Reporting Onboard Deaths and Illnesses: A Tool for Pilots

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U.S. federal regulations

The U.S. Code of Federal Regulations [42 CFR 70.4 and 71.21(b)] contains death and illness reporting requirements for flights engaged in interstate traffic and international flights arriving into the United States, respectively. 42 CFR 70.4 requires the commander in charge of the aircraft (interstate flights) to report before arrival a case or suspected case of communicable disease among passengers or crew members to the local health authority with jurisdiction for the arrival airport. 42 CFR 71.21(b) requires the commander of an aircraft (international flights) arriving into the United States to report before arrival any deaths or illnesses (as defined in the regulations) among passengers or crew to the Centers for Disease Control and Prevention’s (CDC) quarantine station. Conditions that require reporting are explicitly defined in the regulations for international travel, but not in the regulations for interstate travel. CDC recommends that airlines apply the same “required” and “requested” reporting standards for international flights to interstate flights.

What to report to the local health authority or CDC

Required Reporting

In addition to any onboard deaths, the regulations state that a pilot must report to CDC any of the following conditions, as they may indicate a serious contagious illness:

Fever* reported to have lasted more than 48 hours; OR
Fever* of any duration, plus any one of the following: rash, or swelling of the lymph glands, or jaundice (yellowing of skin or eyes); OR
Persistent diarrhea

Requested Reporting

Other symptoms may also indicate a contagious illness that could pose a public health threat. CDC requests that the pilot also report any illness with the following conditions:

Fever* of any duration, plus any one of the following: persistent cough, persistent vomiting, difficulty breathing, headache with stiff neck, reduced level of consciousness, or unexplained bleeding.

* Cabin crew should consider someone to have a fever if the ill person feels warm to the touch, gives a history of feeling feverish, or has an actual measured temperature of 100° F (37.8° C) or greater.

How to report to CDC (interstate or international flights)

For interstate flights, the pilot may notify CDC instead of the local health authority. Either of the following options meets federal regulations for reporting to CDC. The pilot may notify CDC through:

Air Traffic Services (ATS) if in international airspace or Air Traffic Control (ATC) if in U.S. airspace
Inform ATS/ATC there is an onboard death or suspected contagious illness that needs to be reported to CDC.
- If not under U.S. Air Traffic Control (ATC), the international ATS will immediately forward the message to the ATC serving the destination airport in the U.S.
- ATC will notify the Federal Aviation Administration’s Domestic Events Network (DEN) of the report, using the code “…requests a CDC consult.”
- The DEN will send the report to CDC’s Emergency Operations Center (EOC) and the EOC will notify the appropriate CDC Quarantine Station.
- The CDC Quarantine Station will contact a designated airline point of contact (POC) to obtain necessary details of the death or illness.

Airline’s POC (e.g., Operations Center, Flight Control, airline station manager)
Provide to the POC the traveler’s name, seat number or work area, symptoms, approximate age, departure city, and other countries visited, if possible. The POC should contact:
- The CDC Quarantine Station at or closest to the airport where you are arriving: http://www.cdc.gov/quarantine/QuarantineStationContactListFull.html
- The CDC EOC (770.488.7100), who will then notify the appropriate CDC Quarantine Station.

Early reporting ensures prompt ground response to maximize timely care, reduce the risk for spreading disease, and minimize travel disruption.