當乘客或者機組成員懷疑患有流行性感冒時，清潔機艙的因應指南

It is not known when or where the next pandemic strain of influenza will arise in the world. Ill travelers may represent sentinel events associated with emerging infectious diseases such as a pandemic influenza. Due to the speed of international air travel this means of transportation is thought to have a potential role in the rapid movement of emerging infectious diseases. For this reason, there are existing requirements that travelers on international flights arriving in the United States with symptoms suggestive of a condition of public health importance, such as a potential case of pandemic influenza, be reported to the Centers for Disease Control and Prevention (CDC) Division of Global Migration and Quarantine for evaluation. This document provides guidance on appropriate cleaning procedures for passenger aircraft in such a scenario.

Following are general guidelines for cleaning the cabin when an aircraft has carried a traveler who is suspected to have pandemic influenza. These guidelines provide a basic framework of response. This guidance may be modified or additional procedures may be recommended by the CDC as part of the evaluation of an ill traveler, when an influenza pandemic becomes widespread in the United States or as new information about a pandemic strain becomes available.

Influenza viruses can persist on nonporous surfaces for 24 hours or more, but quantities of the virus sufficient for human infection are likely to persist for shorter periods. Although the relative importance of virus transfer from inanimate objects to humans in spreading influenza is not known, hand transfer of the virus to the mucous membranes of the eyes, nose, and mouth resulting in infection is likely to occur. Hand hygiene¹, cough etiquette and respiratory hygiene² are principal means of interrupting transmission of influenza in the absence of influenza vaccine and given limited availability of antiviral medications³. Routine cleaning and disinfection practices may also play a role in minimizing the spread of influenza.

Routine cleaning with soap or detergent and water to remove soil and organic matter, followed by the proper use of disinfectants to inactivate any remaining virus are the basic components of effective environmental management of influenza. Reducing the number of influenza virus particles on a surface through these steps can reduce the chances of hand transfer of virus. Influenza viruses are susceptible to inactivation by a number of chemical disinfectants readily available from consumer and commercial sources (for more general information about disinfection of environmental surfaces, see the CDC/ Healthcare Infection Control Practices Advisory Committee (HICPAC) “Guidelines for Environmental Infection Control in Health-Care Facilities,” available at: http://www.cdc.gov/ncidod/dhqp/gl_environinfection.html ). All disinfectants marketed in the United States are required to be registered by the U.S. Environmental Protection Agency (EPA). These products must be used in accordance with their label instructions; following label instructions is necessary to achieve adequate efficacy and to avoid unreasonable adverse effects.

Routine cleaning methods should be employed throughout the plane with special attention in certain areas as specified below:

1. Wear non-sterile, disposable gloves that are recommended by the manufacturer of the detergent/disinfectant while cleaning the cabin and lavatories and when handling cleaning and disinfecting solutions. Dispose of gloves if they become damaged or soiled or when cleaning is completed, as described in item 5 below; never wash or reuse the gloves. Eye protection, such as a faceshield or goggles, may be required if splashing is expected.
2. Use only disinfectants (including detergent/disinfectants) that are EPA registered/exempt for use on aircraft against influenza viruses, and have been approved by the original equipment (aircraft) manufacturer (OEM)⁴. Clean the surface first, and then apply the disinfectant according to procedures approved by the OEM and as instructed on the disinfectant manufacturer’s label. Ensure adequate contact time for effective disinfection. Adhere to any safety precautions or other label recommendations as directed (e.g., allowing adequate ventilation in confined areas such as lavatories, and proper disposal of unused product or used containers). Avoid using product application methods that cause splashing or generate aerosols. Cleaning activities should be supervised and inspected periodically to ensure correct procedures are followed.
3. The following surfaces should be cleaned and disinfected at the seat of the ill passenger or crew and at adjacent seats in the same row, the backs of the seats in the row in front of the sick passenger’s row, and other areas as noted below:
   • Armrests
   • Seatbacks (the plastic and/or metal part)
   • Tray tables
   • Seat belt latches
   • Light and air controls, cabin crew call button and overhead compartment handles
   • Adjacent walls, windows and windowshades
   • Individual video monitor
   • Lavatory(ies) used by the sick traveler: door handle, locking device,
     toilet seat, faucet, washbasin, adjacent walls and counter.
4. Body fluids (e.g., vomit from the ill traveler) should first be taken up from overtly contaminated surfaces by using an absorbent material, which should then be disposed of as described in item 5 below. Hard, nonporous surfaces may then be cleaned and disinfected as described in item 2 above. Large areas contaminated with body fluids (e.g., covering most of a tray table) should be treated with disinfectant after removal of the body fluid with absorbent material, and then cleaned and given a final disinfection. Since disinfectants are not registered for use on porous surfaces, seat covers and carpeting should be removed carefully and laundered in accordance with the manufacturer’s instructions or disposed of after being removed as described in item 5 below. Although influenza viruses can persist on porous materials, the transfer of these viruses from sheets, bedding, and clothing is not an efficient process.
5. Dispose of soiled material and gloves in a sturdy, leak-proof (e.g., plastic) bag that is tied shut and not reopened. Porous materials that will be laundered can be removed from the aircraft in the same manner. State and local governments should be consulted for appropriate disposal decisions. Barring specific state routine solid waste or medical waste regulations to the contrary, these wastes are considered routine solid wastes in the community that can be sent to municipal solid waste landfills without treatment.
6. When cleaning is completed and gloves have been removed, immediately clean hands with soap and water or an alcohol-based hand gel⁵. Avoid touching the face with gloved or unwashed hands⁶.
7. Do not use compressed air and/or water under pressure for cleaning, or any other methods that can cause splashing or might re-aerosolize infectious material. Vacuum cleaners should be used only after proper disinfection has taken place.

更多資訊

For the most current information about pandemic influenza, including up-to-date guidance documents and related materials, visit http://www.flu.gov/.

For more information about environmental management of pandemic influenza virus, go to http://www.flu.gov/professional/hospital/influenzaguidance.html.

Lists of EPA-registered disinfectants can be found at http://www.epa.gov/oppad001/chemregindex.htm.

¹ When washing hands with soap and water: Wet your hands with clean running water and apply soap. Use warm water if it is available. Rub hands together to make a lather and scrub all surfaces. Continue rubbing hands for 20 seconds.  Rinse hands well under running water.  Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.  Remember: If soap and water are not available, use alcohol-based hand gel to clean hands.  When using an alcohol-based hand gel: Apply product to the palm of one hand.  Rub hands together.  Rub the product over all surfaces of hands and fingers until hands are dry.  (http://www.cdc.gov/cleanhands/)

² The following measures to contain respiratory secretions are recommended for all individuals with signs and symptoms of a respiratory infection:  Cover the nose/mouth when coughing or sneezing; use tissues to contain respiratory secretions and dispose of them in the nearest waste receptacle after use; if you don't have a tissue, cough or sneeze into your upper sleeve, not your hands; perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand gel, or antiseptic handwash) after having contact with respiratory secretions and contaminated objects/materials (http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm 和 http://www.cdc.gov/flu/protect/covercough.htm )

³ Operation of the aircraft environmental control system until at least the ill passenger has deplaned or the deplaning process is complete also may contribute to interrupting transmission and should be performed if consistent with safety factors.  Otherwise, ventilation should be provided from a ground source.  Consistent with FAA guidance (Advisory Circular 125-31), passengers should not be kept on board any aircraft for more than 30 minutes without ventilation.

⁴ OEM-approved disinfectants are normally found in the aircraft maintenance manual or OEM-approved list. Several disinfectants (such as bleach) that are effective against viruses and bacteria must not be used because they could damage aircraft components and equipment or affect safety features such as fire resistance of upholstery.  This applies both to the interior and exterior of the plane (e.g., tires, wheels, and other landing gear, or any high-strength steel components).  In the case of a new virus or bacterium, the CDC, in cooperation with EPA, aircraft manufacturers, and the Federal Aviation Administration, will recommend the appropriate disinfectant(s).

⁵ Handwashing is an important and effective means of preventing the spread of infectious material (e.g., nasal secretions, saliva or other body fluids that may contain viruses or bacteria) from soiled hands to the mouth, nose or eyes, where it can enter the body.  Cleaning the hands with soap and water removes potentially infectious material from the skin.  Hands should be cleaned before preparing food, eating, smoking, or touching the face, and after handling soiled material (e.g., used tissues, lavatory surfaces), coughing or sneezing, and using the toilet.  Waterless, alcohol-based hand gels may be used when soap is not available and hands are not visibly soiled.

⁶ Employees should be trained to remove personal protective equipment to prevent self-inoculation (e.g., touching a contaminated glove and then touching one’s eyes, nose, or mouth).