Enclosure (2) to COMDTINST 6220.9A
produced when an infected person coughs or sneezes. The virus also can spread when a person
touches a surface or object contaminated with infectious droplets and then touches his or her
mouth, nose or eye(s). In addition, it is possible that SARS might be spread more broadly
through the air (airborne spread) or by other ways that are not now known.
b) Pandemic Influenza. An influenza pandemic is a global outbreak of disease that occurs when a
new influenza A virus appears or "emerges" in the human population, causes serious illness, and
then spreads easily from person-to-person worldwide. Since late 2003, influenza A (H5N1) has
emerged as a contagious disease in birds (avian influenza). As of 7 January 2006, human cases
of avian influenza A (H5N1) infection have been reported in multiple countries. Humans
infected with avian influenza A (H5N1) have had direct and prolonged contact with infected
birds. Migrants from regions with avian influenza A (H5N1) have an increased risk of
transporting infected animals. So far, there has been no confirmed spread of avian influenza A
(H5N1) virus from person-to-person. Nonetheless, because all influenza viruses have the ability
to change, scientists are concerned that the avian influenza A (H5N1) virus one day could be
able to infect humans and spread easily from one person to another. Because these viruses do
not commonly infect humans, there is little or no immune protection against them in the human
population. If the avian influenza A (H5N1) virus were to gain the capacity to spread easily
from person-to-person, an influenza pandemic could occur.
3. Prevention and Control Measures.
a) Preventive measures for SARs include minimizing close contact with alien migrants, interacting
with migrants in an open air environment, using disposable gloves if physical contact is required,
and/or using N-95 respirators, as indicated for TB, if close contact is required. Additionally,
instituting proper personal hygiene (e.g., handwashing) can reduce disease transmission.
Alcohol-based hand cleansers are effective and shall be provided if hand washing facilities are
not available.
b) Preventive measures for avian influenza A (H5N1) include avoiding direct physical contact with
birds and any other animal found onboard migrant vessels. If personnel will have direct and
prolonged contact with potentially infected animals, use N-95 respirators, as indicated above for
TB, and follow proper handwashing or decontamination procedures. If there is a pandemic
influenza outbreak, Coast Guard personnel will be given specific preventive measures via an
ALCOAST or other appropriate means.
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