Flying on American Airlines while having a rare genetic skin condition

[Skeptic Ginger]

I fail to see how medically untrained flight crew baselessly ejecting the visibly disabled is a rational way to control the spread of disease.

That's a good way to put it.

 

[Skeptic Ginger]

If the disease was a contagious one, the flight staff would be heroes....

And if they were carrying small pox virus ...

I can't believe how many posts there are here from people who think rashes are dangerous or there is no way to tell.

 

[Skeptic Ginger]

And on the other side we just bar anyone who hasn't had blood work done in the last 12 hours from flying at all. Safety is the most important thing, after all, far better to ground nine hundred million healthy than allow a single sick person to put others at risk!

There you go! That's what I'm trying to say.

 

[Skeptic Ginger]

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.

Good point.

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.

Exactly.

When SARS was spreading (and that one was extremely contagious) they set up heat screeners at airports to detect passengers with fevers. Maybe with all this concern in the thread people would suggest re-implementing that screening?

 

[Skeptic Ginger]

I've known people with psoraiasis and it can look alarming, but it is very characteristic of a dry skin condition (scaliness, redness, dryness). Looking at the kid in the photo it is clear the baby has this group of condition. (NB: In the medical profession psoriasis, ichthyosis and eczema are variations of similar conditions and treated similarly). It is extremely common and unlikely to be confused with 'spotty' illnesses such as measles or chickenpox.

In wikipedia they do like to find the most extreme and gory looking photos to illustrate a medical condition.

Actually those are three different classes of diseases. Psoriasis and eczema might be treated the same. I didn't see anywhere that suppressing the immune response was recommended for ichthyosis but I could have missed it. A genetic protein abnormality is different from the immune system over-reacting. On the other hand, maybe the immune system is involved attacking the abnormal protein?

 

[Skeptic Ginger]

Purleese. I have travelled abroad four times this year already. The first occasion I came down with an unpleasant sore throat and cough, which I blame on the flight.

Air-borne illnesses can't really be identified just by looking at someone.

You couldn't catch a retrovirus such as AIDS from simply breathing it in or sitting next to someone. You'd need to share body fluids.

Even TB that is airborne is very rarely spread on planes.

 

[Skeptic Ginger]

*Shrugs* If you want to turn "Hey if you are showing symptoms carrying some sort of paperwork to show you aren't contagious" into a Nazi-esque SHOW ME YOUR PAPERS so be it.

Hell if you bring an oxygen tank or a portable dialysis machine or vials of insulin there's procedures (of varying degrees) to follow. I don't see this as any different.

When are you going to actually pay attention here and respond to the posts instead of repeating your mistaken idea of contagious rashes?

 

[Skeptic Ginger]

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.

Add a couple days for cultures to come back.

 

[Skeptic Ginger]

...

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

Very good point.

 

[Skeptic Ginger]

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.

It's easily resolved with a little training and some specific guidelines.

 

[Skeptic Ginger]

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.

No, because a flakey dry skin rash isn't on the worry list.

If you are going to screen customers, at least use specific written guidelines rather than leaving stewards to freak out over harmless icky skin.

 

[Skeptic Ginger]

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.

Yep, that was SARS.

For ebola they were asked which countries they'd been in and screened that way.

 

[Skeptic Ginger]

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.

Sigh.

Why are you singling out icky rashes? On what basis is that a concerning symptom?

 

[Skeptic Ginger]

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?

And what responsibility to you place on the airline and it's incompetent training?

 

[Skeptic Ginger]

I should also point out that the crew having no training ejecting a non-contagious person is also going to be the same untrained crew missing the contagious passenger.

 

[Delphic Oracle]

Requiring "certain kinds of passengers" to have a special permission slip (from what authority?) to do things other people get to do automatically seems like a non-starter.

Apply the same "safety of other guests" logic to the grocery store, a restaurant, the movie theater, public transportation, etc.

 

[Pterodactyl]

The airline should give her a free (one way) ticket to Molokai.

 

[sadhatter]

That's a good way to put it.

And it even makes sense, if you ignore getting a doctors note, which would be written by a medical professional, taking the judgement out of the hands of the staff.

 

[sadhatter]

No, because a flakey dry skin rash isn't on the worry list.

If you are going to screen customers, at least use specific written guidelines rather than leaving stewards to freak out over harmless icky skin.

Doctors note takes care of it without making staff make a diagnosis.

Really simple way to word it in the employee handbook

"In any case where there is question as to a customers ability to fly in a manner that is medically safe for all passangers and staff, the opinion of a licensed medical professional in the country in which the issue takes place will be required as staff are not trained to diagnose any disease. "

 

[sadhatter]

Requiring "certain kinds of passengers" to have a special permission slip (from what authority?) to do things other people get to do automatically seems like a non-starter.

Apply the same "safety of other guests" logic to the grocery store, a restaurant, the movie theater, public transportation, etc.

Gun collectors/owners are "Certain kinds of passangers" that we have special rules for in regards to flights.

We actually have lots of "special" types of passangers, why are carriers of disease suddenly different?