[ INSERT Date]
[INSERT Airline Name]
Attn: [INSERT Name and Title of Airline Representative/POC]
[INSERT Airline Address]
[INSERT Airline POC Telephone Number]
[INSERT Airline POC Fax Number]
Dear [INSERT Name]:
Enclosed please find an order from the Centers for Disease Control and Prevention (CDC) requesting information necessary to identify and locate passengers on the following flight(s):
On [INSERT Departure Date], a passenger with [INSERT disease] departed [INSERT Departure Airport Code, City, State, Country] on [INSERT Airline and Flight Number] arriving into [INSERT Arrival Airport Code, City, State, Country] on [INSERT Arrival Date if different from departure date].
Repeat for each leg of same airline
We were notified by public health authorities regarding the travel history of this patient and believe this person to have been infectious during travel. Area health departments, in collaboration with CDC, are undertaking an investigation of possible contacts to this newly identified case so that exposed individuals may be evaluated for infection and offered any treatment that may be indicated. CDC considers the risk of infection for passengers on board the same flights as the ill passenger to vary depending on the aircraft size. This is based on expert opinions as data are lacking.
The passenger information may be provided directly to the requesting CDC Quarantine officer. Alternatively, the information may be sent to CDC Air Activities via encrypted email to [HQ INSERT Air Activities Project Manager’s name] at [HQ INSERT Air Activities Project Manager’s e-mail] or by fax to (404) 498-0820.
If you have specific questions about the ill passenger or persons we believe may have been exposed, you may direct them to [INSERT Name of lead QMO with e-mail and phone number]. If you have any questions about this order or how the requested information will be used by CDC, please contact the CDC Air Activities Project Manager by e-mail at [HQ INSERT Air Activities Project Manager’s e-mail] or by phone at [HQ INSERT Air Activities Project Manager’s telephone number].
Thank you very much for your assistance in this investigation.
Sincerely,
____________________________________________________
Clive M. Brown, MBBS, MPH, MSc, DTM&H (London)
Chief, Quarantine and Border Health Services
encl.
cc: [INSERT Name of lead QMO]
File Type | application/msword |
File Title | [INSERT Date] |
Author | Jjn6 |
Last Modified By | Roland, Efrosini (CDC/OID/NCEZID) (CTR) |
File Modified | 2015-09-23 |
File Created | 2015-09-23 |