As many as 100 passengers were struck by mystery illness on an Emirates Airlines flight that landed at New York’s JFK international airport on Monday. Ten passengers and crew members were hospitalized in New York City after arriving from Dubai on a flight with 521 souls onboard. According to Eric Phillips, a spokesman for NYC Mayor Bill de Blasio, some of the sick had recently visited Mecca, the obligatory pilgrimage site for the world’s Muslims which is currently experiencing an outbreak of influenza. “Health officials are processing tests now to determine the cause. Symptoms still pointing to the flu,” he tweeted. Officials from the Centers for Disease Control were on hand to evaluate the passengers. However, CDC response to other international arrivals has been questioned.
During the flight, the pilot reported that two male passengers had very high fevers and that dozens were “coughing non-stop”, according to ABC News. Passengers reported that fellow travellers were coughing non-stop, but the crew acted professionally. The pilgrimage of hajj to Mecca ended recently, bringing millions to Saudi Arabia. At the hajj, the spread of influenza and respiratory tract infections is common.
NYC acting health commissioner Oxiris Barbot said that the results of tests are expected later. The affected were taken to Jamaica Hospital in Queens and are listed in stable condition.
When as many as 100 people reported feeling unwell during the 14-hour Emirates Flight 203, health workers from the Centers for Disease Control evaluated them while the plane waited on the tarmac of JFK International Airport. Landing at approximately 9am local time, the plane was immediately surrounded by dozens of ambulances and emergency vehicles as worried passengers and crew waited to be evaluated by health officials. Health officials checked the temperatures of passengers as they descended from the plane. All passengers were asked to fill out a form for the CDC.
Deplaning and having temperature taken pic.twitter.com/MVxWqJPLTe— Larry Coben (@LarryCoben) September 5, 2018
The singer Robert Van Winkle, who is known as Vanilla Ice, was on the flight and tweeted: “This is crazy. Apparently there is over 100 people sick on the bottom floor, so happy I’m up top, it’s a double-decker plane 380.” He posted a video on Facebook of the emergency response. He described seeing police and fire brigade vehicles, as well as ambulances. The Airbus plane on which Van Winkle and the others flew has the biggest passenger capacity of any civilian aircraft.
Emirates Airlines and the New York mayor’s office eventually reported that a total of 19 people were confirmed ill. Three passengers and seven crew members were hospitalized, according to the airlines, while nine passengers underwent additional medical screening near the aircraft and were released afterwards. The rest of the passengers were allowed to leave and clear customs.
Measles infection spreads
On the day that the Emirates Airlines flight arrived in New York and received a full response from the CDC, the agency confirmed that a child in Houston was diagnosed with measles. Reportedly, the sick boy is between the ages of one and 3.
A spokesman for the Houston Health Department told Spero News last week that the child had a ‘history of international travel.” However, the spokesman cited federal HIPAA law and would not further identify the child. Also, Texas Children’s Hospital cited the Health Insurance Portability and Accountability Act of 1996 (HIPAA) when it could not verify the identity of the child or whether or not he is a U.S. citizen or an immigrant. HIPAA established national standards for preserving patient privacy.
Several attempts were made by Spero News to obtain further information from the CDC and the Department of Homeland Security went unanswered. The Border Patrol responded to Spero News, however, and advised that the agency does not administer immunizations to persons detained crossing the border illegally. Spero News asked the CDC and DHS whether the agencies track the visa status or citizenship of persons diagnosed with communicable diseases such as measles. They were also asked whether they provide immunizations to persons held in detention, such as the family units seeking asylum in the United States. No response was forthcoming from the agencies despite several attempts by Spero News.
However, the CDC does recognize that the nature of the southwest border of the United States lends itself to the spread infectious diseases. According to the CDC website:
“The U.S.-Mexico border is a unique region where the geopolitical boundary does not inhibit the transmission of infectious diseases among residents on each side of the border.
“The mobility of the U.S.-Mexico border population complicates prevention and investigation of infectious diseases.
“Studies have identified the importance of cross-border movement in the transmission of various diseases, including HIV, measles, pertussis, rubella, rabies, hepatitis A, influenza, tuberculosis, shigellosis, syphilis, Mycobacterium bovis infection, brucellosis, and foodborne diseases, such as infections associated with raw cheese and produce.”
The CDC noted that there are about 300 million legal crossings from Mexico into the United States every year and that about 15 million Americans visit Mexico each year, which means that there is a “culture and commerce, as well as the easy transportation of infectious diseases. The large movement of people across the United States and Mexico border has led to an increase in health issues, particularly infectious diseases such as tuberculosis.”
A nurse who opposes vaccination
Response on the ground in Houston was swift after the young patient at Texas Children's Hospital was diagnosed with measles. When the hospital learned that a nurse had posted the boy’s diagnosis on Facebook, it fired the nurse in question.
The nurse’s post was made on a Facebook page maintained by opponents of vaccination, titled “Proud Parents of Unvaccinated Children.” A parent shared screen shots of the Facebook posts with the hospital. Over the August 25-26 weekend, the nurse at the West Campus of the hospital posted on Facebook: ".. for the first time in my career I saw Measles this week. Actually most of my coworkers and the ER [emergency room] docs saw measles for the first time as well. And honestly, it was rough. The kid was super sick. Sick enough to be admitted to the ICU and he looked miserable...By no means have I changed my vax stance, and I never will. But I just wanted to share my experience and how much worse it was than I expected."
In a comment to a post by one of the others on the Facebook page, the nurse wrote: "I'm not kidding that I thought about swabbing his mouth and bringing it home to my 13 (year old)."
In a response to Spero News, Texas Children's Hospital released a statement regarding the incident:
“We were made aware that one of our nurses posted protected health information regarding a patient on social media. We take these matters very seriously as the privacy and well-being of our patients is always a top priority. After an internal investigation, this individual is no longer with the organization.”
Jenn Blackmer, a spokesperson for the hospital, told Spero News that she could not provide identifying information about the patient. She said that the nurse most likely violated HIPAA regulations and hospital policy by divulging information about the patient. She said that by identifying measles as the infection involved, the nurse had effectively violated hospital policy because the rarity of the disease makes identifying the patient that much easier.
The hospital has confirmed that it is investigating the incident and whether the child may have spread the contagion to family members, hospital staff and patients. Families of the possibly infected children have been informed.
Blackmer could neither confirm or deny whether the nurse in question was vaccinated. She told Spero News that she would later provide information on the numbers of hospital staff who are vaccinated. In other media reports, the hospital confirmed that while staff are encouraged to be vaccinated, staff members who are not vaccinated may have their duties limited.
According to the Texas Board of Nursing, the nurse is in good standing with its licensing board.
Houston health department spokesman Porfirio Villarreal told Spero News that it seemed like an “oxymoron” that a health provider is not vaccinated. Villarreal confirmed that the patient at Texas Children’s Hospital is indeed a male between age one and 3, who has a “history of international travel.” He could not provide any other identifying information about the boy, citing federal HIPAA regulations. He confirmed that the Centers for Disease Control and the Texas state health department have been informed of the casel. He said it is the first measles case in Harris County since 2013 and that the health department is seeking to find out if any other persons have been infected.
While measles is largely preventable through vaccination, and the disease is rare in the United States, its incidence has increased in recent years. Over the last 10 years, the Houston Health Department found that there was on average about 0.5 reported cases of measles per year. In 2018, six measles cases were found among six related persons in Ellis County, while a seventh case was confirmed in Collin County near Dallas.
The Centers for Disease Control and Prevention revealed earlier this month that 107 people from 21 states, including Texas, have reported contracting the measles. The other states are: Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, and Washington. This means that the number of cases for 2018 will outstrip those reported in 2017. That year, there were 118 cases in 2017, and only 86 in 2016.
The last outbreak was in 2015 when 188 people contracted measles. It was linked to a California amusement park where researchers believe that a person with a history of international travel brought it to the U.S.
In August of this year, two persons arrived at Detroit’s international airport and were found to be infected with measles. Neither of the two persons showed symptoms upon arrival after international travel. Detroit is a hub for international flights originating in Asia, Latin America and the Middle East.
"A medical examination is mandatory for all refugees coming to the U.S. and all applicants outside the U.S. applying for an immigrant visa. Aliens in the United States who apply for adjustment of their immigration status to that of permanent resident are also required to be medically examined. Aliens applying for nonimmigrant visas (temporary admission) may be required to undergo a medical examination at the discretion of the consular officer overseas or immigration officer at the U.S. port of entry, if there is reason to suspect that an inadmissible health-related condition exists."