Airlines, cruise lines take steps to halt SARS spread

Travelers returning from areas stricken with severe acute respiratory syndrome, or SARS, the illness that’s showing up around the world, are now as likely to be handed a face mask as an audio headset.

They’re also apt to be questioned about their health and whereabouts for the last 10 days, considered the maximum incubation period for the illness.

They may even be required to have their temperatures taken. Passengers leaving Hong Kong and those arriving at the Singapore airport from Hong Kong or Guangzhou, China, where SARS is thought to have originated, are being monitored.

If their temperatures register more than 100.4 degrees -- the fever level that typically occurs in patients with SARS -- they will be denied boarding and checked further, Hong Kong and Singapore officials say.

The measures reflect a growing trend among airlines, airports and cruise lines eager to calm the anxiety of travelers and stop the spread of SARS.

As of the Travel section’s deadline Tuesday, nearly 4,000 probable cases had been reported from 25 countries, and more than 225 people had died. Mainland China and Hong Kong have been hardest hit.

In the United States there were 39 “probable” cases as of last week. The number of probable cases in the U.S. was revised downward in mid-April from 208 when the Centers for Disease Control and Prevention adopted the World Health Organization’s definition of “probable,” which requires that a person have pneumonia or acute respiratory distress syndrome.

In California, 15 probable cases had been reported as of last week, including five from Los Angeles County and one from Ventura County. Worldwide, 1,935 people have recovered, according to WHO tallies, which do not include U.S. data. (The CDC is not yet tallying recovered cases.) There have been no fatalities in this country.

Besides fever, other symptoms of SARS, which begin seven to 10 days after exposure, may include chills, headache, malaise and body aches, a dry cough and difficulty breathing. Up to 20% of those affected need mechanical ventilation to breathe. The mortality rate is 4%.

Although the illness seems to be contained in the United States, says CDC Director Dr. Julie Gerberding, continued vigilance is urged.

As of press time, travel advisories were still in place from the CDC, which cautions against unnecessary travel to Hong Kong, China, Singapore and Hanoi. In mid-April the CDC issued a travel alert for those going to Toronto, hard hit by the virus, cautioning travelers to avoid health-care facilities caring for SARS patients. WHO’s list cautions only against travel to Hong Kong and Guangdong province, China.

There’s no specific treatment for SARS yet. But earlier this month, scientists from Canada and the CDC announced their separate successes at sequencing the genetic code of the new virus, which will help them develop faster diagnostic tests, antivirals and, it is hoped, a vaccine.

Even with the progress and probable containment in many areas, travelers’ anxieties have not declined, travel experts say. Deborah Deming, a travel agent at Altour Classic Cruise and Travel in Woodland Hills, says some clients who were planning a trip to Southeast Asia aren’t going.

Wanda Ma, an account manager at China Focus Travel, a San Francisco-based company that hosts tours to China, says all of their clients booked for trips there from April 1 through June 15 -- about 1,500 -- have canceled. (As more information becomes available, she said, the company will decide what to do for tours leaving after June 15.)

Patrick Clark of Uniworld, a Los Angeles-based tour operator, said fewer than 10% of his travelers booked on China trips from spring through December had canceled outright; others had postponed and rebooked for later dates.

Some companies are seizing the opportunity to sell antibacterial hand wipes and personal air purifiers worn around the neck.

Several companies suggest the purifiers can ward off SARS, although Gerberding of the CDC says there’s no proof of that.

Frequent hand washing is one way to minimize infection, the CDC advises. It also suggests the use of a facial mask for patients and for those caring for SARS patients or those who may come into household contact with a SARS patient who can’t wear a mask.

Some airlines, including Cathay Pacific and Singapore Airlines, are offering masks to all passengers who travel to or from affected areas. Passengers’ reaction to the measure has been mixed. “Sometimes everyone wears them, sometimes almost no one does,” says Mary Jersin-Shammas, a spokeswoman for Cathay Pacific Airlines, whose hub is in Hong Kong.

Masks are not the only way to inhibit the spread of SARS, says James Boyd, spokesman for Singapore Airlines, which also has begun offering masks to passengers traveling in affected areas.

“We’ve adopted a layered approach” in trying to stem the potential spread of the virus, he adds.

Intensified cleaning procedures for aircraft surfaces, following guidance offered by the CDC, are another measure. Before each departure between SARS-affected areas, disinfectant is applied to all hard surfaces, including tray tables, lavatories, door handles and the galley, Boyd says.

Although the CDC thinks transmission is mainly person to person, by coughing or sneezing, it hasn’t ruled out airborne transmission or the possibility that contaminated objects can spread the virus, which can live two or three hours on surfaces.

Training staff is another preventive measure.

“We’ve briefed and trained our ground staff to be on the lookout for SARS symptoms,” Boyd says. “If they identify someone, they’ll ask specific questions about [that person’s] travel habits.” At the boarding gate, an announcement asks anyone with SARS symptoms to present himself or herself to the staff.

Cruise lines are taking similar precautions, with intensified cleaning procedures, among other measures, although specific methods vary from line to line, says Christine Fischer, a spokeswoman for the International Council of Cruise Lines, whose members include the 16 major lines.

“Some cruise lines are asking passengers to fill out a form [stating that they have not traveled from affected areas] and sign it,” Fischer says. Some simply ask and accept a passenger’s response.

“We’re ... putting masks on board our entire fleet,” says Julie Benson, a spokeswoman for Princess Cruise Lines, which rerouted its April 8 Regal Princess cruise to avoid Vietnam and Singapore.

The masks will be distributed if a suspected SARS case occurs on board, she says. All ships in the line should have masks on board by late April.

The Princess line, like others, has been asking passengers before they board whether they have been through affected areas or visited affected areas, Benson says.

“If they answer yes, they are denied boarding,” she says, estimating that fewer than a dozen passengers have been turned away. “We give them their money back, put them up overnight and pay their airfare home.”

Or, if the cruise is a long one, the line offers to put the passengers up for 10 days, the suggested quarantine period, then fly them to the ship if no symptoms occur.

Up-to-date information on SARS is posted on the CDC Web site, www.cdc.gov/ncidod/sars, and the World Health Organization site, www.who.int.

The Healthy Traveler column appears twice a month. Kathleen Doheny can be reached at kathleendoheny @earthlink.net.