Preparing for airport health emergency 

One area of collaboration by members of the airport community is in handling public health emergencies. With the continued speed and scope of human travel internationally, there will be a global transport network for infectious diseases such that there is a possibility of pathogens being introduced into non-endemic areas.

Airports play a critical role in responding to public health emergencies. An airport public health emergency response involves a coordinated plan to address health threats that could arise in an airport setting. This can include infectious disease outbreaks, bioterrorism threats or events, pandemic outbreaks, natural disasters, and other public health crises.

MPOX is a viral infection that Africa and its aviation sector need to pay attention to. It is spread through contact with infected animals as well as within households. It causes severe fever, flu-like symptoms and a rash of pus-filled blisters across the body, say experts. In 2022 the disease, formerly known as monkeypox, spread around the world — cases turned up everywhere from Africa to America and Australia. A newly discovered strain of the virus, described by some researchers as the most dangerous yet, now threatens to spread into various parts of Africa and so will require attention of planners in airports.

In April the Africa Centres for Disease Control and Prevention advised that there should be an increase in surveillance and contact-tracing efforts. There have been suggestions by some experts that it would be worth deploying the smallpox vaccine among high-risk groups such as sex workers and health-care workers, as it has been known in the past to offer cross-protection against Mpox, which is a related virus.

Robust national emergency preparedness is vital to mitigate the transmission of infectious diseases agents domestically and to prevent onward spread to other countries. With experience gained from the pandemic, it is obvious that there is a complex range of stakeholders who respond to an infectious disease threat being transmitted through air travel.  It is therefore important that protocols be tested and practised extensively in advance of a real emergency.

Simulation exercises will include the identification of possible scenarios based on the probability of hazards and the vulnerability of populations as a basis for planning, and so will provide a useful measure of preparedness efforts and capabilities.

Emergency exercises are only valuable to the extent that airports learn from them and implement their findings into day-to-day practice. Preventing this new Mpox strain from becoming another global health crisis requires swift and co-ordinated action by airports.

There are lessons to learn from the reported case of emergency preparedness from Ireland. A large-scale simulated emergency exercise is usually conducted by one of Ireland’s major international airports every three years to strengthen interagency emergency preparedness. For the first time in 2016, it included a Public Health threat and port health committee was involved in the planning. 

The live real-time exercise included the notification of a possible case of MERSCoV aboard an aircraft carrying 81 people. The exercise also included an undercarriage fire and a subsequent emergency landing of the aircraft. This was a collaborative field exercise that was designed to test the public health response in the context of a complex emergency involving multiple response agencies. The exercise was reported to have involved over 200 participants at the airport including airport and airline staff and management, fire officers, police, health services responders, including national ambulance service, media, regional Public Health and other relevant sites like the National Isolation Unit for infectious diseases (NIU) and Health Protection Surveillance Centre (HPSC), observers, evaluators and passenger volunteers. 

The exercise was carefully planned over a period of six months, involving development of materials, scenario writing, and interrogation of response protocols, leading to the set-up of three different field sites: the operation control centre, the passenger reception area and the plane and runway. Immediately following the exercise, a ‘hot’ debrief took place to clarify the main priorities and other smaller issues, to enable immediate influence on future response and to reduce recall challenges.

The World Health Organisation has declared Mpox a “public-health emergency of international concern”. Not only is preparedness planning important, but there is also a need for continuous stakeholder engagement, public communication, health screening, data collection, enhancing cleaning and disinfection of high-touch surfaces and areas, and ensuring availability and use of PPE for staff as necessary. There should also be provision of training for airport staff on emergency procedures, including how to handle suspected cases of infectious diseases. Airports should educate passengers about health measures, such as proper hygiene practices and vaccination information. They should also use clear signage throughout the airport to guide passengers on health protocols while ensuring that resources such as medical personnel, equipment, and supplies are readily available.

Containing the spread of emerging diseases is  not only a colossal, unambiguous public good, it is good for air travel as well as the aviation industry and other stakeholders. Not only do all stakeholders and the airport community stand to benefit, all should contribute what they can to organising a swifter, more rational response to the emerging public health challenge.

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