airflow to yank dust, microbes, droplets and even smoke out of the air.

Airline personnel, from pilots to flight attendants, have been trained to recognize bird-flu symptoms and are required to report any passenger who looks sick to the control tower before landing.

"We have to be prepared if that virus decides to mutate and it can be transferred human to human," said Robert Tappy, the airport's emissary from the Centers for Disease Control and Prevention.

Swift Reaction

If airline personnel believed a passenger were infected with avian flu, the plane would dock at a special gate. Then a doctor would board -- possibly wearing a contamination suit -- to escort the sick person through an area with a ventilation system.

At the hospital emergency room, the passenger would receive a test specifically designed to identify bird flu; the rest of the passengers on the plane would wait in a special holding area for six hours, when the results come in.

If a passenger was infected, the other passengers on the plane would be quarantined for at least six days to see if they developed symptoms.

In the closed environment of a plane, infection can travel fast. During the SARS outbreak several years ago, 22 passengers on board an Air China flight were infected.

According to Dr. Mark Gingro, who studies disease transmission aboard planes, people seated as far as seven rows in front of the sick person and five rows behind became infected.

Ventilation Is Key

Gringo's new work has shown that by doubling the ventilation rate in the cabin, the infection rate could be reduced by half.

"If you have a properly functioning ventilation system on that aircraft, if you're seated more than four or five seats from the person coughing, you really don't have a lot to fear," Gingro said.

But the flu is infectious before symptoms arise, so there's only so much the airports and airplane personnel can do.

And the latest computer models show that if bird flu does mutate to a human form, it could spread across the United States in as little as three months.

"The country is so interconnected that instead of a single wave slowly spreading across, it jumps from metropolitan area to metropolitan area very quickly," said Tim German, of the National Laboratory in New Mexico.

The CDC has hired German to create computer models of the spread of the disease.In one model, the virus enters the United States at 14 mainland international airports. In just over two months, the disease would spread to every major population center in the country. By three months, the epidemic has spread around the country.

"It's a threat we need to be prepared for," German said.