Scientists want tour bus passengers tracked for flu

"CDC plans flight e-tracking"

Epidemiologists in Las Vegas and Branson, Mo., have asked the Centers for Disease Control and Prevention (CDC) to expand a proposed regulation to include the electronic tracking of tour bus passengers to help stop the spread of pandemic flu.

Robert Niezgoda, regional epidemiology specialist at Taney County Health Department in Missouri, wrote in an e-mail to the CDC that tour buses and their passengers pose more of a threat in spreading the flu because they travel through multiple states compared with airplanes or ships and their passengers. Branson is located in Taney County.

If CDC decided to include tour bus passengers in the proposed rule, this could potentially eclipse the number of airline passengers covered by the rule.

The American Bus Association, an industry trade group, estimates buses in the United States and Canada carry about 860 million passengers a year to Las Vegas and Branson, which is home to 49 theaters, some with a seating capacity of 4,000, featuring a wide range of performers. Branson is among the top ten cities visited by tour bus groups in the United States and Canada.

According to the CDC, airlines carry more than 600 million passengers a year through the 67 hub airports, which would be covered by the proposed rule.

The CDC’s “Control of Communicable Diseases” proposed regulation calls for airlines, travel agents and global reservation systems top collect, store and then transmit a wide range of information on passengers to help the agency control the spread of diseases.

CDC wants airlines or travel agents to electronically collect personal information including names, addresses, e-mail addresses, home and mobile phone numbers, passport or travel document numbers and flight information.

CDC officials said they developed the new regulation because of frustration with manual data collection during the Severe Acute Respiratory Syndrome (SARS) crisis in 2003.

When the agency released the proposed regulations last November, Dr. Marty Cetron, deputy director of the CDC’s Division of Global Migration and Quarantine said lack of detailed electronic passenger information “completely paralyzed our ability to notify people who were onboard together with suspect SARS cases in a timely way.”

Brian Labus, senior epidemiologist at the Clark County Health District in Nevada – which includes Las Vegas – referred to his experience with SARS in 2003 in his request to the CDC to cover tour bus operators and their passengers under the proposed rule.

“We had an experience with SARS that was related to a tour bus and not an airline." Labus said, in an e-mail to the CDC. "A large number of people had traveled with the exposed individual from San Francisco to Los Angeles, then to Las Vegas, then to the Grand Canyon and then back to Las Vegas.”

“Tour bus or train operators should be held to the same requirements as air carrier, as they just as easily transport infected people.” Labus wrote.

Niezgoda asked the CDC in his comments if “any thought has been given to including tour buses in to this rule, or an alternative rule." He said, “during the SARS in Canada, we learned that tour buses from the affected area were moving freely across the border, while airline passengers were being screened.”

Lack of screening of tour bus passengers during the 2003 SARS outbreak did not present a problem, Niezgoda said. But, he added, “in certain scenarios, it is conceivable that a tour bus traveling through several states, making frequent stops, may pose more of a threat than an airplane.”

Niezgoda said he realized it would be difficult to monitor the tour bus industry and its passengers, but “it would be prudent to investigate the problem, so that future control measures or disease surveillance can be implemented.”

The Branson Health Department and the Taney County Health Department routinely conduct surveillance of outbreaks of Norovirus – which can cause stomach pain, diarrhea, and vomiting – “because our tourist industry can be severely affected,” he said.

The comment period on the proposed CDC passenger tracking regulation closes at the end of this month. CDC estimates it will take 18 months to complete the proposed rulemaking. A spokesman for the American Bus Association said the organization did not have any comments about coverage of tour buses and their passengers under the proposed regulation.