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Stopping Global Disease Threats in their Tracks

The Situation

For decades, the New York City (NYC) Health Department has effectively stopped diseases in their tracks — from swine flu to Ebola — protecting the health of New Yorkers and visitors. On Sept. 5, 2018, when the Centers for Disease Control and Prevention (CDC) reported that Emirates Flight 203 from Dubai to John F. Kennedy International Airport (JFK) had many sick passengers aboard, the NYC Health Department quickly responded again. Early reports indicated that about 100 of the 549 people on Flight 203 had a variety of symptoms, ranging from flu-like illness to stomach ailments.


Photo Credit: Tamer Hadi, New York City Health Department 2018

Although the symptoms could have been caused by many common illnesses, some of the reported symptoms were similar to those typically seen in patients with Middle East respiratory syndrome (MERS), a severe respiratory illness caused by a virus, which spreads through close contact and kills approximately one-third of those infected. Currently, all cases of MERS originate from the Arabian Peninsula and nearby countries. Due to the seriousness of this illness and the origin of the flight, the NYC Health Department mobilized a response to determine if the sick passengers had MERS.


Emirates 203 Response: Key Moments

The Public Health Response

Upon receiving reports of illness, the NYC Health Department quickly mobilized its response system and engaged with local, state and federal partners to learn more about the passengers’ health status. The Health Department also coordinated with NYC Health + Hospitals, the City’s public health care delivery system, and the Greater New York Hospital Association to prepare key health care partners.


When Emirates Flight 203 landed at JFK, CDC quarantine staff immediately evaluated the passengers and screened for travel history and illness. Within an hour, NYC Health Department staff arrived at JFK to assist with the response. It was quickly discovered that many of the reportedly sick passengers did not show any symptoms. All people aboard the plane who did not show symptoms were released to continue their journey, while those who had a fever were further evaluated.

In total, 10 people — seven crew members and three passengers — were transported to nearby Jamaica Hospital for care and evaluation. Jamaica Hospital was ready to receive and evaluate these ill travelers in part due to their close work with the NYC Health Department to prepare for these emergencies. Shortly after the patients were hospitalized, a team of Health Department disease detectives and lab technicians arrived to collect more information from patients, assist with laboratory sample collection and transport specimens to the NYC Health Department’s Public Health Laboratory for identification. In just over 24 hours, the Public Health Laboratory conducted two rounds of testing and confirmed that all sick passengers and crew tested negative for the virus that causes MERS (MERS coronavirus, or MERS CoV). The sick members of Emirates Flight 203 had either the common cold or flu.


The Public Health Impact

Rapid mobilization of local public health response systems is essential to quickly detect and limit the spread of highly infectious diseases. Preventing the spread of these diseases in turn prevents sickness, death and significant political and economic consequences. Another example of the everyday protection that public health provides happened in Philadelphia, just as the response at JFK was winding down. The Philadelphia airport reported sick passengers with flu-like symptoms from separate international flights. After a timely response by the Philadelphia Department of Public Health and partner agencies, these passengers also tested negative for MERS-CoV.


Through two decades of emergency planning, training and responding with partners, the NYC Health Department has built strong relationships and systems to quickly detect, respond to and prevent infectious diseases. Dedicated funding from the CDC Public Health Emergency Preparedness cooperative agreement and the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program help make this possible. Infectious disease outbreaks create challenges for both urban and rural areas, but with continued support from the CDC and ASPR, state and local health departments can readily meet these challenges and protect our communities every day.

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