Flying on American Airlines while having a rare genetic skin condition

[TurkeysGhost]

Still wouldn't work, not all illnesses show up in blood tests, and you can be sick and contagious with things that don't show up until later. It's basically impossible to prove that as of the present moment someone is healthy, you can only demonstrate that as of various points in the past there hadn't been any indications of illness.

Pretty much. Even customs only relies on asking people if they have communicable diseases. If a country is experiencing an outbreak, they may ban or quarantine all passengers from that area, but screening individuals is often not effective.

Heckling individuals is a waste of effort.

 

[Vixen]

Right, so clearly we need a full physical at well. I'm sure it won't take more then, oh, 8 or 9 hours per passenger.

Picture the scene:

Official: Sorry Madam, your tests show you have stage 4 cancer. Madam...madam...?

Official: Sorry Sir, your chest X-Ray shows all kinds of shadows on your lungs. Sir...sir...?

Official: Sorry Mrs X., your test shows you have an STD. Mrs. X...Mrs X....? Mr X, we strongly recommend you don't strangle your wife at the airport check-in desk.

 

[Cain]

I watched a documentary where people got on a plane with a person carrying a highly contagious disease. By mid-flight, the disease spread and almost everyone had been infected. Thankfully Brad Pitt survived.

 

[Steve]

I watched a documentary where people got on a plane with a person carrying a highly contagious disease. By mid-flight, the disease spread and almost everyone had been infected. Thankfully Brad Pitt survived.

Obviously only Brad Pitt should be allowed to fly. Ban everyone else!

 

[luchog]

What you describe is the situation already. International flights are a disease vector. Flight crews with no medical expertise occasionally hassling only those passengers with visible ailments will have such little effect in the spread of the disease that it is hard to consider it a useful endeavor.

How are flight crews to discern between an ordinary cough and tuberculosis? Is it COPD or SARS? Someone with a cold and rubella? Someone with a skin condition or smallpox? They can ask, and they have no idea if what they are being told is a lie or not. If flight crews really want to stop the ill from flying, they will need doctors to screen patients. Flight attendants following intuition will be both ineffective and needlessly cruel to the disabled.

I notice that most people arguing in favour of the airline staff's actions are ignoring a fairly critical point that was brought up earlier, many readily communicable diseases are contagious for several days before symptoms manifest, or may manifest mild symptoms for days longer, and are easily mistaken for a cold or allergies during that time.

It also ignores the fact that one of the most common airline-associated disease vectors is not passengers, it's airline staff themselves.

 

[Giordano]

It is all very tricky as I see it. We cannot ask gate agents and attendants to be medical diagnosticians and public health experts but we do want the airlines to identify and prevent from flying someone with a very serious infectious disease such as Ebola. On the other hand we probably don't want airlines to prevent people with common colds from flying even though they are likely to infect many of their fellow passengers.

It is both a matter of the ability to spot a dangerous disease by eye (something trained MDs usually cannot do) and where to draw the line. Certainly someone with a nasty looking but non-infectious skin disease should be allowed to fly, whereas someone with scabies (a nasty and highly infectious skin disease spread by mites) probably should not. What of leprosy, which has very low infectivity even if not treated and virtually none if undergoing treatment? The CDC has a list of "reportable" public health threats, many of which are not directly infectious from person to person and are therefore irrelevant here. However the sublist of CDC reportable diseases that are directly infectious would probably be useful for drafting a no-fly list.

And whose word do we take for the nature of the disease? The patient's word? A "doctor's note" from the passenger that may or may not be valid? Do we grab a suspicious passenger and force them into lab tests and a several day wait before they can board a plane?

This may be one of those awful problems with no ideal answers.

 

[sadhatter]

I notice that most people arguing in favour of the airline staff's actions are ignoring a fairly critical point that was brought up earlier, many readily communicable diseases are contagious for several days before symptoms manifest, or may manifest mild symptoms for days longer, and are easily mistaken for a cold or allergies during that time.

It also ignores the fact that one of the most common airline-associated disease vectors is not passengers, it's airline staff themselves.

Because there are times you can't tell it's not worth it to try?

Because one person could be sick we shouldn't check others?

That is done mental gymnastics right there just to seem like the most open minded kid on the playground.

 

[luchog]

Because there are times you can't tell it's not worth it to try?

Because one person could be sick we shouldn't check others?

Which of the airline staff have medical qualifications to detect and diagnose potentially dangerous illnesses? And to differentiate between them and those with non-contagious conditions?

The chances of airline staff actually catching someone attempting to fly with a serious illness by observing symptoms is vanishingly small. Especially when you realize that by the time serious symptoms manifest, the individual is generally not in any condition to fly on a commercial airline.

In places were serious outbreaks are an issue, there are generally medical personnel available (CDC and their international cohorts) who can make quarantine decisions.

Incidentally, do you happen to know how many serious diseases are communicated by passengers vs. airline staff?

Again, ill but non- or mildly-symptomatic passengers and staff are the biggest and most critical threat, and the least likely to get stopped from flying.

That is done mental gymnastics right there just to seem like the most open minded kid on the playground.

 

[deadrose]

Seem to recall that during one of the big respiratory outbreaks (SARS maybe?) they walked passengers in affected areas through thermal scanners. Anyone running a fever was pulled aside to be checked for symptoms. That doesn't catch all prodromal illnesses but would get a lot of the contagious ones before they were showing full-fledged symptoms.

 

[smartcooky]

Much as I would like to side with the passenger I cannot. It is truly not worth the risk, however small that risk it might appear.

This is no way changes the way I feel about airlines that have acted badly in the past, such as assaulting a passenger and physically dragging him unconscious off a flight for no other reason than they bumped him so their the own airline staff could fly.

 

[TragicMonkey]

Common symptoms of illness include being tired, bloated, or irritable. I suggest any passengers who yawn, are fat, or seem grumpy be barred from flying. Also anyone who manifests ear trouble, blows their nose, seems thirsty or hungry, scratches, fidgets, or seems in any way uncomfortable or uses the bathroom at any point for anything. In fact, any passenger who isn't constantly performing Olympic-level gymnastic routines flawlessly is probably too ill to fly. It's simply not worth the risk.

 

[Giordano]

On the positive side I've been told that a great way to get more room in a coach seat is to pretend to scratch a lot and reassure your seat mates that "It is not infectious unless the little bits of skin actually touch someone."

Also works in subways and in crowds of all kinds...

 

[Dr. Keith]

I notice that most people arguing in favour of the airline staff's actions are ignoring a fairly critical point that was brought up earlier, many readily communicable diseases are contagious for several days before symptoms manifest, or may manifest mild symptoms for days longer, and are easily mistaken for a cold or allergies during that time.

It also ignores the fact that one of the most common airline-associated disease vectors is not passengers, it's airline staff themselves.

Exactly. Assuming there was a contagious person on the plane, it most likely won't be the one the crew thinks it is. They would have been better served by just randomly selecting two passengers to get off the plane. They would have had a better chance of getting it right.

 

[Dr. Keith]

Seem to recall that during one of the big respiratory outbreaks (SARS maybe?) they walked passengers in affected areas through thermal scanners. Anyone running a fever was pulled aside to be checked for symptoms. That doesn't catch all prodromal illnesses but would get a lot of the contagious ones before they were showing full-fledged symptoms.

I went through those in China. A bit nerve wracking, actually. I mean, who feels great while traveling overseas for work. Bad flights, crap meals, ****** hotels, stressful meetings, late nights out, catching up with work emails when you should be sleeping. I took ibuprofen on the way to the airport just to be safe.

 

[bobdroege7]

You want to kick someone off of a plane for medical reasons, you need a medical professional to do that.

Hold the plane and call a doctor.

 

[smartcooky]

Common symptoms of illness include being tired, bloated, or irritable. I suggest any passengers who yawn, are fat, or seem grumpy be barred from flying. Also anyone who manifests ear trouble, blows their nose, seems thirsty or hungry, scratches, fidgets, or seems in any way uncomfortable or uses the bathroom at any point for anything. In fact, any passenger who isn't constantly performing Olympic-level gymnastic routines flawlessly is probably too ill to fly. It's simply not worth the risk.

All which were not the symptoms the passenger was presenting with (and therefore are irrelevant)

Let me put you in the flight attendant's shoes

You see a passenger with a severe rash. It looks very bad, and very contagious. You decide that it isn't your business and you are not qualified to assess it, so you say nothing.

How to you feel about this?

Halfway into the flight, that passenger's rash has grown much, much worse, they have developed a fever, and they are coughing and sneezing. The passengers either side of her and in the row directly in front are all starting to show signs of a rash.

By the time the flight is almost at its destination, the original passenger is now coughing blood, and the nearby passengers are all falling more seriously ill. Other passengers are showing signs of a rash.

How do you feel about this now?

 

[bruto]

"Don't worry, it's not contagious," is probably not a claim I'd be interested in accepting from a stranger, without even any attempt at corroboration or supporting evidence.

In fact, our society is full of rules about not letting laymen assert medical truths without oversight. You don't take your partner's word that they don't have any STDs. You ask to see test results. We don't let people returning from certain parts of Africa simply declare that they're Ebola-free. We screen them. We don't let commercial food preparers decide for themselves what's clean enough. We make them wear hair nets and so forth.

But you're not in charge of an airplane. You need not know what's going on. It seems reasonable that those whose job it is to decide such things should know what they're doing. And it's true (and a good thing) that people coming from certain parts of Africa where ebola is a problem are not taken on their word. But these people weren't coming from there. We don't require an ebola quarantine when you fly out of South Carolina.

 

[TragicMonkey]

All which were not the symptoms the passenger was presenting with (and therefore are irrelevant)

Let me put you in the flight attendant's shoes

You see a passenger with a severe rash. It looks very bad, and very contagious. You decide that it isn't your business and you are not qualified to assess it, so you say nothing.

How to you feel about this?

Halfway into the flight, that passenger's rash has grown much, much worse, they have developed a fever, and they are coughing and sneezing. The passengers either side of her and in the row directly in front are all starting to show signs of a rash.

By the time the flight is almost at its destination, the original passenger is now coughing blood, and the nearby passengers are all falling more seriously ill. Other passengers are showing signs of a rash.

How do you feel about this now?

You may as well ask how I'd feel if they erupted with Borg nanoprobes. Can you name a disease that virulent that progresses as you describe, that quickly? Everyone in the airport and all the other flights would have been infected already, if anything that quick existed. While you're making up scenarios you may as well make it the Borg; at least they're interesting.

 

[Skeptic Ginger]

This post is junk.

Edit. To justify the above sentence look at this link. It is a straight search for ichthyosis images. The links were chosen because they were two of the few that showed the entire body. Come to think of it I could have chosen almost any two photos and leave the rest of the post the same.

Warning. More bad images.
https://www.google.com.au/search?ne.........1....2j1..gws-wiz-img.....0.LPE5F73izpk

What are these images supposed to prove? That no one could easily find some general information on a skin condition the customer had a name for?

I can't help people's medical ignorance. But proper training and a reasonable procedure could prevent the stewards' paranoia seeing an ugly skin condition.

You can have some infection control guidelines that point out which rashes are red flags. This case was nothing but the ignorant ick factor and shame on the airlines.

Rashes on their own are not an indicator someone is contagious. Specific patterns, specific appearances, other symptoms like fever and the medical history are indicators but not any and every rash.

 

[Skeptic Ginger]

I suppose one thing to ask (I actually don't know) is whether there are any reasonably likely infectious diseases that look like ichthyosis. A woman and a child who are, to all appearances, healthy except for their skin condition, which the woman explains is ichthyosis. Does it look like something else, something more likely?

There aren't. The kid's face from the picture could be mistaken for impetigo if the stewards didn't bother to see the mother's skin and other places the kid had a rash. Impetigo would not present all over like that.

Other than that, I can't think of anything.